Psychiatry

Physician due process: Surviving the court of public opinion

Physician
February 6, 2026

A single screenshot. A leaked email thread. A one-star review. Then the verdict arrives fast. Faster than any investigation. Faster than any courtroom. Faster than any truth.

Recent reporting describes how physician and author Peter Attia faced immediate public fallout after the Justice Department released Epstein-related records that included extensive email correspondence. Dr. Attia apologized for the tone of those emails and denied criminal wrongdoing. Major outlets repeated selected lines. Social …

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Breaking the silence: mental health and racism in medical school

Physician
February 4, 2026

An excerpt from Physicians With Lived Experience: How Their Stories Offer Clinical Guidance (APA Publishing, 2025)

“I am a Black gay man from Detroit,” spoke Chris Veal mid-way into a podcast when he was a fourth-year medical student at the University of Vermont Larner College of Medicine. He was coming out of a seven-year depression, COVID-19 had struck, he lost five family members to the disease, and on top of …

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Why scale of effort matters more than ego in health care

Physician
February 4, 2026

The inventor of the Post-it note deserves a medal. Not for convenience, but for clarity. In my practice, those little squares became tactical weapons, bright flags of truth in a sea of institutional delusion. My mother once told Kathy, before our wedding, never to touch the scraps of paper I left everywhere. She understood that my visual memory depended on those markers. Each Post-it was a breadcrumb, a map, a …

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The coffee stain metaphor: Overcoming perfectionism in medicine

Physician
February 3, 2026

I recently attended a very large professional conference. In a rush to make it everywhere and yet feed myself, I was running to get breakfast before the sessions and spilled the majority of this much-desired coffee all over my shirt. Here I was, standing with an impressive, unmistakable, impossible-to-hide giant stain of dark liquid spreading across the front of my solid blue shirt and sleeve with nothing to hide it.

It …

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Health care as a human right vs. commodity: Resolving the paradox

Physician
February 2, 2026

Human rights are understood to be universal and egalitarian. They are inalienable, indivisible, and grounded in a shared moral intuition: that human dignity deserves protection. One of the most widely accepted expressions of that intuition is the obligation to care for those who are physically or emotionally ill. Yet despite this near-universal belief, modern health care systems continue to struggle with a fundamental question: Is health care a human right, …

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Stopping medication requires as much skill as starting it [PODCAST]

Podcast
February 1, 2026
YouTube video

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “How deprescribing in psychiatry offers a path to safer care.” Muhamad explores the growing movement to reduce unnecessary …

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Blaming younger doctors for setting boundaries ignores the broken system [PODCAST]

Podcast
January 31, 2026
YouTube video

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Palliative care physician and certified physician development coach Christie Mulholland discusses her article “5 things health care must stop doing to improve physician well-being.” Christie challenges the pervasive narrative that younger physicians …

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Nervous system dysregulation vs. stress: Why “just relaxing” doesn’t work

Physician
January 31, 2026

During the COVID-19 pandemic, conversations about burnout and stress exploded, particularly among health care workers. Much of the advice centered on self-care practices: taking time off, scheduling massages and spa days, practicing mindfulness, protecting your evenings, using your PTO. While these strategies are valuable, they are not the full story.

Positioning self-care as the solution to stress oversimplifies a much deeper physiological process. For many patients (and clinicians) stress is not …

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Disruptive physician labeling: a symptom of systemic burnout

Physician
January 30, 2026

More physicians than ever are reaching out for support after being labeled disruptive, inefficient, delinquent, reactive, or poor communicators.

These are highly skilled, deeply committed professionals being written up for professionalism concerns, communication issues, behavior, and “reactivity.” These cases span every specialty, gender, and stage of career.

This is not a reflection of declining professionalism. It is a predictable outcome of practicing in an untenable and broken system. It is an expected …

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The hidden costs of the physician non-clinical career transition

Physician
January 30, 2026

I entered medicine believing (perhaps naïvely) that experience mattered. Triple board certification, years of clinical practice across three specialties, and working in New York City felt like assets that would translate beyond the bedside. Like many burned-out physicians, I assumed that transitioning into a non-clinical role would be difficult, but not absurdly so.

I was wrong.

Over several years, I applied to what felt like thousands of positions in pharmaceutical companies, utilization …

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Invoking your rights is the only way to survive a federal investigation [PODCAST]

Podcast
January 29, 2026
YouTube video

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “Physician legal rights: What to do when agents knock.” Muhamad shares a terrifying but essential guide for any …

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Clinical attachment in medicine: How familiarity creates safety

Physician
January 28, 2026

You don’t learn this in medical school: Clinical familiarity creates attachment.

Not the kind we mean in romance. Not even the kind we mean in psychotherapy. Something quieter and more automatic, built through repetition and stakes.

You don’t have to say anything deeply personal for it to happen.

You just have to show up again. And again. And again.

Same hallway turns. Same waiting room chairs. Same voice calling your name. Same pace in …

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Leading with love: a physician’s guide to clarity and compassion

Physician
January 26, 2026

In medicine, we are trained to lead with logic. To analyze, evaluate, and act. We are praised for decisive thinking, efficiency, and evidence-based decisions. In the hardest moments of my life, career, and leadership, none of those tools brought me clarity.

Ten years ago, as a practicing pediatrician and physician leader, my personal life began to fall apart. My husband, who had always been steady and supportive, began to slide into …

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How modern health care design strains patients and clinicians

Conditions
January 25, 2026

My great-grandfather was a small-town doctor in the early 1900s.

It was a different time. A different place. A very different pace.

He knew his patients. He knew their families. He understood their lives, not just their symptoms. Care happened in the context of relationship because that was simply how medicine worked.

Today, health care looks very different. The science is better. The technology is stronger. We can do things now that would …

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ADHD and cannabis use: Navigating the diagnostic challenge

Conditions
January 25, 2026

As a psychiatrist, I increasingly meet patients who come in convinced they have attention-deficit/hyperactivity disorder (ADHD). They arrive prepared: an online screening test, a list of symptoms (poor concentration, low motivation, distractibility) and often a quiet sense of relief at finally having an explanation. Then I do what physicians are trained to do. I take a careful history. I review medications. I ask about sleep, mood, anxiety, substance use, and …

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Why I chose disruption over conformity in medicine

Physician
January 25, 2026

I am no poster boy. I deal with significant physical challenges and mobility issues. The toll continues. I face major medical procedures in the coming year, the price of decades spent serving others while refusing to serve the system. I am actively planning my eventual funeral, which many in my field are likely looking forward to. I served the people, not the system. That choice was the death knell for …

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AI in medicine vs. aviation: Why the autopilot metaphor fails

Physician
January 24, 2026

The pilot of a commercial aircraft, descending into near-zero visibility, hands control to an automated system designed for precisely that moment. The landing is flawless. The passengers are safe. The pilot announces it proudly. Technology functions exactly as promised.

A doctor on board writes, “It made me think about the health care journey I am on with AI. The safety and well-being of 140 people wasn’t left to human intervention; the …

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How the mind-body split in medicine shaped modern clinical care

Conditions
January 24, 2026

In my first and second KevinMD posts, I emphasized how medicine had failed clinicians by not training them in mental health care. All agree, it’s not our fault. Now let’s look at how successfully our teachers did prepare us for patients with medical disorders. There’s an interesting history behind how we developed expertise in physical diseases: Medicine needed to overthrow the four humors theory that guided clinical care …

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Why epistemic trespassing in medicine is a dangerous trend

Conditions
January 22, 2026

Somewhere over the last two decades, medicine began to drift into strange territory. Authority (once grounded in evidence, humility, and disciplined expertise) became diluted. Being loud, charismatic, or highly visible somehow became a substitute for scientific credibility.

We’ve long had celebrity doctors, but a new hybrid has emerged: Physicians who are not celebrities in the traditional sense, yet who speak with sweeping certainty far outside their field of training. A neurosurgeon …

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Beyond burnout: the rise of the optimized, dissociated executive

Conditions
January 20, 2026

The man sitting across from me is a Titan.

In the taxonomy of the 2026 economy, he is the apex predator: an MD, a CEO, and the chair of multiple boards. He has navigated the post-pandemic attrition and the algorithmic market corrections that swallowed lesser firms. He is wildly, empirically successful.

But recently, he sat across from me, sharing a shade of rage I hadn’t seen before. He had just navigated a …

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