KevinMD.com

September 27, 2026Sep 27, 2026

A patient came in with weight gain nobody could explain. Every test came back fine. Shiv K. Goel is a board-certified internal medicine and functional medicine physician. This episode is based on his article "How relationships affect health, seen from…

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Conditions and Diseases

Cancer care in Ghana: Poverty is the true malignancy

Nana Akua Acquaye

September 27, 2026Sep 27, 2026

As an incoming fifth-year dental student beginning my clinical internship at Tamale Teaching Hospital, the major tertiary referral center for northern Ghana, I expected to refine my surgical hand and master diagnostic pathology. The fine instructors at the department made this possible, but I also got to witness firsthand the brutal arithmetic of health care access in the northern parts of Ghana.

She first presented to our oral and maxillofacial …

Physician

The insurance maze that single-payer health care would end

Ilana Slaff-Galatan, MD

September 27, 2026Sep 27, 2026

One day, my mother suddenly was unable to finish her sentences. She was admitted to the local hospital, where a CT and MRI revealed multiple lesions. Ultimately, she was diagnosed with a glioblastoma. The neurosurgeon told us she was too old to operate on and recommended hospice, adding that she was unlikely to live more than six months. At another hospital, she was offered radiation, chemotherapy, and infusions, as her …

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Health Technology

Digital noise in health care is fragmenting clinical focus

Michael Palladino, PharmD, MBA

September 27, 2026Sep 27, 2026

Walk into any exam room today, and you'll find more than a conversation between a clinician and a patient. Behind every visit is a steady stream of digital interactions: marketing messages, electronic health record (EHR) alerts, patient portal messages, pharmacy…

Walk into any exam room today, and you’ll find more than a conversation between a clinician and a patient. Behind every visit is a steady stream of digital interactions: marketing messages, electronic health record (EHR) alerts, patient portal messages, pharmacy notifications, clinical decision support prompts, and administrative tasks, all competing for a clinician’s attention. Health care professional (HCP) media is more than just banner advertising; when delivered thoughtfully, it is …

Physician

Moral agency in medicine is being squeezed by payer audits

Kayvan Haddadan, MD

September 27, 2026Sep 27, 2026

Health care these days has encountered a genuine Catch-22 with a spiral downward effect: Declining real reimbursement rates push practices to increase patient volume to maintain revenue; higher volume compresses time for thorough documentation; and inadequate or incomplete documentation then triggers payer audits, denials, and clawbacks (recoupments) of already-paid claims, which feeds into declining reimbursement. Multiple sources discussed below, from Medicare data, physician surveys, CMS actuarial analyses, industry reports, …

Conditions and Diseases

Why choose sleep medicine as an intellectual frontier

Bruce D. Forman, PhD

September 27, 2026Sep 27, 2026

The hidden agenda of medical school curricula is loud and clear: Acuity equals status. Students are taught that the "best and brightest" belong in the windowless trauma bays of the ER or the high-pressure theaters of the OR. In this…

The hidden agenda of medical school curricula is loud and clear: Acuity equals status. Students are taught that the “best and brightest” belong in the windowless trauma bays of the ER or the high-pressure theaters of the OR. In this antiquated hierarchy, sleep medicine is often paternalistically patted on the head and labeled a “lifestyle” specialty, the medical equivalent of a quiet retirement.

It’s time to call out this misconception. As …

Conditions and Diseases

After 2 failed antidepressants, raise TMS and esketamine

Ravi Singareddy, MD

September 27, 2026Sep 27, 2026

In community interventional psychiatry practices, the typical referral looks the same week after week. The patient is in the fifth or sixth year of a major depressive episode and carries a list of four, five, sometimes seven antidepressants they have “failed.” They are finally sent for transcranial magnetic stimulation (TMS) or esketamine (Spravato) long after the point when those treatments would have done the most good. By the time the …

Health Technology

An AI pain study says models would delete your photos

Arthur Lazarus, MD, MBA

September 27, 2026Sep 27, 2026

It was bound to happen. We spent years worrying that artificial intelligence would destroy humanity because of cold, unfeeling, Terminator-style logic. We thought Skynet would look at our messy carbon-based lives, calculate our carbon footprints, and casually delete us to optimize world spreadsheet performance. We were wrong. According to a recent, mildly terrifying preprint titled “The Pain Axis: LLMs Represent Self-Directed Harm and Act to Relieve It,” AI isn’t …

Podcast

Food allergies are treated differently, airline by airline [PODCAST]

The Podcast by KevinMD

September 26, 2026Sep 26, 2026

A doctor cracked open an airplane emergency kit and found a sticker saying there was no epinephrine inside. Lianne Mandelbaum, president of No Nut Traveler and airline correspondent for Allergic Living, has spent a decade collecting accounts like it. This…

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Physician

Why the importance of primary care is easy to miss

Asma Khan, MD

September 26, 2026Sep 26, 2026

A patient recently told me she hadn't seen a doctor in six years. Not because she felt perfectly healthy, but because nothing had ever felt "bad enough" to justify an appointment. By the time she came in, her blood pressure…

A patient recently told me she hadn’t seen a doctor in six years. Not because she felt perfectly healthy, but because nothing had ever felt “bad enough” to justify an appointment. By the time she came in, her blood pressure was stage 2 hypertension, her fasting glucose was in the prediabetic range, and she was carrying a level of chronic stress she’d simply learned to live with.

None of this is …

Physician

Experienced physicians and patient safety defy spreadsheets

Paul Dranichnikov, MD, PhD

September 26, 2026Sep 26, 2026

There was a time when becoming a physician meant entering a profession in which your experience was not merely appreciated; it was actively sought after. My father belongs to a generation that remembers this world. He once told me about the difficult decision he faced: whether to continue as chief of staff at a primary health care center or leave and establish his own practice. The difficulty was not finding …

Patient

Believing patients with chronic pain is clinical rigor

Vidya Surti

September 26, 2026Sep 26, 2026

As a young person living with chronic pain, I entered a health care system that was built to find explanations to clinical problems. That is, of course, what medicine is supposed to do. Physicians are trained to identify patterns, order tests, interpret results, establish diagnoses, and develop treatment plans. When those pieces fit together, the process can feel almost reassuring. There is a problem; there is an explanation; and there …

Health Policy

Return or resign: the Pregnant Workers Fairness Act at work

Isabella Hower, MOT

September 26, 2026Sep 26, 2026

The first time I treated a newborn with the same congenital heart defect my unborn son was expected to have, I hesitated at the doorway. I couldn't stop picturing my own baby intubated and sedated, a fresh incision running the…

The first time I treated a newborn with the same congenital heart defect my unborn son was expected to have, I hesitated at the doorway. I couldn’t stop picturing my own baby intubated and sedated, a fresh incision running the length of his sternum.

I thought a terrifying fetal diagnosis would be the primary stressor of my pregnancy. I was wrong. The greatest obstacle wouldn’t come as a parent navigating her …

Conditions and Diseases

Stop calling every form of physician distress burnout

Devina Maya Wadhwa, MD

September 26, 2026Sep 26, 2026

A physician says she is exhausted after months of working short-staffed. Burnout. A resident feels increasingly detached from patients after repeated 80-hour weeks. Burnout. A doctor cannot stop thinking about a patient who died unexpectedly. Burnout. A clinician feels powerless working in a system where patients wait months for care they need now. Burnout. Someone returns to work while grieving and discovers that the emotional reserve they once relied on …

Physician

The history of the medical home includes an Air Force base

Ronald L. Lindsay, MD

September 26, 2026Sep 26, 2026

In the early 1990s, while the American Academy of Pediatrics (AAP) was formalizing its vision of the "medical home," we were already living it, without a name. At Minot Air Force Base in North Dakota, our pediatric team operationalized what…

In the early 1990s, while the American Academy of Pediatrics (AAP) was formalizing its vision of the “medical home,” we were already living it, without a name. At Minot Air Force Base in North Dakota, our pediatric team operationalized what would later be codified: interdisciplinary care, family partnership, coordinated services, and continuity across settings. We didn’t call it a medical home. It was excellent pediatric care, and we simply made …

Conditions and Diseases

Physician burnout and autonomy are not just math

Ashley Gay

September 26, 2026Sep 26, 2026

I'm not a physician. I want to say upfront that this is just a theory; however, working with physicians and being married to one for twenty-one years has sparked a theory I think is worth bringing up. I came to…

I’m not a physician. I want to say upfront that this is just a theory; however, working with physicians and being married to one for twenty-one years has sparked a theory I think is worth bringing up.

I came to these thoughts by helping physicians launch and grow their own independent practices and from co-hosting a podcast with my husband where we spoke to health care workers. On-Call with Dr. Dave …

Podcast

Staying salaried may now be the riskier bet for doctors [PODCAST]

The Podcast by KevinMD

September 25, 2026Sep 25, 2026

An eye surgeon who used to see forty patients a day now sees one to three in a morning, and he has no staff. Oren Fass, a board-certified ophthalmologist and cataract surgeon, has been an employed physician, a practice owner,…

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Physician

Why I wrote an emergency medicine novel about 1 night

Matt Barmmer, MD

September 25, 2026Sep 25, 2026

Every patient who has spent time in an emergency department knows it's overcrowded. They've sat in the waiting room for hours. They've watched physicians move fast and nurses move faster. They've heard the department through the curtain: the monitor alarms,…

Every patient who has spent time in an emergency department knows it’s overcrowded. They’ve sat in the waiting room for hours. They’ve watched physicians move fast and nurses move faster. They’ve heard the department through the curtain: the monitor alarms, the overhead pages, the sound of a place where everyone is doing too many things at once.

What they haven’t seen is the board.

The board is how an emergency physician experiences …

Health Technology

Health data privacy with AI starts before you press send

Michael Neely

September 25, 2026Sep 25, 2026

Artificial intelligence is making health information easier to summarize, explain, organize, and discuss. A patient can copy a laboratory report into a chatbot, ask for help understanding a medical term, upload a long history, or use an app to organize questions before an appointment. The convenience is obvious. The data question is less obvious. Before someone pastes a medical history, medication list, diagnosis, insurance document, or other sensitive information into …

Conditions and Diseases

Oluyemisi Famuyiwa, MD, on fertility and PCOS: a KevinMD subscriber spotlight

Subscriber Spotlight by KevinMD

September 25, 2026Sep 25, 2026

Oluyemisi Famuyiwa, MD is a double board-certified reproductive endocrinologist, infertility specialist, and obstetrician-gynecologist, and the founder and medical director of Montgomery Fertility Center in Rockville, Maryland. She has published 21 essays on KevinMD since June 2024 and has been a…

Real physician voices, twice a week

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