Practice Management

Why taxing remittances harms families and global health care

Finance
July 29, 2025

Like many of my fellow physicians, I suspect I’m two things: a child of immigrants and a child of a physician. That combination gave me a unique window into two fundamental systems, health care and global economics, long before I studied either formally. I saw the sacrifices and hard choices required to navigate both, often simultaneously, with no geographic boundary ever limiting our responsibilities.

Many vivid memories from childhood have stayed …

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A physician employment agreement term that often tricks physicians

Finance
July 25, 2025

Lately, I have seen a few instances where physicians have been tricked by a term in their physician employment agreement that clearly does not mean what the physician thinks it means.

The most recent example came when I was negotiating a physician employment agreement, and the physician suggested verbiage concerning her scheduling. The physician suggested that we ask for language that the employer would develop a clinical schedule “after consultation with …

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Building trust in dyad leadership partnerships

Physician
July 24, 2025

What’s a dyad and how do I fit into it?

What do I do? These are the questions every new health care leader asks themselves, as I did, when they first join a dyad partnership. Although there has been much academic writing regarding leadership dyads in health care, with a macro focus on structure and accountability and implementation, there is a paucity of material on the practical aspects of a dyad …

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Why hospital jobs are failing physicians: burnout, pay, and lost autonomy

Finance
July 20, 2025

Hospital employment was once billed as the solution to the headaches of private practice — a way to gain stability, reduce administrative burden, and focus on patient care. But for many physicians, that promise has come undone.

According to the Physicians Foundation’s 2024 report, 60 percent of physicians report frequent feelings of burnout — the highest level on record. Instead of feeling supported, many employed physicians feel …

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Why enterprise risk management is key to value-based health care success

Physician
July 19, 2025

The evolving contemporary era of value-based health care (VBHC) demands new risk leadership. VBHC emphasizes quality, outcomes, safety, equity, and stakeholder satisfaction. With these goals come complex, cross-cutting risks, including workforce shortages, clinical complications, health care staff safety, cyberattacks, and supply chain disruptions. To address the modern risk situation, health care systems must allocate resources to resilient, enterprise-wide risk governance and innovations.

The enterprise risk management (ERM) framework is the centerpiece …

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The shocking risk every smart student faces when applying to medical school

Physician
July 18, 2025

The threats we face throughout our medical practice years are rarely published in the world medical practice literature for a good reason. The medical practice system has so many disruptive, threatening, and hidden educational factors to confess to that it is a miracle we have any American physicians still practicing today. That needs to be changed.

Most physicians in private medical practice, who suffer the most economically, are now reaching their …

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The physician who turned burnout into a mission for change

Physician
July 17, 2025

When I stepped away from my clinical practice, it wasn’t because I didn’t care. It was because I cared deeply—about my patients, my colleagues, and the future of medicine. I didn’t leave to escape. I left to help heal the culture that was quietly breaking so many of us.

You can love medicine and stop seeing patients. You can love medicine and change the way you see patients. Choosing to follow …

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Why more doctors are leaving clinical practice and how it helps health care

Physician
July 16, 2025

The author of a recent article claimed that “we all lose” when an experienced physician prematurely leaves clinical medicine. Of course, it is inevitable that a clinical career will end, but whether patients and society suffer depends on what that retiring doctor does next. Increasingly, it seems, they pursue other ways to help patients and add value to the system by pursuing non-clinical careers. That’s a good thing, because:

Why starting with why can transform your medical practice

Physician
July 16, 2025

Have you ever asked yourself, “Why do your patients select you and your practice for their medical care?” Most medical practices offer the same service, i.e., evaluation and treatment, at approximately the same cost, and produce similar outcomes. After all, how many ways are there to treat a urinary tract infection, diabetes, hypertension, or arthritis? Most doctors are trained to offer similar services, which typically produce identical outcomes. So, why …

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Why your most heroic act might be in a department meeting [PODCAST]

Podcast
July 15, 2025
YouTube video

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

Cardiologist Lauren Weber and critical care physician Jess Bunin, co-founders of All Levels Leadership, discuss their article, “Not all heroes wear capes: Sometimes they just speak up in meetings.” They reframe medical …

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How to advance workforce development through research mentorship and evidence-based management

Physician
July 14, 2025

In the current era of rapid health care changes, a very effective tool for workforce development is research mentorship based on evidence-based principles. As the health care industry faces a worsening shortage of professionals, the need to cultivate talent, empower early-career clinicians, and guide them through structured research and professional development is becoming more urgent. Research mentorship offers a replicable and transformative framework for addressing the health workforce crisis.

Research mentorship …

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Civil discourse as a leadership competency: the case for curiosity in medicine

Physician
July 14, 2025

In the high-stakes, knowledge-driven world of medicine, we’re taught from day one to project an aura of certainty. From the anatomy lab to the hospital wards, the message is clear: know the answers, lead with confidence, and never let them see you sweat. But what if that fixation on “knowing” is holding us back? What if the very traits we’ve been trained to cultivate—the resolute certainty, the surgical precision, the …

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When a medical office sublease turns into a legal nightmare

Physician
July 13, 2025

An excerpt from The Doctor is Out—Justice vs Injustice in America.

In the hug of a crisp autumn morning, with the world adorned in the warm hues of changing leaves, the seed of an idea took root within me—an idea born from the necessity of expanding my medical practice to accommodate the growing needs of my patients.

Crossing the convoluted corridors of administrative tasks and logistical considerations, I found myself confronted …

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Why hospitals are quietly capping top doctors’ pay

Conditions
July 10, 2025

Are 10 percent (or 25 percent) of all the physicians in your specialty breaking the law?

Of course not! Who would think such a thing?

Your friendly neighborhood “nonprofit” hospital, that’s who!

I have been reviewing physician employment agreements for almost 40 years, and in the last few years I have noticed a spike in the number of agreements that “cap” physician salary. A shocking number of hospital employment agreements provide that the …

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How early meetings and after-hours events penalize physician-mothers

Physician
July 9, 2025

Medicine has long valorized the early riser – the physician who arrives before sunrise, who joins 7:30 a.m. meetings and stays for evening journal clubs, case conferences, and post-dinner networking events. These scheduling patterns have come to symbolize dedication, productivity, and professionalism. However, for many physicians, particularly those with caregiving responsibilities, these norms reflect more than tradition; they represent structural exclusion.

The architecture of medical professionalism was built on an outdated …

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Why financial planning is a critical tool for physician well-being [PODCAST]

Podcast
July 8, 2025
YouTube video

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

Certified financial planner Brian Case discusses the article, “Personal financial planning shouldn’t be a taboo subject.” They explore the often-overlooked link between financial stress and the crisis of physician burnout, turnover, and …

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Why evidence-based management may be an effective strategy for stronger health care leadership and equity

Physician
July 4, 2025

In the current complex health care landscape, health care leaders are frequently challenged to make management decisions that are effective but also equitable. Numerous leadership transitions are occurring in Canada’s health care systems because of leadership failures. In British Columbia, multiple health care leaders were replaced in the first half of 2025. David Eby, British Columbia’s Premier, declared, “The anxiety that I have is that the people who see the …

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Why health care leaders fail at execution—and how to fix it

Policy
July 4, 2025

Health care leaders don’t have a vision problem. We have an execution problem.

Over the last two decades, I’ve seen countless strategic plans crafted with care, insight, and bold ambition. Mission statements get refreshed. Core values are realigned. Retreats are held. Vision decks are created and shared from the C-suite to the frontlines. And yet — within weeks — most of those plans fade into the background.

The problem isn’t poor leadership …

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Healing the doctor-patient relationship by attacking administrative inefficiencies

Policy
July 3, 2025

I have a great doctor. I’ve enjoyed his approach to providing care so much that I was greatly distressed when, at my last visit, he told me he was thinking of retiring early. While I consider myself fortunate to have a positive and dependable relationship with my doctor, fewer people now relate to that sentiment than before.

Gallup recently reported that America’s trust in professionals has declined, with overall trust …

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5 blind spots that stall physician wealth

Finance
June 29, 2025

Many of the physicians we work with are highly disciplined, generous with their time, and deeply committed to their profession. They spend years in training, work demanding hours, and carry an enormous sense of responsibility. Yet even with strong incomes and responsible habits, many still feel uncertain about their long-term financial picture.

The problem is not how much they earn. It is that income alone is not a strategy.

Physicians face unique …

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