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How hindsight bias distorts clinical medicine

Physician

March 24, 2026

Hindsight flatters certainty. Clinical medicine does not. After a bad outcome, everyone becomes smarter. The diagnosis looks obvious. The warning signs seem bright. The missed clue appears unforgivable. In the calm of retrospective review, people ask, “How could the doctor not have seen it?” That question sounds fair. Often, it is not. Real-world medicine does not happen in hindsight. It happens in the presence of noise, time pressure, incomplete information, …

Do no harm: Why physician burnout requires bottom-up reform

Desiree Francis, MD

Physician

March 24, 2026

Before there were health care systems, insurance companies, or electronic medical records, there was the healer, a person embedded within the community, accountable not only for technical competence but for character.

My medical training outside the United States, while competitive and rigorous, remained service-oriented and community-based. Medicine historically was grounded in cultivated human qualities: humility, accountability, reverence for life, respect, and relational presence. Healing was not limited to scheduled interventions; it …

Institutional distrust in health care: Why a doctor lost faith

Joshua Mirrer, MD

Physician

March 24, 2026

Faith implies trust: confidence in an idea, a system, or a set of principles. In religion, it often requires adherence to divine authority, shaped by interpretation and tradition. Over time, those traditions can harden into dogma, discouraging curiosity and resisting ideas that challenge the prevailing worldview. This is not unique to religion. Any system that depends on belief risks the same fate.

When contradictions within a belief system become impossible to …

Communicating health to children: a pediatrician’s guide for parents

Joey Skelton, MD

Conditions

March 24, 2026

An excerpt from Your Child Is Not Their Weight: Parenting in a Size-Obsessed World, with permission from the American Academy of Pediatrics, 2026.

A friend and colleague who is a doctor in adult medicine made this comment to me several years ago: “My patients with kids have a harder time with their health than those who do not have kids!”

I pointed out to her that the “patients with kids” she …

Insulin resistance is a survival mechanism, not a broken system [PODCAST]

The Podcast by KevinMD

Podcast

March 23, 2026

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

Metabolic health educator Kevin Whitt discusses his article “Insulin resistance is not a disease: a metabolic reframe.” Kevin argues that the skyrocketing rates of Type 2 diabetes are not the result of …

Debunking 4 myths about fertility treatments for women of color

Ilana Ressler, MD

Physician

March 23, 2026

Regina Townsend, founder of The Broken Brown Egg, writes that “trying to decide if you can emotionally afford the cost of building a Black or Brown family in a world that is concurrently showing you how low they are valued adds additional weight to an already heavy situation.”

Townsend emphasizes the importance of recognizing the lived experiences of women of color: “Infertility doesn’t see color, but my color …

Whole-body MRI screening: a radiologist’s guide to preventive scans

Amit Newatia, MD

Physician

March 23, 2026

Last year, a 45-year-old woman walked into my screening center in Laurel, MD. She was fit, healthy, and had no symptoms whatsoever. She just wanted peace of mind, the kind of baseline health data that her annual physical could not provide. Ninety minutes later, her whole-body MRI revealed a kidney tumor she did not know existed. No pain. No blood in her urine. Nothing to suggest she was harboring a …

How competency-based education is driving medical education reform

Ben Reinking, MD

Physician

March 23, 2026

As a pediatric cardiologist, I have spent my career watching children grow. During clinic visits, we track their height, weight, and milestones. We also sit with families and ask what makes their children smile. We might send a toddler to physical therapy for gross motor delay while we also encourage her love of art or music. Years of listening to parents share what their child enjoys has taught me that …

The truth about short-term opioid prescribing and opioid use disorder

Kayvan Haddadan, MD

Conditions

March 23, 2026

In the thick of the opioid epidemic, there is this widespread fear called “opiophobia,” which basically means people, including patients and doctors, are scared to use opioids even when they are really needed for serious medical issues. This fear comes from the idea that even a short stint on opioids for acute pain, like after surgery, often leads to addiction or worse. John A. Bumpus’s 2025 review in ACS Pharmacology …

AI in health care: Why artificial intelligence cannot replace human empathy

Ryan McCarthy, MD

Physician

March 23, 2026

If you trust the titans of industry, and I do not, we are led to believe that, just around the proverbial corner, the equivalent of C-3PO will arrive to improve health care. How wonderful!

You might remember the fussy, shiny droid, the golden companion of R2-D2 in the Star Wars films. Fluent in over six million forms of communication, C-3PO bubbled with personality, …

AI bias in healthcare: When algorithms erase Black professionals

Seleipiri Akobo, MD, MPH, MBA

Physician

March 23, 2026

I was trying to be cool, so I recently joined a social media challenge with a simple prompt: “Create a caricature of me and my job based on everything you know about me.”

As a hospitalist, physician executive, and burnout architect, my digital footprint is deep. I talk about systemic health care reform, the psychology of exhaustion, and the structural “blueprints” needed to …

How spinal cord stimulation offers relief for chronic pain

Kayvan Haddadan, MD

Conditions

March 22, 2026

Spinal cord stimulation (SCS) continues to be a solid option for people dealing with chronic pain that just will not budge with the usual approaches like medications, physical therapy, or injections. It is a minimally invasive way to deliver low-level electrical pulses through electrodes placed in the epidural space near the spinal cord, helping to change how pain signals reach the brain and often providing relief in areas like the …

Compassion fatigue in medicine: Why the brain numbs trauma

Farid Sabet-Sharghi, MD

Physician

March 22, 2026

In the sterile quiet of an exam room, a physician faces a patient recounting a history of profound trauma. To a layperson, the story is bone-chilling. To the seasoned clinician, it can occasionally and guiltily feel like data. We call it burnout or compassion fatigue, but biologically, it is something more fundamental. The human brain has a finite capacity for empathy.

Our neural circuitry evolved for small tribes, not for a …

The danger of detachment: How medical training reveals character

Ronald L. Lindsay, MD

Physician

March 22, 2026

In 2016, Lauren Gambill wrote on KevinMD about being told, “She is not yours to grieve,” after a patient’s death. The message was clear: Grief was weakness, and physicians were expected to suppress it. Nearly a decade later, Arthur Lazarus argued that medical training does not change personality; it reveals scaffolding. He cited a “Blue Bloods” episode where Danny Reagan dismissed a racist watch leader and former cop with the …

The rhythm of healthy aging: Moving beyond health care metrics

Gerald Kuo

Conditions

March 22, 2026

Families often ask me what “healthy aging” really means. They expect actionable answers: target lab values, a 30-minute exercise prescription, or a strict dietary plan. In modern health care, we deliver these metrics with precision, yet our patients continue to struggle. That gap is not a failure of compliance. It is a failure of imagination. Recently, I found myself contemplating a different kind of prescription while attending a piano recital …

Managing acute heart failure: evidence from the DOSE trial

Benjamin P. Geisler, MD, Jeffrey L. Greenwald, MD, and Kathy May Tran, MD

Conditions

March 22, 2026

An excerpt from 50 Studies Every Hospitalist Should Know.

Debbie Lin Teodorescu, MD, MEng, a cardiologist, and Hugo Torres, MD, MPH, an endocrinologist, authored this article.

The DOSE trial provided good insight into the dosage and frequency for administering loop diuretics in patients presenting with acute decompensated heart failure. Physicians can prescribe intravenous loop diuretics with confidence that their decision is evidence-based, efficacious, and safe.

Research questions

Among patients with hemodynamically …

The clash between defensive medicine and value-based health care

Olumuyiwa Bamgbade, MD

Physician

March 22, 2026

Defensive medicine grows where fear rules. Value-based health care grows where judgment, trust, and outcomes matter. That is the clash now facing many doctors. On paper, health systems say they want high-value care, better outcomes, lower waste, and patient-centered decisions. In real life, many doctors practice in an environment shaped by needless complaints, crushing legal defense costs, underfunded services, regulator overreach, and instant reputational damage through online and social media. …

Cultural humility in medicine: Why respect matters as much as science

Kelly Dórea França

Education

March 22, 2026

What does it really mean to care for someone? I asked myself that question during my first months in medical school, when I realized that medicine was not only about science or protocols. It was about people, each one carrying their own culture, beliefs, and stories. And sometimes those stories mattered as much as the diagnosis itself.

One of my earliest experiences was with a woman from a rural community who …

Why physicians get stuck in productive and numbing cycles

Diane W. Shannon, MD, MPH

Physician

March 21, 2026

I had a mini epiphany recently. I realized there are three basic categories of time:

Productive: many work tasks (but not all), completing a task at home, achieving a specific personal or professional goal.
Non-productive and enriching: sleep, physical activity, being fully present with friends and family, learning something new.
Non-productive, non-enriching, and pleasurable: Netflix bingeing, drinking another glass of wine, zoning out, going down a social media rabbit hole, …
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Why physicians get stuck in productive and numbing cycles

A resident’s first surgery: When the patient teaches the doctor

Kaylan Baban, MD, MPH

Physician

March 21, 2026

“Dr. Baban? Dr. Baban?”

His slurred voice rasps across the room, weak but insistent, cutting through chiming monitors, buzzing fluorescent lights, and the screeching pager slung next to the empty gnaw in my stomach. I freeze where I stand, one hand scratching out post-operative orders on the last emergency surgery of the day, the other midway to the nursing station phone, grasping the silenced pager. My eyes sweep over the recovery …

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