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What’s new in the redesigned KevinMD enhanced author page

Your KevinMD author page has a new look. For subscribers to the KevinMD enhanced author page, it is now a full professional profile, and their photo appears beside their name everywhere they publish on the site. Here are some of…

Your KevinMD author page has a new look. For subscribers to the KevinMD enhanced author page, it is now a full professional profile, and their photo appears beside their name everywhere they publish on the site. Here are some of the authors who already have one.

Join these KevinMD subscribers

What changed

Until now, an enhanced author page meant a photo and a longer bio in a gray box above a list of articles. The redesign …

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What’s new in the redesigned KevinMD enhanced author page

Medical education

Continuing medical education needs a tutor, not a lecture

Like most physicians, I have earned a great many continuing medical education credits in rooms where I learned very little. A slide deck, a speaker reading the slides aloud, a ten-question quiz at the end that anyone could pass by…

Like most physicians, I have earned a great many continuing medical education credits in rooms where I learned very little. A slide deck, a speaker reading the slides aloud, a ten-question quiz at the end that anyone could pass by recognizing the longest answer. The credits counted. Whether my practice changed is another question.

I am an endocrinologist and a geneticist. Both fields move quickly. Genetic variant classifications get revised, new …

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Continuing medical education needs a tutor, not a lecture

Health technology

Mental health apps could unite psychiatrists and therapists

Today I had the privilege of speaking at The Chicago School about technology and serious mental illness. We covered apps, wearables, virtual reality (VR), and prescription digital therapeutics. But one question rose to the center of our conversation, and I…

Today I had the privilege of speaking at The Chicago School about technology and serious mental illness. We covered apps, wearables, virtual reality (VR), and prescription digital therapeutics. But one question rose to the center of our conversation, and I haven’t stopped thinking about it.

If a psychiatrist “orders” an app that requires therapeutic work, how does that therapy actually happen?

This is not hypothetical. The FDA recently cleared Motivista, the first …

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Mental health apps could unite psychiatrists and therapists

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Conditions and diseases

What we are saving when we keep a father alive in the ICU

He was critically ill. During one conversation, his wife told me that their young children believed their father had gone out of town for work and would be home soon. They were too young, she felt, to understand why he…

He was critically ill. During one conversation, his wife told me that their young children believed their father had gone out of town for work and would be home soon. They were too young, she felt, to understand why he was really away, or that he might not return.

Until then, I had been thinking about how to keep him alive. After that conversation, I found myself thinking about the children …

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What we are saving when we keep a father alive in the ICU

Medical education

A $480 editing fee and the fairness of academic publishing

After nearly four decades in medicine, I have had more than my fair share of encounters with academic publishing, some pleasant and some less so. I spent the earlier part of my career in academic medicine and, even after moving…

After nearly four decades in medicine, I have had more than my fair share of encounters with academic publishing, some pleasant and some less so. I spent the earlier part of my career in academic medicine and, even after moving into private practice, I never quite shook the urge to write. These days I gravitate toward essays and books, but working alongside students has pulled me back into case reports …

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A $480 editing fee and the fairness of academic publishing

Conditions and diseases

Responsible healthmaxxing starts with a stopping rule

Wellness culture has become very good at telling people what else they could measure, buy, restrict, stack, or optimize. The newer language of "healthmaxxing" packages that instinct into a single word. At its most extreme, it can turn an ordinary…

Wellness culture has become very good at telling people what else they could measure, buy, restrict, stack, or optimize. The newer language of “healthmaxxing” packages that instinct into a single word. At its most extreme, it can turn an ordinary life into an endless intervention: more supplements, more tests, tighter routines, higher scores, and less tolerance for uncertainty.

The criticism of that version is justified. A routine is not responsible simply …

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Responsible healthmaxxing starts with a stopping rule

Physician voices

AI diagnosis can list 100 causes but can’t examine you

The triage note read, "The patient wants her thyroid checked." On the stretcher, fully dressed, sat a 65-year-old woman with her family members at the bedside. She said she had been feeling weak and tired lately, so bad that even…

The triage note read, “The patient wants her thyroid checked.”

On the stretcher, fully dressed, sat a 65-year-old woman with her family members at the bedside. She said she had been feeling weak and tired lately, so bad that even her voice had turned hoarse. She’d never had any problems with her thyroid in her life, but she had looked it up; maybe it was her thyroid or anemia. That was …

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AI diagnosis can list 100 causes but can’t examine you

Physician voices

Prior authorization delays run on 3 clocks, not just 1

When a surgeon tells a patient, "You need surgery," the patient understandably hears that the next step is scheduling it. Inside the practice, however, an entirely different process is just beginning. The clinical decision must be converted into documentation. The…

When a surgeon tells a patient, “You need surgery,” the patient understandably hears that the next step is scheduling it. Inside the practice, however, an entirely different process is just beginning.

The clinical decision must be converted into documentation. The documentation must be translated into the language of a payer’s policy. The request must reach the organization that actually controls the decision. Only then does the formal review begin.

Prior authorization is …

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Prior authorization delays run on 3 clocks, not just 1

Drugs and prescribing

Does nicotine cause cancer? What clinicians should say

A patient considering a nicotine patch asks, "Doesn't nicotine cause lung cancer?" A reassuring answer should not minimize nicotine's risks. It should explain why a nicotine patch and a cigarette are not medically equivalent. Our survey in Ukraine suggests that…

A patient considering a nicotine patch asks, “Doesn’t nicotine cause lung cancer?” A reassuring answer should not minimize nicotine’s risks. It should explain why a nicotine patch and a cigarette are not medically equivalent.

Our survey in Ukraine suggests that this distinction warrants attention. Healthy Initiatives collected 1,538 responses to a questionnaire targeting health care professionals between October 2025 and September 2026. Asked to identify the most harmful components of smoking, …

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Does nicotine cause cancer? What clinicians should say

Conditions and diseases

How I healed a dysregulated nervous system after burnout

My reckoning arrived in the form of sudden heart palpitations that felt like a physical warning siren. After weeks of intense, recession-era financial pressure, endless work travel, and nights that blurred into early mornings, my body staged a quiet mutiny.…

My reckoning arrived in the form of sudden heart palpitations that felt like a physical warning siren. After weeks of intense, recession-era financial pressure, endless work travel, and nights that blurred into early mornings, my body staged a quiet mutiny. I tried to rationalize the symptoms away. I tried to “push through” the fatigue, attempting to remain the resilient high-performer who didn’t need help. Sadly, human physiology does not negotiate …

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How I healed a dysregulated nervous system after burnout

Physician voices

Sleep deprivation in doctors is a culture problem

The clocks fall back on Sunday, Nov. 1, and most of us will tell our patients the same sensible things we always do: protect your sleep window, keep a consistent wake time, treat insomnia before it becomes chronic. Then we…

The clocks fall back on Sunday, Nov. 1, and most of us will tell our patients the same sensible things we always do: protect your sleep window, keep a consistent wake time, treat insomnia before it becomes chronic. Then we will drive home from a long shift on four hours of sleep and think nothing of it.

Medicine has a culture problem around rest. Somewhere in training we absorb the idea …

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Sleep deprivation in doctors is a culture problem

Physician voices

Who vets your medical malpractice expert witness?

The famous passage in Macbeth, "a tale told by an idiot, full of sound and fury, signifying nothing," refers to the futility of life. Or does it refer to a medical malpractice lawsuit? There are 175 lawyers in Congress; 1…

The famous passage in Macbeth, “a tale told by an idiot, full of sound and fury, signifying nothing,” refers to the futility of life. Or does it refer to a medical malpractice lawsuit?

There are 175 lawyers in Congress; 1 out of every 3 members is a lawyer. There are, also, 20 doctors; 1 out of every 27 members is a doctor.

Of the 175 lawyers, those who were formerly malpractice attorneys …

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Who vets your medical malpractice expert witness?

The Podcast by KevinMD

How to be grateful when you are not a grateful person [PODCAST]

Gratitude is easy to preach and hard to feel on a bad day. One physician spent a 40-year career learning to practice it on purpose. Scott Abramson is a neurologist and author. This episode is based on his article "A…

Listen on Apple Podcasts · Spotify

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Gratitude is easy to preach and hard to feel on a bad day. One physician spent a 40-year career learning to practice it on purpose. Scott Abramson is a neurologist and author. This episode is based on his article “A physician’s three lessons on gratitude in medicine,” published …

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How to be grateful when you are not a grateful person [PODCAST]

Health technology

Fragmented health records fail the women who wait longest

A friend of my mother's went in for routine surgery prep and had her blood drawn. The test showed critically low hemoglobin, and no one followed up. Three months later she saw the surgeon, had the test redrawn, and the…

A friend of my mother’s went in for routine surgery prep and had her blood drawn. The test showed critically low hemoglobin, and no one followed up. Three months later she saw the surgeon, had the test redrawn, and the result was the same. The low hemoglobin had been an early sign of colon cancer, already advanced by the time she was diagnosed. The number that might have saved her …

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Fragmented health records fail the women who wait longest

Conditions and diseases

Dopamine agonist withdrawal is a foreseeable injury

3

Dopamine agonist withdrawal syndrome (DAWS). That is its name. Named in the literature since 2010. Diagnostic criteria exist. It affects, by conservative estimate, one in five to one in four patients who taper off these drugs. This is not a…

Dopamine agonist withdrawal syndrome (DAWS). That is its name. Named in the literature since 2010. Diagnostic criteria exist. It affects, by conservative estimate, one in five to one in four patients who taper off these drugs. This is not a mystery ailment. It is a known, foreseeable medical injury, and foreseeable harm that goes unwarned and unmonitored is not bad luck. It is a failure of duty. If this profession …

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Dopamine agonist withdrawal is a foreseeable injury

Health technology

Will digital therapeutics for schizophrenia reach families?

This month, Click Therapeutics announced that the FDA has cleared Motivista, a smartphone-based prescription digital therapeutic for the negative symptoms of schizophrenia. It is the first prescription digital therapeutic cleared for schizophrenia, and the company calls it the first authorized…

This month, Click Therapeutics announced that the FDA has cleared Motivista, a smartphone-based prescription digital therapeutic for the negative symptoms of schizophrenia. It is the first prescription digital therapeutic cleared for schizophrenia, and the company calls it the first authorized treatment for negative symptoms. For families like mine, that is not a small headline.

Why negative symptoms matter so much

When most people picture schizophrenia, they picture hallucinations and delusions. Medication …

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Will digital therapeutics for schizophrenia reach families?

Conditions and diseases

Chronic kidney disease can hide behind a normal blood test

A normal creatinine result can be reassuring. But for someone with diabetes, high blood pressure, or another risk factor for kidney disease, it may answer only part of the question. Creatinine helps us estimate how well the kidneys filter blood.…

A normal creatinine result can be reassuring. But for someone with diabetes, high blood pressure, or another risk factor for kidney disease, it may answer only part of the question. Creatinine helps us estimate how well the kidneys filter blood. It does not tell us whether albumin, a protein normally kept in the bloodstream, is leaking into the urine. Before we describe a kidney assessment as complete, we should know …

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Chronic kidney disease can hide behind a normal blood test

Physician voices

Dark humor in medicine: when coping becomes cruelty

An excerpt from METACINE: Essays on Health Care in a Changing World. Sometimes I use humor in my writing. Humor has always coexisted with suffering. In the high-stakes, emotionally draining world of medicine, comedy is rarely lighthearted. Instead, it takes…

An excerpt from METACINE: Essays on Health Care in a Changing World.

Sometimes I use humor in my writing. Humor has always coexisted with suffering. In the high-stakes, emotionally draining world of medicine, comedy is rarely lighthearted. Instead, it takes the form of gallows humor: a sharp, cynical, and dark style of joking that addresses illness, trauma, and death.

Medical professionals routinely encounter situations that would overwhelm a layperson. To cope …

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Dark humor in medicine: when coping becomes cruelty

Health technology

Patients using AI want a collaborator, not an authority

Artificial intelligence (AI) is changing the rules of engagement between patients and providers. According to a recent survey from the West Health-Gallup Center on Healthcare in America, one in four Americans now use AI tools for health information or advice.…

Artificial intelligence (AI) is changing the rules of engagement between patients and providers. According to a recent survey from the West Health-Gallup Center on Healthcare in America, one in four Americans now use AI tools for health information or advice.

Most say they’re not trying to bypass providers; they simply want to be better prepared for appointments. Nearly half said their AI-generated research made them feel more confident discussing their …

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Patients using AI want a collaborator, not an authority

Conditions and diseases

Sleep apnea and depression: Screen before a third drug

In a community study of 700 men, 43 percent of those who had both obstructive sleep apnea and insomnia met criteria for depression. That compared with 22 percent of those with insomnia alone and just 8 percent of those with…

In a community study of 700 men, 43 percent of those who had both obstructive sleep apnea and insomnia met criteria for depression. That compared with 22 percent of those with insomnia alone and just 8 percent of those with sleep apnea alone.

That gradient captures something most of us see every week but rarely name. The patient who comes to me on referral has usually cycled through two or three …

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Sleep apnea and depression: Screen before a third drug

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