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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

The Podcast by KevinMD

Burnout, difficult patients, and the question that changes both [PODCAST]

Most patients called difficult have a reason nobody has asked about. Every chart carries labels, and the labels rarely carry the person. Stella Awua-Larbi is a nephrologist who has practiced in the Chicago suburbs for more than 15 years. This…

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Most patients called difficult have a reason nobody has asked about. Every chart carries labels, and the labels rarely carry the person. Stella Awua-Larbi is a nephrologist who has practiced in the Chicago suburbs for more than 15 years. This episode is based on her article “The person …

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Burnout, difficult patients, and the question that changes both [PODCAST]

Physician voices

Time for ACGME to drop maintenance of certification

The Accreditation Council for Graduate Medical Education (ACGME) is currently accepting comments regarding updates to its Common Program Requirements. A quick glance at its proposed strikeouts and additions might suggest a routine and bureaucratic exercise, far removed from the minds…

The Accreditation Council for Graduate Medical Education (ACGME) is currently accepting comments regarding updates to its Common Program Requirements. A quick glance at its proposed strikeouts and additions might suggest a routine and bureaucratic exercise, far removed from the minds or priorities of busy practicing physicians. In reality, ACGME’s update presents an important and urgent opportunity for physicians to be a voice for change in academic medicine. Physicians have until …

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Time for ACGME to drop maintenance of certification

Real physician voices, twice a week

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Physician voices

The medical malpractice crisis began in Cook County

The story of medical malpractice litigation in the United States is like the famous passage in Macbeth. "It is a tale told by an idiot, full of sound and fury, signifying nothing." Medical malpractice lawsuits are nothing new. They have…

The story of medical malpractice litigation in the United States is like the famous passage in Macbeth. “It is a tale told by an idiot, full of sound and fury, signifying nothing.”

Medical malpractice lawsuits are nothing new. They have been filed and tried in America’s courts since 1784. Between 1835 and 1865, there was a rash of them. One might even call it a crisis.

Medical liability insurance is, also, …

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The medical malpractice crisis began in Cook County

Physician voices

How a misread living will led to a 6-day court fight

Six days. $20,000 in legal fees. One advance directive (living will) applied too soon. A 60-year-old man suffered complications after cardiac catheterization, developing acute kidney injury from the intra-arterial dye and pulmonary edema requiring intubation. Serious? Yes. Reversible? Yes. The…

Six days. $20,000 in legal fees. One advance directive (living will) applied too soon.

A 60-year-old man suffered complications after cardiac catheterization, developing acute kidney injury from the intra-arterial dye and pulmonary edema requiring intubation. Serious? Yes. Reversible? Yes.

The patient just needed short-term ventilatory support and temporary dialysis. The plan, consent, and scheduling of a temporary dialysis catheter ensued. Then his advance directive was found.

The attending physician concluded the patient should …

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How a misread living will led to a 6-day court fight

Health policy

A plan to save primary care that puts doctors in charge

PCPs don't have to suffer silently under employers that deprofessionalize them and treat them as the low people on the totem pole of health care. They can embark on a mission to save U.S. health care, while increasing their earnings…

PCPs don’t have to suffer silently under employers that deprofessionalize them and treat them as the low people on the totem pole of health care. They can embark on a mission to save U.S. health care, while increasing their earnings and enhancing their status.

This may sound like a pipe dream. But all the essential elements for it are available. All that’s needed is the political will to make it happen.

As …

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A plan to save primary care that puts doctors in charge

Physician voices

What Gold Star families need beyond flags and funerals

At 2 a.m. on Saturday, Oct. 3, 1970, someone started pounding on our apartment door. My mother thought it was a prank. She had ignored the buzzer downstairs because neighborhood kids occasionally rang doorbells in the middle of the night.…

At 2 a.m. on Saturday, Oct. 3, 1970, someone started pounding on our apartment door. My mother thought it was a prank. She had ignored the buzzer downstairs because neighborhood kids occasionally rang doorbells in the middle of the night. My uncle arrived with his service pistol drawn, expecting trouble.

Instead, he found two Air Force officers standing at the door. One was a lieutenant colonel. The other was a chaplain. …

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What Gold Star families need beyond flags and funerals

Conditions and diseases

Patient education after the visit is a design problem

A patient can leave a medical appointment with an explanation, a printed instruction sheet, and a question that has not occurred to them yet. The question may arrive while arranging a ride, talking to a spouse, or looking at the…

A patient can leave a medical appointment with an explanation, a printed instruction sheet, and a question that has not occurred to them yet.

The question may arrive while arranging a ride, talking to a spouse, or looking at the calendar the evening before a procedure. It may be simple enough that the practice answers it many times a week. For that patient, at that moment, it is the missing piece …

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Patient education after the visit is a design problem

Health technology

AI psychosis hits hardest in a first episode

Researchers at Vanderbilt University Medical Center have published one of the first large looks at what is being called AI psychosis. In a study in JAMA Psychiatry, they reviewed the records of more than 215,000 patients who received mental health…

Researchers at Vanderbilt University Medical Center have published one of the first large looks at what is being called AI psychosis. In a study in JAMA Psychiatry, they reviewed the records of more than 215,000 patients who received mental health care at Vanderbilt between December 2022 and April 2026. They identified 28 people whose psychosis was linked to chatbot use.

Twenty-eight is a small number, about 0.013 percent of patients. …

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AI psychosis hits hardest in a first episode

Patient voices

Losing a mother to cancer, and the long wait for the end

She was the most important person in my life. My mom. The woman whose hands had held mine Before I understood the meaning of holding on, Whose voice was woven into the fabric of my childhood, Whose presence made the…

She was the most important person in my life.

My mom.

The woman whose hands had held mine
Before I understood the meaning of holding on,
Whose voice was woven into the fabric of my childhood,
Whose presence made the world
Feel a little less frightening.

Then came the words no family is ever prepared to hear.
Metastatic colon cancer.

It had already traveled through her body,
Quietly taking pieces of the woman
Who once seemed to know no exhaustion.

She had …

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Losing a mother to cancer, and the long wait for the end

Health technology

How to catch AI scribe errors before you sign the note

Ambient AI scribes have earned a place in a lot of emergency departments, and I understand why. Documentation in emergency medicine is relentless, and anything that gives time back at the end of a shift gets attention. Some of the…

Ambient AI scribes have earned a place in a lot of emergency departments, and I understand why. Documentation in emergency medicine is relentless, and anything that gives time back at the end of a shift gets attention.

Some of the hype holds up. A single-center study in JMIR AI this year followed more than 10,000 emergency encounters over 13 months and tied scribe use to about 73 seconds less documentation …

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How to catch AI scribe errors before you sign the note

Patient voices

Leadership in emergency medicine is long overdue

I write to you as a person with four decades of experience on the business side of health care, specifically in the revenue cycle industry. Importantly in those forty years, the overwhelming majority of my time was spent serving all…

I write to you as a person with four decades of experience on the business side of health care, specifically in the revenue cycle industry. Importantly in those forty years, the overwhelming majority of my time was spent serving all of you in emergency medicine. At the outset of this article, I wish to express my appreciation and gratitude to each, and every one of you, for the opportunity to …

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Leadership in emergency medicine is long overdue

The Podcast by KevinMD

AI, standing orders, and the 9 p.m. call medicine still cannot handle [PODCAST]

A patient with a urinary tract infection calls at 9 p.m. and gets told to call back in the morning. Frustrated patients default to the emergency room instead. Tod Stillson is a family physician, health care entrepreneur, and founder and…

Listen on Apple Podcasts · Spotify

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A patient with a urinary tract infection calls at 9 p.m. and gets told to call back in the morning. Frustrated patients default to the emergency room instead. Tod Stillson is a family physician, health care entrepreneur, and founder and CEO of ChatRx. This episode is based on his …

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AI, standing orders, and the 9 p.m. call medicine still cannot handle [PODCAST]

Conditions and diseases

Cultural humility in psychiatry begins with curiosity

Quite recently, I requested a colleague to proofread a piece of my writing. When I asked for feedback, his reply through the text bubbles on WhatsApp read: "I have not been chanced to go through it." The meaning of it…

Quite recently, I requested a colleague to proofread a piece of my writing. When I asked for feedback, his reply through the text bubbles on WhatsApp read: “I have not been chanced to go through it.”

The meaning of it was perfectly clear. Yet I caught myself correcting his sentence almost automatically in my head. Once I caught myself in the act, I stopped abruptly. I found myself wondering whether the …

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Cultural humility in psychiatry begins with curiosity

Physician voices

The physician retention problem nobody wants to touch

I keenly remember the day one of our partners said he was quitting as soon as possible (no new job lined up, no plan). His dad had died just days before, and he said he simply didn't know how to…

I keenly remember the day one of our partners said he was quitting as soon as possible (no new job lined up, no plan). His dad had died just days before, and he said he simply didn’t know how to keep going. He needed a break, and this was his way out.

For those in private practice, this story likely hits a nerve. Life happens. Physicians hurt and struggle, and often …

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The physician retention problem nobody wants to touch

Health policy

What a baby’s gene therapy owes to curiosity-driven research

Some research starts with an obvious destination: a disease to treat, a test to build, a technology to improve. Other research begins much earlier, with a question about how nature works and no clear application in sight. The difference can…

Some research starts with an obvious destination: a disease to treat, a test to build, a technology to improve. Other research begins much earlier, with a question about how nature works and no clear application in sight. The difference can make the first kind of research seem more useful and the second more difficult to justify. But by the time a scientific problem has a recognizable clinical or technological solution, …

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What a baby’s gene therapy owes to curiosity-driven research

Health policy

Low-value care wastes billions. Clinicians can say no.

In a previous article, I admitted that my criticism of modern medicine had become too broad. I have received excellent care from physicians who looked up from the computer, asked questions, and made me believe they were listening. Exceptional doctors…

In a previous article, I admitted that my criticism of modern medicine had become too broad. I have received excellent care from physicians who looked up from the computer, asked questions, and made me believe they were listening. Exceptional doctors still exist. That admission does not mean the larger problems have disappeared. Caring matters, but caring alone cannot repair the American health care system.

Blaming individual doctors and nurses for the …

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Low-value care wastes billions. Clinicians can say no.

The Podcast by KevinMD

Patients on ventilators have things to say, and no way to say them [PODCAST]

Only 4 in 10 caregivers say a doctor asked how the patient prefers to communicate. The patients who cannot answer often have the most to report. Chris Ross is a speech-language pathologist and school administrator. This episode is based on…

Listen on Apple Podcasts · Spotify

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

Only 4 in 10 caregivers say a doctor asked how the patient prefers to communicate. The patients who cannot answer often have the most to report. Chris Ross is a speech-language pathologist and school administrator. This episode is based on her article “Communication access is a patient safety …

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Patients on ventilators have things to say, and no way to say them [PODCAST]

Drugs and prescribing

Are 12-step programs maligned because they sell nothing?

Twelve Step programs like Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous are free, self-supporting, and do not advertise. That's why many do not know about them and their success rate. Instituted in the 1930s, such programs promote no drugs and…

Twelve Step programs like Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous are free, self-supporting, and do not advertise. That’s why many do not know about them and their success rate. Instituted in the 1930s, such programs promote no drugs and use no psychiatric or psychology experts, relying instead on peer-to-peer healing and often meeting in church basements.

In the last decade, drugmakers and insurance companies, distressed by all that non-prescription health …

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Are 12-step programs maligned because they sell nothing?

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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