KevinMD.com

When the patient portal is the only way to reach your doctor

Arthur Lazarus, MD, MBA

November 8, 2026Nov 8, 2026

An excerpt from METACINE: Essays on Health Care in a Changing World. Primary care is meant to be medicine's front door: the familiar place where a patient can discuss a new symptom, a lingering worry, a medication question, or simply…

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

Primary care is meant to be medicine’s front door: the familiar place where a patient can discuss a new symptom, a lingering worry, a medication question, or simply the uneasy sense that something is not right. It is meant to be a relationship, not merely a point of entry into a larger system.

Yet as hospital chains acquire more …

Drugs and prescribing

After an FDA recall, patients need a plan for the next dose

Danielle Lightsey, RPh

November 8, 2026Nov 8, 2026

A medication recall can answer an important question about a product while leaving the patient's next question unresolved: What should I do about my next dose? That gap matters. A headline may name a medicine without identifying the particular package…

A medication recall can answer an important question about a product while leaving the patient’s next question unresolved: What should I do about my next dose?

That gap matters. A headline may name a medicine without identifying the particular package in a person’s home. A notice may explain a manufacturing problem without explaining how an individual will obtain a replacement. Information about a defective product and advice about continuing treatment serve …

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Alzheimer’s treatment works best early, so why are patients waiting? [PODCAST]

November 7, 2026Nov 7, 2026

Two Alzheimer's drugs now slow the disease, and they work best when symptoms are still mild. Emer MacSweeney is a neuroradiologist and the cofounder and CEO of Re:Cognition Health. This episode is based on her article "Early Alzheimer's detection is…

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Two Alzheimer’s drugs now slow the disease, and they work best when symptoms are still mild. Emer MacSweeney is a neuroradiologist and the cofounder and CEO of Re:Cognition Health. This episode is based on her article “Early Alzheimer’s detection is now a treatment decision,” published on KevinMD. She explains …

Rebuilding public trust in science after COVID-19

Rao M. Uppu, PhD

November 7, 2026Nov 7, 2026

On March 19, 2020, I was called to a meeting by Dr. Bijoy Sahoo, who was serving as provost of our university at the time. I was serving as vice president of the Faculty Senate, and because the Senate president was unavailable, I attended the meeting on behalf of the faculty. The university faced an urgent challenge: how to protect students, faculty, and staff from a rapidly spreading pandemic while …

Yale’s single-payer study skips the physician shortage

Brian Hudes, MD

November 7, 2026Nov 7, 2026

In August, the Yale School of Public Health announced a preprint projecting that a single-payer system could cover every American, avert about 114,000 deaths a year, and cost roughly $1 trillion less than the system it replaces. The release quotes…

I have practiced gastroenterology for more than thirty years, twenty in private practice and the rest in the …

Patient voices

Front-desk mistakes start with overload, not carelessness

Anteneh Negash

November 7, 2026Nov 7, 2026

She wasn't careless. She was carrying too much. The nurse at LabCorp was about to draw my father's blood when she stopped. There was no order for him. There was only an order for my mother. My father had just…

She wasn’t careless. She was carrying too much.

The nurse at LabCorp was about to draw my father’s blood when she stopped. There was no order for him. There was only an order for my mother.

My father had just been seen upstairs. His doctor wanted to check his thyroid. He had been feeling tired and thought it was one of his medicines. The order had been written. It just had my …

Opioid monitoring should not stop between monthly visits

Kayvan Haddadan, MD

November 7, 2026Nov 7, 2026

Over the past decade, the clinical and regulatory environment surrounding opioid prescribing for chronic non-cancer pain has changed substantially. The 2016 Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain and, more significantly, the updated 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain established a clearer framework for risk-benefit assessment, dosage considerations, monitoring, and documentation. These guidelines, combined with sustained scrutiny by the …

American Medical Women's Association

COPD in women starts with subtle signs physicians can miss

November 7, 2026Nov 7, 2026

In my teens, I watched my grandmother slowly change and wither away. I can still remember the feel of her bones under my arms as I advanced through my teen years as her already slim frame became slimmer. I watched as her breathing became more labored, there were more trips to the hospital, and she eventually became tethered to oxygen at ever-increasing flow rates. The sound of the portable concentrator …

Robert Pretzlaff, MD, MBA

Chronic disease care fails when medicine ignores the mind

Robert C. Smith, MD

November 7, 2026Nov 7, 2026

Because medicine excludes psychological and social issues in training and health care, we have a crisis in physical disease care (as well as the mental health crisis). You read correctly: a crisis in medicine’s ostensible forte, physical diseases. It occurs in two situations: when there is mental illness comorbid with a chronic physical disease and when psychosocial factors unrelated to a mental health issue lead to adverse physical disease consequences.

Comorbid …

Physician finance

Leaving medicine is not the only way out for physicians

Laura Simms

November 7, 2026Nov 7, 2026

There is a specific kind of tired that shows up in women who have given their lives to medicine. They matched into competitive residencies, they trained through most of their twenties and into their thirties, and they are excellent at the work. They are also the people everyone else leans on, at the hospital and at home, and many of them have started running the private math on how many …

Physician voices

Will AI replace doctors who no longer have time to care?

November 7, 2026Nov 7, 2026

I work in San Francisco. Every morning I walk six blocks from the train to my office, and as I look down the street, I notice how many cars are wearing hats. The "hat" is the rooftop sensor dome, LiDAR…

I work in San Francisco. Every morning I walk six blocks from the train to my office, and as I look down the street, I notice how many cars are wearing hats. The “hat” is the rooftop sensor dome, LiDAR and cameras, on the Waymo self-driving cars that fill my city’s streets. If they have not come to your city yet, they are on their way. Waymo opened to the …

Medical education

Why smoking cessation takes more than clinician confidence

Giorgi Mzhavanadze & Anastasiya Kalashnikova

November 7, 2026Nov 7, 2026

How confident are health care professionals in helping patients quit smoking? And how often does that confidence translate into practical assistance? Our recent research suggests these questions can produce very different answers. In October, we reported findings from a survey…

In October, we reported findings from a survey of 1,538 Ukrainian health care professionals in Healthcare Business Today. The results revealed a striking contrast: Most respondents felt confident advising patients to quit smoking, despite limited formal training and …

A nerve block checklist cannot replace the final pause

Dr. Girishkumar Modi

November 7, 2026Nov 7, 2026

A nerve block may involve a small needle and a carefully chosen injection, but its final safety decision is larger than either. The patient may be correctly identified, the consent signed, the intended side marked, and the ultrasound machine ready. Yet one question remains until the procedure begins: Did the people about to perform the block actually stop and agree that this is the correct patient, side, and procedure?

In regional …

Medical education

The child psychiatrist shortage starts with what we say

Nitin Gogtay, MD

November 7, 2026Nov 7, 2026

"Why would you waste your medical training to go into psychiatry? Do you not want to be a real doctor?" I have heard about a hundred variations of this in my career. If you decide to become a psychiatrist, people…

“Why would you waste your medical training to go into psychiatry? Do you not want to be a real doctor?” I have heard about a hundred variations of this in my career. If you decide to become a psychiatrist, people will question your wisdom, and then if you decide to become a child psychiatrist, they will almost want to stage an intervention.

I want to be upfront here. I never did …

Clinical trials answer drug questions. Health questions need other tools. [PODCAST]

November 6, 2026Nov 6, 2026

No one ever ran a blinded trial on handwashing. It became standard practice around the world anyway. Narinder Singh Parhar, an internal medicine, hospital medicine, and critical care physician, calls evidence-based medicine one of the field's great achievements and credits…

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Health technology

I build clinical decision support. It does not decide.

Brandy Zachary, DC

November 6, 2026Nov 6, 2026

Last month I wrote here about how AI is changing what patients expect their clinicians to know. Medicine does not have an information problem. It has an interpretation problem. The chart is full. What is missing is someone with the…

In the weeks since, the conversation has moved, and it moved fast. Building clinical decision support has made me ask a related question. …

The infant gut microbiome shapes health for decades

Savita Srivastava, MD

November 6, 2026Nov 6, 2026

When you're expecting your first child, your mind is naturally consumed by the big, tangible details: assembling the crib, choosing a car seat, and debating baby names. But beneath the surface of those exciting preparations, an invisible, high-stakes biological process…

When you’re expecting your first child, your mind is naturally consumed by the big, tangible details: assembling the crib, choosing a car seat, and debating baby names. But beneath the surface of those exciting preparations, an invisible, high-stakes biological process is taking place. From the moment of birth through a child’s second birthday, an entire microscopic ecosystem is taking root inside their body.

As physicians, our clinical training conditions us to …

Physician voices

Are Teams chats private? Not when a lawyer comes asking

Timothy Lesaca, MD

November 6, 2026Nov 6, 2026

Workplace messaging platforms such as Microsoft Teams have become a regular part of clinical work. Health care organizations rely on them to coordinate schedules, manage logistics, and keep teams connected across different locations and telehealth settings. Because these channels are closed to outsiders and separate from the electronic health record, clinicians may view them as informal, friendly, and private. However, it’s worth reconsidering that belief, as it is far from …