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Severe note bloat is fueling dangerous physician burnout

Tech

April 11, 2026

You open the chart. You start clicking. Labs here. Imaging there. Notes in four different tabs, none of them organized in any order a clinician would have chosen. Prior hospitalizations buried three levels down behind a menu that requires two clicks just to find the menu. Medication reconciliation on a screen you have to navigate to separately. Problem list in one place, active diagnoses in another, allergies somewhere a third …

Why self-care alone cannot cure systemic nursing burnout

Anonymous

Conditions

April 11, 2026

Nurses are constantly told that burnout can be prevented through self-care: rest, nutrition, mindfulness, and learning to assert healthy boundaries. I followed that advice. I asserted professional boundaries. I tried to maintain reasonable limits around my time and energy. I attempted to follow the guidance nurses are routinely given about protecting our well-being. Within one year, I was fired from three jobs. This is the contradiction at the center of …

How physician financial autonomy cures physician burnout

Tonya Kuhn, MD

Finance

April 11, 2026

I am going to say something that will irritate some people. A lot of physician burnout is not coming from medicine. It is coming from financial dependence. We train for more than a decade to master the human body, but many physicians cannot explain how their own money actually works. Not really. They do not know where every account is, what the portfolio actually holds, or what the total fees …

Safety-net dentistry restores human dignity for patients recovering from severe addiction [PODCAST]

The Podcast by KevinMD

Podcast

April 10, 2026

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

Clinical director at Franklin Park Family Dental in Dorchester and Tremont Family Dentistry in Boston, Charan Teja Bobba, discusses his article “Treating methamphetamine-associated dental disease in safety-net clinics.” Charan reflects on the …

How patient portal message volume drives physician burnout

Candice Elam, DNP

Conditions

April 10, 2026

A patient sends a portal message at 9:17 p.m. on a Tuesday. “Hey, I’ve been having some chest tightness when I climb stairs. It comes and goes. Also can you refill my metformin and check if my last A1C was OK? I don’t want to come in if I don’t have to.” This message requires clinical triage. It requires chart review. It requires a decision about whether to initiate a …

The second victim label ignores patient safety reality

Timothy Lesaca, MD

Physician

April 10, 2026

Ask any clinician about the drive home after a case goes bad and the patient outcome is tragic. It is a specific kind of heavy silence. We have all had the experience. You do not forget it. You replay the tape in your head dissecting every move, carrying a stain that does not wash off or show mercy. It owns you.

We have had a name for this for 20 years: …

How the hidden war in medicine affects young doctors

Amr Ehab, MD

Physician

April 10, 2026

An excerpt from The Hidden War in Medicine: The Fight No One Warned Us About.

We entered medicine believing something many young doctors believe. That medicine was a noble profession built on collaboration, compassion, and a shared mission: fighting disease! We had many glorious moments that make you cry tears of joy when a patient had been finally healed. From the outside, that is the image everyone sees. Doctors working …

Is HPA axis dysregulation causing your chronic insomnia?

Shiv K. Goel, MD

Conditions

April 10, 2026

Cortisol. Almost always cortisol. I say this to patients more than almost anything else. And I say it having lived it myself, years of high-output clinical work, late nights, early mornings, and the particular exhaustion of lying in bed completely depleted but unable to actually fall asleep. Tired but wired. It is a real physiological state, and it has a name: hypothalamic-pituitary-adrenal (HPA) axis dysregulation. It is not insomnia in …

The hidden risk of protein deficiency in bariatric surgery

Kevin Huffman, DO

Conditions

April 10, 2026

I have treated over 10,000 bariatric patients across my career, and if there is one issue that comes up more than almost anything else, it is protein. Specifically, patients not getting enough of it. The research confirms what I see every day in practice. Only a minority of bariatric patients reach the recommended minimum of 60 grams per day, resulting in the loss of fat-free mass rather than the …

Knee osteoarthritis demands layered pain management

Kayvan Haddadan, MD

Conditions

April 10, 2026

Knee osteoarthritis (OA) remains a leading cause of chronic pain and reduced mobility, affecting millions of adults worldwide, particularly those over age 50. As cartilage deteriorates and inflammation increases, patients often face pain, stiffness, swelling, and limitations in daily activities. Although no cure exists, a structured, escalating treatment plan can significantly alleviate symptoms, preserve function, delay disease progression, and help many individuals avoid or postpone surgery. Current guidelines from the …

Why clinical listening skills outpace artificial intelligence

Ryan Egeland, MD, PhD

Tech

April 10, 2026

In an era of unprecedented technological adoption, it feels almost unfashionable to talk about listening. Artificial intelligence is advancing at breakneck speed. Clinical decision support tools grow more sophisticated every year. And yet, in examining the results of a new national survey from Littmann Stethoscopes, I’m struck by a simple truth that every clinician recognizes, but our system increasingly obscures: The most essential diagnostic tool in medicine is still the …

Health care startups desperately need clinical expertise

Harsha Moole, MD

Finance

April 10, 2026

Last year, a startup pitched me a device designed to improve endoscopic procedures in gastroenterology. Slick deck. Strong team. Blue-chip venture capital (VC) backing. One problem: The device added three extra steps to a workflow that gastroenterologists have spent decades optimizing for speed. Any gastrointestinal (GI) physician would have flagged this in the first five minutes. But the investors who wrote the check? None of them had ever held a …

How expiring ACA enhanced premium tax credits hurt business

Kelly Berry

Policy

April 10, 2026

I’ve recently been forced to make painful and difficult choices that impact my personal life as well as my small business because this Congress has been unwilling to renew tax credits that used to significantly lower the cost of my health insurance. My husband and I are both self-employed entrepreneurs. We don’t have access to corporate health plans and the substantial cost sharing that employers typically …

The hidden clinical cost of HCC coding in primary care

Jeffrey H. Millstein, MD

Physician

April 10, 2026

I am in the exam room, leaning forward hearing my elderly patient describe weeks of worsening fatigue. Her daughter fills the gaps as her mother, hard of hearing and anxious, struggles to find the right words. Her recent lab work shows a steep drop in her blood count. We are working together to understand what is going on. As I prepare to enter orders in the electronic health record (EHR), …

Finding peace and reclaiming humanity within a broken health care system [PODCAST]

The Podcast by KevinMD

Podcast

April 9, 2026

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

Physician wellness coach Jessica Singh discusses the article “Physician burnout: Finding peace in a broken health care system.” Jessica shares a powerful narrative of a grueling swing shift in a rural emergency …

Why walking matters most in post-acute rehabilitation

Neha Sabharwal, DPT

Conditions

April 9, 2026

One of the most common questions I hear in rehabilitation is not asked during therapy sessions. It is usually asked quietly by a family member after the session ends. “Will my mother walk again?” Families rarely ask about therapy intensity or functional scoring systems. They do not ask how many minutes of treatment occurred that day. They ask about walking. Walking represents independence. It represents the possibility of returning home. …

The hidden crisis of trainee health during medical residency

Chinyelu E. Oraedu, MD

Physician

April 9, 2026

In medicine, we are trained to recognize risk in our patients. But we often overlook those same risks in ourselves. Sometimes, the system overlooks them, too. During residency, performance is expected and endurance assumed. Health often declines quietly and almost invisibly. We label it “dedication”; we claim “resilience.” In reality, it is often neither. I learned this lesson over 48 hours, two days that would reshape both my career and …

Health care lobbying is destroying the U.S. system

Richard A. Lawhern, PhD

Conditions

April 9, 2026

In modern times, we frequently encounter messes in our public life. This seems particularly true in American health care, and it is certainly true in our politics. But few citizens seem to put the two issues together sufficiently to effectively demand change. Putting them together is what this article is about.

According to the nonprofit public interest group Open Secrets, individuals and political action committees spent a record $4.5 billion in …

Low-dose lithium treats suicidal ideation safely

Carrie Friedman, NP

Conditions

April 9, 2026

A patient in his 20s recently came to see me in a state of severe distress. He described feeling consumed by his thoughts, constantly anxious, unable to function, and deeply exhausted. His sleep had collapsed. His sense of identity felt lost. He was experiencing persistent passive suicidal thoughts, not because he wanted to die, but because everything felt overwhelming and unrelenting.

Within three days of starting low-dose lithium at 150 milligrams …

Why Florida physician background checks are driving doctors away

Tamzin A. Rosenwasser, MD

Physician

April 9, 2026

I decided to be a physician because my mother died from tuberculosis, after quite a struggle, including with not only tuberculosis, but also with the United States Public Health System, when I was 15 years old. I got an academic scholarship to college and then put myself through medical school.

I did an internal medicine residency at Washington University and Barnes Hospital and was an emergency room physician for about seven …