KevinMD.com

November 12, 2026Nov 12, 2026

Imagine a patient with rheumatoid arthritis calling her pharmacy liaison on Thursday. She usually receives a 30-day supply of her medication by mail. Her last shipment contained less. She has enough through Sunday. The liaison checks the refill status and…

The liaison checks the refill status and sends the coverage question to a patient support advocate. She tells the advocate when the patient needs her next dose. Monday.

The advocate calls the insurer. The representative says the mail-order pharmacy …

Physician finance

Medical practice financial management needs a monthly close

Richard Perry, MBA

November 12, 2026Nov 12, 2026

Fall is decision season in physician practices. A senior partner starts talking about retirement. The practice considers adding an associate. Someone raises a second location. The clinical side of these decisions gets careful attention. The financial side often runs on…

That feeling usually comes from the bank balance. The bank balance is not a financial picture. It is a snapshot of one account on one day, and it was …

The Podcast by KevinMD

Why PCOS may start in the brain, not the ovary [PODCAST]

The Podcast by KevinMD

November 11, 2026Nov 11, 2026

A hormone doctors use to estimate how many eggs remain may also be acting on the brain. Oluyemisi Famuyiwa is a reproductive endocrinologist and infertility specialist. This episode is based on her article "The brain signal that drives polycystic ovary…

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Physician finance

Passive income for physicians is about time, not money

Howard Lau

November 11, 2026Nov 11, 2026

I used to make almost $500,000 a year. And I was broke. Not broke in the way most people mean. The money was there. I was broke in the only currency that actually matters: time. I was a consulting engineer,…

I used to make almost $500,000 a year. And I was broke.

Not broke in the way most people mean. The money was there. I was broke in the only currency that actually matters: time.

I was a consulting engineer, and in my busiest years I worked roughly 4,000 hours. Do the math on that: It’s about 77 hours a week, every week, all year. There were no real vacations, because when …

Physician finance

4 retirement income styles every physician should know

Stanley Liu, MD

November 11, 2026Nov 11, 2026

You know you're supposed to save and invest for retirement throughout your career. But what are you supposed to do with those savings once you're near retirement? Most physicians have no idea, and for good reason: Creating a sustainable retirement…

You know you’re supposed to save and invest for retirement throughout your career. But what are you supposed to do with those savings once you’re near retirement? Most physicians have no idea, and for good reason: Creating a sustainable retirement spending plan is far more complicated than saving for retirement. Planning your retirement finances is one of the most common reasons late-career docs will seek a financial planner.

The problem: A …

Health technology

Mental health chatbots for men need a plan for psychosis

Nicole Drapeau Gillen

November 11, 2026Nov 11, 2026

A recent STAT article describes startups betting that AI chatbots can reach men who won't walk into a therapist's office. The need is real. Men account for as much as 80 percent of suicide deaths, yet they are nearly half…

A recent STAT article describes startups betting that AI chatbots can reach men who won’t walk into a therapist’s office. The need is real. Men account for as much as 80 percent of suicide deaths, yet they are nearly half as likely as women to receive mental health treatment of any kind. A chatbot requires no appointment, no waiting room, and no admission out loud that something is wrong.

But …

Medical education

Why pre-med students with disabilities need mentors too

Madeline Pinches

November 11, 2026Nov 11, 2026

Ask any premedical student and they will tell you that the path to medical school is difficult, which is why we are encouraged to find mentors early. We seek out physicians who can show us what medicine is really like through shadowing and principal investigators who help us grow our skills of scientific inquiry. We even ask our peers and medical students for mentorship, asking questions such as what materials …

Physician finance

Why workplace sabotage in health care is fear, not malice

Dr. Soumya Padala

November 11, 2026Nov 11, 2026

Can we move the line between good and evil? Aleksandr Solzhenitsyn concluded that "the line dividing good and evil cuts through the heart of every human being." It is an idea I have heard Arianna Huffington return to often. Solzhenitsyn…

Can we move the line between good and evil? Aleksandr Solzhenitsyn concluded that “the line dividing good and evil cuts through the heart of every human being.” It is an idea I have heard Arianna Huffington return to often. Solzhenitsyn also believed that line shifts over a lifetime.

As AI reshapes every role and competition grows sharper, how do we push that line toward good? That line runs through the …

Physician voices

Why I didn’t scold my patient for a blood sugar of 527

Dr. Muhammed Jaffar

November 11, 2026Nov 11, 2026

The referral slip pushed across my desk during the busy afternoon outpatient department read like a quiet emergency: GRBS 527. Metformin 500 stat. Refer to diabetologist. Sitting across from me was a 42-year-old kindergarten teacher, her primary complaints being an…

In a crowded clinic, time is the rarest commodity. When confronted with a blood sugar of 527, the systemic pressure on a doctor …

Conditions and diseases

Chronic pain management needs more than a pain score

Kayvan Haddadan, MD

November 11, 2026Nov 11, 2026

Pain relief is rarely just about lowering a number on a 0-10 scale. It is the practical restoration of daily life: being able to walk the dog without stopping every block, sleep through the night, play with grandchildren, return to work or hobbies, sit through a movie, or simply feel like themselves again. Pain reduction becomes meaningful only when it translates into regained function, energy, sleep, and participation. That is …

Medical education

Should the best students still choose medicine in an AI era?

Dr. Ramy M. Mansour

November 11, 2026Nov 11, 2026

For generations, medicine has attracted the academically highest-achieving students in society, and for good reason. Medicine demands extensive knowledge, scientific reasoning, and the ability to make consequential decisions under uncertainty. But medicine is changing, and radiology offers a useful lens.…

But medicine is changing, and radiology offers a useful lens. Few specialties illustrate the relationship between scientific innovation and clinical practice as clearly. MRI didn’t emerge from clinical radiology; it came from physics, mathematics, and engineering. Modern medical AI draws on …

The Podcast by KevinMD

Doctor or nurse? The hospital assumptions that put patients at risk [PODCAST]

The Podcast by KevinMD

November 10, 2026Nov 10, 2026

Snap judgments happen all the time in medicine. Sometimes they are funny, and sometimes they put patients at risk. Christine King, a certified registered nurse anesthetist, has seen it from inside the operating room and from her sister's first oncology…

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Health technology

AI in health care must be built around the patient

Domenico Savatta, MD

November 10, 2026Nov 10, 2026

More than 20 years ago, I began performing robotic surgery when the technology was still unfamiliar to many surgeons and operating room teams. I started my career as an engineer before becoming a physician, so I was naturally drawn to the possibilities. Robotic instruments offered capabilities that conventional laparoscopic surgery could not easily reproduce. I saw an opportunity to perform complex operations with greater precision through smaller incisions.

But I learned …

Patient voices

Why the sickfluencer trend is about belonging, not attention

Sophie Shah

November 10, 2026Nov 10, 20262

Over the past few weeks, the legitimacy of the online disability community has once again become an object of public scrutiny. Prompted in part by the Telegraph's "How Having a Disability Became Cool," which attributes the increasing rate of chronic…

Over the past few weeks, the legitimacy of the online disability community has once again become an object of public scrutiny. Prompted in part by the Telegraph’s “How Having a Disability Became Cool,” which attributes the increasing rate of chronic illness in young women in part to lifestyle trends, the conversation has since metastasized across social media, where an ostensibly simple observation has given way to the much more contentious …

Conditions and diseases

Pelacarsen trial results: Lp(a) fell, heart attacks didn’t

Larry Kaskel, MD

November 10, 2026Nov 10, 2026

In August 2025, I wrote a piece for KevinMD titled "Are we repeating the statin playbook with lipoprotein(a)?" I was skeptical of the excitement surrounding a new generation of drugs that could lower Lp(a) by 80 to 90 percent. Not…

In August 2025, I wrote a piece for KevinMD titled “Are we repeating the statin playbook with lipoprotein(a)?” I was skeptical of the excitement surrounding a new generation of drugs that could lower Lp(a) by 80 to 90 percent. Not because I knew they wouldn’t work, but because nobody had demonstrated that lowering Lp(a) actually prevented heart attacks.

I had seen this movie before with HDL cholesterol. We spent years …

Health technology

Clinical AI scored 38 and 83 percent on the same questions

Vinson James, MD

November 10, 2026Nov 10, 2026

When Brian Hudes, MD, wrote "Why prompt engineering for physicians fails at 2 a.m." on KevinMD in September, he opened with my research. I appreciated that. Then he disagreed with my conclusion. I appreciated that even more. Let me explain…

When Brian Hudes, MD, wrote “Why prompt engineering for physicians fails at 2 a.m.” on KevinMD in September, he opened with my research. I appreciated that. Then he disagreed with my conclusion. I appreciated that even more. Let me explain what I actually found, and why I think we’re both right, just about different parts of the same problem.

What my study showed

I tested six AI models (ChatGPT, Copilot, …

Conditions and diseases

Esketamine for depression often works better by month 3

Ravi Singareddy, MD

November 10, 2026Nov 10, 2026

The most common pitch for esketamine has been speed: a nasal spray that can ease treatment-resistant depression within days, not weeks. But a new systematic review and meta-analysis in the Journal of Affective Disorders suggests the more useful clinical lesson may be the opposite. When the authors pooled nine observational studies of intranasal esketamine used in routine practice, they found that patients were about five times more likely to be …

Physician voices

Why doctors are miserable even after they make it

Lily Johnston, MD, MPH

November 10, 2026Nov 10, 20262

An excerpt from Disconnected: A Surgeon's Search for Healing in a Broken System. It's 2022, and at age thirty-eight, I have finally arrived at the summit. Seventeen years. That's how long it took to ascend this mountain: four years of…

An excerpt from Disconnected: A Surgeon’s Search for Healing in a Broken System.

It’s 2022, and at age thirty-eight, I have finally arrived at the summit. Seventeen years. That’s how long it took to ascend this mountain: four years of college, four years of medical school, seven years of surgical residency and research, and two more years of subspecialty fellowship in vascular surgery. Seventeen years, all leading to this moment. …

The Podcast by KevinMD

Changing careers in medicine? Ask yourself, not everyone else [PODCAST]

The Podcast by KevinMD

November 9, 2026Nov 9, 2026

Deciding on a career change can turn into polling everyone you know until someone says what you want to hear. Lauren Fine, an allergist-immunologist and founder of Permission to Change, felt that pull when she moved from mostly clinical work…

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Conditions and diseases

What personalized nutrition apps get wrong about glucose

Hana Kahleova, MD, PhD, MBA

November 9, 2026Nov 9, 20262

A patient without diabetes came in recently with her phone open to a chart. For three weeks, she had worn an over-the-counter glucose sensor and logged every meal in an app that promised a diet tuned to her biology. The app had flagged her morning oatmeal and her lentil soup as “spike foods,” so she had stopped eating both. Her labs were normal. What she wanted from me was permission …

Real physician voices, twice a week

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