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Understanding the 4 models of health care: Where the U.S. fits

Physician

February 19, 2026

We are frequently told that our health care system is expensive. However, most of us, including physicians, have no notion about what the health care system really is, to judge whether or not we are getting our money’s worth.

There are four major structural models for a health care system:

The Beveridge model (socialized medicine): Health care is provided and financed by the government through tax payments (e.g., United Kingdom’s NHS).

…

What got you here won’t get you there: a physician’s guide to leadership

Harvey Castro, MD, MBA

Physician

February 19, 2026

You became a physician because you were driven. You studied longer, pushed harder, and tolerated pressure better than most. You needed to be right and usually were. That formula worked. It got you through pre-med, medical school, residency, and into practice. It earned you respect and built your reputation.

But at some point, quietly, subtly, that same formula can start working against you. I realized this after reading Marshall Goldsmith’s book, …

The 3-2-1 method: a doctor’s guide to keeping New Year’s resolutions

Anthony Fleg, MD

Physician

February 19, 2026

Welcome to the first weeks of the new year. A great moment to check in.

How are you doing? How are you feeling? Energy level?

The first days of the new year come with a lot of excitement and a lot of pressure.

Excitement for the sense of renewal and becoming better versions of ourselves. Excitement in putting the last year to rest and starting with a clean slate. Excitement at putting down …

Single-payer health care vs. market-based solutions: an economic reality check

Allan Dobzyniak, MD

Policy

February 19, 2026

Single-payer health care is generally defended with “heart-wrenching” virtue signaling divorced from any cost, economic, or financial reality. The idea that any scarce service or commodity is a right and therefore should be free is fanciful, but impossible. With an indebtedness of $38 trillion and growing, adding greater than $40 trillion as estimated for the cost of “Medicare for All” would absolutely drive the country into insolvency. Even without single-payer, …

Learning from patients: How a physician gained strength and resilience

Samantha Fernandes, MD

Physician

February 19, 2026

I remember. It is a gorgeous summer day as the sunlight streaks through the redwood canopy. My grip clenches the dangling rope. My stance wobbles on the itty-bitty circular disk. I am uncertain. Teeter-tottering, I plot my next move. It does not happen. I plummet. My harness transforms into a bucket swing, saving me from the forest floor. I sway in the pleasant breeze. I cannot finish the Level 1 …

Early screening saves limbs from silent vascular disease [PODCAST]

The Podcast by KevinMD

Podcast

February 18, 2026

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

Postdoctoral researcher Wei Zhang discusses the article “Peripheral artery disease prevention: Saving limbs and lives.” Wei explains how peripheral artery disease acts as a silent burden on the “life-highway” vessels of …

The “ethical canary”: How moral injury signals systemic failure

Courtney Markham-Abedi, MD

Conditions

February 18, 2026

For the past month and maybe longer, I have been waking up with pressure in my chest. It worsened in December and continued to worsen in the new year. I had identified it as anxiety, but felt it was of a different quality than my run-of-the-mill anxiety. This feeling was more anguished.

During the first week of January, I volunteered at a clinic, where I saw patients, assessed, and treated psychiatric …

Beyond Flexner: Why we must rethink medical training reform

Ravi Agarwala, MD

Education

February 18, 2026

Our current scheme and its overbearing credentialism is out of date and cannot keep up with a rapidly changing health care environment. Greater flexibility is needed for the well-being of patients and physicians alike.

Professional burnout and anticipated physician shortages continue to be highly debated topics. Indeed, the American Medical Association reports that 45 percent of physicians have symptoms of burnout, and the Association of American Medical Colleges anticipates a …

Rural emergency medicine in New Mexico: a physician’s firsthand account

Sarah Bridge, MD

Physician

February 18, 2026

Recently, I was asked to write about my experience as a rural emergency physician in New Mexico. The timing was uncanny: I am in the final shifts of my first job out of my emergency medicine residency on the East Coast, having spent more than four years working in emergency departments across western rural New Mexico, primarily within the Indian Health Service.

Summarizing this experience concisely feels impossible. Every emergency physician …

Trauma reactivation: Why news headlines trigger past abuse

Barbara Sparacino, MD

Conditions

February 18, 2026

She did not begin with the abuse; she began with sleep.

“I do not know why the news is bothering me so much,” she said. “I cannot turn it off. I feel on edge all the time.”

She was in her late 50s, successful, articulate, and with no prior trauma history documented in her chart. She insisted she was not “overreacting,” just “sensitive to injustice.” At the time, headlines were saturated with …

Ambiguous billing rules threaten every doctor in practice [PODCAST]

The Podcast by KevinMD

Podcast

February 17, 2026

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

Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “Why CPT coding ambiguity harms doctors.” Muhamad analyzes the landmark case of United States v. Ron Elfenbein, where …

Deprescribing in health care: Why less medication can be more

American Medical Association & John Whyte, MD, MPH

Meds

February 17, 2026

Every day, millions of Americans take medications to manage chronic conditions or prevent disease. Prescription drugs are vital tools in modern medicine, but in some circumstances, they can also lead to serious adverse drug interactions, diminished quality of life, and even life-threatening complications.

This is a complex issue with high stakes for patients. Older adults, in particular, are often prescribed multiple drugs by different doctors for different reasons. The Centers for …

What the folinic acid retraction means for autism treatment

Timothy Lesaca, MD

Physician

February 17, 2026

On January 29, 2026, the European Journal of Pediatrics formally retracted what had been the largest randomized clinical trial examining folinic acid as an intervention for autism. The reason, according to the journal’s notice, was direct: The study’s data did not support its published conclusions.

Originally released in 2024, the trial reported that 24 weeks of oral folinic acid therapy produced a “significant reduction” in autism symptoms among 77 children. In …

Value-based care data gap: Why metrics fail to reach the bedside

Ido Zamberg, MD

Policy

February 17, 2026

Value-based care represents one of health care’s most important transformations, driving hospitals and health systems to focus on outcomes that truly matter. To succeed in this model, organizations must track and improve their performance metrics continuously, making data health care’s most valuable currency. It is the foundation for improving patient care, reducing complications, and optimizing resource allocation. Yet despite the growing volume of performance metrics being collected, a critical gap …

The pause medicine never taught us to take

Mary Wilde, MD

Physician

February 17, 2026

As physicians, most of us do not need another Zoom webinar on burnout; we need open space.

Even at the earliest stages of training, we are made to feel that we cannot take a break. In a med school course I teach, I assigned a renewal activity with a short reflection. Some protested, but most expressed gratitude for an assigned pause.

Many admitted how afraid they felt to step away, to take …

The healing power of physician presence in modern medicine

Farid Sabet-Sharghi, MD

Conditions

February 17, 2026

I remember a patient who sat silently, staring at the hospital ceiling. She had survived a sudden illness that left her body weak and her spirit shaken. No tests, medications, or procedures could touch the despair in her eyes. In that moment, I realized something fundamental: The physician’s presence itself can be the most potent form of care.

Medicine, at its best, is more than diagnosis or intervention. It is an …

How naming grief can restore meaning in medical practice

Patrick Hudson, MD

Physician

February 17, 2026

Almost every day, a physician says to me some version of the same sentence.

It may sound like frustration about metrics. Or exhaustion. Or administrative opacity. But beneath it is something more elemental:

“I am grieving what I hoped medicine would be.”

When that sentence is spoken plainly, without defensiveness, something shifts.

The suffering moves from defect to meaning.

Grief, in existential thought, is not weakness. It is evidence of attachment. We grieve what we …

ATTR-CM screening: the missing link in heart failure diagnosis

Radhesh K. Gupta

Conditions

February 17, 2026

Robert felt winded climbing stairs. At 76, he attributed his fatigue to age. He thought his heart medications needed adjusting. His cardiologist agreed, tweaking his blood pressure pills. Six months later, Robert collapsed. In the ER, doctors found his heart walls dangerously thickened, stiff as leather.

A simple nuclear scan revealed the truth: transthyretin amyloid cardiomyopathy, or ATTR-CM, a progressive disease where misfolded proteins infiltrate the heart. Had anyone suspected it …

The honest broker in pediatrics: Building the medical home

Ronald L. Lindsay, MD

Physician

February 17, 2026

When I arrived at a regional military hospital, it was not a dispensary or a community clinic. It was the referral hospital for the northern tier missile and bomber bases, positioned just below the major medical centers. We were second tier, but the stakes were global.

Into that setting, I brought the medical home and a mini-developmental clinic. Through a program for exceptional family members, families from around the world found …

Waiting for the system to change causes burnout [PODCAST]

The Podcast by KevinMD

Podcast

February 16, 2026

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

Board-certified pediatrician and certified coach Jessie Mahoney discusses her article “Why doctors must stop waiting and reclaim their lives.” Jessie explains how medical training conditions doctors to view endurance as a virtue …

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