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The words doctors use during fertility care can wound the patient sitting across the desk. “Failed cycle.” “Poor responder.” “Ovarian failure.” For a woman already carrying the grief of a child she has never had, those words can feel like nails in …
Why “failed cycle” and “poor responder” wound infertility patients [PODCAST]
America feels like the ultimate noncompliant patient.
We stabilize her, patch the wounds, manage the crisis, discharge with recommendations, and within four to eight years she is right back in the ICU on another freedom tangent that destabilizes the entire body of democracy again. The cycle repeats endlessly. Reactive instead of preventive. Fragmented instead of coordinated. Profitable instead of sustainable.
And honestly? The same dysfunction reflected in the country is reflected in …
America on life support: A hospital social worker reflects
Physician burnout is often discussed as if it begins and ends at work. Workload, documentation burden, moral injury, loss of autonomy: These contributors are real. But they don’t exist in isolation.
Physicians don’t shed cognitive load at the end of a shift. The vigilance, decision-making, and emotional regulation required in clinical practice often continue at home, especially inside marriage and family life. Yet relational health is rarely considered a physician well-being …
How physician burnout reaches into marriage
Last month, I clicked “I agree” on a software update for a tool I use in my clinical practice. I do this all the time. So do you. Most of us treat these agreements like airline safety briefings: just background noise before we get to work.
I don’t do that anymore. Here’s why.
Every AI tool coming into psychiatric practice, like the ambient scribe, documentation assistant, or the clinical decision support feature …
Clinical AI liability lands on you, not the vendor
Slow collections in an independent practice are usually treated as a billing problem. The vendor gets called. The workflow gets reviewed. The staff gets reorganized. The denial rate gets a quick check and is reported as a single number for the month, something between 8 and 12 percent. That headline number, by itself, is the wrong metric. A 10 percent denial rate that hides which payers are rejecting, which CPT …
Denial rate segmentation finds your real revenue leak
1. Medical journals are going the way of newspapers, as in “extinct”
Who remembers newspapers? Pre-smartphone compendiums of world and local events on paper that required reporters to investigate and inform?
When newspapers lost their classified ads, their financial fulcrum, to Craigslist, they lost their readers and reporters. No one could pay staff or printing or distribution without readers and advertisers, and the business model is otiose, especially because of the printing …
3 pharma conflicts of interest hiding in plain sight
“Eighty-six-year-old man dies of a stroke.”
It is the kind of sentence medicine writes cleanly, almost mercifully, as though a life can be folded into a diagnosis and quietly filed away. I have read sentences like that in charts, discharge summaries, death certificates. But this time, the man was my father.
His name was Herbert Nelson. Herb. Herbie. Brother Nelson. Elder Nelson. Mr. Nelson. Daddy.
He did not die alone in some forgotten …
Anchoring bias killed my father inside a stroke center
Years ago, I read about the sapeurs of Congo, men living with limited means who spent extraordinary care, money, and intention on clothing, color, elegance, and style. At first glance, it can seem irrational. It is not.
Dress, for them, is not vanity. It is dignity. It is self-definition. It is a refusal to let circumstance have the final word on identity. I have been thinking about that today.
Today is Juneteenth.
Today, …
Dignity in medicine starts with how we are seen
It was a hard week.
A colleague was suddenly gone, thirteen years of patients, of history, of complicated cases, and just like that, the rest of us were absorbing it. The calls. The messages. The patients showing up at my clinic needing someone. My own patients waiting longer. Notes to review that weren’t mine. Work landing on my desk that nobody planned for and nobody asked me about.
I kept my charts …
A hard week is not a verdict on a physician’s career
Offshore online gambling companies, operating from jurisdictions with lax oversight, have built a business model that thrives on easy access for minors while evading meaningful U.S. regulations. These platforms often rely on superficial age verification that fails to protect vulnerable youth, leading to widespread underage participation, addiction, and profound suffering for victims and their families.
Inadequate age verification: a sham that enables harm
Underage gambling thrives on offshore betting sites
Dear colleague,
I know exactly who you are. You are the one who has not missed a deadline since the third grade. You are the one who treats “triple board-certified” like a minimum requirement and “regional medical director” like a starting line. You are the one who has spent twenty years mastering the architecture of everyone else’s survival, while your own foundation is quietly crumbling.
But I have a question for you, …
Who are you when the white coat is off?
For years, food allergy families like mine were told the same thing: “Avoid the allergen and carry epinephrine.” Now, many walk into allergy clinics and hear something entirely different: “There are treatments that can help your child.”
What follows is often overwhelm, not relief.
As a psychologist working with the food allergy community, and as a parent who has sought out those treatments for my son, I have watched families try to …
The emotional weight of choosing food allergy treatment
A patient handed me his phone in clinic last week. He was 58, a runner, no known cardiovascular disease. “Doc, my WHOOP says my recovery has been in the red for two weeks. Should I be worried?”
Ten years ago, I would have politely deflected and ordered an echo if I felt the visit needed a deliverable. Today, I look at his screen. Because his wearable was telling me something his …
How to use patient wearable data in cardiology visits
Most applied behavior analysis (ABA) practices are not lacking data. If anything, they have too much of it. The challenge is pulling it together to get a complete picture of client care, determining next steps, and maintaining compliance. Information lives in different, siloed systems. Getting the information you need often means exporting reports, manually reconciling numbers, and trying to connect the dots. By the time that work is done, the …
How AI is reshaping applied behavior analysis care
For decades, millions of women have walked into clinics, described a complex web of physical and emotional symptoms, and walked out with a diagnosis of polycystic ovary syndrome (PCOS). This condition affects an estimated 170 million women globally during their reproductive years. It is one of the most common endocrine disorders in women, affecting one in eight globally. Yet, the name we have used for it is fundamentally flawed.
The term …
What the polycystic ovary syndrome name change means
My friend Barry has money galore that makes people assume he shouldn’t have any problems at all. He runs a thriving real estate business, owns multiple homes, collects cars, spends weekends on his boat, comes from a family most people would envy, has friends, and can buy expensive tchotchkes, little throwaway things he could replace without a second thought. On paper, he has everything. But every time I saw him, …
Loneliness in successful men hides behind abundance
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!
Patients are being cut off from medications they need, doctors are afraid to prescribe, and the reason traces back to political donations most Americans never see. Richard A. Lawhern, health care educator and patient advocate, joins us to explain how lobbying money …
Dark money is writing your health care laws [PODCAST]
3 a.m. was the time I witnessed a case that changed the way I think.
He came in complaining of epigastric pain. He had eaten a whole chicken that night, a heavy meal, a simple explanation. The residents in the emergency department, exhausted at the end of a 15-hour shift and overwhelmed by the crowd of patients around them, gave him an IV H2 blocker and left him for monitoring. He …
How anchoring bias in medicine missed a heart attack
Food allergy has long been one of the few life-threatening medical conditions that society still treats as entertainment. For years, it has been the punchline in comedies. More recently, it has appeared as a convenient murder weapon in television dramas and thrillers. Now, in a recent comedy series, viewers are presented with something arguably just as dangerous: a storyline built around nearly every major misconception the public holds about food …
Why a Hulu comedy’s food allergy myths are dangerous
When I started earning a real income as a surgeon, I was thirty-two years old and financially illiterate. Nobody had taught me anything about money. Not medical school. Not my mentors. Not the hospital. Not the senior surgeons I admired.
I knew how to stop bleeding. I did not know how compound interest worked.
That personal anecdote is not the point. The point is that it is not personal at all. It …
The physician financial literacy gap nobody addresses
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