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If you have acne, irregular periods, and trouble with your weight, the cause may not be three separate problems. It may be one condition affecting your whole body. PCOS, long called polycystic ovary …
PCOS was never just about your ovaries [PODCAST]
Patients start glucagon-like peptide-1 (GLP-1) drugs expecting to think less about food. They did not expect to think less about alcohol. The nightly drink became easier to skip. Cigarettes felt less urgent. Cannabis, gambling, or compulsive shopping sometimes lost their pull. As “food noise” quieted, another possibility emerged: Perhaps these drugs were turning down craving itself.
At first, these reports might have seemed like coincidences. Instead, they sparked new research. Scientists …
Semaglutide and cravings: what the 2026 trial changed
Gun violence remains a significant public health and safety concern in the United States. Chicago and New York City are often referenced in national conversations about public safety. Both are highly populated and diverse cities that have histories of concentrated gun violence, neighborhood-level inequalities, and extensive violence-prevention infrastructure.
In 2025, Chicago experienced a 34.5 percent reduction in shootings compared to the previous year. Chicago had 1,471 shooting incidents …
Gun violence prevention is a neighborhood story
According to Wikipedia and most dictionaries, “moral agency” is an individual’s ability to make moral choices based on some notion of right and wrong and to be held accountable for these actions. A moral agent is someone “who is capable of acting with reference to right and wrong” and who is responsible for correcting their own errors.
As a health care educator with three decades of research experience in …
Moral agency in medicine is quietly disappearing
I hate how hard it is for doctors to get paid today. I know I’m not alone. I doubt there are any physicians or practice managers in the U.S. who feel like this current process of charting, coding, denials, quality measurements, and clawbacks is working well.
It’s still worth saying out loud though: I hate it. You probably hate it, too. The whole “revenue cycle management” world that we’ve come to …
AI medical billing could end the paperwork madness
Last month marked the fourth anniversary of Dobbs v. Jackson Women’s Health Organization, the Supreme Court decision that fundamentally changed reproductive health care in the United States, returning many parts of the country to a reality that most practicing physicians and many patients had never experienced. Since then, access to reproductive health care and even routine pregnancy care, like miscarriage management, is based not on medical evidence or clinical judgment …
Four years after Dobbs, the untold stories still matter
Early in the morning of December 13, 2023, I dragged myself to the computer at my kitchen island after a terrible night of interrupted sleep. While I had experienced neck pain and stiffness for four months, it was much worse on that particular morning. I tried to prepare notes for my clinic scheduled later that day. Although I knew my patients well, …
Administrative burden in primary care and the end of my career
A patient sees a short video promising to remove tartar at home. Another learns that bleeding gums can be “cured” with a particular oil. Someone with tooth pain orders a temporary filling kit online and postpones seeing a dentist because the pain briefly improves. As a dentist, I have seen how quickly a confident online claim can influence a patient’s decisions. Often, the patient is not being careless. They are …
Dental misinformation is now a patient-safety issue
I don’t know when things started taking the wrong turn.
There are moments when words refuse to come, when they arrive after the moment they are needed, or sometimes do not arrive at all. It is not that I lack thoughts. I have them. Too many, sometimes. But when they are demanded in a precise moment, when someone expects an explanation, a response, a justification, my mind becomes strangely distant from …
Why becoming a senior resident is so uncomfortable
A recent article in the Philadelphia Inquirer described a female psychiatrist whose license was revoked after the state medical board found that she had a years-long sexual relationship with a male patient she began treating at seventeen, while continuing to prescribe him a rotating regimen of up to twelve medications, including stimulants and benzodiazepines. The board also found that she prescribed medications to his mother and father, even though …
Sexual misconduct in psychiatry taints every prescription
Over the years I have seen this many times, as has any physician who has practiced long enough. Two patients come in with the same diagnosis, labs, pathology report, and treatment plan, whether managing a complex melanoma or a chronic inflammatory disease. Yet their bodies respond differently.
We spend our training learning to explain the disease and the drug, and build almost nothing around explaining why individuals respond so differently to …
What AI in medicine still can’t replace
“My mother is bipolar. My brother has OCD. I’m sure this runs in the family.” I hear some version of this in nearly every intake, and I understand why. Family history is a genuinely powerful tool in most of medicine. It helps estimate genetic risk and sharpen diagnostic reasoning. In psychiatry, it’s often treated as carrying that same evidentiary weight. Too often, it doesn’t earn it.
Disease broadly falls into two …
Family history in psychiatry: Ask why, not whether
Early in my clinical training, I learned to read a room before I read a chart. You learn which patients are frightened, which families are about to come apart, and which moments are one wrong word away from becoming physical. What I didn’t learn, what almost none of us were taught, was that being hurt at work would come to feel like part of the job.
That normalization is the real …
Workplace violence prevention is already your duty
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Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!
You keep getting sinus infections, so you keep getting antibiotics. What if the antibiotics are part of the problem? Franklyn R. Gergits is a board-certified otolaryngologist and fellowship-trained otolaryngic allergist with about 30 …
Why your sinus infections keep coming back, and antibiotics may be the reason [PODCAST]
“It’s not just the kids, it’s the parents.”
My sex education came in two forms: an abstinence jingle in middle school, and a sock on a banana in high school. My parents offered a third option: silence. Decades later, not only are individuals’ reproductive rights being stripped away, but reproductive health education in any form is threatened by the federal government at all levels, from elementary schools to medical residencies.
If we …
Sex education is for parents, not just kids
The New York Times reported on June 5, 2026, that new research suggests molecular screening with a 14-protein panel can identify patients who will develop lung cancer in intervening years, allowing prescription of an interleukin-1 beta inhibitor drug (Ilaris) that may be capable of preventing lung cancer. This potentially important development, based upon a report in the journal Cell on the same date, is worthy of publication, but it fails …
The conflict of interest behind a cancer screening test
This week, I wrote here about a lawsuit involving a man with schizoaffective disorder whose use of ChatGPT spiraled into a months-long psychiatric crisis, and about a new clinical framework for understanding how AI can catalyze, amplify, co-author, or become the object of a patient’s delusions. That piece drew on a single, dramatic case. New research published this week suggests the underlying problem is systemic, not exceptional.
Researchers Annika Schoene and …
AI chatbot guardrails are strong only for suicide risk
“I just don’t feel like myself lately.”
It is one of the most common opening lines in midlife primary care, and one of the least diagnostically useful on its face. The patient is forty-four, sleeping badly, irritable in a way she describes as unfamiliar, and struggling to hold a thought through a meeting. Her cycles are still coming, roughly. She has read about perimenopause and dismissed the idea, because she is …
Perimenopause misdiagnosis: what a normal lab result hides
The best person at your front desk gives two weeks’ notice on a Tuesday. It’s nothing dramatic, just a better commute and a job that pays a little more. Everyone wishes her well, and the seat gets filled inside a month.
What doesn’t get filled shows up in pieces over the following weeks. A patient lands in a slot that’s been blocked off for a year, because he gets anxious and …
Is institutional knowledge loss your staffing problem?
Every clinician can attest to the annoyance, stress, and worry that manifests when we think about paperwork. Even the likes of a snake oil salesman currently in charge of CMS, Dr. Oz, penned a piece noting this very real strain on physicians across the U.S. due to prior authorizations. Research has shown that physicians on average are spending up to 13 hours per week on this odious task and …
Medical frailty exemptions are the new prior authorization
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