3 choices that protect physicians in the attention economy

Physician
September 14, 2026

Medicine has developed a new mental health illness of the “attention economy.” The term was introduced by psychologist and Nobel laureate Herbert A. Simon, who argued that an abundance of information creates a scarcity of attention, making human attention an increasingly valuable resource. Physicians always depended on attention to the patient, trainee, colleagues, and the required attention to quiet work of becoming wiser. Yet professional life increasingly unfolds within an …

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3 choices that protect physicians in the attention economy

Medical ethics principles do not decide hard cases

Physician
September 14, 2026

“I know the treatment probably won’t work,” a patient nearing the end of life tells the doctor. “I want to try anyway.” The patient understands the risks but still hopes for a little more time. The physician wants to honor that hope while worrying that side effects could make the patient’s remaining days more painful. If the treatment requires resources in short supply, other patients’ needs make an already difficult …

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Medical ethics principles do not decide hard cases

How physician resilience is built in a busy pain clinic

Conditions and Diseases
September 14, 2026

Walk into any busy pain clinic and the weight lands before you sit down. The pages never stop. The waiting room is packed with people who have already been through too many doctors. Chronic suffering hangs in the air. And that is only the visible load.

Beneath it sits a quieter, more relentless set of pressures. Insurance companies keep cutting rates. Staff feel the squeeze of financial hardship and rightly expect …

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How physician resilience is built in a busy pain clinic

Palliative care in the ICU: what the metrics never count

Conditions and Diseases
September 14, 2026

“I called palliative care because I needed to free up the bed. Otherwise, I could have taken care of this dying patient myself.”

The ICU attending said it standing at the nurses’ station, thumbing through a chart on a rolling laptop cart, already moving toward the next name on his list before I could answer. Down the hall, monitors kept their steady rhythm. Somewhere behind him, a family was gathered around …

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Palliative care in the ICU: what the metrics never count

Abortion bans and intimate partner violence rise together

Conditions and Diseases
September 14, 2026

Pregnancy is a well-documented risk factor for intimate partner violence (IPV), with homicide reported as a leading cause of death for pregnant and postpartum women in the United States. As abortion policy has shifted in the wake of Dobbs v. Jackson (the ruling that overturned Roe v. Wade), researchers have begun examining how abortion access intersects with IPV in a post-Roe world. The sudden changes in abortion access have …

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Abortion bans and intimate partner violence rise together

Why CDC opioid guidelines get the overdose data wrong

Conditions and Diseases
September 14, 2026

On Wednesday, September 9, 2026, the author spoke briefly at a hybrid conference conducted by the Reagan-Udall Foundation for the U.S. Food and Drug Administration in Washington, D.C. This was only the most recent such “listening session” conducted over a ten-year period. And from the first government speaker onward, the meeting reflected many of the historical biases and misdirection of U.S. health care agencies with respect to the so-called …

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Why CDC opioid guidelines get the overdose data wrong

Supplement country-of-origin labels hide the real source

Conditions and Diseases
September 14, 2026

We previously discussed the certificate of analysis myth and economically motivated adulteration in the dietary supplement industry. This article focuses on the basics of how the supply chain of dietary ingredients works and why it is critical for clinicians always to consider the possibility of supplement-induced adverse side effects such as herb-induced liver injury (HILI).

The surging interest in dietary supplements over the past few decades reflects a positive shift …

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Supplement country-of-origin labels hide the real source

Why clinical AI limitations are not a physician problem

Health Technology
September 14, 2026

The most consistent advice physicians receive about clinical AI is that we should be more careful with it. Verify the output. Treat it as a draft. Structure the input. Build verification into practice as the defining skill of the coming decade.

All of this is good counsel. None of it addresses the problem the same authors have already correctly identified.

Harvey Castro made the diagnosis on this site in May 2025, writing …

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Why clinical AI limitations are not a physician problem

Monetize clinical expertise without becoming an influencer

Medical Education
September 14, 2026

Every nurse, pharmacist, PA, and physical therapist in the country has to complete continuing education (CE) hours to keep their license. Those courses don’t write themselves, and accreditation rules mean they can’t be written by just anyone. They have to come from a clinician with the credentials to back up what’s being taught.

That’s a standing demand for physician expertise. Most physicians have no idea they qualify.

The obvious thing first: Your …

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Monetize clinical expertise without becoming an influencer

Doctors were told to be blind to the cost of care [PODCAST]

Podcast
September 13, 2026
YouTube video

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

He counts four wounds in American medicine. Patients rarely bring up the first one, which is what health care costs. Narinder Singh Parhar is a physician with more than three decades in internal …

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Doctors were told to be blind to the cost of care [PODCAST]

How AI can cut administrative burden and wait times

Health Technology
September 13, 2026

Health care in America is broken. We have an aging population that requires complex, ongoing care. We have rising costs. We have a workforce of clinicians who burned out. We don’t have enough clinicians. Today, the average wait time to schedule a new physician appointment in a major U.S. city is 31 days.

That is an entire month of waiting. For a patient managing a chronic condition, a 31-day wait …

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How AI can cut administrative burden and wait times

What sepsis in The Pitt gets right, and what it misses

Conditions and Diseases
September 13, 2026

In my free time, I try not to consume too much work-related content. When you’re in a medical business, manufacturing devices used for sepsis and septic shock patients, the last thing you want is to be reminded of sepsis outside of work. So I was very surprised when I found myself binging The Pitt all weekend. I think there’s a reason why it has become the rare medical drama that …

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What sepsis in The Pitt gets right, and what it misses

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A poem for anyone tired of productivity culture

Physician
September 13, 2026

abandoning ship

swim with the gentle undulations
of our stardusted oceans
as they sensitively surrender
drops of dew up
to the contemplative clouds
to convey ancient intricacies
in the dew’s quiet rest, buoyed patiently by petals who also must obey the call of gravity.

my dear mechanical world
(welded so clumsily by ego)
how blindly naive
your race
neglecting truths
engendered by beauty,
insisting instead that
the weight of time
is measured in capital.

you employ
productivity and efficiency
to justify life
proclaiming ignorantly
that sitting still
serves selfishness,
sloth,
and a stupored mind.

performative …

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A poem for anyone tired of productivity culture

Hurricane season is a fifth season, and medicine has to plan for it [PODCAST]

Podcast
September 12, 2026
YouTube video

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

In South Louisiana, hurricane season is treated like a fifth season of the year. Angela C. Johnson explains what that means for physicians and patients. She is an internal medicine physician and member …

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Hurricane season is a fifth season, and medicine has to plan for it [PODCAST]

AI governance metrics need a door-to-balloon time

Health Technology
September 12, 2026

During the following year, in one of the hospitals, an algorithm will be automatically taken out of service. Either the sepsis model will drift below the performance level at which it was approved, or the monitoring process will detect the tool failing for one subgroup of patients even though the overall figures remain satisfactory, and the system, which was designed to do just that, will suspend the model and wait …

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AI governance metrics need a door-to-balloon time

Charitable giving for physicians: 7 strategies for 2026

Physician Finance
September 12, 2026

Americans give hundreds of billions of dollars to charity each year, making philanthropy a defining feature of our national culture. That generosity benefits more than the organizations and communities receiving support: Research suggests that giving can also improve the donor’s happiness, sense of purpose, and connection to others. Our government actively encourages this behavior through charitable tax deductions and other incentives, reflecting a longstanding public-policy judgment that private generosity serves …

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Charitable giving for physicians: 7 strategies for 2026

Post-stroke pain management: what the 2026 guidelines say

Conditions and Diseases
September 12, 2026

Pain management is rarely a blanket approach. Effective relief depends on the specific type of pain, its underlying mechanism, the patient’s comorbidities, age, functional goals, and overall clinical context. This principle is especially important after stroke, where pain is common, often under-recognized, and can significantly hinder rehabilitation, sleep, mood, and quality of life.

Stroke survivors experience several distinct pain syndromes. Distinguishing them matters because treatments differ.

Central post-stroke pain (CPSP)

Central post-stroke pain …

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Post-stroke pain management: what the 2026 guidelines say

mRNA hype moves faster than the evidence behind it

Medications
September 12, 2026

mRNA technology may be both a remarkable scientific tool and a very effective marketing machine. Those are not mutually exclusive. The challenge is distinguishing a promising platform, a useful treatment, and a product promoted beyond what the evidence can support.

In early 2020, COVID-19 was frightening. We did not know how readily the original strain would spread or how much illness and death it would cause. We soon learned that risk …

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mRNA hype moves faster than the evidence behind it

The sweet spot before physician financial independence

Physician Finance
September 12, 2026

Many physicians believe they can’t escape burnout or an unsustainable career until they’ve become financially independent. Thankfully, it’s not true.

The idea of financial independence (FI) is simple: build enough wealth such that earned income becomes optional. For financial planners, financial independence is a mathematical problem to solve. I might be able to run your numbers in a Monte Carlo analysis and demonstrate you have, say, an 84 percent chance of …

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The sweet spot before physician financial independence

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