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Your ER doctor has about 25 minutes to figure out your medical history and decide what to do next. Hamad Husainy, an emergency physician and physician executive, explains why so much of that …
Why your ER doctor doesn’t know your medical history [PODCAST]
During my pediatrics rotation, I met a 13-year-old girl with obesity. She was trying to follow her doctor’s advice to eat healthier and exercise more, but it was tough: She lacked access to a gym, her neighborhood lacked sidewalks, and local traffic was fast and busy. It was not safe for her to walk or rollerblade alone, despite her motivation to be more active.
Her problem is a common one in …
The built environment is shaping our patients’ health
I am a proud Pakistani Hoosier.
My father immigrated from Pakistan in 1992 in search of a better life than what was possible back home. After moving around for work in those early years, my parents settled outside Indianapolis when I was four years old, and Indiana has been home ever since. As I now pursue my medical education, I find myself thinking often about the two places that shaped me …
From Pakistan to Indiana: climate change and patient health
From 1992 to 1995 I was a GI fellow. Nothing on the market made clinical sense for endoscopy reporting. The tools available were designed by people who had apparently never performed a procedure or written a note for one. I met a colleague in Australia, and together we built one of the first Windows-based endoscopy reporting systems in the country.
Microsoft Access. It worked.
It worked well until the United States moved …
The case for an AI-native health care platform
We all saw the report on early clinical departure. Women are leaving medicine at age 45.8. A senator immediately replied that we needed to be more selective and implied that medical school applicants should accept 30 plus years in a career that is crumbling under our feet.
We know the data. Women physicians have higher burnout than male physicians, and we also know that women physicians have double the suicide …
10 ways to keep women physicians from leaving
Health care leaders often believe organizational struggles are driven by resistance to change. When initiatives fail, engagement declines, or operational performance weakens, the explanation frequently centers on physician pushback, burnout, staffing shortages, or financial pressure. But after years working in complex health care environments, I’ve come to believe many execution failures begin somewhere less visible and far more dangerous: the breakdown of trust between physicians and leadership.
In health care, trust …
Physician trust in leadership drives health care execution
Recent discussions about the employment prospects of PhD graduates in India prompted me to reflect on a broader question that I have considered for many years. India has expanded higher education dramatically over the past several decades, including medical education, doctoral training, and other professional programs. Yet expansion alone does not automatically translate into educational quality, research capacity, clinical excellence, or meaningful career pathways for highly trained graduates. The question …
Has higher education in India kept its promise?
Two people sit in an exam room. One has an illness that will end their life. The other knows. Neither wants to say it out loud, so neither does. The conversation drifts toward next steps (another scan, another line of therapy, another visit on the calendar), and both leave the room feeling that it went well.
This is not a thought experiment. In 2012, the New England Journal of Medicine published …
The collusion in discussing prognosis with cancer patients
We all know the feeling of being in a stressful situation when the body’s fight-or-flight response kicks in. Your palms begin to sweat, your heart pounds, and your blood pressure rises as your brain signals that something may not be safe.
This response can be incredibly helpful when you need to respond to a real threat. However, when the body remains in this heightened state for too long, it can make …
5 ways to calm fight or flight insomnia at bedtime
One of America’s largest and most influential doctor groups earlier this year advised their members to stop conducting surgical interventions on minors who experience gender dysphoria.
In a new position statement, the American Society of Plastic Surgeons noted that “there is insufficient evidence demonstrating a favorable risk-benefit ratio” for those interventions. This announcement represents a watershed moment for the American medical establishment, one that could help spare thousands of vulnerable children …
Pediatric gender transition needs evidence, not ideology
For thirty-five years, I was a practicing vascular surgeon in a four-person private vascular surgery group. For thirteen years, I also served as chairman of surgery for a large health network.
I sat in morbidity and mortality conferences and watched experienced surgeons present cases that quietly revealed patterns. I looked at internal scorecards and noticed which names appeared on the better side of the outcomes curve and which on the worse …
Surgeon outcomes data is no longer ours alone
In April, President Trump, with psychedelic advocates HHS Secretary Robert Kennedy, Jr. and podcaster Joe Rogan at his side, signed the “Accelerating Medical Treatments for Serious Mental Illness” executive order, which dramatically decreases some drug approval times. FDA Commissioner Makary promptly issued priority review vouchers to companies that make psilocybin and the Ecstasy chemical cousin methylone.
Many public health professionals are surprised at how fast the move to legalize Schedule 1 …
The corporate money behind psychedelic drug legalization
Kevin Pho has spent two decades making one argument to physicians: Your online reputation does not manage itself. Patients Google you before they call your office. What they find shapes their decision before you say a word. The solution, as he has consistently framed it, is to create content, to claim the top listings rather than leaving them to chance.
That advice is correct. It is also, in one specific and …
You won the lawsuit. Search still says you lost.
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There was a time when longevity in nursing was something to be proud of, something that reflected commitment, growth, and a deep dedication to patient care. But somewhere along the way, that narrative has shifted. It has become increasingly unsettling to watch longevity in nursing, commitment, loyalty, and experience, be treated not as an asset, but as something to be managed, limited, and at times, even quietly penalized.
Many of us …
Experienced nurse pay is leadership, not a liability
The illusion of safety
“I suffer from depression and my boss told my coworker behind my back that I was using it as an excuse to be lazy, and that if I just listened to some Taylor Swift I’d feel much better.”
– Junior Associate
Anyone with an HR voice will tell you that one of the most important steps you can take to protect your well-being at work is to talk to …
Workplace mental health is a culture problem
There was a time when a SOAP note meant something simple and important. It was a shared language among clinicians: Subjective, Objective, Assessment, Plan, designed to capture what actually happened in the exam room and to communicate it clearly to the next physician who would care for the patient. It was, at its best, a tool for continuity, safety, and professional accountability.
That time is slipping away.
Over the past two decades, …
AI medical notes are losing the patient story
I don’t think many physicians would disagree that EMR usability is a patient safety issue. And yet, health systems seem perfectly happy to place 100 percent of the blame for any glitches on physicians.
I was recently involved in a situation where a physician was being blamed for an obvious system error. The physician in question is an experienced and dedicated pediatrician, well known in the area for her compassion …
EMR errors get blamed on physicians, not systems
I did everything the system asked of me, and much more.
I sought help for a treatable medical condition. I laid down every ounce of pride I had and accepted accountability. I completed every requirement, rebuilt my practice, and spent years proving, through safe, competent care, that recovery works.
And still, my past follows me into every room.
In health care, we tell clinicians to speak up, to seek help early, to protect …
Permanent discipline punishes nurses in recovery
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!
The same instinct that makes you a careful clinician may be the one sabotaging your financial future. Cardiologist and fiduciary financial planner Stanley Liu joins this episode to explain why physicians’ deeply trained …
Why the risk aversion that makes you a good doctor wrecks your finances [PODCAST]
In health care, we often describe what we are experiencing as system failure. We point to clinician burnout, staffing shortages, administrative burden, and the growing distance between those delivering care and those designing it. We talk about breakdowns in communication, gaps in safety, and the increasing strain placed on a workforce asked to adapt faster than it can recover. The language is familiar. The concern is real. But the conclusion …
Health care system design isn’t failing, it’s working
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