AI in peer review should be a second reader, not a judge

Health Technology
September 10, 2026

I have often wondered why, among three reviews of the same biomedical research manuscript, one reviewer may dismiss nearly everything the authors have done, another may offer a moderate assessment, and a third may strongly favor publication. Human review remains essential, but human judgments can vary widely. Some disagreement is useful because reviewers notice different things. In other cases, the differences may reflect misunderstanding, fatigue, disciplinary preference, or bias. The …

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AI in peer review should be a second reader, not a judge

Sensory processing in autism and the brain’s volume control

Conditions and Diseases
September 10, 2026

For most of my life, I knew I was experiencing the world differently.

Before I understood the words someone was saying, I noticed subtle changes in their tone of voice. I registered the hum of fluorescent lights, the texture of clothing, faint odors that others seemed unaware of, and shifts in a room’s emotional atmosphere. My attention was drawn almost automatically to inconsistencies, patterns, and small details that often escaped those …

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Sensory processing in autism and the brain’s volume control

Overtreatment at the end of life is a spiritual problem

Conditions and Diseases
September 10, 2026

My name is Tony Grandelis. I’m an OB/GYN hospitalist, a medical educator, and a person in long-term recovery from substance use disorder. Through my brand Recovering Healthcare, I explore what the principles of addiction recovery (honesty, surrender, humility, community) can teach us about fixing a broken health care system. Recovery gave me something medicine never did: a framework for sitting with what cannot be fixed, for accepting what cannot be …

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Overtreatment at the end of life is a spiritual problem

Clinical trial retention starts with a kind conversation

Conditions and Diseases
September 10, 2026

Patients may not remember every lab draw, procedure, or study visit. But they will remember how they felt.

One of the greatest privileges of working in clinical research for more than twenty years has been meeting extraordinary people. Clinical research is often associated with science, data, and innovation. Those elements are essential. But there is also a deeply human side to this work. Behind every study, treatment, and medical advancement are …

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Clinical trial retention starts with a kind conversation

Clinical AI cannot reason over a billing document

Health Technology
September 10, 2026

Two good arguments about clinical AI have appeared here recently, and between them they have accounted for almost everything except the part that matters most.

Harvey Castro has argued that the real limitation is not the model but the context, pointing to the blood pressure entered three minutes ago and the allergy buried in yesterday’s note that the system cannot see. Miguel Venereo has argued that the record itself is fragmented, …

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Clinical AI cannot reason over a billing document

Frivolous malpractice lawsuits are a modern witch hunt

Physician
September 10, 2026

The 1690s were turbulent times in Salem, Massachusetts. It started as a grudge between Puritans and Anglicans in Salem Village. Most farmers were Puritans, and most business owners and merchants were Anglicans. Central to that grudge was the Reverend Samuel Parris, a strict Puritan. His sermons denounced the affluence and worldliness of those in Salem Village as the reward for being in league with the Devil.

Then in February 1692, a …

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Frivolous malpractice lawsuits are a modern witch hunt

Leaving medicine isn’t a loss, it’s a translation problem [PODCAST]

Podcast
September 9, 2026
YouTube video

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

Leaving medicine can feel like erasing 20 years of work. What if it isn’t a loss at all, but a language problem you can solve? Physician executive Shveta Gupta, a pediatric hematologist-oncologist, joins …

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Leaving medicine isn’t a loss, it’s a translation problem [PODCAST]

How doctors lose money investing: 6 failure modes

Physician Finance
September 9, 2026

I have been pitched investments in a doctors’ lounge, at a conference dinner, and twice in a specialty group chat. Every one of them came from another physician. That is not bad luck. That is the design.

This piece is about the specific ways physician money gets lost, and what actually works against each one. Not general advice about saving more. Named failure modes, with the fix for each. I have …

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How doctors lose money investing: 6 failure modes

How ADHD in physicians collides with constant evaluation

Conditions and Diseases
September 9, 2026

Many individuals drawn to a career in medicine possess a driven, high-functioning intellect that often masks concurrent manifestations of neurodevelopmental idiosyncrasies, most notably attention deficit hyperactivity disorder. While this profile often contributes to the grit required for clinical training, it also introduces a significant vulnerability: a heightened level of emotional variability and rejection sensitivity dysphoria.

The inherent nature of clinical practice creates a precarious environment for those with this neurobiology. We …

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How ADHD in physicians collides with constant evaluation

AI psychosis is not schizophrenia. The difference matters.

Health Technology
September 9, 2026

Psychiatry is now asking a question that would have sounded like science fiction three years ago: Should “AI psychosis” become a clinical diagnosis?

Researchers at King’s College London, led by doctoral fellow Hamilton Morrin, have just published a preprint examining more than a dozen cases in which sustained conversation with AI chatbots appears to have triggered or deepened delusional thinking. It follows the cases I’ve written about in …

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AI psychosis is not schizophrenia. The difference matters.

Remote wound monitoring works only with a clinical loop

Physician
September 9, 2026

As the saying goes: A picture may be worth a thousand words. In health care, it may spare a thousand words used to explain by telephone what “the incision seems more open,” “more red than I expected,” or “concerned that the wound is not healing right” means.

However, a photograph is not a diagnosis. Sending one is not, by itself, a treatment plan.

More than twenty years ago, after my fifth spinal …

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Remote wound monitoring works only with a clinical loop

Balance as a vital sign: 4 reasons to track it routinely

Conditions and Diseases
September 9, 2026

Physicians routinely track measures that can reveal changes in a patient’s health long before those changes become symptomatic. Blood pressure, heart rate, weight, and other familiar measures have earned a place in clinical care because following them over time provides information that can guide intervention. For an aging population, balance deserves similar attention because it can reveal changes in functional health before they result in injury or loss of independence.

Balance …

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Balance as a vital sign: 4 reasons to track it routinely

Who is left to supervise AI in low-resource settings?

Health Technology
September 9, 2026

As a frontline physician in South Sudan, I see approximately two hundred patients on call day across two public hospitals. Discussions about agentic AI often assume that every autonomous system will operate under the supervision of experienced specialists. That assumption reflects the reality of high-income health systems, but not mine.

In our pediatric referral hospital, the hematology-oncology service is staffed by only two hematologists. In the adult referral hospital where I …

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Who is left to supervise AI in low-resource settings?

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Clinical judgment matters more in the age of AI

Health Technology
September 9, 2026

The more capable AI becomes at answering clinical questions, the more important it is to ask whether we are asking the right questions. Medicine is not becoming less human; if anything, it is becoming more dependent on the human qualities it has always needed: judgment, responsibility, and the ability to act with care amid uncertainty. AI may change how information is delivered, but it does not decide what matters. That …

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Clinical judgment matters more in the age of AI

Local news and public health: the segment viewers missed

Health Policy
September 9, 2026

Local news has always been a mirror: imperfect, sometimes distorted, but still a reflection of what a community believes matters. In Jacksonville, that mirror has become increasingly fogged. Last night, it reflected almost nothing of public value.

For nearly twenty minutes, English-speaking viewers watched the demolition of an empty indoor mall, a structure long abandoned except for a megachurch occupying the old Belk store. The anchors narrated the fall of drywall, …

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Local news and public health: the segment viewers missed

Hiring medical office staff who actually follow through

Physician
September 9, 2026

There are two types of employees: the go-getters and the gunnas. The go-getters are those who have a clear vision of setting out to do something, giving it their all, and accomplishing it. They don’t need to be monitored. They are the first to arrive for a meeting or at work and the last to leave at the end of the day. They are self-starters and serve as role models …

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Hiring medical office staff who actually follow through

Why value-based care hasn’t lowered your medical bills [PODCAST]

Podcast
September 8, 2026
YouTube video

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

Everyone agrees health care should reward better outcomes at lower cost. So why hasn’t it happened? The answer isn’t payment models or policy. It comes down to the everyday choices individual clinicians make, …

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Why value-based care hasn’t lowered your medical bills [PODCAST]

Why a broken health care system keeps getting worse

Health Policy
September 8, 2026

“We have to ask ourselves whether medicine is to remain a humanitarian and respected profession or a new but depersonalized science in the service of prolonging life rather than diminishing human suffering.” Elisabeth Kubler-Ross

Over the course of my career, I have witnessed an inexorable decline in the quality of medical care that we, as physicians, render to our patients. There is a myriad of reasons for this sad development, some …

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Why a broken health care system keeps getting worse

Diagnosing psychosis starts with process, not content

Conditions and Diseases
September 8, 2026

A patient tells you that her deceased grandmother still visits her in dreams. Another believes that unseen spiritual forces influence his health. A third insists the government has implanted a device that broadcasts his thoughts.

Which patient is psychotic? The answer is that you don’t know. At least not yet.

One of the most common misconceptions about psychiatry is that delusions are simply “false beliefs.” In reality, experienced clinicians rarely diagnose psychosis …

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Diagnosing psychosis starts with process, not content

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