Independent medical practice runs on operations

Physician Finance
April 30, 2026

Clinical training does not teach operational survival

Clinical training prepares physicians for clinical decisions. It rarely prepares them for the operational decisions that determine whether an independent practice survives the first three years.

A new practice owner may understand diagnosis, treatment, documentation, and patient communication, yet still be unready for payer enrollment, days to get paid, denial management, lease math, compliance deadlines, electronic health record (EHR) tradeoffs, and vendor evaluation. These decisions …

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Independent medical practice runs on operations

Why our health care system is failing chronic disease patients

Conditions and Diseases
April 30, 2026

Chronic disease is rising. Our system is not designed for it. This is not a controversial observation. Across clinical practice, research, and health system leadership, there is growing recognition that the burden of chronic illness is increasing and beginning earlier in life. What is less often acknowledged is that the structure of our health care system has not evolved at the same pace. In clinical settings, this shift is already …

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Why our health care system is failing chronic disease patients

Pediatric airway health and early childhood development clues

Conditions and Diseases
April 30, 2026

I was watching a medical drama recently when a physician identified a patient’s age, not from a chart, but from their teeth. The logic was simple. Worn enamel. Coffee staining. Fully erupted molars. It made for good television. But it also revealed something much bigger, something we rarely talk about in medicine, and almost never teach outside of it: The body is always leaving clues. We just do not know …

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Pediatric airway health and early childhood development clues

She was learning to keep others breathing while losing her own air [PODCAST]

Podcast
April 29, 2026
YouTube video

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

What happens when a woman is diagnosed with a rare, estrogen-sensitive lung disease at 28, in her first week of residency, with no roadmap for whether she can safely …

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She was learning to keep others breathing while losing her own air [PODCAST]

The cost of chaos in medical malpractice litigation

Physician
April 29, 2026

If anything represents the economic effects of medical malpractice, it is the following two cases. One involves a teenage mother and a major academic medical center. According to attorneys on both sides, the lawsuit is legitimate. However, its underlying merit is described as only 25.3 percent. Nevertheless, a legal strategy obscures this. The mother is 16 years old when she conceives and lives in a West African country until 17 …

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The cost of chaos in medical malpractice litigation

The rising cost of clinical placements for nursing students

Medical Education
April 29, 2026

For three months, I searched for a preceptor. I reached out to clinics, private practices, and community providers. I emailed offices, followed up, and posted in professional forums and Facebook groups. I approached the process with persistence and respect for the clinicians whose time I was requesting. Most of the time, I received no response. When I did, the answer was typically the same: not accepting students, already at capacity, …

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The rising cost of clinical placements for nursing students

Doctors leave California over a tilted legal system

Physician
April 29, 2026

As a practicing pain management physician in good standing in California, I’ve observed how accusations against physicians are actively encouraged, while meaningful accountability for false or exaggerated claims is largely ignored. This creates a system that rewards a “throw mud until something sticks” strategy for financial gain by patients, insurers, and other parties. This is precisely why I wrote the book Legal Mind in Medicine to highlight the legal …

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Doctors leave California over a tilted legal system

Integrity in medicine is quietly under strain

Physician
April 29, 2026

There is a sentence physicians have said for generations: “We’ll take good care of you.” It is a good sentence. Patients need to hear it, and most of the time it is said with sincerity. Yet there are moments, more now than before, when that sentence carries a second awareness alongside it. The emergency department is boarding. There may not be an inpatient bed for hours, sometimes longer. Tests, consults, …

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Integrity in medicine is quietly under strain

Surviving cystic fibrosis: a double lung transplant journey

Conditions and Diseases
April 29, 2026

I was eight months old when I was diagnosed with cystic fibrosis, a genetic illness that slowly damages the lungs and can affect digestion and other organs. My parents quickly learned the rhythms of it all: treatments, medications, and constant vigilance.

But here is the part people do not always expect: I still got to be a kid. I rode horses. I ran cross country. I went to college. I fell …

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Surviving cystic fibrosis: a double lung transplant journey

Why nature-based medicine is the future of health care

Medical Education
April 29, 2026

This month, 53 medical schools committed to requiring 40 hours of nutrition education. As the physician who co-taught the first U.S. medical school class in culinary medicine, with Mike Roizen, MD, founding director of the Cleveland Clinic Wellness Institute, I am proud that culinary medicine is now taught in roughly 80 percent of U.S. medical schools. I recognize this as a genuine win. But I have watched this story before, …

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Why nature-based medicine is the future of health care

How to negotiate a physician sabbatical in private practice

Physician
April 29, 2026

When I tell other physicians that I negotiated a sabbatical from private practice, a full semester abroad with my family, followed by months of extended travel, the reaction is almost always the same. It starts with disbelief, moves quickly to calculation (“But who covered you? What happened to your income?”), and ends, more often than not, with a version of: “I could never do that.” I understand the reaction because …

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How to negotiate a physician sabbatical in private practice

When a stomach bug is actually an atypical heart attack

Conditions and Diseases
April 29, 2026

A patient arrives in the emergency department vomiting. Not once or twice, but repeatedly, leaning over the bedside basin, pale and sweating, clearly miserable. Between episodes, he tries to explain what happened. Earlier in the day he felt completely fine. Then the nausea started suddenly, followed by vomiting, cramping, and a cold sweat that made his shirt cling to his back. By the time he arrived in the emergency room, …

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When a stomach bug is actually an atypical heart attack

6 signs of burnout in high-achieving students

Conditions and Diseases
April 29, 2026

The student sitting across from me didn’t think she was burned out. She had just made the dean’s list, locked in a competitive summer internship, and was running two clubs. She was sleeping four hours a night, had stopped texting friends back, and described feeling “nothing” when she opened her acceptance letter to a graduate program she had spent two years working toward. “This is just what college is supposed …

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6 signs of burnout in high-achieving students

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He declined routine X-rays and was denied a dental cleaning [PODCAST]

Podcast
April 28, 2026
YouTube video

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

What happens when a patient makes a reasonable, informed decision to skip a non-mandatory test and the system simply stops? Patient advocate Aaron S. Rosenberg shares how a routine dental visit became a …

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He declined routine X-rays and was denied a dental cleaning [PODCAST]

Why patient understanding is the missing metric in medicine

Physician
April 28, 2026

A patient nods. You explain the diagnosis. You review the plan. You answer questions. You feel like the visit went well.

“Any questions?” you ask.

“No, I am good.”

They leave. And if you are honest, there is a moment, sometimes fleeting, sometimes not, where you wonder: Did they actually understand any of that? As you know, you have to pick up the pace to see another patient. In modern medicine, we measure …

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Why patient understanding is the missing metric in medicine

Transforming nursing education with immersive technology

Health Technology
April 28, 2026

Nursing education is at a breaking point. In classrooms and clinical sites across the country, faculty are stretched thin while students struggle to get the hands-on experiences that build confidence for day one of practice. The result is mounting pressure to expand access without sacrificing quality. Programs must graduate nurses who are technically competent and truly practice-ready, in a profession evolving faster than ever. Striking that balance with lectures, clinicals, …

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Transforming nursing education with immersive technology

Pilot mental health is a safety issue, not a stigma

Physician
April 28, 2026

You know what it feels like to keep working and pushing yourself when you are tired, distracted, or maybe even burned out. It’s common across professions, and we rarely speak about it openly. We almost never think of it as a safety issue. But for airline pilots, that silence can put hundreds of lives at risk.

That is why I believe this belongs in a conversation among clinicians. Medicine is often …

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Pilot mental health is a safety issue, not a stigma

How high pressure destroys relational care in nursing

Conditions and Diseases
April 28, 2026

I am a registered nurse with 16 years of bedside experience, and I have come to understand a problem in health care that is rarely named directly: The conditions we work under shape what we are able to perceive. Care is still delivered. The chart is complete, the discharge is placed, and the bed opens. From the outside, the system appears to function, but something essential is missing, and the …

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How high pressure destroys relational care in nursing

Why Kennedy’s addiction treatment plan raises ethical concerns

Health Policy
April 28, 2026

The current U.S. Secretary of Health and Human Services, Robert F. Kennedy Jr., has consistently captured public attention with his actions and rhetoric, but one aspect of his public health agenda that has received comparatively little scrutiny is his proposed reconceptualization of addiction treatment, undergirded by his support for and stated intent to emulate Patrignano. Patrignano is an addiction treatment program in Italy where people who use drugs (PWUD) participate …

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Why Kennedy’s addiction treatment plan raises ethical concerns

Why mental health care in Nigeria needs a new approach

Conditions and Diseases
April 28, 2026

It started with a headache. At least, that is what she told the nurse. A middle-aged woman sat quietly in the outpatient clinic, her hands folded tightly in her lap. She had visited the hospital three times in two months complaining of headaches, fatigue, and body pains. Her blood pressure was normal. Her blood tests were unremarkable. Her physical examination revealed nothing alarming. Yet something was clearly wrong. After a …

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Why mental health care in Nigeria needs a new approach

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