Physicians writing on KevinMD about the diseases they treat and the people who have them: cancer and its screening arguments, pain and the drugs that treat it, diabetes and the obesity argument, mental illness and who gets treated for it, and the decisions at the end of a life. Five maintained records draw on this archive: Cancer: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, End of life: what physicians say, in their own words, Diabetes and obesity: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.
Obesity affects one-third of the adult U.S. population, including physicians, and is estimated to cost $147 billion annually. How does the Body Mass Index (BMI) of the physician affect the relationship with patients and the care provided? According to a study in Obesity magazine, “Understanding physician body weight as a possible barrier to obesity care is critical given the important role physicians can play in helping patients manage or lose …
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How physician obesity affects patient care
Oncology has long been described as a discipline ruled by biology. Tumor pathways, mutational signatures, margins, and survival curves dominate how we measure, categorize, and predict outcomes. We are taught early in training that tumor biology is king, and much of our decision-making revolves around this truth. Yet, after years of practicing surgical oncology in India, I have learned that biology alone rarely determines the fate of my patients. Culture …
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When culture has the final word in cancer care
I began my career as a nurse practitioner in primary care, where patient visits are often limited to 15 or 20 minutes to manage complex conditions like hypertension, diabetes, and COPD. What struck me was how often these medical issues came with a psychological overlay like depression, anxiety, panic attacks, and trauma. That shaped the course of treatment as much as lab results or medications. The pace of primary care …
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A nurse practitioner on leaving the medical machine
A system hemorrhaging talent: the scale of the crisis
The global health care system is teetering on the edge of a catastrophic workforce deficit, with the World Health Organization projecting a shortfall of 11 million health workers by 2030. Nowhere is this crisis more acute than in the behavioral health sector, which is not merely losing talent but hemorrhaging it. The time for action is not just now, it’s yesterday.
Community …
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The mental health workforce is collapsing
Caring for someone with Alzheimer’s is not just exhausting; it is emotionally disorienting. You lose pieces of someone you love, slowly, in a thousand small ways. And while books, doctors, and websites talk about the medical side of Alzheimer’s, there are things they do not prepare you for like the guilt, the grief, the unexpected laughter, and how much it can break your heart. If you are in this role …
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7 things no one tells you about being a caregiver for someone with Alzheimer’s
Behind every prescription safely dispensed stands a pharmacist making dozens of clinical decisions under mounting pressure. What happens when that pressure becomes unbearable? When the professionals who are the last line of defense against medication harm are pushed to their breaking point, patient safety breaks with them. This crisis is real and it is often invisible.
The invisible epidemic
Surveys and workplace reports repeatedly show that large numbers of pharmacists experience burnout …
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Why pharmacist burnout is a patient safety issue
I am writing this on a flight, somewhere between Los Angeles and Boston. Next to me, a young couple is tending to their ten-month-old baby: passing a bottle, bouncing her when she fusses, trading weary but tender smiles. Their world is diapers and nap schedules, the endless rhythm of caregiving.
My world today looks very different. I am taking my youngest child to college. With this trip, all three of my …
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The paradox of letting your children go
Health care often talks about burnout as if it were a recent discovery. But for many clinicians, the exhaustion they feel did not begin with them. It was inherited, passed down through a system that normalizes overwork, silence, and sacrifice as the price of practicing medicine.
Every generation of providers has heard the same message: This is just how it is. Long shifts, missed meals, unsafe staffing ratios, and silence in …
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The generational trauma of the health care system
Burnout isn’t a personal shortcoming; it’s a system warning. A peer-reviewed Annals of Internal Medicine cost estimate pegs the annual bill for physician burnout near $4.6 billion in turnover and reduced clinical time, an operational risk with human consequences. As an executive who works across clinical and administrative teams, I see this as both a human tragedy and an operational failure that demands leadership attention. The good news: There …
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Leadership levers to reduce burnout
I am the mother of a 37-year-old son diagnosed with autism and Crohn’s disease. He also has serious intellectual and developmental disabilities (IDD), requiring round-the-clock care and support. I also have a medical history of PCOS (polycystic ovary syndrome) and took fertility medication to conceive him. For years, I have watched the autism diagnosis rate climb while public discourse remained fixated on single causes or stigmatizing narratives. But we are …
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A mother’s question about PCOS and her son’s autism
As a pharmacist, I have spent years behind the counter filling prescriptions, answering questions, and giving quick consultations. Most of my days felt routine: scanning barcodes, checking drug interactions, and moving from one patient to the next. But one encounter changed the way I saw my profession forever.
It was a quiet afternoon when an elderly woman walked into the pharmacy. She handed me a prescription for blood pressure medication, but …
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A pharmacist’s lesson in patient care
When a teenage boy develops sudden testicular pain, it should always be treated as an emergency. The most urgent concern is testicular torsion, where the spermatic cord twists and cuts off blood supply to the testicle. In these cases, every hour counts; waiting too long can mean permanent damage, loss of the testicle, and even future fertility problems.
Torsion happens most often in boys and adolescents because the testicles grow …
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Why sudden testicular pain is an emergency
Cap’n Crunch never held a true naval rank; he was called “Cap’n” because he was the highest-ranking person present, not because he replaced someone more qualified. In some clinics, it is the same: the system is built so you rarely, if ever, see a real doctor. Whoever is around with the right badge simply gets the title and responsibility by default. This “Cap’n Crunch” phenomenon is not limited to one …
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The Cap’n Crunch philosophy of medicine
Recent research has revealed that atypical migraine can influence tinnitus in some individuals. Some patients report significant improvement in tinnitus when treated with migraine-specific therapies. But how can someone know whether migraine is a factor in their tinnitus, and what treatments might help?
Understanding migraine beyond headaches
Migraine is a complex neurological disorder, not just a severe headache. Some people experience migraine without ever having a headache. It is thought that inherited …
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The surprising link between migraine and tinnitus
We have all been told the story: High cholesterol leads to heart disease, and statins are the magic bullet. The JUPITER trial, published in The New England Journal of Medicine in 2008, became one of the most heavily publicized pieces of “proof” supporting that belief. It claimed that rosuvastatin significantly reduced heart attacks, strokes, and cardiovascular events, even in people with normal LDL cholesterol levels.
But what if I told you …
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Rethinking the JUPITER trial and statin safety
South Asians are one of the fastest-growing immigrant populations in the United States, yet their health experiences remain poorly understood, often falling into broad “Asian American” categories that erase unique needs. The result is persistent inequities: South Asians face disproportionately high rates of conditions like diabetes, heart disease, and PCOS, while also contending with cultural stigma, language barriers, and limited representation in the health system.
As a public health professional and …
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Why culturally compassionate care matters for South Asian communities
I was at one of the lowest points of my medical training. I had just finished my second-year exams. The stress had left me feeling hollow, anxious, and utterly drained. It was in this fragile state that my own body turned against me.
It started with a fever that would appear every evening. I told myself it was just the change of season. I took paracetamol and tried to ignore it. …
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My rare disease was my greatest teacher
When you step into medical training, you’re often told, both implicitly and sometimes even explicitly, that certain parts of you don’t belong. Sensitivity, doubt, or even just being messy and human can feel like liabilities in a culture that prizes efficiency, certainty, control, and always “having the answer.” Many physicians I work with in therapy describe learning early on to “toughen up,” to silence the softer, more questioning sides of …
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Reclaiming the human parts of a physician
When I received an invitation to a webinar titled “Special Session on a New Autism Risk Test,” I expected a discussion on screening strategies or intervention innovations. Instead, when I researched the company and reviewed its website, I discovered a pitch for a punch-biopsy-based lab test marketed as a way to detect autism risk in newborns as early as two days after birth.
As a nurse practitioner who treats autistic patients, …
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The ethics of marketing unproven autism tests
