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.
For decades, neurology has told us that Alzheimer’s disease is caused by toxic proteins (amyloid plaques and tau tangles) that clog the brain. Pharmaceutical companies have poured billions into anti-amyloid drugs designed to wash them away. The results? Repeated failures, high-profile disappointments, and a handful of marginal approvals with no meaningful improvement in patients’ lives. Sound familiar? In cardiology, we’ve built an entire industry on lowering LDL cholesterol. Statins move …
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Is Alzheimer’s an infectious disease?
It should come as no surprise that GLP-1 receptor agonists have revolutionized the management of obesity and metabolic syndrome. These drugs have shown extraordinary promise in regulating appetite, promoting weight loss, and improving blood sugar control. Nearly one in eight adults (twelve percent) have taken a GLP-1 agonist, and forty-three percent of adults diagnosed with diabetes have used these therapies, numbers likely to have increased further in the last year …
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Life after GLP-1s: How to sustain weight loss
What if recovery from depression was not only about reducing symptoms, but about rekindling a person’s inner spark?
During my years as a Navy nurse in mental health, I witnessed countless people navigating the heavy fog of depression. Many were offered medication, therapy, or structured activity schedules. These approaches saved lives and improved outcomes. Yet sometimes, despite best efforts, patients still felt like they were going through the motions, managing symptoms …
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A new framework for depression recovery
Money management and career planning are considered life skills (but the skill that shapes health self-advocacy) deserves the same status. Without it, care suffers. My family member was recovering from surgery, facing medication safety concerns, severe anxiety, and the need for constant care. At the same time, I was managing my own records and preventive health. Like so many women, I had become the family’s chief health executive, carrying responsibilities …
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Why health self-advocacy is an essential life skill
It should be obvious by now, but somehow it is not: Physicians are not immune to the same emotions that govern human behavior everywhere else. We like to imagine that our white coats and years of training somehow grant us a protective immunity to fear, to shame, to the raw surge of emotion that can stop us in our tracks. The truth is, physicians and other medical professionals are just …
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Are doctors’ emotions fueling the opioid crisis?
Prostate cancer treatment is evolving, and focal therapy is gaining relevance as part of that change.
For decades, patients and their physicians have had limited options: whole-gland treatments like radical prostatectomy or radiation, or active surveillance. But what about the men who fall somewhere in between? What about those who need more than monitoring, yet want to avoid the significant side effects associated with whole-gland therapy?
That is where focal therapy enters …
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Focal therapy for prostate cancer: a new option
I was watching Michigan take on Nebraska the other Saturday when a popular sandwich chain dropped its latest ad: “Our new 500-calorie Fit Sandwich!” Catchy. Marketable. But let’s be honest, it’s mostly bread, a little processed meat, and not much else. Yes, it comes in under 500 calories, but so does half a sleeve of Oreos. Does that make Oreos “fit”? This is the oldest trick in nutrition marketing. We …
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Why a 500-calorie meal isn’t always fit
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
