Conditions

The “patient carryover crisis”: Why hospital readmissions persist

Conditions

January 13, 2026

In hospital boardrooms across America, the “30-day readmission rate” is treated as a financial vital sign. It determines reimbursement levels under the Hospital Readmissions Reduction Program (HRRP); it influences star ratings; and increasingly, under new Department of Justice scrutiny, it serves as a barometer for potential “substandard care” investigations.

Yet, despite decades of regulation and millions spent on discharge planning software, the needle on preventable readmissions barely moves.

The industry is failing …

How flight surgeon training mirrors medical residency stress

Avishek Kumar, MD

Conditions

January 13, 2026

The room went quiet the way rooms do before something consequential, when conversation thins and all you can hear is the pulse in your ears.

“Captain Kumar,” the instructor said, “you have an in-flight engine failure. What do you do?”

I stood at attention, spine locked, as my classmates turned toward me with the focused expectation of a clinical team evaluating a tenuous presentation. A bead of sweat slid down my temple. …

A school nurse’s story of trauma and nurse burnout

Debbie Moore-Black, RN

Conditions

January 11, 2026

School had just started for the new school year. It was hot and humid. I had just retired from ICU nursing and behavioral health, a 46-year career and never skipping a beat. After several months of retirement, I couldn’t sit still. I was bored and had that nagging feeling that I wasn’t done yet with my career. Maybe that nagging feeling was guilt. Like you can’t quit. You can’t stop. …

SNF discharge planning: Why documentation is no longer enough

Rafiat Banwo, OTD

Conditions

January 11, 2026

There is a dangerous assumption circulating in skilled nursing facility (SNF) boardrooms: “If it’s documented in the EMR, we are protected.”

For years, this logic held up. Compliance was a game of checkboxes. Did the nurse educate the patient? Check. Did the patient verbalize understanding? Check. Is the care plan signed? Check.

But the regulatory landscape has shifted beneath our feet. The Department of Justice (DOJ) and CMS are no longer just …

How honoring patient autonomy prevents medical trauma

Sheryl J. Nicholson

Conditions

January 11, 2026

Holding my mother in my arms as she took her last breath changed the way I understand care. That moment, Easter Monday in Canada, was heartbreaking and transformative. Her unwavering faith and peaceful passing contrasted sharply with the confusion that followed when CPR began despite her do-not-resuscitate (DNR) order. I felt helpless.

The experience became the catalyst for my commitment to advocacy and ethical clarity. It taught me that even well-intentioned …

Why fear-based approaches fail in chronic illness care

Bridgette Johnson, PhD, RN

Conditions

January 9, 2026

In caring for patients with chronic illness, we often assume that if people truly understood the consequences of poor disease management, they would change. We explain complications, cite lab values, outline risks, and sometimes lean into fear in hopes that it will motivate action. When patients do not follow recommendations, we label them as noncompliant or unmotivated. Yet chronic illness is not managed in exam rooms or hospital beds. It …

Scrotal pain in young men: When to seek urgent care

Martina Ambardjieva, MD

Conditions

January 8, 2026

Scrotal pain in young men is a frequent reason for emergency department visits and urology consultations. While many underlying causes are benign and self-limiting, others, most notably testicular torsion, represent true urologic emergencies in which delayed intervention can result in irreversible testicular damage.

The clinical challenge lies in distinguishing conditions that allow for short-term observation from those requiring immediate evaluation. This distinction is particularly important in adolescents and young adults, …

Technology for older adults: Why messaging apps are a lifeline

Gerald Kuo

Conditions

January 7, 2026

For many older adults living alone, a smartphone is not a convenience. It is a lifeline.

In elder care meetings, we often discuss telemedicine, wearable sensors, and remote monitoring systems. We focus on dashboards and data. Yet in our pursuit of high-tech solutions, we frequently overlook the most widely used and emotionally loaded digital tool already resting in older adults’ hands: the messaging app.

In Taiwan, as in much of Asia, LINE …

The most venomous sea creatures to avoid

Ashely Alker, MD

Conditions

January 5, 2026

An excerpt from 99 Ways to Die: And How to Avoid Them.

In response to this chapter, I expect to receive a battery of soaking wet letters from infuriated marine biologists, since each species deserves their own chapter, but my editor cut me off.

Flamboyant cuttlefish

The flamboyant cuttlefish is not to be confused with the flamboyant cuddle-fish, which does not exist. The cuttlefish, Metasepia pfefferi, looks like an orchid that ran …

Adult autism assessment: ADOS-4 vs. narrative interviewing

Carrie Friedman, NP

Conditions

January 5, 2026

Over the past decade, there has been a marked rise in adolescents and adults seeking autism evaluations. Many of these individuals are intellectually intact, verbally fluent, and professionally capable, yet have lived for decades with persistent social fatigue, sensory sensitivities, difficulty interpreting unspoken social rules, emotional overwhelm, rigid or all-or-nothing thinking, challenges with transitions, and extensive masking or camouflaging behaviors, all without a diagnosis. When they finally seek clarity, the …

Are mild hypertension guidelines driven by pharma ties?

David K. Cundiff, MD

Conditions

January 5, 2026

In the early 2000s, I included “drugs for mild hypertension” in my book, Money-Driven Medicine: Tests and Treatments That Don’t Work. By 2007, I proposed a Cochrane systematic review of randomized controlled trials (RCTs) to settle the debate. Cochrane is widely considered the “gold standard” of evidence-based medicine; its reviews can shift global clinical practice and multibillion-dollar drug markets.

In 2012, Cochrane published the systematic review of Pharmacotherapy for …

The physician emotional toll of delivering bad news

Alexis Lipton, MD

Conditions

January 5, 2026

You can usually taste the excitement in the air during a first visit for pregnancy. It’s palpable. And the evidence for it is everywhere: the nervous fidgeting of hands. Do you place them on your lap or not-so-casually at your side? Paper drape sheet typically is balled up into tiny handfuls for better “grip” on this one-ply provider of modesty. And the quick glances back and forth between soon-to-be parents …

Why home-based care fails without integrated medication and nutrition

Gerald Kuo

Conditions

January 4, 2026

Consider Mrs. Chen, an 82-year-old woman discharged home after a minor ischemic stroke. On paper, her care plan was flawless.

Her physician intensified her antihypertensive regimen to protect vascular health (medication). Her well-meaning daughter, concerned about blood pressure, switched her to a strict low-sodium porridge diet, unknowingly slashing her protein intake (nutrition). Her physical therapist prescribed a daily walking program to rebuild confidence and strength (exercise).

Two weeks later, Mrs. Chen was …

Methodological errors in Cochrane reviews of anticoagulation therapy

David K. Cundiff, MD

Conditions

January 4, 2026

My previous KevinMD article discussed a Cochrane Collaboration review that was completed in 2002 but was not published until 2006. This review examined three randomized controlled trials (RCTs) comparing anticoagulants with placebos or anti-inflammatory drugs for venous thromboembolism (VTE).

Along with my two co-authors, I found that across these three trials, anticoagulant-treated patients had six deaths out of 66 patients, compared to only one death out of 60 in the placebo …

Why we deny trauma and blame survivors

Peggy A. Rothbaum, PhD

Conditions

January 4, 2026

“The ordinary response to atrocities is to banish them from consciousness. Certain violations of the social compact are too terrible to utter out loud: this is the meaning of the word unspeakable. Trauma survivors want to forget, observers want to forget, and society as a whole wants to forget. It is too painful to do otherwise. We push trauma away and it rears up in other ways: Atrocities, however, …

Read more…

Why we deny trauma and blame survivors

Physicians’ end-of-life choices: a surprising study

M. Bennet Broner, PhD

Conditions

January 3, 2026

In July, I wrote about the importance of end-of-life planning (EOL). Shortly after, I read a study that examined physicians’ EOL plans with advanced cancer and Alzheimer’s disease (stage unspecified). The study encompassed nations with different forms of aid in dying, from the U.S., where a terminal coma is the only option most states allow, to Belgium, where physician-assisted dying (PAD) and euthanasia are available. Although the term suicide …

In-flight medical emergencies: Are planes prepared?

Dharam Persaud-Sharma, MD, PhD

Conditions

January 3, 2026

The cabin was quiet in that familiar, suspended way airplanes always are with a steady engine hum, passengers absorbed in movies, sleep, and anticipation with the intermittent crying child. It was an ordinary flight. Until it wasn’t. The overhead speaker crackled without warning. “If there is a doctor on board, please identify yourself.”

The voice was calm. The effect was not. Just a row behind me, a child no more than …

Why mindfulness fails to cure existential anxiety

Farid Sabet-Sharghi, MD

Conditions

January 3, 2026

For the past several decades, Western spiritual culture has been profoundly shaped by the rebranding of Buddhist contemplative practices (mindfulness, presence, and the exaltation of “the now”). As a psychiatrist, I have witnessed the arrival of this movement inside the consultation room. Patients arrive quoting teachers, apps, and books urging them to stay present, to watch their breath, to release attachment to the future or past. Many have tried, often …

Concierge medicine access: Is it really the problem?

Dana Y. Lujan, MBA

Conditions

January 2, 2026

A recent Johns Hopkins study has reignited that debate. The research documents rapid growth in concierge and direct primary care practices and warns that these models may worsen access to care.

That framing feels intuitive. It is also incomplete.

It assumes that traditional primary care access was functioning before physicians began moving into fee-based models. It was not.

Long before concierge and direct primary care gained traction, primary care access had already …

Emotional abuse recognition: a nurse’s story

Debbie Moore-Black, RN

Conditions

January 2, 2026

I wanted to be at the top. Clinical ladder 4 was the top. You couldn’t get any higher achievement as an ICU nurse than this.

There were many requirements to obtain this:

Community service.
Having a nursing article you wrote published in an established nursing magazine.
Doing many hours as a charge nurse without that differential.

I checked all the boxes, every year. It was hard work. And tiresome. The compensation for …