Conditions and Diseases

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.

Shift work and circadian rhythms shape the 24/7 workplace

Deepak Gupta, MD

September 23, 2026

Work may provide incomparable inner peace, but the timing of that work still matters. A shift may begin in the morning, evening, or night, and it may end during another part of the day. For workers’ circadian rhythms, the relevant question is not simply how long they work, but how the beginning and end of a shift fit together. That question matters whether the work ultimately serves humans or nonhumans.

Does …

Telehealth and postpartum psychosis defy simple blame

Rabia Cheema, MD

Conditions and Diseases

September 22, 2026

A recent public discussion following a tragic event has reduced a complex clinical reality to a simplistic narrative: Telehealth, psychiatrists, or psychiatric medications must be to blame.

That conclusion may feel satisfying in the aftermath of an incomprehensible loss. But it is not how medicine, causation, or accountability should be understood.

A postpartum patient who is unable to get out of bed may appropriately receive care by telehealth. Virtual visits can be …

Underage online gambling needs more than a checkbox

Kayvan Haddadan, MD

Conditions and Diseases

September 22, 2026

Gambling as a recreational activity continues to expand, driven by the constant availability of online platforms. Sports betting, casino-style games, and real-time micro-betting are now accessible on smartphones at any hour, turning what was once occasional into a continuous presence shaped by artificial intelligence, big data, and app designs that permit bets before, during, and after events.

Gambling disorder is recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth …

Why must fourth trimester care begin after delivery?

Allison P. Boyle, DPA, PA-C

Conditions and Diseases

September 22, 2026

Throughout pregnancy, clinicians carefully monitor a woman’s health. Vitals are obtained, laboratory testing is performed, growth is monitored, and complications are identified. Then, a new life is brought into the world, and medical attention dramatically shifts. The medical attention previously directed toward a mother abruptly ends, and the infamous “See you in six weeks” appointment is scheduled.

Unfortunately, childbirth is often considered a marker of the end of maternal medical risk …

Nutrition during cancer treatment is more than calories

Dr. Manjari Chandra

Conditions and Diseases

September 22, 2026

By the time Kapil Grover enrolled in our nutrition program in June 2026, he had already faced substantial nutritional and physical challenges during his cancer journey. He received a colon cancer diagnosis in January 2026, but his symptoms had started months earlier. Stomach problems began in October 2025 and persisted, prompting further investigation. A CT scan revealed several tumors and lesions involving his small and large intestines, leading to extensive …

Why witnessing death outside the hospital felt different

Denise Moulton, RN

Conditions and Diseases

September 21, 2026

I’ve been a registered nurse for over eighteen years. I’ve held dying newborns, guided families through their loved one’s final days, and summoned hospital chaplains to honor last wishes and sit with families in their worst moments. In the controlled chaos of a hospital, health care workers know their roles, and there’s a crash cart three steps away. Death, in a clinical sense, is something that I know.

Or so I …

Medicare home care coverage pays for rehab, not an aide

Raya E. Kheirbek, MD, MPH

Conditions and Diseases

September 21, 2026

American medicine has a peculiar definition of generosity. We will spend enormous sums treating a seriously ill older person: an ambulance, an emergency-room visit, scans, intravenous medications, surgery, and days in hospital. We may then pay to send a profoundly frail patient to a skilled-nursing facility for “rehabilitation.”

But suppose what that patient really needs is someone to help her out of bed, make breakfast, and keep her safe at home. …

Short bursts of exercise can ease the afternoon slump

Neil Baum, MD

Conditions and Diseases

September 21, 2026

A solution to the typical afternoon sinking spell is short bursts of exercise. In this blog, I will discuss the concept of short bursts of exercise and how just 1 to 2 minutes of cardio exercise that won’t make you break out in a sweat will make you more productive and less lethargic.

The evidence continues to grow that even short periods of activity can make a difference. A recent …

Pediatric euthanasia and the fear of a new eugenics

Arthur Lazarus, MD, MBA

Conditions and Diseases

September 21, 2026

Adapted from The New Eugenics in Medicine: Two Novellas About Power, Science, and the Future of Human Worth.

The Netherlands’ first reported termination of life in a child between ages 1 and 12 under its 2024 framework for regulating pediatric euthanasia has become a global lightning rod for debate over the merits and sins of euthanasia.

A Dutch child was almost 2 years old and had been born at 26 …

How to diagnose supplement toxicity in 4 clinical steps

Alisa Sano, MPH

Conditions and Diseases

September 20, 2026

Only 33 percent of patients who use herbs or supplements disclose their use to health care providers, often viewing them as natural and therefore harmless. Targeted history-taking is the ultimate line of defense for ruling in or out herbal/dietary supplement-induced liver injury (HILI) and broader supplement toxicity, including herb-drug interactions.

Clinicians must look beyond standard prescription lists and systematically audit everything a patient ingests. Asking a few high-yield questions …

Chronic inflammation and immune aging may share mechanisms

Andrew Caravello, DO

Conditions and Diseases

September 20, 2026

For more than two decades, I have practiced emergency medicine. The job trains you to recognize patterns quickly because sometimes the pattern is the difference between sending someone home and recognizing a catastrophe that is still assembling itself.

A heart attack arrives after years of vascular disease and suddenly becomes an emergency. A stroke may represent decades of biology revealed in minutes. Sepsis can turn a functioning immune system into something …

Family history of PCOS can reshape metabolic care

Jan Hinnen, MD

Conditions and Diseases

September 20, 2026

A 30-year-old man with obesity and longstanding type 2 diabetes comes in for a routine follow-up. His glycemic control remains poor despite treatment. As the visit unfolds, his physician notices persistent adult-onset acne. Years ago, the encounter might have ended there. Today, I imagine asking another question: “Does anyone in your family have what we used to call polycystic ovary syndrome?” His sister does.

That answer does not diagnose him with …

What being cleared for surgery does not actually mean

Dr. Girishkumar Modi

Conditions and Diseases

September 19, 2026

A patient arrives for surgery after weeks of waiting. They have fasted, taken time off work, arranged transport, and prepared themselves mentally for the operation. Then the anesthesiologist says, “I think we should wait.”

For the patient, this can be frustrating. “I feel fine.” “Why can’t we just go ahead?” These are understandable questions. But one of the less visible parts of an anesthesiologist’s job is deciding not only how to …

How CREST-2 changes asymptomatic carotid stenosis treatment

John R. Laird, Jr., MD

Conditions and Diseases

September 19, 2026

Carotid artery disease remains a major contributor to ischemic stroke, one of the leading causes of death and long-term disability in the United States. While symptomatic carotid stenosis has well-established treatment pathways, the management of asymptomatic carotid artery disease remains an area of ongoing debate. Traditional treatment methods such as intensive medical management have largely functioned as the standard of care for asymptomatic carotid artery disease, with revascularization (carotid endarterectomy …

Physician reimbursement cuts collide with AI audits

Kayvan Haddadan, MD

Conditions and Diseases

September 19, 2026

Physician reimbursement has faced sustained downward pressure for years, while insurers have expanded tools, including AI-driven audits, prior authorizations, and retrospective reviews, so that they can recover or limit payments after (or before) services are delivered. This dynamic contributes to practice strain, consolidation, and reduced patient access. Evidence from Medicare data, physician surveys, and industry analyses supports the core concerns. Not every claim of intentional misconduct or pure profit extraction …

Grief after cancer treatment belongs in follow-up visits

Timothy Lesaca, MD

Conditions and Diseases

September 19, 2026

Recently, a patient of mine shared her final follow-up after successful cancer treatment. Instead of celebrating the clear scans, she burst into tears.

Recovery from serious illness is often seen as a triumphant return to normal life, but the reality is far more complex. For many patients, the end of treatment marks the beginning of a new emotional journey that is rarely discussed or anticipated. As patients recover, the losses from …

Fragmented care left nobody responsible for the patient

Ronald L. Lindsay, MD

Conditions and Diseases

September 19, 2026

After my wife Kathy died, I spent months replaying the events that led to her death. As a physician, I naturally searched for explanations. As a husband, I searched for accountability. What I found instead was a troubling lesson about modern institutions. They are often brilliant at analyzing complexity and surprisingly poor at recognizing the obvious.

Kathy’s medical history was undeniably complex. End-stage renal disease. Coronary artery disease. Heart failure. Peripheral …

Non-opioid pain management gets separate pay in 2026

Stephanie Muh, MD

Conditions and Diseases

September 19, 2026

As the third-highest opioid-prescribing medical specialty representing 6 to 8 percent of all U.S. opioid prescriptions, orthopedic surgeons carry an outsized share of responsibility for reducing patients’ opioid exposure. Orthopedic procedures dominate this pattern as they represent four of the five surgeries with the highest opioid prescription rates among patients aged 45 to 64. Even more alarming, orthopedic surgeons often treat young and active patients, and for many, surgery …

A poem about political division and the will to begin again

Michele Luckenbaugh

Conditions and Diseases

September 18, 2026

I watch the world spinning faster
than I can follow,
a wheel thrown down a hill
with no one reaching for the brake.

Decisions made in haste,
words fired like arrows,
people stepping over the rights of others
as though compassion
has become an inconvenience.

Where is the moral compass
we once carried inside our hearts?

Somewhere above us,
a man sits upon his golden throne,
surrounded by wealth
and power and influence,
and maybe he thinks he can
control the world.

The people below think,
“If he …

Nurse advocacy: The shackles came off before he died

Debbie Moore-Black, RN

Conditions and Diseases

September 18, 2026

It wasn’t long ago that my new homeowners insurance company threatened me, stating I have to get a new roof. Of course they weren’t going to cover it. The last time I had a new roof installed was 2004.

My fellow ICU nurse friend said, “Get my daddy. He has his own roofing company.” And so I did. Patty was an awesome ICU nurse. Well respected with an affluent family. I …

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