Physician

Physicians writing on KevinMD about the life of the profession: the work itself, the exhaustion, what women physicians are paid and asked to carry, the losses the profession has been slow to name, and who decides how physicians work. Five maintained records draw on this archive: Physician burnout: what physicians say, in their own words, Primary care: what physicians say, in their own words, Women in medicine: what women physicians say, in their own words,, Physician suicide: what physicians say, in their own words, and Physicians and administrators: what physicians say about who runs medicine, in their own words.

What do best states to practice medicine rankings miss?

Arthur Lazarus, MD, MBA

Physician

August 30, 2026

An excerpt from Essays and Echoes: Reflections from a Life in Medicine.

Every year, someone ranks the best states in which to practice medicine, presumably because physicians have been unable to make major life decisions without consulting a color-coded map.

The 2026 WalletHub survey evaluates all 50 states and Washington, D.C., across 19 measures, including physician wages, malpractice costs, hospital availability, projected competition, and burnout. Montana ranked first, New York …

Why I left insurance-based medicine and came back

Michael Woo-Ming, MD

Physician

August 29, 2026

I was in my car in the parking lot. It was a long day at the clinic. And I did not want to go back in the next morning.

Us doctors aren’t supposed to say that. When we feel it, we always repeat the same things to ourselves. “You’re tired.” “You’re burned out.” “You need sleep, or a vacation, or perspective, because do you have any idea what you have?” Those …

Why merit decides a medical malpractice case

Howard Smith, MD

Physician

August 28, 2026

If you are sued and satisfied with your defense, read no further. If not, you may find this article helpful.

Merit is inconclusive in every medical malpractice lawsuit ever filed, and it starts with the certificate of merit. To be clear, a certificate of merit is not proof of negligence. Proof is determined at trial. Merit is a measure for the reliability of evidence used in the proof of negligence, and …

Patient dissatisfaction begins before the doctor walks in

Manoj Sreedharan, MD

Physician

August 27, 2026

When patients describe a disappointing health care experience, we often assume the problem occurred in the examination room. Sometimes it did. But after years of caring for patients in urgent and emergency settings and helping lead a high-volume orthopedic urgent care practice, I have learned that many negative patient experiences begin long before the physician walks through the door.

A patient may arrive in pain and not know how long the …

Hospital peer review needs recusal rules, not assumptions

Babajide Ogunseinde, MD

Physician

August 27, 2026

Hospital peer review is one of medicine’s most important mechanisms for protecting patients and maintaining professional standards. Physicians possess the clinical expertise necessary to evaluate the work of other physicians, particularly when questions involve complex procedures, specialty-specific judgment, or unusual complications.

But this structure creates an unavoidable tension. The physicians most qualified to evaluate a colleague may also be the physicians who compete with that colleague for patients, referrals, operating-room access, …

Medical satire: A wolf can pass as your doctor now

Anonymous

Physician

August 27, 2026

When I was just a Medium-Sized Bad Wolf loping through the forest, I stumbled upon a doctor in a white coat, carrying a bag of supplies. It was Sunday night, and dinner options were scarce, since most other humans were home with their families.

“Where are you going so late, Doctor?”

She sighed. “Another patient who refused the flu vaccine is sick with the flu, so I’m bringing them Tamiflu.”

I tricked her …

Medicine disposed of physicians long before it feared AI

Ronald L. Lindsay, MD

Physician

August 27, 2026

I am writing this from the slow, disciplined landscape of recovery (one repaired shoulder, one sling, and one unrepairable truth): Medicine did not suddenly become fragile when AI arrived. It did not suddenly become threatened when APRNs and NPs expanded their scope. It did not suddenly become replaceable in the twenty-first century.

Medicine became fragile when institutions discovered they could dispose of physicians and still call it progress.

I know this because …

Cognitive assessment in primary care almost never happens

John Showalter, MD, MSIS

Physician

August 27, 2026

In my primary care practice, few moments carry as much quiet weight as when an older patient leans in and says, “Doctor, I’m worried about my memory.” That moment is increasingly common, given that an estimated 42 percent of adults who reach age 55 will develop dementia in their lifetime, so nearly every family will face a version of it. It takes courage to say those words out loud, …

Physician addiction is a disease of silence and shame

Michael F. Myers, MD

Physician

August 26, 2026

An excerpt from Physicians With Lived Experience: How Their Stories Offer Clinical Guidance (APA Publishing, 2025).

In an interview that Dr. Grinspoon did with the New York Post in 2016, “I was a doctor – and a drug pusher,” he describes making a home visit as a medical student to tend to a stage 4 cancer patient. While there, he steals a dozen of the patient’s …

5 ways to beat mid-career physician burnout

Neil Baum, MD

Physician

August 26, 2026

We all have times when we wonder, “Did I choose the right profession? Should I recommend a medical career for my children? Is it time to retire?” These questions creep into the minds of mid-career physicians. We often ask ourselves how we should address the mid-career blahs. What can we do to improve our professional satisfaction? How can we combat the dullness and tedium of our workday lives? And how …

What one emergency room shift really costs a doctor

Christine DeSanno, DO

Physician

August 25, 2026

My shift started at 7 a.m. The overnight physician wishes me a good shift. We both know that’s mostly luck. I pick up my first patient before I’ve taken a sip of coffee.

My first few patients are what we affectionately call “bread and butter.” An ankle injury. A cough that’s lingered for two days. Back pain. A medication refill. Someone wants an MRI today because they’ve had headaches for three …

The certification process that has no off-ramp

Victor S. Sloan, MD

Physician

August 25, 2026

For those of you navigating the American Board of Internal Medicine’s (ABIM) Maintenance of Certification, I thought this anecdote might shed some additional light on the problems with the process.

On June 26, I had a two-level spinal fusion. On May 9, I called the board to see if it was possible to “stop the clock” on the questions, since I anticipated, correctly in retrospect, that I would not be in …

Is racial bias in physician discipline being measured?

Babajide Ogunseinde, MD

Physician

August 24, 2026

The central limitation in evaluating racial parity in physician discipline is not the absence of concern, but the absence of standardized upstream data. Existing national systems primarily capture terminal outcomes. The National Practitioner Data Bank (NPDB), for example, receives reports of certain adverse clinical-privileges actions, including review actions restricting privileges for more than 30 days and certain surrenders while under investigation. It does not comprehensively capture the discretionary steps …

What my chronically ill daughter taught me about failure

Christine Marie Deeths, MD

Physician

August 24, 2026

When my chronically ill daughter was about five years old, a (hopefully) well-meaning family member got very angry at me for taking what they called unacceptable risks with her and her health. My family member went on to tell me all about a friend of theirs who had a similar-aged child who had a heart transplant and had since that time lived in a bubble. They were very proud of …

Why should doctors treating family members step back?

Neil J. Farber, MD

Physician

August 22, 2026

An excerpt from Treating a Broken System: A Physician’s Cure For the Healthcare Crisis.

I remember the event clearly, even though it was more than forty years ago. I was a fairly new faculty member in a Philadelphia university medical center, having finished my residency in internal medicine a few years prior. My wife, Terry, and I had been married for six years, and we had two kids at the …

How journal transfer without rejection avoids scrutiny

Ronald L. Lindsay, MD

Physician

August 22, 2026

Academic publishing has its own dialect, a language of polite evasions, soft landings, and decisions that say everything without saying anything at all. After decades in medicine, I thought I had seen every variation of editorial rejection. I was wrong. Recently, I submitted a manuscript describing a structured primary care model for autism diagnosis, a model that worked, was scalable, and addressed the capacity crisis that developmental-behavioral pediatrics has been …

I don’t like who I’ve become in primary care

Wendy Shue, MD

Physician

August 21, 2026

I don’t like who I’ve become, working in primary care.

In the medical community, it seems like we’ve discussed the root causes of burnout ad nauseam: too much paperwork, too many in-basket messages and inane patient requests, too many clicks in the EMR, too-short appointment times, too much corporate consolidation and insurance overreach. But as I see it, the end result, the final common pathway, is this: Most of us have …

Why setting boundaries as a physician feels impossible

Diane W. Shannon, MD, MPH

Physician

August 21, 2026

Many of the physicians I work with bring up the issue of boundaries. “I know I need to set better boundaries, but.” They see the costs. They are clearly aware of what they need to do but just can’t seem to execute. They let patients drive the conversations in the exam room so that they run late and finish notes at midnight. They agree to a schedule change to help …

Research integrity and accountability lessons from 2026

Olumuyiwa Bamgbade, MD

Physician

August 19, 2026

Research misconduct deserves scrutiny. But scrutiny should not become spectacle. The landmark 1980s case of U.S. cardiology researcher John Darsee remains a defining example. Auditors found extensive data fabrication, and federal sanctions reached beyond institutional leadership, forcing science research to confront supervision, authorship, and institutional accountability. The lesson was not simply that one researcher failed. The institution and research system also need safeguards.

Four decades later, the Retraction Watch leaderboard of …

Medical malpractice reform and the lawyers who block it

Howard Smith, MD

Physician

August 19, 2026

Senator Dick Durbin describes his career this way: “Before I was elected to Congress, I worked in a courtroom. For years, I defended doctors and hospitals, and for years, I sued them on behalf of people who were victims of medical malpractice.”

Dick Durbin’s own words betray that, first, he was defense counsel, earning a living being retained by malpractice insurance companies. Second, he was plaintiff counsel, earning a living by …

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