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.
I shake my head in disbelief. Is this really happening in the United States? As a pediatrician and public health advocate, I believe we are witnessing the literal systematic dismantling of our health care system.
Case in point: the federal government’s mishandling of two recent lead contamination crises (in Michigan and Wisconsin). These failures not only expose children to preventable toxic harm, but also reveal a deeper breakdown in democratic accountability …
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A pediatrician on the lead contamination crisis
When people discuss physician burnout, they often reduce it to a workplace issue: long hours, endless charting, electronic health records that seem never to end, and patient loads that test the limits of human capacity. The solutions we’re offered sound deceptively simple: take a vacation, practice gratitude, do yoga, and meditate more. It’s as if wellness could be squeezed into the fifteen minutes we have left after charting at midnight. …
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Physician burnout as a relationship crisis
I didn’t realize how exhausted I was until everything stopped. First came burnout, the quiet unraveling so many physicians know too well. Then grief followed. I lost my mother unexpectedly to an aggressive cancer and, three years later, my father after years of caregiving through advanced Parkinson’s disease. These losses shattered not only my heart but the way I viewed my life and work. For years, I practiced medicine within …
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The making of a rested healer
Something is wrong with our health care system. Our country spends more per capita than any other developed nation, yet we have some of the worst health care outcomes. Rising costs are making health care prohibitive. Access to the system is becoming a growing concern. Medical care has become bureaucratic, bulky, and inefficient. I am a retired physician, a urologist, who has observed the health care system from outside medical …
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The decline of the doctor-patient relationship
Presidents are not immortal. But for much of American history, their bodies have been treated as state secrets, curated, concealed, and choreographed for public reassurance. When illness is hidden, the cost is not just clinical. It is geopolitical.
Warren G. Harding: collapse before the scandal
President Warren G. Harding died suddenly on August 2, 1923, at age 57, while touring the country on his “Voyage of Understanding.” He collapsed in San Francisco’s …
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The secret illnesses of U.S. presidents
I put it on one night among tears and grief. It slid onto my skin like butter, like it was meant for me. It hugged my torso and clung to all the wrong places. The truth is, I had worn it before. I am unsure exactly when I last stopped wearing it. Unlike the donning of the letter, the removal is much quieter. I probably did not realize exactly when …
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A psychiatrist’s scarlet letter of shame
(Author’s note: This article has been a year in the making. Each time another mass shooting makes headlines, I think, this is the moment to speak, and then life intervenes. The opportunity to contribute meaningfully feels missed. But the cruelest irony is this: Wait ten more days, and there will be another tragedy to make the conversation relevant again. That, in itself, is the most heartbreaking fact of all.)
“Study my …
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Is mental illness the root of mass shootings?
“To practice medicine,” a mentor once told me, “is to live with the tension between what you can do and what you should do.”
I didn’t understand him then. I do now. It is two in the morning in a Chicago hospital. The unit hums with fluorescent fatigue. A man in his fifties lies gasping for air, his lungs crowded by metastatic cancer. His chart lists “full code.” His daughter, sobbing …
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Moral distress vs. burnout in medicine
What if the career you spent your life building, the one filled with achievement, purpose, and prestige, is now the cage you cannot escape? That question did not just haunt me; it held me back for years.
I was a successful urologist, specialized in advanced prostate cancer detection, robotic surgery, and men’s health. From the outside, I had it all: a thriving practice, financial security, a respected reputation, and a steady …
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Is your medical career a golden cage?
As I sit breastfeeding a newborn and hastily switch to pump while the newborn (my fourth child) dozes, I have some thoughts that I think are particularly timely given concerns that are facing millions of families of young children in our country. Maternal and infant mortality continue to be worryingly high in the U.S., especially for women and children of color and in socially vulnerable areas of our country. The …
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Medicine fails its working mothers
As a physician, I am trained to diagnose not just the presenting symptom but the underlying pathology. This is the same lens through which many of us in the medical community view the epidemic of American violence. For years, organizations from the AMA to the CDC have called it a public health crisis. This is not merely a metaphor; it is a clinical framework pioneered right here in Chicago by …
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Diagnosing the epidemic of U.S. violence
My wife, Kathy, had stage 4 end-stage renal disease. She was slowly dying, but never stopped living. Her resilience in managing peritoneal dialysis made travel possible, even with the logistical complexities involved. Ireland had long been on our bucket list, inspired by Kathy and Stephanie’s earlier visit while we lived in Peoria. With careful planning, we booked our flights using points out of Orlando, knowing the drive would minimize Kathy’s …
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Traveling with end-stage renal disease
In 2025, Canada’s universal health care or Medicare system confronted a stark wake-up call. Many high-visibility service disruptions exposed the health care delivery model’s fragility and stress points. There were emergency room (ER) closures and specialty service interruptions.
In British Columbia, many hospitals repeatedly and increasingly closed their ERs for hours or days due to staffing shortages. The hospitals in large cities like Delta and Mission had multiple separate ER shutdowns. …
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Canada’s 2025 health care crisis explained
When I opened my dermatology practice 25 years ago, I used paper charts, a prescription pad, and a Dictaphone. Today, I use AI daily: for transcription, charting, and even reviewing complex labs. It’s certainly made my work more efficient.
But I’ve also seen something else: the erosion of trust between patients and physicians. I’m fortunate to practice independently, with the freedom to answer only to my patients, not a corporate boss. …
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What AI can never replace in medicine
In Minot, I practiced a kind of pediatrics no flowchart could predict: improvised, airborne, and often surgical. Minot didn’t always follow the flowchart. One night, a toddler arrived in the emergency room, inebriated. Her father had given her vodka for teething pain, never imagining she’d swallow it. She did. She stopped breathing. I called a code and began CPR, ordering a blood alcohol level (BAL) and routine labs. Her BAL …
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My experiences as an Air Force pediatrician
Racial diversity impacts health care delivery. North American nations like Canada and the U.S. are multi-racial. The U.S. addresses equity via programmatic and regulatory levers layered on a fragmented financing system: Medicaid, the Office of Minority Health’s National CLAS Standards for culturally appropriate services, and targeted maternal and community health initiatives. Nonetheless, persistent racial gaps in insurance, access, and outcomes underscore the limits of non-universal coverage, with maternal mortality for …
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How diverse nations tackle health care equity
Mrs. C is 80, frail, with heart failure and early dementia. The team has begun discussing an ICD. Her daughter wants “everything done.” The resident knows the evidence cold; he can recite the trial data, the ACC recommendations, and the mortality benefit. But he’s frozen at the bedside.
The gap we don’t talk about
Modern medical education does one thing brilliantly: It transmits knowledge. Today’s residents master more pathophysiology, more evidence, and …
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What is practical wisdom in medicine?
I was not just a contributor. I was the pediatrician in the room, the one who translated clinical reality into research clarity, even when the system preferred abstraction.
From 1997 to 2003, I lived a six-year burst of energy: equal parts clinical invention, research precision, and institutional resistance. It was my Trinity Site: a catalytic moment where everything fused: rural care delivery, editorial rigor, and systems reform. The fallout still shapes …
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A pediatrician’s role in national research
The idea that medicine is a “calling” has been entwined deeply within our profession. From white coat ceremonies to recruitment posters featuring smiling doctors holding stethoscopes, we are told that to enter medicine is to answer a higher purpose. This framing is powerful. It inspires loyalty, fuels commitment, and builds identity. That is how the brainwashing begins as it also hides a dangerous truth: Labeling medicine as a calling has …
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The danger of calling medicine a “calling”
As a parent and a doctor of nearly four decades, I’ve often found myself navigating the rugged terrain of a dual existence: the life of a devoted physician, and the life of a dedicated parent. I have not always succeeded in both arenas. My wife and I both bear the weight of our professions, drawn into the noble yet demanding world of medicine. Our missions and ambitions, while fulfilling, have …
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Physician work-life balance and family
