Institutional inbreeding in developmental-behavioral pediatrics

Conditions and Diseases
December 5, 2025

Developmental-behavioral pediatrics (DBP) was once defined by giants, leaders who authored textbooks, set standards, and gave the specialty a clear identity. Today, the field is fragmented, misunderstood, and too often hostile to new ideas. My own career arc illustrates how inbreeding and isolation have hollowed out DBP, leaving children without advocates and institutions without direction.

At a major military medical center, retired military DBPs replaced me. All were trained at that …

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Institutional inbreeding in developmental-behavioral pediatrics

Medicare payment is failing rural health

Health Policy
December 5, 2025

Ten years ago, I quit my job and started a solo office-based practice in rural Washington. I serve patients like Mr. G, an elderly gentleman who drove over 70 miles through mountain passes and rural highways to receive care for gangrene of his foot, as nearby hospitals were either too full or too far away. But Medicare’s broken payment system is endangering practices like mine, quietly dismantling access to affordable …

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Medicare payment is failing rural health

A doctor’s ritual: Reading obituaries

Physician
December 5, 2025

I live across the street from a funeral home. Each day as I see the cars begin to line up and the people in dark clothes gather to say goodbye, I can’t help but wonder about the stories inside. Who were they coming to honor? What kind of life had just ended? So, most mornings, before I check my email or the hospital census, I read the obituaries.

As a child, …

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A doctor’s ritual: Reading obituaries

The physician-nurse hierarchy in medicine

Medical Education
December 5, 2025

When an attending doctor recently took me aside after a particularly hard clinical case with a first-year resident, she made pains to point out to me that the resident felt she wasn’t being treated fairly by nurses, because she was a woman. The physician went on to describe the difficulty of being a woman in a professional world where male colleagues are taken more seriously and treated with more respect, …

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The physician-nurse hierarchy in medicine

How new pancreatic cancer laser therapy works

Conditions and Diseases
December 5, 2025

Researchers at Sichuan University in China have developed a laser therapy that selectively kills pancreatic ductal adenocarcinoma (PDAC) tumors while preserving the surrounding healthy tissue. The technology, built around a 6.1-micron laser, takes advantage of the characteristic collagen fingerprint within PDAC tumors to focus the laser energy where it is needed the most.

The technology has received full approval from the Chinese National Medical Products Administration and will be developed …

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How new pancreatic cancer laser therapy works

How to prevent child sexual abuse [PODCAST]

Podcast
December 4, 2025
YouTube video

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Pediatric emergency medicine physician Bronwen Carroll discusses her article, “The childhood risk we never talk about.” Bronwen explains the staggering data showing child sexual abuse is far more common than many other …

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How to prevent child sexual abuse [PODCAST]

Community hospital innovation: a survival story

Conditions and Diseases
December 4, 2025

Innovation in health care is often described in technological terms (new devices, advanced imaging, digital platforms). But some of the most meaningful forms of innovation happen quietly, inside small hospitals struggling to survive.

This is the story of a community hospital in Taiwan that once faced collapse, and the unexpected lessons it offers to health care leaders everywhere.

Looking for a way forward

In the late 1990s, the hospital was in serious decline. …

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Community hospital innovation: a survival story

California’s opioid policy hypocrisy

Conditions and Diseases
December 4, 2025

California’s opioid policies reveal a stark hypocrisy, imposing draconian restrictions on prescriptions for chronic pain patients (leaving wildfire survivors and others in unrelenting agony) while allocating over $100 million annually through initiatives like the California Harm Reduction Initiative (CHRI) and Proposition 36 to provide free needles, pipes, and fentanyl test strips to addicts with minimal oversight. This disparity is compounded by the Medical Board of California’s (MBC) overreach, where physicians …

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California’s opioid policy hypocrisy

The physician’s change cycle: Why doctors stay stuck

Physician
December 4, 2025

In medicine, we are trained to act decisively in moments of crisis. We respond to hemorrhage, cardiac arrest, and trauma with clarity and speed. Yet when the crisis is internal (when the dysfunction lies within our teams, our leadership structures, or ourselves) many of us hesitate. We tolerate misalignment because it is familiar. We fear change more than we fear staying stuck.

This fear is not benign. It erodes morale, fractures …

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The physician’s change cycle: Why doctors stay stuck

A psychiatrist explains the new frontier of prescribed software treatments [PODCAST]

Podcast
December 3, 2025
YouTube video

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article, “The rise of digital therapeutics in medicine.” Muhamad explains what prescription digital therapeutics (PDTs) are, emphasizing they are …

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A psychiatrist explains the new frontier of prescribed software treatments [PODCAST]

How stigma in psychiatry affects patients

Physician
December 3, 2025

As a psychiatrist, I often find myself confronting not only the symptoms of mental illness but also the deep scars left by stigma. Even in 2025, despite advances in neuroscience and a growing cultural focus on mental health, stigma remains one of the greatest barriers to healing. It manifests in silence, shame, and misunderstanding, and it affects patients, families, and even those of us within the psychiatric profession. Addressing stigma …

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How stigma in psychiatry affects patients

Developmental-behavioral pediatrics: the lost identity

Conditions and Diseases
December 3, 2025

Developmental-behavioral pediatrics (DBP) has lost its identity, and my career shows what happens when leadership retreats.

When I applied for positions in Tucson and Jacksonville, I was not seen as a developmental pediatrician with expertise in neurodevelopmental disabilities. Instead, I became the dumping ground for “Stranger Things” (children whose needs were psychiatric, not developmental). Administrators and chiefs, lacking even a basic understanding of DBP, misrouted cases into my lap. The result …

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Developmental-behavioral pediatrics: the lost identity

The haunting trauma of nursing

Conditions and Diseases
December 3, 2025

We put on that strong face. Resilience. We learn to handle anything. But our outside appearance can fool you as our inner turmoil plays havoc emotionally.

I learned quickly that nursing was not all about holding hands with a sick child in the emergency room or fluffing up a pillow for a dying grandma. My initiation into the dark side of nursing began in the emergency department. I was fresh out …

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The haunting trauma of nursing

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Physician emotional fatigue: When burnout becomes a blind spot

Physician
December 3, 2025

There was a time when I thought burnout was easy to recognize, that it came with flashing red lights and emotional breakdowns. I imagined it as the dramatic kind of collapse you see in movies: a physician walking out mid-shift, tears in their eyes, leaving their stethoscope behind.

In those days, I didn’t really think about burnout. I believed burnout happened to other people, the ones who hadn’t mastered time management …

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Physician emotional fatigue: When burnout becomes a blind spot

Why psychologist training takes years

Conditions and Diseases
December 3, 2025

As a practicing (“licensed”) psychologist, this issue comes up frequently. What are the differences among the myriad of mental-health professionals and does it even matter? As a researcher, as well as a clinician, my first inclination is always to look at the literature when seeking answers. What have others written on whatever topic it is that I am trying to better understand? Did someone else already answer my question? So, …

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Why psychologist training takes years

Why the doctor-patient relationship is nearly dead [PODCAST]

Podcast
December 2, 2025
YouTube video

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Urologist William Lynes discusses his article, “The decline of the doctor-patient relationship.” William explains why he believes this relationship, the critical center of medical care, is broken after 40 years of insidious …

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Why the doctor-patient relationship is nearly dead [PODCAST]

Patient modesty in health care matters

Conditions and Diseases
December 2, 2025

Studies show that many patients have strong convictions regarding their rights and values. Some avoid or delay life-saving medical procedures due to modesty concerns, which can stem from religious, cultural, or personal reasons, or anxieties from previous bad experiences in medical settings. Some patients even travel to another state or country to seek medical care. Others who have been diagnosed with PTSD from abuse in medical settings avoid medical care …

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Patient modesty in health care matters

How to navigate private equity in medicine

Physician Finance
December 2, 2025

In a valuable episode of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, welcomed two guests who have navigated a common trend in independent medicine today: private equity. Dr. Steve Hamilton, sports medicine physician and orthopedic surgeon at Beacon Orthopedics, and Andy Blankemeyer, CEO of Beacon and OrthoAlliance, shared their firsthand experiences with practice growth, private equity partnerships, and what physicians should consider when approached …

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How to navigate private equity in medicine

Why doctors struggle with setting boundaries

Physician
December 2, 2025

“If you tell me how you get your feeling of importance, I’ll tell you what you are. That determines your character. That is the most significant thing about you.”
– Dale Carnegie, How to Make Friends and Influence People

We all want to feel seen, recognized, and appreciated. That’s human nature. But where do you get your feeling of importance? What aspects of yourself are essential to who you are and how …

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Why doctors struggle with setting boundaries

When patients self-diagnose from TikTok

Conditions and Diseases
December 2, 2025

It’s a moment I’ve come to recognize too well as a psychiatry resident: a patient walks into my office already convinced of their diagnosis. They’ve watched a dozen videos, followed mental health influencers on Instagram, and taken online quizzes that “confirmed” what they suspected. They have ADHD, or autism, or borderline personality disorder. They’re not here for an evaluation; they’re here for validation.

On one hand, this moment feels like progress. …

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When patients self-diagnose from TikTok

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