The 2026 7-OH ban will hit dependent users the hardest

Medications
September 3, 2026

“If you violate our rule, we are going to make you pay for it. You could be looking at up to 30-year prison sentences, and believe me, we will be looking to make some examples of bad actors.”

With these words, Florida’s attorney general announced the state’s June 2026 scheduling of 7-hydroxymitragynine (a short-acting psychoactive agent that shares common properties with both opioids and stimulants) and other concentrated derivatives of …

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The 2026 7-OH ban will hit dependent users the hardest

When policy erased my post-operative pain control

Physician
September 3, 2026

The day I met my own system from the wrong side of the bed

I’ve spent a career on the clinician side of the bed: explaining procedures, reassuring families, and signing orders that were supposed to make pain tolerable and recovery humane. Then I had shoulder surgery in Florida.

I went in with a regional block, a plan, and the quiet confidence of someone with a high pain tolerance. Physical therapists have …

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When policy erased my post-operative pain control

A frivolous malpractice lawsuit still raises your premium

Physician
September 3, 2026

There are commercials on TV by prominent plaintiff personal injury law firms advertising for clients. One promotes “If we don’t win, you don’t pay.” Another promotes the notion that anyone who owns a phone already has a lawyer. Still others promote the types of injuries that can be monetized, but never mention medical malpractice.

All imply that a contingency fee totally forgives clients of all legal transaction costs. All imply a …

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A frivolous malpractice lawsuit still raises your premium

Are opioid prescribing rates really driving overdoses?

Medications
September 3, 2026

There very well may have been times throughout our country’s history where opioids have been overprescribed, such as the Civil War era and 2000 to 2010. Of course, determining whether opioid prescribing is actually excessive requires one to quantify an association of opioid prescription rates with some relevant population characteristic (e.g., opioid overdoses per capita). Failing to consider the relationship between opioid prescription rates and any other population characteristic …

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Are opioid prescribing rates really driving overdoses?

When AI misses a diagnosis, the cardiologist signs alone

Conditions and Diseases
September 3, 2026

Artificial intelligence (AI) has rapidly reshaped cardiovascular imaging, particularly echocardiography, where machine learning algorithms now assist in image acquisition, chamber quantification, valvular assessment, strain analysis, and diagnostic interpretation. While these technologies promise enhanced efficiency and diagnostic accuracy, they also introduce an unresolved legal dilemma: When AI contributes to a missed diagnosis, who bears responsibility? Traditional malpractice principles designate the interpreting cardiologist as the primary legal decision-maker. Yet these doctrines evolved …

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When AI misses a diagnosis, the cardiologist signs alone

When you have five doctors and no one is directing your care [PODCAST]

Podcast
September 2, 2026
YouTube video

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

You can have five doctors and still have no one actually in charge of your care. That gap is where patients get lost. In this episode, retired surgeon and patient advocate Alan P. …

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When you have five doctors and no one is directing your care [PODCAST]

Why primary care burnout is really a patient-care problem

Physician
September 2, 2026

For years, I gave my patients advice that I was not following myself. Reduce your stress. Protect your sleep. Listen to your body. Set healthier boundaries. Then I would finish a full day of back-to-back appointments and stay late answering inbox messages, reviewing charts, completing forms, and responding to insurance demands. I would go home physically tired but mentally still at work, replaying the day and thinking about everything waiting …

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Why primary care burnout is really a patient-care problem

Clinical AI should replace workflows, not physicians

Health Technology
September 2, 2026

Every few months, the news runs with a headline about artificial intelligence replacing doctors. A model passes an exam. A chatbot answers a patient question. A system summarizes a chart or reads an image. The debate starts again.

Will AI replace physicians? I think that is the wrong question. The better question is: Which parts of modern medical work should never have been placed on physicians in the first place?

Doctors are …

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Clinical AI should replace workflows, not physicians

A cold cost $945. The cost of primary care is broken.

Physician
September 2, 2026

Imagine with me, it’s January and you are sitting at work. Your muscles start to ache, and you have a strong desire to lay your head down on the desk for a quick rest. Maybe you overdid it shoveling snow a couple of days ago. Maybe you slept wrong.

Over the next 24 hours, you feel worse. You develop a headache. Your eyes burn. Your nose drips like a faucet one …

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A cold cost $945. The cost of primary care is broken.

Physician autonomy predicts who leaves, not exhaustion

Physician Finance
September 2, 2026

A friend told me he had counted it out. Eleven more years and he could stop. He said it the way you would read a lab value, flat, no feeling in it. He is a good doctor. He was not describing a job. He was describing a sentence he had to serve.

That word, trapped, comes up more than exhaustion does.

This piece is about that feeling and what the evidence actually …

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Physician autonomy predicts who leaves, not exhaustion

Cosmetic dentistry abroad is not about the lowest price

Patient
September 2, 2026

I have spent years in front of cameras. Fashion events, interviews, photographs, social media, and meetings are part of my professional life, so I have always been conscious of my smile. I wanted it to look beautiful, modern, and natural, not like a row of extremely white, identical teeth. I wanted a smile that suited my face and made me feel confident whenever I laughed, spoke, or saw myself in …

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Cosmetic dentistry abroad is not about the lowest price

Why the AI therapy law will not protect your patients

Health Technology
September 2, 2026

California’s SB 903 cleared the legislature on August 31, with the Assembly concurring in Senate amendments by a vote of 40 to 0. It now sits on Governor Newsom’s desk. Assuming he signs it, it’s a real, needed law: It bars companies from advertising AI products as “therapy,” and it puts disclosure, consent, and human-oversight requirements around AI used inside licensed clinical care.

When I wrote about this bill back …

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Why the AI therapy law will not protect your patients

Climate medicine deserves the seriousness we gave HIV

Health Policy
September 2, 2026

This summer has offered a compelling case study on why there’s a pressing need for the emerging field of climate medicine and what the medical system must prepare for in the years ahead as extreme heat waves, powerful storms, and out-of-control wildfires become the norm. While commonplace in the West, wildfire smoke has once again drifted in from Canada to reach the East Coast. Catastrophic flooding has devastated …

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Climate medicine deserves the seriousness we gave HIV

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Why a pain management referral feels like an accusation

Conditions and Diseases
September 2, 2026

I vividly recall the expression on Tim’s face during his initial visit to my exam room. Rather than relief, he exhibited suspicion. After enduring years of chronic pain, Tim had been referred to me, an interventional physiatrist, and had come to perceive a referral to “pain management” not as an opportunity for assistance, but as a judgment. He feared I would regard him not as a patient in need, but …

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Why a pain management referral feels like an accusation

Can AI in risk adjustment be trusted to code accurately?

Health Technology
September 2, 2026

Health care’s relationship with artificial intelligence (AI) often swings between two extremes: enthusiasm and anxiety. On one hand, AI is helping clinicians reduce administrative work, uncover relevant information buried in medical records, and identify opportunities to improve patient care. On the other, regulators are becoming increasingly concerned about how AI is used in high-stakes decisions that affect payment, compliance, and patient outcomes.

In February 2026, the Office of Inspector General …

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Can AI in risk adjustment be trusted to code accurately?

Patient balance collection is nobody’s actual job

Physician Finance
September 2, 2026

A patient is checking out after a routine visit, and the front desk has to say the number out loud: 400 dollars, today, under the deductible. The patient’s face changes. The staffer wasn’t hired for this conversation and doesn’t have much beyond “that’s what the system says you owe.”

This exact scene runs in practices everywhere, multiple times a day, and almost nobody standing at that desk was ever specifically trained …

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Patient balance collection is nobody’s actual job

AI in hospital medicine can give hospitalists time back

Health Technology
September 2, 2026

It has been 30 years since the term “hospitalist” was introduced, and while the specialty has grown into one of the fastest-growing medical specialties in the United States, it now faces a defining inflection point. Excessive bureaucratic tasks, financial pressures, escalating documentation demands, and the growing burden of electronic health records (EHRs) are often cited as primary drivers of burnout, affecting over one-third of hospitalists. As an example, hospitalists …

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AI in hospital medicine can give hospitalists time back

She spent weeks on her personal statement. Then someone asked why she didn’t use AI. [PODCAST]

Podcast
September 1, 2026
YouTube video

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

A resident read a student’s personal statement and asked why she didn’t just use ChatGPT. The comment landed like a wound. In this episode, certified coach and professor Kathleen Muldoon returns to unpack …

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She spent weeks on her personal statement. Then someone asked why she didn’t use AI. [PODCAST]

Not medically necessary: the three words that cost me $9,000

Conditions and Diseases
September 1, 2026

Last summer I received a $9,000 bill for an overnight hospital stay that I probably could have done without, medically speaking. It started two days earlier, when I went in for a prostate biopsy. Mind you, this was my third biopsy and each one, including this one, turned out to be negative. Nevertheless, my doctor keeps asking me to undergo these invasive …

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Not medically necessary: the three words that cost me $9,000

GLP-1 weight regain: We are funding the wrong half

Medications
September 1, 2026

I have some version of the same conversation every week now. A patient is starting semaglutide or tirzepatide, and partway through the visit they ask the question I suspect most of us are hearing constantly: What happens if I ever stop?

For a while I gave the honest-but-incomplete answer, that we’d cross that bridge when we got there. I don’t anymore, because I think the real answer has less to do …

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GLP-1 weight regain: We are funding the wrong half

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