Why so many doctors secretly feel like imposters

Physician
July 19, 2025

One of the most important—and least discussed—truths in medicine is this:

Feeling inadequate in medicine isn’t rare. It’s everywhere—quiet, lingering, relentless.

I remember starting my outpatient practice right out of residency. I had joined a large multispecialty group filled with physicians trained at top-tier institutions. Many had been practicing for decades. They were confident. Efficient. Experienced. I was still waiting on my board scores—unsure if I was even certified yet. And yet—there …

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Why telling kids to eat less and move more fails to address obesity

Conditions
July 19, 2025

Despite decades of public health messaging urging children to “eat less and move more,” rates of pediatric obesity continue to rise globally. In the U.S. alone, nearly 1 in 5 children and adolescents aged 2–19 years have obesity, with higher rates among those from low-income or minority backgrounds. While caloric balance is a basic principle of weight regulation, the oversimplification of obesity into a matter of willpower neglects the …

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Why enterprise risk management is key to value-based health care success

Physician
July 19, 2025

The evolving contemporary era of value-based health care (VBHC) demands new risk leadership. VBHC emphasizes quality, outcomes, safety, equity, and stakeholder satisfaction. With these goals come complex, cross-cutting risks, including workforce shortages, clinical complications, health care staff safety, cyberattacks, and supply chain disruptions. To address the modern risk situation, health care systems must allocate resources to resilient, enterprise-wide risk governance and innovations.

The enterprise risk management (ERM) framework is the centerpiece …

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Rethinking physician resilience for sustainable well-being

Physician
July 19, 2025

Personal resilience is one of the three core components of the Stanford model of physician professional fulfillment, used across institutions to inform provider well-being strategy. Yet, limited data suggest only a minority of physicians view personal resilience initiatives as beneficial to their well-being, and physicians have expressed resistance and frustration toward organization-based individual resilience promotion.

I have led and participated in workplace meditation courses, stress management talks, …

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How shared language saved a patient from isolation

Physician
July 19, 2025

I was midway through a busy afternoon clinic when my pager erupted—an inpatient consult request. The case sounded messy: Chronic pancreatitis that had suddenly spiraled downward. A fresh, sizable mass sat in the pancreatic head; tumor markers were positive. Two endoscopic biopsies had failed, and surgery felt too risky for this frail patient. Cancer seemed the only plausible answer.

Rheumatology—my service—was called in because her ANA was weakly positive (1:40). In …

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The shocking risk every smart student faces when applying to medical school

Physician
July 18, 2025

The threats we face throughout our medical practice years are rarely published in the world medical practice literature for a good reason. The medical practice system has so many disruptive, threatening, and hidden educational factors to confess to that it is a miracle we have any American physicians still practicing today. That needs to be changed.

Most physicians in private medical practice, who suffer the most economically, are now reaching their …

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Clinical ghosts and why they haunt our exam rooms

Conditions
July 18, 2025

As a quadruple board-certified physician and a patient with a complex autoimmune disease, I live on both sides of the examination table. My professional life is about finding answers; my personal life has been about the agony of waiting for them.

This dual perspective makes it impossible to ignore a systemic problem in modern medicine: A class of diagnoses that live in the shadows. Seronegative Sjögren’s, mast cell activation syndrome (MCAS), …

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High blood pressure’s hidden impact on kidney health in older adults

Conditions
July 18, 2025

Most people think of high blood pressure as a silent threat to the heart. But it’s time we start talking about another organ it quietly destroys: the kidneys.

As a public health researcher and clinician, I have seen how chronic kidney disease (CKD) creeps in unnoticed—especially among older adults—and how hypertension is often the unspoken culprit. Despite being preventable and treatable in its early stages, CKD remains a major cause of …

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Deep transcranial magnetic stimulation for depression [PODCAST]

Podcast
July 17, 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, “How deep transcranial magnetic stimulation is transforming mental health care.” He shares his experience with deep TMS (dTMS), …

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How declining MMR vaccination rates put future generations at risk

Conditions
July 17, 2025

We thought we had moved on from diseases like rubella. But as measles makes a comeback, rubella may not be far behind, and this time, it could harm the next generation before it’s even born. Most people today have never seen a baby born with congenital rubella syndrome, a condition that causes blindness, deafness, heart defects, and developmental delays. That’s not because it stopped happening—it’s because vaccination kept rubella from …

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The physician who turned burnout into a mission for change

Physician
July 17, 2025

When I stepped away from my clinical practice, it wasn’t because I didn’t care. It was because I cared deeply—about my patients, my colleagues, and the future of medicine. I didn’t leave to escape. I left to help heal the culture that was quietly breaking so many of us.

You can love medicine and stop seeing patients. You can love medicine and change the way you see patients. Choosing to follow …

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Time theft: the unseen harm of abusive oversight

Physician
July 17, 2025

Theft, in its essence, is the unlawful taking of something valuable from another. While usually associated with material possessions, it also extends to intangible assets such as time, reputation, and emotional well-being. When authorities like medical boards or the Department of Justice (DOJ) engage in unfair practices grounded in presumptive guilt, they are not just misusing their roles but actively stripping individuals of these invaluable resources—an abuse of power that …

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How one unforgettable ER patient taught a nurse about resilience

Conditions
July 17, 2025

Every ED has patients who become part of the landscape. They come in once or twice a week, for all kinds of reasons. Sometimes they have chronic medical conditions they are unable to manage. Sometimes they are on the outskirts of society due to mental health or substance abuse disorders. The ER promises a few hours of sleep in a safe place and a meal. I formed an uneasy alliance …

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The future of clinical care: AI’s role in easing physician workload

Tech
July 17, 2025

Walk into any emergency room across the country and you’ll see familiar scenes: crowded waiting rooms, overstretched resources, and overworked physicians balancing patient care with substantial administrative burdens. Against this backdrop, physician burnout remains unacceptably high (48.2 percent of physicians), with clerical duties cited as the most common cause. Many physicians also spend significant time after working hours catching up on …

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Eric Topol explores the science of super-agers and healthy aging [PODCAST]

Podcast
July 16, 2025
YouTube video

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

Cardiologist and author Eric Topol discusses his article, “What super agers can teach us about longevity and health span,” which is an excerpt from his new book, Read more…

Why more doctors are leaving clinical practice and how it helps health care

Physician
July 16, 2025

The author of a recent article claimed that “we all lose” when an experienced physician prematurely leaves clinical medicine. Of course, it is inevitable that a clinical career will end, but whether patients and society suffer depends on what that retiring doctor does next. Increasingly, it seems, they pursue other ways to help patients and add value to the system by pursuing non-clinical careers. That’s a good thing, because:

Harassment and overreach are driving physicians to quit

Physician
July 16, 2025

In the noble pursuit of healing, physicians, especially those in pain clinics, are increasingly caught between the growing burden of patient expectations and a tightening web of regulatory scrutiny. A recent clinical study and a related article on KevinMD converge to highlight a deeply troubling reality: Clinicians are not only being harassed by distressed patients but are also being punished by the systems meant to regulate or protect health care.

A …

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Why regular exercise is the best prescription for lifelong health

Conditions
July 16, 2025

An excerpt from Tales from the Trenches: A life in Primary Care.

For nearly four decades in medical practice, I’ve been asked countless times about the best supplements or vitamins for improving health. Despite widespread hopes that pills can unlock vitality and longevity, the truth is less glamorous and far more powerful: The single best prescription for health is regular physical activity. Exercise, not supplements or medications, is the most …

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When the weight won’t budge: the hidden physiology of grief, stress, and set point

Conditions
July 16, 2025

We often speak of weight as a matter of simple math—calories in, calories out. But the body doesn’t work like an equation when it’s grieving or under chronic stress. It behaves more like a survivor, clinging tightly to resources in the face of perceived danger. And in that physiological equation, cortisol—our primary stress hormone—plays a central role.

The cortisol connection

Cortisol is released by the adrenal glands in response to stress through …

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Why starting with why can transform your medical practice

Physician
July 16, 2025

Have you ever asked yourself, “Why do your patients select you and your practice for their medical care?” Most medical practices offer the same service, i.e., evaluation and treatment, at approximately the same cost, and produce similar outcomes. After all, how many ways are there to treat a urinary tract infection, diabetes, hypertension, or arthritis? Most doctors are trained to offer similar services, which typically produce identical outcomes. So, why …

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