Funding autism treatments that actually work

Conditions
November 18, 2025

Applied Behavior Analysis (ABA) has become the default therapy for autism in the U.S., not because it’s the most effective, but because it’s the most entrenched. Mandated by insurers, funded by Medicaid, and marketed as “medically necessary,” ABA now consumes hundreds of millions of dollars annually. But here’s the truth: ABA is unproven, ethically fraught, and fiscally unsustainable.

As a developmental-behavioral pediatrician and lead investigator for the NIH-funded RUPP trials, I …

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How to reduce unnecessary medications

Physician
November 18, 2025

The greatest challenge for all who practice geriatrics is reducing polypharmacy, the addition of medications that either provide no benefit or cause harm to seniors. Millions of seniors end up on many medications that are not helping them and could be causing side effects. Geriatricians are the experts in what we call de-prescribing, cutting down on unnecessary medications.

The key reasons seniors end up on too many medications are the following. …

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Is owning a medical practice worth the ultimate financial risk? [PODCAST]

Podcast
November 17, 2025
YouTube video

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Certified financial planner Paul Morton discusses his article “Physician practice ownership: risks, rewards, and reality.” Paul breaks down the massive differences between an employed physician’s financial journey and that of an equity …

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Why the media ignores healing and science

Physician
November 17, 2025

I recently published a reflection on KevinMD, “A doctor’s duty on 9/11 in a small town,” a piece about clinical duty, quiet advocacy, and legacy. Boston University included it in my nomination for their Advocacy, Equity & Social Justice Alumni Award. I sent it to every major news outlet in my region. No one responded. One station asked if I’d go on camera. I agreed. Then, silence. This is …

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Why patients delay seeking care

Conditions
November 17, 2025

Every clinic has moments that stick with you. They aren’t always dramatic, but they show why some people end up suffering longer than they should. During my time working as a medical office assistant, I observed a recurring pattern that spanned across various age groups, backgrounds, and diagnoses. Patients didn’t delay care because they were careless. They delayed because the system had quietly taught them to.

One afternoon, a middle-aged woman …

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The burnout crisis in long-term care

Conditions
November 17, 2025

Canada’s primary health care crisis has garnered news headlines and political attention, but an equally alarming crisis is ongoing in long-term care (LTC). More than five years after COVID-19’s deadly sweep through LTC homes, exposing long-standing deficiencies in funding, infrastructure, infection control, staffing and working conditions, many problems remain, driving a critical staffing shortage, burning out workers and impacting resident care. With the need for LTC …

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A story of gaps in cancer care

Conditions
November 17, 2025

Since a diagnosis of colon and rectal cancer in 1993, I have had a number of serious complications and a recurrence. Some, if not most of what occurred could have been avoided. My experience points to some gaps in my health care that providers and patients might want to consider.

I was given the option to choose a cancer treatment and made the wrong choice. As a busy university administrator, I …

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The role of meaning in modern medicine

Physician
November 17, 2025

For the past century, physicians have practiced within the framework of materialism: the belief that everything real can be measured, and everything measurable is real. But that worldview has been quietly eroded by physics itself. In the double-slit experiment, particles behave as waves of probability until observed, at which point they collapse into definite form. Later variations (such as Wheeler’s delayed-choice experiments) demonstrated that observation seems to determine not only …

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Medicine’s silence on RFK Jr. [PODCAST]

Podcast
November 16, 2025
YouTube video

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Diagnostic radiologist Rakesh A. Shah discusses his article “A critique of medicine’s response to RFK Jr.” Rakesh argues that major physician organizations have failed in their duty to protect public health by …

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A new vision for modern, humane clinics

Physician
November 16, 2025

This is an invitation to clinicians and health leaders to shape the next decade of care: more precise, more connected, more human. The tools are here. The leadership is you.

The quiet nudge

If you’ve felt that steady tug that health care could be so much better, you’re not alone, and you’re not wrong. We’re investing more than ever, but patients still meet friction at the exact moment they need ease. That …

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The night of an impalement injury surgery

Conditions
November 16, 2025

On July 6, 2025, in Nanjing, China, a construction worker plunged onto a steel rod that pierced him from pelvis to chest. That night, doctors fought millimeter by millimeter through a five-hour battle against death.

The call at midnight

The phone’s shriek tore through the heavy summer silence just after midnight.

Professor Ji Zhenling, president of Nanjing Jiangbei Hospital, surfaced from sleep, the warmth of his pillowcase still pressed against his cheek. His …

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Finding your child’s strengths: a new mindset

Conditions
November 16, 2025

The question “What’s strong with me?” startled me the first time I heard it. Because we direct so many of our day-to-day thoughts to what’s wrong, it can feel odd to ask what’s strong. But this simple question has the power to release the tight hold that problems have on our thoughts and open a new way of thinking. We’ve all had moments when problems seem so big that it’s …

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The crisis of physician shortages globally

Education
November 16, 2025

Patients once traveled on foot from Afghanistan to see my father, a Cleveland Clinic-trained doctor who practiced in Peshawar, Pakistan. It is easy to attribute such health care to a developing country. But California’s economy outperforms whole nations, and patients in the Central Valley still drive for hours to get life-saving treatment. I have lived and studied in both of these “doctor deserts,” one arid and one fertile. Both are …

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How to better communicate medical numbers

Conditions
November 16, 2025

An important paper, “How to communicate medical numbers,” was published in a recent edition of the Journal of the American Medical Association (JAMA). This is so important, for the doctor-patient relationship, for what journalists write for the public, and for individual decision-making. One of the authors, Angie Fagerlin, PhD, of the University of Utah medical school and Salt Lake City Veterans Affairs Medical Center, was interviewed for a …

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An attorney’s guide to your first physician contract [PODCAST]

Podcast
November 15, 2025
YouTube video

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

Health attorney Dennis Hursh discusses his article “First physician employment agreement mistakes.” Dennis shares his amazement after 30 years in health law at the timidity of new attending physicians during contract negotiations. …

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Why do doctors lose their why?

Physician
November 15, 2025

There’s a quiet heaviness that has settled over medicine, not always visible, but deeply felt. It lingers in hospital corridors and hovers over clinic desks cluttered with charts and cold coffee cups. You can see it in the nurse scrolling through yet another new policy update, her shoulders sagging under invisible weight. You can hear it in the tired sigh of a physician glancing at the clock at 9 p.m., …

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Bureaucratic evil in modern health care

Conditions
November 15, 2025

The creed of compliance

In every hospital, a grotesque comedy unfolds: Poor Sod, our hapless patient, lies gut-shot, aorta spewing like a B-movie fountain. Clinicians, faces blank as overcooked porridge, scurry in a choreographed panic, clutching flowcharts like sacred scrolls. Monitors bleep like a chorus of lobotomised parrots. A registrar, mad enough to trust his gut, tries a life-saving stunt not in the Holy Manual. A nurse, eyes glinting with the …

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Protecting elder clinicians from violence

Conditions
November 15, 2025

The day before the attack, a senior physician at a Catholic university hospital in Taiwan sat with young medical students at noon, talking not about lawsuits or hospital finances, but about Brahms. He loved four-hand piano pieces, especially Brahms’s Hungarian Dances, and he would explain how two players must breathe together, listen to one another, and balance passion with discipline. For him, this was also a lesson about medicine: You …

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Why does lipoprotein(a) exist?

Conditions
November 15, 2025

I just read the new Cleveland Clinic Journal of Medicine introduction by its editor-in-chief, and it’s laying out the usual playbook: demonize lipoprotein(a) (Lp(a)), list all the terrible things it does, and hint that salvation is around the corner, pending results of a major pharmaceutical trial, of course.

It’s a neat narrative arc.

But it’s incomplete.

What’s missing is the one question almost no cardiology article seems willing to ask:

Why does Lp(a) exist …

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The myth of endless availability in medicine

Conditions
November 15, 2025

For years, I believed that the best clinicians were the ones who never stopped. We covered extra shifts, skipped meals, charted past midnight, and proudly wore exhaustion as a badge of honor. My patients were happy, my colleagues admired my work ethic, and I was quietly unraveling.

The slow slide into burnout

Burnout didn’t arrive like a crisis; it crept in as a constant background hum. I began to dread the pager’s …

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