Retirement account taxes distort physician net worth

Physician Finance
August 23, 2026

Your net worth statement is the only financial document in America that routinely counts someone else’s money as yours.

It lists the retirement accounts, the brokerage, the house, the practice interest, and adds them with the quiet confidence of arithmetic. The number is not wrong so much as incomplete. It books your assets at gross, and the largest have a co-owner who has not yet invoiced you. A $5 million pre-tax …

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Retirement account taxes distort physician net worth

The system isn’t broken. It was built this way.

Conditions and Diseases
August 23, 2026

An excerpt from A Failure of Imagination: How the Healthcare System Fails Neurodivergent People—and What We’re Doing Instead.

I’m a physician. That’s the only formal training I have. When I set out, I didn’t know how to start or run a nonprofit. I didn’t know how to build a medical practice, let alone a model of health care delivery from scratch. But I did know this: If you want to …

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The system isn’t broken. It was built this way.

Why should doctors treating family members step back?

Physician
August 22, 2026

An excerpt from Treating a Broken System: A Physician’s Cure For the Healthcare Crisis.

I remember the event clearly, even though it was more than forty years ago. I was a fairly new faculty member in a Philadelphia university medical center, having finished my residency in internal medicine a few years prior. My wife, Terry, and I had been married for six years, and we had two kids at the …

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Why should doctors treating family members step back?

Why vaginismus stays hidden for years before diagnosis

Conditions and Diseases
August 22, 2026

Siya was 35 when she first came to see me. She had been married for seven years and she had not been able to have intercourse. She had seen gynecologists and obstetricians before me. Two of them told her, “Take a glass of wine, all is good.” A few told her to use a numbing gel. Some told her, “First time can be painful, bear with it.” One of them …

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Why vaginismus stays hidden for years before diagnosis

GLP-1 weight loss stigma changes what patients disclose

Medications
August 22, 2026

She had five close friends. She told one.

Not because she doubted the prescription. Her GP had raised tirzepatide after her bloodwork showed worsening insulin resistance, and the decision followed a real clinical conversation. She told one friend because she did not know what the truth might do to the other four relationships.

Would her weight loss still count? Would lunch become surveillance? Would every smaller portion be treated as evidence? Would …

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GLP-1 weight loss stigma changes what patients disclose

Nursing home understaffing is a choice, not a shortage

Conditions and Diseases
August 22, 2026

There was a point, not very long ago, when I thought I understood the staffing crisis in America’s nursing homes.

Like most people, I had heard the statistics. We don’t have enough nurses. Too few certified nursing assistants are entering the profession. Caregivers are overworked, underpaid, and burning out. An aging population needs more care than the workforce can provide.

It all made sense.

When another story surfaced about a resident suffering a …

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Nursing home understaffing is a choice, not a shortage

Painful diabetic neuropathy treatment goes beyond pills

Conditions and Diseases
August 22, 2026

As a pain physician, I see patients every week whose lives have been quietly hijacked by neuropathy. They describe burning feet that keep them awake at night, the strange “electric” jolts that shoot up their legs, or the numbness that makes them fear falling. Many have diabetes. Many have already tried multiple medications. And too many have been told, “There’s nothing more we can do.”

That is simply not true.

Neuropathy …

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Painful diabetic neuropathy treatment goes beyond pills

Chelsea Clinton on maternal mortality and moral optimism

Health Policy
August 22, 2026

Today’s world can often feel cruel, chaotic, and morally adrift. When you see millions at risk of losing health insurance for no justifiable reason, or watch women denied essential care because of political malfeasance, despair feels like a rational response. And yet, amid the noise and injustice, there are those who refuse to give in, people who continue, day after day, to build a more equitable, inclusive, and humane world. …

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Chelsea Clinton on maternal mortality and moral optimism

How journal transfer without rejection avoids scrutiny

Physician
August 22, 2026

Academic publishing has its own dialect, a language of polite evasions, soft landings, and decisions that say everything without saying anything at all. After decades in medicine, I thought I had seen every variation of editorial rejection. I was wrong. Recently, I submitted a manuscript describing a structured primary care model for autism diagnosis, a model that worked, was scalable, and addressed the capacity crisis that developmental-behavioral pediatrics has been …

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How journal transfer without rejection avoids scrutiny

A nurse’s case for going back to basics on your health

Conditions and Diseases
August 22, 2026

What if the answer to our health crisis isn’t a new program, a supplement, or a money-back guarantee?

What if it’s just the basics?

We live in a world of endless health information. Ads promising quick fixes, fad diets with celebrity endorsements, wellness programs that guarantee results or your money back. Everywhere you turn, someone is selling you a shortcut to health. And yet, as a country, we are sicker than ever.

I’ve …

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A nurse’s case for going back to basics on your health

Your leaky gut tests aren’t fixing you [PODCAST]

Podcast
August 21, 2026
YouTube video

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

A teacher came in for migraines and weight loss with a stack of leaky gut test results and a diagnosis that never fixed her. Shiv K. Goel is a board-certified internal medicine and functional medicine physician who argues that leaky gut is …

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Your leaky gut tests aren’t fixing you [PODCAST]

How to run a drill on your physician succession plan

Physician Finance
August 21, 2026

In 2009, a New England Journal of Medicine analysis examined 84,730 patients undergoing inpatient general and vascular surgery and ranked the hospitals by risk-adjusted mortality. The expectation was that the best-performing hospitals would be the ones where less went wrong.

That is not what the data showed. Major complications occurred in 16.2 percent of patients at hospitals in the lowest-mortality quintile and 18.2 percent at hospitals in the highest. Overall complications …

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How to run a drill on your physician succession plan

I don’t like who I’ve become in primary care

Physician
August 21, 2026

I don’t like who I’ve become, working in primary care.

In the medical community, it seems like we’ve discussed the root causes of burnout ad nauseam: too much paperwork, too many in-basket messages and inane patient requests, too many clicks in the EMR, too-short appointment times, too much corporate consolidation and insurance overreach. But as I see it, the end result, the final common pathway, is this: Most of us have …

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I don’t like who I’ve become in primary care

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How to evaluate supplements before the next purchase

Conditions and Diseases
August 21, 2026

An excerpt from The Right Supplements: A Doctor’s Method for Knowing What Your Body Actually Needs.

One afternoon a few years back, a new patient, Mrs. Patterson, came into my office lugging a big plastic grocery bag that rattled with every step she took. She plopped it down on the counter, gave me a tired but hopeful smile, and started pulling out bottles. One after another, thirty-two in total. There …

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How to evaluate supplements before the next purchase

Concussion counts miss what repetitive head impacts do

Conditions and Diseases
August 21, 2026

During this summer’s World Cup, we all watched players redirect the ball with remarkable precision. Our first reaction to a well-executed header was probably, “What a play.” But as a neurosurgeon who has spent much of my career studying head trauma among athletes, I also view those moments through a more clinical lens.

The concern around head impact is not limited to a dramatic collision that produces symptoms or a diagnosed …

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Concussion counts miss what repetitive head impacts do

You already run clinical diligence on every rollout

Physician Finance
August 21, 2026

Your hospital recently adopted a new piece of technology. Maybe it was an EHR module. A patient monitoring upgrade. A documentation tool. A new device in the OR.

Think about what happened next. Some of your colleagues embraced it. Others resisted. The nurses figured out workarounds within a week. The IT department sent three emails about training sessions that nobody attended. Six months later, half the staff is using the new …

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You already run clinical diligence on every rollout

Why addiction treatment needs both medication and therapy

Conditions and Diseases
August 21, 2026

Addiction medications like methadone and Suboxone are incredible resources for those struggling with addiction. In fact, these medications are so effective that there’s been a movement to switch to language that recognizes the merits of medication as its own evidence-based treatment rather than a supplement to therapy. For example, major organizations such as the National Institute on Drug Abuse (NIDA) now avoid the term “medication-assisted treatment” in favor of …

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Why addiction treatment needs both medication and therapy

Why setting boundaries as a physician feels impossible

Physician
August 21, 2026

Many of the physicians I work with bring up the issue of boundaries. “I know I need to set better boundaries, but.” They see the costs. They are clearly aware of what they need to do but just can’t seem to execute. They let patients drive the conversations in the exam room so that they run late and finish notes at midnight. They agree to a schedule change to help …

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Why setting boundaries as a physician feels impossible

A stroke survivor’s case for disability in medical training

Medical Education
August 21, 2026

As a radiology technician and a stroke survivor, my professional journey has been deeply shaped by my personal experiences. In clinical education, we often focus on technical proficiency, but we rarely discuss the structural and social barriers faced by health care professionals with disabilities. This reflection is not a piece of research, but a call to re-evaluate our approach to inclusion in medical training.

When I was just six years old, …

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A stroke survivor’s case for disability in medical training

What a psychiatric diagnosis means is not an explanation

Conditions and Diseases
August 21, 2026

When I tell a patient that she has major depressive disorder, something subtle happens in the room. What I mean and what she hears may be two very different things.

I may mean that her symptoms meet an established set of criteria: depressed mood, loss of interest, changes in sleep or appetite, impaired concentration, and enough distress or dysfunction to cross a diagnostic threshold. She may hear something considerably stronger: The …

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What a psychiatric diagnosis means is not an explanation

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