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Rural health care crisis: Can telemedicine close the gap?

Griffin Popp

Policy

February 20, 2026

Between 2005 and the present, 195 rural hospitals have closed, with a 50-hospital net reduction occurring just between 2017 and 2023. These closures, compounded by significantly worse measures of social determinants of health (SDOH), high prevalence of Medicaid or Medicare patients, and longer commute times, have created a crisis of access for rural Americans.

The disproportionate impact on rural residents

Compared to their urban and suburban counterparts, …

Reviewing locum tenens agreements: Look beyond the hourly rate

Sriman Swarup, MD, MBA

Physician

February 20, 2026

I was halfway through reviewing what looked like an excellent locums opportunity when I realized the hourly rate was the least important number in the agreement. The compensation was strong. The schedule was flexible. Travel was covered. On the surface, it seemed straightforward.

But what ultimately determined whether the opportunity made sense had very little to do with pay. It had to do with clarity.

The difference between conversations and contracts

Locums conversations …

The misuse of hormone therapy in menopause care

Kay Corpus, MD

Conditions

February 20, 2026

As an integrative and functional medicine physician, I prescribe hormone therapy. I also see its misuse daily.

Hormone replacement therapy (HRT), including bioidentical hormone therapy (BHRT), has re-entered menopause care with force, correcting decades of dismissal and undertreatment. That correction was necessary, but the pendulum has swung too far.

What I am seeing clinically is not thoughtful, physiology-based care. It is hormone-first medicine that bypasses stress physiology, nervous system dysregulation, trauma, metabolic …

Physician burnout: Finding peace in a broken health care system

Jessica Singh, MD

Physician

February 20, 2026

Among the people exiting the hospital, I could easily pick out the medical staff leaving their shifts. It wasn’t by their clothing or the time of day, but by the unspoken language of relief on their faces: a calm twinkle in the eyes or a gentle softness around the forehead and jaw. Dawn or dusk, the look was always there. I hoped I’d have it too when I left later …

Why “eat less, move more” fails for midlife weight loss

Marsha Shepherd Whitt

Conditions

February 20, 2026

Clinicians often notice a frustrating pattern: Women in midlife follow standard weight-loss advice, eat less and move more, yet see little progress. Calories are reduced, exercise increases, and still the scale barely moves. This is often blamed on motivation, discipline, or compliance. But in many cases, the real issue is not behavior. It’s physiology.

Perimenopause and menopause are not simply estrogen-deficient states; they are states of altered signaling, altered tissue responsiveness, …

Locum tenens offers physicians a path to freedom [PODCAST]

The Podcast by KevinMD

Podcast

February 19, 2026

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

Pediatrician Trevor Cabrera discusses his article “Locum tenens: Reclaiming purpose, autonomy, and financial freedom in medicine.” Trevor explains how choosing the path of an independent contractor allowed him to pay off massive …

Lifestyle medicine vs. medication: Why prevention is the future

Jenna ODonnell

Education

February 19, 2026

During my first two years as a medical student, I have often been struck not only by how much medicine has advanced, but by how frequently the foundations of health are overlooked. This perspective was shaped early in my career through my first postgraduate role, where I spent three years collecting patient data for a multisite study evaluating a lifestyle-based intervention to reverse metabolic syndrome.

At a data analysis meeting with …

Understanding the 4 models of health care: Where the U.S. fits

Howard Smith, MD

Physician

February 19, 2026

We are frequently told that our health care system is expensive. However, most of us, including physicians, have no notion about what the health care system really is, to judge whether or not we are getting our money’s worth.

There are four major structural models for a health care system:

The Beveridge model (socialized medicine): Health care is provided and financed by the government through tax payments (e.g., United Kingdom’s NHS).

…

What got you here won’t get you there: a physician’s guide to leadership

Harvey Castro, MD, MBA

Physician

February 19, 2026

You became a physician because you were driven. You studied longer, pushed harder, and tolerated pressure better than most. You needed to be right and usually were. That formula worked. It got you through pre-med, medical school, residency, and into practice. It earned you respect and built your reputation.

But at some point, quietly, subtly, that same formula can start working against you. I realized this after reading Marshall Goldsmith’s book, …

The 3-2-1 method: a doctor’s guide to keeping New Year’s resolutions

Anthony Fleg, MD

Physician

February 19, 2026

Welcome to the first weeks of the new year. A great moment to check in.

How are you doing? How are you feeling? Energy level?

The first days of the new year come with a lot of excitement and a lot of pressure.

Excitement for the sense of renewal and becoming better versions of ourselves. Excitement in putting the last year to rest and starting with a clean slate. Excitement at putting down …

Single-payer health care vs. market-based solutions: an economic reality check

Allan Dobzyniak, MD

Policy

February 19, 2026

Single-payer health care is generally defended with “heart-wrenching” virtue signaling divorced from any cost, economic, or financial reality. The idea that any scarce service or commodity is a right and therefore should be free is fanciful, but impossible. With an indebtedness of $38 trillion and growing, adding greater than $40 trillion as estimated for the cost of “Medicare for All” would absolutely drive the country into insolvency. Even without single-payer, …

Learning from patients: How a physician gained strength and resilience

Samantha Fernandes, MD

Physician

February 19, 2026

I remember. It is a gorgeous summer day as the sunlight streaks through the redwood canopy. My grip clenches the dangling rope. My stance wobbles on the itty-bitty circular disk. I am uncertain. Teeter-tottering, I plot my next move. It does not happen. I plummet. My harness transforms into a bucket swing, saving me from the forest floor. I sway in the pleasant breeze. I cannot finish the Level 1 …

Early screening saves limbs from silent vascular disease [PODCAST]

The Podcast by KevinMD

Podcast

February 18, 2026

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

Postdoctoral researcher Wei Zhang discusses the article “Peripheral artery disease prevention: Saving limbs and lives.” Wei explains how peripheral artery disease acts as a silent burden on the “life-highway” vessels of …

The “ethical canary”: How moral injury signals systemic failure

Courtney Markham-Abedi, MD

Conditions

February 18, 2026

For the past month and maybe longer, I have been waking up with pressure in my chest. It worsened in December and continued to worsen in the new year. I had identified it as anxiety, but felt it was of a different quality than my run-of-the-mill anxiety. This feeling was more anguished.

During the first week of January, I volunteered at a clinic, where I saw patients, assessed, and treated psychiatric …

Beyond Flexner: Why we must rethink medical training reform

Ravi Agarwala, MD

Education

February 18, 2026

Our current scheme and its overbearing credentialism is out of date and cannot keep up with a rapidly changing health care environment. Greater flexibility is needed for the well-being of patients and physicians alike.

Professional burnout and anticipated physician shortages continue to be highly debated topics. Indeed, the American Medical Association reports that 45 percent of physicians have symptoms of burnout, and the Association of American Medical Colleges anticipates a …

Rural emergency medicine in New Mexico: a physician’s firsthand account

Sarah Bridge, MD

Physician

February 18, 2026

Recently, I was asked to write about my experience as a rural emergency physician in New Mexico. The timing was uncanny: I am in the final shifts of my first job out of my emergency medicine residency on the East Coast, having spent more than four years working in emergency departments across western rural New Mexico, primarily within the Indian Health Service.

Summarizing this experience concisely feels impossible. Every emergency physician …

Trauma reactivation: Why news headlines trigger past abuse

Barbara Sparacino, MD

Conditions

February 18, 2026

She did not begin with the abuse; she began with sleep.

“I do not know why the news is bothering me so much,” she said. “I cannot turn it off. I feel on edge all the time.”

She was in her late 50s, successful, articulate, and with no prior trauma history documented in her chart. She insisted she was not “overreacting,” just “sensitive to injustice.” At the time, headlines were saturated with …

Ambiguous billing rules threaten every doctor in practice [PODCAST]

The Podcast by KevinMD

Podcast

February 17, 2026

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 “Why CPT coding ambiguity harms doctors.” Muhamad analyzes the landmark case of United States v. Ron Elfenbein, where …

Deprescribing in health care: Why less medication can be more

American Medical Association & John Whyte, MD, MPH

Meds

February 17, 2026

Every day, millions of Americans take medications to manage chronic conditions or prevent disease. Prescription drugs are vital tools in modern medicine, but in some circumstances, they can also lead to serious adverse drug interactions, diminished quality of life, and even life-threatening complications.

This is a complex issue with high stakes for patients. Older adults, in particular, are often prescribed multiple drugs by different doctors for different reasons. The Centers for …

What the folinic acid retraction means for autism treatment

Timothy Lesaca, MD

Physician

February 17, 2026

On January 29, 2026, the European Journal of Pediatrics formally retracted what had been the largest randomized clinical trial examining folinic acid as an intervention for autism. The reason, according to the journal’s notice, was direct: The study’s data did not support its published conclusions.

Originally released in 2024, the trial reported that 24 weeks of oral folinic acid therapy produced a “significant reduction” in autism symptoms among 77 children. In …

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