Canada’s 2025 health care crisis explained

Physician
October 23, 2025

In 2025, Canada’s universal health care or Medicare system confronted a stark wake-up call. Many high-visibility service disruptions exposed the health care delivery model’s fragility and stress points. There were emergency room (ER) closures and specialty service interruptions.

In British Columbia, many hospitals repeatedly and increasingly closed their ERs for hours or days due to staffing shortages. The hospitals in large cities like Delta and Mission had multiple separate ER shutdowns. …

Read more…

First physician employment agreement mistakes

Finance
October 23, 2025

I have been representing physicians for over 30 years, and I am still amazed by the attitude of most young physicians going into their first attending position. These are smart, accomplished, fully qualified physicians who have received some of the best clinical training in the world. And yet, many of these highly trained individuals in a field with massive shortages seem reluctant to acknowledge even the slightest modicum of self-worth.

Bear …

Read more…

Treating chronic pain in older adults

Conditions
October 23, 2025

For decades, I treated patients with chronic pain. One truth became evident early: most older adults prescribed narcotics use them responsibly. My clinical acumen, shaped over more than forty years, intuitively knew this to be true. Still, I understood that intuition and opinion alone are insufficient. Compassion in medicine must be paired with objectivity.

Now the data confirms what practice long suggested. A national survey of adults aged 50 and older …

Read more…

A nurse’s story of hospital bullying

Conditions
October 23, 2025

An 18-year-old was admitted to our ICU with a questionable diagnosis. The drug screen did not reveal what he had taken. Our ICU intensivist speculated he ingested bath salts. Bath salts came to the U.S. around the 2010s. It was cheap and, even better, considered a “legal high” as it was not detectable in drug tests. Josh came to the emergency room psychotic, paranoid, and hallucinating, with hypertension and SVT. …

Read more…

Confronting the hidden curriculum in surgery

Education
October 23, 2025

“It is, I think, not easy to exaggerate the importance of the informal social element in the promotion of science and learning.”
– Abraham Flexner, 1930

As stated by Mr. Flexner, the importance of the informal social element of science and learning is one of the key fundamentals of the hidden curriculum, a well-understood but unspoken rule in medical education and training. The hidden curriculum consists of the unspoken or implicit …

Read more…

Protecting physicians when private equity buys in [PODCAST]

Podcast
October 22, 2025
YouTube video

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

Veteran attorney Dennis Hursh discusses his article “Private practice employment agreements: What happens if private equity swoops in?” In this episode, Dennis explains how private equity acquisitions of medical practices complicate the …

Read more…

Why faith and academia must work together

Education
October 22, 2025

Ten years. That’s how long I carried around this idea I just couldn’t seem to put into action. I wanted to speak openly about this tension I felt as both an academician and an ordained minister. Yes, this false notion that my academic life and my spiritual life had to run on separate tracks. Not only did I want to openly discuss this tension; I wanted to do something about …

Read more…

Pancreatic cancer racial disparities

Conditions
October 22, 2025

The names read like a roll call of Black excellence: congressman John Lewis, the civil rights icon who walked across the Edmund Pettus Bridge and helped change America; congresswoman Sheila Jackson Lee, the tireless advocate for justice who represented Houston for nearly three decades; Aretha Franklin, the Queen of Soul whose voice defined generations; reverend Dr. Calvin O. Butts III, the prophetic voice from Abyssinian Baptist Church who fought for …

Read more…

What AI can never replace in medicine

Physician
October 22, 2025

When I opened my dermatology practice 25 years ago, I used paper charts, a prescription pad, and a Dictaphone. Today, I use AI daily: for transcription, charting, and even reviewing complex labs. It’s certainly made my work more efficient.

But I’ve also seen something else: the erosion of trust between patients and physicians. I’m fortunate to practice independently, with the freedom to answer only to my patients, not a corporate boss. …

Read more…

Why the MAHA plan is the wrong cure

Policy
October 22, 2025

“Make America Healthy Again (MAHA).” Finally, something we can all agree on.

The new MAHA report with its pages of promises taps into something real, something we see daily in primary care practice: Many Americans feel unwell, unheard, and unprotected by the very institutions meant to support them. Compared to our peer countries, we live shorter, sicker lives, suicide rates are rising, and even our children are …

Read more…

Why burnout prevention starts with leadership

Conditions
October 22, 2025

Many people have become “burned out” on the word burnout. Many doctors do not resonate with the term, feeling it describes personal struggles, when systemic issues are the root cause of the challenges facing health care professionals. They offer “moral injury” as a more accurate description. Clinicians can experience either or both at any time during their career.

Recently speaking with Shari Morin-Degel, I appreciated her sharing that because she had …

Read more…

Are SGLT2 inhibitors safe for type 1 diabetes?

Conditions
October 22, 2025

SGLT2 inhibitors have transformed care for people with type 2 diabetes. They not only lower blood sugar but also reduce cardiovascular events and slow the progression of kidney disease. Given these successes, many have asked whether the same benefits extend to people with type 1 diabetes (T1D).

The answer is not straightforward. In T1D, SGLT2 inhibitors remain off-label, and the biggest concern is the increased risk of diabetic ketoacidosis (DKA). Still, …

Read more…

ChatGPT in medicine: risks, benefits, and safer documentation strategies [PODCAST]

Podcast
October 21, 2025
YouTube video

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

Family nurse practitioner Erica Dorn discusses her article “ChatGPT in health care: Risks, benefits, and safer options.” In this episode, Erica explains how clinicians are experimenting with ChatGPT to help with HPI …

Read more…

ADVERTISEMENT

My experiences as an Air Force pediatrician

Physician
October 21, 2025

In Minot, I practiced a kind of pediatrics no flowchart could predict: improvised, airborne, and often surgical. Minot didn’t always follow the flowchart. One night, a toddler arrived in the emergency room, inebriated. Her father had given her vodka for teething pain, never imagining she’d swallow it. She did. She stopped breathing. I called a code and began CPR, ordering a blood alcohol level (BAL) and routine labs. Her BAL …

Read more…

Re-examining the lipid hypothesis and statin use

Conditions
October 21, 2025

A brilliant, like-minded cardiologist recently shared with me “A Reappraisal of the Lipid Hypothesis” by Dr. Robert DuBroff, published in The American Journal of Medicine. It should be required reading for every physician who has ever written “continue statin” without a second thought.

DuBroff’s analysis reviewed 29 randomized controlled trials of cholesterol-lowering therapy conducted after modern trial regulations were adopted. The results were quietly devastating:

How the internship shortage harms Black students

Conditions
October 21, 2025

An excerpt from How I Know White People Are Crazy and Other Stories. Copyright © 2025 Dr. Jonathan Lassiter. Published by Legacy Lit, a Hachette Book Group company. Reproduced by arrangement with the publisher. All rights reserved.

According to Dr. James M. Stedman, a white male clinical psychologist from the University of Texas Health Science Center at San Antonio, there was a shortage of [doctoral] internships as early as 1976. …

Read more…

How diverse nations tackle health care equity

Physician
October 21, 2025

Racial diversity impacts health care delivery. North American nations like Canada and the U.S. are multi-racial. The U.S. addresses equity via programmatic and regulatory levers layered on a fragmented financing system: Medicaid, the Office of Minority Health’s National CLAS Standards for culturally appropriate services, and targeted maternal and community health initiatives. Nonetheless, persistent racial gaps in insurance, access, and outcomes underscore the limits of non-universal coverage, with maternal mortality for …

Read more…

What is practical wisdom in medicine?

Physician
October 21, 2025

Mrs. C is 80, frail, with heart failure and early dementia. The team has begun discussing an ICD. Her daughter wants “everything done.” The resident knows the evidence cold; he can recite the trial data, the ACC recommendations, and the mortality benefit. But he’s frozen at the bedside.

The gap we don’t talk about

Modern medical education does one thing brilliantly: It transmits knowledge. Today’s residents master more pathophysiology, more evidence, and …

Read more…

Aligning psychiatric care and hospital costs

Conditions
October 21, 2025

In inpatient psychiatry, teams often face a familiar problem: The clinicians at the bedside see ongoing risk that warrants hospital-level care, while the payer’s reviewer concludes the stay is no longer “medically necessary.” The result can be frustration, rushed discharges, or days spent on the phone. Behind the scenes, costs mount; measured not just in dollars, but in readmissions, emergency department boarding, and clinician burnout. Physician advisors help resolve this …

Read more…

The dangerous racial bias in dermatology AI

Tech
October 21, 2025

The Bay Area has become the epicenter of artificial intelligence, home to renowned startups and labs racing to prove AI’s power to transform our daily lives.

Just three months ago, California released its own Frontier AI Policy Report, commissioned by Governor Gavin Newsom, which warned that without stronger oversight and transparency, AI models threaten equity and accountability, especially in health care. Nowhere is this danger more urgent than in dermatology.

A …

Read more…

609
pages