Why the cannabis ethics debate is really about human suffering

Meds
December 10, 2025

Most discussions about cannabis stay on the surface: legality, crime, or medical claims. But the core question is this: What suffering does a society allow? After watching a recent documentary with police, lawyers, physicians, and families, I found cannabis is the stage. The real drama is the system behind it. When ethics is pushed far, inconsistencies become impossible to ignore.

1. Legal ethics: When the law punishes pain instead of harm

Some …

Read more…

Why fee-for-service reform is needed

Physician
December 10, 2025

You just saved a patient an emergency room visit with a three-minute portal message. You reviewed their connected blood pressure cuff data, saw a concerning trend, and tweaked their medication. It was efficient, high-quality, proactive care.

Your reward? Zero dollars.

Worse than that, your contribution was invisible. It didn’t count toward your productivity. It didn’t show up on a dashboard. In the eyes of our current health care system, that high-value interaction …

Read more…

Experts applaud the FDA hormone therapy decision to remove boxed warnings

Conditions
December 10, 2025

As a Menopause Society Certified Practitioner (MSCP), I strongly support the recent FDA decision to remove the boxed warnings from FDA-approved estrogen therapies. For decades, these warnings created unnecessary fear and confusion for women and clinicians alike. They were based on early interpretations of the Women’s Health Initiative (WHI) that we now understand were overstated, misapplied, and widely misinterpreted.

The new FDA stance aligns with The Menopause Society guidelines and what …

Read more…

The commercialization of the medical profession

Physician
December 10, 2025

The medical profession has gone through major changes from the days-past to present days. The transition from quackery to science, and from role assuming or inheriting to regulated graduate and postgraduate education.

The changes took place over centuries, but the most notable evolution in medical knowledge and training took place in the last couple of centuries and continues to evolve. Evolves may be used to describe positive as well as negative …

Read more…

Daily chemical exposure timing and your fertility [PODCAST]

Podcast
December 9, 2025
YouTube video

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

Fertility specialist Oluyemisi (Yemi) Famuyiwa discusses her article, “How timing affects chemical exposure risks.” Yemi introduces her fascinating concept of “chrono-exposomics,” explaining how the time of day you are exposed to environmental …

Read more…

Why feeling unlike yourself is a sign of physician emotional overload

Physician
December 9, 2025

Busy physicians are moving so quickly we almost never stop long enough to acknowledge the subtle ways medicine reshapes us. But every physician I’ve ever coached, including myself, can name a moment when they didn’t quite feel like themselves. Maybe it was:

  • An answer that came out sharper than intended.
  • A conversation where you noticed your patience had run thin.
  • A heaviness that you replay over and over on your …

    Read more…

A doctor on high-functioning alcoholism

Physician
December 9, 2025

For decades, I practiced medicine as a dermatologist and dermatopathologist, serving patients and teaching medical students at UC Irvine. I believed I could recognize addiction when I saw it. I was always alert for signs, such as the patient whose story didn’t quite match the evidence, or whose habits hinted at something deeper.

When alcohol came up in conversation, I learned early to quietly double whatever amount the patient reported; experience …

Read more…

How medical students can handle vaccine hesitancy in pediatrics

Education
December 9, 2025

“Explain a time you faced vaccine hesitancy and how you handled it.” As a fourth-year medical student applying for pediatric residency, this question came up often in interviews. It is an experience that almost every medical professional has encountered, even early in training. The first story that came to mind was from my newborn nursery rotation during my third year of medical school.

I met a first-time mother who had just …

Read more…

How to manage intraoperative pain during C-section deliveries

Conditions
December 9, 2025

A cesarean section, or C-section, is one of the most common surgeries in the United States. In 2023, 32.3 percent of live births were cesarean deliveries, while 67.7 percent were vaginal deliveries, according to the National Center for Health Statistics.

Pain during cesarean delivery under neuraxial anesthesia (regional anesthesia including spinal and epidural anesthesia) is a recognized clinical challenge and one that has received growing national attention. Recent media …

Read more…

Why polio eradication needs sanitation

Conditions
December 9, 2025

Before a doctor ever diagnoses a child with acute flaccid paralysis, the culprit leaves definitive clues in the sewer. At the Noguchi Memorial Institute for Medical Research, we spin bottles of wastewater in the centrifuge, pH-balance, and look for these clues. Their presence signals the return of an enemy we once thought we had defeated.

For decades, the world has rallied around the dream of eradication, the triumphant declaration that humanity …

Read more…

An allegory for the broken U.S. health care system

Physician
December 9, 2025

A Guide and a Seeker walk into a bar.

The Seeker says, “I’m so glad I’m here, I’ve been searching far and wide for good beer to slake my thirst, and you, my Guide, have finally brought me here!”

The Guide says, “Ah, I know just the thing. I’ll get you some Dos Equis. A merchant’s representative told me it’s the most interesting beer in the world!”

The Guide tries to order a …

Read more…

Why lifestyle change advice from doctors fails

Conditions
December 9, 2025

At the end of a clinic visit, the conversation often turns to lifestyle: eat healthier, exercise more, cut back on alcohol, sleep better. Patients nod, agree, and walk out the door.

And too often, little changes.

Why does advice that seems so straightforward rarely stick? The answer lies in the gap between medical instruction and human behavior.

The limits of good intentions

Research has shown that simply giving advice is rarely enough. A 2019 …

Read more…

Understanding the cracked pot theory of a medical legacy [PODCAST]

Podcast
December 8, 2025
YouTube video

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

Psychiatrist and author Arthur Lazarus discusses his article, “Finding integrity at the end of a career.” Arthur shares the poignant narrative of Dr. Raul Morales, a community internist facing retirement with a …

Read more…

ADVERTISEMENT

Blackballing in medicine: a physician’s story

Physician
December 8, 2025

Medicine remembers data but forgets voices. I learned this between 1999 and 2003, when I was quietly fired and branded as someone who had “burned too many bridges.” That label was projection, not a critique of my science. My work within the national research network remains foundational to current clinical guidelines, and my training-grant application ranked near the top of all those submitted. Yet the whisper of “bridge-burning” became the …

Read more…

Physician advocacy as a core clinical skill

Education
December 8, 2025

Starting my training as an MD/PhD student at Yale, I expected long nights of memorizing biochemical pathways and drug mechanisms. I predicted challenging times learning how to care for patients in tough situations. But what I didn’t expect was just how difficult the current federal landscape would make this journey.

I felt this directly in early 2025. I came to Yale to study the health of LGBTQ+ populations. But when my …

Read more…

Phytotherapy for kidney stones: a clinical review

Conditions
December 8, 2025

Kidney stone disease remains one of the most common and painful conditions in urology, affecting millions worldwide each year. Global data show a continued rise in incidence (more than 100 million new cases in 2021) making prevention and long-term management a priority for both clinicians and patients. Despite significant advances in minimally invasive treatment, many patients still ask a familiar question: “Is there a natural remedy that can help …

Read more…

Preventive health care architecture: a global lesson

Conditions
December 8, 2025

Across conferences and journals worldwide, we repeat the same aspiration: Health care must shift from treating disease to promoting health. Yet most systems (regardless of country) remain architected around illness. Buildings, budgets, and workflows are still optimized for what happens after the body breaks down.

My perspective changed after speaking with a senior health care leader in Asia. He did not begin by discussing surgical innovation, emergency demands, or reimbursement challenges. …

Read more…

Telehealth stimulant conviction: lessons from the Done Global case

Conditions
December 8, 2025

The recent federal conviction of Done Global’s CEO, Ruthia He, and its clinical president, psychiatrist David Brody, on November 20, 2025, has brought long-standing concerns about virtual ADHD prescribing into undeniable focus. A San Francisco jury found both executives guilty of conspiring to distribute Adderall and other Schedule II stimulants, along with health care fraud and (for He) obstruction of justice. According to the Department of Justice, Done Global generated …

Read more…

The liver’s role in metabolic disease

Conditions
December 8, 2025

If you’re managing metabolic disease for your patients, you’re also dealing with liver disease, whether you realize it or not. Metabolic dysfunction-associated steatotic liver disease (MASLD) affects up to 70 percent of patients who have type 2 diabetes or obesity, yet reliable, routine screening for liver disease is anything but commonplace.

I often wonder why that is. After all, the liver is arguably the most sensitive barometer of metabolic dysfunction, …

Read more…

Modern eugenics: the quiet return of a dangerous ideology

Physician
December 8, 2025

I’m not paranoid. And I don’t believe in conspiracy theories. But as a physician who has spent decades watching the pendulum of medical ethics swing back and forth, I can’t ignore the pattern emerging across public health and politics today. Some of what I’m seeing looks uncomfortably familiar. It looks like eugenics, not the caricature of white coats and calipers, but the quieter, policy-driven, values-encoded version that shaped America a …

Read more…

626
pages