Triaging patient portal messages is a staffing problem

Physician Finance
August 13, 2026

Patients now have a way to reach a physician that no phone call ever offered: directly, in writing, at any hour, with no one screening it first. That was the entire point. It was also, it turns out, the entire problem.

A patient types “not feeling great today” into the portal. It could mean a cold. It could mean chest tightness they’re downplaying. The message looks the same either way, sitting …

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Triaging patient portal messages is a staffing problem

Why breast cancer in young women goes undetected

Conditions and Diseases
August 13, 2026

As I watched the breast biopsy occurring across from me, I could not believe the woman in front of me was 26. I held her hand as she cried from the anesthesia, and I thought to myself, that could be me. She had been diagnosed with invasive ductal carcinoma of the breast a couple of months ago and was getting a lymph node biopsy. At 26, she was nowhere near …

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Why breast cancer in young women goes undetected

Physician inventors need more than an issued patent

Physician Finance
August 13, 2026

Physicians are trained to recognize what we know and, perhaps more importantly, what we do not know. We take a set of clinical findings, develop a differential diagnosis, gather more information, and work toward a treatment plan.

I assumed that same discipline would help me navigate the commercial development of a medical device. It did, but not nearly as much as I expected.

After decades as an anesthesiologist, I co-founded a company …

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Physician inventors need more than an issued patent

Why the physical exam still matters in modern medicine

Medical Education
August 13, 2026

The moment that changed the trajectory of a 79-year-old female patient’s life did not beep, flash, calculate, or appear in an inbox. It did not come from an algorithm or an abnormal lab value. It began quietly, with my mentor’s hands resting on her abdomen.

Like my peers at Touro College of Osteopathic Medicine in Harlem, I have spent years learning the language of modern medicine: lab values, imaging findings, differential …

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Why the physical exam still matters in modern medicine

The future of men’s health is not another prescription

Conditions and Diseases
August 13, 2026

Men’s health has often been limited to discussions about prostate, erectile dysfunction, and testosterone levels. This perspective is narrow. A more comprehensive model connects metabolic health, hormones, sexual function, mental well-being, and everyday self-care. These elements are interconnected and frequently influence one another.

Glucagon-like peptide-1 (GLP-1) therapeutics have accelerated this shift. Medications like semaglutide and tirzepatide have transformed obesity treatment from a focus on willpower to one based on biology, chronic …

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The future of men’s health is not another prescription

Kratom addiction is the next epidemic we can prevent

Conditions and Diseases
August 13, 2026

She arrived at her first outpatient psychiatry appointment with me with her mother by her side. I had read over her chart and reviewed records from the hospital she was stepping down from. She had spent two days in an emergency room, then transferred to a psychiatry unit for a week. In her early twenties with no prior mental health history, raised by a single mother, she excelled in school …

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Kratom addiction is the next epidemic we can prevent

Why soldiers are athletes and their bodies pay for it [PODCAST]

Podcast
August 12, 2026
YouTube video

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

A 30-year-old soldier can have the knees of a 60-year-old. Not from one bad injury, but from carrying a load every single day for years. Family medicine and sports medicine physician Ann Lebeck returns to explain why she came to see soldiers …

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Why soldiers are athletes and their bodies pay for it [PODCAST]

Medication-induced dry mouth quietly damages teeth

Conditions and Diseases
August 12, 2026

During my years in clinical dentistry, I often saw patients develop new dental problems after starting medication for an unrelated condition. The medication lowered their blood pressure, eased their anxiety, improved their sleep, or controlled their allergies. At the same time, their mouths became persistently dry.

Most patients did not connect the dryness to their medication. Some considered it annoying but harmless. Others barely noticed it until eating, speaking, or wearing …

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Medication-induced dry mouth quietly damages teeth

Why MOG antibody disease is more than antibodies

Conditions and Diseases
August 12, 2026

MOG antibody-associated disease is typically understood as an autoimmune disorder in which antibodies target myelin oligodendrocyte glycoprotein, producing demyelination and relapsing neurological symptoms. This antibody-centered model has been clinically useful, but it may be incomplete in explaining why disease expression varies so widely between individuals, why some patients recover remarkably well between attacks, and why similar immunologic profiles can lead to very different trajectories over time. In my independent conceptual …

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Why MOG antibody disease is more than antibodies

The autism guideline that ignored its own evidence

Conditions and Diseases
August 12, 2026

Professional organizations rarely contradict themselves in public. When they do, the contradiction is usually buried in procedural language, masked by committee structure, or softened by the slow drift of policy. But occasionally, the inconsistency becomes visible in plain sight, not because someone exposed it, but because two arms of the same organization published incompatible statements without noticing. That is what happened when the American Academy of Pediatrics (AAP) reaffirmed its …

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The autism guideline that ignored its own evidence

Exercise after rehabilitation is not an optional extra

Conditions and Diseases
August 12, 2026

The day after a man completed a physical fitness assessment for people with disabilities, he came back. He did not return because we had forgotten a test. He was not asking for another consultation. He did not need a prescription. He came back carrying a box of pineapple cakes.

In Taiwan, that gesture means more than bringing dessert. The Taiwanese pronunciation of pineapple is associated with wang-lai, a phrase that sounds …

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Exercise after rehabilitation is not an optional extra

Prescription drug suicide risk is still being hidden

Medications
August 12, 2026

What if you were an MD/researcher at a top 10 medical school who came face-to-face with a lethal side effect to a popular drug? But, when you tried to reveal it, you were engulfed by a legal and professional character assassination campaign that included threats against your academic position and journal publishing history, physical surveillance by private investigators, and even a home break-in?

That is the basic plot of the newly …

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Prescription drug suicide risk is still being hidden

Why physician burnout is really a money problem

Physician Finance
August 12, 2026

The math I’d never done

A few years ago I took a hard fall on our annual family ski trip and landed on my wrist. It wasn’t broken. It wasn’t even a bad injury by any medical standard, just a sprain. But sitting there holding my arm and waiting for the throbbing to settle, a single thought pushed everything else out of my head.

I’m a periodontist. I treat patients with my …

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Why physician burnout is really a money problem

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Hospital accountability: Who owns the whole problem?

Physician
August 12, 2026

An essay by Eric Goldfarb, an information technology executive and patient advocate, opens with a story that feels almost too absurd to be true. I have written nine books of medical satire and thought I had seen it all, yet his experience shows that parts of our system still defy belief.

After Goldfarb’s eighty-eight-year-old father died, Goldfarb reviewed the hospital bill and noticed a charge for a pregnancy test. …

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Hospital accountability: Who owns the whole problem?

Frivolous malpractice lawsuits: Doctors can fight back

Physician
August 12, 2026

Medical malpractice litigation in the United States is the endless struggle to find meaning.

Lawyers, plaintiff and defense attorneys alike, reject the notion that they are involved in a frivolous medical malpractice lawsuit. To protect themselves from this notion, they use semantics. There are four words: legitimate, meritorious, frivolous, and malicious.

Legitimate is whimsical. It is in the eyes of the beholder. According to lawyers, all claims are legitimate.

Legitimate is conflated with …

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Frivolous malpractice lawsuits: Doctors can fight back

Fentanyl interdiction will not end the overdose crisis

Health Policy
August 12, 2026

Overdose deaths are falling in the United States, a sign of genuine progress. But President Trump’s claim that his administration has nearly stopped drugs from entering the country by sea confuses an interdiction statistic with an overdose-prevention strategy.

Trump has repeatedly asserted that his administration reduced maritime drug arrivals by 97 percent or more. That figure, however, merely compares drug seizures across two selected months. Because seizures measure what …

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Fentanyl interdiction will not end the overdose crisis

Why medicine needs both high-tech and high-touch care

Physician
August 12, 2026

The path to a career in medicine often begins with a singular, heroic narrative: the promise to work hard and save lives. This is a noble ambition, and the surgeons and specialists who master complex procedures are essential to our craft. But as one spends decades in clinical practice, the reality of medicine shifts. We realize that the most profound work we do often has little to do with acute …

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Why medicine needs both high-tech and high-touch care

Doctors are now the second opinion, AI is the first [PODCAST]

Podcast
August 11, 2026
YouTube video

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

Your patients are asking ChatGPT what’s wrong with them before they call your office, and getting an answer in seconds. In this episode, Tod Stillson, a board-certified family physician, medical device inventor, and health care entrepreneur, explains how AI chatbots became the …

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Doctors are now the second opinion, AI is the first [PODCAST]

Who owns administrative harm no single decision caused?

Physician
August 11, 2026

Health care organizations make difficult decisions every day. Compliance introduces a new requirement because regulation demands it. Quality establishes another process because patient safety demands it. Finance adjusts staffing because margins demand it. Operations changes workflow because access demands it. Information technology implements a new platform because efficiency demands it. Leadership introduces artificial intelligence because transformation demands it.

Individually, each decision may be reasonable. Collectively, they may create an operating environment …

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Who owns administrative harm no single decision caused?

Health care affordability starts with healthier patients

Conditions and Diseases
August 11, 2026

In Western medical training and clinical practice, one of the first questions a clinician traditionally asks is: “What is your chief complaint?” The patient tells a story. The clinician listens, asks questions, performs an examination, develops a differential diagnosis, and recommends appropriate treatment.

But what if our current health care delivery model itself were the patient? Its chief complaint might sound something like this: “Doctor, I am becoming unaffordable.” And then, …

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Health care affordability starts with healthier patients

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