Adult-onset ADHD is a naming problem, not a new disorder

Conditions and Diseases
August 5, 2026

“I’ve never really been able to focus, but it’s only become a real problem in the last few years, since I started this job. Could I be evaluated for adult ADHD?”

I hear a version of this request often, and it captures a confusion built into the term itself. “Adult ADHD” sounds like it names a condition that begins in adulthood, the way adult-onset diabetes or adult-onset asthma can. It doesn’t, …

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Adult-onset ADHD is a naming problem, not a new disorder

Dance and brain health: a physician’s prescription

Conditions and Diseases
August 5, 2026

In many shamanic societies, if you came to a medicine person disheartened, dispirited, or depressed, they would ask one of four questions: When did you stop dancing? When did you stop singing? When did you stop being enchanted by stories? When did you stop being comforted by silence? I think about those questions often as a physician, and almost nothing I was trained to do begins with any of them.

Most …

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Dance and brain health: a physician’s prescription

Why doctors should read fiction, not just research papers

Conditions and Diseases
August 5, 2026

A randomized controlled trial can tell us that a treatment reduces mortality by a measurable percentage. It cannot tell us what it feels like to receive that treatment, to wait for its results, or to watch someone you love decide whether to accept it. That gap, between what medicine measures and what patients actually experience, is where fiction has always done work that research papers cannot.

Consider Tolstoy’s The Death …

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Why doctors should read fiction, not just research papers

Gratitude in medicine: the people who carried me

Physician
August 5, 2026

Reason

I find that this exercise of thanking and expressing gratitude makes my journey to the land of the unknown joyful. I thought I should do this when I have a clear mind and good health. I am teaching the residents now to understand its value. I am writing this now so that I am not too late to thank all those who helped transform my life. I want to show …

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Gratitude in medicine: the people who carried me

Burnout blames the doctor for a broken system [PODCAST]

Podcast
August 4, 2026
YouTube video

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

What if burnout is the wrong word for what doctors are actually going through? Gus W. Krucke argues that calling physicians burned out treats a systemic failure as a personal one, and that …

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Burnout blames the doctor for a broken system [PODCAST]

Tele-critical care today is not what the studies actually tested

Physician
August 4, 2026

In an early 2026 piece, I criticized the growing practice of outsourcing bedside ICU care to tele-critical care programs. I argued that replacing the in-person work of physicians, nurse practitioners (NPs), and physician assistants (PAs) with remote physicians leads to the lack of a bedside leader, shoddy exams, breaks in the continuity of care, the depersonalization of the doctor-patient relationship, and an overall degradation in the quality of ICU …

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Tele-critical care today is not what the studies actually tested

GLP-1 weight rebound: We have seen this before

Medications
August 4, 2026

We are living through a massive, rapid shift in how we approach human health, and as I watch the excitement surrounding the new generation of glucagon-like peptide-1 (GLP-1) agonists, I can’t help but see a familiar ghost in the room. It feels exactly like the early days of the selective serotonin reuptake inhibitor (SSRI) revolution, a time when we were all so eager for a solution that we sometimes overlooked …

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GLP-1 weight rebound: We have seen this before

Why pre-Roe abortion stories matter again after Dobbs

Health Policy
August 4, 2026

History has a way of repeating itself.

In the years leading up to the Supreme Court’s 2022 Dobbs decision, many women in their seventies, eighties, and nineties still remembered what life was like before Roe v. Wade. They remembered the hidden abortions, the whispered conversations, and the unspoken secrets. A handful of films (including If These Walls Could Talk, A Private Matter, Call Jane, and Ask for Jane) capture pieces of …

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Why pre-Roe abortion stories matter again after Dobbs

Shifting health care toward prevention, not just treatment

Physician
August 4, 2026

Health care has never possessed more scientific knowledge, more sophisticated technology, or more specialized expertise than it does today. Yet despite these remarkable advances, chronic disease continues to rise, health care costs continue to escalate, physician burnout persists, and patients increasingly spend more years living with illness rather than enjoying health.

This paradox raises an important question. A probable explanation: Perhaps our greatest challenge is not a lack of scientific progress. …

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Shifting health care toward prevention, not just treatment

MIPS reporting in 2026 is an operations problem first

Physician Finance
August 4, 2026

Most independent practices treat the Merit-based Incentive Payment System (MIPS) as a clinical-quality program with a billing-side tax. That framing misreads the decision. MIPS participation is mostly an operational question: whether the practice has the data infrastructure, EHR capability, and vendor support to clear the performance threshold, and whether the dollar exposure of skipping is worse than the cost of compliance. The clinical score follows the operational setup, not the …

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MIPS reporting in 2026 is an operations problem first

How clinicians find recovery from gaslighting

Physician
August 4, 2026

I work with many victims of gaslighting around the country. We learn from each other. Those who have lost their licenses to work can follow these steps to regain their licenses and resume their careers.

First, acknowledge that any victim of gaslighting suffers some degree of PTSD. Severe gaslighting leads to complex PTSD. The federal Americans with Disabilities Act (ADA) laws put in place before 2000 state that those suffering from …

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How clinicians find recovery from gaslighting

Extreme heat and psychiatric symptoms: a clinical warning

Conditions and Diseases
August 4, 2026

Earlier this summer, I wrote about “summer SAD,” the very real worsening of mood, anxiety, agitation, and sleep that some people experience during the hottest and brightest months of the year.

After this weekend, I think the conversation needs to go further. Temperatures in the Sacramento area have exceeded 100°F, and over the past several days I have seen multiple previously stable patients experience abrupt and clinically significant psychiatric destabilization.

One patient …

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Extreme heat and psychiatric symptoms: a clinical warning

What plain medical language gives families back

Physician
August 4, 2026

Medicine is built on language. Not just terminology, but a shared vocabulary that allows us to describe the body with precision, to communicate risk without panic, and to translate complexity into clarity for families. Yet in recent years, medical language has drifted toward two extremes: jargon inflation on one side, oversimplification on the other. Both leave patients, and young clinicians, unmoored.

I was reminded of this recently while helping my son …

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What plain medical language gives families back

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Direct-to-consumer drug ads turn doctors into speed bumps

Medications
August 4, 2026

While recuperating from my shoulder replacement (and after signing the usual stack of preoperative forms absolving the surgeon, the hospital, the anesthesiologist, and possibly the parking attendant of every imaginable complication, including dying on the table), I had a lot of time to watch television. Daytime television. The kind with a steady rotation of direct-to-consumer pharmaceutical ads.

If you ever want to understand the state of American medicine, don’t read policy …

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Direct-to-consumer drug ads turn doctors into speed bumps

Who your malpractice defense lawyer really works for

Physician
August 4, 2026

A miscreant is simply a troublemaker. When it comes to a medical malpractice lawsuit, the biggest miscreant is the defense attorney followed closely by the medical malpractice insurance company.

For a doctor, medical malpractice insurance coverage is the difference between financial security and ruin. I practice in the state of Maryland. Maryland law does not force physicians to buy medical malpractice insurance. Nevertheless, doctors must carry a policy, which has a …

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Who your malpractice defense lawyer really works for

Bedsore lawsuits are won and lost on the record [PODCAST]

Podcast
August 3, 2026
YouTube video

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

When a family finds a loved one with a severe bedsore in a nursing home, they often sue. But these cases are rarely decided by the wound itself. They are decided by what …

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Bedsore lawsuits are won and lost on the record [PODCAST]

How our COVID language made everything harder

Conditions and Diseases
August 3, 2026

I have spent a career writing, teaching and speaking about the power of spoken word. I bring a rhetorical understanding of language to various settings: how medical professionals talk, how we talk about people with disabilities, talk within interpersonal relationships and now, talk about COVID. By rhetorical understanding, I mean that words have meanings, are persuasive, contain energy, and have consequences. In short, words create worlds. I refer to this …

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How our COVID language made everything harder

A dismissed malpractice lawsuit still outranks your win

Health Policy
August 3, 2026

Earlier pieces argued that a favorable malpractice outcome leaves almost no public footprint, that outcome documents are the only content that can answer an outcome question, and, from a nine-surgeon Florida sample, that a dismissed lawsuit can still cost privileges.

When I published the Florida findings in July, it might have been fair to argue that they were too particular to cause concern: nine surgeons, one state, one specialty. Florida’s …

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A dismissed malpractice lawsuit still outranks your win

The signs of depression a husband almost missed

Physician
August 3, 2026

An excerpt from Live for Me, Nkem.

We fall into silence for a while before she says, “So what has Nkem done this time?”

My eyes meet hers. She crosses her arms, watching me like someone bracing for a fight.

I rub my face and breathe out. “She hasn’t done anything.”

“Hmm. You are not here to complain about her like you did before? Wasn’t it around this time last year, right after …

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The signs of depression a husband almost missed

Unprocessed trauma is running your next patient encounter

Conditions and Diseases
August 3, 2026

Most of us know the experience of something unexpected happening and reacting before we pause long enough to engage our frontal lobe. We hear ourselves say something we do not mean, feel anger surge before we understand why, or watch ourselves react in a way that feels misaligned with who we believe we are. We say, “I saw red,” “It felt like I was outside my body,” or “I do …

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Unprocessed trauma is running your next patient encounter

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