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Why PBM transparency rules aren’t enough to lower drug prices

Armin Pazooki

Policy

January 28, 2026

House lawmakers recently passed a health care bill that grabbed headlines for what it excluded: a solution to the looming expiration of enhanced Affordable Care Act tax credits. But largely overlooked inside the bill was a provision that did make it through, a long-requested provision toward creating stronger federal legislation directly targeting pharmacy benefit managers (PBMs), the middlemen who increasingly determine what Americans pay for their medications. These rules …

Clinical attachment in medicine: How familiarity creates safety

Nesrin Abu Ata, MD

Physician

January 28, 2026

You don’t learn this in medical school: Clinical familiarity creates attachment.

Not the kind we mean in romance. Not even the kind we mean in psychotherapy. Something quieter and more automatic, built through repetition and stakes.

You don’t have to say anything deeply personal for it to happen.

You just have to show up again. And again. And again.

Same hallway turns. Same waiting room chairs. Same voice calling your name. Same pace in …

Racial disparities in pancreatic cancer screening cost Black lives [PODCAST]

The Podcast by KevinMD

Podcast

January 27, 2026

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

Internal medicine physician Earl Stewart, Jr. discusses his article “Pancreatic cancer racial disparities.” Earl examines the devastating pattern of pancreatic cancer claiming Black cultural icons like John Lewis and Aretha Franklin while …

A poem on kidney cancer survivorship and the annual scan

Michele Luckenbaugh

Conditions

January 27, 2026

Once a year,
I return to two quiet organs
I once carried without thought,
working faithfully in the dark,
asking for nothing,
until one day they asked to be seen.

Cysts.
Small moons of fluid,
bubbles scattered like careless stars
throughout the geography of me.
Harmless, they said.
Mostly.
Until one was not.

That year,
a word entered my body:
cancer.
A word that knows how to make itself at home
in every corner of thought.

A specialist explained
how light and force could be aimed,
how the invader could …

AI-enabled clinical data abstraction: a nurse’s perspective

Pamela Ashenfelter, RN

Tech

January 27, 2026

I’ve spent more than 30 years in nursing, and in recent years my work has shifted to something most people never think about: clinical data abstraction. My job is to review the medical record and extract the pieces of information that clinical registries rely on for research, quality reporting, regulatory requirements, and everyday decision-making. It’s specialized work that depends on clinical judgment, a deep understanding of clinical documentation in the …

Why clinical excellence isn’t enough to sustain a physician-owned hospital

Dr. Bhavin P. Vadodariya

Physician

January 27, 2026

Most physicians begin their careers with a deeply held belief: If treatment is good, patients will come. It feels intuitively correct, and early in practice it often appears to be true. Clinical outcomes build trust, trust brings patients, and for a time the system seems to sustain itself. Yet after years of working inside physician-owned hospitals, group practices, and large corporate health systems, I have learned an uncomfortable truth. Good …

Emergency department metrics vs. reality: Why the numbers lie

Marilyn McCullum, RN

Policy

January 27, 2026

The emergency department didn’t suddenly get worse.

The numbers did.

Every shift, emergency clinicians are measured by dashboards that insist on telling a familiar story: Door-to-provider times are too long, length of stay is unacceptable, left-without-being-seen rates are creeping up. The implication is clear. We’re slow. We’re inefficient. We’re failing.

But those numbers are no longer describing clinical performance. They’re describing system saturation.

Emergency departments today operate in conditions that were once considered temporary …

Hashimoto’s disease in adolescent girls: Why it’s often overlooked

Callia Georgoulis

Conditions

January 27, 2026

Hashimoto’s disease is the most common cause of hypothyroidism in children and adolescents, yet it remains frequently overlooked, particularly in adolescent girls. Fatigue, mood changes, weight gain, and cognitive slowing are often attributed to mental health conditions or dismissed as normal features of puberty, delaying diagnosis and treatment. This pattern reflects a broader failure to recognize how autoimmune thyroid disease presents during adolescence, and how gendered assumptions shape clinical interpretation …

Hidden financial dangers of wRVU thresholds in medical employment agreements [PODCAST]

The Podcast by KevinMD

Podcast

January 26, 2026

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Health care attorney Dennis Hursh discusses his article “wRVU threshold risks in physician contracts.” Dennis explains the critical distinction between a guaranteed salary and a draw against future earnings where failure to …

Leading with love: a physician’s guide to clarity and compassion

Jessie Mahoney, MD

Physician

January 26, 2026

In medicine, we are trained to lead with logic. To analyze, evaluate, and act. We are praised for decisive thinking, efficiency, and evidence-based decisions. In the hardest moments of my life, career, and leadership, none of those tools brought me clarity.

Ten years ago, as a practicing pediatrician and physician leader, my personal life began to fall apart. My husband, who had always been steady and supportive, began to slide into …

Why doctors ignore their own advice on hydration and health

Amanda Shim, MD

Conditions

January 26, 2026

“I’m surprised I haven’t had a kidney stone.”

It’s a running joke among my co-residents, when it’s 3 o’clock in the morning, with over 20 patients in the waiting room, and nobody can remember the last time they had water. Most days, my fluid intake is limited to the sips needed to swallow my antidepressants (to quote my parents, “you can’t just take them whenever you feel sad,” and “it’s not …

Low testosterone in men: a doctor’s guide to TRT safety

Martina Ambardjieva, MD

Conditions

January 26, 2026

A man in his late 40s sits down in my office and says, “Doctor, I think my testosterone is low.”

Sometimes he is already holding lab results. Sometimes he is coming from a gym forum, a friend’s recommendation, or a late-night Google search. But almost always, the story sounds familiar: lower sex drive, fewer morning erections, weaker erections, fatigue, brain fog, mood changes, and that stubborn belly fat that seems to …

Agentic AI in medicine: the danger of automating the doctor

Shiv K. Goel, MD

Tech

January 26, 2026

“Can AI scale in medicine?” is the wrong question.

The real question is: Can AI protect the soul of medicine while people who have never sat with our patients decide their fate?

The ADVOCATE program: an overview

The Trump administration recently launched the ADVOCATE program: Agentic AI-Enabled Cardiovascular Care Transformation. Run by ARPA-H, this initiative aims to build and deploy autonomous “clinical AI agents” for cardiovascular disease, with an FDA authorization pathway of …

Uterine aging in IVF: Why the “soil” matters as much as the seed

Oluyemisi Famuyiwa, MD

Conditions

January 26, 2026

Most clinicians know that eggs age. Fewer acknowledge that the uterus ages too.

In reproductive medicine, we often rely on the seed-and-soil analogy. The seed is the embryo. The soil is the endometrium, the inner lining of the uterus where implantation occurs.

Here is the part that deserves more explicit counseling and strategic planning: Even when embryo quality is controlled, uterine age can independently influence implantation, miscarriage risk, and live birth rates. …

Patient expectations in primary care: the structural mismatch

Ronke Dosunmu, MD

Physician

January 26, 2026

Patient frustration is something many of us carry home at the end of the day. Much of that frustration, however, isn’t personal; it’s structural.

Many patients don’t realize that different primary care models are designed to deliver fundamentally different experiences. They expect concierge-level access and time within insurance-based practices. They want same-day appointments, unhurried visits, and immediate physician availability, regardless of the model they’re in. And when we can’t deliver what …

AI in medical education: the risk to professional identity formation

Vijay Rajput, MD

Education

January 26, 2026

I learned medicine in hallways, in the classroom, and outside.

I learned how to apologize to a patient by watching my attending pull up a chair and say, “I should have done better.” I learned how teams actually work by overhearing tense but respectful disagreements during sign-out. I learned what it meant to belong by being given responsibility before I felt ready. None of those lessons happened on Zoom or Teams.

In …

The telehealth trap: Why single-service roles lead to burnout

Adam Carewe, MD

Physician

January 26, 2026

Across my career, including as CMIO of Kaiser Permanente’s Colorado medical group, I’ve had a front-row seat to how remote care and technology are reshaping clinical practice. I’ve also watched many colleagues make the shift to telehealth positions seeking flexibility and an escape from hospital and clinic burnout. These siloed jobs often lead to a different kind of burnout because they can be isolating, rote, and disconnected from actual systems …

Healing chronic illness requires treating the mind alongside the body [PODCAST]

The Podcast by KevinMD

Podcast

January 25, 2026

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

Internal medicine and functional medicine physician Shiv K. Goel discusses his article “Mind-body connection in chronic disease: Why traditional medicine falls short.” Shiv explores the limitations of conventional medical models that focus …

How modern health care design strains patients and clinicians

Deanna J. Gilmore, RDH

Conditions

January 25, 2026

My great-grandfather was a small-town doctor in the early 1900s.

It was a different time. A different place. A very different pace.

He knew his patients. He knew their families. He understood their lives, not just their symptoms. Care happened in the context of relationship because that was simply how medicine worked.

Today, health care looks very different. The science is better. The technology is stronger. We can do things now that would …

Physician retirement: a cultural shift from system to self

Gerald Kuo

Conditions

January 25, 2026

The number was specific: 18,000 steps.

It came from a retired hospital director in Taipei, a physician-administrator who spent four decades building services, negotiating budgets, and managing crises across a health care system that now treats an aging society as its primary patient.

Most physicians retire into silence. He retired into data.

But the more interesting revelation did not come from his smartwatch. It came from the dinner table.

A shift in governance

In Western …