The link between chronic back pain and depression

Conditions
August 9, 2025

When a patient walks into an orthopedic spine clinic, most providers are focused on one thing: the back. But after over a decade of caring for patients with chronic pain, I noticed something deeper lurking behind the disc herniation and spinal stenosis: depression. And it was not being addressed.

That is why I launched a quality-improvement (QI) project focused on integrating depression screening into the routine evaluation of orthopedic spine patients. …

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COVID-19 was real: a doctor’s frontline account

Conditions
August 9, 2025

Once upon a time there was a pandemic, despite what the “deniers” and conspiracy theorists say. This rare disease outbreak shook every corner of the globe, yet brought out the best in people, people who put their lives on the line to care for the sick and dying.

But to this day, I still hear and read about folks who are convinced the COVID-19 pandemic was blown out of proportion and …

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Why sedation access varies by clinic and hospital

Physician
August 9, 2025

My recent experience as a cancer patient has illuminated many things. It has shown me how our health care system is not standardized and how it sometimes makes patient care decisions based on financial incentives or convenience rather than patient preferences or best clinical practice. Take, for example, the topic of sedation.

The question of whether to sedate is common in pain management, which often involves invasive intraspinal procedures such as …

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Aging in place: Why home care must replace nursing homes

Physician
August 9, 2025

I have been a physician for 44 years.

Besides my office and hospital practice, I also make house calls for less mobile older adults. We all want to stay in the homes where we raised our children, cared for our gardens, and became part of the community. The reality is that we lack the tools and financial resources needed for seniors to “age in place.”

My house calls, though, have provided insights …

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Why America’s medical training pipeline is failing our future [PODCAST]

Podcast
August 8, 2025
YouTube video

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Academic physician executive William Wertheim discusses his article, “America, our health care workforce training isn’t evolving alongside our needs.” He argues that the U.S. medical system is training professionals who will not …

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The silent challenges of female leadership in medicine

Physician
August 8, 2025

We had been trying, but the moment you see the word on the test strip, reality hits differently. My career was on an upward trajectory—I had just been offered a major promotion. And all I could think was: Why now?

When I told my husband how nervous I felt, he assumed it was about my body changing, or how our family of two would soon become three. He was wrong—and visibly …

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Why medicalizing death could strip it of meaning

Physician
August 8, 2025

We’ve medicalized nearly everything in life—birth, aging, sleep, even boredom. Now, in the spirit of efficiency, we’ve begun medicalizing death itself.

In his unsettling essay “The European way to die,” French novelist Michel Houellebecq warns that the normalization of euthanasia and assisted suicide is not a sign of progress but of profound cultural decay. I didn’t expect to find myself agreeing with him.

As a physician for over three decades, I’ve …

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How gut bacteria shape your mental health and mood

Conditions
August 8, 2025

The gut-brain axis is a key player in mental illnesses such as schizophrenia, bipolar disorder, depression, and anxiety.

The intestinal microbiome (the foundation of the gut-brain axis) influences brain function through bidirectional communication via neural (vagus nerve), immune (cytokines), and metabolic pathways. Microbiota alterations may also impair hypothalamic-pituitary-adrenal axis regulation, which, in turn, affects both psychological stress level (cortisol) and whole-body hormonal balance. What’s more, microbial metabolites (such as short-chain fatty …

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Is “do no harm” the most misunderstood phrase in medicine? [PODCAST]

Podcast
August 7, 2025
YouTube video

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

Psychiatrist Sabooh S. Mubbashar discusses his article, “Why ‘do no harm’ might be harming modern medicine.” He reveals that the principle “First, do no harm,” or Primum non nocere, is not part of the original Hippocratic Oath but a later, misattributed addition that has become a dangerously oversimplified slogan. …

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Why health care reform must start with ending monopolies

Tech
August 7, 2025

Monopolies thrive on control. In U.S. health care, that control is quietly breaking the system from within. Today, a small group of supplier-funded entities, including GPOs, PBMs, EHRs, MMIS vendors, and EDI platforms, dictate costs, suppress innovation, and hoard the data that hospitals need to operate effectively.

If we want real health care reform, we must start with monopoly reform.

1. Skyrocketing costs driven by opaque contracts. When a handful of players …

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Why new obesity medications for teens could be a game changer

Conditions
August 7, 2025

When I first saw the CDC’s MMWR latest report on obesity medication prescribing for adolescents, my initial reaction was probably the same as yours: less than 1 percent of teens with obesity got these medications in 2023? That seems pretty dismal.

But then I took a step back and looked at what this data is telling us. And honestly? We’re missing the real story here.

We’re witnessing something historic.

Think about where …

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How insulin resistance may cause Alzheimer’s disease

Conditions
August 7, 2025

Alzheimer’s disease is a ruthless thief, silently stealing the essence of our identities: our memories. It robs us of cherished moments, meaningful relationships, and the independence that makes life vibrant and fulfilling. Traditionally viewed as an inevitable consequence of aging or genetics, groundbreaking research now challenges this perspective, suggesting Alzheimer’s may actually be a form of metabolic disorder aptly coined Type 3 diabetes.

The concept of Alzheimer’s as Type 3 diabetes …

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Why smartwatches won’t save American health care

Physician
August 7, 2025

History has a habit of repeating itself.

Just prior to the 1929 crash, ads supporting the presidential candidacy of Herbert Hoover promoted a tag line promoting prosperity that has lived in infamy: “A chicken for every pot and a car in every garage.”

Now we have Robert Kennedy—our Secretary of Health and Human Services, the cheerleader for the “Make America Healthy Again” movement—promoting another grand idea to solve our nation’s …

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When anxiety runs the show: How medication can help kids thrive

Conditions
August 7, 2025

Ten years old and terrified, my patient sat curled in the chair, tears flowing, knees pulled to her chest, refusing to go to school for the third week in a row. Her parents looked exhausted. “We have tried everything. We don’t want to medicate her… but we can’t keep going like this.”

As a child and adolescent psychiatrist, I’ve had this conversation hundreds of times. Sometimes families walk in asking for …

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Why your digital first impression matters more than ever [PODCAST]

Podcast
August 6, 2025
YouTube video

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

Health care marketing strategist Sara Meyer discusses her article, “First impressions happen online—not in your exam room.” She explains why a physician’s online presence is often the deciding factor for potential patients …

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From nurse practitioner to quality improvement leader in sleep medicine

Conditions
August 6, 2025

I am a doctor of nursing practice and board-certified nurse practitioner with over a decade of experience in internal medicine, pulmonology, and sleep medicine. My career has taken shape in the diverse and fast-paced outpatient care settings of New York, where I’ve had the opportunity to serve patients from a wide range of socioeconomic backgrounds. Many of the individuals I care for face chronic respiratory illnesses, comorbid conditions, and significant …

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Why accommodations aren’t special treatment but essential for equity

Physician
August 6, 2025

“Think of it this way,” the school’s pediatrician said to me, his voice flat in my headphones. “Back in college, would you want a lab partner who needed these accommodations? When I read a letter like this, I picture a student who may not even graduate high school. I have to prepare the family for that reality.”

I took a slow breath, calming myself. This wasn’t how I had hoped the …

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Stop telling burned-out doctors to be more resilient

Conditions
August 6, 2025

Doctors are often praised for their resilience. It’s become a buzzword in medicine, touted as some catch-all antidote to physician burnout. It’s used in keynotes, wellness programs, recruitment ads, hospital HR emails—everywhere really. “Feeling burned out? Improve your resilience.” But I believe that this emphasis on resilience often misses the mark. Worse, it can subtly reinforce the idea that if you’re suffering, you’re not resilient enough.

But what if the problem …

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AI can help heal the fragmented U.S. health care system

Tech
August 6, 2025

The U.S. health care system is a paradox. It’s the most expensive in the world—costing over $4.5 trillion annually—yet produces some of the worst health outcomes among developed nations. Fragmentation is at the core of this crisis. Patients bounce between primary care doctors, specialists, emergency rooms, and insurers, often with no single point of coordination. The result? Redundant tests, misdiagnoses, delayed care, and frustrated clinicians.

Enter artificial intelligence—not as a silver …

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A mindset shift for physicians: Retrain your brain to see what’s going well

Conditions
August 6, 2025

As a physician, you’re trained to spot problems. You scan for risks, anticipate complications, and stay alert for what could go wrong. That mindset helps keep patients safe. However, over time, it can become automatic, even outside of work.

When your attention is always tuned to what’s missing or what might fail, it’s easy to lose sight of what’s going well. One physician I coached was deeply committed to his patients …

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