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Patient expectations in primary care: the structural mismatch

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 …

ADHD and cannabis use: Navigating the diagnostic challenge

Farid Sabet-Sharghi, MD

Conditions

January 25, 2026

As a psychiatrist, I increasingly meet patients who come in convinced they have attention-deficit/hyperactivity disorder (ADHD). They arrive prepared: an online screening test, a list of symptoms (poor concentration, low motivation, distractibility) and often a quiet sense of relief at finally having an explanation. Then I do what physicians are trained to do. I take a careful history. I review medications. I ask about sleep, mood, anxiety, substance use, and …

Multifactorial drivers of the U.S. physician shortage: a data analysis

Brian Hudes, MD

Physician

January 25, 2026

The United States faces a worsening physician shortage despite increases in medical school enrollment and residency growth. This article provides a comprehensive, data-driven analysis of the multifactorial forces reducing effective physician supply. These include training-pathway inflation, declining board-certification throughput, shorter physician career duration, reduced reimbursement, the collapse of private practice, feminization of the workforce, declining IMG participation, and accelerating population aging. Tables and figures throughout this article illustrate how these …

Alex Pretti: a physician’s open letter defending his legacy

Mousson Berrouet, DO

Physician

January 25, 2026

To those who would speak too quickly, to those shaping narratives without knowing the weight of the work, and to those of us still standing, I write this as a physician, as a colleague in medicine, and as someone who understands, intimately, what it means to stand at the threshold between life and death. Not as an idea, not as rhetoric, but as responsibility.

I am not a nurse. I am …

Why I chose disruption over conformity in medicine

Ronald L. Lindsay, MD

Physician

January 25, 2026

I am no poster boy. I deal with significant physical challenges and mobility issues. The toll continues. I face major medical procedures in the coming year, the price of decades spent serving others while refusing to serve the system. I am actively planning my eventual funeral, which many in my field are likely looking forward to. I served the people, not the system. That choice was the death knell for …

Medicare cuts are destroying independent rural medical practices [PODCAST]

The Podcast by KevinMD

Podcast

January 24, 2026

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

Saravanan Kasthuri, medical director at Northwest Endovascular Surgery, and Jason McKitrick, executive director at the Office Based Facility Association, discuss their article “Medicare payment is failing rural health.” Saravanan and Jason analyze …

The elephant in the room: Why physician burnout is a relationship problem

Tomi Mitchell, MD

Physician

January 24, 2026

Let me start with a truth many of us sense long before we ever speak it aloud. We whisper it to ourselves on post-call mornings. We feel it in the drive home after another shift that took more than it gave. We carry it into our kitchens, into our bedrooms, and into the quiet moments where no pager or EMR alert can compete with what’s happening inside us.

The elephant in …

Why the primary care system failure forces unnecessary referrals

Jordan Cantor, DO

Physician

January 24, 2026

A patient with diabetes, hypertension, and obesity comes in for her annual wellness visit. The physician has already spent 20 minutes on chronic disease management and lifestyle guidance. As the visit wraps up, the patient mentions daily heart palpitations that started a month ago.

The exam was benign. The physician has two choices: spend another 20 minutes performing an EKG, discussing differential diagnoses, and developing a workup plan; or refer to …

AI in medicine vs. aviation: Why the autopilot metaphor fails

Arthur Lazarus, MD, MBA

Physician

January 24, 2026

The pilot of a commercial aircraft, descending into near-zero visibility, hands control to an automated system designed for precisely that moment. The landing is flawless. The passengers are safe. The pilot announces it proudly. Technology functions exactly as promised.

A doctor on board writes, “It made me think about the health care journey I am on with AI. The safety and well-being of 140 people wasn’t left to human intervention; the …

How the mind-body split in medicine shaped modern clinical care

Robert C. Smith, MD

Conditions

January 24, 2026

In my first and second KevinMD posts, I emphasized how medicine had failed clinicians by not training them in mental health care. All agree, it’s not our fault. Now let’s look at how successfully our teachers did prepare us for patients with medical disorders. There’s an interesting history behind how we developed expertise in physical diseases: Medicine needed to overthrow the four humors theory that guided clinical care …

Racial mistaken identity in medicine: a pervasive issue in health care

Aba Black, MD, MHS

Physician

January 24, 2026

President Trump recently made national headlines by calling a female reporter “Piggy,” an act widely decried as outrageous, even for a man who doesn’t shy away from misogyny. It’s one thing to intentionally refer to someone with a derogatory, dismissive label. This kind of behavior should appropriately be met with indignation and moral outrage. But what happens when we carelessly (and repeatedly) call someone a name that belongs to …

Artificial intelligence demands that doctors become architects of digital health [PODCAST]

The Podcast by KevinMD

Podcast

January 23, 2026

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

Family physician Tod Stillson discusses his article “Why AI in medicine elevates humanity instead of replacing it.” Tod explains how his career evolution revealed that artificial intelligence is not a threat to …

Is testosterone replacement safe after prostate cancer surgery?

Francisco M. Torres, MD

Conditions

January 23, 2026

It has been six months since my robotic-assisted radical prostatectomy, and I find myself suspended in a strange middle space, grateful to be cancer-free, yet still struggling with a question I cannot fully answer: Is it safe for me to restart testosterone replacement therapy?

Before my diagnosis, testosterone replacement was not just a prescription; it was a restoration. I have lived with hypogonadism for years, and TRT helped me regain the …

AI and moral development: How algorithms shape human character

Timothy Lesaca, MD

Physician

January 23, 2026

Most of us don’t notice moral development happening while it is happening. Moral character forms quietly, through repetition, through what we get used to doing and through what we slowly stop doing without much forethought.

Artificial intelligence matters from a moral perspective long before it ever potentially becomes conscious or autonomous. Although AI may or may not confront us with dramatic ethical dilemmas, it does change our moral lives in a …

The impact of war on the innocence of children

Michele Luckenbaugh

Conditions

January 23, 2026

They are not born into battle.
They arrive with open hands,
with laughter,
with faith that the world will keep them safe.

Yet, men who are not content with peace
clench their fists around power,
mistaking domination for strength
and control for legacy.
They draw borders with bullets
and call it victory.

In their pursuit to prove themselves,
they let the bombs fall.
Roads darken with blood.
Homes become rubble.
The sky learns the language of fire.

And in the wreckage stand the children.

They watch …