Perimenopause misdiagnosis: what a normal lab result hides

Conditions and Diseases
July 30, 2026

“I just don’t feel like myself lately.”

It is one of the most common opening lines in midlife primary care, and one of the least diagnostically useful on its face. The patient is forty-four, sleeping badly, irritable in a way she describes as unfamiliar, and struggling to hold a thought through a meeting. Her cycles are still coming, roughly. She has read about perimenopause and dismissed the idea, because she is …

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Perimenopause misdiagnosis: what a normal lab result hides

Is institutional knowledge loss your staffing problem?

Physician Finance
July 30, 2026

The best person at your front desk gives two weeks’ notice on a Tuesday. It’s nothing dramatic, just a better commute and a job that pays a little more. Everyone wishes her well, and the seat gets filled inside a month.

What doesn’t get filled shows up in pieces over the following weeks. A patient lands in a slot that’s been blocked off for a year, because he gets anxious and …

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Is institutional knowledge loss your staffing problem?

Medical frailty exemptions are the new prior authorization

Health Policy
July 30, 2026

Every clinician can attest to the annoyance, stress, and worry that manifests when we think about paperwork. Even the likes of a snake oil salesman currently in charge of CMS, Dr. Oz, penned a piece noting this very real strain on physicians across the U.S. due to prior authorizations. Research has shown that physicians on average are spending up to 13 hours per week on this odious task and …

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Medical frailty exemptions are the new prior authorization

Vitamin K refusal is a systems failure, not a parental one

Conditions and Diseases
July 30, 2026

I trained in the era when newborn care was a choreography, not a ritual, not a preference, but a sequence built from epidemiology, autopsy reports, and the memories of children we could not save. In the nursery, two injections and a few simple prophylactic steps prevented the worst horrors of early infancy:

  • Vitamin K IM: To prevent catastrophic late-onset vitamin K deficiency bleeding (VKDB)
  • Hib vaccine: To eliminate epiglottitis and …

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Vitamin K refusal is a systems failure, not a parental one

When AI in claims review overcalls a valid claim

Health Technology
July 30, 2026

A medical emergency call is never just a phone call. On the other side of the line, there may be chest pain, shortness of breath, trauma, fear, confusion, or a family member trying to describe symptoms without medical vocabulary. The first information is often incomplete. The situation may change within minutes. A decision has to be made quickly, but it cannot be made blindly.

In São Paulo, Brazil, where I work …

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When AI in claims review overcalls a valid claim

When the DEA became my patient’s doctor

Conditions and Diseases
July 30, 2026

I have practiced neurology for more than fifty years. I have treated patients with refractory neuropathic pain, central pain syndromes, spinal cord injuries, and the cruel mix of conditions that fall under no clean diagnostic label. I have watched patients who were finally stable, finally sleeping, finally functioning, lose their prescriptions not because their physicians did anything wrong, but because the government decided that looking different on paper is the …

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When the DEA became my patient’s doctor

Big Pharma’s drug marketing got stealthy, and you are the target [PODCAST]

Podcast
July 29, 2026
YouTube video

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

The pharma rep with the free lunch is gone. What replaced it is harder to see, and aimed at you and your doctor. Martha Rosenberg is an investigative reporter who has worked at …

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Big Pharma’s drug marketing got stealthy, and you are the target [PODCAST]

What I learned as a research volunteer at 70

Physician
July 29, 2026

My wife answered our telephone. A representative of the state university asked her about my interest in participating again in her group’s research project. She handed the handset to me. For several years, my name has resided in the database of their Office of Human Research. My honoraria, when they offer one, have ranged from a crisp, minimally circulated $50 bill, to gift cards of $15 to 50, and an …

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What I learned as a research volunteer at 70

Why a psychiatric diagnosis is not a biological target

Conditions and Diseases
July 29, 2026

“I have a lot of anxiety and stress. Can I get Prozac, Lexapro, or something like that?”

“My moods are all over the place. One moment I’m happy, the next I’m sad, the next I’m enraged. Can I get a mood stabilizer?”

I hear requests like these constantly. They’re completely understandable. They also reflect a common misunderstanding: that psychiatry works the way the rest of medicine does, where a symptom leads straight …

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Why a psychiatric diagnosis is not a biological target

The male loneliness epidemic hiding behind success

Conditions and Diseases
July 29, 2026

Clinicians often meet men like K at the exact moment their lives start to quietly unravel. They don’t walk in using the language of distress. They show up looking competent, composed, and in control, even as something inside them is slipping. What looks like a business crisis is often an emotional one, driven by shame, isolation, and the belief that suffering must be carried alone.

This story and topic could easily …

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The male loneliness epidemic hiding behind success

Anticipatory anxiety about AI is showing up in clinic

Conditions and Diseases
July 29, 2026

I just finished watching Daniel Kokotajlo’s interview on The Diary of a CEO with Steven Bartlett and reading his full AI 2027 publication in its entirety, and I haven’t been able to shake the feeling that this conversation, one that has clearly sparked a wave of public unease since it aired, is a preview of what I’m already starting to see in the clinic. A patient recently described …

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Anticipatory anxiety about AI is showing up in clinic

The life hack that could undo medical debt credit reports

Physician Finance
July 29, 2026

“I just don’t pay them.”

I was with a group of acquaintances, and we had been engaged in a spirited conversation about the costs of medical care. While I was the only one present who worked in health care, the group itself was fairly homogenous, with individuals in similar stages of life and financial security. Access to health insurance was of no concern in this group, and neither would have been …

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The life hack that could undo medical debt credit reports

Cookbook medicine and the loss of clinical judgment

Physician
July 29, 2026

“The brain is a wonderful organ. It starts working the moment you get up in the morning and does not stop until you get into the office.”
– Robert Frost

Since the publication of my first nonfiction book, Failure to Treat: How a Broken Healthcare System Puts Patients and Practitioners at Risk, I have been deluged with medical stories. In fact, nearly everyone who has read the book has been anxious …

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Cookbook medicine and the loss of clinical judgment

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7 ways to use AI for better health and nutrition

Medical Education
July 29, 2026

Like many doctors, I was initially skeptical about artificial intelligence (AI). As a retired Australian anesthetist, I had spent decades relying on clinical experience, scientific evidence, and professional judgment. I never imagined that one of the most useful health education tools I would encounter would be a mobile phone.

In 2024, I was living with obesity, type 2 diabetes, hypertension, sleep apnea, and gastric reflux. Like many people, I accepted these …

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7 ways to use AI for better health and nutrition

Medical student advocacy begins before you feel ready

Medical Education
July 29, 2026

YouTube video

American Society of Anesthesiologists

One of my favorite quotes is, “If you’re not at the table, you’re on the menu.” I did not fully understand the meaning of that statement until I became involved in advocacy and organized medicine during medical school.

Like many medical students, I entered training focused almost entirely on becoming the …

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Medical student advocacy begins before you feel ready

The best gluten-free Trader Joe’s finds to grab now

Conditions and Diseases
July 29, 2026

This article is for those living or needing to live a gluten-free lifestyle, but still also appreciate a good guide for the grocery store too. Up to 15 percent of Western countries avoid gluten. By the year 2030 there could be up to 600 million people worldwide avoiding gluten, and those numbers could influence a buyers market of a whopping $13.67 billion.

So what is gluten in a nutshell? It’s a …

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The best gluten-free Trader Joe’s finds to grab now

Leaving academic medicine was not falling out of love

Physician
July 29, 2026

Although becoming a doctor is a rigorous endeavor, the journey is somewhat prescribed. I made a decision to become a doctor at seventeen; I boarded that train and rode it through college, medical school, residency, and fellowships. All the while so focused on the destination that I never got off to explore, rarely looked out the windows, and never reconsidered where I was headed.

Now, almost forty, I look around at …

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Leaving academic medicine was not falling out of love

Patient experience in clinical trials starts with kindness

Conditions and Diseases
July 29, 2026

Patients may not remember every lab draw, procedure, or study visit. But they will remember how they felt.

One of the greatest privileges of working in clinical research for more than 20 years has been meeting extraordinary people. Clinical research is often associated with science, data, and innovation. While those elements are essential, there is also a deeply human side to this industry. Behind every study, treatment, and medical advancement are …

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Patient experience in clinical trials starts with kindness

What ChatGPT revealed when a medical student asked it to analyze him [PODCAST]

Podcast
July 28, 2026
YouTube video

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

What happens when you ask ChatGPT to study every conversation you have had and tell you who you really are? One medical student did that, and what it told him changed how he …

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What ChatGPT revealed when a medical student asked it to analyze him [PODCAST]

Moral injury doesn’t care how many hours you worked

Conditions and Diseases
July 28, 2026

I am not a Mormon male. But for fifteen years, I had been doing a remarkably good impression of one. And then, on a Wednesday evening in May 2026, I was outed.

The termination letter was two pages, formal and bloodless. Ninety days’ notice, effective August 31. “With or without cause,” it said, a phrase that is perfectly designed to be both legally protective and humanly devastating. It was signed by …

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Moral injury doesn’t care how many hours you worked

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