KevinMD.com

How medical education debt drives the physician shortage

Finance

March 30, 2026

I have sat in a lot of rooms where smart, well-meaning people puzzle over why American medicine keeps producing the same outcomes: Too few doctors in too many places, primary care is underfunded, and rural hospitals are consistently closing. The answer, frustrating as it is, comes down to a single systems principle: Every system is perfectly designed to get the results it gets. By that standard, we should not be …

The hidden costs of diffuse accountability in medical teams

Gus W. Krucke, MD

Physician

March 30, 2026

I have watched the scope-of-practice debate for decades, from call rooms and crowded wards, from intensive care units and emergency departments, and from the deafening quiet that follows a code well run yet not won.

Early in my career, I argued the way many physicians do, with outcome data and workforce projections. Over time, I came to see that those arguments skirt the deeper question: When clinical authority expands, does accountability …

Overcoming moral injury in medicine: a Doctor’s Day reflection

Seleipiri Akobo, MD, MPH, MBA

Physician

March 30, 2026

The white coat has always been a symbol of a sacred trust, a commitment to “do no harm.” But as we approach Doctor’s Day 2026, many of us find ourselves grappling with a different kind of harm. It is not a physical wound, nor is it the “burnout” often cited in corporate wellness modules. It is the moral injury of us.

In our daily practice, we increasingly find ourselves at the …

A poem of gratitude for narrative medicine on Doctor’s Day

Michele Luckenbaugh

Conditions

March 30, 2026

You stood in the quiet spaces
where fear gathers its weight,
in exam rooms humming with doubt,
in moments when breath was forced
and time seemed unwilling
to promise tomorrow.

You were there.

Not only with stethoscope and chart,
not only with the knowledge of medicine,
but with something far rarer:
a presence that did not rush,
a listening that did not measure itself
against the ticking of a clock.

I remember how you listened to the story,
as if each word mattered,
because to …

Why resilience is not the cure for physician burnout

Lisa Rubiano, DO

Physician

March 30, 2026

When I think about the defining trait physicians have, it is perseverance. Persistence in doing something despite difficulty or delay in achieving success. We work hard to get into medical school. If you do not get accepted the first time, you double down. You apply to more schools, take a course for the MCAT, brush up on interview skills, and pad your resume with more research. You explore less traditional …

Understanding methylation, BDNF, and the ApoE Alzheimer’s gene

Majid Fotuhi, MD, PhD

Conditions

March 30, 2026

An excerpt from The Invincible Brain: The Clinically Proven Plan to Age-Proof Your Brain and Stay Sharp for Life by Majid Fotuhi. Copyright © 2026 by Majid Fotuhi. From Harper Wave, an imprint of HarperCollins Publishers. Reprinted by permission.

Your brain is constantly changing. While the primary structures remain the same, you can grow and shrink your cortex and hippocampus according to what you do. But what about genetics? You …

Finding meaning in medicine: Reconnecting with your childhood calling

Brian Sayers, MD

Physician

March 30, 2026

If you are a child of the 1960s, chances are your mother or grandmother made some of your clothes from scratch. They would go to a fabric store, look through the hundreds of small packets of printed sewing patterns, and select their next project. The patterns were sheets of thin tissue paper containing outlines of how the fabric should be cut, with instructions on how to piece them together. My …

How artificial intelligence sycophancy distorts clinical decision-making

Arthur Lazarus, MD, MBA

Tech

March 29, 2026

Artificial intelligence talks with a voice that is fluent, confident, and increasingly human-like. For clinicians, that voice is both promising and worrisome. It can summarize charts, draft notes, and answer questions with remarkable speed. But it can also do something equally slick yet potentially dangerous: It can agree, virtually all the time.

At first glance, agreement seems harmless. Even helpful. But a growing body of evidence suggests that this tendency, known …

The dysfunctional medical malpractice marketplace and tort reform

Howard Smith, MD

Physician

March 29, 2026

Nationwide, 200,000 lawsuits are filed per year. Among them are between 66,000 and 85,000 medical malpractice cases; however, this number is uncertain. Between 22,000 and 44,000 of these culminate favorably for the plaintiff as a settlement or a verdict. The remainder, two-thirds of all malpractice claims, are dropped or otherwise end favorably for the defendant. These statistics suggest that many medical malpractice claims are frivolous yet are still represented, and …

The cost of time constraints in primary care: Why doctors feel rushed

Ann Lebeck, MD

Physician

March 29, 2026

A patient comes in with hip pain. It is not dramatic hip pain. There is no trauma and no fall. It is just a gradual ache that now wakes her up at night. She cannot sit comfortably. Getting in and out of the car is harder, and she is worried. The X-ray is normal. Now what?

In another era, this is where medicine began, not ended. It began with history, examination, …

Medicine and the United Nations Sustainable Development Goals

Olumuyiwa Bamgbade, MD

Policy

March 29, 2026

Many doctors hear “the United Nations Sustainable Development Goals” and assume the subject belongs to diplomats, ministers, and development agencies. It does not. Doctors advance the Sustainable Development Goals every day, often without naming them. The United Nations’ 2030 Agenda includes 17 goals designed as an integrated framework for human well-being, equity, prosperity, sustainability, and partnership. They are meant to work together, not in silos. That matters because health does …

Why thiamine deficiency is a hidden driver of delirium

Carrie Friedman, NP

Conditions

March 29, 2026

Delirium is one of the most common and most frustrating syndromes we encounter in medicine. It is also one of the most normalized. Up to 30 to 50 percent of hospitalized older adults experience delirium, particularly in intensive care and post-acute settings, yet it is frequently treated as an expected complication rather than a reversible condition with identifiable drivers. We expect it. We document it. We treat around it. And …

Scientific writing and AI: Balancing authorship and assistance

Rao M. Uppu, PhD

Tech

March 29, 2026

William A. Pryor, whose intellectual rigor and scientific voice shaped generations of researchers and the broader world of free radical biology and medicine, often told me something I have never forgotten. Only later did I understand that it was really about cognition.

But what stayed with me most was his insistence on a simpler discipline: Keep your hand on the keyboard and start writing. “The ideas,” he said, “will crystallize as …

Avicenna’s influence on modern medicine: a physician’s reflection

Farid Sabet-Sharghi, MD

Physician

March 29, 2026

In the modern-day world, a physician’s daily routine is often a whirlwind of clinical data, digital notifications, and the latest diagnostic protocols. Yet, in the quiet moments between patients, I find myself returning to the teachings of a man who lived over a millennium ago: Ibn Sina, known to history as Avicenna.

While we often view the history of medicine as a linear climb from “darkness” to “enlightenment,” the Canon of …

The risks of direct-to-consumer pharmaceutical advertising and Big Pharma

Ronald L. Lindsay, MD

Meds

March 29, 2026

In 2002, prescribing risperidone meant fighting through layers of resistance. I had to argue with formulary doctors, armed with a special copy of the New England Journal of Medicine article where my own name was highlighted, just to gain permission. That was the level of scrutiny these drugs once demanded. The article itself was not obscure, it was a landmark trial demonstrating risperidone’s efficacy in children with autism spectrum disorders.

Yet …

The synthetic opioid market: Why cartel arrests do not stop the crisis

Carlos N. Hernandez-Torres, MD

Conditions

March 28, 2026

Recently, I started a patient on high-dose buprenorphine because he could no longer get to his methadone clinic. He lost his leg this year to xylazine-associated wounds. The amputation was not the result of a single dramatic overdose, but of months of progressive tissue necrosis from repeated exposure to fentanyl adulterated with “tranq.” The infection spread. The vascular compromise worsened. Eventually there was nothing left to salvage. He now moves …

Bayesian reasoning in health care: When to refuse medical tests

Martin Bello, PhD

Tech

March 28, 2026

I was diagnosed with benign paroxysmal positional vertigo (BPPV). The diagnosis was not surprising. I had experienced several brief but intense episodes of vertigo, sudden, disorienting sensations that made it difficult to remain upright.

During one episode, I slumped against a bookcase. I did not lose consciousness, but the event was concerning enough that my physician suggested enhanced head and neck MRIs to rule out vascular causes. I have no fear …

The truth about opioid analgesics and nonsteroidal anti-inflammatory drugs

Pat Irving, RN & Richard A. Lawhern, PhD

Conditions

March 28, 2026

We live in a nation of needless pain! According to CDC data from 2021, over 50 million Americans (21 percent of adults) experienced chronic pain that persisted for more than three months. Among these, approximately 17 to 21 million U.S. adults currently experience persistent, high-impact pain on most days: pain that severely limits daily life or work activities.

Increasing numbers of these patients are being denied pain relief …

How high taxes and the California Medical Board fuel the physician shortage

Kayvan Haddadan, MD

Physician

March 28, 2026

Picture this. You finish another long day caring for patients who need you. You head home exhausted but fulfilled. Then the worry creeps in. Will another complaint land on your desk tomorrow? Will your take-home pay cover the mortgage in this state? You love California. You trained here. You built your life here. Yet more and more of us are scanning job postings in Texas, Florida, or Arizona, not because …

Occupational therapy in addiction recovery: Making daily life livable

Irving Gold

Conditions

March 28, 2026

Jonathan first met the health system on the floor of an emergency room.

He had drunk himself into a crisis, and the team did what they are trained to do: stabilize, monitor, and discharge. He got a lecture. He got a referral. He was given an AA meeting list. Then he got on with the long business of suffering.

For years, Jonathan bounced between moments of crisis and well-intentioned medical appointments that …