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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 …

Why physician burnout is actually a loss of professional identity

Timothy Lesaca, MD

Physician

March 28, 2026

Most accounts of physician burnout begin with a familiar list: too many hours, too many clicks, too many patients, and not enough time. The diagnosis follows easily. Doctors are exhausted. Something inside them has been used up. Burned out. That explanation has the advantage of being familiar. It also has the potential to be incomplete. There is another way to understand what is happening, one that comes from an unlikely …

The Silent Variance: How patient friction destroys health care revenue

Donna Harvin‑Graham, MBA

Conditions

March 28, 2026

As health systems move into the 2026 fiscal year, CFOs and hospital boards have already approved their operating budgets. Capital is set aside for oncology expansions, MRI upgrades, and EHR enhancements. Revenue projections are built on patient volume, reimbursement assumptions, and clinical trial enrollment targets.

On paper, the math works. The P&L looks stable.

After more than 20 years in enterprise operations and financial systems, I know budgets fail long before the …

Statin safety and efficacy: What recent studies reveal

Cliff Dominy, PhD

Meds

March 28, 2026

Are you concerned about statins? In the past two weeks, cold hard statistics have cut through the fog of misinformation surrounding these best-selling drugs, focusing instead on the safety and efficacy of lowering your blood cholesterol level. No emotions or bias, just numbers. Welcome information for anyone who has enjoyed numerous trips around the sun and is looking forward to many more.

Middle age, that point in life when your invincibility …

Why physicians must reclaim their right to pause [PODCAST]

The Podcast by KevinMD

Podcast

March 27, 2026

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

Integrative pediatrician Mary Wilde discusses the article “The pause medicine never taught us to take.” Mary discusses how medical training conditions clinicians to fear rest and prioritize a treadmill of servitude over …

Night shift weight loss: a practical fasting guide for physicians

Aaron Grubner, MD

Physician

March 27, 2026

Working the night shift is brutal. Circadian rhythms are disrupted, backup help in true emergencies is limited, and even simple things like labs or imaging can take far longer than they should. But one of the biggest challenges is late-night snacking.

There is something about the combination of darkness, fatigue, and intermittent slow periods that makes it ridiculously easy to inhale a two-pound bag of potato chips without thinking twice. Research …

Why MRI classification systems improve spinal stenosis care

Francisco M. Torres, MD & Purab Patel

Conditions

March 27, 2026

The saying, “treat the patient, not the X-ray,” captures a core challenge we face in spine practice: Clinical symptoms and imaging findings often do not align, making it crucial to approach imaging with a structured framework. This lesson was evident when we treated two patients with strikingly different presentations. The first was a 35-year-old woman whose MRI report identified severe scoliosis and spinal stenosis. Yet, she was totally asymptomatic, with …

The death of medical swagger: How physician status has changed

Paul Dranichnikov, MD, PhD

Physician

March 27, 2026

Fifty years ago, being a doctor was like being a cross between a wizard and a rock star. People would whisper in awe when you walked by: “There goes Dr. High-and-Mighty, saving lives and curing everything from a runny nose to a broken heart!” My dad used to tell me stories about how he would get waved past security, cut to the front of lines, score doctor discounts, and park …

Atypical Parkinson disorders vs. Parkinson disease: key differences

Jerome Lisk, MD, MBA

Conditions

March 27, 2026

The terms parkinsonism, Parkinson disorder, and Parkinson syndrome are all synonymous and can be used interchangeably depending on which you prefer. All of these terms refer to the symptoms. To be diagnosed with a Parkinson disorder, you must exhibit two out of three of the following motor symptoms:

unilateral resting tremor
slowness of movement (bradykinesia)
muscle rigidity or stiffness (cogwheel rigidity)

This is with or without postural instability, which usually refers …

Why clinical medicine is harder than flying a plane

Olumuyiwa Bamgbade, MD

Physician

March 27, 2026

People often say doctors should perform like flight or rescue teams. The comparison sounds flattering. It is also incomplete. Pilots, ship captains, firefighters, coastguards, and rescue teams all work in high-stakes environments. They train hard. They lead under pressure. They make critical decisions with lives at risk. Medicine shares that gravity. But the real-world challenge of clinical medicine is often more complex, less controlled, and more exposed to uncertainties than …

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