Why terminal cancer patients still receive aggressive treatment

Physician
July 31, 2025

Recently, researchers examined whether there had been any changes in the way terminal cancer patients died from 2014 to 2019, given the increased information available on hospice, palliative care, and advanced end-of-life planning (EOLP). They asked whether those who were terminal continued aggressive treatment until their demise. The authors anticipated a decrease in this, but found that the frequency of cancer patients who continued aggressive therapy had not declined. The …

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How doctors can build emotional strength through writing

Physician
July 31, 2025

As I travel the country giving talks to various groups of health care professionals about resilience-building and physician burnout, I sometimes come up against some resistance to the idea. The argument goes something like this: If our emotional exhaustion, depersonalization, and lack of a sense of personal accomplishment (i.e. burnout) is largely caused by work overload, administrative burdens, and the moral distress of trying to practice medicine humanistically amidst insurance …

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When medicine surrenders to ideology

Physician
July 30, 2025

I am a physician-scientist, a title earned through decades of toil in laboratories and hospital wards, where the twin pursuits of truth and healing once reigned supreme. Yet, at the flagship academic hospital of this self-proclaimed “sanctuary state,” I conceal my credentials—not out of humility, but from a grim desire to witness the system unadorned, as it reveals itself to the ordinary patient. What I have beheld is a travesty: …

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How just culture can reduce burnout and boost health care staff retention

Physician
July 30, 2025

Health care systems acknowledge that how they respond to mistakes significantly impacts their workforce’s morale, retention, and overall productivity. The consequences of a punitive culture are costly in terms of financial and operational costs, as it discourages reporting, promotes burnout or fatigue, and aggravates staff turnover. Conversely, implementing a just culture promotes psychological safety, continuous learning, and fairness, which enables health care staff to remain engaged and resilient throughout their …

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Why embracing imperfection makes you truly unforgettable

Physician
July 30, 2025

I love comedy clubs. Always have. My wife calls them my happy place and she’s not wrong. Although I haven’t had the opportunity to attend one recently, I often find myself immersed in stand-up clips from the likes of Dave Chappelle, Chris Rock, Kevin Hart, and a constellation of other comedic virtuosos. Back in the pressure-cooker days of my residency training in New York City, those clubs were my sanctuary. …

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Affordable postpartum hemorrhage solutions every OB/GYN should know

Conditions
July 29, 2025

Postpartum hemorrhage (PPH) remains one of the most common causes of maternal death globally. In many cases, it’s not a matter of lacking knowledge—it’s about lacking access to the tools we need.

In well-resourced U.S. hospitals, the JADA® System has in many ways been a paradigm change by using vacuum-induced uterine tamponade—a technique that creates gentle intrauterine suction to trigger uterine contraction and bleeding control. However, for the vast majority of …

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Why kratom addiction is the next public health crisis

Meds
July 29, 2025

In recent years, kratom, a botanical herb indigenous to Southeast Asia, has surged in popularity across the United States.

Marketed aggressively online and sold openly in vape shops, convenience stores, and specialty herbal outlets, kratom is often portrayed as a natural remedy, an herbal escape from chronic pain, anxiety, and opioid withdrawal. But beneath the alluring veneer of wellness and relief lies a dangerous, largely unregulated substance capable of causing severe …

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Why taxing remittances harms families and global health care

Finance
July 29, 2025

Like many of my fellow physicians, I suspect I’m two things: a child of immigrants and a child of a physician. That combination gave me a unique window into two fundamental systems, health care and global economics, long before I studied either formally. I saw the sacrifices and hard choices required to navigate both, often simultaneously, with no geographic boundary ever limiting our responsibilities.

Many vivid memories from childhood have stayed …

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How are prostate exams done and why you shouldn’t avoid them

Conditions
July 29, 2025

Men don’t usually bring up prostate exams in casual conversation, and that silence is part of the problem.

Across clinics and exam rooms, we see it all the time: men who delay checkups until urinary symptoms become disruptive, or worse, when routine blood work turns into a cause for concern. The truth is, prostate screening isn’t about embarrassment or fear, it’s about staying one step ahead of issues that are common, …

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Airlines’ policy ignores your do not resuscitate (DNR): Discover why and some ways to protect yourself

Conditions
July 29, 2025

“It is a sad state that fear of liability will oftentimes negate the moral choice made by a terminally ill patient.”
– Journal of Air Law and Commerce

Background

In August 2024, I gave a presentation, “You’re suing me because I kept your mom alive? Avoiding wrongful life lawsuits.” I discussed the consequences for medical staff when they disregard a valid DNR and revive a person, against their wishes. There are numerous nationwide …

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A dual citizen’s choice between two imperfect systems [PODCAST]

Podcast
July 28, 2025
YouTube video

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

Certified coach Kathleen Muldoon discusses her article, “Choosing between care and country: a dual citizen’s Independence Day reflection.” As a dual U.S. and Canadian citizen and mother to a child with complex …

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How pediatricians can address the health problems raised in the MAHA child health report

Policy
July 28, 2025

I understand that, in August, we will receive the prescription for the poor results of the recent Make America Healthy Again (MAHA) report focused on children’s health. As a pediatrician, I would like to offer some remedies for the child nutrition shortcomings identified in the report and provide feedback on other health concerns it raises.

Chronic disease rates among children are mentioned first in the report. Authors point to …

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The unseen burden patients carry between appointments

Physician
July 28, 2025

A man sat in my waiting room, heart racing—not from chest pain, but from panic. He’d been Googling his symptoms all night. Not afraid of what is—terrified of what might be. This is the anticipatory anxiety of modern medicine—a silent epidemic that strikes before any diagnosis ever does.

Patients no longer arrive with just symptoms. They bring stories already constructed. Hours of scrolling. Threads of worst-case scenarios. Algorithms feeding fear. By …

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Choosing the best EHR for your new behavioral health business

Tech
July 28, 2025

Clinicians who dream of starting a private practice in the field of behavioral health rarely daydream about the logistics involved. But preparing for common challenges is fundamental to success. Before taking on the roles of both behavioral health provider and entrepreneur, it is important to consider all of the behind-the-scenes work required.

Defining a practice’s niche, navigating regulatory and legal considerations, creating a business plan and a budget, and developing a …

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My journey to loving primary care again

Physician
July 28, 2025

There was a time — not too long ago — when I dreaded the start of each workweek.

I had spent years studying, training, and sacrificing sleep, time with family, and even my health to become a physician. I believed in the value of primary care and the importance of relationships with my patients. But somewhere along the way, the dream started slipping through my fingers. I wasn’t unhappy because of …

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How coaching transforms care for people with multiple sclerosis

Conditions
July 28, 2025

Multiple sclerosis (MS) is an autoimmune-mediated neurodegenerative disease that affects approximately 2.8 million people worldwide, and its incidence has risen over the past decade. As health and wellness professionals who have cared for people living with MS, we have both witnessed the ever-evolving journey and the roller coaster of emotions, psychosocial impact, symptoms, and health challenges that people living with MS face. The muscle weakness that makes walking more …

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Why doctors striking may be the most ethical choice

Physician
July 27, 2025

“When doctors strike, patients die.” That phrase—flattened into certainty—gets tossed around like a moral verdict. It shows up in op-eds, comment threads, morning rounds. As if to say: there’s no argument. The matter’s settled. You swore an oath.

But what oath, exactly?

Most physicians are taught to revere the Hippocratic Oath, but few have read the original versions. It wasn’t universal. It wasn’t sacred scripture. It forbade surgery. It invoked Apollo and …

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Integrating vitamin education in mental health care

Conditions
July 27, 2025

For a long time, I was close-minded to the idea of vitamin supplementation as a meaningful part of mental health treatment. Like many in medicine, I saw it as misguided at best and more a part of wellness culture than real science. However, over time, I realized how often we mistake “That makes sense to me” for “That’s objectively true,” as we are prone to fall prey to our mental …

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How photos shape drug stigma—and what we can do about it

Physician
July 27, 2025

Well before I was a physician, I was an art history major at Bowdoin College. Beneath towering pine trees, I spent much of my time in dim lecture rooms off the quad and in the quiet galleries of Maine’s art museums, studying paintings, sculptures, and photographs to understand not just what was being portrayed, but also what they revealed about the people, places, ideas, and defining events of their time. …

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From participants to partners: Rethinking clinical trial design

Physician
July 27, 2025

Clinical trials are the cornerstone of progress in cancer treatment. Yet, paradoxically, the very patients these trials are designed to help often face the greatest obstacles to participation. While the concept of “patient-centered” clinical trials has been around for years, more than 20 percent of U.S. clinical trials fail to accrue a sufficient number of participants, forcing them to fold.

Why aren’t patients enrolling in clinical trials?

While there have …

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