New autism treatment guidelines expand options for families

Conditions
November 22, 2025

When the American Academy of Child and Adolescent Psychiatry released its October 2025 policy statement expanding what counts as valid, evidence-supported autism treatment, it marked a turning point that has been needed for years. For more than a decade, insurance companies pushed a narrow, outdated narrative that applied behavior analysis was the only evidence-based intervention for autism. That narrative was not accurate. It shaped policy, and it left families with …

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Why visitor bans hurt patient care

Education
November 22, 2025

When the first pandemic lockdowns swept through hospitals, our hallways went silent. The absence of visitors felt practical at first, a necessary shield against viral spread. But weeks turned into months, and that silence began to echo with something deeper: distrust.

I remember walking into a patient’s room to find her eyes fixed on the door. She wasn’t waiting for the nurse. She was waiting for her daughter, the daughter she …

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Direct primary care in low-income markets

Policy
November 22, 2025

Even the most “affordable” DPC models struggle in lower-income markets because the behavioral economics of these populations create high churn and unstable revenue. Practices that succeed in underserved areas nearly always diversify into employer partnerships, institutional contracts, or expansion into higher-income neighborhoods. Without understanding these behavioral and economic realities, physicians risk building a model the community cannot sustain long-term.

I previously argued that physicians must answer five market questions before …

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Is white coat hypertension harmless?

Conditions
November 22, 2025

It happens almost every clinic day. A patient walks in, sits down for their vital signs, and their blood pressure reads higher than expected. Sometimes much higher. Moments later, when I retake it myself after we’ve talked for a few minutes, it’s 20 or 30 points lower.

“But, doctor, I check it at home and it’s never this high!”

They are right. This is the phenomenon of white coat hypertension, blood pressure …

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How to fight for your loved one during a medical crisis [PODCAST]

Podcast
November 21, 2025
YouTube video

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Physician and professional certified coach Chrissie Ott discusses her article “How an insider advocate can save a loved one.” Chrissie shares a terrifying recent story of a friend’s elderly, Spanish-speaking mother who …

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Is trauma surgery a dying field?

Physician
November 21, 2025

When I was a resident, the trauma surgeon was the go-to person for anything complicated. It seemed like they could do everything, and do it well. That’s what drew me to the field. There was a confidence, decisiveness, and scope that made trauma surgery feel like the pinnacle of surgical mastery.

For most of my career, I’ve worked as a trauma and critical care surgeon, from busy academic Level I trauma …

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Gen Z, ADHD, and divided attention in therapy

Conditions
November 21, 2025

Halfway through a teletherapy session, you notice your therapist pause mid-sentence. They’ve just heard the soft clatter of your keyboard, or seen your eyes flick sideways to a second screen. You’re technically “there” on video, but a work email just popped up, laundry is buzzing, someone’s messaging you, and suddenly the session is sharing space with three other tabs in your brain.

On the therapist’s end, it can feel like talking …

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Innovation in medicine: 6 strategies for docs

Tech
November 21, 2025

Medicine thrives on structure. Protocols, guidelines, and standards safeguard patient outcomes and reduce error. Yet the same structure that preserves consistency can quietly suppress creativity.

For physicians who dream of improving systems, innovating within such rigid frameworks can feel like trying to work inside a box. But structure and creativity do not have to be opposites. Oftentimes, the struggle lies in how we spark creativity in a system built for safety.

The …

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Why we fund unproven autism therapies

Physician
November 21, 2025

The average KevinMD reader may wonder why I’m so prolific in my commentary on pediatric medicine and the systemic reforms it demands. The answer is simple: I go to the source. Always.

That habit was forged nearly 30 years ago when the American Academy of Pediatrics invited me to serve as contributing section editor for Developmental-Behavioral Pediatrics in AAP Grand Rounds. My role: select key studies, critique methodology, and distill bottom-line …

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Early-onset breast cancer: a survivor’s story

Conditions
November 21, 2025

I found a lump at age 32, just four months after a clear clinical breast exam. No family history. No genetic markers. I noticed the golf-ball-sized mass one day while putting on my bra.

It turned out to be stage 3C, with spread to 14 lymph nodes, as advanced as it gets without being terminal. I went through a year of aggressive treatments: bilateral mastectomy, chemo, radiation, reconstruction, and hormone therapy.

My …

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Why mocking food allergies in movies is a life-threatening problem [PODCAST]

Podcast
November 20, 2025
YouTube video

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Food allergy advocate Lianne Mandelbaum discusses her article “Why Hollywood’s allergy jokes are dangerous.” As the mother of a child with a life-threatening food allergy, Lianne shares her personal trauma and outrage …

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Why we need to expand Medicaid

Education
November 20, 2025

When I began PA school, I faced an unexpected financial hurdle: I no longer qualified for employer-sponsored health insurance, and although at the time, I didn’t meet the requirements for Medicaid, I did qualify for subsidized health coverage through the marketplace. However, even with subsidies, the monthly premiums and out-of-pocket costs were still a financial strain. To afford health care and cover basic living expenses, I had to continue working …

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Remote second opinions for equitable cancer care

Conditions
November 20, 2025

Where a person lives far too often determines the quality of cancer care they receive and, ultimately, their chances of survival. Despite decades of progress in precision oncology, stark disparities persist between patients treated in urban academic centers and those in rural or underserved communities. A JAMA Network Open study of nearly 37,000 patients found that when rural and urban patients receive the same, protocol-driven care, their outcomes …

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How your past shapes the way you lead

Physician
November 20, 2025

Leadership is often discussed in broad strokes: some leaders are structured and precise, while others are flexible and improvisational. But behind those visible styles lie quiet personal and generational histories, the emotional terrain that shaped how we learned safety, trust, and control. I’ve come to see that these histories profoundly influence how we lead and how we’re perceived as leaders, especially in health care, where the stakes are high and …

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How private equity harms community hospitals

Physician
November 20, 2025

Early in the pandemic, we began using yellow cloth isolation gowns, environmentally superior, perhaps, to the paper gowns that preceded them, but not without complications. The strings at the neck were invariably tied and tightly knotted after going through the wash. If you’re a smallish doctor or nurse, the pre-tied neckline hung down around the tip of the xiphoid. I stood outside my patients’ rooms on long, weary days and …

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How culturally compassionate care builds trust and saves lives [PODCAST]

Podcast
November 19, 2025
YouTube video

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Public health professional Nishat Uddin discusses her article “Why culturally compassionate care matters for South Asian communities.” Nishat explains why South Asians, one of the fastest-growing U.S. populations, face disproportionate rates of …

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The U.S. health care crisis: a Titanic parallel

Physician
November 19, 2025

Two years ago, Drs. Aaron Morgenstein, Corinne Sundar Rao, and Shreekant Vasudhev drew a compelling parallel between the Titanic’s tragic voyage and the looming crisis in U.S. health care. They highlighted systemic issues such as administrative egotism, outdated practices, and substandard resources, warning that without significant course corrections, the health care system was on a collision path with disaster.

Today, in 2025, the iceberg has struck, and the cracks are …

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Why psychiatrists can’t treat family members

Conditions
November 19, 2025

As a psychiatrist, I’m often asked by family or friends to “help,” to intervene in the mental struggles of a loved one, a friend, or even a distant acquaintance. It usually begins with kindness and concern: “Could you just talk to them?” or “Maybe you can prescribe something, you’d know what’s best.” What follows is always a difficult conversation, because I have to explain something that sounds incomprehensible to most …

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Interdisciplinary medicine: lessons from the cockpit

Physician
November 19, 2025

In aviation, the right seat is typically reserved for the instructor. In medicine, it’s the role of the diagnostician, the mentor, the gatekeeper. I once piloted a T-37B “Tweet” trainer from the right seat, not as a student, but as someone trusted to guide. That experience shaped how I approach clinical decision-making, interdisciplinary fluency, and the choreography of care.

During a military training program, our squad faced a simulated obstacle: an …

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Aging parents and Thanksgiving: a gentle check-in

Conditions
November 19, 2025

Thanksgiving is my favorite holiday. I love the cooking, the noise, the parade, the extra side dishes no one really has room for. Every year I tell my parents I want to “go bigger”: more food, more people, more traditions. And every year, my mother looks at me with a mix of love and exasperation and says some version of, “Can we please do a little less this year? My …

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