Self-insured employer health plans face a new reckoning

Health Policy
July 24, 2026

In 2026, the movement in health care toward accountability has begun. A future press release will mark this year as the crescendo that put transparency on price and fiduciary responsibility back into health care. It starts with self-insured employers who have funded health benefits for their workforce under the latest provisions of ERISA, the Employee Retirement Income and Security Act. At long last, the black box that held the secrets …

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Self-insured employer health plans face a new reckoning

Comorbid mental illness affects 30 million Americans

Conditions and Diseases
July 24, 2026

In patients with chronic disabling physical symptoms, clinicians often overlook an associated mental illness. Why? Patients typically do not offer the psychological symptoms needed to make a diagnosis. Instead, they emphasize physical symptoms and their disability. To make a diagnosis, I’ll review that clinicians need to view severe physical symptoms as a “red flag” for a comorbid mental health problem.

An earlier KevinMD post highlighted that primary care providers lack …

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Comorbid mental illness affects 30 million Americans

Summer seasonal affective disorder hides in plain sight

Conditions and Diseases
July 24, 2026

When most people hear the words seasonal affective disorder, they picture winter. Dark mornings. Short days. Cold weather. Fatigue. Oversleeping. Wanting to stay under the covers. Only wanting to go out for donuts.

But seasonal depression does not always come in winter. For some people, summer is the difficult season. And summer-pattern seasonal affective disorder can look very different from the winter depression most of us recognize. Instead of slowing down, …

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Summer seasonal affective disorder hides in plain sight

Women physicians are leaving. Whose problem is it?

Physician
July 24, 2026

Making the decision to leave clinical practice was a leap off a cliff into thin air when I wasn’t sure I had a place to land. Who was I, what would I do, if I wasn’t a physician? It felt like such a loss; I loved being able to do such deeply meaningful work.

This was back in the dark ages of the late 1990s, before “burnout” was a household word. …

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Women physicians are leaving. Whose problem is it?

Why delayed dental care is rarely about not caring

Conditions and Diseases
July 24, 2026

When a patient arrives with advanced dental disease, it is easy to focus on the visible damage: untreated decay, infection, pain, or tooth loss. The question often becomes, “Why did they wait so long?” But that question can oversimplify a much more complicated reality. Delayed dental care is not always the result of indifference or poor personal choices. For many people, it reflects a combination of financial pressure, limited access, …

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Why delayed dental care is rarely about not caring

What the children of physicians carry

Conditions and Diseases
July 24, 2026

Back when I was a senior in college, I wrote a peer recommendation for my pre-med boyfriend’s medical school application. Nearly two decades later, that boyfriend is my husband, the father of my adorable children and a surgeon who I am incredibly proud of.

I may just have my B.S. and no M.D. or PhD after my name but I’ve certainly put in my time throughout the past fifteen-plus years of …

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What the children of physicians carry

A broken health care system and the physician shortage

Health Policy
July 24, 2026

An excerpt from Failure to Treat: How a Broken Healthcare System Puts Patients and Providers at Risk.

Over the course of my career, I have witnessed an inexorable decline in the quality of medical care that we, as physicians, render to our patients. There is a myriad of reasons for this sad development, some the fault of physicians, but the majority caused by a health care system that is almost …

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A broken health care system and the physician shortage

3 bedside tools for adolescent overdose prevention

Conditions and Diseases
July 24, 2026

The call came at 2 a.m. Not about a new patient. About one who had left.

She had been in my department three days earlier. Eighteen years old. Came in with chest tightness after a night out. Tox screen negative. Discharged. Three days later, fentanyl overdose. Dead. I have replayed that visit more times than I can count.

New data published in Emergency Medicine News puts a number on how many families …

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3 bedside tools for adolescent overdose prevention

Put the patient first: a surgeon’s best lesson

Physician
July 24, 2026

As the anniversary of my father’s death approaches, I have been thinking about him as both a father and a surgeon. Those two parts of his life were never entirely separate, at least not for me. My surgical education began long before medical school, residency or fellowship, because I grew up watching how he approached his work, how he treated people and how seriously he took the responsibility that came …

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Put the patient first: a surgeon’s best lesson

Why flexibility matters more for physician retention

Physician
July 24, 2026

Physicians are exiting medicine faster than the sector can replace them. We’ve been facing burnout, workforce shortages, growing administrative burdens, and other mounting pressures. Physicians are 82 percent more likely to burn out than workers in other occupations, and for many years, traditional practice models have offered few alternatives. As a result, there is a deepening sustainability crisis occurring in medicine.

As a practicing anesthesiologist for more than 30 years, …

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Why flexibility matters more for physician retention

Doctors who ignore AI will get left behind [PODCAST]

Podcast
July 23, 2026
YouTube video

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

When your hospital decides how to use AI, will you be in the room or will you be handed whatever someone else picked? Physicians have done this before, letting insurance and then EMRs …

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Doctors who ignore AI will get left behind [PODCAST]

Social determinants of health hide in plain sight

Health Policy
July 23, 2026

A fifteen-year-old boy arrived at the hospital after what appeared to be a generalized seizure.

The story seemed straightforward. Witnesses described loss of consciousness, convulsions, and urinary incontinence. By the time I met him, the obvious questions had already been asked. The investigations had already begun. A CT scan was ordered. Laboratory tests were pending. Everyone was searching for a neurological explanation, including me.

As I worked through the history, I considered …

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Social determinants of health hide in plain sight

Medical uniform design is quietly shaping the runway

Conditions and Diseases
July 23, 2026

Until recently, I believed I understood uniforms.

For more than fifteen years, I covered the fashion industry, attending runway shows, interviewing designers, and writing about the ways clothing reflects culture. Fashion has always borrowed ideas from uniforms, whether military tailoring, aviation jackets, or workwear. I thought I knew why.

Then, after a serious leg injury at Paraiso Miami Swim Week, I unexpectedly found myself in a hospital, not as a journalist, but …

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Medical uniform design is quietly shaping the runway

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The same maternal inequity, from Ecuador to America

Health Policy
July 23, 2026

“I want my mom.”

I still remember hearing those words from a twelve-year-old pregnant patient during my internship at a public maternity hospital in Quito, Ecuador. She had become pregnant after being sexually abused by a neighbor and came from a low-income community with limited access to education and health care resources. When I met her, she was alone in a hospital bed during labor, crying and asking for her mother …

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The same maternal inequity, from Ecuador to America

Physician unions are surging, and money is not why

Physician
July 23, 2026

The email arrived on a Tuesday afternoon. It thanked everyone for their dedication, praised the organization’s proud history, and announced that the hospital had been acquired. There would be new leadership, new opportunities, and a town hall meeting the following week. Clinical operations would continue as usual.

There was one thing missing. No one had asked the physicians.

For generations, doctors assumed that if the ownership of a hospital or medical practice …

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Physician unions are surging, and money is not why

Measles complications can hide in the brain

Conditions and Diseases
July 23, 2026

The child is already well by the time the virus settles in.

The fever broke. The rash faded. The parents exhaled. Life moved forward: first steps, first words, first day of school. In a small number of children, though, the measles virus does not leave. It retreats inward, past the bloodstream, past the immune system’s reach, and takes up residence in the brain. Quietly. Without announcement. It waits there, sometimes for …

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Measles complications can hide in the brain

Stoicism for physicians: a quiet anchor on hard shifts

Physician
July 23, 2026

Imagine walking into a busy clinic shift. The pages are going off, patients need attention, and the emotional weight of the work feels heavy on your shoulders. In moments like these, the ancient wisdom of Stoicism can serve as a quiet anchor. Philosophers like Seneca, Marcus Aurelius, and Epictetus understood that life brings many challenges. They taught practical ways to respond with clarity, courage, and compassion. Their reflections on action …

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Stoicism for physicians: a quiet anchor on hard shifts

Why we need closure, and why we may not

Physician
July 23, 2026

A friend once asked me a question that stopped me in my tracks. Not externally. Internally. I am a highly verbal person inwardly, and while the conversation continued around me, another one had already begun in my head.

Earlier that day I had been cataloging the various grievances I believed had been inflicted upon me by another person I had once counted as a friend. After listening patiently for some time, …

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Why we need closure, and why we may not

Why “fine” is not clinical reasoning in medical education

Conditions and Diseases
July 23, 2026

An attending physician recently described one of the most troubling encounters she had witnessed involving a medical student. A student emerged from a well-child visit and offered a reassuring summary: “The kid is fine. Everything is good.”

The patient, however, was not a child whose history could be dismissed with a casual adjective. The child had undergone surgical repair of a ventricular septal defect and had a history of failure to …

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Why “fine” is not clinical reasoning in medical education

Our obsession with youth is making us shallow

Physician
July 23, 2026

In my thirty years of clinical practice, I have witnessed the landscape of the human face undergo a quiet, profound transformation. It is not happening through biology, but through the scalpel, the needle, and the digital filter.

For most of human history, an aging face was a history book. It served as a cartography of experience, where lines around the eyes mapped a lifetime of laughter, and furrows in the brow …

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Our obsession with youth is making us shallow

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