Meeting transgender patients where they are: a health care imperative

Physician
July 22, 2025

An excerpt from Pandemics, Poverty, and Politics: Decoding the Social and Political Drivers of Pandemics from Plague to COVID-19.

Many transgender (TG) people live with the constant threat of violence. International research documented a total of over 2,000 murders of TG humans between January 2008 and April 2016.43 (These findings are likely greatly underreported.) Even more widespread is nonlethal violence against TG communities. A national U.S. study indicated that 35 …

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How to break the cycle of judgment in medicine [PODCAST]

Podcast
July 21, 2025
YouTube video

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Pediatrician and certified coach Jessie Mahoney discusses her article, “Why judgment is hurting doctors—and how mindfulness can heal.” She argues that the culture of medicine is steeped in judgment—from the language of …

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How value-based care transforms chronic kidney disease management

Conditions
July 21, 2025

Chronic kidney disease (CKD) affects more than 1 in 7 U.S. adults, while approximately 2 in 1,000 are living with end-stage kidney disease (ESKD)—kidney failure that is treated either with a kidney transplant or through dialysis. Today, however, there is much that can be done to prevent kidney failure if CKD is diagnosed early and comorbid conditions are well managed. Patients with CKD and ESKD have multiple complex chronic …

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Why rigorous training is vital for today’s surgeons

Physician
July 21, 2025

Are you serious? It’s 2 a.m., and you take a patient to the OR for what you believe is a bowel obstruction or appendicitis — only to find metastatic cancer, necrotic bowel, or something equally catastrophic. The patient is unstable, anesthesia is struggling to maintain blood pressure, and you can’t simply apply a wound vac and leave the patient in the ICU. This is when your training must take over.

Since …

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The hidden cost of professionalism in medical training

Education
July 20, 2025

I sat in my pink childhood bed, my name still written in cursive above it from when I redesigned the room at seven years old, staring at the letter that shattered my dream. I had been dismissed from medical school for “professionalism” concerns. I didn’t know what came next. No roadmap. No support. Just the crushing reality that everything I had worked for was suddenly gone.

Medical education demands resilience and …

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The cost of ending shadowing in medical education

Education
July 20, 2025

A faculty-wide email recently announced that shadowing in our emergency department would no longer be recognized as a valid educational activity. I wrote back asking why. The reply was brief, dismissive, and telling:

“It doesn’t pay the rent.”

That line has stuck with me—not just because it was flippant, but because it revealed something deeper about how we now view education.

Shadowing has long served as the first bridge between curiosity and calling …

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Why hospital jobs are failing physicians: burnout, pay, and lost autonomy

Finance
July 20, 2025

Hospital employment was once billed as the solution to the headaches of private practice — a way to gain stability, reduce administrative burden, and focus on patient care. But for many physicians, that promise has come undone.

According to the Physicians Foundation’s 2024 report, 60 percent of physicians report frequent feelings of burnout — the highest level on record. Instead of feeling supported, many employed physicians feel …

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Why so many doctors secretly feel like imposters

Physician
July 19, 2025

One of the most important—and least discussed—truths in medicine is this:

Feeling inadequate in medicine isn’t rare. It’s everywhere—quiet, lingering, relentless.

I remember starting my outpatient practice right out of residency. I had joined a large multispecialty group filled with physicians trained at top-tier institutions. Many had been practicing for decades. They were confident. Efficient. Experienced. I was still waiting on my board scores—unsure if I was even certified yet. And yet—there …

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Why telling kids to eat less and move more fails to address obesity

Conditions
July 19, 2025

Despite decades of public health messaging urging children to “eat less and move more,” rates of pediatric obesity continue to rise globally. In the U.S. alone, nearly 1 in 5 children and adolescents aged 2–19 years have obesity, with higher rates among those from low-income or minority backgrounds. While caloric balance is a basic principle of weight regulation, the oversimplification of obesity into a matter of willpower neglects the …

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Why enterprise risk management is key to value-based health care success

Physician
July 19, 2025

The evolving contemporary era of value-based health care (VBHC) demands new risk leadership. VBHC emphasizes quality, outcomes, safety, equity, and stakeholder satisfaction. With these goals come complex, cross-cutting risks, including workforce shortages, clinical complications, health care staff safety, cyberattacks, and supply chain disruptions. To address the modern risk situation, health care systems must allocate resources to resilient, enterprise-wide risk governance and innovations.

The enterprise risk management (ERM) framework is the centerpiece …

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Rethinking physician resilience for sustainable well-being

Physician
July 19, 2025

Personal resilience is one of the three core components of the Stanford model of physician professional fulfillment, used across institutions to inform provider well-being strategy. Yet, limited data suggest only a minority of physicians view personal resilience initiatives as beneficial to their well-being, and physicians have expressed resistance and frustration toward organization-based individual resilience promotion.

I have led and participated in workplace meditation courses, stress management talks, …

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How shared language saved a patient from isolation

Physician
July 19, 2025

I was midway through a busy afternoon clinic when my pager erupted—an inpatient consult request. The case sounded messy: Chronic pancreatitis that had suddenly spiraled downward. A fresh, sizable mass sat in the pancreatic head; tumor markers were positive. Two endoscopic biopsies had failed, and surgery felt too risky for this frail patient. Cancer seemed the only plausible answer.

Rheumatology—my service—was called in because her ANA was weakly positive (1:40). In …

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The shocking risk every smart student faces when applying to medical school

Physician
July 18, 2025

The threats we face throughout our medical practice years are rarely published in the world medical practice literature for a good reason. The medical practice system has so many disruptive, threatening, and hidden educational factors to confess to that it is a miracle we have any American physicians still practicing today. That needs to be changed.

Most physicians in private medical practice, who suffer the most economically, are now reaching their …

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Clinical ghosts and why they haunt our exam rooms

Conditions
July 18, 2025

As a quadruple board-certified physician and a patient with a complex autoimmune disease, I live on both sides of the examination table. My professional life is about finding answers; my personal life has been about the agony of waiting for them.

This dual perspective makes it impossible to ignore a systemic problem in modern medicine: A class of diagnoses that live in the shadows. Seronegative Sjögren’s, mast cell activation syndrome (MCAS), …

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High blood pressure’s hidden impact on kidney health in older adults

Conditions
July 18, 2025

Most people think of high blood pressure as a silent threat to the heart. But it’s time we start talking about another organ it quietly destroys: the kidneys.

As a public health researcher and clinician, I have seen how chronic kidney disease (CKD) creeps in unnoticed—especially among older adults—and how hypertension is often the unspoken culprit. Despite being preventable and treatable in its early stages, CKD remains a major cause of …

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Deep transcranial magnetic stimulation for depression [PODCAST]

Podcast
July 17, 2025
YouTube video

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

Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article, “How deep transcranial magnetic stimulation is transforming mental health care.” He shares his experience with deep TMS (dTMS), …

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How declining MMR vaccination rates put future generations at risk

Conditions
July 17, 2025

We thought we had moved on from diseases like rubella. But as measles makes a comeback, rubella may not be far behind, and this time, it could harm the next generation before it’s even born. Most people today have never seen a baby born with congenital rubella syndrome, a condition that causes blindness, deafness, heart defects, and developmental delays. That’s not because it stopped happening—it’s because vaccination kept rubella from …

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The physician who turned burnout into a mission for change

Physician
July 17, 2025

When I stepped away from my clinical practice, it wasn’t because I didn’t care. It was because I cared deeply—about my patients, my colleagues, and the future of medicine. I didn’t leave to escape. I left to help heal the culture that was quietly breaking so many of us.

You can love medicine and stop seeing patients. You can love medicine and change the way you see patients. Choosing to follow …

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Time theft: the unseen harm of abusive oversight

Physician
July 17, 2025

Theft, in its essence, is the unlawful taking of something valuable from another. While usually associated with material possessions, it also extends to intangible assets such as time, reputation, and emotional well-being. When authorities like medical boards or the Department of Justice (DOJ) engage in unfair practices grounded in presumptive guilt, they are not just misusing their roles but actively stripping individuals of these invaluable resources—an abuse of power that …

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How one unforgettable ER patient taught a nurse about resilience

Conditions
July 17, 2025

Every ED has patients who become part of the landscape. They come in once or twice a week, for all kinds of reasons. Sometimes they have chronic medical conditions they are unable to manage. Sometimes they are on the outskirts of society due to mental health or substance abuse disorders. The ER promises a few hours of sleep in a safe place and a meal. I formed an uneasy alliance …

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