When the weight won’t budge: the hidden physiology of grief, stress, and set point

Conditions
July 16, 2025

We often speak of weight as a matter of simple math—calories in, calories out. But the body doesn’t work like an equation when it’s grieving or under chronic stress. It behaves more like a survivor, clinging tightly to resources in the face of perceived danger. And in that physiological equation, cortisol—our primary stress hormone—plays a central role.

The cortisol connection

Cortisol is released by the adrenal glands in response to stress through …

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Why starting with why can transform your medical practice

Physician
July 16, 2025

Have you ever asked yourself, “Why do your patients select you and your practice for their medical care?” Most medical practices offer the same service, i.e., evaluation and treatment, at approximately the same cost, and produce similar outcomes. After all, how many ways are there to treat a urinary tract infection, diabetes, hypertension, or arthritis? Most doctors are trained to offer similar services, which typically produce identical outcomes. So, why …

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Why your most heroic act might be in a department meeting [PODCAST]

Podcast
July 15, 2025
YouTube video

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Cardiologist Lauren Weber and critical care physician Jess Bunin, co-founders of All Levels Leadership, discuss their article, “Not all heroes wear capes: Sometimes they just speak up in meetings.” They reframe medical …

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Life’s detours may be blessings in disguise

Physician
July 15, 2025

This past weekend, my wife and I made our way to Winnipeg, a sleepy town nestled in the Canadian province of Manitoba. The occasion? A family celebration. My niece and her husband had just welcomed a beautiful baby girl, and they insisted, almost reverently, that my wife become the godmother. It was a request we could not, and frankly, did not want to, refuse.

Winnipeg, or “Winterpeg” as some Canadians jokingly …

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Inside the heart of internal medicine: Why we stay

Physician
July 15, 2025

I’ve practiced outpatient internal medicine for over a decade, joining my current group straight out of residency. Since then, I’ve watched the landscape shift—corporate takeovers, tightening regulations, staffing shortages, and endless debates over salary, documentation, and work-life balance.

And yet—I still believe in this work.

Reimbursements have been cut. Morale has taken hits. But that’s not just an internal medicine problem—it’s a health care problem. Across every specialty, we’re navigating a system …

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The quiet grief behind hospital walls

Physician
July 15, 2025

The slow beeping of the monitor comes to a halt and someone eventually shuts it off.

Click clack.

The machines are quiet now. I take one more look at the innocent, boyish young face and wonder what kind of life he had led. I leave the room, along with the rest of the team. A hand draws the curtain closed.

Death.

Quite literally, the most final force on Earth. The permanent, irreversible cessation of …

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Why peer support can save lives in high-pressure medical careers

Conditions
July 15, 2025

Locums can be a very challenging space, at least for anesthesiologists. Environments are frequently disrupted. There is often animosity between clinicians coping long-term with turmoil and inadequate staffing, and the temporary locums who fill a gap and are often paid substantially more for their intrusion. In anesthesia, the quality of the relationship between clinician and the total environment is essential. This includes nuances of the culture, scheduling structure and expectations, …

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Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

Policy
July 15, 2025

Imagine going to a restaurant where, instead of being charged separately for your appetizer, main course, and dessert, you pay a fixed price for the entire meal. That’s the idea behind a bundled payment plan in health care. Instead of billing patients and insurers for every individual test, treatment, or doctor’s visit during a medical episode—like a knee replacement—providers receive a single, comprehensive payment for all services related to a …

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How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]

Podcast
July 14, 2025
YouTube video

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

Pediatrician Daniel Johnson discusses his article, “From isolation to innovation: the power of learning communities in health care.” He reflects on the collaborative, case-based learning that makes medical training exciting and contrasts …

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Why clinical research is a powerful path for unmatched IMGs

Education
July 14, 2025

For thousands of International Medical Graduates (IMGs) every year, the third week of March is defined by a single, gut-wrenching question: Did I match? The entire future seems to hinge on a single email. We spend years navigating exams, clinical rotations, and visa applications, all for a shot at a residency spot in the United States. But what happens when that email doesn’t bring good news? For many, it feels …

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Addressing menstrual health inequities in adolescents

Conditions
July 14, 2025

Menstrual health is one of the most neglected aspects of adolescent care—especially for teens living in poverty. For these adolescents, getting a period doesn’t just mean discomfort—it means missing school, hiding pain, and facing daily choices between basic needs and menstrual products.

In both low- and high-income countries, period poverty is a quiet crisis. In the U.S., nearly one in five teens has missed school because they couldn’t afford menstrual products. …

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How to advance workforce development through research mentorship and evidence-based management

Physician
July 14, 2025

In the current era of rapid health care changes, a very effective tool for workforce development is research mentorship based on evidence-based principles. As the health care industry faces a worsening shortage of professionals, the need to cultivate talent, empower early-career clinicians, and guide them through structured research and professional development is becoming more urgent. Research mentorship offers a replicable and transformative framework for addressing the health workforce crisis.

Research mentorship …

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The truth about perfection and identity in health care

Physician
July 14, 2025

As we move through life, questions of identity echo through our minds—bouncing like a pinball, scattered and relentless.

Am I a doctor? A friend? A colleague? A leader? A husband? A parent? A son? These questions don’t just arise—they linger. Because every day, we’re asked to balance who we truly are with who we’re expected to be. We carry the weight of responsibility, chasing clarity, meaning, and success. We show up …

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Civil discourse as a leadership competency: the case for curiosity in medicine

Physician
July 14, 2025

In the high-stakes, knowledge-driven world of medicine, we’re taught from day one to project an aura of certainty. From the anatomy lab to the hospital wards, the message is clear: know the answers, lead with confidence, and never let them see you sweat. But what if that fixation on “knowing” is holding us back? What if the very traits we’ve been trained to cultivate—the resolute certainty, the surgical precision, the …

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Healing beyond the surface: Why proper chronic wound care matters

Conditions
July 13, 2025

An excerpt from Heal Your Wound: A Doctor’s Guide For Hard-To-Heal Wounds.

Chronic wounds are more than just a medical issue, they can be a daily challenge that can impact every part of a person’s life. From physical discomfort to emotional stress, these wounds often linger for weeks or months, especially when tied to conditions like diabetes, poor circulation, or limited mobility.

But here is the good news: With the right …

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Why specialist pain clinics and addiction treatment services require strong primary care

Conditions
July 13, 2025

Specialist pain clinics and addiction management services are vital in addressing some of the most complex and costly health care conditions. However, their success depends on stable and robust primary care systems. Without strong primary care as a foundation, these health care initiatives risk fragmentation, poor continuity, and low patient accountability. Stable primary care ensures timely access, coordinated care, longitudinal monitoring, and patient engagement, all essential elements for the value-based …

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Dear July intern: It’s normal to feel clueless—here’s what matters

Education
July 13, 2025

It’s July—the official new year for medicine.

You’re either a brand-new intern, wide-eyed and exhausted, equal parts proud and terrified, or maybe you’re stepping into fellowship, wondering how you’re suddenly supposed to be the expert. You’re navigating hallways you haven’t mapped yet, still figuring out whether your badge works on the north wing or the south elevator, trying to remember where you parked, and already questioning if you made a huge …

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Who gets to be well in America: Immigrant health is on the line

Policy
July 13, 2025

As lawmakers debate cuts to Medicaid and restrictions on care for undocumented immigrants, the question isn’t just what America covers—it’s who.

Proposals like the No Medicaid for Illegal Immigrants Act of 2025, and related attempts to embed its provisions in the One Big Beautiful Bill Act, aim to block federal funding for Medicaid services to undocumented families. Some state plans go further, threatening to remove children from CHIP if …

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When a medical office sublease turns into a legal nightmare

Physician
July 13, 2025

An excerpt from The Doctor is Out—Justice vs Injustice in America.

In the hug of a crisp autumn morning, with the world adorned in the warm hues of changing leaves, the seed of an idea took root within me—an idea born from the necessity of expanding my medical practice to accommodate the growing needs of my patients.

Crossing the convoluted corridors of administrative tasks and logistical considerations, I found myself confronted …

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Why the heart of medicine is more than science

Physician
July 12, 2025

Take a moment—not just to see where you are, but to remember how far you’ve come.

Through obstacles that once felt impossible.

Through stress that nearly broke you.

Through moments when the weight of it all made you question everything.

But still—you kept going.

Because medicine isn’t just a job. It’s a calling.

And here, decisions aren’t just professional—they’re life and death.

You meet people at their most vulnerable, in their most intimate realities.

There’s no room for …

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