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The moral injury of “not medically necessary” denials

Physician

January 16, 2026

The first denial arrived not with cruelty or malice, but with a phrase so familiar it barely registers as language anymore: “not medically necessary.” The cancer drug, recommended by oncologists and supported by evidence and standard of care, was rejected. No phone call. No physician-to-physician conversation. Just an automated letter and a bureaucratic pause inserted into a life that no longer had room for delay.

The family appealed. They fought. They …

What is palliative medicine and why is it so misunderstood?

Patricia M. Fogelman, DNP

Conditions

January 16, 2026

After years of leading palliative medicine departments, as a Fellow of the American Academy of Hospice and Palliative Medicine, I’ve had countless conversations that start the same way. A colleague in the hallway says, “Oh, palliative care—that’s so important. You all are so nice.” Or a hospital administrator tells me, “We wish we could give you more, but resources are tight right now.” Or my personal favorite: “Palliative care is …

Capping student loans destroys the rural medical pipeline [PODCAST]

The Podcast by KevinMD

Podcast

January 15, 2026

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

Kenneth Botelho, founding director of the doctor of medical science (DMSc) program at The College of St. Scholastica and a physician assistant, discusses his article “Federal graduate-loan caps threaten rural health care …

Is physician unionization the answer to a broken health care system?

Allan Dobzyniak, MD

Physician

January 15, 2026

Can there actually be a medical profession with physicians as only employees in an industrialized corporate or socialized system with a union representing their collective interests? Does it matter, and should it matter? Are there still alternatives?

Asking another party, specifically the government, to solve major predicaments consuming the profession is not a plan. Worse, it is a clear sign of dependency and weakness. There is no other entity that can …

Will AI replace primary care physicians?

P. Dileep Kumar, MD, MBA

Tech

January 15, 2026

Primary care providers and primary care medicine are on the downswing in the U.S., burdened with increasing demands of documentation and numerous complicated quality programs in the face of rapidly diminishing reimbursements. While the tribe is disappearing fast, enter its newest nemesis: artificial intelligence (AI).

You might wonder why AI is detrimental to primary care and primary care physicians. The common notion is that physicians, including primary care physicians, will be …

The decline of professionalism in medicine: a structural diagnosis

Patrick Hudson, MD

Physician

January 15, 2026

Most physicians sense it, even if they struggle to name it.

Something fundamental has changed in medicine. Not the science. Not the patients. Not even, at root, the doctors themselves. What has changed is the status of medicine as a profession, and with it, the psychological footing that once made the work bearable.

For much of the last century, medicine functioned as a profession in the classical sense. That meant more than …

The patchwork era of medical board certification

Brian Hudes, MD

Physician

January 15, 2026

The phrase “board-certified” once carried a universal meaning. A physician had met rigorous training and testing standards and could practice confidently anywhere in the country. That clarity has faded. Today, certification and recertification requirements differ not only by specialty but also by which board you happen to fall under. What was once a single national standard has splintered into a patchwork of rules, fees, and timelines that seem designed less …

Physician suicide represents a silent epidemic demanding urgent reform [PODCAST]

The Podcast by KevinMD

Podcast

January 14, 2026

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Psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “Physician suicide prevention: a call to action.” Muhamad opens with the tragic losses of Dr. Nolan R. Williams and Dr. …

How neurodiversity in relationships shapes communication

Farid Sabet-Sharghi, MD

Physician

January 14, 2026

One of the marks of a good physician is the ability to approach illness from two complementary angles. We bring scientific knowledge, training, and objectivity to understand what is happening in the body. But the work doesn’t end there. What truly elevates a clinician is the willingness to honor how the patient experiences their illness, the internal narrative that no lab test can measure.

This dual lens is not unique to …

Physician suicide: a daughter-in-law’s story of loss and grief

Carrie Friedman, NP

Conditions

January 14, 2026

When my father-in-law died by suicide, our family did not just lose a person. We lost the gravitational center of a small universe.

He was a giant in my eyes. Not because of his curriculum vitae, though his was extraordinary, but because of the way he moved through the world: steady, modest, and relentlessly devoted to the people who needed him.

He had survived what should have broken a human being. As …

Why lifestyle matters more than BPC-157 and semaglutide

Shiv K. Goel, MD

Physician

January 14, 2026

“Doc, can you prescribe me some BPC-157 with sermorelin, and maybe semaglutide too?”

He didn’t come in asking about his sleep.

He didn’t mention that his last meal the night before was at 11:30 p.m., eaten in front of a laptop glowing with unanswered emails.

He didn’t bring up the statin he’d been taking for years, the creeping fatigue he’d started to normalize, or the way his waistline had slowly expanded as his …

How deductive reasoning changes medical malpractice lawsuits

Howard Smith, MD

Physician

January 14, 2026

Most recognize me from posts about deductive reasoning on KevinMD, but I never explain deductive reasoning’s effect on a conventional medical malpractice lawsuit. Here is how it affects such a lawsuit.

All medical malpractice lawsuits have four things in common:

All have an underlying complication, either an error-of-nature, which is caused by random chance, or a medical error, which is caused by the medical intervention.
All test the premise that there …
Read more…

How deductive reasoning changes medical malpractice lawsuits

Personal memories reveal the transformation of HIV care over four decades [PODCAST]

American College of Physicians & The Podcast by KevinMD

Podcast

January 13, 2026

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Professor and senior associate dean of engagement Janet A. Jokela discusses her article “Reflecting on the significance of World AIDS Day from the 1980s to now.” Janet shares harrowing memories from her …

How blaming women for a baby’s sex persisted through history

George F. Smith, MD

Physician

January 13, 2026

It doesn’t take much to understand that women have had it tough throughout history. While seemingly in our age there is near parity (with many women heads of state in Mexico, Italy, Moldova, Iceland, etc.), they only gained the right to vote in the U.S. 105 years ago (with the 19th Amendment to the Constitution), which was 50 years after Black men in 1870 (the 15th Amendment). There have always …

The “patient carryover crisis”: Why hospital readmissions persist

Rafiat Banwo, OTD

Conditions

January 13, 2026

In hospital boardrooms across America, the “30-day readmission rate” is treated as a financial vital sign. It determines reimbursement levels under the Hospital Readmissions Reduction Program (HRRP); it influences star ratings; and increasingly, under new Department of Justice scrutiny, it serves as a barometer for potential “substandard care” investigations.

Yet, despite decades of regulation and millions spent on discharge planning software, the needle on preventable readmissions barely moves.

The industry is failing …

How flight surgeon training mirrors medical residency stress

Avishek Kumar, MD

Conditions

January 13, 2026

The room went quiet the way rooms do before something consequential, when conversation thins and all you can hear is the pulse in your ears.

“Captain Kumar,” the instructor said, “you have an in-flight engine failure. What do you do?”

I stood at attention, spine locked, as my classmates turned toward me with the focused expectation of a clinical team evaluating a tenuous presentation. A bead of sweat slid down my temple. …

Economic reality tests the limits of subscription medicine [PODCAST]

The Podcast by KevinMD

Podcast

January 12, 2026

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

Health care strategist Dana Y. Lujan discusses her article “Is direct primary care sustainable in a downturn?” Dana explains how the rising cost of living and subscription fatigue are challenging the retail …

Why ACIP’s ruling on universal hepatitis B vaccination endangers newborns

A. Lane Baldwin, MD

Physician

January 12, 2026

On December 5, I started my hospital shift learning that the ACIP (Advisory Committee on Immunization Practices) had voted against offering universal administration of hepatitis B vaccine at birth, opposing the long-standing practice endorsed by experts. After a long day of examining newborn babies and counseling families, my mind drifted back to the announcement and unearthed a memory of a boy named Sam.

Sam was born a healthy newborn to loving …

AI in medicine: Why it won’t replace doctors but will redefine them

Tod Stillson, MD

Tech

January 12, 2026

I have spent my career practicing medicine in the real world: caring for patients, managing uncertainty, and making decisions where the stakes are personal and immediate. In recent years, I have also spent considerable time designing and deploying medical software that uses artificial intelligence in live clinical environments. Together, these experiences have reshaped how I think about the future of our profession.

That combination of experiences has led me to a …

Claude for Healthcare vs. administrative burden: a physician’s review

Shiv K. Goel, MD

Tech

January 12, 2026

Last week, I spent over two hours on a prior authorization for a patient who needed a medication she’d been stable on for years. Two hours of hold music, transferred calls, and faxed forms, while patients waited.

That same week, Anthropic announced Claude for Healthcare: An AI system that can verify coverage requirements, build claims appeals, and streamline prior authorizations in minutes. OpenAI launched ChatGPT Health days earlier. Both promise to …

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