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Are mild hypertension guidelines driven by pharma ties?

Conditions

January 5, 2026

In the early 2000s, I included “drugs for mild hypertension” in my book, Money-Driven Medicine: Tests and Treatments That Don’t Work. By 2007, I proposed a Cochrane systematic review of randomized controlled trials (RCTs) to settle the debate. Cochrane is widely considered the “gold standard” of evidence-based medicine; its reviews can shift global clinical practice and multibillion-dollar drug markets.

In 2012, Cochrane published the systematic review of Pharmacotherapy for …

The physician emotional toll of delivering bad news

Alexis Lipton, MD

Conditions

January 5, 2026

You can usually taste the excitement in the air during a first visit for pregnancy. It’s palpable. And the evidence for it is everywhere: the nervous fidgeting of hands. Do you place them on your lap or not-so-casually at your side? Paper drape sheet typically is balled up into tiny handfuls for better “grip” on this one-ply provider of modesty. And the quick glances back and forth between soon-to-be parents …

Why midlife men feel lost and exhausted [PODCAST]

The Podcast by KevinMD

Podcast

January 4, 2026

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

Emergency physician Kenneth Ro discusses his article “Why midlife men feel unanchored and exhausted.” Kenneth explains why men between 40 and 60 often visit clinics requesting hormone testing when they are actually …

The Dr. Google debate: Building a doctor-patient partnership

Santina Wheat, MD, MPH

Physician

January 4, 2026

If you’ve been practicing medicine for any length of time, you’ve likely felt that familiar moment of overwhelm when a patient walks in with a stack of printouts, a list of 30 questions, or a frustrated statement like, “Well, I did my research.” And if we’re honest, many of us feel our chest tighten just a little. We feel the time pressure. We feel the responsibility. And sometimes, we feel …

Why home-based care fails without integrated medication and nutrition

Gerald Kuo

Conditions

January 4, 2026

Consider Mrs. Chen, an 82-year-old woman discharged home after a minor ischemic stroke. On paper, her care plan was flawless.

Her physician intensified her antihypertensive regimen to protect vascular health (medication). Her well-meaning daughter, concerned about blood pressure, switched her to a strict low-sodium porridge diet, unknowingly slashing her protein intake (nutrition). Her physical therapist prescribed a daily walking program to rebuild confidence and strength (exercise).

Two weeks later, Mrs. Chen was …

Psychedelic-assisted therapy: science, safety, and regulation

Muhamad Aly Rifai, MD

Meds

January 4, 2026

We are hearing stories about mushrooms and MDMA and see clinics advertise ketamine. We hear of friends chasing a spiritual reset. Many in America feel the weight of depression, trauma, and addiction inside families. Psychedelics sit at the center of this pressure, with hope on one side and hype on the other.

KevinMD already published multiple essays on psychedelic medicine since 2022, including pieces on what physicians need to know, prudence …

Physician coaching: a path to sustainable medicine

Ben Reinking, MD

Physician

January 4, 2026

Perhaps you are standing in the same place I once stood: From the outside, everything looks great, but on the inside, you’re running on fumes.

In my mid-40s, I was on the verge of becoming a full professor. Our dream house was under construction. My retirement plan was on track so I could stop working before 60. Our kids were grown and thriving, launching their own lives. On paper, life was …

Methodological errors in Cochrane reviews of anticoagulation therapy

David K. Cundiff, MD

Conditions

January 4, 2026

My previous KevinMD article discussed a Cochrane Collaboration review that was completed in 2002 but was not published until 2006. This review examined three randomized controlled trials (RCTs) comparing anticoagulants with placebos or anti-inflammatory drugs for venous thromboembolism (VTE).

Along with my two co-authors, I found that across these three trials, anticoagulant-treated patients had six deaths out of 66 patients, compared to only one death out of 60 in the placebo …

Why we deny trauma and blame survivors

Peggy A. Rothbaum, PhD

Conditions

January 4, 2026

“The ordinary response to atrocities is to banish them from consciousness. Certain violations of the social compact are too terrible to utter out loud: this is the meaning of the word unspeakable. Trauma survivors want to forget, observers want to forget, and society as a whole wants to forget. It is too painful to do otherwise. We push trauma away and it rears up in other ways: Atrocities, however, …

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Why we deny trauma and blame survivors

Eldest daughter syndrome explains the hidden cause of physician burnout [PODCAST]

The Podcast by KevinMD

Podcast

January 3, 2026

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

Board-certified pediatrician and certified coach Jessie Mahoney discusses her article “The burden of the eldest daughter.” Jessie explores the unique psychological weight carried by firstborn women who are taught early on to …

Physicians’ end-of-life choices: a surprising study

M. Bennet Broner, PhD

Conditions

January 3, 2026

In July, I wrote about the importance of end-of-life planning (EOL). Shortly after, I read a study that examined physicians’ EOL plans with advanced cancer and Alzheimer’s disease (stage unspecified). The study encompassed nations with different forms of aid in dying, from the U.S., where a terminal coma is the only option most states allow, to Belgium, where physician-assisted dying (PAD) and euthanasia are available. Although the term suicide …

Physician investment in patients: ethical risks and rewards

Francisco M. Torres, MD

Physician

January 3, 2026

At its best, the doctor-patient relationship is an intimate one. Often, our patients appear before us in the most vulnerable moments of their lives. We treat their diseases, but we also tend to their emotional and spiritual well-being. That kind of intimacy can be meaningful and rewarding, but it can also breed awkward and even potentially compromising interactions. That is particularly true when money gets involved.

Despite widespread dissatisfaction with the …

How physician coaching helps restore energy reserves

Diane W. Shannon, MD, MPH

Physician

January 3, 2026

I’ve recently been intrigued by this question: Are you giving from extra or essence?

In many respects, giving from one’s essence is what burnout is all about. Your energy reserves (emotional, physical, mental, cognitive) are heading rapidly toward empty. Because of a mismatch between the energy drain from internal and external stressors and the ability to replenish your energy, you are left depleted.

I see this mismatch daily in the physicians whom …

Agentic AI in medicine: Moving beyond ChatGPT

Harvey Castro, MD, MBA

Tech

January 3, 2026

At this point, numerous individuals have become engaged with ChatGPT. We’ve asked it to summarize a complex patient history and draft a discharge summary or explanation of a rare clinical concept. At first, it feels like magic. However, after several weeks, that same old feeling of frustration returns. Why does this still feel like more work?

The problem is not that technology is lacking. The problem is that ChatGPT was never …

In-flight medical emergencies: Are planes prepared?

Dharam Persaud-Sharma, MD, PhD

Conditions

January 3, 2026

The cabin was quiet in that familiar, suspended way airplanes always are with a steady engine hum, passengers absorbed in movies, sleep, and anticipation with the intermittent crying child. It was an ordinary flight. Until it wasn’t. The overhead speaker crackled without warning. “If there is a doctor on board, please identify yourself.”

The voice was calm. The effect was not. Just a row behind me, a child no more than …

Why physician wellness programs must evolve beyond institutions

Jessie Mahoney, MD

Physician

January 3, 2026

Wellness programming must evolve beyond institutions if we are serious about supporting physicians, especially women physicians.

For wellness to be taken seriously, it had to begin within institutions. Those efforts offered visibility and legitimacy. But institutional wellness is not the whole answer.

For 17 years, I led wellness initiatives inside a large medical organization. I saw the value of bringing attention to physician well-being. I also saw the limitations. Six years ago, …

Why mindfulness fails to cure existential anxiety

Farid Sabet-Sharghi, MD

Conditions

January 3, 2026

For the past several decades, Western spiritual culture has been profoundly shaped by the rebranding of Buddhist contemplative practices (mindfulness, presence, and the exaltation of “the now”). As a psychiatrist, I have witnessed the arrival of this movement inside the consultation room. Patients arrive quoting teachers, apps, and books urging them to stay present, to watch their breath, to release attachment to the future or past. Many have tried, often …

Public health and primary care integration

Tyler B. Evans, MD, MPH

Physician

January 3, 2026

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

We talk about health as if it were an individual act of will, a matter of personal choice or risk tolerance. But anyone who has walked alongside people living in poverty, in refugee settlements, in overcrowded housing, or on the street knows that illness does …

Corporate greed and medical complicity fueled a $250,000 drug [PODCAST]

The Podcast by KevinMD

Podcast

January 2, 2026

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

Internal medicine and pulmonary physician Bharat Desai discusses his article “How Acthar Gel became a $250,000 drug.” Bharat shares the shocking moment he realized an obsolete pituitary extract from 1952 was being …

The physical exam in the AI era

Jason Ryan, MD

Physician

January 2, 2026

For decades, many have documented the decline of the physical exam. As imaging grew more powerful, labs more precise, and algorithms more accurate, the stethoscope and reflex hammer faded in importance. Some even speculated that technology would eventually make hands-on diagnostic skills obsolete.

But the next era of medicine may flip that prediction on its head.

Picture a future where artificial intelligence participates in nearly all patient management decisions. This seems inevitable …

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The physical exam in the AI era