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Is tramadol really ineffective and risky?

Meds

December 29, 2025

For nearly half a century, tramadol has been used as a pain reliever. It is not perfect, no analgesic is, but it has helped millions upon millions of patients with chronic pain. That is why recent headlines declaring tramadol “less effective” and “more risky” caught my attention. These stories were based on a single meta-analysis, which concluded that this medication offers “limited analgesic benefits” and that its harms, …

Why patient trust in physicians is declining

Mansi Kotwal, MD, MPH

Physician

December 29, 2025

My last patient of the day had been to four other doctors before coming to see me. She was coming in for abdominal pain that had been going on for about two years and had seen multiple specialists that resulted in multiple tests, in hopes to get an explanation for her symptoms. She came in wanting answers, but also skeptical of me. Skeptical of my ability to help her, skeptical …

Mindfulness in the journey: Finding rewards in the middle

Diane W. Shannon, MD, MPH

Physician

December 29, 2025

I recently returned from a truly magical trip to Iceland. While there, my husband and I hiked, ate wonderful food, and soaked in a different culture.

On day five of six, we ventured out to find what was described as a “hot springs river,” a body of water fed equally by glacier melt and geothermal hot springs. As a floating enthusiast, this was a must-see for me.

We hiked for an hour, …

Treating your bone density like a retirement account [PODCAST]

The Podcast by KevinMD

Podcast

December 28, 2025

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Orthopedic surgeon Yoshihiro Katsuura, medical student Mark Polemidiotis, and premedical student Cyrus Nasr discuss their article, “Why young people need to care about bone health now.” Yoshihiro, Mark, and Cyrus explain that …

Why insurance must cover home blood pressure monitors

Soneesh Kothagundla

Conditions

December 28, 2025

Three weeks after giving birth, you are hit with a blinding headache and fading vision. The next available appointment with your doctor is two weeks away. You finally go to your doctor, and your blood pressure has already reached a dangerous level without you even realizing.

The solution is straightforward. A home blood pressure monitor costs between $69 and $169. Yet most insurers will not cover it because many states do …

Moral dilemmas in medicine: Why some problems have no solutions

Patrick Hudson, MD

Physician

December 28, 2025

Every now and then I go back to a book I read decades ago. Sometimes it feels dated, a period piece. Sometimes it sounds uncannily current, as if it has been waiting. And sometimes it does both at once, which is more unsettling.

Recently I reread Moral Dilemmas in Medicine, first published in 1975. I read it as a younger physician, still believing that if you learned enough and tried …

Physician non-compete clauses: a barrier to patient access

Sharisse Stephenson, MD, MBA

Physician

December 28, 2025

Patients rarely see the contracts behind their care, but physicians feel them every day. And one contract clause in particular (the non-compete) is quietly worsening the physician shortage and blocking patients from seeing the very doctors who want to care for them.

I learned this firsthand.

After serving as a neurologist and EEG medical director in Portsmouth, Virginia, I was forced out of my role under a two-year non-compete. The restriction forbids …

The risks of the single-provider dental sedation model

Rita Agarwal, MD & Sangeeta Kumaraswami, MD

Conditions

December 28, 2025

Anesthesia and sedation in dental patients has come under scrutiny in recent years, fueled in part by high-profile tragedies, such as the deaths of six-year-old Caleb in 2015, cardiologist Dr. Henry Patel in 2020, and the five media-reported deaths in 2025. These incidents serve as a stark reminder that the current landscape of dental sedation practices is fraught with inconsistencies and a lack of oversight, which can have devastating consequences …

Restoring clinical judgment through medical education reform

Anonymous

Physician

December 28, 2025

A modest proposal for the reform of American medicine might begin, improbably enough, in a suburban pediatrician’s office where, last week, a physician of evident earnestness instructed my adolescent son to sleep until noon whenever possible, on the theory that tardy rising is the royal road to superior intelligence. The authority cited was a single paper (published, with all due respect, in the journal Personality and Individual Differences) bearing the …

How doctors can reclaim control in a corporate system [PODCAST]

The Podcast by KevinMD

Podcast

December 27, 2025

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Palliative care physician and certified physician development coach Christie Mulholland discusses her article, “Reclaiming physician agency in a broken system.” She shares her personal story of leaving a prestigious academic position after …

Why I left pediatric cardiology: a story of moral injury

Susan MacLellan-Tobert, MD

Physician

December 27, 2025

I retired from my pediatric cardiology practice almost two years ago, and I keep circling back to one of the final days of my career. For a long time, I told myself I had simply burned out, worn thin by the pace and the paperwork. Only with time and reflection have I realized I didn’t step away because I was tired, I stepped away because of deep moral injury.

I remember …

Home for Christmas: a physician’s tale of prior authorization

Edward Anselm, MD

Physician

December 27, 2025

It was Christmas Eve 2005, and the health plan was closing at 3 p.m. By 4 p.m., the nurses, doctors, pharmacists, and support staff who handled utilization management for HIP Health Plan were already on their way home. My usual role at the health insurance company involved creating quality profiles for physicians caring for our roughly 1 million members. But that afternoon, I was covering hospital admissions so colleagues could …

Why current medical malpractice tort reforms fail

Howard Smith, MD

Physician

December 27, 2025

It is beyond a doubt that, in many states, including the state of Maryland in which I am licensed, tort reforms for medical malpractice occupy a good part of the legislative agenda. In Maryland, tort reforms bring:

Caps: The cap on noneconomic damages is first set at $650,000, and increases by $15,000 each year. Medical malpractice has a separate cap structure; however, the cap is $905,000. There must be an …
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Why current medical malpractice tort reforms fail

Why U.S. health care outcomes lag behind other nations

Ariane Marie-Mitchell, MD, PhD, MPH

Physician

December 27, 2025

The news headlines and the online chatter are full of chest-thumping claims from both political parties about saving democracy, scandalous finger-pointing at the other guys, battles over sound bites, and circus antics to grab the attention of the media. It is easy to get distracted by all the political drama and lose sight of important facts.

When it comes to health outcomes, the U.S. is leading the world in the amount …

How political polarization causes real psychological trauma [PODCAST]

The Podcast by KevinMD

Podcast

December 26, 2025

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Psychiatrist Farid Sabet-Sharghi discusses his article, “The psychological trauma of polarization.” Farid explains how the human psyche is evolutionarily wired for connection, making the current climate of hostility and division deeply traumatic. …

The quiet bravery of breast cancer screening

Michele Luckenbaugh

Conditions

December 26, 2025

There is a stillness in the waiting room,
not exactly silence,
but a quiet that settles over chairs,
minds diverted elsewhere.

Here, women sit in chairs
with their thoughts
floating in opposing directions,
pretending to read magazines,
while their minds
wander hallways
they would rather not travel.

My name is called softly,
and my heart skips a beat,
the time has come.

I follow the routine,
changing from street clothes
into bare arms and a borrowed gown
that never seems to fit properly.

I take a deep breath,
trying …

How automation threatens medical ethics principles

Muhammad Mohsin Fareed, MD

Conditions

December 26, 2025

With an overwhelming role of automation in modern health care industry, the concept of medical ethics seems to be fading away in the waves of murky economic profiting from value-based bundles meant for pure revenue generation. The commercialized approach towards practice of medicine requires readdressing the core ethical framework which lies at the hearth of patient-doctor relationship. Being innate and inextricable part of clinical medicine, ethical responsibility is meant for …

When to test for pediatric seasonal allergies

Dr. Tanya Tandon

Conditions

December 26, 2025

With the onset of fall and winter season, my clinic in the Bronx braces for a flood of worried parents. A toddler coming in with itchy, watery eyes and a runny nose becomes a far too common sight. Parents share of their battles against poorly ventilated apartments, mould and cockroach infestations, housing insecurities; adding to this, the threat of RSV, flu, and COVID-19 exposures in day care and school causes …

A doctor’s humbling journey through prostate cancer recovery [PODCAST]

The Podcast by KevinMD

Podcast

December 25, 2025

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

Interventional physiatrist Francisco M. Torres discusses his article, “A doctor’s own prostate cancer recovery.” He shares his vulnerable story of undergoing a robot-assisted radical prostatectomy and the unexpected shame and “erosion of …

The loss of storytelling with ambient AI systems

Alexandria Phan, MD

Tech

December 25, 2025

Laura, my department chair, is relentless in her enthusiasm for ambient AI systems in clinical care. Daily emails, weekly reminders, and even personal demonstrations; she’s convinced this is the future of medicine. Watching her, I can’t help but feel both admiration and unease. Her excitement is genuine, but I wonder if we’re rushing toward something we don’t fully understand.

And in many ways, she’s right. There’s a quiet joy in having …