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Conditions and diseases

Regulatory T cell reprogramming heads to trial in 2026

Most people have heard of cancer immunotherapy by now. These treatments help a patient's own immune system recognize and attack cancer. The best-known examples are immune checkpoint inhibitors such as pembrolizumab (Keytruda) and nivolumab (Opdivo). These drugs release certain "brakes"…

Most people have heard of cancer immunotherapy by now. These treatments help a patient’s own immune system recognize and attack cancer. The best-known examples are immune checkpoint inhibitors such as pembrolizumab (Keytruda) and nivolumab (Opdivo). These drugs release certain “brakes” that normally keep the immune system from becoming overactive. Another approach, called CAR-T therapy, is more involved. Doctors remove some of a patient’s T cells, a type of white blood …

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Regulatory T cell reprogramming heads to trial in 2026

Physician voices

Why I left insurance-based medicine and came back

I was in my car in the parking lot. It was a long day at the clinic. And I did not want to go back in the next morning. Us doctors aren't supposed to say that. When we feel it,…

I was in my car in the parking lot. It was a long day at the clinic. And I did not want to go back in the next morning.

Us doctors aren’t supposed to say that. When we feel it, we always repeat the same things to ourselves. “You’re tired.” “You’re burned out.” “You need sleep, or a vacation, or perspective, because do you have any idea what you have?” Those …

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Why I left insurance-based medicine and came back

The Podcast by KevinMD

What a dragonfly teaches physicians about burnout and self-compassion [PODCAST]

After 20 years as a pediatrician, she stopped believing burnout meant she couldn't hack it. The problem was never her. In this episode, pediatrician and physician career development coach Gita Balakumar reframes burnout as a systemic burden wrongly blamed on…

Listen on Apple Podcasts · Spotify

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After 20 years as a pediatrician, she stopped believing burnout meant she couldn’t hack it. The problem was never her. In this episode, pediatrician and physician career development coach Gita Balakumar reframes burnout as a systemic burden wrongly blamed on the individual, and offers a different way to think about it. …

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What a dragonfly teaches physicians about burnout and self-compassion [PODCAST]

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Health policy

The case against for-profit health care on Wall Street

The American health care system, as I see it, is undergoing a quiet, clinical decapitation. At the root of this crisis is a fundamental, irreconcilable conflict of interest: the presence of health care companies on the public stock market. While…

The American health care system, as I see it, is undergoing a quiet, clinical decapitation. At the root of this crisis is a fundamental, irreconcilable conflict of interest: the presence of health care companies on the public stock market. While we like to believe our medical institutions are guided by the Hippocratic Oath, the reality is that once a company goes public, the Oath is replaced by a fiduciary duty …

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The case against for-profit health care on Wall Street

Conditions and diseases

The ethical concerns with IVF we are not discussing

A recent article discussed the inequitable nature of infertility treatment, with which I agree. Yet, its remediation raised several ethical questions. First, why use IVF when there are 329,000 children in domestic foster care in 2024, many awaiting adoption? The…

A recent article discussed the inequitable nature of infertility treatment, with which I agree. Yet, its remediation raised several ethical questions. First, why use IVF when there are 329,000 children in domestic foster care in 2024, many awaiting adoption? The drive to reproduce may be biological, but the desire for an infant is societal, and there is no evidence that adopting an older child is less rewarding.

Foster children are in …

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The ethical concerns with IVF we are not discussing

Health policy

How health insurance middlemen delay patient care

A friend I am calling "M" to protect her privacy was diagnosed with breast cancer two months ago. When we met in 6th grade science class, she had a bustling eBay business selling Beanie Babies. Now she has three young…

A friend I am calling “M” to protect her privacy was diagnosed with breast cancer two months ago. When we met in 6th grade science class, she had a bustling eBay business selling Beanie Babies.

Now she has three young boys, including a two-year-old, and has been a public-school teacher for 19 years. She receives health insurance coverage through her job, and until two months ago she said she loved her …

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How health insurance middlemen delay patient care

Conditions and diseases

What patients don’t say in the dental chair

There is a question I have learned to ask that almost never appears in any clinical protocol. Not "Where does it hurt?" or "How long have you had this problem?" But something much quieter: "Is there anything else you'd like…

There is a question I have learned to ask that almost never appears in any clinical protocol. Not “Where does it hurt?” or “How long have you had this problem?” But something much quieter: “Is there anything else you’d like me to know?”

The answers to that question have taught me more about patient care than I expected. Over time, I’ve realized that patients rarely come into the clinic carrying only …

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What patients don’t say in the dental chair

Drugs and prescribing

Sliding scale insulin is a 1934 idea in a 2026 hospital

Somewhere in a hospital right now, a physician is ordering a sliding scale of short-acting insulin to be given before a meal, at a dose set by the premeal blood glucose. Not a correction dose for hyperglycemia on top of…

Somewhere in a hospital right now, a physician is ordering a sliding scale of short-acting insulin to be given before a meal, at a dose set by the premeal blood glucose. Not a correction dose for hyperglycemia on top of a meal dose. The meal dose. Blood glucose before a meal describes what has already happened. It says nothing about whether the tray holds 20 g of carbohydrate or 90. …

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Sliding scale insulin is a 1934 idea in a 2026 hospital

Physician voices

Why merit decides a medical malpractice case

If you are sued and satisfied with your defense, read no further. If not, you may find this article helpful. Merit is inconclusive in every medical malpractice lawsuit ever filed, and it starts with the certificate of merit. To be…

If you are sued and satisfied with your defense, read no further. If not, you may find this article helpful.

Merit is inconclusive in every medical malpractice lawsuit ever filed, and it starts with the certificate of merit. To be clear, a certificate of merit is not proof of negligence. Proof is determined at trial. Merit is a measure for the reliability of evidence used in the proof of negligence, and …

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Why merit decides a medical malpractice case

Health technology

How a doctor with no coding background built his own bedside AI tools [PODCAST]

At 2 a.m., a surgeon needed an answer fast and had no one to ask. So he built the tool himself, with no coding background. In this episode, consultant cardiac anesthesiologist Ahmed Elsonbaty explains how a single bleeding-patient case in…

Listen on Apple Podcasts · Spotify

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

At 2 a.m., a surgeon needed an answer fast and had no one to ask. So he built the tool himself, with no coding background. In this episode, consultant cardiac anesthesiologist Ahmed Elsonbaty explains how a single bleeding-patient case in the operating room pushed him to create bedside clinical decision-support tools …

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How a doctor with no coding background built his own bedside AI tools [PODCAST]

Physician voices

Patient dissatisfaction begins before the doctor walks in

When patients describe a disappointing health care experience, we often assume the problem occurred in the examination room. Sometimes it did. But after years of caring for patients in urgent and emergency settings and helping lead a high-volume orthopedic urgent…

When patients describe a disappointing health care experience, we often assume the problem occurred in the examination room. Sometimes it did. But after years of caring for patients in urgent and emergency settings and helping lead a high-volume orthopedic urgent care practice, I have learned that many negative patient experiences begin long before the physician walks through the door.

A patient may arrive in pain and not know how long the …

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Patient dissatisfaction begins before the doctor walks in

Physician voices

Hospital peer review needs recusal rules, not assumptions

Hospital peer review is one of medicine's most important mechanisms for protecting patients and maintaining professional standards. Physicians possess the clinical expertise necessary to evaluate the work of other physicians, particularly when questions involve complex procedures, specialty-specific judgment, or unusual…

Hospital peer review is one of medicine’s most important mechanisms for protecting patients and maintaining professional standards. Physicians possess the clinical expertise necessary to evaluate the work of other physicians, particularly when questions involve complex procedures, specialty-specific judgment, or unusual complications.

But this structure creates an unavoidable tension. The physicians most qualified to evaluate a colleague may also be the physicians who compete with that colleague for patients, referrals, operating-room access, …

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Hospital peer review needs recusal rules, not assumptions

Drugs and prescribing

How supplement fraud slips past a certificate of analysis

In our first article, we discussed the international regulatory clash between U.S. supplement mandates (21 CFR 111) and foreign food/supplement laws. This gap can lead to inadequate dietary ingredient identity verification. "We review a Certificate of Analysis (CoA) for 100…

In our first article, we discussed the international regulatory clash between U.S. supplement mandates (21 CFR 111) and foreign food/supplement laws. This gap can lead to inadequate dietary ingredient identity verification.

“We review a Certificate of Analysis (CoA) for 100 percent of our globally sourced ingredients.” This is a frequently offered defense by supplements’ brand owners when challenged on international supply chain vulnerabilities. To a physician, this defense sounds like an …

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How supplement fraud slips past a certificate of analysis

Conditions and diseases

Celiac disease in college: 3 skills to build first

Every year, families celebrate college acceptances while quietly worrying about something that has little to do with academics, roommates, or move-in day logistics. Their concern is food, and more specifically, whether their child is prepared to manage celiac disease independently…

Every year, families celebrate college acceptances while quietly worrying about something that has little to do with academics, roommates, or move-in day logistics. Their concern is food, and more specifically, whether their child is prepared to manage celiac disease independently in an environment that looks very different from the carefully structured routines they have relied upon for years.

For many families, gluten-free living becomes part of the household routine. Parents know …

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Celiac disease in college: 3 skills to build first

Physician voices

Medical satire: A wolf can pass as your doctor now

When I was just a Medium-Sized Bad Wolf loping through the forest, I stumbled upon a doctor in a white coat, carrying a bag of supplies. It was Sunday night, and dinner options were scarce, since most other humans were…

When I was just a Medium-Sized Bad Wolf loping through the forest, I stumbled upon a doctor in a white coat, carrying a bag of supplies. It was Sunday night, and dinner options were scarce, since most other humans were home with their families.

“Where are you going so late, Doctor?”

She sighed. “Another patient who refused the flu vaccine is sick with the flu, so I’m bringing them Tamiflu.”

I tricked her …

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Medical satire: A wolf can pass as your doctor now

Physician voices

Medicine disposed of physicians long before it feared AI

I am writing this from the slow, disciplined landscape of recovery (one repaired shoulder, one sling, and one unrepairable truth): Medicine did not suddenly become fragile when AI arrived. It did not suddenly become threatened when APRNs and NPs expanded…

I am writing this from the slow, disciplined landscape of recovery (one repaired shoulder, one sling, and one unrepairable truth): Medicine did not suddenly become fragile when AI arrived. It did not suddenly become threatened when APRNs and NPs expanded their scope. It did not suddenly become replaceable in the twenty-first century.

Medicine became fragile when institutions discovered they could dispose of physicians and still call it progress.

I know this because …

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Medicine disposed of physicians long before it feared AI

Physician voices

Cognitive assessment in primary care almost never happens

In my primary care practice, few moments carry as much quiet weight as when an older patient leans in and says, "Doctor, I'm worried about my memory." That moment is increasingly common, given that an estimated 42 percent of adults…

In my primary care practice, few moments carry as much quiet weight as when an older patient leans in and says, “Doctor, I’m worried about my memory.” That moment is increasingly common, given that an estimated 42 percent of adults who reach age 55 will develop dementia in their lifetime, so nearly every family will face a version of it. It takes courage to say those words out loud, …

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Cognitive assessment in primary care almost never happens

Conditions and diseases

Are naked nails in health care just a beauty trend?

"Rich women no longer paint their nails." Like many provocative declarations born on TikTok, the phrase is exaggerated. Yet it points to a real beauty shift. After years of elaborate nail art, extensions, chrome finishes, and long almond-shaped manicures, the…

“Rich women no longer paint their nails.” Like many provocative declarations born on TikTok, the phrase is exaggerated. Yet it points to a real beauty shift. After years of elaborate nail art, extensions, chrome finishes, and long almond-shaped manicures, the most desirable nails of the moment may be the ones that appear to have nothing on them at all.

The trend has been called “naked nails”: short, natural-looking nails with a …

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Are naked nails in health care just a beauty trend?

Conditions and diseases

Why physician burnout starts with cheap dopamine

The practice of medicine was once anchored to a physical place. Whether it was an office, a hospital, or an outpatient clinic, there was a threshold to cross, a door to close, and a boundary that separated the physician from…

The practice of medicine was once anchored to a physical place. Whether it was an office, a hospital, or an outpatient clinic, there was a threshold to cross, a door to close, and a boundary that separated the physician from the patient. Today, that fortress has vanished. We are now connected to our work on a constant basis. Between electronic messages, automated requests for prescription refills, and the endless stream …

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Why physician burnout starts with cheap dopamine

Drugs and prescribing

The Seroquel controversy most doctors have forgotten

Few drugs boast the rap sheet of Seroquel (quetiapine). After the pharmaceutical industry marketed atypical antipsychotics like Seroquel as amazingly superior to older antipsychotics like Thorazine and Haldol (pay no attention to their same tardive dyskinesia side effects), Seroquel became…

Few drugs boast the rap sheet of Seroquel (quetiapine). After the pharmaceutical industry marketed atypical antipsychotics like Seroquel as amazingly superior to older antipsychotics like Thorazine and Haldol (pay no attention to their same tardive dyskinesia side effects), Seroquel became its manufacturer’s second-best-selling drug globally, behind only Nexium and netting $5.3 billion in 2011. Many have forgotten Seroquel’s contested past, including how an early proponent went to prison in …

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The Seroquel controversy most doctors have forgotten

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