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Unregulated botanical products: the hidden risks of convenience store supplements

Meds

December 25, 2025

Walk into a convenience store. You will see sleek bottles, gummies, shots, and powders in bright wrappers. Companies market them as calm, focus, energy, sleep, pain relief. People treat them like upgraded vitamins. They swipe a card and head home. Nobody runs a checklist on dose, interactions, tolerance, withdrawal, or contamination.

This culture runs on a simple story. Natural means safe and plant means gentle. Legal means regulated while a label …

The 3 E’s: a physician-created framework for healing burnout

Tomi Mitchell, MD

Physician

December 25, 2025

Medicine teaches us to recognize disease, to listen for the subtle signs of pathology, to read lab values and imaging scans as if they are languages unto themselves. Yet what many of us were never taught is how to interpret the quiet, internal signals of our own humanity. We can identify cardiac murmurs with precision, but we often miss the whispers of our own exhaustion.

As physicians, we spend years mastering …

How end-of-life planning can be a gift

Dustin Grinnell

Conditions

December 25, 2025

This is a work of fiction.

I directed Mrs. Powell to sit and make herself comfortable. She lowered herself into the chair at the round table in the lobby of my office slowly, her frail, 90-year-old frame eventually settling into it.

“How’s your health, Mrs. Powell?” I asked. This is how I approached most conversations in which a client asked if they could meet suddenly. Usually, it meant they had gotten some …

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How end-of-life planning can be a gift

“The meds made me do it”: Unpacking the Nick Reiner tragedy

Arthur Lazarus, MD, MBA

Meds

December 25, 2025

“The meds made me do it” has become a familiar refrain whenever psychiatric treatment intersects with tragedy. It is a phrase heavy with implication, suggesting loss of control, a sense of medical betrayal, and a system that failed at its most basic task: keeping people safe. When cases like the Nick Reiner tragedy enter the public consciousness, that phrase resurfaces almost reflexively, offering a deceptively simple explanation for something incredibly …

Mind-body connection in chronic disease: Why traditional medicine falls short

Shiv K. Goel, MD

Physician

December 25, 2025

Linda had seen seven physicians in three years. She was on five medications. And she was exhausted, not just physically, but existentially.

“Dr. Goel,” Linda said quietly, “I’ve done everything they told me. The diets. The pills. The exercise programs. Why isn’t anything working?”

At 54, Linda was a meticulous accountant living with hypertension, type 2 diabetes, obesity, chronic fatigue, and generalized anxiety disorder. Her lab results painted a picture of metabolic …

The dangers of oral steroids for seasonal illness

Megan Milne, PharmD

Meds

December 25, 2025

“I’m here (cough) to pick up (cough) the steroid,” says the visibly sick patient at the pharmacy. The pharmacist tries not to breathe in too deeply to catch the contagion as she hands over the box of pills. The patient has no idea that others have nicknamed it “poison” or “the Devil’s drug,” because it’s not worth it. The risks of casually prescribing prednisone or Medrol Dosepaks for seasonal illnesses …

Saving limbs from the silent threat of peripheral artery disease [PODCAST]

The Podcast by KevinMD

Podcast

December 24, 2025

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Vascular surgeon Xzabia Caliste discusses her article, “The silent disease causing 400 amputations daily.” She shares the heartbreaking personal story of witnessing both her aunt and uncle lose their limbs to peripheral …

Why intercultural competence matters in health care

Evangelos Chavelas

Education

December 24, 2025

During one of my junior internships, I met a patient whose care challenged not so much my medical knowledge as my understanding of culture. Mr. L., a 20-year-old university student originally from China, presented to the clinic with complaints of low back pain. He firmly believed his back pain was caused by an “improper” posture. During our discussion aimed at clarifying this misconception, I encountered considerable resistance. After speaking with …

Physician exploitation: Why burnout is the wrong diagnosis

Tina F. Edwards, MD

Physician

December 24, 2025

“Doctors need to develop resilience against burnout!”

After 20 years in medicine, every time I hear this, my jaw tightens, and my TMJ reminds me I have a very limited tolerance for nonsense.

Let’s call this what it is: not burnout, exploitation.

You cannot “resilience” your way out of systemic extraction. You cannot mindfulness your way out of an industry built on squeezing more and more labor out of you for less and …

Physician shortage and private equity: the ruin of U.S. health care

John C. Hagan III, MD

Physician

December 24, 2025

U.S. health care, once a citadel of innovation and quality, has sadly devolved into a complex, frustrating, and frequently inaccessible system. It is so disorganized and inefficient it might not even meet the definition of a “system.” U.S. health care fails to address the needs and expectations of patients on many occasions and in many ways. For most of my career, I have considered U.S. health care the best in …

Catching type 1 diabetes before it becomes life-threatening [PODCAST]

The Podcast by KevinMD

Podcast

December 23, 2025

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

Pediatric endocrinologist Shara Bialo discusses her article, “Why type 1 diabetes screening should be part of back-to-school.” She highlights that back-to-school visits are a critical window to screen for type 1 diabetes …

The consequences of adopting AI in medicine

Jordan Liz, PhD

Tech

December 23, 2025

Across society, AI is being adopted at an staggering rate. In medicine in particular, AI is helping physicians analyze diagnostic tests, calculate disease risk, summarize patient history, and formulate treatment plans. Health care administrators are using AI to manage and optimize workflows. Insurance companies report that AI is improving consumer service, expediting claims, and detecting fraud. AI-assisted medical research is discovering new drugs to combat Parkinson’s, …

Pediatrician vs. grandmother: Choosing love over medical advice

Jessie Mahoney, MD

Physician

December 23, 2025

I am a pediatrician. I am a mother. And now, a grandmother. These identities don’t always move in harmony.

When I learned my twin granddaughters had been born at home, the physician in me reacted immediately. My mind began cataloging risks, reviewing worst-case scenarios, mentally scanning for everything that could have gone wrong.

The grandmother in me, however, was called to show up differently: with love, not fear. With presence, not panic. …

How I got Dr. Luis Torres Díaz on Wikipedia: a grandson’s journey

Francisco M. Torres, MD

Physician

December 23, 2025

I grew up hearing stories about my grandfather, Dr. Luis Torres Díaz, the way some children hear stories about national heroes. In our family, he was one of them. He was not a war hero or political figure but a quiet, thoughtful, and brilliant scientist. My grandfather was a chemist, a poet, a professor, a dean, a museum founder, a man whose life seemed to stretch across disciplines with an …

Direct primary care vs psychotherapy models: Why they aren’t interchangeable

Arthur Lazarus, MD, MBA

Physician

December 23, 2025

I read Zoe Crawford’s thoughtful KevinMD essay on the limitations of direct primary care (DPC) with great interest. Her frustration as a medically complex patient navigating a fragmented health care system will resonate with anyone who has struggled to obtain timely imaging, referrals, or specialty care. As a clinician who has spent a career thinking and writing about how health systems fail both patients and physicians, I agree with …

The hidden depth of the rural primary care shortage

Esther Yu Smith, MD

Physician

December 23, 2025

Today I am a urologist, a cardiologist, a psychiatrist, a rheumatologist. But truly, I am a rural family medicine doctor in one of the most underserved counties in the country. And I am tired.

I do not pretend to have the depth of each specialist. What I have is necessity, a toolkit built on scarcity. Practicing medicine on an island, where specialists are rare, calendars are full for months, and visiting …

When hospitals act like platforms, clinicians become content

Gerald Kuo

Conditions

December 23, 2025

For years, hospitals have been urged to modernize. We are told to digitize workflows, optimize performance, and rely on dashboards and algorithms to improve efficiency. Much of this advice is reasonable. Medicine cannot function without systems.

But recently, while observing hospital transformation from within, I began to feel a familiar unease, one I had encountered before outside of medicine.

It reminded me of how digital platforms operate.

Platforms are not inherently unethical. They …

Preventing physician burnout: an educational approach

William Lynes, MD

Physician

December 23, 2025

The frequency and severity of physician burnout have resulted in an epidemic that is impairing the American health care delivery system. Herbert Freudenberger coined the term burnout in 1977, referring to a syndrome characterized by emotional exhaustion, depersonalization or cynicism, and a lack of personal accomplishment. He noted that burnout reduced health care workers’ ability to provide excellent patient care and adversely affected their well-being.

Physician burnout is rampant in the …

Why high-quality embryos sometimes fail to implant [PODCAST]

The Podcast by KevinMD

Podcast

December 22, 2025

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

Double board-certified obstetrician-gynecologist and reproductive endocrinology and infertility specialist Erica Bove discusses her article, “Why do high-quality IVF embryos fail.” Erica explores the heartbreaking reality of recurrent implantation failure, challenging the assumption …

The risk of diagnostic ideology in child psychiatry

Dr. Sami Timimi

Conditions

December 22, 2025

Adapted from Searching for Normal: A New Approach to Understanding Mental Health, Distress and Neurodiversity. (Penguin Random House Canada/Signal, 2025.)

February 1992. I’m in the consulting-room side of a one-way mirror divide. Opposite us in the room are four people: thirteen-year-old Sofia, her older sister Julieta, and their mother and father. The parents speak with a strong Spanish accent. The girls’ mother has an anxious look on her face. She …

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