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Tech

Human connection in medicine is the art AI cannot replace

I never thought I would have to reckon with my own mortality in my twenties. But there I was, cut off from the world in an ICU quarantine room, a monitor ringing in my ear, tuberculosis and multi-organ failure closing…

I never thought I would have to reckon with my own mortality in my twenties. But there I was, cut off from the world in an ICU quarantine room, a monitor ringing in my ear, tuberculosis and multi-organ failure closing in. Words swirled around me as I fought to stay awake, and all I could think was: This isn’t fair. If only they [the doctors] had checked my liver when …

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Human connection in medicine is the art AI cannot replace

Physicians

Physician leadership roles have a cost no résumé shows

The other day, LinkedIn informed me that I was a strong match for a developmental-behavioral pediatrics section chief position at an academic medical center in the Midwest. The irony was hard to miss. Years ago, I held essentially the same…

The other day, LinkedIn informed me that I was a strong match for a developmental-behavioral pediatrics section chief position at an academic medical center in the Midwest.

The irony was hard to miss. Years ago, I held essentially the same leadership position. It nearly killed me.

The recommendation arrived complete with all the reassuring language modern recruiting systems like to use. My qualifications matched the position well. My experience aligned with the …

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Physician leadership roles have a cost no résumé shows

Physicians

Goals of care should be decided long before the ICU

In the midst of a busy Monday clinic, I field calls from the nursing facility in India where my aunt is slowly dying. The young doctors there are traumatized by our family's refusal to have her admitted to a hospital.…

In the midst of a busy Monday clinic, I field calls from the nursing facility in India where my aunt is slowly dying. The young doctors there are traumatized by our family’s refusal to have her admitted to a hospital. I have become their counselor and guide.

My aunt was a mother to many nieces and nephews, despite having no children of her own. Over the years, I watched her keep …

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Goals of care should be decided long before the ICU

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Podcast

Doctors hide their PTSD out of fear for their license [PODCAST]

A trauma surgeon spent two decades on call for the worst nights of other people's lives. Then he ran his hospital's pandemic response. Then he could not function. Jeremy Heffner is a trauma surgeon, speaker, and author. This episode is…

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A trauma surgeon spent two decades on call for the worst nights of other people’s lives. Then he ran his hospital’s pandemic response. Then he could not function. Jeremy Heffner is a trauma surgeon, speaker, and author. This episode is based on his article “Why frontline health care …

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Doctors hide their PTSD out of fear for their license [PODCAST]

Conditions

Is your postpartum pelvic floor really a 30-year problem?

1. The six-week myth vs. the thirty-year reality We all know the current standard of maternal health care operates on a dangerous illusion: the big ole' six-week checkup. We tell moms that once they pass this test, congrats! Recovery is…

1. The six-week myth vs. the thirty-year reality

We all know the current standard of maternal health care operates on a dangerous illusion: the big ole’ six-week checkup. We tell moms that once they pass this test, congrats! Recovery is complete and they are cleared to return to normal life and exercise.

It would be convenient if bodies healed by the calendar, wouldn’t it? What really happens during pregnancy, birth, and lactation …

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Is your postpartum pelvic floor really a 30-year problem?

Policy

Nursing home ratings hide what the federal record shows

When a patient asks where to go for a knee replacement, a colonoscopy, or their mother's rehab stay, they have usually already looked. Not at the federal record. At the stars. Here is what the stars do not show. Our…

When a patient asks where to go for a knee replacement, a colonoscopy, or their mother’s rehab stay, they have usually already looked. Not at the federal record. At the stars.

Here is what the stars do not show. Our analysis of Centers for Medicare & Medicaid Services records found that 46 percent of U.S. nursing homes carry at least one federal civil money penalty on the current enforcement record, and …

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Nursing home ratings hide what the federal record shows

Physicians

Who monitors patients after telehealth ADHD prescribing?

Last month, I took on five new patients who were already prescribed stimulants. I had not met any of them in person before. Each came to me with a diagnosis, an active Schedule II prescription, and a chart note from…

Last month, I took on five new patients who were already prescribed stimulants. I had not met any of them in person before. Each came to me with a diagnosis, an active Schedule II prescription, and a chart note from a telehealth visit that I cannot fully piece together. My role now seems to be continuing these prescriptions. I am concerned about the handoff, and I doubt anyone decided who …

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Who monitors patients after telehealth ADHD prescribing?

Conditions

Refusing to treat a patient is not the same as a boundary

A recent study found that, compared with people from other cultures, Americans are less likely to report feeling a sense of obligation to be present for their friends. If that reflects a broader cultural shift, it raises an uncomfortable question:…

A recent study found that, compared with people from other cultures, Americans are less likely to report feeling a sense of obligation to be present for their friends. If that reflects a broader cultural shift, it raises an uncomfortable question: Is this same emphasis on personal autonomy and individual comfort seeping into health care? Are health care professionals increasingly opting out of their obligation to care for patients when the …

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Refusing to treat a patient is not the same as a boundary

Policy

Access to interventional psychiatry should not end downtown

A standard course of repetitive transcranial magnetic stimulation (TMS) for depression means coming to the clinic five days a week for four to six weeks, roughly 20 to 36 sessions. That is because response depends mainly on the number of…

A standard course of repetitive transcranial magnetic stimulation (TMS) for depression means coming to the clinic five days a week for four to six weeks, roughly 20 to 36 sessions. That is because response depends mainly on the number of sessions delivered, not on calendar time.

Esketamine (Spravato) carries a different but equally demanding logistical load. Under its FDA safety program, known as a Risk Evaluation and Mitigation Strategy (REMS), each …

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Access to interventional psychiatry should not end downtown

Education

Chronic curiosity is a diagnosis worth keeping for life

ChatGPT once diagnosed me with chronic curiosity. I've been thinking about that diagnosis ever since, so I wanted to sit with it a little longer. Typically, the word "chronic" comes with a bad connotation. All it really means is that…

ChatGPT once diagnosed me with chronic curiosity. I’ve been thinking about that diagnosis ever since, so I wanted to sit with it a little longer.

Typically, the word “chronic” comes with a bad connotation. All it really means is that something is going to be with you forever but won’t shorten your life. If anything, chronic curiosity might extend mine; it means my brain is always working harder than baseline. …

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Chronic curiosity is a diagnosis worth keeping for life

Meds

Hunger after stopping tirzepatide can feel like burning

When my hunger returned, it felt as though my stomach was burning from the inside out. It was acute, painful, and very physical. I pushed everything else aside and concentrated on getting rid of it. There was no negotiating with…

When my hunger returned, it felt as though my stomach was burning from the inside out.

It was acute, painful, and very physical. I pushed everything else aside and concentrated on getting rid of it. There was no negotiating with hunger that intense. My attention narrowed to what I could eat to make it stop.

I am a registered nurse with more than thirty years of clinical experience. I have had bariatric …

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Hunger after stopping tirzepatide can feel like burning

Tech

How to test ambient AI scribes before you sign a contract

For over a decade, the administrative burden in specialty medicine has quietly worsened. Orthopedic surgeons doing forty patients a day are spending more time in the EHR than in the room. Ambient AI scribes have changed that equation in ways…

For over a decade, the administrative burden in specialty medicine has quietly worsened. Orthopedic surgeons doing forty patients a day are spending more time in the EHR than in the room. Ambient AI scribes have changed that equation in ways that are only beginning to show up in the data. But the real opportunity isn’t efficiency for its own sake. It’s building toward a future where technology absorbs the mundane …

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How to test ambient AI scribes before you sign a contract

Podcast

ICU telemedicine done right is a program, not a doctor on a screen [PODCAST]

A patient in intensive care gets worse at 2 a.m., and the hospital has no critical care doctor in the building. Chris Gallagher, a cardiologist and founder of Access TeleCare, has spent 15 years building virtual care programs inside hospitals,…

Listen on Apple Podcasts · Spotify

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

A patient in intensive care gets worse at 2 a.m., and the hospital has no critical care doctor in the building. Chris Gallagher, a cardiologist and founder of Access TeleCare, has spent 15 years building virtual care programs inside hospitals, and he explains why that gap is so hard …

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ICU telemedicine done right is a program, not a doctor on a screen [PODCAST]

Policy

Voting and health outcomes: the cycle doctors ignore

Poor health can negatively impact any and all aspects of our lives, often discouraging us from participating fully in activities we otherwise would. It shouldn't be surprising, then, that those with worse health are also less likely to vote, or…

Poor health can negatively impact any and all aspects of our lives, often discouraging us from participating fully in activities we otherwise would. It shouldn’t be surprising, then, that those with worse health are also less likely to vote, or that voter participation is inversely associated with time spent in inpatient care. And while we may accept this at face value, the downstream consequences of this are often …

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Voting and health outcomes: the cycle doctors ignore

Physicians

Whole-person care starts in the operating room

For most of my career, my work has begun at the moment a patient is most vulnerable. As an anesthesiologist, I meet people at the threshold of surgery, often anxious, sometimes in pain, and always placing extraordinary trust in a…

For most of my career, my work has begun at the moment a patient is most vulnerable. As an anesthesiologist, I meet people at the threshold of surgery, often anxious, sometimes in pain, and always placing extraordinary trust in a physician they may have met only minutes earlier. My responsibility is to protect them through an experience they cannot control and, under general anesthesia, cannot describe while it is happening.

That …

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Whole-person care starts in the operating room

Physicians

What doctors are talking about in 2026: AI, pain, burnout

Clinicians wrote about AI more than anything else this quarter. Readers spent their time elsewhere: on burnout, on pain and opioids, and on what medicine costs the people who practice it. The first Insights by KevinMD report.

Clinicians wrote about AI more than anything else this quarter. Readers spent their time elsewhere: on burnout, on pain and opioids, and on what medicine costs the people who practice it. The first Insights by KevinMD report.

What doctors are talking about in 2026: AI, pain, burnout

Tech

AI hallucinations can invent what colleagues think of you

As physicians, we are increasingly told that artificial intelligence will summarize our work, amplify our ideas, and help readers understand complex issues. But what happens when AI begins describing not what we have said, but what it imagines others think…

As physicians, we are increasingly told that artificial intelligence will summarize our work, amplify our ideas, and help readers understand complex issues. But what happens when AI begins describing not what we have said, but what it imagines others think about us?

I recently conducted an informal experiment that exposed a troubling tendency in generative AI. After sharing excerpts from my manuscript The Autopsy, I asked Google’s Gemini a straightforward question: …

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AI hallucinations can invent what colleagues think of you

Conditions

Losing your athletic identity after a heart diagnosis

A routine EKG at my annual physical was supposed to be uneventful. Instead, it ended my marathon career. This past winter, I was diagnosed with arrhythmogenic right ventricular cardiomyopathy (ARVC), a rare inherited heart disease associated with ventricular arrhythmias, sudden…

A routine EKG at my annual physical was supposed to be uneventful. Instead, it ended my marathon career.

This past winter, I was diagnosed with arrhythmogenic right ventricular cardiomyopathy (ARVC), a rare inherited heart disease associated with ventricular arrhythmias, sudden cardiac arrest, and an increased risk of life-threatening events during intense endurance exercise. I had no symptoms. No warning signs. I felt like the healthiest version of myself. Yet suddenly I …

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Losing your athletic identity after a heart diagnosis

Policy

Lancaster County measles outbreak exposes a crisis of trust

For ten years, I lived with my family, 45 minutes from the rolling clover fields and dairy farms of Lancaster County, Pennsylvania, iconic markers of a world defined by quiet tradition. Yet in the fall of 2026, this peaceful landscape…

For ten years, I lived with my family, 45 minutes from the rolling clover fields and dairy farms of Lancaster County, Pennsylvania, iconic markers of a world defined by quiet tradition. Yet in the fall of 2026, this peaceful landscape has become a dark microcosm of modern medicine’s greatest crisis: the weaponization of politics, the spread of bad-faith disinformation, and the collapse of public trust in the medical profession.

As Pennsylvania …

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Lancaster County measles outbreak exposes a crisis of trust

Physicians

Slowing down in medicine starts with being interruptible

One morning I sat on the porch with a cup of tea and read slowly. Birds moved somewhere beyond the yard. Wind passed through the trees. The locusts were already loud. Nothing remarkable happened. And yet, after a while, I…

One morning I sat on the porch with a cup of tea and read slowly. Birds moved somewhere beyond the yard. Wind passed through the trees. The locusts were already loud. Nothing remarkable happened.

And yet, after a while, I had the strange sense that my mind had returned to me. There was enough. Enough time to finish the paragraph. Enough quiet to notice the air. Enough room for one thought …

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Slowing down in medicine starts with being interruptible

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