Medicine and metaphysics belong together again

Physician
July 6, 2026

For most of human history, medicine and metaphysics were inseparable. Physicians sought not only to understand the body but to understand the meaning of illness, the purpose of suffering, and the relationship between healer and patient. Healing was more than the manipulation of physical matter. It engaged the whole person.

That began to change in the late nineteenth and early twentieth centuries. The remarkable successes of scientific medicine, driven by advances …

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Medicine and metaphysics belong together again

How drug marketing shapes what your doctor prescribes

Conditions and Diseases
July 6, 2026

In April 2025, Gilead Sciences paid $202 million to settle allegations that it paid kickbacks to doctors through speaker fees and lavish dinners in return for more written prescriptions for their drugs. This is the illegal version that made the news headlines.

And the legal version? It may be sitting in your medicine cabinet.

A recent survey found that nearly 1 in 3 Americans aren’t filling their prescriptions simply due …

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How drug marketing shapes what your doctor prescribes

When diagnosing rare disease falls to the family

Conditions and Diseases
July 5, 2026

Medicine tells a clean story about diagnosis. A set of symptoms appears. A clinician evaluates them. Tests are ordered. Patterns emerge. A name is assigned. Uncertainty resolves. That version is comforting because it suggests order: cause, method, resolution. It also collapses under sustained complexity. For some patients, that collapse is not theoretical. It is lived over years.

Our son started entering hospitals at 8 months old.

Not once or twice, but in …

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When diagnosing rare disease falls to the family

How California can stop underage online gambling

Health Policy
July 5, 2026

As California voters decide between Xavier Becerra and Steve Hilton for governor, one growing public health concern needs more focus from both: the surge in underage online gambling. Easy access through phones and apps creates risks that could spiral if left unchecked. AB 2617, the Protecting Kids from Online Gambling Act, provides a practical starting point. Advancing, refining, and enforcing solid measures here should be a priority regardless of …

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How California can stop underage online gambling

The 3 flight-line lessons operating room safety missed

Physician
July 5, 2026

Surgery borrowed the checklist from aviation and stopped there. Three more lessons from the flight line, on distraction, automation, and fixation, are still waiting to be picked up.

On September 11, 1974, Eastern Air Lines Flight 212 descended toward Charlotte in light fog. The cockpit voice recorder captured the crew talking about politics and used cars while the DC-9 sank below its assigned altitude. The airplane hit terrain short of the …

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The 3 flight-line lessons operating room safety missed

How the happiest countries protect mental health

Health Policy
July 5, 2026

Mental health policy has gained increasingly earned attention in the last decade, and policy solutions are needed now more than ever. According to the 2016 Commonwealth Fund International Health Policy Survey, the United States has the second-highest rate of self-reported emotional distress among high-income nations. Among high-earning adults in these countries, those in the U.S. were the most likely to have been diagnosed with depression, anxiety, or other mental health …

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How the happiest countries protect mental health

Your ambient AI scribe consent checkbox is not consent

Health Technology
July 5, 2026

Every ambient AI scribe demo ends the same way. The visit wraps, the note is already written, and you get an evening back.

None show the part at the beginning where you must tell the patient a machine is listening, explain what that means, answer questions, and get their agreement before the visit can begin.

That disclosure is not a ten-second formality. It is a conversation, and in psychiatry, it can derail …

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Your ambient AI scribe consent checkbox is not consent

The cataract surgery waste hiding in the trash bin

Conditions and Diseases
July 5, 2026

Gowned and gloved, mask in place, surgical technician Savannah Stanford prepares the operating room. She tears open plastic wrapping with a practiced pop and rip. The sound, sharp as a pistol crack, cuts through the silence before the day’s first case. Blue drapes spill over the table; syringes clatter against stainless steel. “A lot of wrappers,” she said. “A lot of plastic. Some things come in multiple plastic wrappers, not …

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The cataract surgery waste hiding in the trash bin

A medical board complaint that fueled my burnout

Physician
July 5, 2026

My wife worked as a retail store manager for twelve years. We often joked that her customers were one psychiatric hospitalization away from turning into my patients. As my career progressed, our jokes became a disappointing reality. My meetings with insurance reviewers, outpatient clinics, and even hospital administrators referenced “consumers” and “clients.” The issue with the use of the term “provider” becomes more important if our patients are seen as …

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A medical board complaint that fueled my burnout

The most dangerous part of a hospital discharge

Conditions and Diseases
July 4, 2026

Everyone celebrates a successful hospital discharge. The patient is medically stable. The paperwork is complete. The prescriptions have been sent. Transportation has been arranged. Another bed becomes available for the next patient who needs care. On paper, the system worked.

Yet discharge is not the finish line. It is a transition point. For hospitals, discharge often marks the successful completion of an episode of care. For patients and families, it marks …

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The most dangerous part of a hospital discharge

Radiofrequency ablation and the young back pain patient

Conditions and Diseases
July 4, 2026

I remember my early years in interventional physiatry with a clarity that only comes from repetition. A young patient, often in their twenties or thirties, would walk in with a single, unremarkable complaint: axial low back pain, non-radiating. The exam told a consistent story: pain reproduced with extension and rotation, no radicular findings, and no neurological deficits. Imaging was equally quiet: maybe a mildly bulging disc, some early facet hypertrophy, …

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Radiofrequency ablation and the young back pain patient

A physician’s three lessons on gratitude in medicine

Physician
July 4, 2026

A rabbi asks his students a question: “Where does God dwell?” One student answered, “Heaven.” Another answered, “We are only human; we cannot possibly know where God dwells.” “No,” the rabbi replied. “God dwells wherever we choose to let God in.” Might not the same question be asked about gratitude? Where does gratitude dwell? And the answer may be the same. Gratitude dwells wherever we choose to let gratitude into …

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A physician’s three lessons on gratitude in medicine

Smartphone overuse is a disease doctors ignore

Physician
July 4, 2026

Imagine, for a moment, an epidemic sweeping the country. No one is immune. Its vague symptoms range from physical to mental, but they appear unrelated. Unlike during COVID, however, there is no outcry from health officials, the government, or the public. The problem is widely felt but rarely confronted; its insidious nature allows it to pass as normal. Therefore, the medical and scientific communities have made no serious effort to …

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Smartphone overuse is a disease doctors ignore

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Why the wrong physician employer can end your career

Physician
July 4, 2026

Today, many physicians will be considering applying for employment at a hospital or clinic. You might be one of those. Finding your next employer is the most important decision you have made since you entered medical school, because selecting the wrong one may end your career as a doctor. And even if a bad employer choice does not end your career, you may have a difficult experience in re-starting your …

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Why the wrong physician employer can end your career

The quiet skills that actually save a medical career

Conditions and Diseases
July 4, 2026

Medicine trains us to master physiology, pharmacology, and diagnostic reasoning. We spend years learning how to manage ventilators, interpret imaging, and navigate complex clinical decisions. But the skills that actually determine whether a physician survives a career, or is broken by it, are almost never taught. They are quiet skills. Uncelebrated skills. Skills that determine whether you can practice with dignity in a system that often makes dignity difficult.

After four …

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The quiet skills that actually save a medical career

The gender pay gap isn’t just about what she chose

Physician
July 4, 2026

Every discussion about the gender pay gap in medicine eventually comes back to the same explanation: Women choose different specialties, different schedules, or jobs with more flexibility. Some of that is obviously true. But I’ve never thought it explained the whole picture, and the profession leans on that explanation a little too heavily.

Even when researchers account for specialty choice, hours worked, and practice setting, women physicians still tend to earn …

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The gender pay gap isn’t just about what she chose

How fear of the stock market quietly costs doctors a million dollars [PODCAST]

Podcast
July 3, 2026
YouTube video

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

Doctors spend over a decade training and then quietly leave a fortune on the table when they handle their own money. In this episode, economics professor Hernan Moscoso Boedo explains why high income and years of schooling do not make physicians good …

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How fear of the stock market quietly costs doctors a million dollars [PODCAST]

Why billing can make or break a new practice

Physician
July 3, 2026

When I finished residency in New York and moved to Hawaii, I spent a couple of years in an established practice before deciding to go out on my own. The reasons were probably the same ones many physicians consider independent practice in the first place: autonomy, the ability to shape the patient experience yourself, and the opportunity to build something that reflects how you actually want to practice medicine.

Two years …

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Why billing can make or break a new practice

Chronic pain management: Match the treatment to the cause

Conditions and Diseases
July 3, 2026

Chronic pain affects millions and demands a nuanced, individualized strategy. Providers draw from training and comfort zones, but the scientific literature supports a multimodal framework that integrates pharmacological, rehabilitative, psychological, and interventional options. No single modality universally outperforms others. Outcomes improve when treatments target the underlying pain generator, whether nociceptive, neuropathic, inflammatory, or vertebrogenic, while considering patient-specific factors like comorbidities and functional goals.

Pharmacological management

Opioids provide potent analgesia for certain …

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Chronic pain management: Match the treatment to the cause

Adaptation to illness matters as much as the diagnosis

Conditions and Diseases
July 3, 2026

Picture two patients seated in the same waiting room, hearing the same diagnosis from the same physician on the same day. From that moment, their lives diverge, each setting out on a journey shaped by individual choices, relationships, and ways of coping.

For one patient, the diagnosis becomes a consuming shadow. Every ache signals a smaller world. Fear and anger begin to strain relationships that were once strong. Work no longer …

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Adaptation to illness matters as much as the diagnosis

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