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The ticking clock: How time constraints in medicine hurt patient care

Physician

February 25, 2026

We are taught to watch for conflicts of interest in the form of pharmaceutical pens and consulting checks, yet we often overlook the most pervasive corruption of all: the ticking of the clock.

We traditionally describe medical conflicts of interest in corporate terms: free dinners, speaking fees, and consulting arrangements. These temptations are real, and they deserve the scrutiny and rules we apply to them. But they are external distractions. The …

Insulin resistance is not a disease: a metabolic reframe

Kevin Whitt

Conditions

February 25, 2026

Type 2 diabetes and metabolic disease are now so common that they are treated as an expected part of modern life rather than as a systemic failure. Roughly 90 percent of American adults are now prediabetic or diabetic, and most are unaware of it. This progression quietly opens the door to heart disease, non-alcoholic fatty liver disease, cancer, neurodegeneration, and other chronic illnesses that are then managed downstream.

We are not …

Understanding Moore’s Law and the exponential growth of technology

Richard A. Lawhern, PhD

Conditions

February 25, 2026

When I was a teenager, practical computers did not yet exist. In 1966, my first exposure to a computer in engineering school was a room-sized mainframe whose fast memory consisted of a foot-tall rotating magnetic disc that could store 8,000 “bytes” (each byte containing eight “bits,” which allow for 256 possible values representing alphabetic letters or numbers).

At the time, we could forget about storing the full text of the King …

From glucose to vascular health: the future of diabetes care

Palma Shaw, MD

Conditions

February 25, 2026

Historically, diabetes management focused on blood glucose control and preventing severe complications such as neuropathy and amputation. Over the past two decades, this limited view has proven insufficient for long-term health. Many now emphasize risk factor management, lifestyle changes, and early screening instead of crisis response.

The vascular health risk of a diabetes surge

Diabetes is an epidemic: In the last decade alone, the number of adults living with the disease globally …

“The only thing that will change will be our name”: a private equity cautionary tale

Anonymous

Physician

February 25, 2026

“The only thing that will change will be our name.”

These were the words shared by a senior partner when our staff was informed that the partnership had decided to sell the practice to a private equity firm. Unfortunately, as the story unfolded, that was also the moment that my future changed.

I was an associate when those now infamous words were uttered. While I was wary of this transition, it was …

Community cooperatives offer a solution to the affordable health care crisis [PODCAST]

The Podcast by KevinMD

Podcast

February 24, 2026

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

Physician, author, and health care reform advocate David K. Cundiff discusses his article “Accountable care cooperatives: a 2026 vision for U.S. health care.” David analyzes the severe funding crisis affecting American families …

The vascular surgeon shortage: Why amputations are rising

Daniel Torrent, MD

Conditions

February 24, 2026

Steven couldn’t remember when he first noticed the spot on his toe, only that it began as a blister a few weeks earlier. He finally saw his doctor, but only when the entire toe had turned black. His doctor referred him to me, but he missed the appointment because the drive was 90 minutes, and he couldn’t take the day off work.

Two weeks later, half of his foot was dead, …

The shadow ledger: Uncovering the financial cost of nursing turnover

Kristen Cline, BSN, RN

Conditions

February 24, 2026

When I told ProPublica that it was too expensive to protect us, I was naming what every number in this piece confirms. The system made a calculation about what our lives were worth, and it got the math catastrophically wrong.

I have been a nurse for almost 20 years, working in emergency departments, intensive care units, and eventually the back of a helicopter as a flight nurse. I have watched the …

Leadership in action: How a broken pager fixed a hospital

Ronald L. Lindsay, MD

Physician

February 24, 2026

Sometimes, the smallest failures expose the largest truths. At a remote Air Force base hospital, a silent pager revealed not my incompetence, but my supervisor’s lack of leadership, and set in motion a chain of events that reshaped the hospital’s command structure and ultimately influenced the future of Air Force pediatrics.

What began as a malfunction during an award ceremony became the catalyst for decisive leadership, a reorganization of medical services, …

Profits before patients: the hidden cost of U.S. health care

Dr. Shantanu Rai

Physician

February 24, 2026

If you want to understand what “profits before patients” means in American health care, don’t start with a spreadsheet. Start with a story.

During residency, I cared for a middle-aged mother of two who came to our community hospital emergency room struggling to breathe. It didn’t take long to realize she needed something we couldn’t offer: urgent heart surgery at a larger hospital.

After a 30-hour shift, I filed the transfer request …

Why maintenance of certification varies widely: a system in crisis

Brian Hudes, MD

Physician

February 24, 2026

If you asked ten physicians to explain how they maintain board certification, you’d get at least ten different answers, maybe more. Some take quarterly quizzes. Some submit CME attestations every five years. Some do both. Others, grandfathered in before time-limited certification existed, do nothing at all. Yet every one of them carries the same professional label: board-certified physician.

That simple title, once synonymous with competence, now hides a dizzying patchwork of …

Modern technology must revolutionize the archaic physician job search [PODCAST]

The Podcast by KevinMD

Podcast

February 23, 2026

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

Practicing anesthesiologist and the physician co-founder of Marit Health Rob Anderson discusses his article “Why can’t finding a doctor job be like Zillow.” Rob shares his personal journey through divorce and house …

Why death certificates fail to capture the reality of aging

Deon Hayley, MD

Conditions

February 23, 2026

What do old people die from?

Ella passed away last week at age 84. I have cared for her since she was admitted to the nursing home two years ago. Her granddaughter called me wanting to know the cause of death. In old age, the cause of death is often the wrong question, as the end is usually not a single cause but a slow convergence of many.

Ella had a list …

AI governance in health care: Why physicians must lead the design

Tod Stillson, MD

Physician

February 23, 2026

Artificial intelligence is no longer approaching medicine. It is already embedded inside it. It drafts our notes. It summarizes research. It suggests differentials. It triages messages. It promises efficiency, scale, and relief from burnout. Physicians are adopting it quickly. That speed should give us pause.

The greatest threat facing physicians in 2026 is not resisting artificial intelligence. It is allowing artificial intelligence in health care to be designed without us. Every …

Managing celiac disease: Overcoming the hidden social burden

Kamiah Gibson

Conditions

February 23, 2026

After I got diagnosed with celiac disease when I was 19, I faced a difficult choice every time friends invited me out: I could either stay home, or I could risk getting terribly sick.

I was a college volleyball player at West Virginia University when I started experiencing severe migraines and stomach issues. I could not eat anything without getting sick, which resulted in me losing 40 pounds in just two …

Military leadership lessons for the U.S. health care crisis

Richard A. Lawhern, PhD

Conditions

February 23, 2026

It is said that we live in difficult times, and that reality is unavoidable for anyone who does not live as a hermit in a cave somewhere. For patients and their doctors, the signs of impending failure are equally unavoidable.

Health care consumes 18 percent of U.S. gross domestic product and continues to rise faster than the rate of inflation. Consumer confidence in the goodwill and scientific integrity of U.S. health …

Surgical practice efficiency: How to fix a broken system

Paul Toomey, MD

Physician

February 23, 2026

For years, patients did not complain about their surgical care. They complained about not getting calls back.

The frustrating part was that my staff was calling them back. Messages were left. Voicemails filled up. Phone trees were in place. And still, patients felt ignored, staff felt defensive, and I found myself on a constant apology tour.

I assumed this was just how modern medical offices worked.

We had three people answering phones. We …

Value-based care workforce: Bridging the gap in clinical education

Kenneth Botelho, DMSc, PA-C

Policy

February 23, 2026

Health care is rapidly transitioning toward value-based care, yet many clinicians remain uncertain about what it actually means for their daily work. Despite widespread discussion of quality metrics, cost containment, and population health, clinicians are increasingly expected to deliver system-level outcomes without structured preparation to function within the systems that demand them.

If health care seeks to improve the lives of clinicians and patients while strengthening continuity of care, it must …

The death of private practice: unequal pay and hospital power

John C. Hagan III, MD

Policy

February 23, 2026

American health care has changed so profoundly in the last three to four decades that it is all but unrecognizable to those of us spending our careers in private practice. In my opinion, the root causes are not that complex. Foremost among them is the unconscionable disparity between the remuneration received by hospital-employed physicians and that of their counterparts in private practice for the same service or procedure.

This is abetted …

Curing U.S. health care: Why a fair health tax is the answer

Shah-Naz H. Khan, MD

Policy

February 23, 2026

The veil of pretense was snatched long ago. So, politicians dare not brazenly declare that the U.S. has the greatest health care in the world. The system is broken. Neither Republicans nor Democrats have a remedy. It is a perverted Robin Hood system, where the rich are robbed to serve the poor poorly.

The exorbitant insurance premiums are unaffordable for many, and for others, it is as if it were a …