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Managing a Black Swan in health care: a lesson in transparency

Physician

February 2, 2026

An excerpt from On All Sides of the Bed: One physician’s/CEO’s journey.

In the early summer of 2013, our hospital collided with a Black Swan.

Before Europeans discovered Australia, they were familiar only with white swans. The discovery of black swans overturned a long-held assumption. In business and risk theory, a “Black Swan” refers to a rare, unpredictable event with massive consequences, a concept popularized by Nassim Nicholas Taleb. For us, …

Health care as a human right vs. commodity: Resolving the paradox

Timothy Lesaca, MD

Physician

February 2, 2026

Human rights are understood to be universal and egalitarian. They are inalienable, indivisible, and grounded in a shared moral intuition: that human dignity deserves protection. One of the most widely accepted expressions of that intuition is the obligation to care for those who are physically or emotionally ill. Yet despite this near-universal belief, modern health care systems continue to struggle with a fundamental question: Is health care a human right, …

Why voicemail in outpatient care is failing patients and staff

Dan Ouellet

Tech

February 2, 2026

Voicemail has quietly become one of the most fragile points in outpatient care, not because clinicians or staff are failing, but because the system itself no longer fits the reality of modern health care.

Every day, patients call clinics with legitimate needs: appointment requests, medication questions, post-procedure concerns, insurance clarifications. When no one answers, they are routed to voicemail and asked to leave a message. From that moment on, the system …

Living with vitiligo: Overcoming shame and control

Dr. Reshma Stanislaus

Conditions

February 2, 2026

For those who know me personally, you know that I have vitiligo. Vitiligo is an autoimmune disease affecting the skin, where there are patches of depigmentation (the skin appears white or pink). It is sometimes associated with other medical conditions.

I met someone recently and they said that they were curious about my skin. I am used to looks or questions and am happy to educate people about vitiligo, so I …

Stopping medication requires as much skill as starting it [PODCAST]

The Podcast by KevinMD

Podcast

February 1, 2026

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

Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “How deprescribing in psychiatry offers a path to safer care.” Muhamad explores the growing movement to reduce unnecessary …

Deductive reasoning in medical malpractice: a quantitative approach

Howard Smith, MD

Physician

February 1, 2026

Conventionally, medical malpractice is argued using inductive reasoning. There is nothing wrong with inductive reasoning. It is a component of critical thinking. However, it is just a component. Inductive reasoning is more subjective than objective and the influences of selection bias, avoidance bias, and confirmation bias are undetectable.

Deductive reasoning is also a component of critical thinking. It is not immune from these same biases; however, deductive reasoning is more robust …

Building a clinical simulation app without an MD: a developer’s guide

Helena Kaso, MPA

Tech

February 1, 2026

I am not a doctor. I am a software developer who taught herself mobile development while working full-time and raising two kids. But I built a clinical simulation app used by medical students, and here is how I made sure it is actually clinically sound.

The credibility problem

When you don’t have an MD, you can’t rely on intuition or clinical experience. Every design decision has to be defensible, referenced, and auditable. …

Post-stroke cognitive impairment: the hidden challenge of recovery

Rida Ghani

Conditions

February 1, 2026

When clinicians think about stroke recovery, attention often focuses on motor deficits, speech impairment, and the risk of recurrent cerebrovascular events. Cognitive outcomes, however, are frequently treated as secondary or inevitable consequences rather than primary targets of intervention. This oversight carries consequences. Post-stroke cognitive impairment (PSCI) is common, persistent, and one of the strongest predictors of long-term disability, institutionalization, and caregiver burden, yet it remains under-recognized in routine care.

As acute …

The milkweed and the wind: a poem on aging as renewal

Michele Luckenbaugh

Conditions

February 1, 2026

The years pass without ceremony.

They do not always announce themselves.
Sometimes they slip by like quiet weather,
like afternoons we cannot later recall
except by the way the light
once rested against a wall.

Time moves like autumn wind,
unannounced,
persistent,
tender in its own indifferent way.

A milkweed stands in a field,
having grown tall without noticing
the exact moment it became mature.
Its green has deepened,
its stem stiffened with understanding.

Now the wind arrives,
and the pods open
not in grief,
but in readiness.

Each …

The cost of certainty in modern medicine

Priya Dudhat

Education

February 1, 2026

“I don’t know” may be one of the most difficult phrases to both hear and admit. As a patient, fewer words can make you more anxious, and as a health care provider, fewer words can make you feel more powerless. As a whole, the medical community has fostered and embraced a culture of certainty, discouraging the phrase “I don’t know” because of the helplessness it can instill in patients and …

Blaming younger doctors for setting boundaries ignores the broken system [PODCAST]

The Podcast by KevinMD

Podcast

January 31, 2026

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

Palliative care physician and certified physician development coach Christie Mulholland discusses her article “5 things health care must stop doing to improve physician well-being.” Christie challenges the pervasive narrative that younger physicians …

Nervous system dysregulation vs. stress: Why “just relaxing” doesn’t work

Claudine Holt, MD

Physician

January 31, 2026

During the COVID-19 pandemic, conversations about burnout and stress exploded, particularly among health care workers. Much of the advice centered on self-care practices: taking time off, scheduling massages and spa days, practicing mindfulness, protecting your evenings, using your PTO. While these strategies are valuable, they are not the full story.

Positioning self-care as the solution to stress oversimplifies a much deeper physiological process. For many patients (and clinicians) stress is not …

U.S. opioid policy history: How politics replaced science in pain care

Richard A. Lawhern, PhD & Stephen E. Nadeau, MD

Meds

January 31, 2026

Based on our combined experience of over 70 years in patient advocacy, pain management, and behavioral neurology, we are convinced that U.S. public perception and public policy on treatment of pain have been driven almost entirely by sociopolitical and legal factors. Seldom in recent years has policy been significantly influenced by science.

The U.S. enjoyed a brief period of scientifically enlightened policy in the late 1990s through 2008. A large number …

Alex Pretti’s death: Why politics belongs in emergency medicine

Marilyn McCullum, RN

Conditions

January 31, 2026

Emergency medicine trains clinicians to recognize patterns early, anticipate deterioration, and intervene before outcomes become irreversible. We pride ourselves on seeing what others miss. Yet we are repeatedly instructed, explicitly or implicitly, to ignore the largest pattern of all. Political decisions consistently and predictably shape who arrives in our emergency departments, how sick they are, and how unsafe the environment becomes for the people expected to care for them.

If political …

Women in health care leadership: Navigating competition and mentorship

Sarah White, APRN

Conditions

January 31, 2026

In recent years, medicine has become more open about burnout, workforce shortages, and the challenges facing women in health care leadership. We write about mentorship programs, leadership pipelines, and the need to bring more women into ownership and executive roles. We celebrate women who build clinics, lead departments, and create space for others to rise.

What we talk about far less is what happens when women actually meet each other in …

Senior financial scams: a guide for primary care physicians

John C. Hagan III, MD

Conditions

January 31, 2026

In an increasingly digital world, older adults are often viewed as prime targets for financial scams. These malicious schemes exploit vulnerabilities inherent in aging, such as social isolation, cognitive decline, and trustfulness. As primary care physicians, we are in a unique position to recognize the signs of vulnerability in our older patients. Understanding the methods employed by fraudsters, the impact on victims, and how to educate them on preventative measures …

Moral courage in medical training: the power of the powerless

Kathleen Muldoon, PhD

Education

January 31, 2026

I have the great honor and privilege of coaching medical students throughout their training. In the past week, several students have shared experiences that have stayed with me: On clinical rotations, some shared stories of being referred to only as “student one” or “student two,” their humanity quietly erased. Others described managing food and housing insecurity while carrying the financial burden of medical education. Still others, particularly students with darker …

A blueprint for pediatric residency training reform

Ronald L. Lindsay, MD

Physician

January 31, 2026

The false promise of efficiency

The latest punditry calls for three-year medical schools, stripped of ethics and other vital subjects, with less clinical training. The rationale? Efficiency. The result? A generation of physicians unprepared for the complexity of children’s lives.

General pediatricians themselves admit in published surveys that they “know squat” about developmental-behavioral pediatrics (DBP) after residency. Yet the proposed solution is to shorten training further. That is not reform; it is …

The gastroenterologist shortage: Why supply is falling behind demand

Brian Hudes, MD

Physician

January 31, 2026

The story of gastroenterology in 2025 is no longer about productivity or reimbursement, it’s about manpower. Hospitals and practices across the U.S. are struggling to recruit, retain, or even temporarily staff the specialists who manage digestive diseases, perform colon cancer screening, and handle emergency procedures like ERCP. What we’re facing isn’t simply a staffing issue; it’s a structural shortage decades in the making.

The shrinking pipeline of gastroenterologists

In the mid-1990s, roughly …

Waking up at 4 a.m. is not required for success [PODCAST]

The Podcast by KevinMD

Podcast

January 30, 2026

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

Physician, former health care executive, certified coach, speaker, and organizational consultant Laura Suttin discusses her article “Why the 4 a.m. wake-up call isn’t for everyone.” Laura shares her personal struggle with the …

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