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Physical therapist and certified lymphedema specialist Maureen McBeth discusses her article “Beyond BMI: Why weight management must look inside the body.” Maureen explains why common tools like the bathroom scale and body …
Why measuring muscle mass matters more than tracking your weight [PODCAST]
The opioid crisis rages on, and there is plenty of blame to go around: pharmaceutical companies, drug distributors, reckless prescribers, the FDA. One entity that has been overlooked is health insurance, whose incentives pushed chronic pain patients to take opioids in the first place.
Check out your insurance plan and the copays you pay for different services. In one of ours, a generic medication costs $10 a month, at most. Physical …
Health insurance incentives and alternatives to opioids for chronic pain
Independent medicine is often described as nostalgic, a relic of a prior era in which physicians owned small practices and made decisions without corporate oversight. But independence is not nostalgia; it is infrastructure.
Today, nearly 75 percent of physicians in the United States are employed by hospitals, health systems, or corporate entities, according to the American Medical Association. In 2012, that number was closer to 50 percent. Private equity investment in …
Independent medical practice: Why private clinics are essential
Hindsight flatters certainty. Clinical medicine does not. After a bad outcome, everyone becomes smarter. The diagnosis looks obvious. The warning signs seem bright. The missed clue appears unforgivable. In the calm of retrospective review, people ask, “How could the doctor not have seen it?” That question sounds fair. Often, it is not. Real-world medicine does not happen in hindsight. It happens in the presence of noise, time pressure, incomplete information, …
How hindsight bias distorts clinical medicine
Before there were health care systems, insurance companies, or electronic medical records, there was the healer, a person embedded within the community, accountable not only for technical competence but for character.
My medical training outside the United States, while competitive and rigorous, remained service-oriented and community-based. Medicine historically was grounded in cultivated human qualities: humility, accountability, reverence for life, respect, and relational presence. Healing was not limited to scheduled interventions; it …
Do no harm: Why physician burnout requires bottom-up reform
Faith implies trust: confidence in an idea, a system, or a set of principles. In religion, it often requires adherence to divine authority, shaped by interpretation and tradition. Over time, those traditions can harden into dogma, discouraging curiosity and resisting ideas that challenge the prevailing worldview. This is not unique to religion. Any system that depends on belief risks the same fate.
When contradictions within a belief system become impossible to …
Institutional distrust in health care: Why a doctor lost faith
An excerpt from Your Child Is Not Their Weight: Parenting in a Size-Obsessed World, with permission from the American Academy of Pediatrics, 2026.
A friend and colleague who is a doctor in adult medicine made this comment to me several years ago: “My patients with kids have a harder time with their health than those who do not have kids!”
I pointed out to her that the “patients with kids” she …
Communicating health to children: a pediatrician’s guide for parents
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Metabolic health educator Kevin Whitt discusses his article “Insulin resistance is not a disease: a metabolic reframe.” Kevin argues that the skyrocketing rates of Type 2 diabetes are not the result of …
Insulin resistance is a survival mechanism, not a broken system [PODCAST]
Regina Townsend, founder of The Broken Brown Egg, writes that “trying to decide if you can emotionally afford the cost of building a Black or Brown family in a world that is concurrently showing you how low they are valued adds additional weight to an already heavy situation.”
Townsend emphasizes the importance of recognizing the lived experiences of women of color: “Infertility doesn’t see color, but my color …
Debunking 4 myths about fertility treatments for women of color
Last year, a 45-year-old woman walked into my screening center in Laurel, MD. She was fit, healthy, and had no symptoms whatsoever. She just wanted peace of mind, the kind of baseline health data that her annual physical could not provide. Ninety minutes later, her whole-body MRI revealed a kidney tumor she did not know existed. No pain. No blood in her urine. Nothing to suggest she was harboring a …
Whole-body MRI screening: a radiologist’s guide to preventive scans
As a pediatric cardiologist, I have spent my career watching children grow. During clinic visits, we track their height, weight, and milestones. We also sit with families and ask what makes their children smile. We might send a toddler to physical therapy for gross motor delay while we also encourage her love of art or music. Years of listening to parents share what their child enjoys has taught me that …
How competency-based education is driving medical education reform
In the thick of the opioid epidemic, there is this widespread fear called “opiophobia,” which basically means people, including patients and doctors, are scared to use opioids even when they are really needed for serious medical issues. This fear comes from the idea that even a short stint on opioids for acute pain, like after surgery, often leads to addiction or worse. John A. Bumpus’s 2025 review in ACS Pharmacology …
The truth about short-term opioid prescribing and opioid use disorder
If you trust the titans of industry, and I do not, we are led to believe that, just around the proverbial corner, the equivalent of C-3PO will arrive to improve health care. How wonderful!
You might remember the fussy, shiny droid, the golden companion of R2-D2 in the Star Wars films. Fluent in over six million forms of communication, C-3PO bubbled with personality, …
AI in health care: Why artificial intelligence cannot replace human empathy
I was trying to be cool, so I recently joined a social media challenge with a simple prompt: “Create a caricature of me and my job based on everything you know about me.”
As a hospitalist, physician executive, and burnout architect, my digital footprint is deep. I talk about systemic health care reform, the psychology of exhaustion, and the structural “blueprints” needed to …
AI bias in healthcare: When algorithms erase Black professionals
Spinal cord stimulation (SCS) continues to be a solid option for people dealing with chronic pain that just will not budge with the usual approaches like medications, physical therapy, or injections. It is a minimally invasive way to deliver low-level electrical pulses through electrodes placed in the epidural space near the spinal cord, helping to change how pain signals reach the brain and often providing relief in areas like the …
How spinal cord stimulation offers relief for chronic pain
In the sterile quiet of an exam room, a physician faces a patient recounting a history of profound trauma. To a layperson, the story is bone-chilling. To the seasoned clinician, it can occasionally and guiltily feel like data. We call it burnout or compassion fatigue, but biologically, it is something more fundamental. The human brain has a finite capacity for empathy.
Our neural circuitry evolved for small tribes, not for a …
Compassion fatigue in medicine: Why the brain numbs trauma
In 2016, Lauren Gambill wrote on KevinMD about being told, “She is not yours to grieve,” after a patient’s death. The message was clear: Grief was weakness, and physicians were expected to suppress it. Nearly a decade later, Arthur Lazarus argued that medical training does not change personality; it reveals scaffolding. He cited a “Blue Bloods” episode where Danny Reagan dismissed a racist watch leader and former cop with the …
The danger of detachment: How medical training reveals character
Families often ask me what “healthy aging” really means. They expect actionable answers: target lab values, a 30-minute exercise prescription, or a strict dietary plan. In modern health care, we deliver these metrics with precision, yet our patients continue to struggle. That gap is not a failure of compliance. It is a failure of imagination. Recently, I found myself contemplating a different kind of prescription while attending a piano recital …
The rhythm of healthy aging: Moving beyond health care metrics
An excerpt from 50 Studies Every Hospitalist Should Know.
Debbie Lin Teodorescu, MD, MEng, a cardiologist, and Hugo Torres, MD, MPH, an endocrinologist, authored this article.
The DOSE trial provided good insight into the dosage and frequency for administering loop diuretics in patients presenting with acute decompensated heart failure. Physicians can prescribe intravenous loop diuretics with confidence that their decision is evidence-based, efficacious, and safe.
Research questions
Among patients with hemodynamically …
Managing acute heart failure: evidence from the DOSE trial
Defensive medicine grows where fear rules. Value-based health care grows where judgment, trust, and outcomes matter. That is the clash now facing many doctors. On paper, health systems say they want high-value care, better outcomes, lower waste, and patient-centered decisions. In real life, many doctors practice in an environment shaped by needless complaints, crushing legal defense costs, underfunded services, regulator overreach, and instant reputational damage through online and social media. …
The clash between defensive medicine and value-based health care
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