KevinMD.com

October 4, 2026Oct 4, 2026

CSI:OPIOIDs (Clinical Context of Suicide Following Opioid Transitions) is a rigorous scientific research study that systematically examines suicides occurring after prescription opioid dose reductions or discontinuations in patients with long-term (chronic) pain. Using psychological autopsy methods using detailed interviews with bereaved survivors combined with medical record review where obtainable, it seeks to characterize the multifactorial demographic, societal, clinical, and health-system factors involved. The study began as a pilot supported by …

Policy

Why milk banks in emergencies must plan like blood banks

Sharron Bransburg-Zabary, PhD

October 4, 2026Oct 4, 2026

As more families depend on human milk banks to meet the vital health and nutritional needs of babies, these facilities should implement emergency response plans, similar to those in blood and tissue banks and other critical medical services. Human milk is a lifesaving resource for preterm, low-birth-weight, and critically ill infants, with the World Health Organization recommending pasteurized donor milk for babies who are unable to receive their …

Podcast

Why women doctors leave in their forties and what keeps them [PODCAST]

The Podcast by KevinMD

October 3, 2026Oct 3, 2026

Women physicians are walking away from practice in their forties, and not because they stopped loving the work. Dawn Sears is a gastroenterologist of 25 years and the founder of GutGirlMD Consulting, where she coaches physicians and runs Women in…

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Physicians

The physician independent contractor path is a third option

Paul B. Johnson, MD

October 3, 2026Oct 3, 2026

For much of my medical training, I assumed there were two basic career paths for physicians. You could become an employed physician, trading some autonomy for stability and institutional support. Or you could own a practice, accepting the administrative and…

I ultimately chose neither.

For approximately a decade, I have built my clinical career primarily as an independent contractor. As an …

Education

Should medical student research be banned?

Joshua P. Parreco, MD

October 3, 2026Oct 3, 2026

I run student and resident research projects as a trauma surgeon. For years the emails trickled in. This year they do not. Students arrive with a question and a draft and ask to be put on a paper. Large language models made literature searches, coding, chart review, and a first manuscript cheaper. They noticed.

On August 20, Will Flanary, better known as Dr. Glaucomflecken, titled a podcast episode “Medical Student …

Policy

3 ways communities can ease the loneliness epidemic

Tista S. Ghosh, MD, MPH

October 3, 2026Oct 3, 2026

Imagine if we only treated lung cancer and never tackled smoking. Is that what we're doing with depression? We always ask people struggling with depression to reach out. But maybe we should also ask whether anyone is within reach. Every…

Imagine if we only treated lung cancer and never tackled smoking. Is that what we’re doing with depression? We always ask people struggling with depression to reach out. But maybe we should also ask whether anyone is within reach.

Every October, Depression Awareness Month urges us to recognize the symptoms and seek help. As a physician, I support that message. As a public health and preventive medicine practitioner, I also ask …

Physicians

Dual-physician couples don’t need work-life balance

Dr. Saulat Sajjad Sheikh & Inna Massaro, DO, MMM

October 3, 2026Oct 3, 2026

We get asked this all the time: "How do you do it? How do you raise kids, manage a household, remember that someone needs poster board for school tomorrow, get everyone to practice, and somehow sustain two demanding physician careers?"…

We get asked this all the time: “How do you do it? How do you raise kids, manage a household, remember that someone needs poster board for school tomorrow, get everyone to practice, and somehow sustain two demanding physician careers?” The answer is: not gracefully. We have calendars. We have systems. We have childcare. We outsource things. We occasionally feed our children cereal for dinner, and somewhere, at almost all …

Finance

The 457(b) plan risks physicians sign without knowing

Mike Chando, MBA

October 3, 2026Oct 3, 2026

On a Tuesday evening, Dr. Anna Reyes is offered a partnership in an independent group across town. Accepting means leaving the nonprofit health system that employs her, and the buy-in requires capital within the year. Anna is hypothetical. That night,…

That night, she opens the statement for the 457(b) deferred compensation plan she has funded for eight years. The balance is about $500,000. She wants to know how much of it she can …

Policy

The developmental pediatrician shortage is about to deepen

Ronald L. Lindsay, MD

October 3, 2026Oct 3, 2026

A recent Guardian article described a troubling reality unfolding across England: Nearly 1 million people are waiting for ADHD assessments, approximately 295,000 are awaiting autism evaluations, and some National Health Service (NHS) regions have imposed minimum waiting periods of two years before patients can even be assessed. “Two-year waiting times highlight NHS struggle with rise in ADHD and autism awareness” reported that overwhelmed health systems are struggling to keep …

Podcast

Loneliness, not weakness, is driving women out of medicine [PODCAST]

The Podcast by KevinMD

October 2, 2026Oct 2, 2026

Medical training hands you a ready-made group of friends. Then it ends, and many women physicians find themselves starting over alone in a new city. Cassie Burton Greenbaum is a pediatric critical care physician and the founder of Off Service…

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Physicians

My first year as an attending physician almost broke me

Elizabeth Rubin Ribak, MD

October 2, 2026Oct 2, 2026

I can finally write this essay almost five years out. That's how long it took me to fully heal. To process. To gain perspective. I graduated residency in June 2020 at the height of COVID. I, along with my family,…

I can finally write this essay almost five years out. That’s how long it took me to fully heal. To process. To gain perspective.

I graduated residency in June 2020 at the height of COVID. I, along with my family, including my husband, two preschoolers, a four-month-old infant, and two dogs, drove from Miami to Chicago to complete an amazing fellowship. The year was perfect, though masked, sometimes scary, and full …

Meds

Does CVS controlled substance policy put patients at risk?

Arthur Lazarus, MD, MBA

October 2, 2026Oct 2, 2026

Recently, a close friend called me in a panic. He was running dangerously low on lorazepam and asked if I could prescribe a small, bridging quantity over the weekend until his regular refill was due in a few days. As a physician, I wanted to help, but I first advised him to do what any reasonable patient would: call his pharmacy, CVS, explain the situation, and ask for a sliver …

Policy

First Nations health care: Consultation is not control

Olumuyiwa Bamgbade, MD

October 2, 2026Oct 2, 2026

Canadian health organizations invite First Nations representatives to comment on services after budgets and priorities have already taken shape. Consultation can improve a proposal, but it offers limited influence when the decisions remain elsewhere. Health equity requires First Nations to…

For physicians, governance may seem distant from the examination room. Yet governance determines whether patients …

Physicians

Are antidepressant prescriptions for teens rising too fast?

Timothy Lesaca, MD

October 2, 2026Oct 2, 2026

She is fifteen and has been taking sertraline for three weeks. Her mother asks if we can increase the dose, since the first dose didn't work quickly enough. I look at her medication list, which is already longer than mine…

She is fifteen and has been taking sertraline for three weeks. Her mother asks if we can increase the dose, since the first dose didn’t work quickly enough. I look at her medication list, which is already longer than mine was at twice her age. I find myself doing something I rarely do during a seven-minute visit: I pause.

I do not doubt the value of antidepressants. I have seen these …

Physicians

Who is liable for direct-to-consumer lab testing?

Joseph Phelan, MD

October 2, 2026Oct 2, 2026

Ever had a patient bring in a packet of test results you never ordered and countless questions on results for tests you've never even heard of? If not, prepare yourself. Direct-to-consumer (DTC) lab testing began modestly in 1977 when the…

Ever had a patient bring in a packet of test results you never ordered and countless questions on results for tests you’ve never even heard of? If not, prepare yourself.

Direct-to-consumer (DTC) lab testing began modestly in 1977 when the FDA approved at-home pregnancy tests. Over the last 50 years, it has evolved into a multi-billion-dollar industry offering hundreds of tests without a prescription. Some companies even sell panels of hundreds …

Finance

Dennis Hursh, Esq, on physician employment contracts: a KevinMD subscriber spotlight

Subscriber Spotlight by KevinMD

October 2, 2026Oct 2, 2026

Dennis Hursh, Esq is a health law attorney with more than 40 years of experience and the founder of Physician Agreements Health Law, which reviews physician employment agreements for a fixed fee. He has published 27 essays on KevinMD since…

…

Conditions

Medication for opioid addiction is the cornerstone of care

Walter S. Wightman, MD

October 2, 2026Oct 2, 2026

Addiction. The American Board of Preventive Medicine certified me as an addiction medicine specialist so how bad can the term be? My patients called themselves addicts. Heck, they called themselves junkies and fentanyl fiends. That’s not a license to stigmatize. Nor does it mean that substance use disorder patients appreciate people outside the clan calling them that. Just treat people with respect. The affliction truly is a disease, not a …

Policy

How an AI tool explained Ruan v. United States to doctors

Richard A. Lawhern, PhD

October 2, 2026Oct 2, 2026

As a health care educator with three decades of experience in research and hundreds of published papers, I have written at some length both on KevinMD and in clinical journals, concerning the dangers of artificial intelligence in medicine. I have also recently written about the profound differences between meanings of the term “Red Flag” in legal versus clinical contexts. Moreover, I have declared that predictive algorithms on …

Physicians

An expert witness got patient autonomy exactly wrong

Howard Smith, MD

October 2, 2026Oct 2, 2026

One medical expert for the plaintiff attorney is most credited for the outcome in a widely publicized obstetric malpractice case against an academic medical center. That outcome is, at most, dubious, and that medical expert is, at most, highly credentialed, holding a medical degree along with several additional advanced degrees and training as an obstetrician and as a perinatologist.

It is his opinion that the baby suffered brain damage largely because …

Tech

AI psychosis warning signs families should watch for

Nicole Drapeau Gillen

October 1, 2026Oct 1, 2026

In a recent interview with UCSF Magazine, Dr. Karthik Sarma makes a careful point about the phrase "AI psychosis." It implies chatbots cause psychosis directly, and he doesn't think the evidence supports that. He prefers "AI-associated psychosis." Heavy chatbot use,…

In a recent interview with UCSF Magazine, Dr. Karthik Sarma makes a careful point about the phrase “AI psychosis.” It implies chatbots cause psychosis directly, and he doesn’t think the evidence supports that. He prefers “AI-associated psychosis.” Heavy chatbot use, he suggests, may be a symptom of an emerging episode rather than its cause. He also says it’s unlikely that someone with no risk factors or underlying vulnerability to …

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