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Drugs and prescribing

Why drug advertising is not the public service it claims

I have authored previous articles on pharmaceutical advertisements. I noted that they used glitz to sell their products, which was not helpful to patients, especially as many new products had potentially more severe side effects than older ones and were…

I have authored previous articles on pharmaceutical advertisements. I noted that they used glitz to sell their products, which was not helpful to patients, especially as many new products had potentially more severe side effects than older ones and were not necessarily more effective. The only significant difference may be that newer products are more expensive.

Safety is a greater concern at present, as the Food and Drug Administration (FDA) has …

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Why drug advertising is not the public service it claims

Physician voices

What 40 years of technology in medicine gained and cost

I have been practicing medicine since 1985. With good fortune, I hope to continue practicing for several more years. When younger physicians ask what medicine was like when I began, I am careful not to romanticize the past. The pre-computer…

I have been practicing medicine since 1985. With good fortune, I hope to continue practicing for several more years.

When younger physicians ask what medicine was like when I began, I am careful not to romanticize the past. The pre-computer era had many shortcomings. Paper charts were often unavailable. Records were fragmented. Laboratory results could be misplaced. Communication was slower. Finding information could be frustrating. Many aspects of modern medicine are …

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What 40 years of technology in medicine gained and cost

Conditions and diseases

Active listening in medicine starts with slowing down

Medical school had trained me to move quickly; there was always another exam to prepare for, another deadline to meet, another task to attend to as I worked toward the next milestone. When I learned that I would need to…

Medical school had trained me to move quickly; there was always another exam to prepare for, another deadline to meet, another task to attend to as I worked toward the next milestone. When I learned that I would need to remediate, what initially felt like an academic setback gradually became something else: an opportunity to notice habits I had carried into both medicine and my relationships.

Without the familiar rhythm of …

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Active listening in medicine starts with slowing down

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Conditions and diseases

Oxytocin for autism is the wrong question to ask

Oxytocin is frequently reduced to an appealing but misleading nickname: the "love hormone." In reality, oxytocin is a hormone and neuropeptide involved in childbirth, lactation, attachment, stress regulation, social learning, and the brain's response to interpersonal information. Rather than simply…

Oxytocin is frequently reduced to an appealing but misleading nickname: the “love hormone.” In reality, oxytocin is a hormone and neuropeptide involved in childbirth, lactation, attachment, stress regulation, social learning, and the brain’s response to interpersonal information. Rather than simply creating trust or affection, it appears to influence which social signals receive our attention and how strongly we respond to them.

In a safe relationship, greater sensitivity to another person’s face, …

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Oxytocin for autism is the wrong question to ask

Health technology

How AI gait analysis helped me walk again after surgery

I never expected artificial intelligence to help me relearn how to walk. After an osteotomy on my left second metatarsal, something about my gait felt wrong. I had previously undergone the same surgery on my right foot, yet this recovery…

I never expected artificial intelligence to help me relearn how to walk.

After an osteotomy on my left second metatarsal, something about my gait felt wrong. I had previously undergone the same surgery on my right foot, yet this recovery was different. I could feel myself compensating on the left side, trying to match my right leg’s rhythm. I wasn’t limping exactly. In fact, I had become remarkably good at disguising …

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How AI gait analysis helped me walk again after surgery

Physician voices

The clinic closes at 5. Illness does not.

At 5 p.m., the clinic closes. The appointment schedule ends, routine messages move into the next business day's queue, and results that arrive later may wait for review. Patients are directed to an after-hours line, urgent care, or the emergency…

At 5 p.m., the clinic closes. The appointment schedule ends, routine messages move into the next business day’s queue, and results that arrive later may wait for review. Patients are directed to an after-hours line, urgent care, or the emergency department if the situation cannot wait.

Illness follows a different schedule. A medication started on Wednesday causes dizziness on Friday night. A fever rises on Saturday. Pain that was intermittent during …

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The clinic closes at 5. Illness does not.

Health policy

AI data centers are a public health crisis

There's a hum in the warm summer air in Lowell, Massachusetts. A low hum, more felt than heard. What could it be? Cicadas? A small plane overhead? Perhaps something much larger, more permanent, and more concerning to public health: an…

There’s a hum in the warm summer air in Lowell, Massachusetts. A low hum, more felt than heard. What could it be? Cicadas? A small plane overhead? Perhaps something much larger, more permanent, and more concerning to public health: an AI data center.

During the summer after my first year of medical school, I was asked by everyone back home my thoughts on AI in medicine. In those conversations, I saw …

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AI data centers are a public health crisis

Conditions and diseases

When mental health labels become part of who we are

Psychiatry occupies a place in public discourse that no other medical specialty does. Its language permeates everyday conversation, its concepts appear in film and literature, and its diagnoses are invoked casually in both social and digital spaces. No cardiologist or…

Psychiatry occupies a place in public discourse that no other medical specialty does. Its language permeates everyday conversation, its concepts appear in film and literature, and its diagnoses are invoked casually in both social and digital spaces. No cardiologist or gastroenterologist encounters anything quite comparable.

Psychiatry deals directly with the domains that define human experience: emotion, thought, behavior, and relationships. Unlike ischemia or amyloid deposition, these are not biological processes removed …

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When mental health labels become part of who we are

Conditions and diseases

Healing with compassion: Hope is a key ingredient to survival

It was all over his face. I couldn't help but notice Mr. P's unspoken disappointment in missing the target goal weight for his anticipated bariatric (weight loss) surgery, the recommended treatment for his obesity. The number on the scale this…

It was all over his face. I couldn’t help but notice Mr. P’s unspoken disappointment in missing the target goal weight for his anticipated bariatric (weight loss) surgery, the recommended treatment for his obesity. The number on the scale this day had trended slightly upward from what was documented at his last appointment. The physician was displeased at his noncompliance in picking up the medicine that was prescribed to him, …

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Healing with compassion: Hope is a key ingredient to survival

Conditions and diseases

Lead aprons carry MRSA. Most are never cleaned.

While in New Orleans last month for the 2026 AORN Global Surgical Conference and Expo, I attended a session called, "Is It Really Clean? ATP (Adenosine Triphosphate) Contamination Monitoring." The discussion got into the nitty gritty of rapid measurement of…

While in New Orleans last month for the 2026 AORN Global Surgical Conference and Expo, I attended a session called, “Is It Really Clean? ATP (Adenosine Triphosphate) Contamination Monitoring.” The discussion got into the nitty gritty of rapid measurement of cleanliness: what ATP testing is, where it is used inside a hospital, and the surfaces that fail testing most consistently. The real gem of the presentation was the list of …

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Lead aprons carry MRSA. Most are never cleaned.

Conditions and diseases

Moral injury and the cost of a parasocial society

According to a 2023 essay in the Atlantic by a Harvard happiness researcher, the term parasocial interaction has a specific origin. As the essay notes, "The term parasocial interaction was introduced in the 1950s by the social scientists Donald Horton…

According to a 2023 essay in the Atlantic by a Harvard happiness researcher, the term parasocial interaction has a specific origin. As the essay notes, “The term parasocial interaction was introduced in the 1950s by the social scientists Donald Horton and R. Richard Wohl.” In their groundbreaking 1956 paper, Horton and Wohl open with a now-familiar observation. One of the striking characteristics of the new mass media, radio, …

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Moral injury and the cost of a parasocial society

Physician voices

Women physicians die sooner. Hospitals still won’t act.

In nearly every occupation in America, women live longer than men. This is one of the most stable findings in public health, true for teachers, lawyers, engineers, retail workers, and factory workers alike. Medicine is the exception. A 2025 analysis…

In nearly every occupation in America, women live longer than men. This is one of the most stable findings in public health, true for teachers, lawyers, engineers, retail workers, and factory workers alike. Medicine is the exception.

A 2025 analysis in JAMA Internal Medicine, led by researchers at Harvard Medical School, examined more than 3.6 million deaths recorded in the National Vital Statistics System between 2020 and 2022. Physicians as a …

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Women physicians die sooner. Hospitals still won’t act.

Conditions and diseases

4 conversations that lower a patient’s dementia risk

Every day, primary care physicians speak to and counsel patients about controlling blood pressure, lowering cholesterol, maintaining a healthy weight, exercising, and getting preventative cancer screenings. Yet conversations about brain health often don't happen until patients or their families notice…

Every day, primary care physicians speak to and counsel patients about controlling blood pressure, lowering cholesterol, maintaining a healthy weight, exercising, and getting preventative cancer screenings. Yet conversations about brain health often don’t happen until patients or their families notice memory problems. Forgetfulness is often thought of as a normal part of aging, and dementia is viewed as something physicians cannot proactively address.

But prevention and risk reduction can, and should, …

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4 conversations that lower a patient’s dementia risk

Health technology

AI chatbots and suicide: what our tests found

Zane Shamblin was a 23-year-old recent graduate of Texas A&M University who died by suicide in July 2025. Shamblin had talked with ChatGPT for hours on the day of his suicide. CNN published an investigation of the case in which…

Zane Shamblin was a 23-year-old recent graduate of Texas A&M University who died by suicide in July 2025. Shamblin had talked with ChatGPT for hours on the day of his suicide. CNN published an investigation of the case in which it reviewed nearly 70 pages of chats from the day of Shamblin’s suicide and excerpts from thousands more pages of conversations from the preceding months. Shamblin had been using …

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AI chatbots and suicide: what our tests found

Medical education

Learning medicine with AI before learning to think

Artificial intelligence has been part of conversations about the future of medicine for years. As a medical student, I have heard about its potential in lectures, read about its development in health care, and watched discussions about how it may…

Artificial intelligence has been part of conversations about the future of medicine for years. As a medical student, I have heard about its potential in lectures, read about its development in health care, and watched discussions about how it may change the way physicians practice. For a long time, though, it felt like something that would arrive later, after I had already learned how to be a doctor.

Then I saw …

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Learning medicine with AI before learning to think

Conditions and diseases

A physical therapy referral needs more than a signature

One of the reasons I chose to specialize in physical medicine and rehabilitation (PM&R) was influenced by Puerto Rico's distinctive regulations governing physical therapy. At the time I trained, a physical therapy practice could not legally operate without a physiatrist's…

One of the reasons I chose to specialize in physical medicine and rehabilitation (PM&R) was influenced by Puerto Rico’s distinctive regulations governing physical therapy. At the time I trained, a physical therapy practice could not legally operate without a physiatrist’s license on file. Only a physiatrist could refer a patient to physical therapy, and only a physiatrist’s credentials permitted the clinic to function, as defined under Puerto Rico’s …

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A physical therapy referral needs more than a signature

Conditions and diseases

Treating a narcissistic patient who would not sit down

An excerpt from Behind the Couch. If you were to ask me how many patients I have seen over the years, I could only give a very rough estimate. Unless, of course, I were to dig deeply into my records.…

An excerpt from Behind the Couch.

If you were to ask me how many patients I have seen over the years, I could only give a very rough estimate. Unless, of course, I were to dig deeply into my records. But from that great mass of people, a number of patients will always remain in my memory. Some were simply more remarkable than others, more unusual, or they came with …

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Treating a narcissistic patient who would not sit down

The Podcast by KevinMD

PCOS was never just about your ovaries [PODCAST]

If you have acne, irregular periods, and trouble with your weight, the cause may not be three separate problems. It may be one condition affecting your whole body. PCOS, long called polycystic ovary syndrome, was recently proposed for renaming to…

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If you have acne, irregular periods, and trouble with your weight, the cause may not be three separate problems. It may be one condition affecting your whole body. PCOS, long called polycystic ovary syndrome, was recently proposed for renaming to reflect its hormonal and metabolic roots, and Oluyemisi “Yemi” Famuyiwa explains …

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PCOS was never just about your ovaries [PODCAST]

Drugs and prescribing

Semaglutide and cravings: what the 2026 trial changed

Patients start glucagon-like peptide-1 (GLP-1) drugs expecting to think less about food. They did not expect to think less about alcohol. The nightly drink became easier to skip. Cigarettes felt less urgent. Cannabis, gambling, or compulsive shopping sometimes lost their…

Patients start glucagon-like peptide-1 (GLP-1) drugs expecting to think less about food. They did not expect to think less about alcohol. The nightly drink became easier to skip. Cigarettes felt less urgent. Cannabis, gambling, or compulsive shopping sometimes lost their pull. As “food noise” quieted, another possibility emerged: Perhaps these drugs were turning down craving itself.

At first, these reports might have seemed like coincidences. Instead, they sparked new research. Scientists …

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Semaglutide and cravings: what the 2026 trial changed

Health policy

Gun violence prevention is a neighborhood story

Gun violence remains a significant public health and safety concern in the United States. Chicago and New York City are often referenced in national conversations about public safety. Both are highly populated and diverse cities that have histories of concentrated…

Gun violence remains a significant public health and safety concern in the United States. Chicago and New York City are often referenced in national conversations about public safety. Both are highly populated and diverse cities that have histories of concentrated gun violence, neighborhood-level inequalities, and extensive violence-prevention infrastructure.

In 2025, Chicago experienced a 34.5 percent reduction in shootings compared to the previous year. Chicago had 1,471 shooting incidents …

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Gun violence prevention is a neighborhood story

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