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Can flu shots prevent heart attacks?

Conditions

November 4, 2025

As an internist and lipidologist, I’ve spent decades parsing data on statins, ezetimibe, PCSK9 inhibitors, and the endless parade of “LDL-lowering breakthroughs.” Yet the most potent, and perhaps the most underappreciated, intervention to prevent heart attacks each winter doesn’t come from a cardiology journal or a pharmaceutical rep. It comes from your local pharmacy fridge. For years, I’ve told my patients that getting a flu shot may prevent a heart …

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Can flu shots prevent heart attacks?

The hidden cardiovascular cost of alcohol

Monzur Morshed, MD and Kaysan Morshed

Conditions

November 4, 2025

A glass of wine with dinner. A cocktail on a Friday evening. A few beers over the weekend. For many of my patients, alcohol is woven seamlessly into daily life: a social lubricant, a way to unwind, even something they’ve been told might be “heart-healthy.”

Yet, in my clinic, I see the other side. A patient who comes in with fluctuating blood pressure, convinced their readings must be wrong. Another who …

A cautionary tale about pramipexole

Anonymous

Meds

November 4, 2025

I never thought I’d be the cautionary tale.

For decades, I worked at a financial company. I’m a youth sports coach, a husband, and a father of two. I’ve spent decades coaching, mentoring players, and proudly producing high school sports telecasts. I built a life around leadership, precision, and community.

But none of that prepared me for what happened when I was prescribed pramipexole (Mirapex) to treat Parkinson’s.

The warnings were there: compulsive …

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A cautionary tale about pramipexole

What is professional inertia in medicine?

Ronald L. Lindsay, MD

Physician

November 4, 2025

I learned that in a rural exam room where four agencies circled a child with autism; and no one moved. Not the nurse. Not the case manager. Not the system. The child failed the Autism Screening Test. He was nonverbal, avoided eye contact, even with his parents, and flapped his hands while playing with toys in unusual ways. The signs were classic. The diagnosis was clear. I spoke the “A” …

A Huntington’s trial brings hope and grief

Erin Paterson

Conditions

November 4, 2025

It’s been weeks since the news broke of UniQure’s trial successfully slowing the progression of HD, and I still find myself breaking down in tears. I have been going about my life, doing the groceries, going to the gym, cleaning the house, and the tears keep coming unexpectedly. I am happy about the news, but that is not how it feels in my body. I have come to realize …

How misinformation endangers our progress against preventable diseases [PODCAST]

The Podcast by KevinMD

Podcast

November 3, 2025

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

Emergency physician Drew Remignanti discusses his article “A world without vaccines: What history teaches us about public health.” In this conversation, Drew reflects on historical lessons from smallpox, polio, and measles to …

The rise of digital therapeutics in medicine

Muhamad Aly Rifai, MD

Physician

November 3, 2025

Most people now manage pieces of their health on a phone, from steps to sleep to blood pressure cuffs that talk to the cloud. Digital therapeutics go a step further. They are not wellness trackers or meditation apps. They are medical treatments delivered by software, built on clinical evidence, cleared by regulators, and prescribed or recommended by clinicians to prevent, manage, or treat a diagnosis. That is the core idea, …

Lipoprotein(a): the hidden cardiovascular risk factor

Alexander Fohl, PharmD

Conditions

November 3, 2025

Lipoprotein(a) [Lp(a)] was, until recently, an underrecognized cardiovascular risk factor. However, extensive research over the last 15 years (including vast genome-wide association studies) has confirmed an independent, causal link between elevated lipoprotein(a) levels and atherosclerotic cardiovascular disease (ASCVD). The science has shown that, despite their small size, Lp(a) particles can have a substantial health impact, and as many as one in every five individuals worldwide has elevated levels (defined as …

Systematic neglect of mental health

Ronke Lawal

Tech

November 3, 2025

For the third time in six weeks, a 34-year-old woman sat in an emergency room, desperate for help, and for the third time, the system failed to see her. It saw her dehydration, severe enough to require IV fluids. It saw her malnutrition, with electrolyte imbalances that required correction. It saw her vision problems, concerning enough for an ophthalmologic consultation. It saw everything except the person suffering. Each time, the …

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Systematic neglect of mental health

What teen girls ask chatbots in secret

Callia Georgoulis

Conditions

November 3, 2025

Teen girls are turning to chatbots, not for homework help, but for the questions they’re too afraid to ask anyone else. Not their parents. Not their teachers. Sometimes not even their closest friends. Instead, they whisper their fears into an empty chat box late at night, hoping the words land softly somewhere.

These aren’t silly or shallow questions. They’re small windows into a generation growing up online, trying to feel safe …

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What teen girls ask chatbots in secret

Paraphimosis and diabetes: the hidden link

Shirisha Kamidi, MD

Physician

November 3, 2025

Paraphimosis is a urological emergency characterized by the inability to reduce a retracted foreskin over the glans penis, leading to vascular congestion, edema, and potential tissue necrosis. While paraphimosis can result from local trauma, poor hygiene, or iatrogenic causes, it is increasingly recognized as a clinical manifestation associated with underlying systemic disease, particularly diabetes mellitus.

Diabetes mellitus, especially when undiagnosed or poorly controlled, exerts profound effects on local tissue immunity, wound …

Silicon Valley’s primary care doctor shortage

George F. Smith, MD

Physician

November 3, 2025

Not long ago, a friend told me, “I switched insurance and can’t find a doctor who will take me.” Another said, “I left a leading integrated health plan after going on Medicare and now no one will see me.” These aren’t isolated complaints. They’ve become the new reality in an affluent U.S. region: It’s easier to buy a multimillion-dollar home than to find a new primary care doctor.

I saw this …

Why women in medicine need to lift each other up [PODCAST]

The Podcast by KevinMD

Podcast

November 2, 2025

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

Board-certified pediatrician and certified coach Jessie Mahoney discusses her article, “Why don’t women in medicine support each other?” She explores how scarcity, competition, and cultural conditioning have discouraged women physicians from advocating …

The problem with laboratory reference ranges

Larry Kaskel, MD

Conditions

November 2, 2025

Tonight, my lab quietly changed what it considers a “normal” ApoB. On Monday, my patient’s ApoB of 98 mg/dL was comfortably green. On Tuesday, that same number was flagged high, a 30-point swing in the normal range overnight. No new evidence. No new trial. No public health crisis. Just a reference-range recalibration. And with that one quiet adjustment, millions of people who went to bed “normal” may wake up “abnormal.”

Reference …

My persistent adverse reaction to an SSRI

Scott McLean

Meds

November 2, 2025

Two years ago, I took a single 20 mg dose of escitalopram. Like millions of others, I was prescribed this antidepressant with the expectation that it would help, or at worst, have mild side effects that would pass. Instead, I experienced an immediate and severe adverse reaction. What I could not have imagined then was that the symptoms would not resolve; they have persisted and, over time, have only worsened.

Since …

Why carrier screening results are complex

Oluyemisi Famuyiwa, MD

Conditions

November 2, 2025

Carrier screening has outgrown the language we still use to explain it. The rapid expansion of genetic testing has uncovered new layers of complexity in how conditions present, how results should be interpreted, and how patients experience and act on genetic information. To practice responsibly in this era of Genetic Carrier Screening 3.0, clinicians must understand not only what we are testing for, but how and why the results look …

The crisis in modern autism diagnosis

Ronald L. Lindsay, MD

Conditions

November 2, 2025

Autism was never meant to be diagnosed in 15 minutes.

The original vision, born in war-torn Vienna and postwar Baltimore, called for deep observation, multidisciplinary insight, and time. But somewhere between the ideal and the insurance code, we lost the standard.

Today, families navigate a system built for speed, not truth. And children pay the price.

The ideal vs. reality

In theory, pediatricians perform routine developmental surveillance. Screenings like the M-CHAT happen at 18 …

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The crisis in modern autism diagnosis

A poem about being seen by your doctor

Michele Luckenbaugh

Conditions

November 2, 2025

I come to you with stories
I cannot name.
They press against my chest
waiting for a moment when
it feels safe
for them to be set free.

Pain is a language
I find difficult to speak aloud,
and the silence between us
feels like a waiting room
that will never empty,
pressing in on me,
catching my breath.

Two strangers,
white walls between us,
your eyes move toward the clock,
while mine look at my folded hands
resting in my lap.

I wonder
am I just a time …

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A poem about being seen by your doctor

A doctor’s cure for imposter syndrome

Noah V. Fiala, DO

Physician

November 2, 2025

Picture this: It’s your second month of residency, and you’re deep into a hectic ED shift. The pressure is on; you’re managing patients, making decisions, and trying to get better. Then, a mistake happens. Not one that results in significant harm to the patient, but maybe you miss a diagnosis, fumble a procedure, or are just overwhelmed in general. You know failure is part of growth, but that doesn’t make …

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A doctor’s cure for imposter syndrome

Why humanity matters in medicine [PODCAST]

The Podcast by KevinMD

Podcast

November 1, 2025

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

Certified coach and professor Kathleen Muldoon discusses her article, “The humanity we bring: a call to hold space in medicine.” She shares how her experience as a mother in the neonatal intensive …

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