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How health care lobbying distorts the U.S. opioid crisis

Policy

April 12, 2026

KevinMD recently published a paper describing the horrible impacts of health care lobbying in the U.S. This article assesses how effective the lobbyists have been in misdirecting four key legislators on health care-related committees of the U.S. House of Representatives and Senate.

As we will shortly discover, these highly influential lawmakers have parts of their story right. They also have parts desperately wrong, in ways that are destroying American medicine …

The evolving standard of medical weight loss and obesity treatment

Howard Smith, MD

Conditions

April 12, 2026

Obesity is an epidemic. Obesity, the predispositions for obesity, and the medical consequences of obesity are a major, if not the major, contributing factors to most medical conditions that plague American society. This is true for everything, including cancers. For instance, how many people smoke in the mistaken belief that smoking controls appetite, and how many cancers have obesity as a risk factor? There are genetic …

Artificial general intelligence and the future of surgery

David Stonko, MD

Tech

April 12, 2026

It is no secret that the hyperscalers (e.g., Google Cloud, Amazon AWS, etc.) and the frontier AI labs (e.g., OpenAI, Anthropic, DeepMind) are devoting extraordinary attention, time, and capital to the AI buildout. The big four (Amazon, Google, Microsoft, Meta) have earmarked over $600 billion to this in 2026 alone. This trend has been the central theme in the equity market for the last three years or so. During this …

How an international medical graduate fought workplace retaliation

Daniela Rizzo, MD

Physician

April 12, 2026

I am sharing my experience of what I believe to be retaliation and the non-renewal of my contract at a major academic medical center in New York following my refusal to engage with inappropriate advances. As an international medical graduate who immigrated to the U.S. from Brazil at the age of three, I have devoted my life to medicine and patient care. Throughout my career, I have worked across multiple …

Unrecognized depression is a hidden crisis in medicine

Francisco M. Torres, MD

Conditions

April 11, 2026

I began my physical medicine and rehabilitation residency in 1986, during the height of the acquired immunodeficiency syndrome (AIDS) epidemic. Fear shaped every personal interaction. We were still learning how human immunodeficiency virus (HIV) spread, how to protect ourselves, and how to care for patients who were as terrified of the diagnosis as they were of the disease.

Of all the many patients I saw that year, one has particularly stayed …

How weight-loss injections are changing obesity treatment

Mani Habibi, MD

Conditions

April 11, 2026

Is science shaping the future of obesity care, or is pharmaceutical marketing now in the driver’s seat? After 15 years in bariatric surgery, I am witnessing a shift that should make us all pause. From the gold standard of laparoscopic results to the “liberal” use of new injections for runway aesthetics, we are at a crossroads. Are we truly treating a disease, or are we building a model of lifelong …

Severe note bloat is fueling dangerous physician burnout

Brian Hudes, MD

Tech

April 11, 2026

You open the chart. You start clicking. Labs here. Imaging there. Notes in four different tabs, none of them organized in any order a clinician would have chosen. Prior hospitalizations buried three levels down behind a menu that requires two clicks just to find the menu. Medication reconciliation on a screen you have to navigate to separately. Problem list in one place, active diagnoses in another, allergies somewhere a third …

Why self-care alone cannot cure systemic nursing burnout

Anonymous

Conditions

April 11, 2026

Nurses are constantly told that burnout can be prevented through self-care: rest, nutrition, mindfulness, and learning to assert healthy boundaries. I followed that advice. I asserted professional boundaries. I tried to maintain reasonable limits around my time and energy. I attempted to follow the guidance nurses are routinely given about protecting our well-being. Within one year, I was fired from three jobs. This is the contradiction at the center of …

How physician financial autonomy cures physician burnout

Tonya Kuhn, MD

Finance

April 11, 2026

I am going to say something that will irritate some people. A lot of physician burnout is not coming from medicine. It is coming from financial dependence. We train for more than a decade to master the human body, but many physicians cannot explain how their own money actually works. Not really. They do not know where every account is, what the portfolio actually holds, or what the total fees …

Safety-net dentistry restores human dignity for patients recovering from severe addiction [PODCAST]

The Podcast by KevinMD

Podcast

April 10, 2026

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

Clinical director at Franklin Park Family Dental in Dorchester and Tremont Family Dentistry in Boston, Charan Teja Bobba, discusses his article “Treating methamphetamine-associated dental disease in safety-net clinics.” Charan reflects on the …

How patient portal message volume drives physician burnout

Candice Elam, DNP

Conditions

April 10, 2026

A patient sends a portal message at 9:17 p.m. on a Tuesday. “Hey, I’ve been having some chest tightness when I climb stairs. It comes and goes. Also can you refill my metformin and check if my last A1C was OK? I don’t want to come in if I don’t have to.” This message requires clinical triage. It requires chart review. It requires a decision about whether to initiate a …

The second victim label ignores patient safety reality

Timothy Lesaca, MD

Physician

April 10, 2026

Ask any clinician about the drive home after a case goes bad and the patient outcome is tragic. It is a specific kind of heavy silence. We have all had the experience. You do not forget it. You replay the tape in your head dissecting every move, carrying a stain that does not wash off or show mercy. It owns you.

We have had a name for this for 20 years: …

How the hidden war in medicine affects young doctors

Amr Ehab, MD

Physician

April 10, 2026

An excerpt from The Hidden War in Medicine: The Fight No One Warned Us About.

We entered medicine believing something many young doctors believe. That medicine was a noble profession built on collaboration, compassion, and a shared mission: fighting disease! We had many glorious moments that make you cry tears of joy when a patient had been finally healed. From the outside, that is the image everyone sees. Doctors working …

Is HPA axis dysregulation causing your chronic insomnia?

Shiv K. Goel, MD

Conditions

April 10, 2026

Cortisol. Almost always cortisol. I say this to patients more than almost anything else. And I say it having lived it myself, years of high-output clinical work, late nights, early mornings, and the particular exhaustion of lying in bed completely depleted but unable to actually fall asleep. Tired but wired. It is a real physiological state, and it has a name: hypothalamic-pituitary-adrenal (HPA) axis dysregulation. It is not insomnia in …

The hidden risk of protein deficiency in bariatric surgery

Kevin Huffman, DO

Conditions

April 10, 2026

I have treated over 10,000 bariatric patients across my career, and if there is one issue that comes up more than almost anything else, it is protein. Specifically, patients not getting enough of it. The research confirms what I see every day in practice. Only a minority of bariatric patients reach the recommended minimum of 60 grams per day, resulting in the loss of fat-free mass rather than the …

Knee osteoarthritis demands layered pain management

Kayvan Haddadan, MD

Conditions

April 10, 2026

Knee osteoarthritis (OA) remains a leading cause of chronic pain and reduced mobility, affecting millions of adults worldwide, particularly those over age 50. As cartilage deteriorates and inflammation increases, patients often face pain, stiffness, swelling, and limitations in daily activities. Although no cure exists, a structured, escalating treatment plan can significantly alleviate symptoms, preserve function, delay disease progression, and help many individuals avoid or postpone surgery. Current guidelines from the …

Why clinical listening skills outpace artificial intelligence

Ryan Egeland, MD, PhD

Tech

April 10, 2026

In an era of unprecedented technological adoption, it feels almost unfashionable to talk about listening. Artificial intelligence is advancing at breakneck speed. Clinical decision support tools grow more sophisticated every year. And yet, in examining the results of a new national survey from Littmann Stethoscopes, I’m struck by a simple truth that every clinician recognizes, but our system increasingly obscures: The most essential diagnostic tool in medicine is still the …

Health care startups desperately need clinical expertise

Harsha Moole, MD

Finance

April 10, 2026

Last year, a startup pitched me a device designed to improve endoscopic procedures in gastroenterology. Slick deck. Strong team. Blue-chip venture capital (VC) backing. One problem: The device added three extra steps to a workflow that gastroenterologists have spent decades optimizing for speed. Any gastrointestinal (GI) physician would have flagged this in the first five minutes. But the investors who wrote the check? None of them had ever held a …

How expiring ACA enhanced premium tax credits hurt business

Kelly Berry

Policy

April 10, 2026

I’ve recently been forced to make painful and difficult choices that impact my personal life as well as my small business because this Congress has been unwilling to renew tax credits that used to significantly lower the cost of my health insurance. My husband and I are both self-employed entrepreneurs. We don’t have access to corporate health plans and the substantial cost sharing that employers typically …

The hidden clinical cost of HCC coding in primary care

Jeffrey H. Millstein, MD

Physician

April 10, 2026

I am in the exam room, leaning forward hearing my elderly patient describe weeks of worsening fatigue. Her daughter fills the gaps as her mother, hard of hearing and anxious, struggles to find the right words. Her recent lab work shows a steep drop in her blood count. We are working together to understand what is going on. As I prepare to enter orders in the electronic health record (EHR), …

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