KevinMD.com

July 9, 2026Jul 9, 2026

Health care systems do not function on institutional design alone; they function on the invisible labor of the people moving through them. There's a kind of education you don't choose. It begins, in my case, when my son is eight…

Health care systems do not function on institutional design alone; they function on the invisible labor of the people moving through them.

There’s a kind of education you don’t choose. It begins, in my case, when my son is eight months old and continues for nearly two decades. At some point, it stops feeling like managing medical care and starts feeling like learning a second language, except the language is institutional, …

Conditions and diseases

AI is filling a gap doctors have no time for

Andrew Beck

July 9, 2026Jul 9, 2026

On a Friday afternoon, my cardiologist sent me a message through the patient portal. It read, in full: "You do have coronary atherosclerosis resulting in moderate narrowing but no major narrowing of the arteries. I unfortunately do not have a…

On a Friday afternoon, my cardiologist sent me a message through the patient portal. It read, in full: “You do have coronary atherosclerosis resulting in moderate narrowing but no major narrowing of the arteries. I unfortunately do not have a clear sense of total plaque burden based on this study. Look forward to discussing in more detail next visit.”

My next appointment was four months away.

I am 55 years old. I …

Physician voices

What epigenetics reveals about inherited trauma

Farid Sabet-Sharghi, MD

July 9, 2026Jul 9, 2026

I still remember the quiet thrill of first learning about epigenetics as an emerging field. For a long time, medical science treated the genetic code as a fixed blueprint, an unyielding, unchangeable text. Epigenetics changed that narrative. It revealed that while the underlying script of our DNA remains the same, environmental experiences act like annotations in the margins, dictating which chapters are read and which are silenced.

Finally, we had a …

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Conditions and diseases

Why patient access breaks before staffing does

Donna Harvin‑Graham, MBA

July 9, 2026Jul 9, 2026

Waiting rooms reveal more than we often acknowledge. The clock can feel louder than the conversation, and patients quietly rehearse their symptoms after weeks of waiting, hoping they will not forget something important. Clinicians enter exam rooms carrying not just…

Waiting rooms reveal more than we often acknowledge.

The clock can feel louder than the conversation, and patients quietly rehearse their symptoms after weeks of waiting, hoping they will not forget something important. Clinicians enter exam rooms carrying not just the backlog of delays but the accumulated strain of navigating a system that rarely moves in step with the care they are trying to deliver.

These moments are not rare; they are …

Conditions and diseases

Mechanism of injury is the key to proving causation

Kayvan Haddadan, MD

July 9, 2026Jul 9, 2026

As a physician trained in musculoskeletal care and neurologic deficits, and as a qualified medical evaluator (QME) and independent medical examiner (IME) dealing with personal injury accident cases and work-related incident cases, and also as an expert witness, we are dealing with establishing causation of the accident or incident to the impairment that is being claimed. This is done using biomechanics to relate the mechanism of injury to the …

Physician voices

Home-based cardiac care needs clinical-grade proof

Ben Green, MD

July 9, 2026Jul 9, 2026

For over 60 years, the hospital has been the epicenter of cardiac care. It made sense: The technology and equipment required to test, treat, and manage patients could only be found within the walls of a clinic, due to both cost and logistical complexity. For decades, the “gold standard” was tethered to the zip code of the nearest medical center.

The disruption of this model over the last five-plus years has …

Physician voices

What an ER doctor fears about in-flight emergencies

Veronica Bonales, MD

July 9, 2026Jul 9, 2026

I have been an emergency medicine physician for many years. Trauma, cardiac arrests, strokes, lacerations. I've seen them all. But sometimes I wonder how I would do in an actual emergency. I mean, I can run a trauma or cardiac…

I have been an emergency medicine physician for many years. Trauma, cardiac arrests, strokes, lacerations. I’ve seen them all. But sometimes I wonder how I would do in an actual emergency. I mean, I can run a trauma or cardiac arrest code without much problem on my own turf. Get them into the resuscitation room where I have a full team and multiple resources at my disposal. Everyone knows their …

Conditions and diseases

How addiction stigma in health care costs lives

Devika Bhushan, MD & Taylor Moss, MPH

July 9, 2026Jul 9, 2026

When Taylor's father asked a doctor for help, he did everything right: He made the appointment, showed up, and told the truth. "I need help," he said. "I think I'm struggling with addiction." But the doctor just looked at him…

When Taylor’s father asked a doctor for help, he did everything right: He made the appointment, showed up, and told the truth. “I need help,” he said. “I think I’m struggling with addiction.” But the doctor just looked at him and shrugged: “Well, what do you want me to do about that?”

The truth is, as a medical community, we dismiss substance use disorder and the people who live with it …

Physician voices

Physician recertification is a revenue model, not quality

Ronald L. Lindsay, MD

July 9, 2026Jul 9, 2026

I spent my career in developmental-behavioral pediatrics building programs, training physicians, and caring for children and families who needed clarity, steadiness, and advocacy. I stayed current because my patients deserved it, not because a board demanded proof. Long before I retired, I made a deliberate decision: I opted out of recertification in both general pediatrics and neurodevelopmental disabilities.

I stepped away for a simple reason. I no longer practiced in …

Physician voices

How to practice civility in medicine

Timothy Lesaca, MD

July 9, 2026Jul 9, 2026

"Labour to keep alive in your heart that little spark of celestial fire called conscience." - Rule 110 from Rules of Civility, copied by George Washington as a teenager The most consequential gesture in a clinic visit is sometimes the…

“Labour to keep alive in your heart that little spark of celestial fire called conscience.”
– Rule 110 from Rules of Civility, copied by George Washington as a teenager

The most consequential gesture in a clinic visit is sometimes the smallest one: a hand resting on the door handle. The visit seems over. The plan has been explained, the orders are in, and the day is already running late. Then, as you …

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How to practice civility in medicine

Conditions and diseases

Why renaming PCOS to PMOS changes how we treat it

Carrie Lam, MD

July 9, 2026Jul 9, 2026

When I read that experts had officially renamed PCOS to polyendocrine metabolic ovarian syndrome, my first reaction was not surprise. It was relief. After years of practicing medicine and six years of treating my own PCOS, someone had finally written…

Six years ago I was building my own practice from the ground up while quietly falling apart …

The Podcast by KevinMD

Why patient engagement platforms must reduce staff burden [PODCAST]

The Podcast by KevinMD

July 8, 2026Jul 8, 2026

Orthopedic surgeon Kevin J. Campbell discusses the article "Understanding Generation 2 patient engagement platforms." Kevin discusses the article through a practical distinction between first-generation patient engagement tools that increase access but also increase staff workload, and second-generation platforms designed to…

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Orthopedic surgeon Kevin J. Campbell discusses the article “Understanding Generation 2 patient engagement platforms.” Kevin discusses the article through a practical distinction between first-generation patient engagement tools that increase access but also increase staff workload, and second-generation platforms designed to answer routine patient questions without pulling every message into an …

Health technology

What telemedicine gets right that in-person care gets wrong

Viktor Simunović, MD

July 8, 2026Jul 8, 2026

A patient called at 7:45 on a Tuesday morning. She was a nurse, working nights. She had confirmed flu, her employer needed documentation within 24 hours, and the nearest GP clinic had a three-week wait for a routine appointment. Getting seen that day would have meant taking a taxi to an urgent care waiting room, feverish, and sitting next to people who didn’t need to be exposed to influenza.

She got …

Medical education

AI fabricated references threaten medical evidence

Rao M. Uppu, PhD

July 8, 2026Jul 8, 2026

Generative AI systems can create references to papers that do not exist and make them look real. In medicine, a fabricated or poorly verified reference is not simply a bibliographic error. It weakens the chain of evidence on which reviews,…

A recent article by Topaz and colleagues in The Lancet highlights an important and growing threat to scientific integrity: the increasing appearance of …

Drugs and prescribing

GLP-1 coverage cuts hit disabled patients hardest

Tom Peteet, MD, MPH, MEd

July 8, 2026Jul 8, 2026

As a physician, telling my patients "no" never gets easier. In some cases, I have good reason, such as declining to increase opioids because of the risk of side effects. In other cases, I can only gently tell patients, "The…

As a physician, telling my patients “no” never gets easier. In some cases, I have good reason, such as declining to increase opioids because of the risk of side effects. In other cases, I can only gently tell patients, “The health care system doesn’t want to pay.” In the coming months, I will be saying “no” a lot more often. As of July 1, MassHealth, the state’s Medicaid program, …

Physician voices

The difficult patient is really a difficult encounter

Devina Maya Wadhwa, MD

July 8, 2026Jul 8, 2026

There are some patients whose names change the atmosphere of a day before they have even entered the room. You see the name on your schedule and feel it immediately. It may be a glance at the clock, a slight…

There are some patients whose names change the atmosphere of a day before they have even entered the room.

You see the name on your schedule and feel it immediately. It may be a glance at the clock, a slight tightening in your chest, or the quiet hope that the visit might somehow be shorter than you remember. Every clinician knows this feeling, although few of us admit it openly.

The patient …

Physician voices

How to lighten your mental load by asking better questions

Lauren Fine, MD

July 8, 2026Jul 8, 2026

The heaviest things we carry are rarely the tasks. They are the standards we never thought to question. My morning mental routine: Who is picking the kids up? What are we having for dinner? What time do I need to…

The heaviest things we carry are rarely the tasks. They are the standards we never thought to question.

My morning mental routine: Who is picking the kids up? What are we having for dinner? What time do I need to be at work, and how much is on my plate there? What time do I need to pick the kids up in time to make dinner? Maybe we will just eat …

Physician voices

Health care burnout is a structural problem, not resilience

Paul Dranichnikov, MD, PhD

July 8, 2026Jul 8, 2026

The cold coffee cups are the least of it. They sit abandoned on desks and in reporting rooms, small monuments to interruptions, unfinished tasks, and priorities that shift by the minute. Beside them stands the inevitable glass of lukewarm water, another reminder that even the most basic needs are often postponed in the service of someone else’s urgency.

What is far more difficult to ignore are the sleepless nights. The anxiety …

The Podcast by KevinMD

Numbness after a mastectomy no one warns you about [PODCAST]

The Podcast by KevinMD

July 7, 2026Jul 7, 2026

Most women lose feeling in their chest after a mastectomy, and almost no one warns them ahead of time. Emily Hansen, a patient advocate who has spent nearly two decades in health care communication working with surgeons and breast cancer…

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Conditions and diseases

What every primary care physician should know about BasicMed

Paul Loschiavo

July 7, 2026Jul 7, 2026

Recently, I called the office of my primary care physician. I asked the person who answered the phone, "Will the doctor sign an FAA BasicMed form?" The person said, "Let me check," and returned a minute later. "She cannot. You…

Recently, I called the office of my primary care physician. I asked the person who answered the phone, “Will the doctor sign an FAA BasicMed form?” The person said, “Let me check,” and returned a minute later. “She cannot. You need to see an FAA doctor.” I tried to explain that she could, but I could not convince the desk person.

The following explains BasicMed, the Federal Aviation Administration (FAA) program …

Real physician voices, twice a week

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