Why specialist pain clinics and addiction treatment services require strong primary care

Conditions
July 13, 2025

Specialist pain clinics and addiction management services are vital in addressing some of the most complex and costly health care conditions. However, their success depends on stable and robust primary care systems. Without strong primary care as a foundation, these health care initiatives risk fragmentation, poor continuity, and low patient accountability. Stable primary care ensures timely access, coordinated care, longitudinal monitoring, and patient engagement, all essential elements for the value-based …

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Dear July intern: It’s normal to feel clueless—here’s what matters

Education
July 13, 2025

It’s July—the official new year for medicine.

You’re either a brand-new intern, wide-eyed and exhausted, equal parts proud and terrified, or maybe you’re stepping into fellowship, wondering how you’re suddenly supposed to be the expert. You’re navigating hallways you haven’t mapped yet, still figuring out whether your badge works on the north wing or the south elevator, trying to remember where you parked, and already questioning if you made a huge …

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Who gets to be well in America: Immigrant health is on the line

Policy
July 13, 2025

As lawmakers debate cuts to Medicaid and restrictions on care for undocumented immigrants, the question isn’t just what America covers—it’s who.

Proposals like the No Medicaid for Illegal Immigrants Act of 2025, and related attempts to embed its provisions in the One Big Beautiful Bill Act, aim to block federal funding for Medicaid services to undocumented families. Some state plans go further, threatening to remove children from CHIP if …

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When a medical office sublease turns into a legal nightmare

Physician
July 13, 2025

An excerpt from The Doctor is Out—Justice vs Injustice in America.

In the hug of a crisp autumn morning, with the world adorned in the warm hues of changing leaves, the seed of an idea took root within me—an idea born from the necessity of expanding my medical practice to accommodate the growing needs of my patients.

Crossing the convoluted corridors of administrative tasks and logistical considerations, I found myself confronted …

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Why the heart of medicine is more than science

Physician
July 12, 2025

Take a moment—not just to see where you are, but to remember how far you’ve come.

Through obstacles that once felt impossible.

Through stress that nearly broke you.

Through moments when the weight of it all made you question everything.

But still—you kept going.

Because medicine isn’t just a job. It’s a calling.

And here, decisions aren’t just professional—they’re life and death.

You meet people at their most vulnerable, in their most intimate realities.

There’s no room for …

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How Ukrainian doctors kept diabetes care alive during the war

Physician
July 12, 2025

When the full-scale war broke out in Ukraine, the country’s health care system was suddenly thrown into chaos. Hospitals were destroyed or severely damaged by missile attacks. Medical professionals were forced to flee, relocating to relatively safer areas in the western regions of the country. Millions of civilians became internally displaced. Amid this disruption, doctors in western Ukraine found themselves facing unprecedented challenges, trying to reorganize services and adapt rapidly …

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Why Grok 4 could be the next leap for HIPAA-compliant clinical AI

Tech
July 12, 2025

When ChatGPT burst onto the scene in late 2022, many clinicians glimpsed the future then ran smack into a wall of red tape labeled “HIPAA.” Since then, large-language models (LLMs) have matured from clever chatbots into workhorse tools that summarize admission notes, draft prior-authorization letters, and even suggest antibiotic dosing. Yet most models still sit outside the guarded perimeter of protected health information.

Grok 4, the next-generation model from xAI, could …

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How women physicians can go from burnout to thriving

Physician
July 12, 2025

I’ve been working with women physicians intensively now for six years, and I’ve noticed a few things.

The women I work with are amazing. They are altruistic and caring. They are resilient, independent, and able to put others’ needs before their own. They are smart, detail-oriented, and care about getting things right.

If you’re a patient (and we all are at some point), this is exactly what you want in your doctor. …

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What a childhood stroke taught me about the future of neurosurgery and the promise of vagus nerve stimulation

Conditions
July 12, 2025

I had a stroke at the age of five.

It was an ischemic event, rare in children, difficult to diagnose, and often missed in early stages. I experienced a sudden loss of motor function that led to a long period of rehabilitation. I spent months relearning how to walk, balance, and perform basic movements, guided by physical therapists and the steady structure of routine. I was too young to understand what …

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Beyond burnout: Understanding the triangle of exhaustion [PODCAST]

Podcast
July 11, 2025
YouTube video

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

Physician coach Nicole Perrotte and physician advocate and physical therapist Kim Downey discuss their article, “Love, empathy, and the triangle of exhaustion: Why humanity must come first.” Nicole introduces her powerful framework, …

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Facing terminal cancer as a doctor and mother

Conditions
July 11, 2025

In elementary school, my teachers always told us it was important to understand math because “you won’t always have a calculator in your pocket.” That sentiment hasn’t aged well, given that my iPhone and Alexa are always within reach. But no one said, “You better learn this because one day you’ll be teaching your own kids during a plague.” That was where the real value lay. In medical school, I …

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Online eye exams spark legal battle over health care access

Policy
July 11, 2025

Brick-and-mortar stores must deal with online competition. Even health clinics face disruption from telemedicine. Yet optometrists have special protection in South Carolina.

When a telehealth company invented a safe and effective way for doctors to renew vision prescriptions remotely, political insiders rallied in Columbia to ban the service in South Carolina. Now, nine years later, the state-sponsored favoritism could end.

The South Carolina Supreme Court, which already rejected an attempt to …

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FDA delays could end vital treatment for rare disease patients

Meds
July 11, 2025

The FDA is failing rare disease patients. I’m one of them.

I’ve been on elamipretide for three years now. It is the only treatment that has made a meaningful difference in my life with primary mitochondrial myopathy—a degenerative genetic condition that impairs how my cells convert food and oxygen into energy. Mitochondria provide over 90 percent of the energy our bodies need; when they fail, the highest-demand tissues—like muscle, brain, and …

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Pharmacists are key to expanding Medicaid access to digital therapeutics

Meds
July 11, 2025

More than 78 million Americans rely on Medicaid or CHIP for their health care. Yet many still cannot access FDA-approved digital therapeutics because their state does not include them in covered benefits.

Prescription digital therapeutics (PDTs) are software-based treatments authorized by the FDA. They are delivered through smartphones or tablets and are used to manage conditions such as substance use disorder, ADHD, diabetes, and chronic insomnia. For people who face long …

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Why ADHD in women requires a new approach [PODCAST]

Podcast
July 10, 2025
YouTube video

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

Pediatrician Arti Lal discusses her article, “Why ADHD in women is finally getting the attention it deserves.” She explores why new ADHD diagnoses nearly doubled for adult women from 2020 to 2022 …

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AI is already replacing doctors—just not how you think

Tech
July 10, 2025

When I was a young bonnie lad of just 16, I was lucky enough to score a meeting with Sandy Napel, PhD at Stanford University’s Radiological Sciences Laboratory (RSL). I demonstrated a prototype algorithm that automatically identified the position and course of arteries on CT scans. It was the first shot in a nearly decade-long academic research career that included early publications on using neural networks (the precursor to today’s …

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Why doctors must stop ignoring unintentional weight loss in patients with obesity

Conditions
July 10, 2025

When so many children and adults struggle with obesity, it’s easy to see why weight loss is often celebrated. Unfortunately, health care professionals sometimes apply those same social narratives to clinical decision-making, and the consequences can be dangerous.

I’ve developed two distinct clinical niches: metabolic dysfunction and tuberculosis. A colleague once asked me to review the chart of a patient with a history of obesity who had been admitted to an …

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Why more doctors are choosing direct care over traditional health care

Physician
July 10, 2025

Let’s start with a simple truth: Medicine is hard.

It’s hard for doctors, and it’s hard for patients. The headaches of today’s health care ecosystem—endless paperwork, shrinking appointment times, and the ever-present shadow of insurance approvals—can make it feel like the heart of medicine is slipping away.

Lost in the system

For years, I practiced in the traditional insurance-based model. I loved being a doctor, but I found myself spending more time on …

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Why hospitals are quietly capping top doctors’ pay

Conditions
July 10, 2025

Are 10 percent (or 25 percent) of all the physicians in your specialty breaking the law?

Of course not! Who would think such a thing?

Your friendly neighborhood “nonprofit” hospital, that’s who!

I have been reviewing physician employment agreements for almost 40 years, and in the last few years I have noticed a spike in the number of agreements that “cap” physician salary. A shocking number of hospital employment agreements provide that the …

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Why point-of-care ultrasound belongs in emergency department triage

Conditions
July 10, 2025

The ED is swamped with new patient arrivals. As a result, the 20-year-old who told the triage nurse he is having difficulty breathing waits an hour before his turn in the triage room. The emergency department technician hands me the ECG—sinus tachycardia—and takes the vitals.

Me: “What brings you to the emergency department today?”

Him: “I feel like I cannot breathe. It started all of a sudden at work.”

As I scroll through …

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