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The clash between defensive medicine and value-based health care

Physician

March 22, 2026

Defensive medicine grows where fear rules. Value-based health care grows where judgment, trust, and outcomes matter. That is the clash now facing many doctors. On paper, health systems say they want high-value care, better outcomes, lower waste, and patient-centered decisions. In real life, many doctors practice in an environment shaped by needless complaints, crushing legal defense costs, underfunded services, regulator overreach, and instant reputational damage through online and social media. …

Cultural humility in medicine: Why respect matters as much as science

Kelly Dórea França

Education

March 22, 2026

What does it really mean to care for someone? I asked myself that question during my first months in medical school, when I realized that medicine was not only about science or protocols. It was about people, each one carrying their own culture, beliefs, and stories. And sometimes those stories mattered as much as the diagnosis itself.

One of my earliest experiences was with a woman from a rural community who …

Why physicians get stuck in productive and numbing cycles

Diane W. Shannon, MD, MPH

Physician

March 21, 2026

I had a mini epiphany recently. I realized there are three basic categories of time:

Productive: many work tasks (but not all), completing a task at home, achieving a specific personal or professional goal.
Non-productive and enriching: sleep, physical activity, being fully present with friends and family, learning something new.
Non-productive, non-enriching, and pleasurable: Netflix bingeing, drinking another glass of wine, zoning out, going down a social media rabbit hole, …
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Why physicians get stuck in productive and numbing cycles

A resident’s first surgery: When the patient teaches the doctor

Kaylan Baban, MD, MPH

Physician

March 21, 2026

“Dr. Baban? Dr. Baban?”

His slurred voice rasps across the room, weak but insistent, cutting through chiming monitors, buzzing fluorescent lights, and the screeching pager slung next to the empty gnaw in my stomach. I freeze where I stand, one hand scratching out post-operative orders on the last emergency surgery of the day, the other midway to the nursing station phone, grasping the silenced pager. My eyes sweep over the recovery …

What world leaders can learn from diverse medical teams

Zoran Naumovski, MD

Physician

March 21, 2026

I do not watch the news anymore. I do not listen to it on the radio. I do not even read about it online. But every once in a while, I will catch myself reading an article on Google News on my iPad. I, too, fall prey to clickbait on occasion. But, for the most part, I avoid the news: local, regional, state, national, and even international. It is too …

The controversy over Maintenance of Certification for grandfathered physicians

Bernard Leo Remakus, MD

Physician

March 21, 2026

I received a lifetime certification from the American Board of Internal Medicine (ABIM) in 1983. Since then, I have not participated in any of the Board’s “Maintenance of Certification” (MOC) programs.

I have taken the continuation of my medical education seriously, and have performed more than the number of hours required for my state licensure, professional liability insurability, and AMA continuing education recognition awards. Additionally, I have taught medical students and …

Criticism stings because doctors care deeply about their work [PODCAST]

The Podcast by KevinMD

Podcast

March 20, 2026

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

Pediatrician and certified coach Jessie Mahoney discusses her article “Dealing with physician negative feedback.” Jessie validates the pain that comes with criticism, noting that it hurts not because physicians are weak, but …

Why patient-centered care transforms chronic pain management

Kayvan Haddadan, MD

Physician

March 20, 2026

The real magic in chronic pain care isn’t just the pills or the procedures, but it’s the connection between doctor and patient. When a physician shows genuine empathy and truly listens, patients feel seen, trust deepens, and outcomes improve in ways that often outshine standard treatments. Take this striking study: Among more than 1,400 people with chronic low back pain, those cared for by highly empathic doctors ended up with …

Beyond standard protocols: How translational science helps difficult IVF cases

Lina Gabriela Villar Muñoz, MD

Conditions

March 20, 2026

I have stood in that exam room more times than I care to admit, my hand lingering on the door handle, searching for a way to tell a patient that she has no viable embryos to transfer because her egg quality is poor. “Poor egg quality” is not a diagnosis but an observation, and one that leaves us uncertain whether the problem is intrinsic to the patient or a response …

Navigating your orthopedic surgery residency after Match Day

John E. Klibanoff, MD

Education

March 20, 2026

For students matching into orthopedic surgery, Match Day is both an achievement and an invitation. I matched 36 years ago. I still remember the anxiety of not knowing where on my list I would match. Orthopedic surgery was exclusive then. It still is. Recent analyses show that orthopedic surgery offered 916 residency positions across 218 programs in 2024, with a 74.3 percent match rate for U.S. allopathic seniors. That is …

Evidence-based medicine vs. clinical judgment: a medical student’s perspective

Jay Pendyala

Education

March 20, 2026

As a third-year medical student, I always carried three essentials during my emergency medicine clerkship: a stethoscope, a Celsius, and at my fingertips, MDCalc. With a few taps, I could translate uncertainty into structure: the Wells criteria for pulmonary embolism, NEXUS for cervical spine imaging, CAM for delirium, COWS for opioid withdrawal. These tools did not replace my clinical reasoning, but they scaffolded it. They allowed me to justify and …

How to manage a difficult patient and survive a high-conflict encounter

Olumuyiwa Bamgbade, MD

Physician

March 20, 2026

Every difficult patient is not dangerous. But every high-conflict encounter carries risk. Doctors like to think clinical skill will protect them: It will not. In modern practice, a physician can make a sound decision, communicate it poorly, and still walk into a complaint, a licensing problem, a lawsuit, or public reputational damage. That risk becomes even sharper in the care of chronic pain, substance misuse, insurance-driven visits, and patients whose …

How the new DOT ruling on food allergies threatens air travel safety

Lianne Mandelbaum, PT

Conditions

March 20, 2026

On March 18, 2026, the U.S. Department of Transportation issued a ruling that could make air travel less safe for millions of Americans with food allergies, by limiting a basic accommodation many rely on to prevent life-threatening exposure. Food allergies are a serious, life-threatening medical condition that remains widely misunderstood. For millions of travelers, navigating airline policies is an unpredictable challenge, where inconsistent accommodations and societal skepticism create unnecessary risk. …

The secret sauce of leadership trust in health care teams

All Levels Leadership

Physician

March 20, 2026

One of the true joys of leadership lies in building and leading an effective team. The sense of a shared vision and of all parts of the team striving in a coordinated fashion toward it is exhilarating. In contrast, we have all experienced what it is like when a team is struggling, with no common vision or shared effort. You might be wondering, “What is it that separates effective teams …

The psychology of hero worship: When admiration overrides reason

Rao M. Uppu, PhD

Conditions

March 20, 2026

Emotional contagion and crowd psychology are powerful forces that shape human behavior in large gatherings. In India, where collective identity and reverence for public figures often run deep, emotional responses within crowds may take on added intensity. This reflection draws on an incident from Tamil Nadu to illustrate how collective emotion can sometimes override proportion and common sense, with implications for community safety and well-being.

This may sound amusing today, but …

Florida health care legislation 2026: top bills to watch

Del Carter, MD

Policy

March 20, 2026

As Florida’s 2026 state legislative session reaches the halfway point, there are several health care bills up for discussion. While every session seems to have its own theme, common issues repeat themselves year after year. Here are some of the top bills involving health care in the Florida Legislature today.

AI regulation in insurance

Artificial intelligence (AI) and the concern for its regulation continues to be a hot topic. Mandatory Human Reviews …

How junk food shrinks your brain and fuels depression

Marc Arginteanu, MD

Conditions

March 20, 2026

Let us cut to the chase: Your daily dose of junk food is not just padding your waistline; it is quietly eroding the most complex organ in your body. The evidence is no longer scattered case reports or instinctive hunches. It is an ever-growing stack of human epidemiology, neuroimaging, and mechanistic biology. Ultra-processed foods (UPFs) are associated with depression, a shriveling brain, systemic inflammation (which crosses the blood-brain barrier), gut …

The 3 levels of psychiatric treatment: biological, psychosocial, moral

Mark D. Kilgus, MD, PhD and Nicolas Badre, MD

Conditions

March 19, 2026

One can consider that psychiatric treatment occurs on three levels: biological, then psychosocial, and then moral-existential. First, if needed, the psychiatrist prescribes medication to rectify biological abnormalities. Second, the therapist facilitates psychotherapy to address psychosocial problems. Third, the therapist uses the clinician-patient …

Violence against health care workers: the silence must end

Carleigh Beriont and June Zanes Garen, RN

Policy

March 19, 2026

I spent decades as a nurse, choosing a profession grounded in care, patience, science, and the belief that showing up for others matters, even on the hardest days.

In 2017, that belief was shattered when I was physically assaulted at work. I survived, but I carry the scars of that day, both visible and unseen.

I have worked hard to heal through therapy, reflection, and learning how to trust my body again. …