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The hidden moral injury behind value-based health care

Physician

July 24, 2025

She works for a not-for-profit health system, but nothing about what she described to me felt charitable. A young physician, just a few years into her career, she’s already facing a choice that no doctor should ever have to make: protect her patients or protect the metrics that determine her employer’s paycheck.

The heart of the problem

This physician works under a value-based payment model. On paper, it sounds great: Pay doctors …

Nurse-initiated protocols for sepsis: a strategic imperative for patient care and hospital operations

Rhonda Collins, DNP, RN

Conditions

July 24, 2025

Sepsis continues to pose a serious threat to patients and a significant challenge to hospital systems. Despite advances in awareness and clinical guidelines, delays in diagnosis and treatment remain common and costly. Sepsis is the leading cause of death in U.S. hospitals and costs the U.S. health care industry $62 billion annually.

The ripple effects of sepsis extend far beyond the bedside, impacting everything from …

From rejection to resilience: a doctor’s rise through the Caribbean route

Ryan Nadelson, MD

Education

July 23, 2025

The memories are still raw: Stepping off the plane alone, unsure of what came next. Where was the campus? The car? A place to live? I didn’t know a soul. I was in a different country, surrounded by uncertainty.

There were moments I truly wondered if I’d make it. I was afraid I’d fail—that this dream might slip through my fingers. How could I study medicine on a tiny island and …

Rethinking medical gatekeeping in the age of AI

Justin Schrager, MD, MPH

Tech

July 23, 2025

The other day, I was deep in conversation with my co-founder, Aaron Patzer, reflecting on how we each approach health concerns in our personal lives. Despite my background in emergency medicine and his in tech, we had surprisingly similar medical information seeking habits: We both turn to large language models (LLMs), tap into our networks, and—when possible—avoid visiting a doctor.

What struck me wasn’t just our shared behavior, but how universal …

Why physicians struggle with caregiving and how to cope with grace

Jessie Mahoney, MD

Physician

July 23, 2025

As physicians, we are trained to care—for patients, colleagues, and our communities.

When it comes to caring for our own aging parents and ill family members, most of us find ourselves overwhelmed, overfunctioning, under-resourced, depleted, and isolated. More often than not, we find ourselves assigned the caregiving role—explicitly or implicitly—because we’re “the doctor in the family.”

We think our medical training should make caregiving easier. But the opposite is true. We know …

How molecular discoveries are transforming preeclampsia prediction and care

Thomas McElrath, MD, PhD and Kara Rood, MD

Conditions

July 23, 2025

When reviewing poor maternal health outcomes in the U.S., it is clear we cannot keep doing the same thing and expect to make pregnancy safe and healthy for all. A new approach is needed that harnesses the power of molecular advances to bring precision medicine to pregnancy health. Preeclampsia, one of the most dangerous complications in pregnancy, is a disorder of high blood pressure that has eluded the ability to …

Why agency and partnership are vital in modern health care

Alan P. Feren, MD

Physician

July 23, 2025

We often hear the phrase “practice what you preach.” As both a physician and a patient, I’ve learned that nowhere is this more important than in how we navigate health care.

Over the years, I’ve written about the importance of collaboration between physicians and patients. But as I’ve grown older and more frequently interact with the health care system, I’ve come to believe that good care rests on four essential elements:

How neuroplasticity offers hope for complex PTSD

Hannah Holmes

Conditions

July 22, 2025

“It’s not just in your head.” For people living with complex PTSD (CPTSD), these words offer more than comfort—they offer scientific truth. Trauma doesn’t just scar the mind; it reshapes the brain. But so does healing.

The hidden epidemic of CPTSD

Unlike its better-known cousin PTSD, complex PTSD often emerges from prolonged, repeated trauma—domestic abuse, childhood neglect, trafficking, emotional captivity. And while DSM-5 only nods to it, millions silently live with its …

WeightWatchers shifts to value-based care with GLP-1 strategy

Olumuyiwa Bamgbade, MD

Physician

July 22, 2025

WeightWatchers (WW) recently completed a broader financial reorganization, realigning leadership with a sharper focus on clinical innovation and women’s health, including menopause support. The reorganization includes appointing a chief medical officer to lead a more integrated, medically informed approach.

WW’s reorganization bankruptcy was driven by mounting debt and pressure from newer weight-loss therapy products, namely GLP-1 drugs like Ozempic and Wegovy. It was also impacted by a shifting landscape where traditional …

How reforming insurance, drug prices, and prevention can cut health care costs

Patrick M. O'Shaughnessy, DO, MBA

Policy

July 22, 2025

Rising costs are dominating kitchen table conversations across the country, and health care is no exception. In response, federal and state regulators have introduced a range of proposals to curb spending and improve efficiencies—some thoughtful, others deeply flawed. As a former emergency medicine physician and now a health care executive with over three decades of experience, I’ve seen what works and what doesn’t. If we’re serious about cost control, we …

New treatments for enlarged prostate offer faster relief with fewer side effects

Martina Ambardjieva, MD

Conditions

July 22, 2025

Benign prostatic hyperplasia (BPH), commonly referred to as an enlarged prostate, is a highly prevalent condition affecting millions of men as they age. While it is not cancerous, its impact on daily life can be significant, causing lower urinary tract symptoms (LUTS) such as frequent urination, weak stream, urgency, or nocturia.

Over the past decade, treatment options for BPH have expanded considerably. In addition to medications and conventional surgery, there are …

Meeting transgender patients where they are: a health care imperative

Tyler B. Evans, MD, MPH

Physician

July 22, 2025

An excerpt from Pandemics, Poverty, and Politics: Decoding the Social and Political Drivers of Pandemics from Plague to COVID-19.

Many transgender (TG) people live with the constant threat of violence. International research documented a total of over 2,000 murders of TG humans between January 2008 and April 2016.43 (These findings are likely greatly underreported.) Even more widespread is nonlethal violence against TG communities. A national U.S. study indicated that 35 …

How to break the cycle of judgment in medicine [PODCAST]

The Podcast by KevinMD

Podcast

July 21, 2025

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

Pediatrician and certified coach Jessie Mahoney discusses her article, “Why judgment is hurting doctors—and how mindfulness can heal.” She argues that the culture of medicine is steeped in judgment—from the language of …

How value-based care transforms chronic kidney disease management

Timothy Pflederer, MD

Conditions

July 21, 2025

Chronic kidney disease (CKD) affects more than 1 in 7 U.S. adults, while approximately 2 in 1,000 are living with end-stage kidney disease (ESKD)—kidney failure that is treated either with a kidney transplant or through dialysis. Today, however, there is much that can be done to prevent kidney failure if CKD is diagnosed early and comorbid conditions are well managed. Patients with CKD and ESKD have multiple complex chronic …

Why rigorous training is vital for today’s surgeons

Philip Alford, MD

Physician

July 21, 2025

Are you serious? It’s 2 a.m., and you take a patient to the OR for what you believe is a bowel obstruction or appendicitis — only to find metastatic cancer, necrotic bowel, or something equally catastrophic. The patient is unstable, anesthesia is struggling to maintain blood pressure, and you can’t simply apply a wound vac and leave the patient in the ICU. This is when your training must take over.

Since …

The hidden cost of professionalism in medical training

Hannah Wulk

Education

July 20, 2025

I sat in my pink childhood bed, my name still written in cursive above it from when I redesigned the room at seven years old, staring at the letter that shattered my dream. I had been dismissed from medical school for “professionalism” concerns. I didn’t know what came next. No roadmap. No support. Just the crushing reality that everything I had worked for was suddenly gone.

Medical education demands resilience and …

The cost of ending shadowing in medical education

Matthew Ryan, MD, PhD

Education

July 20, 2025

A faculty-wide email recently announced that shadowing in our emergency department would no longer be recognized as a valid educational activity. I wrote back asking why. The reply was brief, dismissive, and telling:

“It doesn’t pay the rent.”

That line has stuck with me—not just because it was flippant, but because it revealed something deeper about how we now view education.

Shadowing has long served as the first bridge between curiosity and calling …

Why hospital jobs are failing physicians: burnout, pay, and lost autonomy

Justin Nabity, CFP

Finance

July 20, 2025

Hospital employment was once billed as the solution to the headaches of private practice — a way to gain stability, reduce administrative burden, and focus on patient care. But for many physicians, that promise has come undone.

According to the Physicians Foundation’s 2024 report, 60 percent of physicians report frequent feelings of burnout — the highest level on record. Instead of feeling supported, many employed physicians feel …

Why so many doctors secretly feel like imposters

Ryan Nadelson, MD

Physician

July 19, 2025

One of the most important—and least discussed—truths in medicine is this:

Feeling inadequate in medicine isn’t rare. It’s everywhere—quiet, lingering, relentless.

I remember starting my outpatient practice right out of residency. I had joined a large multispecialty group filled with physicians trained at top-tier institutions. Many had been practicing for decades. They were confident. Efficient. Experienced. I was still waiting on my board scores—unsure if I was even certified yet. And yet—there …

Why telling kids to eat less and move more fails to address obesity

Callia Georgoulis

Conditions

July 19, 2025

Despite decades of public health messaging urging children to “eat less and move more,” rates of pediatric obesity continue to rise globally. In the U.S. alone, nearly 1 in 5 children and adolescents aged 2–19 years have obesity, with higher rates among those from low-income or minority backgrounds. While caloric balance is a basic principle of weight regulation, the oversimplification of obesity into a matter of willpower neglects the …

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