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When GLP-1 doesn’t work, look at chronic stress

Conditions

May 15, 2026

A 59-year-old woman sat tearfully in my office today. She had spent seven weeks on tirzepatide with virtually no weight loss. “How is this possible?” she asked. “I’m eating like a saint.”

She had struggled with obesity and weight-related frustration for years. Recently divorced, grieving a death in the family, caring for a mentally ill adult daughter, working full time, sleeping poorly, and living with severe anxiety, she described her stress …

How a diversionary legal strategy harms medical malpractice

Howard Smith, MD

Physician

May 15, 2026

A set of medical malpractice cases can be presented as examples of a legal strategy that may undermine a fair trial. In Case A v. Medical Center A, a 16-year-old girl conceives in and lives in a developing country until 17 weeks of gestation and receives no prenatal care until 20 weeks of gestation, when she arrives in the United States. At that time, she is found to have chlamydia.

Other …

Medical apology laws don’t reduce malpractice lawsuits

Timothy Lesaca, MD

Physician

May 15, 2026

An apology after medical harm still matters, but perhaps not for the reasons medicine once believed.

For a long time, medicine saw apologizing after a bad outcome as risky or, at best, a way to protect oneself. Doctors were told to say as little as possible: Avoid guessing, don’t admit fault, and don’t apologize. This made sense in a legal system where lawsuits are common. But after a serious mistake, staying …

Independent physicians are missing from health care policy

Scott Tzorfas, MD

Policy

May 15, 2026

A new federal Health Care Advisory Committee has been announced to guide policy for Medicare, Medicaid, and other major health programs. Its mission is ambitious: improve outcomes, modernize care, and address the growing burden of chronic disease.

But there is a glaring omission. Not one independent, private practice physician, someone who manages chronic illness in the community every day, is represented. That is striking because at least one-quarter of all physicians …

Physicians in venture capital see what others miss

Harsha Moole, MD

Finance

May 15, 2026

Nobody in my residency program would have predicted I’d end up in venture capital. Certainly not me.

I immigrated to the United States from India with a straightforward plan: become the best physician-scientist I could and build a career in academic medicine. For the first chapter of my professional life, that’s exactly what I did. I trained in internal medicine, published over 100 peer-reviewed papers including in the New England Journal …

Why corporate medicine fails every physician-patient

Ronald L. Lindsay, MD

Physician

May 15, 2026

Physicians make the worst patients. Not because we are demanding or entitled, but because we know exactly what is happening behind the curtain. We know when a delay is avoidable. We know when a clinician is being rushed. We know when a decision is being shaped by billing codes rather than clinical judgment. And we know when a system is quietly failing us, the same system we once defended, taught, …

Continuity of care in HIV/AIDS lives in the people who stay

Gus W. Krucke, MD

Physician

May 15, 2026

There are moments in medicine when the entire architecture of modern health care reveals both its brilliance and its limitations at the same time.

Years ago, a familiar face appeared quietly in our treatment room, though diminished enough that several people did not recognize him immediately. He had once been the life of every room he entered, effortlessly social, funny, alive in the particular way some people seem born carrying light …

The tragic reality of pregnancy-associated breast cancer

Dr. Damane Zehra

Physician

May 15, 2026

This photo shows one of my patients’ children. (I am sharing the photo with the family’s consent.) Can you guess the secret behind this photo? Let me tell you about the background.

The difficult diagnosis of pregnancy-associated breast cancer

Mrs. U was in her first trimester of pregnancy when she discovered a lump in her right breast. Work-up revealed that it was a highly …

Why a rheumatologist asks every doctor to remember being six years old [PODCAST]

The Podcast by KevinMD

Podcast

May 14, 2026

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

What if the cure for physician burnout isn’t a wellness workshop but a 10-minute exercise you can do alone in a quiet room? Brian Sayers is a rheumatologist in Austin, Texas, with nearly …

Clinician peer support is a patient safety issue

Olumuyiwa Bamgbade, MD

Physician

May 14, 2026

Frontline clinicians work in a paradox. We care for others at their most vulnerable moments, yet we struggle to admit our own vulnerability. We recognize pain in patients, but we may miss it in the colleague working with us. We respond quickly to patients’ clinical deterioration, but we ignore our emotional deterioration until it becomes dangerous.

Frontline clinician suicide is not only an individual tragedy. It is also a workplace warning …

Normal labs miss what most patients are living through

Shiv K. Goel, MD

Conditions

May 14, 2026

She sat across from me, results in hand, and asked the question I have heard more times than I can count.

“If everything is normal, why do I still feel like this?”

I did not have a clean answer. Not because she was wrong to ask. Because she was right, and medicine, at that moment, had run out of language.

Her CBC was normal. Her CMP was normal. Thyroid unremarkable. Inflammatory markers unimpressive. …

Death certificate errors expose flawed medical history

Karen Glover, MD

Physician

May 14, 2026

My mother died recently. I received the death certificate. I disagree with her cause of death. The doctor who completed her worksheet did not know her well. The death certificate has a diagnosis that she never had that was handed down from her previous doctor. It omitted a long-standing, chronic disease. Why am I bothered? Because I would complete death certificates on a routine basis, for I am a hospice …

Early bone loss is missed until something breaks

Steven E. Warren, MD, DPA

Conditions

May 14, 2026

Bone loss is one of the most predictable surprises in medicine.

It is predictable because the risk factors are everywhere: menopause, aging, low muscle, low protein intake, steroid exposure, inflammatory disease, low sex hormones, diabetes, smoking, alcohol, thyroid disease, malabsorption, kidney disease, eating disorders, and medications that quietly affect bone. It is a surprise because many patients do not know there is a problem until something breaks. That is not prevention. …

Recurrent sinus infections leave damage beyond your sinuses

Franklyn R. Gergits, DO, MBA

Conditions

May 14, 2026

When a patient walks into my office after five failed antibiotic courses, the first thing that goes through my mind isn’t clinical. It’s human. I’m worried about what happened to the healthy bacteria in her nose, the protective organisms that have been defending her sinuses since the day she was born. I’m worried about her gut. And honestly, I’m worried about something bigger than both: the generations of kids and …

How gold cards can drive California pain management reform

Kayvan Haddadan, MD

Policy

May 14, 2026

Key issues in California’s health care system highlight some structural problems that hit patients, doctors, and communities hard. These aren’t abstract policy debates; they are day-to-day realities in pain management, chronic care, and everyday practice. Core issues, which were pulled from the previously published articles, include but are not limited to:

Physician exodus and shortages: High taxes, aggressive board scrutiny, and a tough environment drive doctors out of California …
Read more…

How gold cards can drive California pain management reform

Primary care crisis requires new training and skills

Justin Oldfield, MD

Physician

May 14, 2026

The primary care crisis has been well documented. Experts cite low pay, lack of respect and administrative burden, all of which have contributed to burnout and a growing shortage of primary care physicians (PCPs). But even if we solve those problems, are PCPs well-prepared to care for an increasingly older, sicker population saddled with psychiatric disease? For many PCPs practicing today, the answer is no. There are myriad reasons for …

3 reasons credentialing delays push past 90 days

GetPracticeHelp

Finance

May 14, 2026

The extra 90 days is not a rounding error

A 90-day credentialing timeline and a 180-day credentialing timeline can sound like two versions of the same problem. They are not. The second version can mean another quarter of rent, software, malpractice coverage, staff time, loan payments, marketing spend, and owner compensation before the practice can bill a major payer.

For a typical primary care startup, 90 additional days of fixed costs can …

Institutional misrepresentation harms vulnerable patients

Ann Lebeck, MD

Physician

May 14, 2026

She came back three weeks later, sicker. She had been seeing a physical therapist for her lower back pain. At her last visit she mentioned that her cough was getting worse. He said nothing, and she did not push it. She assumed if it mattered, he would have said so.

What she did not know was that she had been told she was seeing “the doctor.” Not a physical therapist. The …

Moral injury in medicine goes beyond simple burnout

Gus W. Krucke, MD

Physician

May 14, 2026

Most young physicians enter medicine with a sincere desire to help people. They expect long hours, difficult training, and personal sacrifice. What many do not expect is how profoundly the environment around them will shape not only how they practice medicine, but who they become.

Medicine teaches many things that never appear on a syllabus. A resident quickly learns which patient encounters generate complaints, portal messages, administrative scrutiny, or poor satisfaction …

Why clinical ethics and medical law demand your attention

Daniel Sokol, JD

Conditions

May 14, 2026

Most clinicians give little thought to ethics and law until something goes wrong. This is understandable. They are immersed in concrete clinical tasks, ordering tests, reading reports, examining patients, and running clinics. Ethics can feel abstract and legal rules distant from daily practice.

As an ethicist and trial attorney, I see the consequences of ethical error every week. They can harm patients, erode trust in the profession, and destroy promising careers. …

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