KevinMD.com

May 13, 2026May 13, 2026

In clinical practice, it is not uncommon for autistic patients to arrive after years of treatment with a firm conclusion: Psychiatric medications do not work for them. This belief is typically built on multiple medication trials, inconsistent benefit, and often significant side effects. But the conclusion itself may be misleading. What is often being observed is not true treatment resistance, but a mismatch between standard psychopharmacology and the neurobiology of …

Physician finance

Missed claims filing deadlines threaten patient care

Assinatha Mukantaganzwa

May 13, 2026May 13, 2026

I used to think health care finance was mostly about numbers. Then I worked inside the financial operations of a health care organization and realized how much patient care depends on systems most people never see. One experience has stayed…

A claim for care that had already been provided was sitting in a billing backlog, approaching the payer’s filing deadline. The treatment had been completed. The staff …

Physician voices

Point-of-care ultrasound transforms emergency medicine

Joshua Guttman, MD

May 13, 2026May 13, 2026

Emergency medicine is exciting, at least, that is the story we tell. It is so exciting that there are entire television (TV) shows built around it. Resuscitations, critical illness. And medical mysteries we get the first crack at solving. That is what draws people in. It is what drew me in. But the truth is, real emergency medicine does not look like television. After medical school and residency, after the …

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Physician voices

Health outcomes rely on more than just health care

Jalene Jacob, MD, MBA

May 13, 2026May 13, 2026

If the quality of health care was the only major determining factor of health outcomes, then the healthiest cities in the U.S. would simply be those with the best health care facilities. Recent national rankings of city health status, based on composite measures of health care access, food environment, physical activity, and built infrastructure, reveal a different reality. The cities that perform best are those where health is structurally …

Health policy

Medical malpractice risks persist even after saving a life

Chinmeri Nwuba

May 13, 2026May 13, 2026

It is 2:17 a.m. in a crowded emergency room. A patient is rushed in. The patient is unconscious, unstable, and rapidly deteriorating. There is no time to obtain a detailed medical history, no opportunity for a careful discussion of risks, and obviously no time to seek consent. The doctor decides to take immediate action which saves the patient’s life. Weeks pass. The same doctor is served with a lawsuit.

At first …

Conditions and diseases

Nursing violence causes silent and painful cumulative stress

Adam J. Wickett, BSN, RN

May 13, 2026May 13, 2026

There is a part of nursing we do not talk about. Not in school. Not in orientation. Not even with each other most of the time. It is the part where you learn to function in environments where violence, whether real or threatened, becomes part of the job. And over time, you start to notice something: You are not reacting to the stress the way you used to, and you …

Conditions and diseases

Aesthetic medicine needs stronger scientific evidence

Dr. Daniela Estrella

May 13, 2026May 13, 2026

There is a quiet but growing discomfort among physicians working at the intersection of clinical care and aesthetic medicine. It is not about technique. It is not about patient demand. It is about something more fundamental: the pace at which practice is evolving compared to the pace at which evidence is being produced. Over the past decade, aesthetic medicine has expanded rapidly. Procedures once considered niche are now routine, widely …

The Podcast by KevinMD

You can’t stent a capillary: Why aging starts in your smallest blood vessels [PODCAST]

The Podcast by KevinMD

May 12, 2026May 12, 2026

What if the real driver of aging isn't your mitochondria or your telomeres but the tiny capillaries you never think about? Double board-certified emergency and internal medicine physician Kenneth Ro returns to the show to make a compelling case that…

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What if the real driver of aging isn’t your mitochondria or your telomeres but the tiny capillaries you never think about? Double board-certified emergency and internal medicine physician Kenneth Ro returns to the show to make a compelling case that microvascular decline is the overlooked upstream force behind nearly every disease …

Conditions and diseases

Psychiatric polypharmacy is a reassessment failure

Carrie Friedman, NP

May 12, 2026May 12, 2026

The 72-year-old woman sitting in front of me had spent nearly a decade anxious. Not ordinary stress, not fleeting worry, but the kind of chronic physiologic anxiety that hijacks sleep, amplifies rumination, tightens the chest, and slowly shrinks a person’s world. For over eight years, she had been treated with escalating doses of bupropion, eventually reaching 450 mg daily, the maximum recommended dose. And I found myself returning to a …

Physician voices

Doctors with mental illness need our care, not silence

Michael F. Myers, MD

May 12, 2026May 12, 2026

An excerpt from Physicians With Lived Experience: How Their Stories Offer Clinical Guidance (APA Publishing, 2025). What follows is a slightly edited narrative, the story of Kieran Allen, MD. Dr. Allen is from Australia, a psychiatry resident (registrar) at the…

An excerpt from Physicians With Lived Experience: How Their Stories Offer Clinical Guidance (APA Publishing, 2025).

What follows is a slightly edited narrative, the story of Kieran Allen, MD. Dr. Allen is from Australia, a psychiatry resident (registrar) at the time of writing. Dr. Allen writes from a different perspective, that of someone with a relapsing and remitting mental illness. He focuses on this for the …

Physician voices

Primary care access is the real problem, not the system

Payam Zamani, MD

May 12, 2026May 12, 2026

Primary care is often described as broken, but that diagnosis misses the real issue. The clinical foundation remains strong. The problem lies in how access to care is designed and delivered. Primary care isn't broken; access is. People can manage…

Primary care is often described as broken, but that diagnosis misses the real issue. The clinical foundation remains strong. The problem lies in how access to care is designed and delivered.

Primary care isn’t broken; access is.

People can manage nearly every aspect of their lives instantly through technology, yet health care still relies on outdated models that require patients to wait days or even weeks for routine care. This creates frustration …

Medical education

Physician autonomy and the hidden curriculum of medicine

Gus W. Krucke, MD

May 12, 2026May 12, 2026

If you are a physician, you have likely heard the question: "What would you do?" Increasingly, the answer is shaped before you have the chance to speak. Patients assume that the physician responsible for their care is the one making…

If you are a physician, you have likely heard the question: “What would you do?” Increasingly, the answer is shaped before you have the chance to speak.

Patients assume that the physician responsible for their care is the one making the decisions. In many cases, that assumption no longer holds.

Modern health care is organized around teams, protocols, and layers of oversight that shape decisions before they reach the bedside. These structures …

Health policy

A Medicare for All alternative that keeps insurers in

Ken Terry

May 12, 2026May 12, 2026

An excerpt from Beyond Medicare For All: Cracking the Code of the Healthcare Affordability Crisis. If our goal is high-quality, comprehensive, affordable health care for all, we must make health care less profitable. If health systems and corporations continue to…

An excerpt from Beyond Medicare For All: Cracking the Code of the Healthcare Affordability Crisis.

If our goal is high-quality, comprehensive, affordable health care for all, we must make health care less profitable. If health systems and corporations continue to control health care and their main goal is profit, health costs will continue to rise faster than the ability of society to pay, regardless of any reform efforts.

On the other …

Conditions and diseases

Unexplained symptoms require deeper medical curiosity

Mercedes Fleming

May 12, 2026May 12, 2026

I am 75 years old, and I can see perfectly. My vision is 20/20. The tests are normal. The symptom is not. The disturbance is monocular, dynamic, and light-based, not structural, not degenerative in any way that current imaging captures. And yet, every day, I see the world through a veil of intrusive light that no one seems willing to investigate.

After months of medical appointments, I have learned a difficult …

Conditions and diseases

How to redesign night shift in health care

Chinyelu E. Oraedu, MD

May 12, 2026May 12, 2026

Hospitals operate around the clock. Emergencies do not pause at midnight. Sepsis progresses overnight. Stroke symptoms emerge at 3 a.m. Trauma arrives unannounced. Respiratory failure does not respect business hours. While much of the world sleeps, health care professionals continue…

Hospitals operate around the clock.

Emergencies do not pause at midnight. Sepsis progresses overnight. Stroke symptoms emerge at 3 a.m. Trauma arrives unannounced. Respiratory failure does not respect business hours. While much of the world sleeps, health care professionals continue making high-stakes decisions in ICUs, emergency departments, labor floors, hospital wards, and operating rooms across the country.

Yet there remains a conversation health care systems are still largely avoiding: What is the …

Conditions and diseases

Clinician grief is a hidden crisis in modern hospice care

Linda Ellington, RN

May 12, 2026May 12, 2026

I stood knocking at the door of my hospice patient like I did every Monday for the past eight months. A musically talented man in his early 40s was always waiting for my weekly nursing visit, more so for the aspect of socialization. He was diagnosed with colon cancer two years prior and had a colostomy bag, leaving this once vibrant, social, even handsome man a shell of what he …

Physician voices

Physician vs. provider is an ethics issue, not just style

American College of Physicians

May 12, 2026May 12, 2026

A position paper about using the term physician instead of provider? What does this have to do with biomedical ethics? I fully support calling ourselves physicians and not providers, and have been sensitive to this issue in part thanks to…

A position paper about using the term physician instead of provider? What does this have to do with biomedical ethics?

I fully support calling ourselves physicians and not providers, and have been sensitive to this issue in part thanks to American College of Physicians (ACP) President Emeritus Dr. Robert McLean’s call to action in his 2019 inaugural address. At first, I was puzzled that this became an issue for the …

Conditions and diseases

HIV care requires better patient education today

Yeralis Rodriguez Velazquez, RN

May 12, 2026May 12, 2026

There was a moment when human immunodeficiency virus (HIV) was at the center of public conversation. Campaigns were everywhere. Education was constant. Awareness was urgent. Today, that urgency feels quieter. In many ways, this shift reflects progress. Advances in treatment have transformed HIV into a manageable chronic condition. Stigma, while still present, is not as visible as it once was. Patients are living longer, fuller lives. From the outside, it …

The Podcast by KevinMD

Bolus or drip? What the DOSE trial actually showed about heart failure [PODCAST]

The Podcast by KevinMD

May 11, 2026May 11, 2026

What if one of the most common escalation strategies for acute heart failure doesn't actually improve outcomes? Internal medicine physicians Benjamin P. Geisler, Jeffrey L. Greenwald, and Kathy May Tran, editors of 50 Studies Every Hospitalist Should Know, join the…

Listen on Apple Podcasts · Spotify

Listen and followApple Podcasts Spotify YouTubeMore apps · Browse all episodes

What if one of the most common escalation strategies for acute heart failure doesn’t actually improve outcomes? Internal medicine physicians Benjamin P. Geisler, Jeffrey L. Greenwald, and Kathy May Tran, editors of 50 Studies Every Hospitalist Should Know, join the show to break down what the DOSE trial really tells us …

Physician finance

Accounts receivable days hide four billing problems

GetPracticeHelp

May 11, 2026May 11, 2026

A cash symptom can have several causes A practice owner notices the same warning signs: collections are lower than expected, the bank balance feels tighter, and the billing report shows money still sitting unpaid. The first conclusion is usually simple.…

A cash symptom can have several causes

A practice owner notices the same warning signs: collections are lower than expected, the bank balance feels tighter, and the billing report shows money still sitting unpaid. The first conclusion is usually simple. Billing is the problem.

Sometimes that is true. More often, the word “billing” is covering several different problems that require different fixes. A slow front desk, a coding issue, payer delays, denial …

Real physician voices, twice a week

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