The U.S. health care crisis: a Titanic parallel

Physician
November 19, 2025

Two years ago, Drs. Aaron Morgenstein, Corinne Sundar Rao, and Shreekant Vasudhev drew a compelling parallel between the Titanic’s tragic voyage and the looming crisis in U.S. health care. They highlighted systemic issues such as administrative egotism, outdated practices, and substandard resources, warning that without significant course corrections, the health care system was on a collision path with disaster.

Today, in 2025, the iceberg has struck, and the cracks are …

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Why psychiatrists can’t treat family members

Conditions
November 19, 2025

As a psychiatrist, I’m often asked by family or friends to “help,” to intervene in the mental struggles of a loved one, a friend, or even a distant acquaintance. It usually begins with kindness and concern: “Could you just talk to them?” or “Maybe you can prescribe something, you’d know what’s best.” What follows is always a difficult conversation, because I have to explain something that sounds incomprehensible to most …

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Interdisciplinary medicine: lessons from the cockpit

Physician
November 19, 2025

In aviation, the right seat is typically reserved for the instructor. In medicine, it’s the role of the diagnostician, the mentor, the gatekeeper. I once piloted a T-37B “Tweet” trainer from the right seat, not as a student, but as someone trusted to guide. That experience shaped how I approach clinical decision-making, interdisciplinary fluency, and the choreography of care.

During a military training program, our squad faced a simulated obstacle: an …

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Aging parents and Thanksgiving: a gentle check-in

Conditions
November 19, 2025

Thanksgiving is my favorite holiday. I love the cooking, the noise, the parade, the extra side dishes no one really has room for. Every year I tell my parents I want to “go bigger”: more food, more people, more traditions. And every year, my mother looks at me with a mix of love and exasperation and says some version of, “Can we please do a little less this year? My …

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Trauma in high-functioning adults

Conditions
November 19, 2025

A few days ago, I was speaking with a high-achieving, articulate, brilliant friend, someone always up and doing, super-expressive. During our conversation, I noticed her stumbling over her words, which was quite unusual, and her fidgety hands. She was narrating a traumatic incident that had occurred to her and how it tore her apart and made her simply give up on everything, in her words, “she was done.” Throughout the …

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How Acthar Gel became a $250,000 drug

Physician
November 19, 2025

It started with a phone call.

“Doc,” my CEO said, “do you know this doctor?”

I asked why.

“He wrote a prescription for a drug that cost $250,000 for one course.”

“You must mean $25,000,” I said.

“No,” she replied. “The insurer already paid two hundred fifty thousand dollars.”

I assumed it had to be a miracle therapy, some one-in-a-million life-saving treatment. Then she told me the name: Acthar Gel. I nearly fell out of my …

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Physician legal rights: What to do when agents knock

Physician
November 19, 2025

An excerpt from Doctor Not Guilty.

The Fifth Amendment of the United States Constitution exists for a reason. It protects you from self-incrimination. If you remember one rule from this book, hold on to this: Never talk to the police.

By “police,” I mean every investigative agent: FBI, DEA, OIG, HHS, state boards of medicine, and investigators from the attorney general’s office. Not with a lawyer. Not without one. Not ever.

Silence …

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How to succeed in your medical training

Education
November 19, 2025

The practice of medicine is fundamentally different from the study of medicine. Right now, you’re being rewarded for memorizing and test-taking. But being a good doctor is about communication, clinical judgment under uncertainty, and treating whole humans in context. The skills that get you through preclinical years aren’t the ones that make you excellent at the bedside. Start developing those now: learn to really listen, to tolerate ambiguity, and to …

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Why medical malpractice data is hidden

Physician
November 19, 2025

I learned the forbidden truth by searching “how many medical malpractice lawsuits are filed per year and how many are frivolous?” The answer is “17,000-20,000 and all are legitimate.” This answer is incongruous with seven facts.

The facts are: First, a complication causes a medical malpractice lawsuit. Some are medical errors; some are random errors-of-nature. Since an error-of-nature is not caused by negligence, a resulting lawsuit is frivolous. Second, …

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A financial vision to define your retirement [PODCAST]

Podcast
November 18, 2025
YouTube video

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

Certified financial planners Michael Lynch and Alisa Olsen discuss their article “Create your own financial vision for independence,” an excerpt from their book Taking Care of Your Future: Your Simple System for …

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AI in medical imaging: When algorithms block the view

Tech
November 18, 2025

He spent his youth memorizing lungs. That was how he learned chest X-rays, not by chasing abnormalities, but by studying thousands of perfectly normal films until his eyes could sense when something was ever so slightly wrong. “If you don’t know normal,” he would tell residents, “you’ll never understand abnormal.”

He was a chest physician, not a radiologist, yet his skill with chest imaging became legendary. At Taipei Veterans General Hospital, …

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The danger of dismantling DEI in medicine

Physician
November 18, 2025

I am a gastrointestinal medical oncologist. I am also a Black woman. When people ask me how I got here, this is the story I share. In 2011, while sitting in a medical school lecture I received an email from a classmate that read: “Open this, you should apply.” It described a program for students who are underrepresented in medicine and interested in pursuing a career in oncology. Without hesitation, …

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Female athlete urine leakage: A urologist explains

Conditions
November 18, 2025

Female athletes have redefined strength and endurance, but one common issue still hides in silence: urine leakage during training or competition.

It’s more common than most realize. In certain sports like gymnastics, trampolining, and CrossFit, the rates are particularly high. Still, many women keep silent, assuming it’s a normal side effect of being active or that nothing can be done.

As a urologist, I often meet women who are in top physical …

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Why the 4 a.m. wake-up call isn’t for everyone

Physician
November 18, 2025

I thought that’s what I had to do to be successful: Wake up at 4 a.m., get after it, hustle before the world wakes up, and join the club of high performers who swear by their pre-dawn routines. So I tried it. And I was miserable. I’m talking dragging-myself-out-of-bed, foggy-brain, counting-down-the-hours-until-I-could-go-back-to-sleep kind of miserable.

As a brand-new full-time entrepreneur, I was forcing myself into a routine that felt like punishment, all …

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Are you neurodivergent or just bored?

Meds
November 18, 2025

Do you get bored when reading a boring book? Do you struggle to concentrate when you haven’t had enough sleep? Do you have difficulty following instructions, make careless mistakes and forget to return calls? Are you sometimes the last one to “get” a joke?

You may be “suffering from” with Autism Spectrum Disorder (ASD) and are “neurodivergent” and “on the spectrum.”

Today’s ASD “neurodivergence” craze has spawned at least two lucrative and …

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Funding autism treatments that actually work

Conditions
November 18, 2025

Applied Behavior Analysis (ABA) has become the default therapy for autism in the U.S., not because it’s the most effective, but because it’s the most entrenched. Mandated by insurers, funded by Medicaid, and marketed as “medically necessary,” ABA now consumes hundreds of millions of dollars annually. But here’s the truth: ABA is unproven, ethically fraught, and fiscally unsustainable.

As a developmental-behavioral pediatrician and lead investigator for the NIH-funded RUPP trials, I …

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How to reduce unnecessary medications

Physician
November 18, 2025

The greatest challenge for all who practice geriatrics is reducing polypharmacy, the addition of medications that either provide no benefit or cause harm to seniors. Millions of seniors end up on many medications that are not helping them and could be causing side effects. Geriatricians are the experts in what we call de-prescribing, cutting down on unnecessary medications.

The key reasons seniors end up on too many medications are the following. …

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Is owning a medical practice worth the ultimate financial risk? [PODCAST]

Podcast
November 17, 2025
YouTube video

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

Certified financial planner Paul Morton discusses his article “Physician practice ownership: risks, rewards, and reality.” Paul breaks down the massive differences between an employed physician’s financial journey and that of an equity …

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Why the media ignores healing and science

Physician
November 17, 2025

I recently published a reflection on KevinMD, “A doctor’s duty on 9/11 in a small town,” a piece about clinical duty, quiet advocacy, and legacy. Boston University included it in my nomination for their Advocacy, Equity & Social Justice Alumni Award. I sent it to every major news outlet in my region. No one responded. One station asked if I’d go on camera. I agreed. Then, silence. This is …

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Why patients delay seeking care

Conditions
November 17, 2025

Every clinic has moments that stick with you. They aren’t always dramatic, but they show why some people end up suffering longer than they should. During my time working as a medical office assistant, I observed a recurring pattern that spanned across various age groups, backgrounds, and diagnoses. Patients didn’t delay care because they were careless. They delayed because the system had quietly taught them to.

One afternoon, a middle-aged woman …

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