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Brian Hudes, MD

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Brian Hudes, MD

A board-certified gastroenterologist and hepatologist with more than thirty years of clinical experience.

30 articles on KevinMD · 1 podcast episode

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Articles, page 2

Physician voices

End-of-life care cost substance use: When compassion meets economic reality

At two o'clock in the morning, the emergency department doors open to a familiar story. A middle-aged man arrives with massive gastrointestinal bleeding, severe jaundice, and advanced cirrhosis from decades of alcohol use. He has no insurance, no primary care…

At two o’clock in the morning, the emergency department doors open to a familiar story. A middle-aged man arrives with massive gastrointestinal bleeding, severe jaundice, and advanced cirrhosis from decades of alcohol use. He has no insurance, no primary care provider, no stable home, and no ongoing addiction treatment. The next 10 days bring mechanical ventilation, endoscopic procedures, dialysis, and intensive care. The total bill will exceed $100,000, nearly all …

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End-of-life care cost substance use: When compassion meets economic reality

Physician voices

The gastroenterologist shortage: Why supply is falling behind demand

The story of gastroenterology in 2025 is no longer about productivity or reimbursement, it's about manpower. Hospitals and practices across the U.S. are struggling to recruit, retain, or even temporarily staff the specialists who manage digestive diseases, perform colon cancer…

The story of gastroenterology in 2025 is no longer about productivity or reimbursement, it’s about manpower. Hospitals and practices across the U.S. are struggling to recruit, retain, or even temporarily staff the specialists who manage digestive diseases, perform colon cancer screening, and handle emergency procedures like ERCP. What we’re facing isn’t simply a staffing issue; it’s a structural shortage decades in the making.

The shrinking pipeline of gastroenterologists

In the mid-1990s, roughly …

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The gastroenterologist shortage: Why supply is falling behind demand

Physician voices

Multifactorial drivers of the U.S. physician shortage: a data analysis

The United States faces a worsening physician shortage despite increases in medical school enrollment and residency growth. This article provides a comprehensive, data-driven analysis of the multifactorial forces reducing effective physician supply. These include training-pathway inflation, declining board-certification throughput, shorter…

The United States faces a worsening physician shortage despite increases in medical school enrollment and residency growth. This article provides a comprehensive, data-driven analysis of the multifactorial forces reducing effective physician supply. These include training-pathway inflation, declining board-certification throughput, shorter physician career duration, reduced reimbursement, the collapse of private practice, feminization of the workforce, declining IMG participation, and accelerating population aging. Tables and figures throughout this article illustrate how these …

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Multifactorial drivers of the U.S. physician shortage: a data analysis

Physician voices

The patchwork era of medical board certification

The phrase "board-certified" once carried a universal meaning. A physician had met rigorous training and testing standards and could practice confidently anywhere in the country. That clarity has faded. Today, certification and recertification requirements differ not only by specialty but…

The phrase “board-certified” once carried a universal meaning. A physician had met rigorous training and testing standards and could practice confidently anywhere in the country. That clarity has faded. Today, certification and recertification requirements differ not only by specialty but also by which board you happen to fall under. What was once a single national standard has splintered into a patchwork of rules, fees, and timelines that seem designed less …

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The patchwork era of medical board certification

Physician voices

Did ABIM MOC reform actually fix the problem for physicians?

The American Board of Internal Medicine (ABIM) made headlines in late 2024 when it announced the elimination of its unpopular two-year Maintenance of Certification (MOC) point requirement. On paper, this looked like progress, a gesture toward simplification after years of…

The American Board of Internal Medicine (ABIM) made headlines in late 2024 when it announced the elimination of its unpopular two-year Maintenance of Certification (MOC) point requirement. On paper, this looked like progress, a gesture toward simplification after years of criticism from physicians who felt trapped in an expensive, time-consuming cycle that added little value to their actual practice. But beneath the surface, the reform raises a harder question: Has …

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Did ABIM MOC reform actually fix the problem for physicians?

Physician voices

The U.S. gastroenterologist shortage explained

The story of gastroenterology in 2025 is no longer about productivity or reimbursement; it's about manpower. Hospitals and practices across the U.S. are struggling to recruit, retain, or even temporarily staff the specialists who manage digestive diseases, perform colon cancer…

The story of gastroenterology in 2025 is no longer about productivity or reimbursement; it’s about manpower. Hospitals and practices across the U.S. are struggling to recruit, retain, or even temporarily staff the specialists who manage digestive diseases, perform colon cancer screening, and handle emergency procedures like ERCP. What we’re facing isn’t simply a staffing issue; it’s a structural shortage decades in the making.

The shrinking pipeline of gastroenterologists

In the mid-1990s, roughly …

Read more…

The U.S. gastroenterologist shortage explained

Physician finance

Why physicians need financial independence and how to achieve it

In the modern world, physicians are respected and highly regarded for their compassion, dedication, skill, and knowledge. People value the effort physicians put into taking care of others often before taking care of themselves. While this noble profession was once…

In the modern world, physicians are respected and highly regarded for their compassion, dedication, skill, and knowledge. People value the effort physicians put into taking care of others often before taking care of themselves. While this noble profession was once lucrative, many now find it challenging to make ends meet, given falling reimbursements, lack of independence, and exorbitant student loans. Achieving financial independence is not just a personal goal; it …

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Why physicians need financial independence and how to achieve it

Physician voices

The shifting landscape of gastroenterology manpower and compensation

The field of gastroenterology in the United States has undergone a significant transformation over the past 5 to 10 years, driven by a confluence of historical changes in training programs, changing demographics among GI doctors due to the relatively new…

The field of gastroenterology in the United States has undergone a significant transformation over the past 5 to 10 years, driven by a confluence of historical changes in training programs, changing demographics among GI doctors due to the relatively new specialty of GI endoscopy, and a dwindling supply of gastroenterologists. These factors have culminated in a notable impact on gastroenterology physician salaries and have raised important questions about the …

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The shifting landscape of gastroenterology manpower and compensation

Physician voices

The core problem behind physician burnout: loss of independence

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Physician burnout and the shortage of physicians are pressing issues within the health care industry, often unnoticed by the general public until their own health is at stake. The erosion of the title "doctor" and the increasing encroachment on physician…

Physician burnout and the shortage of physicians are pressing issues within the health care industry, often unnoticed by the general public until their own health is at stake. The erosion of the title “doctor” and the increasing encroachment on physician authority have contributed significantly to this problem. Physicians have allowed the interference of the federal government, burdensome regulations, and insurance company restrictions to impede their ability to provide quality care. …

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The core problem behind physician burnout: loss of independence

Physician voices

The case for eliminating recertification by the ABIM

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The American Board of Internal Medicine (ABIM) has long been responsible for setting standards and ensuring the competence of internal medicine practitioners. However, the practice of mandatory recertification has faced increasing scrutiny and debate within the medical community. This article…

The American Board of Internal Medicine (ABIM) has long been responsible for setting standards and ensuring the competence of internal medicine practitioners. However, the practice of mandatory recertification has faced increasing scrutiny and debate within the medical community. This article explores some of the key reasons why eliminating recertification requirements imposed by the ABIM could have significant benefits for physicians and patient care.

Lack of evidence for improved patient outcomes

One of …

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The case for eliminating recertification by the ABIM

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