Ronald L. Lindsay, MD

Ronald L. Lindsay is a developmental-behavioral pediatrician.

Why developmental and behavioral pediatrics faces a recruitment collapse

Physician

December 14, 2025

For two months I have staged testimony, written op-eds, and amplified coalition voices about the collapse of developmental and behavioral pediatrics (DBP). This piece is an epilogue, a reckoning with a specialty that once held promise but now clings to aspirational posters instead of actionable reform.

The poster problem

The Society for Developmental and Behavioral Pediatrics (SDBP) recently circulated a flyer titled Critical Outcomes in DBP. Page 2 lists “Solutions” to the …

A physician’s tribute to his medical technologist wife

Ronald L. Lindsay, MD

Physician

December 12, 2025

At a northern U.S. Air Force base, it did not take long for the hospital administration to realize that the Red Cross volunteer in pediatrics (my late wife Kathy) was no ordinary civilian. With her two-year degree in medical technology and a bachelor’s in biology, plus board certification through the American Society for Clinical Pathology, Kathy quickly caught the attention of Capt. Humphries, the chief of the hospital laboratory.

Unlike most …

Why true leadership in medicine must be learned and earned

Ronald L. Lindsay, MD

Physician

December 10, 2025

I learned about leadership from my father as a child. My father enlisted in the U.S. Air Force (USAF) and went through basic training. He was a “slick sleeve,” no rank insignia on his shirt sleeve as an Airman Basic. It took him the bare minimum of time, five years, to be promoted to technical sergeant because of his skills in electronics. The USAF selected him for Officers Training School. …

Blackballing in medicine: a physician’s story

Ronald L. Lindsay, MD

Physician

December 8, 2025

Medicine remembers data but forgets voices. I learned this between 1999 and 2003, when I was quietly fired and branded as someone who had “burned too many bridges.” That label was projection, not a critique of my science. My work within the national research network remains foundational to current clinical guidelines, and my training-grant application ranked near the top of all those submitted. Yet the whisper of “bridge-burning” became the …

A pediatrician’s medical service in war and peace

Ronald L. Lindsay, MD

Physician

December 6, 2025

I was the expectant team leader at Minot, the one designated to survive “a little longer than the others” if nuclear war came. My role was not glamorous. It was a reminder that even in medicine, some of us were expendable. Years later, I was nearly sent to the First Gulf War, and I watched colleagues deployed to Afghanistan, developmental pediatricians pressed into service far from the children they were …

Institutional inbreeding in developmental-behavioral pediatrics

Ronald L. Lindsay, MD

Conditions

December 5, 2025

Developmental-behavioral pediatrics (DBP) was once defined by giants, leaders who authored textbooks, set standards, and gave the specialty a clear identity. Today, the field is fragmented, misunderstood, and too often hostile to new ideas. My own career arc illustrates how inbreeding and isolation have hollowed out DBP, leaving children without advocates and institutions without direction.

At a major military medical center, retired military DBPs replaced me. All were trained at that …

Developmental-behavioral pediatrics: the lost identity

Ronald L. Lindsay, MD

Conditions

December 3, 2025

Developmental-behavioral pediatrics (DBP) has lost its identity, and my career shows what happens when leadership retreats.

When I applied for positions in Tucson and Jacksonville, I was not seen as a developmental pediatrician with expertise in neurodevelopmental disabilities. Instead, I became the dumping ground for “Stranger Things” (children whose needs were psychiatric, not developmental). Administrators and chiefs, lacking even a basic understanding of DBP, misrouted cases into my lap. The result …

Why not all ADHD generics are created equal

Ronald L. Lindsay, MD

Conditions

November 29, 2025

A 2022 KevinMD article raised concerns about generic formulations of ADHD medications. The author described what many patients and families had already discovered: Not all generics are created equal. For those of us who lived through the substitutions, the difference was not abstract. It was a roller coaster that intruded on daily life, even on vacation.

The generic in question was manufactured by Mallinckrodt. Unlike Concerta, which uses an osmotic-controlled …

Autism prevalence surveillance: a reckoning, not a crisis

Ronald L. Lindsay, MD

Conditions

November 26, 2025

A recent Wall Street Journal graphic traces the rise in autism prevalence among eight-year-olds from 2000 to 2020. The slope is unmistakable, upward, steady, and steep. But it’s not a crisis. It’s a reckoning.

Each inflection point on that chart marks a milestone in institutional clarity:

2000: The CDC begins formal autism surveillance.
2007: The American Academy of Pediatrics urges universal screening at …
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Autism prevalence surveillance: a reckoning, not a crisis

Pediatric leadership silence on FDA ADHD recall

Ronald L. Lindsay, MD

Conditions

November 24, 2025

“The FDA has issued a nationwide recall of lisdexamfetamine capsules.”

That sentence in Newsweek magazine should have triggered alerts, guidance, and coordinated response. Instead, the silence from pediatric leadership has been deafening. Newsweek turned to the FDA and the American Academy of Family Physicians. Where are the leadership of the American Academy of Pediatrics (AAP) and the Society for Developmental and Behavioral Pediatrics? Silent. Why?

The recall that should have sparked action

In …

Did the CDC just dismantle vaccine safety clarity?

Ronald L. Lindsay, MD

Policy

November 22, 2025

“Vaccines do not cause autism.” That statement once anchored public health. The CDC just dismantled it, quietly, strategically, and dangerously.

Presumption reversed, justice subverted

Attorney Lindsey Halligan didn’t misspeak when she claimed James Comey must prove his innocence beyond a reasonable doubt to a Virginia grand jury. She exposed the new doctrine: guilt by accusation, innocence by loyalty. Then she staged a procedural ambush. She bypassed the full grand jury entirely. She …

Why we fund unproven autism therapies

Ronald L. Lindsay, MD

Physician

November 21, 2025

The average KevinMD reader may wonder why I’m so prolific in my commentary on pediatric medicine and the systemic reforms it demands. The answer is simple: I go to the source. Always.

That habit was forged nearly 30 years ago when the American Academy of Pediatrics invited me to serve as contributing section editor for Developmental-Behavioral Pediatrics in AAP Grand Rounds. My role: select key studies, critique methodology, and distill bottom-line …

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Why we fund unproven autism therapies

Interdisciplinary medicine: lessons from the cockpit

Ronald L. Lindsay, MD

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 …

Funding autism treatments that actually work

Ronald L. Lindsay, MD

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 …

Why the media ignores healing and science

Ronald L. Lindsay, MD

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 …

A new autism care model in Idaho

Ronald L. Lindsay, MD

Conditions

November 15, 2025

Idaho has become the first state to end Medicaid funding for Applied Behavior Analysis (ABA) therapy. This marks a shift away from concerns about inflated billing and variable outcome metrics toward a model focused on measurable and inclusive care. As a pediatrician who participated in NIMH-RUPP trials and has observed the clinical evolution of ABA, I recognize the significance of Idaho’s decision. The state acted proactively rather than awaiting federal …

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A new autism care model in Idaho

A pediatrician’s reckoning with behavior therapy

Ronald L. Lindsay, MD

Physician

November 7, 2025

For decades, I practiced developmental-behavioral pediatrics with a focus on coordinated care, measurable goals, and clinical accountability. I believed that if we could define a child’s needs clearly and track progress with integrity, we could build systems that honored both science and dignity.

But I now realize I missed something critical.

After reviewing the #BanABA initiative and speaking with Dr. Henny Kupferstein, I’ve come to understand the full scope of harm linked …

The collapse of developmental pediatrics

Ronald L. Lindsay, MD

Physician

November 7, 2025

The terrain I refused to leave

At Madigan Army Medical Center, I built a diagnostic model that delivered autism answers in under 30 minutes. No shortcuts, just smarter care. A Ph.D. pediatric nurse practitioner performed triage. I conducted the Screening Tool for Autism in Toddlers (STAT-MD), a targeted autism screening protocol developed at Vanderbilt, confirmed criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and families left …

What is professional inertia in medicine?

Ronald L. Lindsay, MD

Physician

November 4, 2025

I learned that in a rural exam room where four agencies circled a child with autism; and no one moved. Not the nurse. Not the case manager. Not the system. The child failed the Autism Screening Test. He was nonverbal, avoided eye contact, even with his parents, and flapped his hands while playing with toys in unusual ways. The signs were classic. The diagnosis was clear. I spoke the “A” …

The crisis in modern autism diagnosis

Ronald L. Lindsay, MD

Conditions

November 2, 2025

Autism was never meant to be diagnosed in 15 minutes.

The original vision, born in war-torn Vienna and postwar Baltimore, called for deep observation, multidisciplinary insight, and time. But somewhere between the ideal and the insurance code, we lost the standard.

Today, families navigate a system built for speed, not truth. And children pay the price.

The ideal vs. reality

In theory, pediatricians perform routine developmental surveillance. Screenings like the M-CHAT happen at 18 …

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The crisis in modern autism diagnosis