Anesthesiology

The hidden dangers of dental sedation and dental anesthesia in kids

Irim Salik, MD

Conditions

April 24, 2026

A healthy, 4-year-old girl was brought to the pediatric dental office for treatment of several cavities. The parents were told their child would be given medication to help her “sleep” through the procedure. Easier and quicker than going to a hospital, office-based dental sedation was presented as a safe, routine option for children.

After the sleeping medication was administered, the child grew quiet and became still. The dental work began. At …

How a hidden genetic mutation creates a severe pediatric anesthesia risk

Physician

April 6, 2026

Imagine a healthy eight-year-old boy going under general anesthesia for a routine procedure. His preanesthetic workup is unremarkable. His family history raises no flags. He receives sevoflurane, the most commonly used inhaled anesthetic in pediatric practice worldwide, and he does not wake up the same.

This is not a theoretical scenario. It has happened to families of Venezuelan ancestry on multiple continents, across multiple decades, and no one connected the dots. …

Tracheostomy communication barriers: a gap in medical training

Alyssa Lambrecht, DO

Conditions

March 15, 2026

Despite an ongoing shift in medical training across the country to enhance physician communication skills, there remains limited formal training communicating with patients who have tracheostomies. With over 100,000 tracheostomies performed every year in the United States, clinicians in every field will encounter patients who have individualized communication needs. These patients often experience isolation, depression, and anxiety due to an inability to interact and communicate with others. Clinicians can and …

The truth about ketamine: an anesthesiologist explains drug safety

Jim Ellwood, MD

Conditions

February 27, 2026

Unfortunately, we’re all too familiar with the tragic headlines:

Matthew Perry, cause of death: ketamine overdose
Michael Jackson, cause of death: propofol overdose
Prince and Tom Petty, cause of death: fentanyl overdose

We can easily conclude from these stories that ketamine, propofol, and fentanyl are inherently dangerous substances. When used irresponsibly or in the wrong hands, they are dangerous. But as an anesthesiologist, I, and many other medical professionals, use these …

Outsourcing patient contact: a solution for multilingual health care

Deepak Gupta, MD

Conditions

February 26, 2026

The fissuring of health care, along the lines of “The Fissured Workplace: Why Work Became So Bad for So Many and What Can Be Done to Improve It” by David Weil (2014), may not be entirely negative after all. Outsourcing patient contact services, perioperative or otherwise, to centralized, multilingual third-party entities with nationwide reach may be the need of the hour in an ever-evolving multilingual society seeking health care. In …

Spaced repetition in medicine: Why current apps fail clinicians

Dr. Sunakshi Bhatia

Physician

February 6, 2026

In the high-stakes world of medical education and lifelong clinical practice, there is a constant battle taking place: the struggle between the human brain and the Ebbinghaus forgetting curve.

The science of memory is settled. Dozens of studies confirm that spaced repetition consistently outperforms traditional “massed” study (cramming) for long-term retention. By reviewing a clinical concept just as it is about to slip from our neurons, we “hack” the brain into …

The risks of the single-provider dental sedation model

Rita Agarwal, MD & Sangeeta Kumaraswami, MD

Conditions

December 28, 2025

Anesthesia and sedation in dental patients has come under scrutiny in recent years, fueled in part by high-profile tragedies, such as the deaths of six-year-old Caleb in 2015, cardiologist Dr. Henry Patel in 2020, and the five media-reported deaths in 2025. These incidents serve as a stark reminder that the current landscape of dental sedation practices is fraught with inconsistencies and a lack of oversight, which can have devastating consequences …

How to manage intraoperative pain during C-section deliveries

Megan Rosenstein, MD, MBA & The Doctors Company

Conditions

December 9, 2025

A cesarean section, or C-section, is one of the most common surgeries in the United States. In 2023, 32.3 percent of live births were cesarean deliveries, while 67.7 percent were vaginal deliveries, according to the National Center for Health Statistics.

Pain during cesarean delivery under neuraxial anesthesia (regional anesthesia including spinal and epidural anesthesia) is a recognized clinical …

Understanding the deadly gaps in pediatric dental safety [PODCAST]

The Podcast by KevinMD

Podcast

November 30, 2025

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

Pediatric anesthesiologist Irim Salik discusses her article, “The hidden danger in pediatric dental offices.” Irim reveals a terrifying oversight in ambulatory pediatric dental care: children are suffering neurologic injuries or dying during …

Language doulas bridge care gaps

Deepak Gupta, MD, Kaya Chakrabortty, and Yara Ismaeil

Physician

November 28, 2025

During health care encounters with patients from diverse linguistic and cultural backgrounds, there is always a concern about information getting lost in translation between health care providers and their patients. Language and cultural concordance significantly affect the quality and effectiveness of health care delivery. Although phone-in interpreters, with or without video capabilities, are accessible online, none can match in-person interpretation. Even if high-profile political conversations have adapted to artificially intelligent …

Read more…

Language doulas bridge care gaps

Why can’t finding a doctor job be like Zillow?

Rob Anderson, MD

Finance

September 30, 2025

After seventeen years of marriage, I found myself divorced, co-parenting, and facing two of life’s most daunting transitions at once: reentering the dating world and buying a new home. The reasons were many: parenting stressors, mid-life transitions, childhood wounds, and outside influences. There was no doubt that my career as a full-time, call-taking anesthesiologist also played a role. While the brutal 24-hour calls and 80-hour weeks were mostly behind me, …

The hidden danger in pediatric dental offices

Irim Salik, MD

Physician

September 21, 2025

A dangerous truth is hidden behind the winning smiles and cartoon-adorned walls at pediatric dental offices: Children are dying or suffering from debilitating neurologic injury during routine care, and few are paying attention. This glaring oversight in ambulatory pediatric dental care is concerning not only for the potential harm to vulnerable, unknowing families but also to the medical community at large. Now more than ever, pediatric dental care is being …

How physician burnout and system reform are shaping the future of U.S. health care

Irim Salik, MD

Policy

September 18, 2025

As a young pediatric anesthesia attending, I would often roll my eyes at resident trainees who prioritized their personal needs and required mental health days. I may have even looked down upon them as lazy, weak, and lacking grit. I prided myself on my work ethic, sacrificing time with my two children and aging parents for the sake of my patients. Medicine is a calling, not just a job, I …

The high cost of gender inequity in medicine

Kolleen Dougherty, MD

Physician

September 13, 2025

Women now make up over one-third of the physician workforce and more than half of medical school graduates, yet medicine remains shaped by a deeply entrenched culture of inequity. This inequity not only harms the careers and well-being of women physicians, it also jeopardizes patient care and weakens our national health care system.

As a physician and author of the forthcoming book Doctoring While Female: The Personal and National Toll of …

Should anesthesiologists object to unnecessary procedures?

Deepak Gupta, MD

Physician

September 7, 2025

Before making the case for evolving formal fellowships for physician anesthesiologists to conscientiously and systematically object to unnecessary health care, particularly unnecessary procedures, it is worth first exploring what constitutes “necessary.” Only then can we begin to regulate what may be considered “unnecessary.” Can physician anesthesiologists lead such academic and practical regulatory efforts, even amid potential conflicts of interest inherent in their role as anesthesia care providers?

This raises several important …

How market forces fracture millennial physicians’ careers

Shannon Meron, MD

Physician

September 1, 2025

This first decade of my career as a millennial physician is starting to look as fragmented on my CV as it has felt in reality, chasing even a modicum of the stability that the physicians of my father’s generation took for granted. Meanwhile, the chaos engendered by market forces like vertical and horizontal integration across insurance and hospital systems, private-equity-backed buyouts of physician practices and surgery centers, and now just …

Could ECMO change where we die and how our organs are donated?

Deepak Gupta, MD

Conditions

August 29, 2025

The question is not where one is born, because birthplace—whether a country or continent—is never chosen by oneself, but always determined by others and the surrounding environment.

Nor is the question where one lives, because even though the place, country, or continent may seem self-chosen, it is often influenced or guided by others and external circumstances.

The real question is where one belongs, because the feeling of belonging—to a place, country, or …

Why sedation access varies by clinic and hospital

Francisco M. Torres, MD & Simon Wahba

Physician

August 9, 2025

My recent experience as a cancer patient has illuminated many things. It has shown me how our health care system is not standardized and how it sometimes makes patient care decisions based on financial incentives or convenience rather than patient preferences or best clinical practice. Take, for example, the topic of sedation.

The question of whether to sedate is common in pain management, which often involves invasive intraspinal procedures such as …

Why the physician shortage may be our last line of defense

Yuri Aronov, MD

Physician

June 2, 2025

In an age where medicine is increasingly shaped by administrators, algorithms, and corporate cost-cutting, physicians find themselves stripped of many of the economic tools that once defined their professional autonomy.

The days when physicians—especially in fields like internal medicine, pediatrics, and even general surgery—could rely on billing, collections, and the straightforward logic of fee-for-service income are largely over. Reimbursement has stagnated or declined in real terms, overhead costs rise yearly, and …

The anesthesia spectrum: Guiding patients through comfort options in oral surgery

Dexter Mattox, MD, DMD

Meds

April 30, 2025

“Will I be asleep or awake during my procedure?” This is the first question many patients ask before oral surgery. It reveals a common misconception: That anesthesia works like a light switch.

It doesn’t.

Anesthesia exists on a spectrum with multiple options that can be tailored to your specific needs, procedure type, and anxiety level.

Beyond all-or-nothing

As an oral …