Emergency physicians, nurses, and residents writing on KevinMD from the emergency department: acute care, the realities of the ER, boarding and overcrowding, violence against staff, and medicine practiced under pressure. Most contributors work in emergency departments. For what emergency physicians and nurses have said about being assaulted at work and told it was part of the job, see Violence against health care workers: what physicians and nurses say, in their own words. For what emergency physicians wrote in the first weeks and months of the pandemic, see COVID-19: what physicians wrote as it happened. For what emergency physicians and pain patients have said about opioid prescribing, see Opioids: what physicians and pain patients say, in their own words. For what physicians in the highest-burnout specialty have said about burnout since 2009, see Physician burnout: what physicians say, in their own words.

Treating prisoners in the emergency room without losing me

Physician
June 28, 2026

Working as an emergency medicine physician, I come into contact with people on the wrong side of the law regularly. We evaluate local inmates for a variety of complaints such as chest pain, sports injuries, falls, seizures, etc. We also get a number of patients from the back of police cars and the city jail holding center. These come in as requiring “medical clearance for incarceration.” Most of the time, …

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Treating prisoners in the emergency room without losing me

How true crime is radicalizing your kids online [PODCAST]

Podcast
June 24, 2026
YouTube video

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Your child is messaging neo-Nazis on Discord, role-playing the Columbine shooting on Roblox, or making fan art of mass killers, and you have no idea. That is the pattern Matthew Turner, an emergency medicine physician at Hershey Medical Center, is now seeing …

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How true crime is radicalizing your kids online [PODCAST]

Why your ER doctor doesn’t know your medical history [PODCAST]

Podcast
June 14, 2026
YouTube video

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Your ER doctor has about 25 minutes to figure out your medical history and decide what to do next. Hamad Husainy, an emergency physician and physician executive, explains why so much of that …

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Why your ER doctor doesn’t know your medical history [PODCAST]

ED boarding fails patients before treatment begins

Conditions and Diseases
June 8, 2026

I am writing this from a hospital bed, though it took far longer than it should have to get here.

I was directly admitted by a surgical team for treatment of a post-surgical infection. The expectation in such cases is straightforward: admission to an inpatient unit for monitoring, treatment, and recovery. Instead, I spent hours in a secondary waiting room, followed by placement in a chair in a shared emergency department …

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ED boarding fails patients before treatment begins

When medicine confuses professionalism vs. compliance

Physician
June 4, 2026

Medicine changes in many ways. Some changes arrive with public debate, policy announcements, and formal declarations of progress. Others arrive more quietly, through repetition, habit, and the slow accumulation of what becomes normal. In my experience, the most consequential changes in professional life often come that second way. They are absorbed long before they are named.

We speak often of the hidden curriculum in training. Young physicians learn not only science …

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When medicine confuses professionalism vs. compliance

A nurse in the Holocaust meets an impossible order

Physician
May 29, 2026

An excerpt from The Jewish Hospital. Copyright 2026 Jonathan Hammel. Excerpted by permission of Skyhorse Publishing Inc.

Lena spotted Dr. Kreindl, who without his cigarette, seemed a bit lost. But he knew better than to light up: the Gestapo would have never tolerated such an act of freedom, coming from a Jew.

“Ah, there you are,” he said. “Listen, it’s quite simple. Most of these patients have ingested large doses of …

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A nurse in the Holocaust meets an impossible order

Mission over margin: a community ER doctor’s discipline

Physician
May 26, 2026

The May 2, 2026, New England Journal of Medicine (NEJM) Perspective, “From Mission to Margin in Academic Medicine,” articulates an internal struggle I feel frequently. All physicians recognize the formative environment Dr. Vyas describes as something that must be fiercely protected, and his call to action against the commodification of training resonates deeply. As an emergency department physician practicing outside of this setting, I recognize that when we succumb …

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Mission over margin: a community ER doctor’s discipline

Telemedicine as a career, not a side gig

Physician
May 21, 2026

We were on a call recently with a physician who told us, almost in passing, that she’d been seeing patients on a telemedicine platform for four years. She said it the way you’d mention a hobby. Then she added, before we could say anything, that of course it was just a side gig.

She’d been doing it for four years. It was her practice.

We’ve had some version of that conversation hundreds …

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Telemedicine as a career, not a side gig

Substance use screening is vital for adolescent health

Conditions and Diseases
May 16, 2026

Last year, I saw a teenager in the emergency department (ED). He was 15, and his mother brought him in after finding a vape in his backpack. She wanted him screened for substance use, but he wanted no part of it.

I asked him a few questions anyway. He gave short answers and stared at the ceiling while his mother watched from the doorway. No one in the room felt comfortable. …

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Substance use screening is vital for adolescent health

Physician depression doesn’t always look like depression

Physician
May 15, 2026

An excerpt from Lifeline: What To Do After A Mental Health Crisis.

I have spent over two decades in emergency medicine. I know what a mental health crisis looks like. I know the clinical signs, the language, the interventions. I have initiated more psychiatric holds than I can count, written discharge summaries for people leaving my ER with a handful of pamphlets and a follow-up appointment I quietly hoped they …

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Physician depression doesn’t always look like depression

Treating adolescent opioid use disorder with buprenorphine

Conditions and Diseases
May 5, 2026

I recently reviewed the case of a 17-year-old who came into the emergency department (ED) after a friend found him unresponsive at a party. He had taken what he thought was a Percocet. It was fentanyl. He survived because his friend called 911 and paramedics arrived with naloxone in time. But here is what happened next: nothing. He was observed, medically cleared, and discharged. No one offered him naloxone to …

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Treating adolescent opioid use disorder with buprenorphine

The real work starts after a mental health crisis

Physician
May 3, 2026

I have intubated people who took every pill they could find. I have told families, in bare conference rooms, that the person they brought in barely made it. I have done this across 23 years in emergency medicine, thousands of cases, in every configuration of crisis the human mind can produce, and I believed, the way physicians are trained to believe, that stabilizing the crisis was the job. That what …

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The real work starts after a mental health crisis

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When a stomach bug is actually an atypical heart attack

Conditions and Diseases
April 29, 2026

A patient arrives in the emergency department vomiting. Not once or twice, but repeatedly, leaning over the bedside basin, pale and sweating, clearly miserable. Between episodes, he tries to explain what happened. Earlier in the day he felt completely fine. Then the nausea started suddenly, followed by vomiting, cramping, and a cold sweat that made his shirt cling to his back. By the time he arrived in the emergency room, …

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When a stomach bug is actually an atypical heart attack

Trusting clinical intuition to spot an atypical heart attack

Physician
April 19, 2026

An excerpt from Those Shoes: A Physician’s Reckoning with Life, Death and the Medical Machine.

The nurse caught me before I walked in the room, “This next patient says he knows you.” I looked in the room and saw Jim, the gate guard in my neighborhood. “What’s he here for?” “Back pain,” she said, with a look I recognized. “You know what he wants.” I knew what she meant. Back …

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Trusting clinical intuition to spot an atypical heart attack

Peer-led storytelling in adolescent substance use prevention

Conditions and Diseases
April 8, 2026

Every week in the pediatric emergency department, I see the consequences of adolescent substance use that started too early and went unaddressed for too long. A teenager in crisis. A family blindsided. A window of prevention that closed long before anyone realized it was open.

We keep asking the same question: How do we reach kids before it gets to this point?

The answer, it turns out, might already be sitting in …

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Peer-led storytelling in adolescent substance use prevention

The physician-in-triage model and rapid evaluation in emergency medicine

Conditions and Diseases
April 5, 2026

Most emergency departments feel perpetually behind. The waiting room fills, ambulances stack, and staff move quickly yet still feel behind. The reflex explanation everyone gives is capacity. We need more beds, more rooms, more space. That explanation is intuitive. It is also often incomplete.

In many departments, nothing meaningful happens after triage until a patient is placed in a permanent treatment room. No bed means no provider evaluation. No provider evaluation …

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The physician-in-triage model and rapid evaluation in emergency medicine

Why hospital systems fail to notice the human behind the bill [PODCAST]

Podcast
April 3, 2026
YouTube video

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Patient advocate Eric Goldfarb discusses the article “How a pregnancy test on a male patient revealed health care flaws.” Eric shares the absurd and heartbreaking story of finding a pregnancy test charge …

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Why hospital systems fail to notice the human behind the bill [PODCAST]

Proactive monitoring can prevent emergencies by catching heart signals early [PODCAST]

Podcast
March 25, 2026
YouTube video

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Health care executive Chris Darland discusses their article “Why remote patient monitoring needs a preventive shift.” Chris explains that remote patient monitoring is currently too reactive, functioning as a safety net that …

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Proactive monitoring can prevent emergencies by catching heart signals early [PODCAST]

Health care cyberattacks expose a critical national security failure

Health Technology
March 18, 2026

Everything we know about keeping people alive under pressure we learned from war. Triage was invented on a Napoleonic battlefield. Tourniquets, hemostatic dressings, damage control resuscitation, the golden hour itself. Military surgeons figured out how to stop bleeding and move casualties while the ground was still shaking, and civilian medicine inherited every lesson. The emergency department and the battlefield have always been adjacent theaters, running the same protocols under different …

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Health care cyberattacks expose a critical national security failure

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