Physicians writing on KevinMD about running a practice: staffing and overhead, the payer paperwork that arrives with every patient, ownership and consolidation, the administrators and executives who now employ most physicians, and the models physicians have built to get out from under all of it. Four maintained records draw on this archive: Primary care: what physicians say, in their own words, Direct primary care: what physicians say, in their own words, Physicians and administrators: what physicians say about who runs medicine, in their own words, and Private equity and corporate medicine: what physicians say, in their own words.

Health care investing demands thorough clinical diligence

Physician Finance
April 12, 2026

Your hospital recently adopted a new piece of technology. Maybe it was an electronic health record (EHR) module. A patient monitoring upgrade. A documentation tool. A new device in the operating room (OR). Think about what happened next. Some of your colleagues embraced it. Others resisted. The nurses figured out workarounds within a week. The information technology (IT) department sent three emails about training sessions that nobody attended. Six months …

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Health care investing demands thorough clinical diligence

Administrative burden is driving severe physician burnout

Physician
April 12, 2026

You trained for years to become a physician so you could heal people. Yet every day, you find yourself fighting the very system that is supposed to support you. A patient presents with classic symptoms warranting a specific imaging study, medication, or procedure. You know what they need. The evidence is clear. But instead of moving forward with care, you are forced into a gauntlet of prior authorizations, peer-to-peer reviews, …

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Administrative burden is driving severe physician burnout

How physician financial autonomy cures physician burnout

Physician Finance
April 11, 2026

I am going to say something that will irritate some people. A lot of physician burnout is not coming from medicine. It is coming from financial dependence. We train for more than a decade to master the human body, but many physicians cannot explain how their own money actually works. Not really. They do not know where every account is, what the portfolio actually holds, or what the total fees …

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How physician financial autonomy cures physician burnout

How patient portal message volume drives physician burnout

Conditions and Diseases
April 10, 2026

A patient sends a portal message at 9:17 p.m. on a Tuesday. “Hey, I’ve been having some chest tightness when I climb stairs. It comes and goes. Also can you refill my metformin and check if my last A1C was OK? I don’t want to come in if I don’t have to.” This message requires clinical triage. It requires chart review. It requires a decision about whether to initiate a …

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How patient portal message volume drives physician burnout

Health care startups desperately need clinical expertise

Physician Finance
April 10, 2026

Last year, a startup pitched me a device designed to improve endoscopic procedures in gastroenterology. Slick deck. Strong team. Blue-chip venture capital (VC) backing. One problem: The device added three extra steps to a workflow that gastroenterologists have spent decades optimizing for speed. Any gastrointestinal (GI) physician would have flagged this in the first five minutes. But the investors who wrote the check? None of them had ever held a …

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Health care startups desperately need clinical expertise

How expiring ACA enhanced premium tax credits hurt business

Health Policy
April 10, 2026

I’ve recently been forced to make painful and difficult choices that impact my personal life as well as my small business because this Congress has been unwilling to renew tax credits that used to significantly lower the cost of my health insurance. My husband and I are both self-employed entrepreneurs. We don’t have access to corporate health plans and the substantial cost sharing that employers typically …

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How expiring ACA enhanced premium tax credits hurt business

Redefining physician leadership and adversity after a life-changing illness

Physician
April 9, 2026

There are moments in life when the identity you have carefully built over decades is interrupted so abruptly that you are forced to ask who you are when the familiar parts no longer function the way they once did.

For physicians, identity often begins early. We learn to attach meaning to competence, endurance, reliability, and service. We become the person others call when decisions must be made, when systems feel uncertain, …

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Redefining physician leadership and adversity after a life-changing illness

Why physicians pay more in taxes and how to reclaim your income [PODCAST]

Podcast
April 8, 2026
YouTube video

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Physician and tax specialist Logan Foltz discusses the article “Physician tax strategies: Why your tax bill is so high and how to fix it.” Logan explains why the Internal Revenue Code patterns …

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Why physicians pay more in taxes and how to reclaim your income [PODCAST]

Why loving organizations are the secret to ending burnout in medicine [PODCAST]

Podcast
April 7, 2026
YouTube video

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Physician coach Apurv Gupta discusses the article “What is a loving organization?” Apurv describes his model of a loving organization as a system that designs the clinical environment to make safety and …

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Why loving organizations are the secret to ending burnout in medicine [PODCAST]

How to win peer-to-peer calls: a medical director’s guide

Physician
April 7, 2026

I review your peer-to-peer calls. Here is why you keep losing.

I sit on the other side of your peer-to-peer call.

I am a physician medical director in utilization management. When you call to overturn a denial, I am the one listening. I have taken thousands of these calls over the past decade. I can tell within the first 30 seconds whether you are going to win.

Most of you lose. Not because …

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How to win peer-to-peer calls: a medical director’s guide

The physician leadership transition: Moving beyond the exam room

Physician
April 2, 2026

An excerpt from The Leadership Prescription: How High-Performing Clinicians Become Visionary Leaders.

There I was in my habitual rhythm, seeing patients back-to-back and enjoying it. After all, seeing the patients was the fun part; the administrative burden that accompanied it was nauseating and heralded the real risk of burnout. The administrators regarded me as someone who could easily create rapport with the patients. I was the kind of physician who …

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The physician leadership transition: Moving beyond the exam room

How medical education debt drives the physician shortage

Physician Finance
March 30, 2026

I have sat in a lot of rooms where smart, well-meaning people puzzle over why American medicine keeps producing the same outcomes: Too few doctors in too many places, primary care is underfunded, and rural hospitals are consistently closing. The answer, frustrating as it is, comes down to a single systems principle: Every system is perfectly designed to get the results it gets. By that standard, we should not be …

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How medical education debt drives the physician shortage

How high taxes and the California Medical Board fuel the physician shortage

Physician
March 28, 2026

Picture this. You finish another long day caring for patients who need you. You head home exhausted but fulfilled. Then the worry creeps in. Will another complaint land on your desk tomorrow? Will your take-home pay cover the mortgage in this state? You love California. You trained here. You built your life here. Yet more and more of us are scanning job postings in Texas, Florida, or Arizona, not because …

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How high taxes and the California Medical Board fuel the physician shortage

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How to spot artificial intelligence recruiters who target candidates from LinkedIn

Physician
March 26, 2026

The rise of artificial intelligence-generated profiles means that by 2028, globally, one in four job candidates will be fake, according to research and advisory firm Gartner. Once hired, an impostor can install malware to demand a ransom from a company, steal its customer data, trade secrets, or funds. That is one side of the coin. Here is the other: the fake recruiter. I have been receiving emails from recruiters …

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How to spot artificial intelligence recruiters who target candidates from LinkedIn

Independent medical practice: Why private clinics are essential

Physician
March 24, 2026

Independent medicine is often described as nostalgic, a relic of a prior era in which physicians owned small practices and made decisions without corporate oversight. But independence is not nostalgia; it is infrastructure.

Today, nearly 75 percent of physicians in the United States are employed by hospitals, health systems, or corporate entities, according to the American Medical Association. In 2012, that number was closer to 50 percent. Private equity investment in …

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Independent medical practice: Why private clinics are essential

AI bias in healthcare: When algorithms erase Black professionals

Physician
March 23, 2026

I was trying to be cool, so I recently joined a social media challenge with a simple prompt: “Create a caricature of me and my job based on everything you know about me.”

As a hospitalist, physician executive, and burnout architect, my digital footprint is deep. I talk about systemic health care reform, the psychology of exhaustion, and the structural “blueprints” needed to …

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AI bias in healthcare: When algorithms erase Black professionals

Criticism stings because doctors care deeply about their work [PODCAST]

Podcast
March 20, 2026
YouTube video

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Pediatrician and certified coach Jessie Mahoney discusses her article “Dealing with physician negative feedback.” Jessie validates the pain that comes with criticism, noting that it hurts not because physicians are weak, but …

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Criticism stings because doctors care deeply about their work [PODCAST]

The secret sauce of leadership trust in health care teams

Physician
March 20, 2026

One of the true joys of leadership lies in building and leading an effective team. The sense of a shared vision and of all parts of the team striving in a coordinated fashion toward it is exhilarating. In contrast, we have all experienced what it is like when a team is struggling, with no common vision or shared effort. You might be wondering, “What is it that separates effective teams …

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The secret sauce of leadership trust in health care teams

Physician financial risk: Balancing capacity and tolerance

Physician Finance
March 19, 2026

It keeps us up at night. We pay thousands to hundreds of thousands of dollars a year to protect ourselves from it. Our hospitals or practices have entire departments dedicated to managing it.

It is “Risk.”

Avoiding risk is an inherent part of modern medicine. Every day, we practice CYA documentation, ensure our patients sign informed consent forms, and do everything we can to minimize the risk that someone will sue us …

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Physician financial risk: Balancing capacity and tolerance

The hidden cost of long-term care policy for family caregivers

Conditions and Diseases
March 18, 2026

Every spring, millions of families across Chinese communities around the world travel back to their hometowns for Qingming Festival, often translated as “Tomb-Sweeping Day.” It is a centuries-old tradition of honoring ancestors. Highways fill with traffic. Families gather at gravesites to clean tombstones, burn incense, and leave offerings of food. On the surface, Qingming is about remembering the dead. But in many homes, the holiday quietly exposes a different reality: …

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The hidden cost of long-term care policy for family caregivers

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