Primary Care

Why physicians must lead payment tariff negotiations

Physician

March 18, 2026

Many physicians see fee schedules, payment rates, billing codes, and pension negotiations as administrative work best left to a few elected representatives, policy experts, or government staff. However, these physician payment tariff negotiations shape how care is delivered, how practices remain viable, how new services are recognized, and how the profession sustains itself over time. They involve fee codes, billing rules, payment rates, service descriptions, pensions, compensation models, and allocation …

Primary care compensation models: Why wRVUs are obsolete

Yul Ejnes, MD

Physician

March 18, 2026

It is time to dethrone the office visit as the king of primary care physician compensation and how the work of a primary care physician is defined.

Several months ago, a reporter asked me how many patients I see in a typical day. I told her that the question should not be how many patients I see each day, but how many patients I take care of each day, a number …

Why physicians are absorbing risk, not leading

Gus W. Krucke, MD

Physician

March 17, 2026

Physicians are often described as leaders of the health care team. The language shifts, quarterback, captain, final decision-maker, but the implication is constant: someone is clearly in charge. At the bedside, the reality feels more complicated.

In every functioning system, there is a final point of responsibility, the person who answers when outcomes are poor. In medicine, that person remains the physician. We sign the charts. We carry the malpractice risk. …

The hidden cost of ignoring public health infrastructure

Lujain Mattar

Education

March 15, 2026

Modern health care works tirelessly to treat illness and save lives, yet it often intervenes after disease has already taken hold. The system prioritizes acute treatment over prevention, despite overwhelming evidence that early intervention and public health strategies save more lives, earlier, and at far lower cost. While dramatic rescues capture attention, the quieter work that could prevent disease is often underappreciated, leaving patients and communities to face preventable health …

Overcoming dental anxiety for better oral health care

Kaushal Shah, DMD

Conditions

March 15, 2026

Dental anxiety remains one of the most common yet overlooked barriers to oral health care. Despite advances in modern dentistry (painless techniques, improved anesthetics, and patient-centered care), millions of people continue to delay or completely avoid dental visits because of fear. The consequences extend far beyond oral health; untreated dental disease can significantly affect overall health, confidence, and quality of life. For many patients, dental anxiety begins early in life. …

Dual physician marriage: stories of love and partnership in medicine

Deborah Shlian, MD, MBA and Joel Shlian, MD, MBA

Physician

March 15, 2026

An excerpt from Lessons Learned: Stories from Dual Physician Marriages, published by the American Association for Physician Leadership (AAPL), is available in print and eBook at Amazon and the AAPL bookstore.

How do two people build a strong marriage while both are practicing physicians? Medicine is demanding, and marriage can be too. Plenty has been written about how those pressures can strain relationships, but far less …

Improving tobacco treatment in clinical practice

Edward Anselm, MD

Conditions

March 14, 2026

Modern medicine can transplant organs, cure hepatitis C, and deploy artificial intelligence to read radiology scans. Yet one of the most effective life-saving interventions in clinical medicine, treatment for tobacco dependence, is still delivered inconsistently. More than 28 million Americans continue to smoke cigarettes. Evidence-based treatments are widely available, inexpensive, and highly cost-effective. But across health systems, physicians rarely deliver them in a systematic way. By every measure, physicians are …

The lost art of connection: Why medicine needs to slow down

Dean Robosa, MD

Physician

March 14, 2026

I called my old professor the other day to ask a very specific question about the Geriatric Depression Scale and expressed to him a big frustration on my end on how we are no longer able to perform such complex assessments among our patients, especially in primary care. During residency, we are taught to take thorough histories and perform physical exams by the book, but in reality, it is very …

Why “just relaxing” fails when your nervous system is stuck in survival mode [PODCAST]

The Podcast by KevinMD

Podcast

March 13, 2026

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

Occupational medicine physician and life coach Claudine Holt discusses her article “Nervous system dysregulation vs. stress: Why ‘just relaxing’ doesn’t work.” Claudine challenges the common advice to treat burnout with self-care like …

Clinical communication skills: the power of structured language

Alan P. Feren, MD

Physician

March 13, 2026

Consider a common scenario. A 65-year-old patient presents with intermittent chest discomfort present for several days and no prior history of heart disease, including among family members. The physical exam is unrevealing. An EKG and cardiac enzymes are negative. The clinician explains, “I do not see anything concerning. Given your age and symptoms, this is likely reflux. Let us have you wait three hours after eating before retiring for the …

Heat therapy activates proteins that repair cells and protect the heart [PODCAST]

The Podcast by KevinMD

Podcast

March 12, 2026

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

Hematologist-oncologist Khushali Jhaveri discusses her article “What the research really says about infrared saunas.” Khushali shares her personal journey from skepticism to advocacy after experiencing the profound physiological shifts of infrared heat …

Securing physician autonomy with employer-sponsored direct primary care

Dana Y. Lujan, MBA

Physician

March 11, 2026

I play Go. Not chess. Not checkers. Go: the ancient strategy game where the objective is not to capture pieces but to claim territory. In chess, you attack. In checkers, you jump. In Go, you place. Each stone lands quietly. Each position builds on the last. The opponent is still arguing about three moves ago while the board is already decided. The board has been built one placement at a …

Why implementation is not the same as readiness in health care

Tiffiny Black, DM, MPA, MBA

Conditions

March 10, 2026

Health care leaders often declare change a success long before the people inside the system feel steady again.

New technologies go live. Policies are implemented. Metrics stabilize. From an operational standpoint, the work appears complete. Yet beneath the surface, distress lingers, silence deepens, and trust erodes.

This paradox is becoming increasingly familiar to clinicians: Change is labeled “successful,” but the human experience tells a different story.

The problem is not resistance.
It is not …

Pharmaceutical advertising dangers: Why drug ads hurt patients

George Issa, MD

Physician

March 9, 2026

One of the absolute worst ideas anyone in the government ever had was letting pharmaceutical companies advertise directly to the public. A public with roughly zero medical knowledge. A public that believes any weird twinge, sneeze, or momentary fatigue is a death sentence. We need that miracle pill, now! For our constipation, insomnia, erectile dysfunction, mysterious rashes, or the inevitable blood clot that we just know is coming.

These ads don’t …

The economic shift from fee-for-service to direct primary care

Dana Y. Lujan, MBA

Policy

March 9, 2026

According to the Primary Care Collaborative, primary care accounts for roughly 5 percent of health care spending, yet it influences nearly 90 percent of downstream costs. That statistic is not a compliment. It is a diagnosis. And for a profession that has spent decades accepting influence as a substitute for economic ownership, it is long past time to read it that way. For decades, physicians …

A celebrity patient and the core of patient confidentiality

Francisco M. Torres, MD

Physician

March 9, 2026

During my second year of private practice, I was still close enough to academics to miss morning conferences, but far enough along to appreciate a predictable lunch break. It was then that I had an encounter that taught me why the core ethics of medicine must remain steady, even when the patient is someone the world recognizes. It happened on a Thursday, a day when the clinic usually looked like …

Finding balance in political turmoil: a poem on resilience

Michele Luckenbaugh

Conditions

March 8, 2026

The world has slipped out of rhythm,
like a clock knocked from the wall
that still insists on ticking,
though the hours no longer agree.

Nothing aligns with the way it lived
in my body a year ago.
Then, there was a sense of ballast.
Morning came without dread
clinging to its edges.
I could rise,
place my feet on the floor,
and believe, perhaps naively,
that the ground would hold.

I believed the voices we chose would,
at minimum, remember us.
That disagreement was …

Names as social texts: Navigating cultural identity in medicine

Esiri Gbenedio

Education

March 8, 2026

I cannot recall the first time my name was mispronounced; that is the point. It happened so often that no single moment stands out. The sounds were altered to make them easier. In first grade, a boy loudly said my name sounded like “cereal.” I disliked it but did not tell a teacher. Early on, I learned how others would value attributes like skin color, regardless of my permission.

When adults …

Medicine in 1926: What being a doctor was really like

George F. Smith, MD

Physician

March 7, 2026

Even with all the incredible advances in medicine over the past 70 years, there remain severe deficits in the care of many serious deadly diseases. Pancreatic cancer, multiple sclerosis, glioblastoma, Alzheimer’s, ALS, and ovarian cancer easily come to mind in that desperate category.

However, let’s get a perspective of what it was really like to practice medicine a hundred years ago. What kind of doctors were there? What did they do? …

Rebuilding patient trust through the evolutionary mismatch framework

Vikas Patel, MD

Conditions

March 4, 2026

How one reframing changed the way my patients think about me, and their health.

Every day, a patient sits across from me, arms crossed, waiting for me to tell them what pill to take. Or worse, waiting for confirmation of what they already believe: that the medical system has nothing real to offer, their doctor is just a middleman for pharma companies or an insurance shill, and that the answer to …

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