Primary care

8,116 articles · Since 2004

Articles, page 2

Why I built a medical home model for military families

October 12, 2026Oct 12, 2026

The Franklin Medal sits in a box in my attic. Most days I don't think about it. Life has a way of burying old honors beneath newer responsibilities. Yet every so often I remember that silver medal and what it…

The Franklin Medal sits in a box in my attic. Most days I don’t think about it. Life has a way of burying old honors beneath newer responsibilities. Yet every so often I remember that silver medal and what it represents.

I am not a descendant of Benjamin Franklin. I am one of his heirs.

More than two centuries ago, Franklin left money to the city of Boston to reward academic merit …

Physician voices

How to prepare for a doctor’s appointment and be heard

Terry Adirim, MD, MPH, MBA

October 11, 2026Oct 11, 20262

An excerpt from The Prepared Patient: Your Guide to Surviving the Health Care System. In today's health care system, patient-centered care often feels more like an unattainable ideal than a reality. Systemic inefficiencies seem to overshadow the promise of collaboration,…

An excerpt from The Prepared Patient: Your Guide to Surviving the Health Care System.

In today’s health care system, patient-centered care often feels more like an unattainable ideal than a reality. Systemic inefficiencies seem to overshadow the promise of collaboration, empathy, and individualized attention, while rushed appointments and fragmented communication prevail. The result? A disconnect between what patients need and what the system delivers.

One of the most significant barriers to …

Physician voices

Dolly bought Porter Wagoner’s songs, then gave them back

Osmund Agbo, MD

October 10, 2026Oct 10, 2026

It was in late spring of 1964, just a day after graduating from high school, that a diminutive farm girl packed her belongings and bade farewell to the life she had known in the Smoky Mountains of rural Tennessee. Her destination? Nashville, the mecca of country music. She left behind the two-bedroom cottage where she had lived with her parents and eleven siblings, carrying little more than a dream and …

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Physician voices

A medical home pioneer meets fragmented care as a patient

Ronald L. Lindsay, MD

October 10, 2026Oct 10, 2026

For years, I spoke about the importance of coordinated care. Long before the term became fashionable, I helped build what would later become known as a medical home at Minot Air Force Base. The concept was straightforward. Somebody had to own the whole patient. Not just a diagnosis. Not just a specialty. Not just a laboratory value. The whole patient.

At the time, it seemed obvious. It still does. What surprises …

Conditions and diseases

I was wrong: Doctors who listen still exist

Christopher H. Foster, PhD, MPA

October 9, 2026Oct 9, 2026

The last time I wrote for KevinMD, I asked, "What happened to real care in health care?" I was tired of commercial after commercial promising that a new drug could fix nearly anything. I was frustrated by the steady stream…

The last time I wrote for KevinMD, I asked, “What happened to real care in health care?” I was tired of commercial after commercial promising that a new drug could fix nearly anything. I was frustrated by the steady stream of new labels and acronyms that sometimes make ordinary human struggles sound like conditions waiting for a prescription. That frustration was personal, but it was not entirely imagined. From …

Medical education

Teaching clinical reasoning starts with saying it out loud

Lynn McComas, DNP, ANP-C

October 7, 2026Oct 7, 2026

One of the most useful teaching techniques I have used as a preceptor is also one of the simplest: I think out loud. Experienced clinicians make hundreds of small decisions throughout the day. We know which questions to ask, which…

Much of that thinking becomes so automatic that we may not realize our students cannot see it. They can watch us conduct …

Conditions and diseases

Informed consent has become a signature, not a choice

M. Bennet Broner, PhD

October 6, 2026Oct 6, 2026

When I began studying medical ethics, forty-five years ago, patient autonomy and informed consent (IC) were major issues. While some academics and practitioners today argue that autonomy has been overly emphasized, in my decades of practice and as a patient,…

There is little oversight of medical IC by a federal or state agency, but to state that it is required and its general …

Conditions and diseases

5 OCD screening questions every clinician should ask

Ravi Singareddy, MD

October 6, 2026Oct 6, 2026

Obsessive-compulsive disorder (OCD) is one of the most delayed diagnoses in psychiatry, and much of that delay happens in offices like ours. Patients typically notice their first symptoms in adolescence or early adulthood but are not correctly diagnosed until roughly a decade later. One outpatient study found an average of about 12.8 years between symptom onset and diagnosis, and a meta-analysis of 31 studies put the pooled duration of untreated …

Physician voices

Slowing down in medicine starts with being interruptible

Sherry M. Adkins, MD, MPH

October 4, 2026Oct 4, 2026

One morning I sat on the porch with a cup of tea and read slowly. Birds moved somewhere beyond the yard. Wind passed through the trees. The locusts were already loud. Nothing remarkable happened. And yet, after a while, I…

One morning I sat on the porch with a cup of tea and read slowly. Birds moved somewhere beyond the yard. Wind passed through the trees. The locusts were already loud. Nothing remarkable happened.

And yet, after a while, I had the strange sense that my mind had returned to me. There was enough. Enough time to finish the paragraph. Enough quiet to notice the air. Enough room for one thought …

Physician voices

Who is liable for direct-to-consumer lab testing?

Joseph Phelan, MD

October 2, 2026Oct 2, 2026

Ever had a patient bring in a packet of test results you never ordered and countless questions on results for tests you've never even heard of? If not, prepare yourself. Direct-to-consumer (DTC) lab testing began modestly in 1977 when the…

Ever had a patient bring in a packet of test results you never ordered and countless questions on results for tests you’ve never even heard of? If not, prepare yourself.

Direct-to-consumer (DTC) lab testing began modestly in 1977 when the FDA approved at-home pregnancy tests. Over the last 50 years, it has evolved into a multi-billion-dollar industry offering hundreds of tests without a prescription. Some companies even sell panels of hundreds …

The Podcast by KevinMD

Why more medicine isn’t making us healthier [PODCAST]

The Podcast by KevinMD

September 30, 2026Sep 30, 2026

America spends nearly a fifth of its economy on health care, yet chronic disease keeps rising and prevention lags. Narinder Singh Parhar, an internist and intensivist with four decades of experience across outpatient, hospital, and ICU care, argues that American…

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The Podcast by KevinMD

Amazon and Uber set the bar that primary care is judged against [PODCAST]

The Podcast by KevinMD

September 29, 2026Sep 29, 2026

A car shows up when you click a button and groceries arrive by tonight, but a doctor's appointment takes weeks. Payam Zamani started MY DR NOW while he was still a resident, in a clinic of twelve hundred square feet,…

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A car shows up when you click a button and groceries arrive by tonight, but a doctor’s appointment takes weeks. Payam Zamani started MY DR NOW while he was still a resident, in a clinic of twelve hundred square feet, and now runs more than eighty of them as founder …

The Podcast by KevinMD

Why patients stop trusting doctors who listened to them [PODCAST]

The Podcast by KevinMD

September 28, 2026Sep 28, 2026

A patient says her hip has hurt for a while. Whether she leaves trusting her doctor depends on what happens next. Alan P. Feren, a retired surgeon, health care consultant, and patient advocate, separates active listening, which makes a patient…

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The Podcast by KevinMD

Some relationships work like medicine. Others work like a diagnosis. [PODCAST]

The Podcast by KevinMD

September 27, 2026Sep 27, 2026

A patient came in with weight gain nobody could explain. Every test came back fine. Shiv K. Goel is an internal medicine and functional medicine physician. This episode is based on his article "How relationships affect health, seen from the…

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Conditions and diseases

After 2 failed antidepressants, raise TMS and esketamine

Ravi Singareddy, MD

September 27, 2026Sep 27, 2026

In community interventional psychiatry practices, the typical referral looks the same week after week. The patient is in the fifth or sixth year of a major depressive episode and carries a list of four, five, sometimes seven antidepressants they have “failed.” They are finally sent for transcranial magnetic stimulation (TMS) or esketamine (Spravato) long after the point when those treatments would have done the most good. By the time the …

Physician voices

Why the importance of primary care is easy to miss

Asma Khan, MD

September 26, 2026Sep 26, 2026

A patient recently told me she hadn't seen a doctor in six years. Not because she felt perfectly healthy, but because nothing had ever felt "bad enough" to justify an appointment. By the time she came in, her blood pressure…

A patient recently told me she hadn’t seen a doctor in six years. Not because she felt perfectly healthy, but because nothing had ever felt “bad enough” to justify an appointment. By the time she came in, her blood pressure was stage 2 hypertension, her fasting glucose was in the prediabetic range, and she was carrying a level of chronic stress she’d simply learned to live with.

None of this is …

Physician voices

Experienced physicians and patient safety defy spreadsheets

Paul Dranichnikov, MD, PhD

September 26, 2026Sep 26, 2026

There was a time when becoming a physician meant entering a profession in which your experience was not merely appreciated; it was actively sought after. My father belongs to a generation that remembers this world. He once told me about the difficult decision he faced: whether to continue as chief of staff at a primary health care center or leave and establish his own practice. The difficulty was not finding …

Physician voices

The history of the medical home includes an Air Force base

Ronald L. Lindsay, MD

September 26, 2026Sep 26, 2026

In the early 1990s, while the American Academy of Pediatrics (AAP) was formalizing its vision of the "medical home," we were already living it, without a name. At Minot Air Force Base in North Dakota, our pediatric team operationalized what…

In the early 1990s, while the American Academy of Pediatrics (AAP) was formalizing its vision of the “medical home,” we were already living it, without a name. At Minot Air Force Base in North Dakota, our pediatric team operationalized what would later be codified: interdisciplinary care, family partnership, coordinated services, and continuity across settings. We didn’t call it a medical home. It was excellent pediatric care, and we simply made …

Physician voices

Losing your doctor: the grief no health system notices

Timothy Lesaca, MD

September 25, 2026Sep 25, 2026

There is a small, unreasonable part of us that expects our doctors to stay in one place forever. We know better, of course. We know they grow older, become tired, change jobs, and make plans. Yet the person we bring…

There is a small, unreasonable part of us that expects our doctors to stay in one place forever.

We know better, of course. We know they grow older, become tired, change jobs, and make plans. Yet the person we bring our uncertainty to is not supposed to become another uncertainty. We may notice the gray hair without quite imagining the day when someone else opens the door.

Few relationships ask so much …

Physician voices

The 15-minute appointment is not the boundary of care

Alan P. Feren, MD

September 24, 2026Sep 24, 2026

Care does not have to be finished in one encounter. But it must not be allowed to disappear between encounters. When primary care clinicians say they cannot adequately manage their patients' concerns in 15 minutes, I take that seriously. A…

Care does not have to be finished in one encounter. But it must not be allowed to disappear between encounters.

When primary care clinicians say they cannot adequately manage their patients’ concerns in 15 minutes, I take that seriously. A patient may arrive with a new symptom, several chronic conditions, medications prescribed by different clinicians, and questions about what has changed. The clinician faces that complexity alongside chart review, examination, documentation, …

Primary care

Articles, page 2

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