Physicians writing on KevinMD about the primary care shortage, the fifteen-minute visit, panel size, what primary care is paid against procedural specialties, continuity, and the administrative load that has grown around the work. 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, Prior authorization: what physicians say, in their own words, and Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words.

What clinical research nurses do that no one sees

Conditions and Diseases
July 10, 2026

A clinical trial may be remembered for a breakthrough treatment, a new therapy, or a headline-making discovery. But its true story begins with people. Behind every promising result is a patient placing their trust in the unknown, and a clinical research nurse or study coordinator standing beside them every step of the way.

When people think about clinical trials, they often think about physicians, sponsors, study results, and scientific discoveries. What …

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What clinical research nurses do that no one sees

Why medicine makes doctors feel they are never enough [PODCAST]

Podcast
July 9, 2026
YouTube video

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Clinicians are pushed to do more with less, until many quietly conclude they are not enough. J. C. Sue, a family medicine physician and adjunct faculty member, returns to unpack where that belief …

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Why medicine makes doctors feel they are never enough [PODCAST]

Why patient access breaks before staffing does

Conditions and Diseases
July 9, 2026

Waiting rooms reveal more than we often acknowledge.

The clock can feel louder than the conversation, and patients quietly rehearse their symptoms after weeks of waiting, hoping they will not forget something important. Clinicians enter exam rooms carrying not just the backlog of delays but the accumulated strain of navigating a system that rarely moves in step with the care they are trying to deliver.

These moments are not rare; they are …

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Why patient access breaks before staffing does

What telemedicine gets right that in-person care gets wrong

Health Technology
July 8, 2026

A patient called at 7:45 on a Tuesday morning. She was a nurse, working nights. She had confirmed flu, her employer needed documentation within 24 hours, and the nearest GP clinic had a three-week wait for a routine appointment. Getting seen that day would have meant taking a taxi to an urgent care waiting room, feverish, and sitting next to people who didn’t need to be exposed to influenza.

She got …

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What telemedicine gets right that in-person care gets wrong

How to lighten your mental load by asking better questions

Physician
July 8, 2026

The heaviest things we carry are rarely the tasks. They are the standards we never thought to question.

My morning mental routine: Who is picking the kids up? What are we having for dinner? What time do I need to be at work, and how much is on my plate there? What time do I need to pick the kids up in time to make dinner? Maybe we will just eat …

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How to lighten your mental load by asking better questions

Health care burnout is a structural problem, not resilience

Physician
July 8, 2026

The cold coffee cups are the least of it. They sit abandoned on desks and in reporting rooms, small monuments to interruptions, unfinished tasks, and priorities that shift by the minute. Beside them stands the inevitable glass of lukewarm water, another reminder that even the most basic needs are often postponed in the service of someone else’s urgency.

What is far more difficult to ignore are the sleepless nights. The anxiety …

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Health care burnout is a structural problem, not resilience

What every primary care physician should know about BasicMed

Conditions and Diseases
July 7, 2026

Recently, I called the office of my primary care physician. I asked the person who answered the phone, “Will the doctor sign an FAA BasicMed form?” The person said, “Let me check,” and returned a minute later. “She cannot. You need to see an FAA doctor.” I tried to explain that she could, but I could not convince the desk person.

The following explains BasicMed, the Federal Aviation Administration (FAA) program …

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What every primary care physician should know about BasicMed

How compliance quietly captured medical ethics

Physician
July 7, 2026

There is a fifth pillar of American medical ethics. It was never voted on, never formally adopted, and never appears in Beauchamp and Childress. It governs clinical conduct more reliably than the other four combined. It is called compliance.

What the compliance framework has accomplished is not the erosion of beneficence, non-maleficence, autonomy, and fidelity. It is their capture. Each pillar has been quietly redefined until it means something closer to …

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How compliance quietly captured medical ethics

Why your treatment plan falls apart after you leave the doctor [PODCAST]

Podcast
July 6, 2026
YouTube video

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Most doctor visits do not fail in the room. They fail after you walk out, holding a plan and no clear idea of when something has gone wrong enough to call back. In this episode, retired surgeon and patient advocate Alan P. …

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Why your treatment plan falls apart after you leave the doctor [PODCAST]

Xylitol for cavity prevention belongs in schools

Conditions and Diseases
July 6, 2026

Tooth decay is one of the most common chronic diseases of childhood, yet it is almost entirely preventable. Despite advances in dental care, millions of children continue to experience cavities that affect their ability to eat, sleep, concentrate in school, and thrive.

Much of our current approach focuses on treatment rather than prevention. Even when we promote prevention, we often rely on ideal routines that are not consistently achievable for many …

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Xylitol for cavity prevention belongs in schools

Smartphone overuse is a disease doctors ignore

Physician
July 4, 2026

Imagine, for a moment, an epidemic sweeping the country. No one is immune. Its vague symptoms range from physical to mental, but they appear unrelated. Unlike during COVID, however, there is no outcry from health officials, the government, or the public. The problem is widely felt but rarely confronted; its insidious nature allows it to pass as normal. Therefore, the medical and scientific communities have made no serious effort to …

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Smartphone overuse is a disease doctors ignore

From military to medicine, the mindset that follows you

Physician
June 30, 2026

The uniform changed, but the mindset never really left.

Long before I stepped into hospitals in London or research labs in Tokyo, I wore Army green in training exercises across New York as a medic in the U.S. Army. At the time, I did not know that many of the lessons shaping me there would later define how I approached medicine.

People often assume military training is primarily about aggression, toughness, or …

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From military to medicine, the mindset that follows you

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Dental fear is not really about pain

Conditions and Diseases
June 30, 2026

I used to hide my smile in photographs.

Not because I was shy. Not because I was having a bad day. But because I had convinced myself that my teeth were too big, too much, too visible. I watched people with smaller, neater teeth and quietly wished mine were different. I kept my lips together in every picture for years.

I am a dental surgery assistant. And for a long time, I …

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Dental fear is not really about pain

Why physician is not the same as provider [PODCAST]

Podcast
June 29, 2026
YouTube video

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Calling a doctor a provider sounds harmless. The American College of Physicians says it isn’t. Janet Jokela, former treasurer of the American College of Physicians, professor, and medical educator, discusses the KevinMD article “Physician vs. provider is an ethics issue, not …

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Why physician is not the same as provider [PODCAST]

Private equity in direct primary care is winning

Physician Finance
June 29, 2026

The independent medicine community celebrated when the numbers dropped. Eighty-three percent growth in practice sites. Seventy-eight percent more clinicians. Conference decks updated overnight. Nobody asked who owns them now.

The Health Affairs data is real. The growth is real. What the numbers do not show is ownership. And ownership is where the story changes.

Goldman Sachs Asset Management, Charlesbank Capital Partners, Blue Sea Capital, Shore Capital Partners, and Revelstoke Capital Partners …

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Private equity in direct primary care is winning

Why the physician community is not an insurance product

Physician
June 29, 2026

I recently heard an insurance CEO say at a meeting of our state medical association that “the physician community is our product.” What struck me almost as much as the phrase itself was that no one in the room appeared to challenge it.

Perhaps the phrase was intended as corporate shorthand for network strength, partnership, or market value. But language matters, especially when it comes from institutions that increasingly control payment, …

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Why the physician community is not an insurance product

A poem on the doctor-patient relationship and facing fear

Conditions and Diseases
June 28, 2026

I sit within four silent walls,
Waiting for answers
That may never come.
The clock moves,
The sun rises and falls,
Yet the questions remain.
Uninvited companions occupying
Every corner of the room.

What is happening within me?
Why does this pain cling so tightly,
Wrapping itself around muscle, bone,
Thought and spirit?

I try to escape it.
I call upon memories of laughter,
Of loved ones gathered around a table,
Of morning birdsong
And summer breezes moving through trees.

But pain is stubborn.
It follows me there,
Casting …

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A poem on the doctor-patient relationship and facing fear

Primary care is the conductor medicine forgot

Physician
June 26, 2026

There’s a table somewhere. A conference room, good lighting, people who care. Someone passes a document around. Someone else has a slide deck. They’re talking about health care, about access, about cost, about what patients need and what physicians should do in fifteen minutes.

Fifteen minutes.

Has anyone at that table ever had their pain evaluated in fifteen minutes? Their chronic disease managed? Their whole complicated life, the medications, the specialists, the …

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Primary care is the conductor medicine forgot

Why is patient care coordination now a DIY project?

Physician
June 25, 2026

I never expected to spend my retirement navigating a health care system that increasingly requires patients to do the work once handled by the system itself. But that is where we are. The modern patient must track their own records, coordinate their own referrals, chase their own authorizations, and solve problems that once belonged to the infrastructure. It is a strange inversion: the more complex the system becomes, the more …

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Why is patient care coordination now a DIY project?

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