Physician Burnout and Mental Health

Physicians writing on KevinMD about burnout, moral injury, depression, and suicide in medicine: what causes burnout and whether the word fits, resilience training and why physicians distrust it, who leaves and why, the fear of seeking help and the licensing questions behind it, what physicians say actually helps, and, on the patient side, psychiatry, access to care, and the arguments over diagnosis and treatment. Three maintained records draw on this archive: Physician burnout: what physicians say, in their own words, Physician suicide: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.

The danger of worshipping resilience in medicine

Anthony Grandelis, MD

Physician

June 30, 2026

The longer I’ve practiced medicine, the more uncomfortable I’ve grown with the word resilience.

I’m a physician, and I am also a person in long-term recovery from addiction. Both of those identities have shaped everything about how I move through health care, and nowhere do they collide more sharply than in the culture of resilience that medicine holds so dear. We praise it like a virtue. We stitch it into wellness …

The physician burnout fix nobody prescribes

Michael Carlini

Conditions and Diseases

June 30, 2026

There’s a quiet assumption baked into how most physicians think about their careers: If you have the capacity to earn a certain income, you should. More RVUs, more shifts, more call. The math always seems to point in one direction.

I want to question that assumption, because I’m watching it cost the doctors I coach something they can’t get back. When physicians come to me feeling depleted, the first instinct, theirs …

Moral injury in medicine: the cost of endless accommodation

Eddie Saliba, APRN, FNP-C

Conditions and Diseases

June 29, 2026

When the pattern became impossible to ignore

A patient came into the office after two or three days of cough, congestion, body aches, and fatigue. Fairly typical upper respiratory symptoms. I offered to test him for COVID. He scoffed and dismissively declined any viral testing.

Apparently he already “knew” what this was. According to him, it was “turning into bronchitis,” and what he “needed” was a Z-pack. I explained that after only …

What medical regulation can learn from restorative justice

Kayvan Haddadan, MD

Physician

June 29, 2026

Medical regulatory agencies play a foundational role in protecting patients and maintaining high professional standards. When rules are applied clearly, consistently, and supportively, they create space for physicians to deliver excellent care while sustaining their own well-being. Yet administrative burdens and process complexities often contribute to stress. A promising solution lies in blending traditional oversight with restorative justice principles and a holistic health lens, approaches that address the whole person …

How to build an ADHD treatment plan beyond medication

Carrie Friedman, NP

Conditions and Diseases

June 28, 2026

When a child is diagnosed with ADHD, the conversation is often much narrower. Medication. Maybe a school form. Maybe a vague suggestion to “try therapy.” Then parents are sent back into the same exhausted home, the same chaotic mornings, the same homework battles, the same social struggles, the same emotional explosions, and the same school system that often does not know what to do with a child who is bright, …

Racial bias in schizophrenia diagnosis must end

Timothy Lesaca, MD

Conditions and Diseases

June 28, 2026

A young Black woman waits in a psychiatric emergency room. She is grieving, traumatized, and depressed. The clinician, however, describes her as “guarded,” “hostile,” and “paranoid” in the chart. She leaves with a schizophrenia diagnosis, a prescription for a first-generation antipsychotic, and a future shaped by a label she should never have received.

This is not a hypothetical situation. The Harvard Review of Psychiatry documented this case in 2023. She was …

How nervous system overload masquerades as personal failure

Devina Maya Wadhwa, MD

Physician

June 27, 2026

For many people, mornings no longer begin gently. The day now arrives all at once: emails, headlines, notifications, unanswered messages, schedules, worries, reminders, and the quiet pressure to immediately become productive. Before the body has fully awakened, the mind has already entered a state of vigilance.

Increasingly, I meet patients who describe feeling exhausted before the day has meaningfully begun. Not necessarily in the dramatic language of burnout or acute crisis, …

Rushed adult ADHD evaluations put patients at risk

Carrie Friedman, NP

Conditions and Diseases

June 26, 2026

Adult ADHD is real. It is impairing. It is often missed, especially in bright, high-achieving adults, women, and people who learned to compensate for years before finally burning out. But the solution to underdiagnosis cannot be overdiagnosis.

We are now seeing a second problem emerge: rushed adult ADHD evaluations, often completed in 30 to 60 minutes, sometimes based heavily on a brief questionnaire, followed quickly by stimulant prescribing. The patient may …

Physician loneliness is driving women out of medicine

Cassie Burton Greenbaum, MD

Physician

June 26, 2026

We tell burned-out physicians to practice self-care, set boundaries, build resilience. And still, women are leaving medicine earlier and at higher rates than men, taking with them decades of clinical expertise and leaving behind a replacement cost that runs into the hundreds of thousands of dollars per physician. We’ve named burnout as the problem, but haven’t addressed an important driving factor. The missing piece isn’t a wellness app or a …

Rethinking neuroplasticity and mental health in psychiatry

Farid Sabet-Sharghi, MD

Conditions and Diseases

June 26, 2026

Every week, a familiar reflection settles into the corners of my mind as I look at my office desk. As a practicing psychiatrist, my days are spent navigating a gentle but persistent paradox. On one hand, my workspace is increasingly filled with paperwork: diagnostic standardizations, complex neuropsychological testing matrices, and formal institutional accommodation forms designed to categorize human behavior into neat, permanent columns. On the other hand, sitting across from …

The thermodynamics of depression brain fog

Ronke Lawal, MBA

Conditions and Diseases

June 26, 2026

The first law: Nothing is lost

“I used to be smart, now I can’t think. I used to solve puzzles pretty easily, but now I don’t have any logic whatsoever. Sometimes I don’t even remember the days I had a week ago. I don’t know why my brain doesn’t work anymore.”

I kept seeing the same grief in different words: people who were not simply sad, but bewildered by the disappearance of …

Deportation and addiction: My patient died alone

Amanda Perez, MD

Physician

June 26, 2026

Maria was 42 years old when she died alone.

As an internal medicine resident and future addiction medicine physician, I have the immense honor of caring for undocumented immigrants at a nonprofit community clinic in Philadelphia. As the granddaughter of Cuban political refugees, caring for immigrant populations is central to my identity as a physician. As such, I am proud to work at a clinic that provides care to patients who …

What public shaming reveals about a loss of trust

Steven Merahn, MD

Conditions and Diseases

June 25, 2026

You have witnessed it, probably this week. A stranger correcting another stranger’s behavior. A comment on someone’s parenting, posted for an audience of thousands. A heated exchange over a parking spot that somehow becomes a referendum on someone’s character. The neighbor who reports another neighbor’s hedge height to the township. The pile-on that turns a stranger’s bad day into a national referendum, complete with their employer tagged in the replies.

Correcting …

Red lights, green lights, and the art of resilience

Kayvan Haddadan, MD

Conditions and Diseases

June 24, 2026

Unlike my earlier pieces, which often stitched together studies and data to build an argument, this one grew straight out of ordinary mornings. Pulling up to the same stop sign on my commute, waiting for the light to turn green, easing over to let an ambulance through with its urgent lights flashing. Touched by a reality check, one of my friends who lost his significant other of long years has …

Compassion fatigue is evidence of caring, not failing

Pamela S. Spear, OTD

Conditions and Diseases

June 24, 2026

There is a quiet accumulation that happens in caring professions. It rarely arrives all at once. More often, it builds gradually through repeated exposure to grief, crisis, trauma, fear, loss, and emotional responsibility. Over time, many health care workers begin carrying far more than their job descriptions ever acknowledge.

We call it compassion fatigue, burnout, stress, or emotional exhaustion. Different words, same reality. And yet many clinicians still quietly believe it …

How physician burnout reaches into marriage

Ronke Dosunmu, MD

Physician

June 22, 2026

Physician burnout is often discussed as if it begins and ends at work. Workload, documentation burden, moral injury, loss of autonomy: These contributors are real. But they don’t exist in isolation.

Physicians don’t shed cognitive load at the end of a shift. The vigilance, decision-making, and emotional regulation required in clinical practice often continue at home, especially inside marriage and family life. Yet relational health is rarely considered a physician well-being …

Dignity in medicine starts with how we are seen

Ravi S. Aysola, MD

Physician

June 22, 2026

Years ago, I read about the sapeurs of Congo, men living with limited means who spent extraordinary care, money, and intention on clothing, color, elegance, and style. At first glance, it can seem irrational. It is not.

Dress, for them, is not vanity. It is dignity. It is self-definition. It is a refusal to let circumstance have the final word on identity. I have been thinking about that today.

Today is Juneteenth.

Today, …

Underage gambling thrives on offshore betting sites

Kayvan Haddadan, MD

Conditions and Diseases

June 22, 2026

Offshore online gambling companies, operating from jurisdictions with lax oversight, have built a business model that thrives on easy access for minors while evading meaningful U.S. regulations. These platforms often rely on superficial age verification that fails to protect vulnerable youth, leading to widespread underage participation, addiction, and profound suffering for victims and their families.

Inadequate age verification: a sham that enables harm

A core failure lies in the …

Who are you when the white coat is off?

Seleipiri Akobo, MD, MPH, MBA

Physician

June 22, 2026

Dear colleague,

I know exactly who you are. You are the one who has not missed a deadline since the third grade. You are the one who treats “triple board-certified” like a minimum requirement and “regional medical director” like a starting line. You are the one who has spent twenty years mastering the architecture of everyone else’s survival, while your own foundation is quietly crumbling.

But I have a question for you, …

Read more…

Who are you when the white coat is off?

How AI is reshaping applied behavior analysis care

Brad Smith, PhD

Conditions and Diseases

June 21, 2026

Most applied behavior analysis (ABA) practices are not lacking data. If anything, they have too much of it. The challenge is pulling it together to get a complete picture of client care, determining next steps, and maintaining compliance. Information lives in different, siloed systems. Getting the information you need often means exporting reports, manually reconciling numbers, and trying to connect the dots. By the time that work is done, the …