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.

Moving beyond the false binary of medicine as a calling

Physician
March 19, 2026

There is a resident doctor on TikTok named Julia who is also a raver. She posts about her training, and her weekends, dancing, festivals, après ski, living a full and visibly joyful life outside the hospital. The comments on her videos are glowing. “I would love to have a doctor like you.” “You seem like a real person.” A lot of patients are not looking for a self-sacrificing doctor who …

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Moving beyond the false binary of medicine as a calling

Why immersive travel may be a powerful tool for behavior change

Physician
March 18, 2026

In lifestyle medicine, we know the script: eat better, move more, manage stress, sleep well, connect with others. Many of us know what to do. But knowledge alone does not create transformation. What does? Identity. That quiet internal voice that tells us who we are and what we are capable of. Research by Daphna Oyserman and colleagues shows that identity drives behavior …

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Why immersive travel may be a powerful tool for behavior change

ADHD in physicians: Why medical training punishes neurodiversity

Conditions and Diseases
March 18, 2026

I was halfway through my first year of OB-GYN residency when I learned that my brain had been working against me my entire life. By then, I had passed licensing exams, matched into a surgical specialty, and learned how to function convincingly while exhausted. What I had not learned, and what medicine never taught me, was how to recognize when “high functioning” was actually quiet suffering. And that distinction matters, …

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ADHD in physicians: Why medical training punishes neurodiversity

The Schism of Time: Bridging the generational gap in the workplace

Physician
March 17, 2026

In our modern professional landscape, we are witnessing a phenomenon I call the Schism of Time. It is not just a gap in age; it is a fundamental difference in how we perceive value, and “spend” the hours of our lives.

As technology accelerates, the cadence of our work shifts. We see a friction between the “Deep Time” often championed by seasoned leaders, rooted in legacy, patience, and incremental growth, and …

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The Schism of Time: Bridging the generational gap in the workplace

Why modern medicine feels more like a bureaucracy than a profession

Physician
March 17, 2026

I walked through a beautiful hallway the other day, the kind hospitals and clinics seem to favor now, polished floors, warm lighting, and old oak paneling on the walls. It looked less like a medical building and more like the lobby of a boutique hotel. At the end of the hallway sat a receptionist who was having a bad day. Or maybe she was just doing her job. She glanced …

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Why modern medicine feels more like a bureaucracy than a profession

Why perfectionism in medicine leads to moral injury

Conditions and Diseases
March 16, 2026

In the hallowed halls of medical school, we are often screened for traits that make the “ideal doctor”: high empathy, meticulous perfectionism, and a profound sense of duty. We are the fixers, the ones who find deep meaning in the intersubjective space between healer and patient. Yet, there is a shadow side to this personality architecture that no one talks about, an underlying proclivity toward rejection sensitivity.

The very traits that …

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Why perfectionism in medicine leads to moral injury

Wellness requires safe spaces outside the medical system [PODCAST]

Podcast
March 14, 2026
YouTube video

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

Pediatrician and certified coach Jessie Mahoney discusses her article “Why physician wellness programs must evolve beyond institutions.” Jessie reflects on her seventeen years leading in-house wellness initiatives and argues that while institutional …

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Wellness requires safe spaces outside the medical system [PODCAST]

Workplace boundaries: How to stop answering e-mails at 5 p.m.

Physician
March 14, 2026

An excerpt from NOMERGENCY: Reclaiming Focus and Calm from False Urgency.

Your heart plummets.

It’s 4:55 p.m., five minutes until freedom, five minutes until you’re finally out the door to go and try that restaurant your friends have been raving about for months. But you’ve already caught a glimpse of the new e-mail from your boss, and it cannot be unseen.

The subject line reads: “Take a quick look?”

Your stomach twists.

Maybe I …

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Workplace boundaries: How to stop answering e-mails at 5 p.m.

Lowercase PTSD: Why emergency staff are still hypervigilant

Conditions and Diseases
March 14, 2026

In the emergency department, you learn to function under pressure. You compartmentalize. You prioritize. You override your own nervous system in order to keep someone else alive.

During COVID, that skill became oxygen.

We worked in zones of four to eight critical patients, all unstable, all needing constant vigilance, or we were assigned to the lobby and hallways, managing 50 or 60 patients triaged as “non-critical,” knowing any one of them could …

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Lowercase PTSD: Why emergency staff are still hypervigilant

Ketamine therapy for chronic pain and substance misuse

Medications
March 13, 2026

Health care works best when it solves real problems in real lives. That is why recent research on ketamine therapy for chronic pain deserves attention. The peer-reviewed study looked at 20 adults living with chronic pain who also struggled with substance misuse. The results suggest that carefully designed pain treatment may help more than pain alone. It may also improve mood and support recovery from substance misuse. In a …

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Ketamine therapy for chronic pain and substance misuse

Understanding the types of PTSD and how to treat them

Conditions and Diseases
March 13, 2026

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event, characterized by intrusive memories (flashbacks, nightmares), avoidance of reminders, negative mood changes (fear, anger, detachment), and heightened arousal (easily startled, irritability). The diagnosis of PTSD requires symptoms lasting over a month causing significant distress or impairment, and not due to substances or other conditions.

The five types of post-traumatic stress disorder

There are …

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Understanding the types of PTSD and how to treat them

The 9 laws of health care quality: Why metrics miss the point

Physician
March 12, 2026

I have spent years watching the development of quality programs. What began as a way to ensure patient safety has gradually given way to an independent group of individuals whose job it is to interpret regulations and monitor those interpretations. In the process, the clinical richness of medicine has been lost. Judgment, narrative, and context matter less than forms and metrics. The work has shifted away from the bedside and …

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The 9 laws of health care quality: Why metrics miss the point

The hidden risks of AI-generated progress notes in psychotherapy

Health Technology
March 12, 2026

Imagine a patient who spends most of a therapy session talking about a single memory. He describes sitting in his car after visiting his mother in a nursing home, unable to start the engine. He sits there for nearly 20 minutes, staring at the steering wheel and wondering when the roles had reversed, when he had become the parent and she the child. Nothing dramatic happens in the session. No …

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The hidden risks of AI-generated progress notes in psychotherapy

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Grief and healing: Learning to live with absence

Conditions and Diseases
March 12, 2026

Life begins, and life ends.
We know this
the way we know the sun will rise,
as a fact, not a feeling.

Those we cherish
and those who cherished us
leave without rehearsal,
no warning bell
to soften the blow.
As if the heart
could ever be trained for absence.

They were threaded into the ordinary,
morning light, evening quiet,
the familiar rhythm of breath and belonging.

We assumed their nearness was permanent,
the way we assume tomorrow.

There were shared breaths of laughter,
tears that needed …

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Grief and healing: Learning to live with absence

When a code blue happens on a psychiatry unit

Conditions and Diseases
March 11, 2026

The overhead call still feels wrong when it happens on a psychiatry unit. Code blue. The words echo through hallways designed for containment and calm, not cardiac arrest. Psychiatry is supposed to be about listening, de-escalation, and meaning-making. A code blue interrupts that narrative abruptly, reminding everyone in earshot that bodies, not diagnoses, ultimately set the terms. What struck me most was not the urgency of the response (clinicians are …

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When a code blue happens on a psychiatry unit

Physician burnout definition: Why it is blocked energy, not just exhaustion

Physician
March 10, 2026

Most physicians experience burnout as exhaustion. We say, “I have nothing left.” The assumption is simple: We are depleted, and what we need is rest. But after decades in medicine, and years of listening carefully to burned-out clinicians, I wonder if that assumption is wrong.

What if burnout is not a lack of energy at all? What if it is energy that has nowhere to go?

Physicians enter medicine with extraordinary life …

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Physician burnout definition: Why it is blocked energy, not just exhaustion

Physician neutrality: a beacon of ethics in a divided world

Physician
March 9, 2026

I watched with horror, grief, and tears in my eyes as the events of the last week unfolded. We witnessed a catastrophic massacre of Iranians seeking nothing more than the basic freedom to exist outside an oppressive system. As conflicts ignite in various corners of the world, it feels as though the fabric of our global society is tearing at the seams.

Yet, amidst the darkness, there was a silver lining: …

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Physician neutrality: a beacon of ethics in a divided world

How to handle clinical disagreement with patients

Physician
March 9, 2026

One of the hardest moments in medicine is not making a diagnosis. It is not writing the prescription. It is sitting across from a patient who wants something you do not believe is right for them and knowing that whatever you say next will either build trust or break it. That moment comes every day in modern practice. A patient wants an antibiotic for a virus. A patient wants a …

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How to handle clinical disagreement with patients

The quiet paradox of physician mental health and medication

Physician
March 9, 2026

Physicians are trained, above all, to project steadiness. Long before we feel it, we learn to perform it. The lesson begins early in training. The pager goes off, a room fills with urgency, and the expectation is unspoken but unmistakable: Remain calm. Do not let uncertainty show. Do not let fear show. Patients need confidence. Teams need direction. Over time, the composure stops feeling like a performance. It becomes a …

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The quiet paradox of physician mental health and medication

The Platinum Rule in health care: Moving beyond the Golden Rule

Conditions and Diseases
March 7, 2026

An excerpt from In Search of Dignity: A Lifetime of Reflections.

Several years before her death at the age of 55 years due to complications of cerebral palsy, my sister Ellen was again in hospital, this time in intensive care and on the brink of respiratory collapse. To say cerebral palsy had shaped her life is an understatement, in that it molded nearly every facet of her being, from the …

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The Platinum Rule in health care: Moving beyond the Golden Rule

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