Psychiatry

How fNIRS and light therapy are shaping precision psychiatry

Conditions
January 19, 2026

Light drives human biology. Morning light sets the daily clock. Daylight supports attention, energy, and mood. Evening darkness supports sleep. Modern routines disrupt that rhythm through indoor lighting, screens, night shifts, and rapid travel. Psychiatry sees the costs. Sleep disruption feeds anxiety. Circadian drift worsens depression. Cognitive speed and motivation fall when sleep timing slips. Most recently, screen time has joined circadian disruptors.

Light as a diagnostic tool

Light already powers diagnosis …

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The moral injury of “not medically necessary” denials

Physician
January 16, 2026

The first denial arrived not with cruelty or malice, but with a phrase so familiar it barely registers as language anymore: “not medically necessary.” The cancer drug, recommended by oncologists and supported by evidence and standard of care, was rejected. No phone call. No physician-to-physician conversation. Just an automated letter and a bureaucratic pause inserted into a life that no longer had room for delay.

The family appealed. They fought. They …

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Physician suicide represents a silent epidemic demanding urgent reform [PODCAST]

Podcast
January 14, 2026
YouTube video

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Psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “Physician suicide prevention: a call to action.” Muhamad opens with the tragic losses of Dr. Nolan R. Williams and Dr. …

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How neurodiversity in relationships shapes communication

Physician
January 14, 2026

One of the marks of a good physician is the ability to approach illness from two complementary angles. We bring scientific knowledge, training, and objectivity to understand what is happening in the body. But the work doesn’t end there. What truly elevates a clinician is the willingness to honor how the patient experiences their illness, the internal narrative that no lab test can measure.

This dual lens is not unique to …

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Physician suicide: a daughter-in-law’s story of loss and grief

Conditions
January 14, 2026

When my father-in-law died by suicide, our family did not just lose a person. We lost the gravitational center of a small universe.

He was a giant in my eyes. Not because of his curriculum vitae, though his was extraordinary, but because of the way he moved through the world: steady, modest, and relentlessly devoted to the people who needed him.

He had survived what should have broken a human being. As …

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Why sustainable habit change requires more than willpower

Physician
January 10, 2026

Pick up a bestselling nonfiction book today and you’ll see confident claims about habit change, dopamine detoxes, and rewiring the “default mode network.” These ideas now circulate in podcasts, blogs, and social media as if the brain were an appliance that simply needs the right setting. But in real life, human behavior is not so easily reconfigured.

What I’ve observed is that habits, motivations, and compulsive patterns are shaped not only …

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Why addiction is no longer just a clinical category

Physician
January 6, 2026

Addiction is no longer a clinical category. It has become the cultural baseline.

We used to think of addiction as something that happened to a few vulnerable people who “couldn’t handle” life’s pressures. Now it’s woven into everyday existence. Most of us reach for our phones before we reach for a breath. We chase stimulation without noticing we’re chasing. We live in a world that subtly trains us to crave.

Somewhere along …

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Adult autism assessment: ADOS-4 vs. narrative interviewing

Conditions
January 5, 2026

Over the past decade, there has been a marked rise in adolescents and adults seeking autism evaluations. Many of these individuals are intellectually intact, verbally fluent, and professionally capable, yet have lived for decades with persistent social fatigue, sensory sensitivities, difficulty interpreting unspoken social rules, emotional overwhelm, rigid or all-or-nothing thinking, challenges with transitions, and extensive masking or camouflaging behaviors, all without a diagnosis. When they finally seek clarity, the …

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Geography as destiny: the truth about U.S. life expectancy disparities

Policy
January 5, 2026

Every New Year arrives with its familiar rituals. We raise a glass, make a resolution, and offer a toast to things we hope will be different this time around: better habits, better balance, better health. We say “I’ll drink to that” as shorthand for optimism, an easy affirmation that the future is still negotiable and a longer life is possible.

Then along comes a map.

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Psychedelic-assisted therapy: science, safety, and regulation

Meds
January 4, 2026

We are hearing stories about mushrooms and MDMA and see clinics advertise ketamine. We hear of friends chasing a spiritual reset. Many in America feel the weight of depression, trauma, and addiction inside families. Psychedelics sit at the center of this pressure, with hope on one side and hype on the other.

KevinMD already published multiple essays on psychedelic medicine since 2022, including pieces on what physicians need to know, prudence …

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Why we deny trauma and blame survivors

Conditions
January 4, 2026

“The ordinary response to atrocities is to banish them from consciousness. Certain violations of the social compact are too terrible to utter out loud: this is the meaning of the word unspeakable. Trauma survivors want to forget, observers want to forget, and society as a whole wants to forget. It is too painful to do otherwise. We push trauma away and it rears up in other ways: Atrocities, however, …

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Eldest daughter syndrome explains the hidden cause of physician burnout [PODCAST]

Podcast
January 3, 2026
YouTube video

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Board-certified pediatrician and certified coach Jessie Mahoney discusses her article “The burden of the eldest daughter.” Jessie explores the unique psychological weight carried by firstborn women who are taught early on to …

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Why physician wellness programs must evolve beyond institutions

Physician
January 3, 2026

Wellness programming must evolve beyond institutions if we are serious about supporting physicians, especially women physicians.

For wellness to be taken seriously, it had to begin within institutions. Those efforts offered visibility and legitimacy. But institutional wellness is not the whole answer.

For 17 years, I led wellness initiatives inside a large medical organization. I saw the value of bringing attention to physician well-being. I also saw the limitations. Six years ago, …

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Why mindfulness fails to cure existential anxiety

Conditions
January 3, 2026

For the past several decades, Western spiritual culture has been profoundly shaped by the rebranding of Buddhist contemplative practices (mindfulness, presence, and the exaltation of “the now”). As a psychiatrist, I have witnessed the arrival of this movement inside the consultation room. Patients arrive quoting teachers, apps, and books urging them to stay present, to watch their breath, to release attachment to the future or past. Many have tried, often …

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Physician attrition rates rise: the hidden crisis in health care

Physician
January 2, 2026

America’s physician shortage is no longer a distant projection. It is happening now, steadily, one resignation, early retirement, and practice closure at a time.

A nationwide, longitudinal analysis published in Annals of Internal Medicine tracked more than 712,000 physicians caring for Medicare patients over a decade and found a troubling trend: Physician attrition from clinical practice rose from 3.5 percent in 2013 to 4.9 percent in 2019, across every specialty, …

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Concierge medicine access: Is it really the problem?

Conditions
January 2, 2026

A recent Johns Hopkins study has reignited that debate. The research documents rapid growth in concierge and direct primary care practices and warns that these models may worsen access to care.

That framing feels intuitive. It is also incomplete.

It assumes that traditional primary care access was functioning before physicians began moving into fee-based models. It was not.

Long before concierge and direct primary care gained traction, primary care access had already …

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GLP-1 psychological side effects: a psychiatrist’s view

Conditions
December 30, 2025

As a physician-psychiatrist, I have watched the rise of GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound) with genuine admiration. They are transforming metabolic health, reducing cardiovascular risk, and offering hope to patients who have struggled for decades. For many, these medications are lifesaving.

But alongside the excitement, I’m witnessing something rarely discussed: a change in personality and affect, especially at higher doses.

This pattern reminds me of the early days of SSRIs. When …

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Tangible support saves health care workers from systemic collapse [PODCAST]

Podcast
December 29, 2025
YouTube video

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CEO, president, and founder of the Clinician Burnout Foundation Jodie Green and physician advocate and physical therapist Kim Downey discuss their article “Why wellness programs fail health care.” Jodie and Kim explain …

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5 things health care must stop doing to improve physician well-being

Physician
December 29, 2025

I direct a Faculty Well-being Champions Program overseeing 47 physician champions across 33 departments. I also practice palliative care part-time and coach physicians navigating burnout. I liaise with well-being leaders nationwide, some at programs just checking a wellness box, others genuinely trying to get it right. This year taught me that well-being work reveals patterns. The same destructive habits show up across institutions, specialties, and conversations.

As 2025 closes, here are …

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How doctors can reclaim control in a corporate system [PODCAST]

Podcast
December 27, 2025
YouTube video

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Palliative care physician and certified physician development coach Christie Mulholland discusses her article, “Reclaiming physician agency in a broken system.” She shares her personal story of leaving a prestigious academic position after …

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