Psychiatry

The hidden cost of uncompensated work on physician burnout

Physician

March 5, 2026

Physicians are renowned for their dedication to helping others. The problem is that their dedication has become synonymous with self-sacrifice and working for free.

Giving away time, energy, and expertise is simply “what good doctors are supposed to do.”

We work through lunch. We attend meetings during lunch. We respond to patient messages on our days off. We prepare lectures and teach without compensation. Leaders hold space for complaints and conflict and …

Physician burnout solutions: Why system change isn’t enough

Diane W. Shannon, MD, MPH

Physician

March 5, 2026

When I experienced burnout as a young primary care physician, I thought it was my fault. Actually, I didn’t know it was burnout; I had never heard the word. But I believed whatever was causing the deep exhaustion, lack of empathy, and feelings of uselessness were surely due to a flaw or weakness in me.

Eventually, I stumbled across the definition of professional burnout. I was so curious to understand what …

Rest is a holy practice: Reclaiming the soul of medicine [PODCAST]

The Podcast by KevinMD

Podcast

March 4, 2026

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Developmental behavioral pediatrician Roxanne Almas discusses her article “The making of a rested healer.” Roxanne shares her deeply personal journey through the “quiet unraveling” of burnout and the profound grief of losing …

Applied behavior analysis criticism: the closed feedback loop

Ronald L. Lindsay, MD

Conditions

March 3, 2026

In engineering, a feedback loop is meant to stabilize a system. In medicine, feedback guides us toward better outcomes. But in applied behavior analysis (ABA), feedback has become a trap, recycling failure under the guise of science, and leaving children and families caught in its circuitry.

The closed circuit

Stevens’ feedback loop diagrams are elegant in their simplicity: arrows circling back, showing how inputs and outputs can stabilize a system. In healthy …

Coping with survivor guilt: wisdom from Saadi Shirazi and Viktor Frankl

Farid Sabet-Sharghi, MD

Physician

March 3, 2026

When someone you love is in a different location and suffering while you are safe, a heavy silence begins to fill the room. This survivor guilt is one of the most difficult burdens to carry because it turns even the smallest joys, a hot cup of tea, a peaceful morning, or a moment of laughter, into something that feels like a betrayal. The heart constantly asks: Why them and not …

Psychological safety in health care: Why speaking up saves lives

Jalene Jacob, MD, MBA

Physician

March 2, 2026

During a busy morning, a junior nurse notices a discrepancy between a patient’s medication order and the usual dosing protocol. The unit is short-staffed, rounds are running behind, and the attending physician appears visibly rushed. The nurse hesitates, worried about slowing the team down or appearing inexperienced.

The unit manager who is present during rounds, notices the nurse’s hesitation and pauses the discussion. Rather than pushing forward, the manager says, “Before …

Lessons from 47 years: long-term marriage and palliative care

Richard A. Lawhern, PhD

Conditions

March 2, 2026

My wife is dying.

The day has yet to be determined, but the causes are certain. Stage 4 metastatic pancreatic and liver cancers will allow her a few weeks more in which to say goodbye to a large circle of family and friends. She has decided not to undergo chemotherapy or radiation that at best might extend her life by a few weeks, at the cost of the quality of whatever …

Why I stopped accepting pharmaceutical-sponsored lunches

Timothy Lesaca, MD

Physician

March 2, 2026

A pharmaceutical representative recently brought lunch to my office to present a new drug. The drug may help some patients. The food was abundant. The room was full, with excess all around, including leftovers that were eventually thrown away. None of that is unusual in American medicine.

What has become unusual, at least for me, is how hard it now is to separate the plate in front of me from the …

Bipolar I and the illusion of insight: a firsthand account

Tommy Saborido, MD

Physician

February 28, 2026

I’m Tommy. Bipolar type one, I’m told. I actually have something to say, something to share.

The thing no one talks about in mental health, bipolar type one specifically, is how seductive and sweet the upswing feels. It’s deeply more than just “good” to me. It feels like the limits of the brain have been cut loose, severed, done away with. Suddenly all those moments and ideas and thoughts and connections …

Orthorexia nervosa turns healthy habits into a harmful obsession [PODCAST]

The Podcast by KevinMD

Podcast

February 26, 2026

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Internal medicine physician Sally Daganzo discusses her article “The hidden epidemic of orthorexia nervosa.” Sally explains how the pursuit of a perfect diet can spiral into a debilitating obsession where food rules …

Physician mental health and suicide prevention: stories of survival

Michael F. Myers, MD

Physician

February 26, 2026

An excerpt from Physicians With Lived Experience: How Their Stories Offer Clinical Guidance (APA Publishing, 2025).

Foreword by Jennifer Breen Feist

Foreword by Jennifer Breen Feist, who lost her beloved sister, Dr. Lorna Breen, to suicide on April 26, 2020. After describing the initial shock and unwanted global publicity of her death, she wrote this:

As the emails, letters, and phone calls continued to pour in, my husband …

Navigating the hype and hope of psychedelic medicine [PODCAST]

The Podcast by KevinMD

Podcast

February 25, 2026

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Psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “Psychedelic-assisted therapy: science, safety, and regulation.” Muhamad explores the complex landscape of psychedelic medicine, balancing the growing public interest with …

The ticking clock: How time constraints in medicine hurt patient care

Timothy Lesaca, MD

Physician

February 25, 2026

We are taught to watch for conflicts of interest in the form of pharmaceutical pens and consulting checks, yet we often overlook the most pervasive corruption of all: the ticking of the clock.

We traditionally describe medical conflicts of interest in corporate terms: free dinners, speaking fees, and consulting arrangements. These temptations are real, and they deserve the scrutiny and rules we apply to them. But they are external distractions. The …

Marijuana rescheduling: Why the medical community’s silence is dangerous

Farid Sabet-Sharghi, MD

Meds

February 22, 2026

By presidential order, marijuana has been rescheduled from Schedule I to Schedule III. This is not a subtle bureaucratic shift. It is a historic decision with major medical, regulatory, and cultural implications. Yet, astonishingly, much of the medical community has responded with near silence. There has been little serious discussion, no broad professional debate, and minimal effort to educate clinicians or the public about what this change does, and does …

Asking what love would do transforms leadership [PODCAST]

The Podcast by KevinMD

Podcast

February 21, 2026

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Pediatrician and certified coach Jessie Mahoney discusses her article “Leading with love: a physician’s guide to clarity and compassion.” Jessie shares how a personal crisis involving her husband’s severe depression forced her …

The “ethical canary”: How moral injury signals systemic failure

Courtney Markham-Abedi, MD

Conditions

February 18, 2026

For the past month and maybe longer, I have been waking up with pressure in my chest. It worsened in December and continued to worsen in the new year. I had identified it as anxiety, but felt it was of a different quality than my run-of-the-mill anxiety. This feeling was more anguished.

During the first week of January, I volunteered at a clinic, where I saw patients, assessed, and treated psychiatric …

What the folinic acid retraction means for autism treatment

Timothy Lesaca, MD

Physician

February 17, 2026

On January 29, 2026, the European Journal of Pediatrics formally retracted what had been the largest randomized clinical trial examining folinic acid as an intervention for autism. The reason, according to the journal’s notice, was direct: The study’s data did not support its published conclusions.

Originally released in 2024, the trial reported that 24 weeks of oral folinic acid therapy produced a “significant reduction” in autism symptoms among 77 children. In …

The healing power of physician presence in modern medicine

Farid Sabet-Sharghi, MD

Conditions

February 17, 2026

I remember a patient who sat silently, staring at the hospital ceiling. She had survived a sudden illness that left her body weak and her spirit shaken. No tests, medications, or procedures could touch the despair in her eyes. In that moment, I realized something fundamental: The physician’s presence itself can be the most potent form of care.

Medicine, at its best, is more than diagnosis or intervention. It is an …

Waiting for the system to change causes burnout [PODCAST]

The Podcast by KevinMD

Podcast

February 16, 2026

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Board-certified pediatrician and certified coach Jessie Mahoney discusses her article “Why doctors must stop waiting and reclaim their lives.” Jessie explains how medical training conditions doctors to view endurance as a virtue …

Why a chief wellness officer hid her medication use for 13 years

Michael F. Myers, MD

Physician

February 14, 2026

An excerpt from Physicians With Lived Experience: How Their Stories Offer Clinical Guidance (APA Publishing, 2025).

“Here is the truth: I have been on a stable dose of Wellbutrin (Bupropion) for thirteen years, and despite being quite a public advocate about self-disclosure and mental health, I have never once said that out loud. If you have ever read anything I’ve written before …

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