Psychiatry

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 …

Physician attrition rates rise: the hidden crisis in health care

Arthur Lazarus, MD, MBA

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, …

Concierge medicine access: Is it really the problem?

Dana Y. Lujan, MBA

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 …

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

Farid Sabet-Sharghi, MD

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 …

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

The Podcast by KevinMD

Podcast

December 29, 2025

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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 …

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

Christie Mulholland, MD

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 …

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

The Podcast by KevinMD

Podcast

December 27, 2025

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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 …

Why I left pediatric cardiology: a story of moral injury

Susan MacLellan-Tobert, MD

Physician

December 27, 2025

I retired from my pediatric cardiology practice almost two years ago, and I keep circling back to one of the final days of my career. For a long time, I told myself I had simply burned out, worn thin by the pace and the paperwork. Only with time and reflection have I realized I didn’t step away because I was tired, I stepped away because of deep moral injury.

I remember …

How political polarization causes real psychological trauma [PODCAST]

The Podcast by KevinMD

Podcast

December 26, 2025

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Psychiatrist Farid Sabet-Sharghi discusses his article, “The psychological trauma of polarization.” Farid explains how the human psyche is evolutionarily wired for connection, making the current climate of hostility and division deeply traumatic. …

Unregulated botanical products: the hidden risks of convenience store supplements

Muhamad Aly Rifai, MD

Meds

December 25, 2025

Walk into a convenience store. You will see sleek bottles, gummies, shots, and powders in bright wrappers. Companies market them as calm, focus, energy, sleep, pain relief. People treat them like upgraded vitamins. They swipe a card and head home. Nobody runs a checklist on dose, interactions, tolerance, withdrawal, or contamination.

This culture runs on a simple story. Natural means safe and plant means gentle. Legal means regulated while a label …

“The meds made me do it”: Unpacking the Nick Reiner tragedy

Arthur Lazarus, MD, MBA

Meds

December 25, 2025

“The meds made me do it” has become a familiar refrain whenever psychiatric treatment intersects with tragedy. It is a phrase heavy with implication, suggesting loss of control, a sense of medical betrayal, and a system that failed at its most basic task: keeping people safe. When cases like the Nick Reiner tragedy enter the public consciousness, that phrase resurfaces almost reflexively, offering a deceptively simple explanation for something incredibly …

Preventing physician burnout: an educational approach

William Lynes, MD

Physician

December 23, 2025

The frequency and severity of physician burnout have resulted in an epidemic that is impairing the American health care delivery system. Herbert Freudenberger coined the term burnout in 1977, referring to a syndrome characterized by emotional exhaustion, depersonalization or cynicism, and a lack of personal accomplishment. He noted that burnout reduced health care workers’ ability to provide excellent patient care and adversely affected their well-being.

Physician burnout is rampant in the …

The risk of diagnostic ideology in child psychiatry

Dr. Sami Timimi

Conditions

December 22, 2025

Adapted from Searching for Normal: A New Approach to Understanding Mental Health, Distress and Neurodiversity. (Penguin Random House Canada/Signal, 2025.)

February 1992. I’m in the consulting-room side of a one-way mirror divide. Opposite us in the room are four people: thirteen-year-old Sofia, her older sister Julieta, and their mother and father. The parents speak with a strong Spanish accent. The girls’ mother has an anxious look on her face. She …

The political selectivity of medical freedom: a double standard

Arthur Lazarus, MD, MBA

Policy

December 22, 2025

I’ve been thinking about “choice” a lot lately, not the rich, ethically grounded version we teach in medical school, rooted in autonomy, informed consent, and shared decision-making, but a thinner, more selective version now circulating in political and legal discourse. The kind that sounds principled until you read the fine print.

The message goes like this: You may choose, just make sure you choose correctly.

It’s the literary equivalent of Animal Farm: …

Understanding factitious disorder imposed on another and child safety

Timothy Lesaca, MD

Conditions

December 20, 2025

Factitious disorder imposed on another (FDIA), formerly known as Munchausen syndrome by proxy (MSBP), represents one of the most egregious and dangerous forms of child maltreatment encountered in clinical practice. Although terminology has evolved, the core phenomenon described decades ago remains unchanged: A caregiver, most often the mother, intentionally fabricates, exaggerates, or induces illness in a child to meet psychological needs. The child suffers not only from the caregiver’s direct …

Physician grief and patient loss: Navigating the emotional toll of medicine

Francisco M. Torres, MD

Physician

December 20, 2025

“Doc, I’ve seen enough doctors. I only trust you. I want you to do my knee replacement and fix my heart.”

I heard the conviction in his voice when I heard these words from this patient. Sitting across from me was a 76-year-old army veteran I had cared for over two decades. He had seen multiple specialists, endured countless consultations, and, in the end, he wanted me, the physician who had …

Joy in medicine: a new culture

Kelly D. Holder, PhD & Kim Downey, PT & Sarah Hollander, MD

Conditions

December 20, 2025

Kelly D. Holder, PhD, and I first met at the Dr. Lorna Breen Heroes Foundation Health Care Worker Well-Being Day in Washington, D.C., where she was a presenter. I was impressed with Kelly’s work, focusing on helping health care professionals and leaders co-create a culture of well-being, which is so critical in medicine today.

This resonates deeply with Sarah Hollander, MD’s belief that the culture of medicine must change, starting in …

Read more…

Joy in medicine: a new culture

A pediatrician’s reckoning with applied behavior analysis [PODCAST]

The Podcast by KevinMD

Podcast

December 19, 2025

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Developmental-behavioral pediatrician Ronald L. Lindsay discusses his article, “A pediatrician’s reckoning with behavior therapy.” He shares his profound professional and personal pivot, …

How deprescribing in psychiatry offers a path to safer care

Muhamad Aly Rifai, MD

Meds

December 19, 2025

America learned to add medications. Add one for sleep. Add one for nausea from the first. Add one for weight gain from the second. Add a second antidepressant when the first loses effect. Add a stimulant when a mood stabilizer slows a teenager down. Add an antipsychotic when anxiety erupts in the clinic room. Add a statin because a lab number sits outside a guideline range. Patients, however, feel the …

Finding meaning in medicine through the lens of Scarlet Begonias

Arthur Lazarus, MD, MBA

Physician

December 18, 2025

“Once in a while you get shown the light
In the strangest of places if you look at it right.”

That line from Scarlet Begonias (lyrics by Robert Hunter, melody by Jerry Garcia) has followed generations like a benediction disguised as a song lyric. Released in 1974 on the Grateful Dead album From the Mars Hotel, it has become something more than poetry. It is a philosophy of attention, a reminder that …

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