Psychiatry

The problem with perfectionism in health care

Physician

December 8, 2025

We work in an impossibly depleted health care system and under impossibly high expectations of perfection from society. We hold our peers, our team members, our trainees, and most of all, ourselves to rigid, lofty ideals of flawlessness. By glorifying perfectionism in medicine, we have effectively dehumanized ourselves.

The oath we take is “Do No Harm.” It is not “Try your best to do no harm.” Is it appropriate to expect …

A leader’s journey through profound grief and loss [PODCAST]

The Podcast by KevinMD

Podcast

December 7, 2025

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

Health care strategist Dana Y. Lujan discusses her article, “Grief and leadership in health care.” Dana shares her devastating personal story of losing both her son’s father and, six years later, her …

A pediatrician’s medical service in war and peace

Ronald L. Lindsay, MD

Physician

December 6, 2025

I was the expectant team leader at Minot, the one designated to survive “a little longer than the others” if nuclear war came. My role was not glamorous. It was a reminder that even in medicine, some of us were expendable. Years later, I was nearly sent to the First Gulf War, and I watched colleagues deployed to Afghanistan, developmental pediatricians pressed into service far from the children they were …

Institutional inbreeding in developmental-behavioral pediatrics

Ronald L. Lindsay, MD

Conditions

December 5, 2025

Developmental-behavioral pediatrics (DBP) was once defined by giants, leaders who authored textbooks, set standards, and gave the specialty a clear identity. Today, the field is fragmented, misunderstood, and too often hostile to new ideas. My own career arc illustrates how inbreeding and isolation have hollowed out DBP, leaving children without advocates and institutions without direction.

At a major military medical center, retired military DBPs replaced me. All were trained at that …

A psychiatrist explains the new frontier of prescribed software treatments [PODCAST]

The Podcast by KevinMD

Podcast

December 3, 2025

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

Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article, “The rise of digital therapeutics in medicine.” Muhamad explains what prescription digital therapeutics (PDTs) are, emphasizing they are …

How stigma in psychiatry affects patients

Devina Maya Wadhwa, MD

Physician

December 3, 2025

As a psychiatrist, I often find myself confronting not only the symptoms of mental illness but also the deep scars left by stigma. Even in 2025, despite advances in neuroscience and a growing cultural focus on mental health, stigma remains one of the greatest barriers to healing. It manifests in silence, shame, and misunderstanding, and it affects patients, families, and even those of us within the psychiatric profession. Addressing stigma …

Developmental-behavioral pediatrics: the lost identity

Ronald L. Lindsay, MD

Conditions

December 3, 2025

Developmental-behavioral pediatrics (DBP) has lost its identity, and my career shows what happens when leadership retreats.

When I applied for positions in Tucson and Jacksonville, I was not seen as a developmental pediatrician with expertise in neurodevelopmental disabilities. Instead, I became the dumping ground for “Stranger Things” (children whose needs were psychiatric, not developmental). Administrators and chiefs, lacking even a basic understanding of DBP, misrouted cases into my lap. The result …

Why psychologist training takes years

Peggy A. Rothbaum, PhD

Conditions

December 3, 2025

As a practicing (“licensed”) psychologist, this issue comes up frequently. What are the differences among the myriad of mental-health professionals and does it even matter? As a researcher, as well as a clinician, my first inclination is always to look at the literature when seeking answers. What have others written on whatever topic it is that I am trying to better understand? Did someone else already answer my question? So, …

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Why psychologist training takes years

When patients self-diagnose from TikTok

Anadil Coria, MD

Conditions

December 2, 2025

It’s a moment I’ve come to recognize too well as a psychiatry resident: a patient walks into my office already convinced of their diagnosis. They’ve watched a dozen videos, followed mental health influencers on Instagram, and taken online quizzes that “confirmed” what they suspected. They have ADHD, or autism, or borderline personality disorder. They’re not here for an evaluation; they’re here for validation.

On one hand, this moment feels like progress. …

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When patients self-diagnose from TikTok

Imposter syndrome: a poem of self-talk

Mary Remón, LCPC

Conditions

December 1, 2025

Many of the physicians I work with live with a quiet weight of imposter syndrome. They show up every day for patients, teams, and families, yet doubt their own belonging.

I wrote a short reverse poem, “Worthy in Reverse,” as a way to explore how self-talk can shape that inner experience. This poem was inspired by “Worst Day Ever?” by Chanie Gorkin, which creatively uses structure to shift perspective.

It is simple …

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Imposter syndrome: a poem of self-talk

How online physician reviews impact your medical career

Timothy Lesaca, MD

Physician

November 30, 2025

Have you ever wondered how a single online comment might shape your reputation as a physician? I have, especially after reading a review that sardonically suggested I had earned my medical degree from Amazon (the company, not the rainforest). The jab was clearly meant to sting. Although I regret the dissatisfaction behind it, it gave me pause. How much weight do we give these offhand remarks, and what do they …

Divorced during residency: a story of clarity

Emma Fenske, DO

Physician

November 27, 2025

Keeping my head down and working through intern year was all I had known. My days blurred into nights, and my weeks into months. The dreary Pacific Northwest winters had only compounded this. Despite a quiet yearning for connection and community, I declined most social invitations. My sense of obligation did not end at the hospital doors. It followed me home, where expectations and emotional responsibilities lingered. I often felt …

The ethical conflict of the Charlie Gard case

Timothy Lesaca, MD

Conditions

November 24, 2025

Some cases linger in our memory because of the humanity at their center. The case of Charlie Gard, which unfolded in England in 2017, is one of those. It took place within the National Health Service and under a legal framework in which courts decide a child’s treatment when parents and clinicians cannot agree. Before it became a global controversy, before it drew international headlines, it began as something far …

Gen Z, ADHD, and divided attention in therapy

Ronke Lawal

Conditions

November 21, 2025

Halfway through a teletherapy session, you notice your therapist pause mid-sentence. They’ve just heard the soft clatter of your keyboard, or seen your eyes flick sideways to a second screen. You’re technically “there” on video, but a work email just popped up, laundry is buzzing, someone’s messaging you, and suddenly the session is sharing space with three other tabs in your brain.

On the therapist’s end, it can feel like talking …

Why we fund unproven autism therapies

Ronald L. Lindsay, MD

Physician

November 21, 2025

The average KevinMD reader may wonder why I’m so prolific in my commentary on pediatric medicine and the systemic reforms it demands. The answer is simple: I go to the source. Always.

That habit was forged nearly 30 years ago when the American Academy of Pediatrics invited me to serve as contributing section editor for Developmental-Behavioral Pediatrics in AAP Grand Rounds. My role: select key studies, critique methodology, and distill bottom-line …

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Why we fund unproven autism therapies

Why psychiatrists can’t treat family members

Farid Sabet-Sharghi, MD

Conditions

November 19, 2025

As a psychiatrist, I’m often asked by family or friends to “help,” to intervene in the mental struggles of a loved one, a friend, or even a distant acquaintance. It usually begins with kindness and concern: “Could you just talk to them?” or “Maybe you can prescribe something, you’d know what’s best.” What follows is always a difficult conversation, because I have to explain something that sounds incomprehensible to most …

Trauma in high-functioning adults

Ronke Lawal

Conditions

November 19, 2025

A few days ago, I was speaking with a high-achieving, articulate, brilliant friend, someone always up and doing, super-expressive. During our conversation, I noticed her stumbling over her words, which was quite unusual, and her fidgety hands. She was narrating a traumatic incident that had occurred to her and how it tore her apart and made her simply give up on everything, in her words, “she was done.” Throughout the …

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Trauma in high-functioning adults

Funding autism treatments that actually work

Ronald L. Lindsay, MD

Conditions

November 18, 2025

Applied Behavior Analysis (ABA) has become the default therapy for autism in the U.S., not because it’s the most effective, but because it’s the most entrenched. Mandated by insurers, funded by Medicaid, and marketed as “medically necessary,” ABA now consumes hundreds of millions of dollars annually. But here’s the truth: ABA is unproven, ethically fraught, and fiscally unsustainable.

As a developmental-behavioral pediatrician and lead investigator for the NIH-funded RUPP trials, I …

Why patients delay seeking care

Rida Ghani

Conditions

November 17, 2025

Every clinic has moments that stick with you. They aren’t always dramatic, but they show why some people end up suffering longer than they should. During my time working as a medical office assistant, I observed a recurring pattern that spanned across various age groups, backgrounds, and diagnoses. Patients didn’t delay care because they were careless. They delayed because the system had quietly taught them to.

One afternoon, a middle-aged woman …

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Why patients delay seeking care

The myth of endless availability in medicine

Emmanuel Chilengwe

Conditions

November 15, 2025

For years, I believed that the best clinicians were the ones who never stopped. We covered extra shifts, skipped meals, charted past midnight, and proudly wore exhaustion as a badge of honor. My patients were happy, my colleagues admired my work ethic, and I was quietly unraveling.

The slow slide into burnout

Burnout didn’t arrive like a crisis; it crept in as a constant background hum. I began to dread the pager’s …