Psychiatry

A nurse practitioner on leaving the medical machine

Conditions

October 7, 2025

I began my career as a nurse practitioner in primary care, where patient visits are often limited to 15 or 20 minutes to manage complex conditions like hypertension, diabetes, and COPD. What struck me was how often these medical issues came with a psychological overlay like depression, anxiety, panic attacks, and trauma. That shaped the course of treatment as much as lab results or medications. The pace of primary care …

A poem for a physician in the ICU

Janet E. O'Brien, MD

Physician

October 7, 2025

In the ER, we ask, Was he wearing a seatbelt
Partly for the note, but partly so we can remove ourselves
From exploded flesh, splintered bones,
Not sure if we can save that eye.
Something in us says, that will not be me;
I take precautions. We live on,
On the strength of the stories we tell ourselves.

But in the ICU, when one of our own has come in,
After a well-informed try at smothering the spark,
There …

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A poem for a physician in the ICU

The mental health workforce is collapsing

Ronke Lawal

Conditions

October 7, 2025

A system hemorrhaging talent: the scale of the crisis

The global health care system is teetering on the edge of a catastrophic workforce deficit, with the World Health Organization projecting a shortfall of 11 million health workers by 2030. Nowhere is this crisis more acute than in the behavioral health sector, which is not merely losing talent but hemorrhaging it. The time for action is not just now, it’s yesterday.

Community …

The stoic cure for modern anxiety

Osmund Agbo, MD

Physician

October 7, 2025

Our one and only daughter has gone off to college. My wife and I dropped her off the weekend before. As we made the four-hour drive from Houston to Baton Rouge along I-10, the road stretched ahead, both endless and fleeting, as if time itself were torn between holding on and letting go. Between bursts of laughter and quiet silences, we spoke of classes, friendships, boys, the discipline of focus, …

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The stoic cure for modern anxiety

Why physicians with ADHD are struggling with burnout despite success [PODCAST]

The Podcast by KevinMD

Podcast

October 5, 2025

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

Certified coach Michael Carlini discusses his article “Why physicians with ADHD are burning out.” Michael explains how high-IQ physicians often mask their ADHD symptoms through hyper-organization, perfectionism, and hyperfocus, which allows them …

The paradox of letting your children go

Alana Epstein, MSW, LCSW

Conditions

October 5, 2025

I am writing this on a flight, somewhere between Los Angeles and Boston. Next to me, a young couple is tending to their ten-month-old baby: passing a bottle, bouncing her when she fusses, trading weary but tender smiles. Their world is diapers and nap schedules, the endless rhythm of caregiving.

My world today looks very different. I am taking my youngest child to college. With this trip, all three of my …

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The paradox of letting your children go

The generational trauma of the health care system

Tiffiny Black, DM, MPA, MBA

Conditions

October 4, 2025

Health care often talks about burnout as if it were a recent discovery. But for many clinicians, the exhaustion they feel did not begin with them. It was inherited, passed down through a system that normalizes overwork, silence, and sacrifice as the price of practicing medicine.

Every generation of providers has heard the same message: This is just how it is. Long shifts, missed meals, unsafe staffing ratios, and silence in …

The case for regulating, not banning, kratom

Heidi Sykora, DNP, RN

Meds

October 3, 2025

Kratom (Mitragyna speciosa) has become a topic of significant debate among clinicians, policymakers, and the public due to differing views on its safety, pharmacology, and regulatory requirements. A recent article raises important concerns about kratom’s pharmacological actions, potential for addiction, psychiatric risks, and regulatory challenges. Although the goal of protecting public health is admirable, it is crucial that discussions around kratom are rooted in current scientific evidence and avoid …

Why imposter syndrome is a systemic issue, not a personal flaw [PODCAST]

The Podcast by KevinMD

Podcast

October 1, 2025

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

Physician Jessie Mahoney discusses her article “Imposter syndrome is not a personal failing.” Jessie explains how self-doubt among physicians is less about individual weakness and more about a conditioned mindset reinforced by …

Reclaiming the human parts of a physician

Annia Raja, PhD

Conditions

October 1, 2025

When you step into medical training, you’re often told, both implicitly and sometimes even explicitly, that certain parts of you don’t belong. Sensitivity, doubt, or even just being messy and human can feel like liabilities in a culture that prizes efficiency, certainty, control, and always “having the answer.” Many physicians I work with in therapy describe learning early on to “toughen up,” to silence the softer, more questioning sides of …

Stepping down in medicine is an evolution

Jessie Mahoney, MD

Physician

October 1, 2025

In medicine, we’re trained to stay. To endure. To prove our worth by how much we can carry and how long we can carry it. Our roles become our identities. Our achievements and labels become scaffolds of self-worth. In medicine, stepping down is often labeled as a sign of weakness. So we hold on to roles even when they no longer fuel us. We are usually still doing the job …

The ethics of marketing unproven autism tests

Carrie Friedman, NP

Conditions

October 1, 2025

When I received an invitation to a webinar titled “Special Session on a New Autism Risk Test,” I expected a discussion on screening strategies or intervention innovations. Instead, when I researched the company and reviewed its website, I discovered a pitch for a punch-biopsy-based lab test marketed as a way to detect autism risk in newborns as early as two days after birth.

As a nurse practitioner who treats autistic patients, …

From Tokyo to Paris: Bringing the brushstrokes of healing to Western medicine

Francesco Panto, MD, PhD & Vikram Madireddy, MD

Physician

October 1, 2025

When we think about palliative care, our first instinct is to picture pain medications, symptom checklists, and clinical protocols. But for patients with terminal brain cancer, the reality is much more complex. As speech declines, as motor function deteriorates, and as identity itself feels threatened, the greatest need is not always more medicine; it is meaning, connection, and dignity.

In recent years, I have had the opportunity to study an ancient …

A psychiatrist reflects on two decades of treating depression with ketamine [PODCAST]

The Podcast by KevinMD

Podcast

September 30, 2025

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

Psychiatrist Muhamad Aly Rifai discusses his article “A psychiatrist’s 20-year journey with ketamine.” Aly recounts his first encounters with ketamine at the National Institute of Mental Health, where its rapid impact on …

The psychiatrist’s self as a clinical tool

Farid Sabet-Sharghi, MD

Physician

September 30, 2025

Psychiatry, perhaps more than any other medical specialty, is a field defined by ambiguity. Unlike other branches of medicine, where diagnostic tests and standardized protocols guide treatment, psychiatry often operates in a landscape where clear-cut answers are rare. The psychiatrist’s primary tools are not scalpels or stethoscopes, but words, presence, and (most crucially) the self.

Psychological transference and countertransference: double-edged swords

Psychological transference and countertransference are central to the practice of psychiatry, …

The crisis in inpatient psychiatric care

Muhamad Aly Rifai, MD

Conditions

September 30, 2025

Here is what I have seen across two decades of admitting and managing patients on inpatient psychiatric units. People do not ask for a locked door when life is comfortable. They come to us when the ground drops out. Families arrive with the weight of sleepless nights in their faces. Emergency clinicians pass me the chart, then the baton, and sometimes the quiet plea that says please help this person …

A physician’s guide to managing interruptions

Mary Remón, LCPC

Conditions

September 29, 2025

You are entering orders, rounding, or thinking through a patient problem in the hospital when a team member interrupts. Then comes another interruption. And another. You lose your train of thought, and you feel your jaw clench. Does this sound familiar? Physicians are expected to be efficient, accurate, and approachable, yet these three goals are nearly unattainable due to constant interruptions. Studies show that physicians are interrupted, during critical tasks, …

Finding integrity at the end of a career

Arthur Lazarus, MD, MBA

Physician

September 28, 2025

An excerpt from Born to Heal: Medical Narratives Set to the Soundtrack of Classic Rock.

Dr. Raul Morales sat alone in Exam Room 3, now used for storage, staring out at the fading autumn light through a slit in the blinds. The clinic was quiet, eerily so. His last patient had left an hour ago. He was supposed to be packing up his …

Why self-care is not enough for clinicians

Pragya Thakur, MBA

Conditions

September 28, 2025

Sarah, an emergency room nurse with eight years of experience, did not leave because she stopped caring. She left because the numbers no longer worked. Student loans outpaced her wages, overtime became mandatory without premium pay, and patient loads rose to unsafe levels. Eventually, the arithmetic of her life and work collapsed.

Sarah’s story is not unusual. Across the country, clinicians are leaving medicine in numbers that no longer feel like …

Crypto trading’s impact on mental and physical health

Dr. Aristomenis Exadaktylos, Dr. Suhaib J. S. Ahmad, and Dr. Thomas Mueller

Conditions

September 26, 2025

In 2024, centralized cryptocurrency exchanges recorded approximately USD 18.4 trillion in trading volume, with Binance alone accounting for forty percent (~USD 7.7 trillion). While the total number of cryptocurrency holders exceeded 600 million globally, active traders (those engaging in high-frequency or large-scale trading) appear limited to thirty to sixty million monthly users. Epidemiological data indicate these traders skew male (≈sixty-one percent), primarily aged 25 to 34 (thirty-four percent of owners), …

Psychiatry

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