KevinMD.com

October 30, 2026Oct 30, 2026

An excerpt from Jimmy's Story: Forging a New Path for American Healthcare. Looking back, I had submitted my fictional tale, "Standing Vigil 2020," to the New England Journal of Medicine (NEJM), a premier peer-reviewed professional journal. The NEJM had sponsored…

An excerpt from Jimmy’s Story: Forging a New Path for American Healthcare.

Looking back, I had submitted my fictional tale, “Standing Vigil 2020,” to the New England Journal of Medicine (NEJM), a premier peer-reviewed professional journal. The NEJM had sponsored a fiction-writing contest, and I had received a terse letter of rejection of my submission. Little did I know at the time of the writing that my grandson would ultimately …

Conditions and diseases

Chronic pain and cognitive decline feed each other

Kayvan Haddadan, MD

October 30, 2026Oct 30, 2026

Chronic pain and cognitive impairment frequently coexist in older adults, creating a self-reinforcing loop that accelerates functional decline, increases disability, and reduces quality of life. More than half of patients in pain clinics report cognitive difficulties, and roughly 45 to 50 percent of people living with dementia experience chronic pain. Longitudinal evidence demonstrates that persistent pain is associated with accelerated cognitive decline and elevated dementia risk. In a large nationally …

Physician voices

Robotic brain surgery sent my patient home within a day

Dr. Homoud Aldahash

October 30, 2026Oct 30, 2026

Robotic surgery is redefining what's possible in medicine, turning once unimaginable procedures into everyday realities that save lives across the globe. When we look at the human brain, with its intricate architecture and concentration of critical structures, operations inside the…

Robotic surgery is redefining what’s possible in medicine, turning once unimaginable procedures into everyday realities that save lives across the globe. When we look at the human brain, with its intricate architecture and concentration of critical structures, operations inside the skull require the utmost delicacy. As a neurosurgeon, I have dedicated over twenty-five years to understanding this complexity, driven by a passion found early in my medical training. This is …

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Health technology

How much time do AI scribes really save physicians?

Brian Hudes, MD

October 30, 2026Oct 30, 2026

Doctors report feeling better with AI scribes. The measured time savings are smaller than many of them perceive, and the work of checking the AI is still unpriced. In a 2026 study of 252 physicians in the American Journal of…

Doctors report feeling better with AI scribes. The measured time savings are smaller than many of them perceive, and the work of checking the AI is still unpriced.

In a 2026 study of 252 physicians in the American Journal of Managed Care, 86.5 percent said an AI scribe reduced their documentation time. The authors also measured documentation time directly. They found no significant association between the change a physician perceived and …

Conditions and diseases

Lianne Mandelbaum, PT, on food allergy safety: a KevinMD subscriber spotlight

Subscriber Spotlight by KevinMD

October 30, 2026Oct 30, 2026

Lianne Mandelbaum, PT, is a physical therapist and a leading advocate for airline safety measures to protect food-allergic passengers. She is president of No Nut Traveler, a food allergy nonprofit, and airline correspondent for Allergic Living. She has published 18…

…

Conditions and diseases

3 pediatric migraine traps that keep kids in pain

Deb Mojumder, MD, PhD

October 30, 2026Oct 30, 2026

On a recent Monday morning, 13-year-old Maya sat at her family's kitchen table with the blinds pulled shut, shielding her eyes from the sliver of sun cutting across the counter. Her breakfast sat untouched. She pressed both palms into her…

On a recent Monday morning, 13-year-old Maya sat at her family’s kitchen table with the blinds pulled shut, shielding her eyes from the sliver of sun cutting across the counter. Her breakfast sat untouched. She pressed both palms into her temples, dreading the first-period math test she was about to miss.

Her mother, exhausted after months of watching these episodes escalate, spotted a crumpled candy wrapper from the night before. She …

The Podcast by KevinMD

U.S. health care won’t be fixed until everyone can see a doctor [PODCAST]

The Podcast by KevinMD

October 29, 2026Oct 29, 2026

Almost 50 years into practice, a cardiologist says American health care is getting worse by the day. Peter R. Kowey specializes in heart rhythm disorders and ran a cardiology division for 25 years. This episode is based on his article…

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Conditions and diseases

What a penile filler death should teach us about safety

TJ Tsay, MD

October 29, 2026Oct 29, 2026

Igho "Tiny" Ubiribo was forty-three when he died after receiving penile filler injections in Bangkok. My condolences go to his wife and family. As we discuss what happened, I want to be mindful of the pain they are going through.…

Igho “Tiny” Ubiribo was forty-three when he died after receiving penile filler injections in Bangkok. My condolences go to his wife and family. As we discuss what happened, I want to be mindful of the pain they are going through.

His death made headlines because he was known publicly. But the questions it raises matter to anyone considering this procedure. We should be asking the same questions even if this case …

Conditions and diseases

I wrote a book doubting statins. Now I have heart disease.

Larry Kaskel, MD

October 29, 2026Oct 29, 20262

I have spent much of my 35-year medical career questioning the conventional wisdom surrounding cholesterol and cardiovascular disease. I'm an internist, a lipidologist, and what I affectionately call a lipidologist in recovery. I even wrote a book challenging the widespread…

I have spent much of my 35-year medical career questioning the conventional wisdom surrounding cholesterol and cardiovascular disease. I’m an internist, a lipidologist, and what I affectionately call a lipidologist in recovery. I even wrote a book challenging the widespread use of statins.

I remain skeptical of the idea that cholesterol is the principal villain in coronary artery disease. I believe inflammation, immune responses, and potentially infectious organisms deserve considerably more …

Health technology

An AI scribe records the words, not the patient

Nancy Jiang, MD

October 29, 2026Oct 29, 20262

Last month I sat in on yet another demo for a new ambient AI scribe tool, the kind that's supposed to turn a recorded visit into a clean note by the time you walk out of the room. It was…

Last month I sat in on yet another demo for a new ambient AI scribe tool, the kind that’s supposed to turn a recorded visit into a clean note by the time you walk out of the room. It was good. Really good. Good enough that I left thinking about all the charting I wouldn’t have to do that night, and also thinking about something else, which is that the …

Health technology

AI in radiology: A missing flag is not a negative read

Harvey Castro, MD, MBA

October 29, 2026Oct 29, 2026

Picture a busy ED at 1 a.m. A CT pulmonary angiogram comes back from the scanner. The worklist shows no AI flag for pulmonary embolism. The radiologist has 30 studies in the queue. The patient's heart rate is still 112.…

What does the missing flag mean? A new study says: less than most of us assume.

On Oct. 21, researchers at Emory published a look at two FDA-cleared PE detection algorithms …

Drugs and prescribing

The GLP-1 shortage ended. The adherence problem did not.

Danielle Lightsey, RPh

October 29, 2026Oct 29, 2026

For several years, glucagon-like peptide-1 (GLP-1) medications seemed to dominate conversations in community pharmacy. Patients called asking whether specific products were available, prescriptions were transferred between pharmacies, and pharmacy staff spent considerable time checking inventories and monitoring shortages. It was…

GLP-1 receptor agonists, including semaglutide (Ozempic and Wegovy) and …

Physician voices

What not being valedictorian taught me about potential

Ronald L. Lindsay, MD

October 29, 2026Oct 29, 2026

There were three of us who probably could have been valedictorian. I was one of them. At English High School in Boston, I earned straight A's from tenth grade onward. Yet my academic record contained a blemish that proved impossible…

There were three of us who probably could have been valedictorian. I was one of them.

At English High School in Boston, I earned straight A’s from tenth grade onward. Yet my academic record contained a blemish that proved impossible to overcome. A B+ in ninth-grade English.

The explanation was even harder to forget than the grade itself. My teacher wrote that my work “did not reach my potential.”

At fourteen, I was …

Physician voices

Why malpractice carriers settle cases they could win

Howard Smith, MD

October 29, 2026Oct 29, 2026

As a doctor, I rely on legislators to safeguard my professional interests, most of which concern medical malpractice litigation. However, because they fail in this mission, I do not trust them, so I become proactive. I know that medical malpractice…

I know that medical malpractice insurance carriers face operational challenges, to which I am completely sympathetic. The most important challenge is whether to settle a defensible case, which involves a severe complication but no negligence, or …

The Podcast by KevinMD

Joining a private practice? Get the partnership terms in writing first. [PODCAST]

The Podcast by KevinMD

October 28, 2026Oct 28, 2026

Being offered partnership in a medical practice is usually good news, but not always. One physician paid $60,000 to buy in, then signed a contract making her cover all of a $325,000 bonus her two partners had given themselves. That…

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Health policy

Why payer contracting can no longer be a back-office job

Christine Mulheran

October 28, 2026Oct 28, 2026

Payer contracting has reached an inflection point. Although these contracts are the lifeblood of a health system, the managed care function is often seen as a routine set of transactional and administrative activities. Too often, these critical activities sit within an overwhelmed and under-resourced team that isn’t optimally connected with enterprise strategy. The result is that health systems are leaving significant value on the table by failing to capture the …

Health technology

Accessibility is not a device. It is an ecology.

Dr. Roshan Agarwal & Roshni Nair

October 28, 2026Oct 28, 2026

"Yeh kaise aaye hai?" This first comment followed us through the wooden doors of the theater, accompanied by snickering from the group of young boys who had said it. Inside, the lobby was flooded with bright fluorescent light, movie posters…

“Yeh kaise aaye hai?”

This first comment followed us through the wooden doors of the theater, accompanied by snickering from the group of young boys who had said it. Inside, the lobby was flooded with bright fluorescent light, movie posters stretched from floor to ceiling, and the overpowering smell of buttered popcorn and samosas. My family waded through it, working my grandmother’s wheelchair through the clusters of people. I was ten …

Health technology

Accelerated TMS: 5 questions families should ask first

Nicole Drapeau Gillen

October 28, 2026Oct 28, 2026

Psychiatrist Ravi Singareddy did something rare in his recent KevinMD piece on accelerated transcranial magnetic stimulation (TMS): He slowed the hype down. SAINT's open-label pilot reported remission in about 90 percent of completers. Under sham control, remission was closer to…

Psychiatrist Ravi Singareddy did something rare in his recent KevinMD piece on accelerated transcranial magnetic stimulation (TMS): He slowed the hype down. SAINT’s open-label pilot reported remission in about 90 percent of completers. Under sham control, remission was closer to 50 percent versus 21 percent. SWIFT showed that an accelerated deep TMS course could match a standard one, reaching remission about a week sooner. His conclusion: “Faster” is not …

Physician voices

Uncertainty in medicine beats a confident deepfake

Yemeng Lu-Myers, MD, MPH

October 28, 2026Oct 28, 2026

New fear unlocked: waking up to a viral TikTok of "me," gushing about a probiotic nasal spray that cures chronic sinus infections. As a board-certified ear, nose, and throat surgeon, I've been considering creating a platform to combat the misinformation…

New fear unlocked: waking up to a viral TikTok of “me,” gushing about a probiotic nasal spray that cures chronic sinus infections.

As a board-certified ear, nose, and throat surgeon, I’ve been considering creating a platform to combat the misinformation on social media. Before I even made an account, the American Medical Association reported about recent scams involving AI-generated deepfakes of influential doctors peddling unproven supplements on TikTok. A woman spent …

The Podcast by KevinMD

Self-care isn’t self-indulgence, and burnout isn’t only a personal problem [PODCAST]

The Podcast by KevinMD

October 27, 2026Oct 27, 2026

Doctors and nurses are trained to take excellent care of other people's health, and often don't look after their own. Close to half the health care workforce has burnout, and it shows in rounded shoulders, lower back problems, and little…

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Doctors and nurses are trained to take excellent care of other people’s health, and often don’t look after their own. Close to half the health care workforce has burnout, and it shows in rounded shoulders, lower back problems, and little time to process a patient’s death. Internal medicine and critical care physician …

Real physician voices, twice a week

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