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The real risk of medical tourism complications is distance

Tue, 29 Sep 2026 19:00:04 +0000

A meaningful portion of my practice involves reconstructive work, not the kind that follows trauma or cancer, but the kind that follows cosmetic procedures that went wrong. Patients come to me after abdominoplasties that developed into sepsis, after injections administered by unlicensed individuals, after hair transplants that left permanent scarring. Much of what I do

5 competencies the future of medical education requires

Tue, 29 Sep 2026 17:00:00 +0000

Medical education has always carried an enormous responsibility: deciding what a future physician needs to know. For generations, the answer seemed relatively straightforward. Give medical students a rigorous foundation in anatomy, physiology, biochemistry, pathology, pharmacology, microbiology, and other basic sciences. Build clinical knowledge upon that foundation. Then provide supervised clinical experience until the student becomes

AI chatbots and psychosis: Families see the harm first

Tue, 29 Sep 2026 16:00:00 +0000

A new scoping review in npj Digital Medicine should be read by every clinician who treats serious mental illness. Diel, Torous, and colleagues reviewed 119 articles on the mental health harms of large language model chatbots. They sorted the harms into five categories: direct psychiatric harm, behavioral and relational harm, cognitive harm, safety failures, and

Hearing screening in primary care is a single question

Tue, 29 Sep 2026 15:00:37 +0000

We measure blood pressure before a patient has a stroke. We check cholesterol before a coronary event. We evaluate vision before impairment interferes with driving or reading. So why is hearing treated differently? For many people, the last routine hearing test they remember was in elementary school. Decades pass before anyone checks again, often after

After-hours charting isn’t a backlog. It’s a team problem.

Tue, 29 Sep 2026 14:00:00 +0000

The last patient leaves around six. Dinner happens, eventually, and the kids go down around eight. The laptop comes back out after that, open to a stack of notes from a day that had exactly zero room in it for finishing them. Two-fifteen was the closest thing to a gap today, and a nurse used

Autism behavior therapy needs a physician in the room

Tue, 29 Sep 2026 13:00:34 +0000

This month, the Centers for Medicare and Medicaid Services (CMS) announced a new 173-page toolkit to help states ensure more effective and less costly autism care for children. The launch came as government data shows spending on care increased by 421 percent between 2021 and 2025, far outpacing the 67 percent growth in the number

AI and physician judgment: the risk when AI is mostly right

Tue, 29 Sep 2026 12:00:00 +0000

For many physicians, the first truly useful encounter with generative AI has been remarkably mundane. It takes notes. Ambient AI listens to the encounter, organizes the conversation, drafts the clinical note, and gives the physician something increasingly scarce in medicine: time. That is a genuine accomplishment. But it may also have created a misleading picture

Physicians and the death penalty: There is no humane way

Tue, 29 Sep 2026 11:00:14 +0000

“Do No Harm” is perhaps the most famous medical maxim. But reciting it is one thing; living by it is another. Sometimes, the question of “harm” is up for debate. Throughout history, physicians have lent their knowledge to all manner of atrocities, warfare, torture, and mass sterilization, often justified under the supposedly noble pursuit of

Why patients stop trusting doctors who listened to them [PODCAST]

Mon, 28 Sep 2026 23:00:58 +0000

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes A patient says her hip has hurt for a while. Whether she leaves trusting her doctor depends on what happens next. Alan P. Feren, a retired surgeon, health care consultant, and patient advocate, separates active listening, which makes a patient feel heard, from careful listening, which

Blood sugar and brain aging start long before diabetes

Mon, 28 Sep 2026 21:00:53 +0000

Most of us have a well-rehearsed speech for patients with elevated blood sugar. We talk about the heart. The kidneys. The eyes. The feet. We walk through the whole organ-by-organ checklist a glucose reading can quietly damage over the years. What most of us, myself included, haven’t been saying nearly often enough is anything about

What did the tirzepatide study actually test?

Mon, 28 Sep 2026 19:00:51 +0000

If you take Ozempic, Wegovy, Mounjaro, or Zepbound, or you are simply trying to make sense of GLP-1s (glucagon-like peptide-1) and GIPs (glucose-dependent insulinotropic polypeptide), you may have seen a recent Medscape article asking whether GIP really adds any benefit in type 2 diabetes. It is a fair scientific question. The problem is that the

What did the tirzepatide study actually test? originally appeared in KevinMD.com.

Why is psychic pain treated as a symptom instead of pain?

Mon, 28 Sep 2026 15:00:32 +0000

There is a conceptual inconsistency in contemporary medicine that I have become increasingly unable to reconcile. Psychiatry recognizes psychic pain as a genuine clinical phenomenon, and suicidology has long recognized unbearable psychological pain as integral to suicidal states. Neuroscience has simultaneously demonstrated that nociception, affective pain, reward, motivation, salience, stress responsivity, and emotional regulation are

Diagnostic overshadowing and the war in her throat

Mon, 28 Sep 2026 14:00:00 +0000

The referral came from a mental health clinic. A woman had been putting the hose of a handheld vacuum cleaner into her mouth, pushing the nozzle toward the back of her throat, and turning it on. She had done this more than once a day for several days. The clinician who examined her found bruising

Why do charity commercials leave clinicians uneasy?

Mon, 28 Sep 2026 13:00:00 +0000

Every night on mainstream streaming platforms, I see the same rotation of charity commercials: protect dogs, save Syrian children, shelter American runaways, support childhood cancer care, preserve wildlife. Each one asks for a small monthly donation (99 cents, $5, $19), and each one insists that without your contribution, the suffering continues. As a physician, I

Revenue cycle management is more than medical billing

Mon, 28 Sep 2026 12:00:00 +0000

Ask an independent practice owner who handles the revenue cycle and the answer is usually the name of a billing company. Ask what that company actually does each month and the answer gets shorter. Claims go out. Payments get posted. Denials get worked. Statements get mailed. That is medical billing, and it is valuable work.

Why AI fails in health care: Your data is the problem

Mon, 28 Sep 2026 11:00:49 +0000

Health care has never had more data. The industry generates approximately 30 percent of the world’s data volume, and that share continues to grow faster than nearly every other industry. Electronic health records, claims systems, pharmacy records, lab results, care management notes, social determinants of health data, wearable devices, and patient-generated information are producing an

Some relationships work like medicine. Others work like a diagnosis. [PODCAST]

Sun, 27 Sep 2026 23:00:15 +0000

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes A patient came in with weight gain nobody could explain. Every test came back fine. Shiv K. Goel is a board-certified internal medicine and functional medicine physician. This episode is based on his article “How relationships affect health, seen from the exam room,” published on KevinMD.

Cancer care in Ghana: Poverty is the true malignancy

Sun, 27 Sep 2026 21:00:32 +0000

As an incoming fifth-year dental student beginning my clinical internship at Tamale Teaching Hospital, the major tertiary referral center for northern Ghana, I expected to refine my surgical hand and master diagnostic pathology. The fine instructors at the department made this possible, but I also got to witness firsthand the brutal arithmetic of health care

The insurance maze that single-payer health care would end

Sun, 27 Sep 2026 19:00:39 +0000

One day, my mother suddenly was unable to finish her sentences. She was admitted to the local hospital, where a CT and MRI revealed multiple lesions. Ultimately, she was diagnosed with a glioblastoma. The neurosurgeon told us she was too old to operate on and recommended hospice, adding that she was unlikely to live more

Digital noise in health care is fragmenting clinical focus

Sun, 27 Sep 2026 15:00:41 +0000

Walk into any exam room today, and you’ll find more than a conversation between a clinician and a patient. Behind every visit is a steady stream of digital interactions: marketing messages, electronic health record (EHR) alerts, patient portal messages, pharmacy notifications, clinical decision support prompts, and administrative tasks, all competing for a clinician’s attention. Health