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GLP-1s, weight loss, and the inflammation tests your patient needs [PODCAST]

Mon, 25 May 2026 23:00:21 +0000

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! A cardiologist who helped set national cholesterol and weight targets for 40 years now says those numbers can mislead. Richard M. Fleming, a physician specializing in cardiovascular and inflammatory disease, argues that weight loss on a GLP-1 does not automatically mean

Spirituality is a remedy for physician burnout

Mon, 25 May 2026 21:00:03 +0000

A physician, whom I will call Dr. Hannah, initially sought coaching from me to address burnout and optimize clinical documentation in the electronic medical record. One of the major challenges that surfaced in her first coaching session was that she did not know who she was outside of work. She also wanted to bring more

Spirituality is a remedy for physician burnout originally appeared in KevinMD.com.

Philanthropy for scientific research is underused

Mon, 25 May 2026 19:00:17 +0000

I often wonder why giving has so little to do with how much one has. A millionaire may hesitate to part with even a few thousand dollars for a person in need, while someone with only a modest savings may readily give away a meaningful share of it for a good cause. Clearly, something deeper

Why high-functioning adults are delaying psychiatric care

Mon, 25 May 2026 17:00:34 +0000

A pearl forms when an irritant gets trapped inside an oyster and can’t get out. The oyster doesn’t remove it. It layers over it until damage becomes structural. That’s what I keep seeing in patients who waited years before seeking psychiatric care. The delay is often interpreted as denial or avoidance. In practice, many adults

The quiet loss of dignity in medicine

Mon, 25 May 2026 15:00:07 +0000

When institutions begin to fear the consequences of telling the truth, the First Amendment becomes a parchment promise rather than a living principle. Medicine is not immune to this cultural shift. Physicians who once spoke freely about patient safety, training standards, and systemic failures now hesitate, not because they lack conviction, but because the corporate

The quiet loss of dignity in medicine originally appeared in KevinMD.com.

Anesthesiologist bedside manner matters more than skill

Mon, 25 May 2026 13:00:32 +0000

In anesthesia, we meet patients at one of the most vulnerable moments of their lives. We care for patients as a team, and I’m grateful for the skilled certified registered nurse anesthetists (CRNAs) I work alongside every day. Often, we are asked to earn trust quickly, while patients place their safety and comfort in our

Doctor patient trust cannot be automated

Mon, 25 May 2026 11:00:25 +0000

He is an engineer from Guatemala, in his sixties. The Spanish accent has gone mostly quiet after decades in the States, but not entirely. Six months ago I did a radical prostatectomy on him. Localized disease, favorable risk, I spared the nerves. It went the way you hope these things go. Today, sitting across from

Doctor patient trust cannot be automated originally appeared in KevinMD.com.

Is coaching in medical education replacing mentorship?

Sun, 24 May 2026 21:00:07 +0000

Walk into any medical school or residency program today and you will find coaching everywhere. There are coaches for Step exams, OSCEs, research productivity, wellness, leadership, residency applications, and even “professional identity.” On the surface, this seems like progress, offering structured support, individualized feedback, and measurable outcomes. But beneath this expansion lies a more uncomfortable

A medical school experience that redefined providing care

Sun, 24 May 2026 19:00:48 +0000

My first experience of “providing care” did not unfold as I had imagined: after years of training, thoroughly studying everything there is to know about the human body, and being perfectly prepared to care for someone. Instead, it began quietly, with a white coat and a stethoscope that fit about as comfortably as my pseudo-physician

Physician burnout is quietly costing doctors themselves

Sun, 24 May 2026 17:00:33 +0000

What if I told you that burnout is not the most dangerous thing happening to primary care physicians right now? I actually think there’s something worse, and it’s happening quietly. Because many experienced doctors are slowly losing something they never expected to lose: themselves. Not their license. Not their income. Not even their career. Themselves.

Polycystic ovary syndrome is more than ovarian

Sun, 24 May 2026 16:00:51 +0000

The name polycystic ovary syndrome may have unintentionally narrowed how medicine understood one of the most common endocrine disorders affecting women. The ovaries were visible. The deeper physiology was not. For decades, the syndrome was largely framed around irregular ovulation, infertility, excess androgen symptoms, and the characteristic “string of pearls” appearance seen on ultrasound. Yet

Polycystic ovary syndrome is more than ovarian originally appeared in KevinMD.com.

How AI improves clinical reasoning for medical students

Sun, 24 May 2026 15:00:20 +0000

“The eyes only see what the brain knows.” A patient said this to me recently, and it stopped me in my tracks. He was reflecting on his own experience in the medical system: the many physicians he had seen for the same problems, and the various different diagnoses he had received. Although each of those

How GLP-1 medications compare to bariatric surgery

Sun, 24 May 2026 13:00:28 +0000

For most of my career as a bariatric surgeon, I told patients that surgery was the most reliable tool we had for significant, sustained weight loss. That conversation has fundamentally changed. In the past three years, GLP-1 receptor agonists, a class of medications originally developed for type 2 diabetes, have redefined what is medically achievable

Overcoming physician burnout during medical residency

Sun, 24 May 2026 11:00:55 +0000

I had matched into one of my top pick residencies, and I was living out my “dream life.” I was a very proud active-duty military member, and I was an oral and maxillofacial surgery resident. I loved where I lived, and my co-residents were amazing. The program fit my personality, and I was surrounded by

How moving from nursing to medicine improves oncology care

Sat, 23 May 2026 21:00:57 +0000

I still remember the heavy silence of the psychiatric unit during the peak of COVID-19. No family visitors, no group therapy, just the low hum of monitors and the crushing weight of isolation. One of my patients had survived a suicide attempt after losing his wife and daughter in a car accident. His grief filled

Why hospitals delay action on impaired physicians

Sat, 23 May 2026 19:00:12 +0000

The challenges in dealing effectively with this issue are compounded by multiple factors. These include an overall national shortage of physicians, particularly in rural communities, as well as being more prevalent in some specialties than others. In addition, if an impaired physician has been a long-standing member and past leader of the medical staff, is

Lifestyle, mindfulness, and the neuroscience of happiness

Sat, 23 May 2026 18:00:34 +0000

I have been gathering information about the neuroscience of happiness for over a year now, since the completion of my previous book, Legal Mind in Medicine, and decided to put a glimpse of it in an article form for the Memorial weekend reading. Happiness stands as a central human pursuit, shaping our physical health, mental

When normal creatinine hides post-operative kidney injury

Sat, 23 May 2026 17:00:54 +0000

The conversation in the surgical ICU happens the same way every time. “His creatinine spiked post-op, but it came back down before discharge. The labs look normal now. The kidney recovered.” Cardiac surgeons hear this reassurance so often it’s become standard. The patient leaves the hospital with normal kidney function on the discharge summary. By

The hidden cost of medical malpractice litigation

Sat, 23 May 2026 16:00:59 +0000

The emergency department was bright after midnight. An older man in his 80s arrived short of breath and frightened, surrounded by anxious family members. He had diabetes, chronic kidney disease, heart failure, and a recent fever. The nurse checked his blood pressure and tried to calm his daughter. The physician reviewed the chart and knew

Why medical training ignores the business of medicine

Sat, 23 May 2026 15:00:32 +0000

We spend a lot of time talking about how broken the medical system is: burnout, moral injury, administrative overload, loss of autonomy. We propose solutions: better workflows, more staffing, policy reform, technological innovation. But there is a harder truth we tend to avoid. The overall medical training system needs an overhaul. Medical training does not