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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

Fragmented care needs clinical direction, not more data

Sat, 23 May 2026 14:00:09 +0000

Patients often assume that someone is directing their care. That there is a clinician who sees the whole picture, integrates the information, and guides what happens next. In many cases, that is not how modern care is structured. Patients move between clinicians (primary care, specialists, urgent care, consultants), each focused appropriately on a specific aspect

How lifestyle interventions reverse type 2 diabetes

Sat, 23 May 2026 13:00:02 +0000

I was a resident physician in New York City when I met a Jamaican woman in her early 40s, newly diagnosed with type 2 diabetes. The hospital was always crowded and the schedules unpredictable, making continuity difficult. But appointment after appointment, she found her way back to me. She trusted me and even brought me

Why thymic involution is the aging organ doctors miss

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

There is an organ sitting behind my sternum that most of my patients have never heard of. Most of my colleagues rarely mention it. And yet, quietly, steadily, for the past four decades, it has been disappearing. The thymus. The schoolhouse of the immune system. The place where T cells learn to distinguish self from

How HIV stigma creates barriers to effective HIV care

Sat, 23 May 2026 11:00:20 +0000

HIV in Puerto Rico is no longer defined by lack of treatment, but by the persistence of stigma. From my perspective as a Doctor of Nursing Practice (DNP) student and future Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), stigma remains one of the most significant barriers to effective HIV care. While biomedical advances such as antiretroviral

Primary care, bloodletting, and what medicine got right [PODCAST]

Fri, 22 May 2026 23:00:42 +0000

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! Robert C. Smith is best known for arguing medicine lost its mind. This episode he explains why he is still proud to be a doctor. Primary care physicians deliver 75 percent of the nation’s mental health care without training for it,

Prescribing is down, opioid overdose deaths are not

Fri, 22 May 2026 22:00:42 +0000

It is often said in popular literature that figures lie and liars figure. However, sometimes in science, the lie is by omission. What we don’t say can be even more important in our conclusions than what we do. Two charts illustrate this principle in a centrally important issue of U.S. clinical practice. The first chart