KevinMD.com

I defended nicotine. Then I found my own heart disease.

Sun, 08 Nov 2026 14:00:00 +0000

Last year, I wrote an article for KevinMD defending nicotine. My argument was straightforward: Nicotine had been unfairly demonized because of its association with cigarettes, and we’d largely ignored its potential therapeutic benefits. I still believe that. But a few weeks ago, I underwent a coronary CT angiogram and discovered that I have coronary artery

When the patient portal is the only way to reach your doctor

Sun, 08 Nov 2026 13:00:00 +0000

An excerpt from METACINE: Essays on Health Care in a Changing World. Primary care is meant to be medicine’s front door: the familiar place where a patient can discuss a new symptom, a lingering worry, a medication question, or simply the uneasy sense that something is not right. It is meant to be a relationship,

After an FDA recall, patients need a plan for the next dose

Sun, 08 Nov 2026 12:00:00 +0000

A medication recall can answer an important question about a product while leaving the patient’s next question unresolved: What should I do about my next dose? That gap matters. A headline may name a medicine without identifying the particular package in a person’s home. A notice may explain a manufacturing problem without explaining how an

Alzheimer’s treatment works best early, so why are patients waiting? [PODCAST]

Sun, 08 Nov 2026 00:00:36 +0000

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes Two Alzheimer’s drugs now slow the disease, and they work best when symptoms are still mild. Emer MacSweeney is a neuroradiologist and the cofounder and CEO of Re:Cognition Health. This episode is based on her article “Early Alzheimer’s detection is now a treatment decision,” published on

Rebuilding public trust in science after COVID-19

Sat, 07 Nov 2026 22:00:00 +0000

On March 19, 2020, I was called to a meeting by Dr. Bijoy Sahoo, who was serving as provost of our university at the time. I was serving as vice president of the Faculty Senate, and because the Senate president was unavailable, I attended the meeting on behalf of the faculty. The university faced an

Yale’s single-payer study skips the physician shortage

Sat, 07 Nov 2026 21:00:00 +0000

In August, the Yale School of Public Health announced a preprint projecting that a single-payer system could cover every American, avert about 114,000 deaths a year, and cost roughly $1 trillion less than the system it replaces. The release quotes the authors as saying such a system requires “no new discovery, only enactment.” I have

Front-desk mistakes start with overload, not carelessness

Sat, 07 Nov 2026 20:00:00 +0000

She wasn’t careless. She was carrying too much. The nurse at LabCorp was about to draw my father’s blood when she stopped. There was no order for him. There was only an order for my mother. My father had just been seen upstairs. His doctor wanted to check his thyroid. He had been feeling tired

Opioid monitoring should not stop between monthly visits

Sat, 07 Nov 2026 19:00:00 +0000

Over the past decade, the clinical and regulatory environment surrounding opioid prescribing for chronic non-cancer pain has changed substantially. The 2016 Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain and, more significantly, the updated 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain established a clearer framework for

COPD in women starts with subtle signs physicians can miss

Sat, 07 Nov 2026 18:00:00 +0000

In my teens, I watched my grandmother slowly change and wither away. I can still remember the feel of her bones under my arms as I advanced through my teen years as her already slim frame became slimmer. I watched as her breathing became more labored, there were more trips to the hospital, and she

Chronic disease care fails when medicine ignores the mind

Sat, 07 Nov 2026 17:00:00 +0000

Because medicine excludes psychological and social issues in training and health care, we have a crisis in physical disease care (as well as the mental health crisis). You read correctly: a crisis in medicine’s ostensible forte, physical diseases. It occurs in two situations: when there is mental illness comorbid with a chronic physical disease and

Leaving medicine is not the only way out for physicians

Sat, 07 Nov 2026 16:00:00 +0000

There is a specific kind of tired that shows up in women who have given their lives to medicine. They matched into competitive residencies, they trained through most of their twenties and into their thirties, and they are excellent at the work. They are also the people everyone else leans on, at the hospital and

Will AI replace doctors who no longer have time to care?

Sat, 07 Nov 2026 15:00:00 +0000

I work in San Francisco. Every morning I walk six blocks from the train to my office, and as I look down the street, I notice how many cars are wearing hats. The “hat” is the rooftop sensor dome, LiDAR and cameras, on the Waymo self-driving cars that fill my city’s streets. If they have

Why smoking cessation takes more than clinician confidence

Sat, 07 Nov 2026 14:00:00 +0000

How confident are health care professionals in helping patients quit smoking? And how often does that confidence translate into practical assistance? Our recent research suggests these questions can produce very different answers. In October, we reported findings from a survey of 1,538 Ukrainian health care professionals in Healthcare Business Today. The results revealed a striking

A nerve block checklist cannot replace the final pause

Sat, 07 Nov 2026 13:00:00 +0000

A nerve block may involve a small needle and a carefully chosen injection, but its final safety decision is larger than either. The patient may be correctly identified, the consent signed, the intended side marked, and the ultrasound machine ready. Yet one question remains until the procedure begins: Did the people about to perform the

The child psychiatrist shortage starts with what we say

Sat, 07 Nov 2026 12:00:00 +0000

“Why would you waste your medical training to go into psychiatry? Do you not want to be a real doctor?” I have heard about a hundred variations of this in my career. If you decide to become a psychiatrist, people will question your wisdom, and then if you decide to become a child psychiatrist, they

Clinical trials answer drug questions. Health questions need other tools. [PODCAST]

Sat, 07 Nov 2026 00:00:41 +0000

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes No one ever ran a blinded trial on handwashing. It became standard practice around the world anyway. Narinder Singh Parhar, an internal medicine, hospital medicine, and critical care physician, calls evidence-based medicine one of the field’s great achievements and credits it with saving millions of lives.

I build clinical decision support. It does not decide.

Fri, 06 Nov 2026 21:00:00 +0000

Last month I wrote here about how AI is changing what patients expect their clinicians to know. Medicine does not have an information problem. It has an interpretation problem. The chart is full. What is missing is someone with the time and the tools to ask why. In the weeks since, the conversation has moved,

The infant gut microbiome shapes health for decades

Fri, 06 Nov 2026 20:00:00 +0000

When you’re expecting your first child, your mind is naturally consumed by the big, tangible details: assembling the crib, choosing a car seat, and debating baby names. But beneath the surface of those exciting preparations, an invisible, high-stakes biological process is taking place. From the moment of birth through a child’s second birthday, an entire

Are Teams chats private? Not when a lawyer comes asking

Fri, 06 Nov 2026 19:00:00 +0000

Workplace messaging platforms such as Microsoft Teams have become a regular part of clinical work. Health care organizations rely on them to coordinate schedules, manage logistics, and keep teams connected across different locations and telehealth settings. Because these channels are closed to outsiders and separate from the electronic health record, clinicians may view them as

A stock market crash brings a second crisis: elder fraud

Fri, 06 Nov 2026 18:00:00 +0000

At a bank counter in central Taiwan, a man in his sixties tried to break a time deposit and withdraw 1 million New Taiwan dollars. He believed a stock-investment team would manage the money for him. Bank staff became concerned and called the police. The disturbing detail was not the amount. Police had already intervened