KevinMD.com

Protect physicians from bureaucracy, not from patients

Tue, 25 Aug 2026 12:00:28 +0000

Lately, there has been considerable discussion about the changing boundaries between physicians and patients. How quickly should doctors respond to portal messages? When does reasonable access become unreasonable intrusion? Where does professional responsibility end and personal time begin? These are legitimate questions. Physicians are entitled to privacy, reasonable working hours, and protection from inappropriate demands.

The certification process that has no off-ramp

Tue, 25 Aug 2026 11:00:58 +0000

For those of you navigating the American Board of Internal Medicine’s (ABIM) Maintenance of Certification, I thought this anecdote might shed some additional light on the problems with the process. On June 26, I had a two-level spinal fusion. On May 9, I called the board to see if it was possible to “stop the

The certification process that has no off-ramp originally appeared in KevinMD.com.

Leaving her practice to reinvent herself from scratch [PODCAST]

Mon, 24 Aug 2026 23:00:08 +0000

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes! She built a thriving practice in Manhattan and appeared all over the media. Then she walked away, and it was never burnout. Samantha Nazareth is a gastroenterologist and the author of the memoir I Left Anyway: The Life I Was Supposed

Why nearly every pre-med now takes a gap year

Mon, 24 Aug 2026 19:00:26 +0000

An increasing number of pre-med students in the U.S. are electing to take a gap year, but is this the best option for them? More importantly, is it best for the medical field as a whole? Many students believe taking a gap year improves their admission chances. While compounding variables prevent conclusive proof that a

Why nearly every pre-med now takes a gap year originally appeared in KevinMD.com.

Prior authorization appeals stopped being a decision

Mon, 24 Aug 2026 18:00:29 +0000

The letter says denied. It’s not the first one this month, and the physician already knows how this goes: Read it, feel briefly annoyed, and move on to the next patient, because the last three appeals went nowhere and there’s no real reason to think this one would be different. Nothing about that moment is

Fat quality, not quantity, is the number that matters

Mon, 24 Aug 2026 17:00:26 +0000

I’ve been doing this long enough to have believed in technologies that failed, and doubted technologies that succeeded. That is a humbling education, and it is the one I trust most. I watched the Prostatron arrive, microwave thermotherapy that was going to spare men the operating room for their prostates. It had its moment, and

Is racial bias in physician discipline being measured?

Mon, 24 Aug 2026 16:00:08 +0000

The central limitation in evaluating racial parity in physician discipline is not the absence of concern, but the absence of standardized upstream data. Existing national systems primarily capture terminal outcomes. The National Practitioner Data Bank (NPDB), for example, receives reports of certain adverse clinical-privileges actions, including review actions restricting privileges for more than 30 days

Why naming co-agents in your power of attorney backfires

Mon, 24 Aug 2026 15:00:59 +0000

“It is better to have one bad general in charge than two good ones.” – Napoleon In Arizona, you may name multiple agents to act on your behalf under a single durable medical power of attorney. However, it is generally advisable not to go down this route. This is because with multiple agents in charge,

The revenue gap a physician notice period never closes

Mon, 24 Aug 2026 14:00:05 +0000

A resignation letter arrives with ninety days written on it. Most practices read that as ninety days to find a replacement, and the search starts that afternoon. What the letter actually started is three clocks running at once, and only one of them speeds up when the practice hires faster. The payer contracts have their

What my chronically ill daughter taught me about failure

Mon, 24 Aug 2026 13:00:24 +0000

When my chronically ill daughter was about five years old, a (hopefully) well-meaning family member got very angry at me for taking what they called unacceptable risks with her and her health. My family member went on to tell me all about a friend of theirs who had a similar-aged child who had a heart

911 dispatcher mental health is not a wellness issue

Mon, 24 Aug 2026 12:00:03 +0000

A 911 dispatcher might never see the blood, the wreckage, or the scared family waiting by the road. But they hear everything. They hear the panic in a parent’s voice when a child stops breathing. They listen as domestic violence happens in real time. Sometimes, they stay on the line during a suicide attempt, a

Caring for my wife with Alzheimer’s taught me to surrender

Mon, 24 Aug 2026 11:00:52 +0000

An excerpt from Everything Is Going to Be All Right: A Faith Journey Through Alzheimer’s. Listening to Christian music in her room in the nursing home, I turned to my wife. “Isn’t it going to be amazing when we see Jesus face-to-face?” She smiled and leaned forward to look directly into my eyes. She told

Nattokinase vs. statins and the limits of plaque data

Sun, 23 Aug 2026 21:00:04 +0000

The latest health craze from the wellness world is growing across social media platforms, leaving many wondering if they can stop taking their cholesterol medications. According to Google Trends, Americans are Googling “nattokinase” 130 percent more now than they did this time last year, and #natto pulls up over 200,000 posts on Instagram. Interest has

Why blaming doctors makes patients less safe

Sun, 23 Aug 2026 19:00:03 +0000

“People aren’t the problem. The problem is the problem.” I heard that sentence for the first time sitting in a circle of student desks in a restorative and transformative justice class two years ago. I didn’t know then that I was about to spend the rest of my medical training inside an institution that had

Why blaming doctors makes patients less safe originally appeared in KevinMD.com.

Voice loss after thyroid surgery changed how I heal

Sun, 23 Aug 2026 17:00:30 +0000

I woke up in the recovery room looking for a clock on the wall. It was two hours past when my surgery was supposed to end. Before my mind caught up to my body, I understood that a complication had occurred. My hand went to my throat, which was bandaged and sore. I tried to

When chronic sinusitis and brain fog get blamed on age

Sun, 23 Aug 2026 16:00:54 +0000

There is a sentence I hear from older patients that bothers me more than it used to. “I guess I’m just getting old.” They say it almost apologetically. They came to see me because they can’t breathe through their nose, they wake up exhausted, or have lived with sinus pressure and congestion for years. But

What makes a pain management referral actually land

Sun, 23 Aug 2026 15:00:58 +0000

I know things are busy right now. We are stressed, and not the kind of stress that lunch-hour chair yoga fixes. Stress shows up in small ways, like a grocery cart left in a parking lot instead of being returned to the corral. It’s not laziness, it’s bandwidth. But it also means the next person

NCLEX failure rates expose gaps in nursing education

Sun, 23 Aug 2026 14:00:02 +0000

As a health care educator and patient advocate on the one hand, and a retired nurse on the other, the authors regularly correspond with doctors, nurses, and nurse practitioners. Richard Lawhern is a nationally recognized subject matter expert on pain management. Debra Lewis is a retired nurse who shares stories here of some of the

In primary care, listening is a clinical skill

Sun, 23 Aug 2026 13:00:57 +0000

As a family nurse practitioner, I’ve learned that the most meaningful moments in medicine rarely happen because I found the perfect medication. They happen because someone finally felt heard. Every day in primary care, patients arrive carrying more than symptoms. They bring uncertainty, fear, frustration, and often years of feeling overlooked. Many have seen multiple

In primary care, listening is a clinical skill originally appeared in KevinMD.com.

Retirement account taxes distort physician net worth

Sun, 23 Aug 2026 12:00:00 +0000

Your net worth statement is the only financial document in America that routinely counts someone else’s money as yours. It lists the retirement accounts, the brokerage, the house, the practice interest, and adds them with the quiet confidence of arithmetic. The number is not wrong so much as incomplete. It books your assets at gross,