Kratom bans confuse the leaf with a semisynthetic opioid

Health Policy
September 24, 2026

Consider what happened in Walker County, Georgia, in the fall of 2025. Multiple middle schoolers became ill after eating gummies at school, though even the eventual headcount was never fully settled, with local reports ranging from three to five students. Emergency room physicians diagnosed a kratom overdose based on the clinical picture, and within hours the story was national: Kratom gummies had hospitalized children. Investigators collected one of the gummies …

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Kratom bans confuse the leaf with a semisynthetic opioid

Stigmatizing language in medical records harms care

Patient
September 24, 2026

I have never asked medicine to promise me a cure. I have asked it to help me stay alive long enough to come home to my children.

My medical record is not subtle. Recurrent pancreatitis led to sepsis and multi-organ failure in 2016, a Whipple procedure in 2017, and a total pancreatectomy in 2021. I now have no functioning pancreas, insulin-deficient type 3c diabetes, severely altered gastrointestinal anatomy, and an inability …

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Stigmatizing language in medical records harms care

Improving patient access starts with board governance

Patient
September 24, 2026

In most medical practices, daily operations rely on a familiar routine. Information moves between teams as appointments begin, and direct care continues alongside the administrative tasks that support it. These processes were designed years ago, built around historical demands and earlier models of care delivery. As patient needs change and clinical pressures grow more complex, the supporting systems beneath them do not always keep pace. Gaps begin to appear in …

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Improving patient access starts with board governance

Drought and antibiotic resistance are linked in new study

Conditions and Diseases
September 24, 2026

Droughts may be creating the perfect conditions for antibiotic-resistant bacteria to thrive. As the frequency and severity of droughts intensify in regions like California, scientists worry about the potential impact on human health.

Throughout the world, the overuse and misuse of antibiotics have led to the emergence of antimicrobial resistance (AMR), a growing global health threat that contributes to millions of deaths every year. Environmental factors like drought may worsen this …

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Drought and antibiotic resistance are linked in new study

Pain score after surgery should not define recovery

Conditions and Diseases
September 24, 2026

After surgery, patients are often asked a familiar question: “How bad is your pain on a scale from zero to ten?” Naturally, most people want that number to be zero. As doctors, we want our patients to be comfortable too. But after many operations, completely removing every trace of pain may not be realistic. And sometimes, trying too hard to reach zero can create problems of its own.

A better question …

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Pain score after surgery should not define recovery

Why exhaustion can make you see things that aren’t there [PODCAST]

Podcast
September 23, 2026
YouTube video

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

You drive home after a long shift and see someone standing at the roadside. It turns out to be a sign. ≈ had that happen more than once, and her first thought …

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Why exhaustion can make you see things that aren’t there [PODCAST]

3 reforms to counter wellness influencers in practice

Physician
September 23, 2026

We spend our days in the quiet reality of clinical practice. We chase elusive diagnoses, weigh the fine distinctions of symptom presentation, and measure our clinical instincts against rigorous decades of peer-reviewed science. We sit across from human beings in moments of vulnerability, applying a lifetime of anatomy, neurobiology, and pharmacology to parse real suffering from pathology.

Yet, step outside the exam room door, and we are met with a deafening …

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3 reforms to counter wellness influencers in practice

Shift work and circadian rhythms shape the 24/7 workplace

Conditions and Diseases
September 23, 2026

Work may provide incomparable inner peace, but the timing of that work still matters. A shift may begin in the morning, evening, or night, and it may end during another part of the day. For workers’ circadian rhythms, the relevant question is not simply how long they work, but how the beginning and end of a shift fit together. That question matters whether the work ultimately serves humans or nonhumans.

Does …

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Shift work and circadian rhythms shape the 24/7 workplace

Physicians paid for G2211 twice. Most never bill it.

Physician Finance
September 23, 2026

In 2024, Medicare cut every physician’s rates about 2 percent to fund a code that 3 out of 4 of them never billed. The cut was automatic. The code has to be claimed by hand.

The code is G2211. CMS calls it a visit complexity add-on. In plain words, it pays for office visits where you are the patient’s ongoing doctor, either as the continuing focal point for all their care …

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Physicians paid for G2211 twice. Most never bill it.

Medicaid managed care and the case for mutual stewardship

Health Policy
September 23, 2026

Roughly half of American children receive their health care through Medicaid or CHIP. These programs were legislated to cover them, and the choice has been made (repeatedly, across decades and both parties) not to fund them at the level their aims require. Pediatricians did not make that choice and should not stop saying it is the wrong one.

However, that choice, and the confines it creates, defines the real-world conditions …

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Medicaid managed care and the case for mutual stewardship

Choosing a limb lengthening surgeon requires accountability

Physician
September 23, 2026

Patients considering cosmetic limb lengthening usually begin with one question: How much height can be gained? That question is understandable, but it should not drive the decision. The more important issue is who will remain responsible for the patient’s care throughout the process and what will happen if recovery requires extra attention.

Cosmetic limb lengthening is often presented as a procedure that increases height. Technically, that is the goal, but it …

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Choosing a limb lengthening surgeon requires accountability

Why AI crisis advice may fail families facing psychosis

Health Technology
September 23, 2026

Every caregiver of someone with schizophrenia or bipolar disorder knows this moment: Someone you love is in crisis, and at some point (because it’s 2 a.m., because the on-call line is busy, because you don’t know what else to do) you open a browser or a chat window and type the question directly. What crisis resources are there for psychosis? What crisis resources are there for mania?

Those two questions aren’t …

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Why AI crisis advice may fail families facing psychosis

How AI phone systems in health care create barriers

Health Technology
September 23, 2026

Recently, I cared for a woman at a Pittsburgh shelter clinic whose blood pressure was dangerously elevated. She told me she had insurance through a regional health plan but had not seen a primary care physician in quite some time. I prescribed losartan, a common blood pressure medication, and e-prescribed it to a downtown CVS pharmacy. A week later, she returned. She had not received the medication.

The pharmacy had told …

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How AI phone systems in health care create barriers

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The conflict of interest that discloses as nothing

Medications
September 23, 2026

With 66 percent of U.S. adults, some 131 million people, now taking prescription drugs, and with Medicare drug spending running into the hundreds of billions, it is worth asking how the pharmaceutical industry came to occupy so central a place in American health care. Several recent developments show how the relationship works.

The FDA announced this month that it is hiring more than 2,000 employees, rebuilding after reductions …

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The conflict of interest that discloses as nothing

AI data centers and public health demand regulation

Health Technology
September 23, 2026

Little has captured public awareness in recent years more than the meteoric rise of artificial intelligence (AI). With this rise has come a fair share of controversy, with many both inside and outside of health care claiming, or at least hoping, that it will bring about a revolution that improves patient care, improves patient outcomes, reduces physician workloads, and drives down health care costs. Many are eager adopters, hopeful to …

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AI data centers and public health demand regulation

Telehealth and postpartum psychosis defy simple blame

Conditions and Diseases
September 22, 2026

A recent public discussion following a tragic event has reduced a complex clinical reality to a simplistic narrative: Telehealth, psychiatrists, or psychiatric medications must be to blame.

That conclusion may feel satisfying in the aftermath of an incomprehensible loss. But it is not how medicine, causation, or accountability should be understood.

A postpartum patient who is unable to get out of bed may appropriately receive care by telehealth. Virtual visits can be …

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Telehealth and postpartum psychosis defy simple blame

ChatGPT for triage: 5 rules I teach ER residents

Health Technology
September 22, 2026

I work in Dallas-Fort Worth (DFW) emergency departments where Spanish and English share the same hallway. Residents ask me the same question every block: Can we use ChatGPT for triage?

My answer is short. You can use it to practice thinking. You cannot use it to decide who waits. Here is what I actually teach on shift and in conference.

1. Fluency is not acuity

A clean English summary can hide a Spanish …

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ChatGPT for triage: 5 rules I teach ER residents

Underage online gambling needs more than a checkbox

Conditions and Diseases
September 22, 2026

Gambling as a recreational activity continues to expand, driven by the constant availability of online platforms. Sports betting, casino-style games, and real-time micro-betting are now accessible on smartphones at any hour, turning what was once occasional into a continuous presence shaped by artificial intelligence, big data, and app designs that permit bets before, during, and after events.

Gambling disorder is recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth …

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Underage online gambling needs more than a checkbox

How to reassure patients: 5 steps beyond normal tests

Physician
September 22, 2026

Physicians reassure people every day:

  • “Your tests are normal.”
  • “There is nothing dangerous going on.”
  • “This is good news.”
  • “You are going to be OK.”

We usually say these things with good intentions. We want to reduce fear, provide perspective, and help patients leave our offices or emergency departments feeling safer than when they arrived. But sometimes reassurance does not reassure.

The patient continues asking questions. They return to the emergency department. …

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How to reassure patients: 5 steps beyond normal tests

How to build a dementia care pathway, not a referral sheet

Health Policy
September 22, 2026

On the 13th floor of the Jen Chi station-front building in Taipei, a school bell rings. The room does not feel like a hospital.

Older adults move through simple exercise, cognitive activities, music, conversation, and the small rituals that make a day feel like a day. Some need prompting. Some repeat a question. Some are stronger than their families expected. Nearby, caregivers finally have a little room to breathe.

What stays with …

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How to build a dementia care pathway, not a referral sheet

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