Every joint replacement patient leaves my office with a plan. When to walk, how to ice, when to drive, when to come back. We talk about stairs, showers, sleep, and the first night home. What most of them do not…
Every joint replacement patient leaves my office with a plan. When to walk, how to ice, when to drive, when to come back. We talk about stairs, showers, sleep, and the first night home. What most of them do not leave with is an answer to a question they are thinking about and almost never ask: When can I have sex again?
A new kind of capital For decades, we have treated brain health solely as a medical issue, something to address only when it begins to fail. That's beginning to change, as more experts recognize that the capabilities of the human…
A new kind of capital
For decades, we have treated brain health solely as a medical issue, something to address only when it begins to fail. That’s beginning to change, as more experts recognize that the capabilities of the human mind (our ability to think, adapt, learn, and make decisions) impact more than just the day-to-day lives of individuals. They influence the well-being and stability of families, workplaces, populations, and society …
A meaningful portion of my practice involves reconstructive work, not the kind that follows trauma or cancer, but the kind that follows cosmetic procedures that went wrong. Patients come to me after abdominoplasties that developed into sepsis, after injections administered…
A meaningful portion of my practice involves reconstructive work, not the kind that follows trauma or cancer, but the kind that follows cosmetic procedures that went wrong. Patients come to me after abdominoplasties that developed into sepsis, after injections administered by unlicensed individuals, after hair transplants that left permanent scarring. Much of what I do in the consultation room is assess what can be improved, what cannot be reversed, and …
We measure blood pressure before a patient has a stroke. We check cholesterol before a coronary event. We evaluate vision before impairment interferes with driving or reading. So why is hearing treated differently? For many people, the last routine hearing…
We measure blood pressure before a patient has a stroke. We check cholesterol before a coronary event. We evaluate vision before impairment interferes with driving or reading.
So why is hearing treated differently? For many people, the last routine hearing test they remember was in elementary school. Decades pass before anyone checks again, often after the problem has become impossible to ignore. Conversations are frustrating, family members are repeating themselves, and …
This month, the Centers for Medicare and Medicaid Services (CMS) announced a new 173-page toolkit to help states ensure more effective and less costly autism care for children. The launch came as government data shows spending on care increased by…
This month, the Centers for Medicare and Medicaid Services (CMS) announced a new 173-page toolkit to help states ensure more effective and less costly autism care for children. The launch came as government data shows spending on care increased by 421 percent between 2021 and 2025, far outpacing the 67 percent growth in the number of children receiving services. It also followed recent investigations by the New York …
"Do No Harm" is perhaps the most famous medical maxim. But reciting it is one thing; living by it is another. Sometimes, the question of "harm" is up for debate. Throughout history, physicians have lent their knowledge to all manner…
“Do No Harm” is perhaps the most famous medical maxim. But reciting it is one thing; living by it is another. Sometimes, the question of “harm” is up for debate. Throughout history, physicians have lent their knowledge to all manner of atrocities, warfare, torture, and mass sterilization, often justified under the supposedly noble pursuit of “reducing harm.”
Capital punishment or the death penalty is another instance of this dilemma. Doctors shouldn’t …
Most of us have a well-rehearsed speech for patients with elevated blood sugar. We talk about the heart. The kidneys. The eyes. The feet. We walk through the whole organ-by-organ checklist a glucose reading can quietly damage over the years.…
Most of us have a well-rehearsed speech for patients with elevated blood sugar. We talk about the heart. The kidneys. The eyes. The feet. We walk through the whole organ-by-organ checklist a glucose reading can quietly damage over the years. What most of us, myself included, haven’t been saying nearly often enough is anything about the brain, and a study published this summer in Molecular Psychiatry is a good reason …
There is a conceptual inconsistency in contemporary medicine that I have become increasingly unable to reconcile. Psychiatry recognizes psychic pain as a genuine clinical phenomenon, and suicidology has long recognized unbearable psychological pain as integral to suicidal states. Neuroscience has…
There is a conceptual inconsistency in contemporary medicine that I have become increasingly unable to reconcile. Psychiatry recognizes psychic pain as a genuine clinical phenomenon, and suicidology has long recognized unbearable psychological pain as integral to suicidal states. Neuroscience has simultaneously demonstrated that nociception, affective pain, reward, motivation, salience, stress responsivity, and emotional regulation are interconnected biological processes.
Yet when psychic pain becomes intolerable, psychiatry has remarkably little therapeutic infrastructure directed …
As an incoming fifth-year dental student beginning my clinical internship at Tamale Teaching Hospital, the major tertiary referral center for northern Ghana, I expected to refine my surgical hand and master diagnostic pathology. The fine instructors at the department made…
As an incoming fifth-year dental student beginning my clinical internship at Tamale Teaching Hospital, the major tertiary referral center for northern Ghana, I expected to refine my surgical hand and master diagnostic pathology. The fine instructors at the department made this possible, but I also got to witness firsthand the brutal arithmetic of health care access in the northern parts of Ghana.
She first presented to our oral and maxillofacial …
The hidden agenda of medical school curricula is loud and clear: Acuity equals status. Students are taught that the "best and brightest" belong in the windowless trauma bays of the ER or the high-pressure theaters of the OR. In this…
The hidden agenda of medical school curricula is loud and clear: Acuity equals status. Students are taught that the “best and brightest” belong in the windowless trauma bays of the ER or the high-pressure theaters of the OR. In this antiquated hierarchy, sleep medicine is often paternalistically patted on the head and labeled a “lifestyle” specialty, the medical equivalent of a quiet retirement.
In community interventional psychiatry practices, the typical referral looks the same week after week. The patient is in the fifth or sixth year of a major depressive episode and carries a list of four, five, sometimes seven antidepressants they have…
In community interventional psychiatry practices, the typical referral looks the same week after week. The patient is in the fifth or sixth year of a major depressive episode and carries a list of four, five, sometimes seven antidepressants they have “failed.” They are finally sent for transcranial magnetic stimulation (TMS) or esketamine (Spravato) long after the point when those treatments would have done the most good. By the time the …
A physician says she is exhausted after months of working short-staffed. Burnout. A resident feels increasingly detached from patients after repeated 80-hour weeks. Burnout. A doctor cannot stop thinking about a patient who died unexpectedly. Burnout. A clinician feels powerless…
A physician says she is exhausted after months of working short-staffed. Burnout. A resident feels increasingly detached from patients after repeated 80-hour weeks. Burnout. A doctor cannot stop thinking about a patient who died unexpectedly. Burnout. A clinician feels powerless working in a system where patients wait months for care they need now. Burnout. Someone returns to work while grieving and discovers that the emotional reserve they once relied on …
I'm not a physician. I want to say upfront that this is just a theory; however, working with physicians and being married to one for twenty-one years has sparked a theory I think is worth bringing up. I came to…
I’m not a physician. I want to say upfront that this is just a theory; however, working with physicians and being married to one for twenty-one years has sparked a theory I think is worth bringing up.
I came to these thoughts by helping physicians launch and grow their own independent practices and from co-hosting a podcast with my husband where we spoke to health care workers. On-Call with Dr. Dave …
Oluyemisi Famuyiwa, MD is a double board-certified reproductive endocrinologist, infertility specialist, and obstetrician-gynecologist, and the founder and medical director of Montgomery Fertility Center in Rockville, Maryland. She has published 21 essays on KevinMD since June 2024 and has been a…
Oluyemisi Famuyiwa, MD is a double board-certified reproductive endocrinologist, infertility specialist, and obstetrician-gynecologist, and the founder and medical director of Montgomery Fertility Center in Rockville, Maryland. She has published 21 essays on KevinMD since June 2024 and has been a guest …
There are plenty of things we tend to accept as part of getting older: turning the television up, struggling to follow conversations in restaurants, or asking people to repeat themselves because everyone seems to mumble these days. Other signs are…
There are plenty of things we tend to accept as part of getting older: turning the television up, struggling to follow conversations in restaurants, or asking people to repeat themselves because everyone seems to mumble these days.
Other signs are easier to overlook. You stop noticing the microwave beep or refrigerator alert. You miss phone notifications. While none of these seem significant on their own, they capture one of the biggest …
I very recently started work at a new hospital as part of a yearly rotation while in training. This hospital has a fire board with the names of staff, followed by two small circles containing the words IN and OUT,…
I very recently started work at a new hospital as part of a yearly rotation while in training. This hospital has a fire board with the names of staff, followed by two small circles containing the words IN and OUT, and a tiny black magnet that closely resembles a knight from a portable chessboard. The idea, at least at first glance, seems deceptively simple.
This population, either injured workers under workers' compensation or personal-injury claimants, faces distinct drivers of delayed recovery, including secondary gain concerns, litigation, workplace psychosocial factors, fear-avoidance beliefs, and system-level incentives that can prolong disability. Guidelines from the American College of…
This population, either injured workers under workers’ compensation or personal-injury claimants, faces distinct drivers of delayed recovery, including secondary gain concerns, litigation, workplace psychosocial factors, fear-avoidance beliefs, and system-level incentives that can prolong disability. Guidelines from the American College of Occupational and Environmental Medicine (ACOEM), state workers’ compensation medical treatment guidelines (e.g., New York, California), the 2022 Centers for Disease Control and Prevention (CDC) Clinical Practice Guideline for Prescribing …
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…
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 …
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.…
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.
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…
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.
