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Most clinical research treats patients like data points. What gets lost when researchers stop listening to the people they study, and what does it cost the science itself? Niharika Singh is a biomedical engineer and pre-medical student with research experience at Genentech, Abbott, AstraZeneca, and the Keck School of Medicine, and a global ambassador with the United Nations SURGhub. She discusses the KevinMD article "Patient involvement transforms modern clinical research." You will hear the difference between treating a patient as a data set, engaging them as a collaborator, and inviting their emotional and lived experience into the study design. She walks through the Tiger Project hernia training across India and Ghana, what medical device design verification taught her about surgical research, and why AI in medicine is making patient voice harder to hear. You will hear a research methodology that treats the patient's voice as data worth collecting, and a case for defending human connection as AI changes how medicine is practiced. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
A 30 to 40 percent Medicare cut just hit the doctors who keep your local hospital running, and the policy meant to stop hospital monopolies is accelerating them instead. John Birkmeyer, president of the medical group at Sound Physicians and a former Dartmouth health services researcher, discusses the KevinMD article "Medicare practice expense cuts will hurt patients." You'll hear how CMS quietly slashed the practice expense portion of Medicare payments for the first time in 20 years, hitting independent hospitalists, ER doctors, and critical care groups with net cuts of 6 to 10 percent. You'll learn why CMS aimed at hospital-owned practices but instead pulled the rug from under the independent groups already operating at 2 to 4 percent margins, why rural hospitals will struggle hardest to staff, and how the resulting consolidation drives up prices for every patient. You'll also hear what CMS could fix in its 2027 rule and why physician advocacy now is the only correction available before more independent practices fold. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Your child is messaging neo-Nazis on Discord, role-playing the Columbine shooting on Roblox, or making fan art of mass killers, and you have no idea. That is the pattern Matthew Turner, an emergency medicine physician at Hershey Medical Center, is now seeing in his pediatric ER, where parents bring in children after spotting a chat-message leak that exposes months of online radicalization. He discusses the KevinMD article "The true crime community is radicalizing kids online." You'll hear how the true crime community pulls kids as young as eight from casual interest into obsession, imitation, and sometimes real-world violence, with one 14-year-old going on to commit a mass shooting. You'll learn which warning signs matter, why parental firewalls don't work, and the named resources clinicians and parents can use right now, including Parents for Peace, the Prevention Practitioners Network, and the Global Project Against Hate and Extremism. If you treat children or raise them, this conversation names a threat hiding inside platforms you already let them use. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Imagine being penalized for delivering good care to your frailest patients. Medicare's quality scoring program was built for healthy outpatients, not the elderly residents of nursing homes, but it is the system doctors who round in skilled nursing facilities are forced to play. Steve Buslovich, a physician executive and geriatrician, discusses the KevinMD article "How Medicare's MIPS impacts skilled nursing facilities and clinicians." You'll hear how MIPS metrics conflict with the five-star quality measures facilities must report, why tightly controlling A1C in frail elders can cause harm, and how documentation discrepancies between physicians and facilities create financial and legal risk for both. You'll learn which nine measures actually fit post-acute long-term care, why CMS needs frailty-based quality metrics, and how AI and synced EHRs can pull data automatically so clinicians can get back to the bedside. If you practice in or operate a nursing home, this conversation names the rules of a game you didn't choose to play. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
The words doctors use during fertility care can wound the patient sitting across the desk. "Failed cycle." "Poor responder." "Ovarian failure." For a woman already carrying the grief of a child she has never had, those words can feel like nails in a coffin. Oluyemisi Famuyiwa, a fertility specialist, argues that infertility grief is compounded by cultural stigma and by clinical language medicine rarely audits. This episode is based on her article "The emotional impact of infertility is grief unspoken," published on KevinMD. You will hear why up to 40 to 50 percent of infertility cases involve a male factor, why the team-based script ("do it for your partner") often gets a resistant husband to agree to testing, what social media hides about donor eggs and late-in-life pregnancies, why no supplement can reverse the biological aging of eggs, and why being culturally nosy is one of the most useful clinical skills a fertility doctor can develop. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Patients are being cut off from medications they need, doctors are afraid to prescribe, and the reason traces back to political donations most Americans never see. Richard A. Lawhern, health care educator and patient advocate, joins us to explain how lobbying money shapes health care legislation and what patients can do about it. This episode is based on his article "Health care lobbying is destroying the U.S. system," published on KevinMD. You will hear why $4.5 billion was spent influencing the 2024 election, how undisclosed donors block reforms like single payer, and why nearly a quarter of every health care dollar goes to administrative costs that do nothing for patients. Richard explains how the National Campaign to Protect People in Pain trains advocates to reach committee staffers and shift the political calculus. Press play to hear how the system actually works and where ordinary advocates can apply pressure. True team-based care starts with you. At ChenMed, we believe the best way to care for patients is to change the way we practice medicine. When you join our team, you are empowered to lead. We've moved beyond the traditional volume-heavy model to focus on true value-based care. Our model gives you the time and resources to manage complex cases and make a lasting impact on your community. Whether you are applying for a primary care physician, nurse practitioner, or medical director position, you will feel supported by a physician-led culture that understands your challenges. Your dedication doesn't go unnoticed here. You'll be rewarded with a career that offers both professional fulfillment and a better quality of life. Visit ChenMed.com/physicians-KevinMD to learn more. VISIT SPONSOR → https://ChenMed.com/physicians-KevinMD Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Most of the people deciding where billions of health care dollars get invested have never treated a patient. Harsha Moole, a physician scientist and health care venture capital founder, joins Kevin to discuss his KevinMD article "The crash cart that taught me physician-led investing." You'll hear how a single overlooked workflow problem on a hospital crash cart became a multi-hospital company, why physician-led groups screen every deal through three gates of clinical, regulatory, and reimbursement diligence, and how doctors can get involved without leaving their day job by advising startups, advising venture funds, or co-investing through a physician network. Harsha also breaks down why angel investing requires a long timeline, the discipline to diversify across 4 to 10 companies, and money you can afford to lose. If you've ever looked at a health care product and thought you could have told them it wouldn't work, this conversation makes the case for using that clinical instinct beyond the bedside. True team-based care starts with you. At ChenMed, we believe the best way to care for patients is to change the way we practice medicine. When you join our team, you are empowered to lead. We've moved beyond the traditional volume-heavy model to focus on true value-based care. Our model gives you the time and resources to manage complex cases and make a lasting impact on your community. Whether you are applying for a primary care physician, nurse practitioner, or medical director position, you will feel supported by a physician-led culture that understands your challenges. Your dedication doesn't go unnoticed here. You'll be rewarded with a career that offers both professional fulfillment and a better quality of life. Visit ChenMed.com/physicians-KevinMD to learn more. VISIT SPONSOR → https://ChenMed.com/physicians-KevinMD Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Most doctors were never taught how to sit with a patient's grief, anger, or fear without absorbing it. Eva Minkoff, a health care executive coach, and Kim Downey, a physical therapist and physician advocate, join Kevin to discuss their KevinMD article "How regulating clinical empathy prevents physician burnout." You'll hear why physicians who lean too far into patient emotion burnout, why those who shut down lose trust and treatment adherence, and why both paths end in the same exhaustion. Eva walks through her three-step framework (recognize the feeling, distinguish it from the story, address the emotion first) and explains why naming a patient's anger or grief in five seconds builds the connection that protects both the doctor and the care. Kim brings the patient view, sharing how doctors who stay present without drowning create the kind of relationship she calls sacred. If you're a clinician asking how to keep caring without burning out, listen for the five-second practice Eva walks through. True team-based care starts with you. At ChenMed, we believe the best way to care for patients is to change the way we practice medicine. When you join our team, you are empowered to lead. We've moved beyond the traditional volume-heavy model to focus on true value-based care. Our model gives you the time and resources to manage complex cases and make a lasting impact on your community. Whether you are applying for a primary care physician, nurse practitioner, or medical director position, you will feel supported by a physician-led culture that understands your challenges. Your dedication doesn't go unnoticed here. You'll be rewarded with a career that offers both professional fulfillment and a better quality of life. Visit ChenMed.com/physicians-KevinMD to learn more. VISIT SPONSOR → https://ChenMed.com/physicians-KevinMD Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Medical students who skip writing their own reflections are not lazy, they are surviving an irrational system. Kathleen Muldoon, a coach and professor, returns to discuss what student AI use in medical education actually reveals about the curriculum, the hidden incentives behind it, and why she calls students in instead of catching them. This episode is based on her article "Driving medical education reform through intellectual honesty," published on KevinMD. You will hear why pass-fail courses inside graded curricula push students to put their energy elsewhere, why the hidden curriculum speaks louder than the syllabus, and what students disclosed when she asked them what was going on. You will learn what her workshops are designed to do that AI cannot, why she believes AI cannot teach empathy, and what a more humane medical education would actually require. Press play to find out why she thinks the next generation of clinicians is not the problem, and what the systems training them must change to produce humane physicians. True team-based care starts with you. At ChenMed, we believe the best way to care for patients is to change the way we practice medicine. When you join our team, you are empowered to lead. We've moved beyond the traditional volume-heavy model to focus on true value-based care. Our model gives you the time and resources to manage complex cases and make a lasting impact on your community. Whether you are applying for a primary care physician, nurse practitioner, or medical director position, you will feel supported by a physician-led culture that understands your challenges. Your dedication doesn't go unnoticed here. You'll be rewarded with a career that offers both professional fulfillment and a better quality of life. Visit ChenMed.com/physicians-KevinMD to learn more. VISIT SPONSOR → https://ChenMed.com/physicians-KevinMD Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Most patients on antidepressants are told they can't take methylene blue, even for brain fog. Steven E. Warren, a physician and longevity medicine clinician, joins Kevin to discuss his KevinMD article "51 cases that reframe methylene blue serotonin syndrome." You'll hear why 50 of the 51 published serotonin-syndrome cases involved high-dose IV methylene blue given under anesthesia, mostly during parathyroid surgery, rather than the low oral doses used in outpatient longevity practice. Steven walks through the Goldilocks dosing posture he uses for patients with brain fog, why he screens every patient's full medication list for interactions before starting, and why he tells every patient there are no randomized trials behind methylene blue. He also describes the broader longevity practice he sees daily: patients stacking peptides from the gym, megadosing vitamin D from podcasts, and ordering supplements off Amazon without quality control. If you're a clinician fielding methylene blue questions or a patient considering it, listen for the questions Steven thinks should be asked before starting any unstudied supplement. True team-based care starts with you. At ChenMed, we believe the best way to care for patients is to change the way we practice medicine. When you join our team, you are empowered to lead. We've moved beyond the traditional volume-heavy model to focus on true value-based care. Our model gives you the time and resources to manage complex cases and make a lasting impact on your community. Whether you are applying for a primary care physician, nurse practitioner, or medical director position, you will feel supported by a physician-led culture that understands your challenges. Your dedication doesn't go unnoticed here. You'll be rewarded with a career that offers both professional fulfillment and a better quality of life. Visit ChenMed.com/physicians-KevinMD to learn more. VISIT SPONSOR → https://ChenMed.com/physicians-KevinMD Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Up to 40 percent of infertility cases involve combined male and female factors, but the male partner is often skipped. Erica Bove, a reproductive endocrinology and infertility specialist, returns to discuss why that gap exists and what can be done about it. This episode is based on her article "What is often overlooked about male factor infertility," published on KevinMD. You will hear how prescribed testosterone for low energy and low sex drive can wipe out sperm production, sometimes irreversibly, and why men taking it for low T frequently have no idea their fertility is at stake. You will learn what a basic semen analysis screens for and what a full male evaluation adds, including hormonal testing and a reproductive urologist exam. You will hear how varicocele surgery alone can resolve a couple's infertility, why marijuana and tobacco are unusually bad for sperm, and why every change shows up three months later. Press play to find out which male factor causes are most often missed, and which are most often reversible. True team-based care starts with you. At ChenMed, we believe the best way to care for patients is to change the way we practice medicine. When you join our team, you are empowered to lead. We've moved beyond the traditional volume-heavy model to focus on true value-based care. Our model gives you the time and resources to manage complex cases and make a lasting impact on your community. Whether you are applying for a primary care physician, nurse practitioner, or medical director position, you will feel supported by a physician-led culture that understands your challenges. Your dedication doesn't go unnoticed here. You'll be rewarded with a career that offers both professional fulfillment and a better quality of life. Visit ChenMed.com/physicians-KevinMD to learn more. VISIT SPONSOR → https://ChenMed.com/physicians-KevinMD Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Your ER doctor has about 25 minutes to figure out your medical history and decide what to do next. Hamed Husaini, an emergency physician and physician executive, explains why so much of that data never reaches the bedside and what AI can do about it. This episode is based on his article "AI in health care data management: Curing the EHR overload," published on KevinMD. You will hear why records from skilled nursing facilities, primary care, and home health rarely get read in time, why duplicate medications and missed end-of-life directives slip through, and how a one-page AI synopsis pushed into the native EHR before you walk into the room changes what the next 25 minutes look like. Hamed argues the bottleneck is not data volume; it is the pull model that asks busy clinicians to fetch records they never have time to read. If the system already feels like it should know your records and still doesn't, this episode names why and what changes when the data starts flowing the other direction. True team-based care starts with you. At ChenMed, we believe the best way to care for patients is to change the way we practice medicine. When you join our team, you are empowered to lead. We've moved beyond the traditional volume-heavy model to focus on true value-based care. Our model gives you the time and resources to manage complex cases and make a lasting impact on your community. Whether you are applying for a primary care physician, nurse practitioner, or medical director position, you will feel supported by a physician-led culture that understands your challenges. Your dedication doesn't go unnoticed here. You'll be rewarded with a career that offers both professional fulfillment and a better quality of life. Visit ChenMed.com/physicians-KevinMD to learn more. VISIT SPONSOR → https://ChenMed.com/physicians-KevinMD Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
The same instinct that makes you a careful clinician may be the one sabotaging your financial future. Cardiologist and fiduciary financial planner Stanley Liu joins this episode to explain why physicians' deeply trained aversion to risk becomes maladaptive once it leaves the hospital. This episode is based on his article "Physician financial risk: Balancing capacity and tolerance," published on KevinMD. You will learn why risk capacity and risk tolerance are two different variables, and why mistaking one for the other quietly drives bad financial decisions. You will hear why the physicians most at financial risk are those with low capacity and high tolerance, and why high-earning doctors with no debt sometimes stay stuck in toxic jobs they have the financial freedom to leave. You will also learn what questions a planner asks to surface the money scripts shaping your choices. Listen if you have ever wondered whether your discomfort with financial risk is protecting you or holding you back. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What if the cure for physician burnout has been making it worse the whole time? Lisa Rubiano, an internal medicine physician and physician coach, spent over a decade as a hospitalist before burning out in 2021 and stepping back to figure out what really went wrong. This episode is based on her article "Why resilience is not the cure for physician burnout," published on KevinMD. You will hear why the resilience narrative quietly shifts blame onto individual physicians while letting toxic systems off the hook, how the Quadruple Aim turned clinician well-being into a vague self-care mandate, and what it actually takes to unlearn the belief that you should be able to push through anything. Lisa breaks down why setting boundaries feels so hard, why systems have no real incentive to change, and where physicians are quietly building their own way out. Listen for the moment that makes the self-blame stop. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Patients know when you are not really present with them, and trust is built or broken in the first few minutes. Jess Bunin, an intensivist, and George Mount, a rheumatologist, co-founders of All Levels Leadership, argue that trust in clinical teams is a practiced skill built from three concrete components: empathy, logic, and authenticity. This episode is based on their article "The secret sauce of leadership trust in health care teams," published on KevinMD. You will hear why a critical care fellow was required to say "I don't know" once on rounds even when he knew, what a three-time cancer survivor noticed about the physicians she actually trusted, and how to communicate through genuine uncertainty without losing your team. You will also learn why George Mount spends the first few minutes of a patient encounter on trust before he asks about the chief complaint. Listen for a grounded framework for repairing trust when it wobbles. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Most physicians using AI on patient data have no idea what the real security risks are. Francisco M. Torres, an interventional physiatrist, and Purab Patel, a medical student with a programming background, argue that cybersecurity has become a patient safety issue in medicine, and that the AI pipelines physicians now rely on are more complex than most clinicians realize. This episode is based on their article "Navigating the cybersecurity challenges of artificial intelligence in medicine," published on KevinMD. You will hear how changing a few pixels in a medical image can flip an AI diagnosis, why AI note-taking can miss clinically significant findings, and what questions to ask any vendor before trusting a black box with patient data. You will also learn why Francisco tells his kids that AI certification may matter more than an MBA. Listen for a grounded take on treating AI as a tool, not a truth machine. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Medicare Advantage covers more than half of seniors, and the debate over what it really costs is stuck in two camps. Timothy Bulat, a senior consulting actuary who spent nearly two decades leading Medicare Advantage analytics inside a major insurer, raises a question the loudest voices keep avoiding: who actually pays for the program, and is the value being shared fairly? This episode is based on his article "The truth about Medicare Advantage funding and costs," published on KevinMD. You will hear how plans simultaneously manage costs well and extract excess taxpayer dollars through coding intensity and favorable selection, why headlines about Medicare Advantage being "in retreat" are overblown, and which specific policy levers (risk adjustment reform, benchmarking, slowing annual payment growth) the Biden and Trump administrations have already started using. Listen for the distinction Timothy draws between a funding cut and a smaller increase, and why that distinction matters for every clinician dealing with prior auth. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Is medicine a calling or just a job? Christie Mulholland thinks that question is the wrong one, and answering it keeps physicians stuck in burnout. Christie, a palliative care physician and certified physician development coach, returns to the show to introduce a four-quadrant matrix that maps how called you feel to medicine against how satisfied you actually are practicing it. This episode is based on her article "Moving beyond the false binary of medicine as a calling," published on KevinMD. She walks through each quadrant (the calling, the craft, the wound, and the wall) and the specific coaching question that unlocks a next step for physicians living in each one. Christie also talks about how profit-driven systems benefit when "calling" stays the only acceptable answer, why work-life balance keeps getting squeezed out of clinical careers, and when a career pause becomes the move that smaller adjustments cannot replace. Listen for the question that names where you actually are. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Medical AI is evolving faster than the legal system can regulate it. Richard E. Anderson, CEO of The Doctors Company, the nation's largest physician-owned medical malpractice insurer, argues that the gap between what AI can do clinically and what courts are ready to judge has created a difficult position for physicians, and that it will take a long time for the system to catch up. This episode is based on his article "The future of U.S. medicine: 10 health care trends in 2026," published on KevinMD. You will hear why following an AI recommendation that diverges from the current standard of care can put a physician in legal jeopardy, why Anderson has seen almost no AI-related lawsuits so far despite widespread clinical use, what physicians should document every time they choose not to follow an AI recommendation, and what the 17-year lag between scientific discovery and standard-of-care adoption means for anyone practicing with AI today. Listen for a grounded read on medical AI heading into 2026. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Rural doctors hit a ceiling around 35 patients a day, and hiring more clinicians will not move it. Tod Stillson, a family physician, medical device inventor, and health care entrepreneur, argues that the physician shortage is not a headcount problem but a knowledge-scaling problem, and that AI with a doctor in the loop is the only realistic way to extend a physician's judgment to more patients without replacing the human relationship. This episode is based on his article "How artificial intelligence scales physician extension," published on KevinMD. You will hear why he spent two years codifying his own clinical judgment into software, why his text-based triage system outperformed general-purpose AI in a recent study, and what physicians risk if direct-to-consumer companies keep capturing demand while doctors stay on the sidelines. You will also learn why governance of the medical knowledge base has to come from physicians, not from startups in San Francisco or Boston. Listen for a grounded case for AI as capacity multiplier, not replacement. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Most physicians spend more time fighting their software than seeing patients, and piling on new tools has not fixed it. Grace E. Terrell, a physician executive, argues that decades of layering electronic health records, population health tools, remote patient monitoring, and now AI onto sixty-year-old billing infrastructure has produced a Frankenstein stack that burns out clinicians and harms patients. This episode is based on her article "Connected health care workflows: From chore to core patient care," published on KevinMD. You will hear why layering new tools on old infrastructure keeps failing, how prior authorization became an arms race, and what a genuinely connected workflow would feel like for a clinician evaluating a patient with suspected spinal abscess. You will also learn the one question to ask any vendor pitching a new tool, and why her company's CIO believes EHRs themselves may not survive the next five years. Listen for a concrete path from chore to core patient care. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
The same Robert Kennedy Jr. who sued Monsanto over glyphosate in 2017 is now defending an order to expand its production. What does a functional medicine physician do with that? Shiv K. Goel, an internal medicine and functional medicine physician, argues that the Make America Healthy Again movement correctly names the chronic disease crisis, ultra-processed food, and a broken food system, then prescribes the wrong treatment. This episode is based on his article "Make America Healthy Again fails true functional medicine," published on KevinMD. You will hear why MAHA's root-cause language overlaps with functional medicine, why undermining vaccines during a measles outbreak is the contradiction the guest cannot ignore, how silence on Medicaid and SNAP cuts hurts the patients most harmed by chronic disease, and why clinicians must reclaim root-cause language from populist politics. If you have felt torn between agreeing with parts of MAHA and rejecting the rest, this conversation draws the line the guest thinks physicians have to hold. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
One AI-hallucinated citation on cross-examination, and the expert witness career you built is over. It is already happening. Tracy Liberatore, a former physician assistant turned attorney and founder of the National Expert Academy, walks through the real court cases where clinical experts leaned on generative AI and watched their reports, and their reputations, get thrown out. This episode is based on her article "Expert witness credibility is destroyed by AI opinions," published on KevinMD. You will hear why AI hallucinated citations are ending careers in medical-legal work, why one expert was allowed to keep AI in his workflow because he could account for every prompt, what responsible AI use actually looks like for clinicians writing expert reports, and the brain flip clinicians have to make to defend a process rather than a conclusion. If you do expert witness work, or are thinking about it, this conversation names the line you cannot cross. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
You hit every number: top grades, top test scores, top patients-per-hour. So why does practicing medicine feel hollow? Ben Reinking, a board-certified pediatric cardiologist, medical educator, and certified physician development coach, argues that the same metric-driven mindset that carries pre-meds into medical school is the one leaving attendings disconnected from why they practice. This episode is based on his article "How competency-based education is driving medical education reform," published on KevinMD. You will hear why a 15-minute billing slot frustrates both patient and physician, how competency-based education and entrustable professional activities shift the question from "did you meet the number" to "do we trust you in the system," and why admitting "I don't know, but let me figure it out" gets discouraged when learners are judged only by scores. If you have ever sensed the gap between your scorecard and your purpose, this conversation names what you have been feeling. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
When you open your Match Day envelope, you step into an orthopedic surgery field that looks nothing like it used to. John E. Klibanoff, an orthopedic surgeon, discusses his article "Navigating your orthopedic surgery residency after Match Day," published on KevinMD. He explains why nobody will care about your physiology grade or your rotation honors once you start residency, and why the old archetype of the tall, athletic, Northeast-raised orthopedic surgeon no longer describes the field. You will hear how AI and short online snippets have collapsed a week of attending-to-attending research into thirty minutes over coffee, how impaction devices and minimally invasive tools have opened recon and spine surgery to surgeons of any stature, and why younger faculty and peer networks are replacing top-down lectures. Klibanoff also explains why mentorship and adaptability matter more than competitiveness, and why patients now arrive with hours of their own research to bring into the room. Listen to hear what actually earns you the craft of orthopedic surgery after Match Day. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
You hear code blues overhead in a hospital all the time, but one on a psychiatry unit is different. A young patient died after a cardiac event, and what followed looked nothing like a code blue on a medical floor. Devina Maya Wadhwa, a psychiatrist, discusses her article "When a code blue happens on a psychiatry unit," published on KevinMD. She describes the locked oxygen tanks and missing electrical outlets that slowed the response, the coroner's investigation that opened automatically, and the police interview that felt like an interrogation. You will hear why standard debriefs fall short when staff are trained for emotional safety rather than cardiac arrest, how self-doubt follows a physician long after the incident report closes, and what genuine check-ins could look like weeks later. Wadhwa also names the hypervigilance that settles over the unit afterward and why she believes sharing these stories is empowering and deeply healing. Listen to hear what psychiatric teams carry when a patient dies on their floor. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
A cardiologist who helped set national cholesterol and weight targets for 40 years now says those numbers can mislead. Richard M. Fleming, a physician specializing in cardiovascular and inflammatory disease, argues that weight loss on a GLP-1 does not automatically mean a patient is getting healthier, and that some patients who never lose a pound are already metabolically well. This episode is based on his article "GLP-1 agonists and weight loss: Treating the disease, not the number," published on KevinMD. You will hear why body mass index was never built to diagnose individuals, why inflammatory and thrombotic markers track disease more honestly than the scale, and how clinical trials from CAST to ACCORD have shown what happens when medicine treats the surrogate instead of the patient. He walks through which inflammation tests a primary care physician can run before, during, and after GLP-1 therapy, including high-sensitivity CRP, homocysteine, and fibrinogen. Hear why a 40-year insider says precision medicine requires precision measurement, not precision weighing. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
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, and Smith has spent his career trying to fix that. But before the fix, he makes a case that may surprise his own readers: modern medicine has been astonishingly effective at what it was built to do. This episode is based on his article "How the mind-body split in medicine shaped modern clinical care," published on KevinMD. You will hear how 2,500 years of four humors and bloodletting gave way to a physical-disease framework that doubled life expectancy from 40 to 80. You will also learn why that same framework now leaves psychiatry stalled. Hear why the reformer who wants to overhaul mental health care still says medicine has never been better at the thing it was built to do. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
A federal agency recognized food allergy as a disability, then limited boarding protection to one allergen category. Lianne Mandelbaum, a leading advocate for airline safety measures to protect food-allergic passengers, returns to explain how the March 2026 DOT ruling created a hierarchy within a single medical condition, leaving passengers with egg, sesame, milk, shellfish, and wheat allergies without the same pre-boarding rights granted to those with peanut and tree nut allergies. This episode is based on her article "How the new DOT ruling on food allergies threatens air travel safety," published on KevinMD. You will hear about a Southwest captain who removed a passenger for asking to pre-board with a pistachio allergy, an allergen that is covered under the new ruling. You will also hear why a Northwestern survey of 4,704 food-allergic travelers found that 98 percent experience flight anxiety and 70 percent were promised accommodations that never arrived. Hear why the guest says this ruling cements airline inconsistency as federal policy, and what physicians can do to push back. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What happens to your body and clinical judgment when you're managing a code blue at the exact hour your biology demands deep sleep? Chinyelu E. Oraedu is an academic hospitalist and nocturnist with 17 years of post-residency experience who has dedicated her career to understanding the science and human reality of night shift medicine. In this episode, based on her KevinMD article "How night shift medicine exposes the reality of physician stress," she breaks down why the 2 to 3 a.m. window is the most dangerous period for both patients and providers, when melatonin peaks, alertness bottoms out, and emergencies keep coming. You will learn practical strategies for surviving and thriving on night shift, from the right timing for caffeine intake to using light therapy at your workstation to suppress melatonin secretion. Oraedu explains why sleep is the single most important factor for night shift workers and why she tells every resident to protect it above exercise, meals, and everything else. She also shares surprising early data from her own research showing that night shift workers who build intentional structure around their schedule report high satisfaction. Whether you are an incoming intern about to start your first night float rotation or a seasoned nocturnist still battling fragmented sleep, this conversation offers a practical framework for reducing the hidden health risks of working against your circadian rhythm. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Hosted by Michael Tetreault | Editor-in-Chief, Concierge Medicine Today Episode Overview In one of the most comprehensive episodes in DocPreneur Leadership Podcast history, host Michael Tetreault takes an honest, evidence-based, and encouraging look at the cash-pay and subscription-based primary care landscape — who it serves, how it works, where it's heading, and what every physician and advanced practice clinician needs to understand before making a career-defining decision. This episode doesn't take sides. It takes a clear-eyed look at the full picture — including the parts that don't always make it into the conference keynote. What's Covered in This Episode The Foundation Not all subscription-based primary care models are the same. Two models operating in this space share surface-level similarities but are structurally distinct businesses with different economic logic, different patient populations, and different long-term trajectories. Understanding which one you're considering — and why — changes everything about how you plan. A Lesson From Healthcare History Before committing to any practice model, it helps to understand what happened to the movements that came before it. This episode traces three instructive parallels: the micropractice and ideal medical practice movement of the early 2000s; the decades-long fight for healthcare price transparency and what happened when physicians finally got it; and the rise and reality check of retail health — what scaled, what didn't, and why. The common thread in every model that has achieved durable scale in American healthcare is the same: structural fit with the economic environment, not ideological purity. Two Pathways, One Brand Name The episode walks through both economic models in the cash-pay primary care space — the purist, cash-only, no-insurance model and the employer-integrated model — explaining how each works, who each serves, and what the financial picture actually looks like for physicians considering either path. The revenue math is done out loud. The sustainability data from peer-reviewed research is cited. The patient demographic fit for each model is examined honestly and specifically. Who Each Model Serves — and Where Other Models Fit Better A detailed breakdown of the patient populations each model genuinely serves well — and an honest, evidence-based look at the patient populations where other models may be a better structural fit. Including Medicare-eligible patients, patients with complex chronic disease, lower-income households, and employees of small and mid-sized businesses. The Overlooked Opportunity — NPs, PAs, and Advanced Practice Clinicians One of the most significant and underexplored opportunities in subscription-based healthcare delivery today is the direct-care model as a pathway for nurse practitioners, physician assistants, and other advanced practice clinicians. The evidence on NP and PA-led primary care outcomes is strong and peer-reviewed. The physician shortage projections make the need urgent. And the organizational infrastructure for advanced practice clinician-led direct-care practices is largely unbuilt — which means the opportunity belongs to whoever moves first. The Organizational Landscape An honest look at what the multiplicity of organizations, coalitions, and alliances in the cash-pay primary care space tells us — and what research on professional association dynamics says about the long-term implications of organizational fragmentation for legislative effectiveness and individual practice planning. One Brand, Two Directions Drawing on four documented historical parallels from the history of American medicine — the AMA and managed care, osteopathic medicine's identity divide, family medicine's emergence as a separate specialty, and the micropractice movement — the episode makes the case that two communities with genuinely different economic interests and regulatory priorities currently sharing a brand name may, consistent with historical precedent, find their own distinct professional homes over time. This is presented as pattern recognition grounded in verified historical evidence — and as practical planning context for physicians building practices today. The Tax and Structuring Update A clear, practical summary of the 2025 "One Big Beautiful Bill" Act changes — effective January 2026 — and what they mean for HSA eligibility of cash-pay membership fees. What qualifies, what doesn't, and why legal counsel is essential before making any representations to patients about tax-advantaged payment options. Eight Questions Before You Commit A practical pre-decision checklist — eight specific questions every physician or advanced practice clinician should be able to answer clearly before committing to any cash-pay practice pathway. Key Takeaways Cash-pay primary care and concierge medicine are not the same model, do not serve the same patient populations, and should not be evaluated as interchangeable alternatives. The purist cash-pay model has grown from approximately 100 practices in 2009 to over 2,100 by 2023 — real and meaningful growth. The financial sustainability data, however, reflects consistent challenges that peer-reviewed research has documented specifically in lower-income markets and solo practice settings. The employer-integrated pathway has stronger structural sustainability — multiple revenue streams, embedded benefit relationships, and documented employer cost reductions of 12 to 20 percent over three to five years. A December 2025 Johns Hopkins study found concierge and cash-pay primary care practices combined grew 83.1 percent between 2018 and 2023. The employer-integrated model is the primary driver of that growth trajectory. Concierge medicine — particularly the PCM model — is not retreating. The global concierge medicine market is projected to surpass $34 billion by 2032 and is growing at a compound annual rate that outpaces most healthcare market segments. The National Academy of Medicine's 2021 Future of Nursing report, AAMC physician shortage projections, and peer-reviewed NP/PA outcomes research collectively point to advanced practice clinician-led direct-care models as one of the most significant underexplored opportunities in subscription-based healthcare delivery. Pattern recognition from healthcare history — price transparency, retail health, the micropractice movement — consistently shows that the distance between a compelling healthcare idea and durable scaled impact is longer and more complicated than early advocacy suggests. Models that have achieved durable scale in American primary care share one characteristic: structural fit with the economic environment, not independence from it. Sources and Citations All claims in this episode are supported by published, verifiable sources. Full citations below. Micropractice and Practice Model History Moore, G. (2002). "Accountability and Improvement in Physician Practice." Family Medicine. Moore, G. & Showstack, J. (2003). "Primary Care Medicine in Crisis." Health Affairs. healthaffairs.org AAFP TransforMED Initiative. (2006). aafp.org Nutting, P.A. et al. (2010). "Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home." Annals of Family Medicine. Rittenhouse, D.R. et al. (2009). "Primary Care and Accountable Care." New England Journal of Medicine. Rittenhouse, D.R. & Shortell, S.M. (2009). "The Patient-Centered Medical Home." JAMA. Price Transparency Research Pathak, Y. & Muhlestein, D. (2024). "Public Awareness and Use of Price Transparency: Report From a National Survey." West Health Institute / Gallup. pmc.ncbi.nlm.nih.gov Parente, S.T. (2023). "Estimating the Impact of New Health Price Transparency Policies." Inquiry.pmc.ncbi.nlm.nih.gov ScienceDirect. (2025). "Outcomes of Price Transparency Policies for Healthcare Services in the United States: A Systematic Review." sciencedirect.com Retail Health Fein, A.J. (2017). "Retail Clinic Check Up: CVS Retrenches, Walgreens Outsources, Kroger Expands." Drug Channels. drugchannels.net CNBC. (2024). "Why Walmart, Walgreens, CVS Retail Health Clinic Experiment Is Struggling." cnbc.com Healthcare Finance News. (2023). "Retail Clinics Seeing Utilization Soar, Popularity Grow." healthcarefinancenews.com MedCity News. (2023). "Retail Clinics Are Gaining Momentum." medcitynews.com Cash-Pay and Subscription Primary Care Market Data MedCity News. (March 2026). "DPC Is Scaling — The Financing Architecture Isn't Ready." medcitynews.com Johns Hopkins. (December 2025). Study on concierge and cash-pay practice growth 2018–2023. As cited in MedCity News, March 2026. Liaw, W. et al. (2024). "Direct Primary Care: Financial Analysis and Potential to Reshape the U.S. Healthcare Landscape." Journal of General Internal Medicine. springer.com Lujan, D.Y. (2025). "Why Direct Primary Care Models Fail." KevinMD. kevinmd.com Doan, L. et al. (2019). "Physician Perspectives on Direct Primary Care." Family Medicine. Eskew, P.M. & Klink, K. (2015). "Direct Primary Care: Practice Distribution and Cost Across the Nation." Health Affairs. healthaffairs.org Tseng, P. et al. (2018). "Administrative Costs Associated With Physician Billing and Insurance-Related Activities." JAMA Internal Medicine. Medscape Physician Compensation Report. (2023). medscape.com Employer-Integrated Model Spann, S.J. et al. (2020). "Employer-Sponsored Direct Primary Care." Journal of Occupational and Environmental Medicine. National Alliance of Healthcare Purchaser Coalitions. (2021). purchaseralliance.org Kaiser Family Foundation. (2023). Employer Health Benefits Annual Survey. kff.org National Business Group on Health. (2022). businessgrouphealth.org Employers Health Coalition. (2022). employershealthcoalition.org Patient Demographics and Population Health Anderson, G.F. (2010). "Chronic Conditions: Making the Case for Ongoing Care." Johns Hopkins Bloomberg School of Public Health. Tikkanen, R. & Abrams, M.K. (2020). "U.S. Health Care from a Global Perspective." Commonwealth Fund.commonwealthfund.org Collins, S.R. et al. (2022). "Paying for It: How Health Insurance and Healthcare Costs Are Shaping the Lives of American Adults." Commonwealth Fund. commonwealthfund.org Bureau of Labor Statistics. (2023). "Contingent and Alternative Employment Arrangements." bls.gov Petterson, S. et al. (2012). "Unequal Distribution of the U.S. Primary Care Workforce." Annals of Family Medicine. Advanced Practice Clinicians and Nursing Laurant, M. et al. (2019). "Revision of Professional Roles and Quality Improvement in Primary Care." New England Journal of Medicine. Naylor, M.D. & Kurtzman, E.T. (2010). "The Role of Nurse Practitioners in Reinventing Primary Care." Health Affairs. healthaffairs.org National Academy of Medicine. (2021). "The Future of Nursing 2020–2030." nationalacademies.org AAMC. (2021). "The Complexities of Physician Supply and Demand: Projections from 2019–2034." aamc.org Legal, Tax, and Compliance Eischen, J. (2025). Legal Commentary on Cash Practice Structuring. eischenlawoffice.com DLA Piper. (2025). "Paying for Direct Primary Care Arrangements With HSAs." dlapiper.com IRS Notice 26-05. irs.gov CMS. "Opt-Out Affidavits and Private Contracts." cms.gov Organizational and Professional Identity Research Hoff, T.J. (2010). Practice Under Pressure: Primary Care Physicians and Their Medicine in the Twenty-First Century. Rutgers University Press. Scott, W.R. (2008). Institutions and Organizations: Ideas and Interests. SAGE Publications. Freidson, E. (2001). Professionalism: The Third Logic. University of Chicago Press. Wolinsky, H. & Brune, T. (1994). The Serpent on the Staff: The Unhealthy Politics of the American Medical Association. Putnam. Gevitz, N. (2004). The DOs: Osteopathic Medicine in America. Johns Hopkins University Press. Stephens, G.G. (1989). "Family Medicine as Counterculture." Journal of Family Practice. Colwill, J.M. (1992). "Where Have All the Primary Care Applicants Gone?" New England Journal of Medicine. Meltzer, D.O. & Chung, J.W. (2014). "The Population-Based Physician Workforce." Health Affairs.healthaffairs.org Bodenheimer, T. & Pham, H.H. (2010). "Primary Care: Current Problems and Proposed Solutions." Health Affairs. healthaffairs.org Grumbach, K. & Grundy, P. (2010). "Outcomes of Implementing Patient Centered Medical Home Interventions." JAMA. Concierge Medicine Market Data Grand View Research. (2022). Concierge Medicine Market Size & Growth Report. grandviewresearch.com Precedence Research. (2023). U.S. Concierge Medicine Market Size and Forecast. globenewswire.com MDVIP. (2020). Personalized Primary Care Reduces ER Visits, Hospitalizations, and Outpatient Expenditures.mdvip.com AAPP / Software Advice. (2023). "Concierge Medicine Salary and Definition." softwareadvice.com Disclaimer The DocPreneur Leadership Podcast is produced by Concierge Medicine Today, LLC, an independent healthcare leadership publication. This episode and its accompanying summary are intended for educational and informational purposes only. Nothing in this episode or summary constitutes medical, legal, financial, or accounting advice. The information presented reflects publicly available research, published data, and editorial observation, and is not intended to replace the guidance of qualified medical, legal, financial, or business professionals. All factual claims are supported by named, verifiable third-party sources, which are cited in full above. Concierge Medicine Today makes no guarantee regarding the completeness or currency of external sources cited and encourages listeners to verify information independently. References to specific organizations, publications, legal decisions, or market data are provided for educational context only. Mention of any organization, publication, or individual does not constitute endorsement, and no commercial relationship exists between Concierge Medicine Today and any source cited in this episode unless otherwise disclosed. Physicians, nurse practitioners, physician assistants, and other clinicians considering any practice model change are strongly encouraged to seek qualified legal counsel with specific experience in healthcare compliance, tax structuring, and the applicable regulatory environment in their state before making any practice or business decisions. © 2007–2026 Concierge Medicine Today, LLC. All rights reserved. Reproduction or distribution of this content without written permission is prohibited.
What happens when you match into a residency but it still feels like a loss? Kathleen Muldoon is a coach and medical educator with 20 years of experience partnering with medical students through some of training's most high-stakes moments. In this episode, based on her KevinMD article "What Match Day teaches us about unexpected life paths," she unpacks the hidden emotional weight of Match Day, the moment when a plain white envelope determines what kind of doctor you get to be. You will hear about the student who quietly told her "you won't understand" because they did match but not into the future they had pictured, and why that subtle disappointment deserves just as much space as celebration. Muldoon explains how medical training conditions future physicians to perform success while hiding vulnerability, widening a gap between personhood and performance that fuels physician burnout later in careers. She shares coaching techniques that help students stop treating feedback as an indictment of identity and start treating it as useful data, a skill that translates directly to sitting with patients whose lab results bring unwelcome news. If you work with trainees or remember your own moment of tearing open that envelope, this conversation reframes disappointment as an invitation rather than a verdict. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
Why do patients refuse statins backed by decades of data in millions of people yet eagerly inject peptides tested in fewer than 20? Emergency medicine physician and longevity practitioner Vikas Patel confronts this paradox head-on. In this episode, based on his KevinMD article "Why the FDA regulations on peptide therapy matter," he breaks down what compounds like BPC-157 actually promise, what the evidence really shows, and why the gap between anecdotal hype and clinical proof should concern both physicians and patients. You will learn how the erosion of trust in medicine through the COVID years fueled demand for unregulated therapies promoted on podcasts and social media, why physicians who take an absolutist stance risk pushing patients further from reliable guidance, and how reframing long-term statin data dramatically changes the risk conversation. Patel also shares his practical approach to meeting patients where they are without compromising scientific integrity, and why he believes at least a handful of popular peptides will eventually prove their worth if anyone bothers to study them. If you want to have smarter conversations with patients about peptide therapy and rebuilding trust, press play. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What keeps millions of people from sitting in a dentist's chair, even when modern technology has made procedures more comfortable than ever? Kaushal Shah is a general dentist and dental director managing multiple practices in the Dallas area with 15 years of clinical experience. In this episode, based on his KevinMD article "Overcoming dental anxiety for better oral health care," he explains why dental anxiety remains the single greatest obstacle to routine oral health care and what clinicians can do about it. You will hear how anxiety starts as early as infancy, why the entire office team from receptionist to assistant plays a critical role in calming nervous patients, and how simple techniques like using epinephrine-free anesthetic or computer-guided injection systems such as STA can dramatically reduce needle fear. Shah also shares his approach to sedation options ranging from nitrous oxide to general anesthesia, including how his practice screens patients and ensures safety with a physician anesthesiologist always present. He offers a direct message to physicians whose patients avoid dental visits until infections force them into a primary care office. If you or your patients have been putting off dental care out of fear, this episode lays out a practical path forward. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What if the cure for physician burnout isn't a wellness workshop but a 10-minute exercise you can do alone in a quiet room? Brian Sayers is a rheumatologist in Austin, Texas, with nearly 40 years in private practice who founded an anonymous counseling program that has funded almost 4,000 visits for fellow physicians. In this episode, based on his KevinMD article "Finding meaning in medicine: Reconnecting with your childhood calling," he makes a case that reconnecting with your origin story in medicine can realign you with the purpose you may have lost under paperwork, frustration, and systemic pressure. You will hear how he traces his own calling back to a homemade doctor's smock his mother sewed him as a child, how watching physicians care for his dying father shaped his vision of what a doctor should be, and why he asks physicians in small groups to write and share the moment they first wanted to practice medicine. He also tackles the controversy around calling medicine a "calling" and whether that language enables exploitation. If your daily practice no longer resembles the dream that launched it, this conversation will remind you where to look. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What if the biggest threat to your success in medical training has nothing to do with how much you study? Vance Lehman, professor of neuroradiology and chief of neuroradiology education at the Mayo Clinic, spent over two years researching why capable trainees stumble despite strong clinical knowledge. In this episode, based on his KevinMD article "The hidden curriculum: What medical school does not teach you," he explains how unspoken expectations, invisible social dynamics, and stealth influences shape evaluations and career trajectories far more than most trainees realize. You will learn why making a strong first impression on a new rotation triggers a powerful psychological feedback loop, how generational biases from attendings quietly distort trainee evaluations, and why years of excelling at test scores can actually leave you blind to the skills that matter most in clinical settings. Lehman also shares practical steps any medical student or resident can take tomorrow to stop leaving their reputation to chance. If you are in medical training or teach those who are, this episode reveals the forces you feel every day but have never had a name for. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What if the real driver of aging isn't your mitochondria or your telomeres but the tiny capillaries you never think about? Double board-certified emergency and internal medicine physician Kenneth Ro returns to the show to make a compelling case that microvascular decline is the overlooked upstream force behind nearly every disease of aging. In this episode, based on his KevinMD article "How the microvasculature drives the human aging process," he explains why your body shuts down capillaries you stop using through a process called capillary rarefaction, and how that quietly starves tissues of oxygen long before symptoms appear. You will hear how microvascular disease connects diabetic complications, heart failure with preserved ejection fraction, and even sepsis under one unifying framework. He also shares why exercise works at a level deeper than most clinicians discuss, what GLP-1 agonists may be doing to your pericytes, and why VO2 max and heart rate variability are your best windows into microvascular health. This episode will change how you think about what it truly means to age well. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What if one of the most common escalation strategies for acute heart failure doesn't actually improve outcomes? Internal medicine physicians Benjamin P. Geisler, Jeffrey L. Greenwald, and Kathy May Tran, editors of 50 Studies Every Hospitalist Should Know, join the show to break down what the DOSE trial really tells us about managing diuretics on the wards. Based on their KevinMD article "Managing acute heart failure: evidence from the DOSE trial," they explain why continuous furosemide infusions showed no clinical advantage over intermittent boluses for decongestion, and what that means for your daily practice. You will hear how headline-driven medicine can mislead clinicians, why knowing who was excluded from a trial matters as much as the results, and how evidence-based medicine teaching is evolving in the age of AI. Whether you are a hospitalist, a trainee on the wards, or a primary care physician managing heart failure transitions, this episode will sharpen how you read and apply the studies that shape patient care. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What happens when the nurses sent to care for your medically fragile child have never even touched the equipment keeping him alive? Patient advocate Ashley Youngdale knows firsthand. As the mother of a son with Mobius syndrome who required a trach and ventilator, she became his primary nurse, trainer, and care coordinator when the pediatric home health care system fell short. In this episode, based on her KevinMD article "Pediatric home health care oversight: Why accountability is failing," Ashley reveals how the nursing shortage does more than leave shifts unfilled. It erodes the very accountability structures meant to protect vulnerable patients. You will hear why credentials do not guarantee competence, how blurred boundaries with home care nurses can put families at risk, and why parents must learn to enforce their own standards when oversight systems fail. If you care for a medically complex child or work in home health nursing, this conversation will change how you think about who is truly responsible for patient safety. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What happens when a physician who spent decades treating patients suddenly finds himself on the other side of the exam table, unable to get a simple answer about his own aneurysm? Jeffrey Junig, a psychiatrist and addiction medicine specialist, shares how a life-saving surgery and a casually dropped diagnosis exposed the growing disconnect between clinical excellence and patient experience. Based on his KevinMD article, "Why quality of life in health care is often overlooked," this conversation digs into what gets lost in 15-minute visits, why patients turn to the internet when doctors won't engage, and how even a physician with full access to medical literature struggled to advocate for his own care. You'll hear practical advice for patients who feel rushed or dismissed, honest reflection on polypharmacy and the limits of app-based communication, and a powerful case for why the doctor-patient relationship remains the most undervalued tool in medicine. If you've ever left a clinic feeling unheard, this episode will remind you that your questions deserve real answers. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What if the biggest driver of unnecessary ER visits, malpractice claims, and patient anxiety isn't a missed diagnosis but a missed sentence? Alan P. Feren, a retired surgeon, independent physician, health care consultant, and patient advocate, returns to the show to break down why clinical reasoning that stays inside a doctor's head fails everyone involved. Based on his KevinMD article, "Clinical communication skills: the power of structured language," this conversation introduces his five disciplines of language, a practical framework that helps physicians translate their thinking into words patients can actually use. You'll learn why vague instructions like "return if symptoms worsen" leave patients guessing, how 30 to 40 percent of malpractice suits trace back to communication failures, and why naming what has been ruled out can matter just as much as naming the diagnosis. Feren also addresses treatment burden, the overlooked question of whether a patient can realistically follow the plan you just prescribed. None of this requires extra time or systemic overhaul, just a shift in how you structure what you already say. If you want one framework that improves patient satisfaction, reduces downstream costs, and restores meaning to the clinical encounter, press play. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What happens when patients from opposite ends of the political spectrum sit together in your waiting room and start talking like neighbors? Psychiatrist Farid Sabet-Sharghi explores why the medical office remains one of the last spaces where shared humanity overrides division. Based on his KevinMD article, "Physician neutrality: a beacon of ethics in a divided world", this conversation moves from the exam rooms of a polarized America to the prisons of Iran, where physicians and nurses risked torture and death to treat wounded protesters. Sabet-Sharghi shares the story of his father, a pediatrician arrested for his Bahai faith, who opened a clinic inside the very prison that held him. He draws a line from that radical moral courage to the quieter tests physicians face every day: speaking up when colleagues are mistreated, pushing back when systems reduce healers to "providers" and "prescribers," and refusing to let financial stratification erode the dignity of primary care. You'll hear why he now prefers "unbending moral integrity" over neutrality, how physician burnout connects to a lost sense of calling, and what younger doctors need to hear about why their work still matters. This is a conversation that will remind you why you entered medicine in the first place. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What happens when a Division I athlete loses 40 pounds, can barely form sentences during practice, and keeps hearing from doctors that it might just be anxiety? Kamiah Gibson, a D1 women's volleyball player at Ohio State and psychology graduate student, shares how she had to diagnose herself after finding celiac disease information on TikTok, only to be told over the phone to "just eat gluten-free" days before a three-week road trip. Based on her KevinMD article, "Managing celiac disease: Overcoming the hidden social burden," this conversation reveals the gap between a celiac diagnosis and actually knowing how to live with one. Gibson describes training eight hours a day on a body that could not absorb nutrients, the isolation of being afraid to eat anywhere, and how a consumer gluten detection sensor gave her the confidence to travel and share meals with friends again. You'll hear why cross-contamination is the hidden danger that most newly diagnosed patients are never warned about, how the emotional toll of chronic illness redirected her career from pre-med to mental health therapy, and what advice she offers young adults navigating a diagnosis that reshapes every social interaction around food. If you or someone you know lives with celiac disease, this is the episode to share. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What happens when a physician searches her own name online and gets redirected to a billionaire-backed corporate clinic she has no connection to? Stephanie Waggel, a physician and founder of Improve Medical Culture, explains how vertical integration in health care is quietly suffocating independent practices while most doctors and patients have no idea it is happening. Based on her KevinMD article, "The dangers of vertical integration in health care," this conversation unpacks how a single corporate entity can own the insurance company, the pharmacy benefit manager, the drug distributor, the retail pharmacy, and the provider group all at once. Waggel breaks down why this consolidation drives up costs rather than lowering them, how private equity and venture capital firms pressure physician-owned practices into selling, and why the consumer ultimately loses when one entity controls pricing at every step. You'll hear her compare health care models across the U.S., U.K., Canada, and Australia, learn why she believes pharmacists should own pharmacies and doctors should own clinics, and discover the community-based survival strategies independent practitioners are using to stay visible. If you care about the future of the doctor-patient relationship and the survival of independent medicine, this one deserves your attention. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
When was the last time your dentist mentioned that artificial intelligence was scanning your X-rays before you even sat down in the chair? General dentist Sowjanya Gunukula explains how AI is quietly transforming routine dental checkups in ways most patients never hear about. Based on her KevinMD article, "How AI in dentistry is changing your next checkup," this conversation breaks down the two major applications reshaping dental care today: radiographic analysis that color-codes cavities and bone loss in real time, and predictive analytics that sort patients into risk categories for more personalized treatment plans. Gunukula describes how AI acts as a second set of eyes that never gets tired, catching early problems on busy days that the human eye might miss. You'll learn why dentistry is shifting from reactive to preventive, how AI-driven risk profiling can mean less time in the chair and lower costs, and why patients should feel empowered to ask their dentist how these tools are being used. She also addresses concerns about over-reliance and explains why responsible adoption keeps the patient relationship at the center. If you want to understand what is already happening behind the scenes at your next dental visit, this episode is worth your time. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What happens when a woman is diagnosed with a rare, estrogen-sensitive lung disease at 28, in her first week of residency, with no roadmap for whether she can safely have children? Anesthesiologist Lyndsay Hoy shares her experience navigating family planning after being diagnosed with lymphangioleiomyomatosis (LAM), a rare disease that predominantly affects women of childbearing age. Her episode is based on her KevinMD article, "Reproductive care for rare diseases: the missing playbook," Even with a medical degree, institutional access, and a physician partner, Hoy found the answers incomplete, and she knows most women facing similar diagnoses have far less support. You will hear why rare disease patients so often become their own case managers, bridging pulmonology, reproductive endocrinology, and genetics with no coordinated system guiding them. Hoy draws on the oncofertility model built around hormone-sensitive breast cancer as proof that structured reproductive counseling can be developed even under uncertainty. She outlines what a minimum viable playbook for rare disease reproductive care should include and the work already underway at the LAM Foundation. If you care about closing the gaps in women's health care, this conversation will change how you see the problem. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What happens when a patient makes a reasonable, informed decision to skip a non-mandatory test and the system simply stops? Patient advocate Aaron S. Rosenberg shares how a routine dental visit became a case study in conditional care after he declined bite-wing X-rays and was told his cleaning could not proceed. His episode is based on his KevinMD article, "Informed refusal vs. denied care: a dental case study," You will hear how a recommendation quietly became a requirement, how licensure risk was invoked despite no such mandate existing in ADA guidelines, and how the visit ended with no care delivered at all. Rosenberg draws on his career spanning clinical practice, health systems, and insurance to examine how standardization, liability concerns, and billing structures can squeeze out shared decision making. He makes the case that informed refusal is a patient right that only has meaning if care remains available after a reasonable decline. He also explores where to draw the line, distinguishing non-mandatory diagnostics tied to preventive care from urgent clinical scenarios where compliance may be essential. If you have ever wondered whether health care systems are quietly replacing clinical judgment with rigid protocols, this episode will sharpen how you think about patient autonomy. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
When did volunteering stop being a choice and start being a condition of professionalism? Pediatrician, certified coach, and mindfulness and yoga teacher Jessie Mahoney realized she had donated over 2,000 hours of uncompensated work as a volunteer clinical professor, all while holding leadership roles and raising three kids, and she had never once questioned it. Her episode is based on her KevinMD article, "The hidden cost of uncompensated work on physician burnout," Mahoney traces how residency culture normalized unpaid labor and how systems now depend on it, framing obligation as generosity and penalizing anyone who pushes back. You will hear why she believes uncompensated work is low-hanging fruit in the fight against physician burnout and how the expectation of free labor disproportionately affects women, who now make up roughly 60 percent of the physician workforce. She offers practical language for setting boundaries, including the phrase "I wish I could, but I don't have capacity right now," and explains why compensation does not have to mean money alone. Mahoney also explores how generational tension among physicians reinforces the cycle and why collective action, from retreats to unionization, may be what finally shifts the culture. If you have ever felt guilty for questioning what medicine asks of you for free, this conversation will reframe that instinct entirely. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
What happens when a doctor closes the chart but the patient leaves without understanding what was actually said? Retired surgeon, independent physician, health care consultant, and patient advocate Alan P. Feren describes what he calls "unfinishedness," the gap between administrative closure and true clinical closure that leaves patients disoriented and adrift. His episode is based on his KevinMD article, "Unfinishedness in medicine: When a good visit feels incomplete," Feren shares the story of his mother-in-law, who was diagnosed with very early chronic lymphocytic leukemia but only heard the word "cancer," never grasping that her condition called for watch and wait rather than alarm. She was dead within a year. He argues that physicians routinely achieve structural closure through documentation and prescriptions while failing to make their clinical reasoning visible and understandable to patients. You will hear why cognitive overload and system pressures cause well-meaning doctors to treat a finished chart as a psychological safety mechanism, what treatment burden means and why ignoring it undermines adherence, and how patients can ask orientation-based questions to close the gap themselves. Feren also explains how AI can serve as an add-on to clinical reasoning rather than a replacement. If you have ever left a doctor's visit unsure what just happened, this episode gives you the language to change that. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
When is the most powerful thing a medical student can do in a patient's room simply to stop talking? Medical students Jay Pendyala and Jonathan Berg draw on years of competitive chess to explain how the game quietly trains skills that medical school rarely teaches directly. Their episode is based on their KevinMD article, "What chess taught me about clinical reasoning and humanism," Pendyala and Berg break down how chess mirrors clinical encounters across three phases, from the structured opening of patient intake through the ambiguity of the middle game hospital course to the high-stakes endgame of discharge or difficult family meetings. You will hear why prophylaxis, the chess concept of anticipating your opponent's threats, maps directly onto anticipating disease progression and surgical complications. They explore how playing thousands of games under time pressure prepared them for real-world urgency like door-to-balloon times and trauma bays, and why resilience built at the chessboard transfers to moments when a clinical plan falls apart. Perhaps most striking is their reflection on silence, the comfort with saying nothing that chess cultivates and that proves essential in psychiatry rotations and conversations with seriously ill patients. If you are looking for a fresh lens on clinical reasoning, pattern recognition, and preventing medical student burnout, this conversation delivers all three. Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended