The Podcast by KevinMD

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Some relationships work like medicine. Others work like a diagnosis. Sep 27, 2026

Show notes

A patient came in with weight gain nobody could explain. Every test came back fine. Shiv K. Goel is a board-certified internal medicine and functional medicine physician. This episode is based on his article "How relationships affect health, seen from the exam room," published on KevinMD. He treats the people in a patient's life as part of the same picture as sleep, alcohol, and diet. A difficult supervisor and plain loneliness count as stress the way a marriage does. He is careful to say that a hard relationship does not cause disease. It changes the load the body is carrying, and that load shows up physically. You will hear what he rules out first: thyroid disease, anemia, diabetes, and sleep apnea. You will also hear what a flat cortisol curve tells him about long-running stress, and the questions he asks when nothing turns up. He is not a marriage counselor, and that referral belongs to someone else. He closes with two questions, one for physicians and one for everyone else.

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Food allergies are treated differently, airline by airline Sep 26, 2026

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A doctor cracked open an airplane emergency kit and found a sticker saying there was no epinephrine inside. Lianne Mandelbaum, president of No Nut Traveler and airline correspondent for Allergic Living, has spent a decade collecting accounts like it. This episode is based on her article "Epinephrine on airplanes should not depend on the airline," published on KevinMD. You will hear what a proposed federal rule would change, replacing the required medication list with a flexible one and stripping the exemption paperwork that was the only record of which airlines carried nothing. She explains why antihistamines do not belong under an anaphylaxis heading, why one auto-injector is not enough when two passengers react to the same meal, and why nobody knows how often it happens. You will also hear how a food label can look complete, satisfy federal rules, and still omit the allergen. Press play to hear what she is asking people to send the agency before the comment window closes, and the eight cents per at-risk passenger she says the fix would cost.

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Staying salaried may now be the riskier bet for doctors Sep 25, 2026

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An eye surgeon who used to see forty patients a day now sees one to three in a morning, and he has no staff. Oren Fass, a board-certified ophthalmologist and cataract surgeon, has been an employed physician, a practice owner, and an owner who sold to private equity, and he now runs a solo micro practice. This episode is based on his article "The hidden variable in the physician burnout debate," published on KevinMD. You will hear how his agents read incoming faxes, start the scheduling, and apply his billing rules, and why he says this was not feasible three years ago. He is direct about why doctors feel stuck, from the six to twelve month timelines on licenses and insurance panels to the second shift of charting that starts at six in the evening. He also argues that ownership and creativity are the two bets worth making now, and that the salaried job may be the riskier one. You will hear where he thinks the model fits, and where it does not.

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Doctors' kids miss them, and the family builds its own fixes Sep 24, 2026

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A surgeon's kids FaceTime him from their iPads while he is in the operating room, and he cannot pick up. Alyssa Kressel, a strategic communications professional, has spent more than fifteen years alongside her husband's surgical training. This episode is based on her article "What the children of physicians carry," published on KevinMD. You will hear why the usual advice about adjusting hours does not fit a transplant schedule, and why she puts the weight on the time he is home. She talks about the doctors' wives and surgeons' wives groups that offered solidarity when nobody had a fix, about the resentment she is still working through, and about the bracelets she braided from old scrubs that grew into a stuffed animal with a pocket for notes. She also says what she wishes his residency had offered the people waiting at home. If you are in a health care family, or you train the people in one, this conversation names what the kids carry and what one family built to help them hold it.

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Why exhaustion can make you see things that aren't there Sep 23, 2026

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You drive home after a long shift and see someone standing at the roadside. It turns out to be a sign. Chinelle Miller had that happen more than once, and her first thought was that something was wrong with her. She is a physician and multidisciplinary artist. This episode is based on her article "Why seeing things doesn't mean you're losing your mind," published on KevinMD. You will hear what she found when she looked into it, and how the same experience shows up for other people she talked to. She describes what she was told when she raised it with her own therapist, why the same thing can show up with grief, and how she caught herself trying to pathologize her own experience. She explains why she thinks diagnostic terms have become buzzwords, the questions she tells people to ask themselves, and when the answer is to stop researching and ask someone. Stay to the end for her case that the expert, not the internet, is who gets to say it's normal.

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Making AI work for physicians Sep 22, 2026

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Doctors have heard promises about health technology for decades. Now artificial intelligence has to deliver something better than what health care already has. Seema Verma, executive vice president and general manager of Oracle Health and Life Sciences and former administrator of the Centers for Medicare and Medicaid Services, explains where health systems stand with AI today. You will hear why ambient listening became the proof point physicians did not want taken away, and why bolt-on AI tools on older electronic health records could create more burden. Seema lays out the questions to ask before you trust an AI tool, including how it was trained, how it explains its recommendations, and whether a human stays in the loop. She also explains how AI could make value-based care work and which metrics show whether it is paying off. This episode is sponsored by Oracle Health. Find out more at oracle.com/health. Press play to hear where she hopes AI will raise the quality of care and cut administrative cost, and why it only works with the right data.

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Why business pressure and threats ended a career she loved Sep 21, 2026

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She loved the job for 20 years. She left anyway. Christine King, certified registered nurse anesthetist, returns to explain what changed in the operating room and what it cost her. This episode is based on her article "Why I left health care after almost 20 years," published on KevinMD. You will hear why decisions about whether a procedure happens started to feel like insurance decisions rather than medical ones. You will hear what workplace violence looks like in an operating room, where the threats came less from patients than from the people she worked alongside. You will hear why those incidents so rarely get reported, and why she thinks the newest generation of physicians is already different. You will hear what the stress did physically, and what eased when she stopped. And you will hear what she would tell a student choosing between nursing and medical school. Press play for the one thing she wishes she had done more of, and why she thinks the people behind her already will.

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Retirement isn't the end of medicine, it's a second act Sep 20, 2026

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Many doctors picture themselves practicing until the day they die. Andrea Hayes decided otherwise, and tells you what came next. She is a retired endocrinologist, author, and speaker. This episode is based on her article "From endocrinologist to writer: a doctor's second act," published on KevinMD. You will hear how 30 years in practice, 25 of them independent and five in concierge medicine, ended without a single dramatic exit. She describes the office manager who stole a quarter of a million dollars while she was grieving her father, and how that betrayal pushed her to learn the business side she had ignored. She explains why she now tells physicians to build a plan B, a plan C, and a plan D, and what she found out about publishing after traditional publishers turned her down. She also explains how living with type 1 diabetes since age 15 shaped how she connected with patients. Stay to the end for her case that it is never too late to become someone you did not expect to be.

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Blaming the doctor is cheaper than fixing the record system Sep 19, 2026

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A pediatrician gave a child vaccines the chart said he needed. The record showing he had already had them was buried in the system. Dennis Hursh is a health law attorney and founder of Physician Agreements Health Law. This episode is based on his article "EMR errors get blamed on physicians, not systems," published on KevinMD. The health system did not fix the record system. It counseled the physician and moved to put her on a corrective action plan for failing to follow its vaccine policy. He explains why she resigned rather than carry that on her record, what a corrective action plan does to you at credentialing for the next five years, and why a non-compete means she will not see those patients again after 40 years in that community. He also walks through the contract language he negotiates: an agreed independent reviewer, and 60 days to fix anything the reviewer finds. Stay to the end for his argument that due process belongs in your contract before anyone accuses you of poor quality care.

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Why acne, chin hair, and irregular cycles are more than an ovary problem Sep 18, 2026

Show notes

A condition named for the ovaries turns out to run through the muscle, the liver, and the pancreas. Insulin is the signal connecting them, and different organs hear it differently. Oluyemisi Famuyiwa, reproductive endocrinologist and founder of the Montgomery Fertility Center, returns to walk through it. This episode is based on her article "How insulin drives polyendocrine metabolic ovarian syndrome," published on KevinMD. You will hear why the pancreas makes more insulin when muscle stops responding, and why the ovary and the liver are still listening when it does. You will hear what that does to androgen levels, and why acne, chin hair, and stubborn weight show up before irregular cycles. You will hear why body weight is a poor guide to who has PCOS, since lean patients carry the same elevated androgens and irregular cycles. And you will hear which tests she orders and why she works this across internal medicine and endocrinology. Press play for the reframe she leaves clinicians with: this is more than the ovary and more than insulin.

This episode is brought to you by ModMed.

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