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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 “Read more…
Why doctors burn out connecting with patients, and how to fix it [PODCAST]
One of the questions I get asked most often outside of the operating room has nothing to do with facelift techniques or eyelid anatomy.
It usually happens at dinner parties. Someone eventually finds out I’m a facial plastic surgeon, and after a few minutes the question comes: “Do you ever say no to patients?”
I always laugh because the answer is immediate. Absolutely. All the time. It’s my favorite thing to say. …
Why I say no during a cosmetic surgery consultation
The definition of a “doctor” is shifting in a way that feels increasingly fragmented. Growing up with a father who practiced for decades as a primary care physician before pursuing a residency in pediatrics, my baseline understanding of medicine was rooted in the “whole doctor” model. In that world, a physician addressed the majority of a patient’s needs and sought specialized intervention only when a situation truly demanded it. Today, …
The generalist physician hiding in every specialist
In 2022, during a hospitalization following an extreme psychological and physiological crisis, I experienced something I struggled to describe using existing clinical language. What followed did not feel like recovery, coping, or reframing. It felt like a complete neurological and existential reorganization.
As a researcher and writer grounded in trauma science, I searched for frameworks that could explain the magnitude and durability of the change. Post-traumatic growth (PTG) came closest. Yet …
Post-traumatic growth is not just cognitive reframing
“Doctor, I’m not against medicine,” the patient said quietly, arms crossed before the conversation had barely begun. “I just don’t want any more vaccines.” The physician paused. The patient was a 65-year-old man with diabetes, chronic lung disease, and a recent hospitalization for pneumonia. The patient’s chart showed that he was overdue for influenza, COVID-19 booster, pneumococcal, and RSV immunizations. Ten years earlier, this discussion might have taken less than …
Vaccine hesitancy is a language problem, not just science
In an effort to discover the Neuroscience of Happiness, the concept that a significant portion of our daily happiness derives from how we contribute to the happiness of others is strongly supported by research on prosocial behavior, empathy, and social relationships. While pinpointing an exact percentage is difficult, multiple studies reveal a clear positive correlation between caring for others’ well-being and our own.
From early childhood, giving behaviors boost happiness. …
Why acts of kindness make you measurably happier
There is no doctor in my village.
I grew up in Logwerle, a small community in Central Equatoria State, South Sudan. When people got sick, they traveled far for care, or they didn’t get care at all. In 2003, my family moved to northern Uganda so I could get an education. I started primary school at Teremunga Primary School in Koboko, completed my O-levels at St. Charles Lwanga, and my A-levels …
AI in global health has continent-sized blind spots
It starts the same way every time.
A parent sends a text at 10:47 p.m. Their two-year-old has had a fever for three days. The urgent care closed at nine. The ER is 45 minutes away and will cost them $400 before anything is done. The on-call nurse line put them on hold. So they do what parents in 2026 do: They scroll, they worry, and they wait for morning.
I built …
Why pediatric direct primary care belongs at the door
For the first decade of my medical career, I thought I was treating bodies. By the second decade, I noticed something else. I was usually treating relationships. Patients almost never told me directly.
A woman in her late forties came into my office last year. She had gained 22 pounds in a year, on a routine that had worked for the decade before it. Her labs were normal. Her thyroid was …
How relationships affect health, seen from the exam room
It was my first ICU call shift as a second-year resident, and my first time holding the code pager, which rested, quiet but not quite forgotten, in my scrub top pocket until around 10 p.m.
The overhead speakers blared to life just as the pager began to beep. I ran to the cardiac ICU, forgetting my carefully organized ACLS cards on my call room desk. The patient was a middle-aged male …
Knowing when to stop treatment is medicine’s quiet burden
There is a father somewhere on the internet, grieving his son on camera, doing the brave and devastating work of converting his loss into warning signs for someone else’s child. He lists them carefully: if someone tidy becomes constantly disorganized, if nothing excites them anymore, if the texture of their daily life has quietly collapsed, please speak to someone, get professional help.
The comments beneath the video tell you everything about …
Isolation and suicidal thoughts: the quiet friend
Every physician begins as a traveler.
Before the white coat, before the title, before the privilege of caring for patients, we are all aspiring travelers trying to reach the same destination: competence, wisdom, clinical excellence, and the ability to serve human beings in their most vulnerable moments. Some begin that journey on well-paved roads, guided by physicians in the family, excellent schools, professional mentors, and the financial freedom to prepare without …
Merit in medical school admissions is more than scores
My wife and companion of nearly 50 years is dead. She used to say that when I was home, the house was pretty quiet. As a health care educator and patient advocate, much of my time was spent at my computer in my study. But on the rare occasions when I traveled for work, the house was “too quiet” for her. If I didn’t before, I would understand what she …
What home hospice care gave us in her final days
This April, I had the privilege of taking an elective at my medical school entitled “Empowering Clinicians-in-Training to Address Domestic Violence.” Through sessions led by physicians, community leaders, survivor advocates, and survivors, my classmates and I learned how to leverage our role as soon-to-be physicians to identify, support, and advocate for survivors of domestic violence.
Not even a week after the course ended, national headlines announced the death of Dr. …
Domestic violence medical training is failing survivors
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!
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 …
What’s actually behind medical students using AI [PODCAST]
Every day, I am invited into the most intimate and vulnerable chapters of another person’s life. Chapters no one ever plans for, marked by fear, grief, courage, and extraordinary love.
I have sat across from a 64-year-old man newly diagnosed with prostate cancer and watched tears fall from his eyes for the first time in over a decade. I have seen trembling hands of a young woman reach instinctively for her …
Oncology grief is the price of caring deeply for patients
As our calendars roll forward into the month of June, the summer season brings thoughts of family vacations, graduation ceremonies, and outdoor gatherings to many. But for me and others along the Gulf Coast, June 1 carries added meaning as …
Physicians and natural disasters: the fifth season
The most unsettling thing about artificial intelligence is not what it can do. It is what people feel when they talk to it.
I keep hearing the same things. “It listens.” “It doesn’t rush me.” “It helps me think.” “It seems to care.” Some people say this with embarrassment, as though confessing a weakness. Others say it with relief. A few say it with something close to gratitude.
These reactions have set …
AI in health care is a mirror, not a therapist
When a recent study in Nature Medicine compared general-purpose AI models with specialized clinical tools, the headline was exactly the kind the technology world likes to see: The generalists came out on top.
The reactions were predictable. Some observers treated the study as proof that specialized clinical software is no longer needed, arguing that bigger and more powerful AI models will always win. Others dismissed the study, pointing out that AI …
Why the safest medical AI knows when not to answer
I arrived at the office early that morning. The hospital still carried that mixture of stale coffee, disinfectant, and human exhaustion that exists only in medical corridors before eight in the morning. When I opened the door to the first examination room, I smiled peacefully. There sat Leon and Ilana. I had known them for so many years that it was impossible to remember when we had stopped addressing each …
Statistics are not destiny: a story of hope in oncology
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