Loneliness, not weakness, is driving women out of medicine

A physician was fired by the doctors she had trained, in part because she preferred to see her own patients herself. Moral injury, she argues, does not require 100-hour weeks. Sarah A. Vlach is a physiatrist and sports medicine physician. This episode is based on her article "Moral injury doesn't care how many hours you worked," published on KevinMD. You will hear how her working conditions slowly deteriorated, including nine months without a medical assistant, and why her first response was to knuckle down and work harder. She describes how financial incentives like RVUs now shape decisions in both corporate and private practice, and why she sees a two-track system forming as more clinicians move to cash-based care. She offers advice for new physicians starting out with large loans, and she explains how the Physician Support Line and writing about the experience helped her. Press play to hear what she wishes she had done sooner, and why she has found there is life after being a physician.

The words you put in a patient's chart can be used to deny their disability claim. A note that says "stable" or "improved" can mean one thing to you and another to the insurer. Jennifer Hess, an ERISA disability attorney and Riemer Hess partner, represents physicians and other professionals in long-term disability claims. This episode is based on her article "Why your patient's disability claim was denied," published on KevinMD. You'll hear why a fixed return-to-work date on a disability form can get benefits cut off, and what to write instead. You'll also learn how to add context to notes about improvement, pain, or depression, and why a short narrative letter can go a long way. Jennifer explains why you can ask insurers to put their questions in writing instead of answering on a surprise call. She also makes the case for checking your own disability policy, since you could one day be on the other side of the table. Hear what to write, what to leave out, and what to read before you sign.

Many doctors who run their own practices spend hours on work someone else could do. One practice owner who charges $300 an hour was his own receptionist, verifying insurance all night and stepping away from a family dinner to take a patient's call. Central AI and Wing Assistant CEO Karan Kanwar discusses his KevinMD article "The physician opportunity cost nobody puts on a bill." He argues that this time, along with the revenue lost when calls go unanswered, never shows up on a profit and loss statement. You'll hear why practices hesitate, from reluctance to let go of tasks to worries about HIPAA compliance and connecting to the EHR. He walks through the easiest places to start, including phone calls, payer calls, billing and test result questions, and non-clinical questions about medical equipment. He also shares how to judge whether an AI vendor will still be around. Stay for a simple exercise: look at everything you do in a day and decide what you can give away.

When you can't speak for yourself, a living will is supposed to speak for you. Too often, it doesn't. Seventy percent of U.S. adults don't have one, and those who do often keep it in a drawer at home. Emergency physician and MIDEO Health Technologies CEO Ferdinando Mirarchi and attorney Thaddeus Mason Pope discuss their KevinMD article "Why problems with advance directives keep harming patients." You'll learn that 80 percent of physicians equate the mere presence of an advance directive with a do not resuscitate (DNR) order. Mirarchi calls it the lethal glance, a split-second read by a clinician who has never met the patient. The errors go both ways: resuscitating people who never wanted it and failing to resuscitate people who chose full code. They explain how a POLST differs from an advance directive, how professional bias creeps in, and how patient-recorded videos can make your wishes clear in seconds. You'll leave knowing what to set up for yourself and your family now, and why clinicians should stop and ask instead of assuming.

Someone tells you their memory is slipping. What you say next can decide whether treatment is still an option for them. Emer MacSweeney is a neuroradiologist and the cofounder and CEO of Re:Cognition Health. This episode is based on her article "Early Alzheimer's diagnosis now decides who gets treated," published on KevinMD. She explains why two licensed treatments work only inside a narrow early window, and why a year spent waiting for an appointment can put a patient past it. You will hear how the three biomarker tests compare, including the blood test that is now widely available, and why she says not to order one unless the patient has symptoms. She also names the early signs she takes seriously: short-term memory trouble, losing words, getting lost in familiar places. If you have ever told someone their memory is just getting older, this conversation explains what that reassurance can cost.