Stopping medication requires as much skill as starting it
Release Date: 02/01/2026
Stopping medication requires as much skill as starting it
The Podcast by KevinMD
Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article "." Muhamad explores the growing movement to reduce unnecessary medications in mental health care, a practice that has long been established in geriatrics but is now gaining traction in psychiatry. He describes the "prescribing cascade" where side effects are treated with more drugs, leading to patients feeling trapped in a cage of routine and chemical dependency. The conversation highlights the critical importance of having an exit plan for every prescription and...
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Blaming younger doctors for setting boundaries ignores the broken system
The Podcast by KevinMD
Palliative care physician and certified physician development coach Christie Mulholland discusses her article "." Christie challenges the pervasive narrative that younger physicians lack work ethic and argues that their boundary-setting is a rational response to an untenable system. The conversation explores why well-being initiatives fail when they are treated as volunteer hobbies without budget or authority. Christie explains the double standard where new technology is an investment but physician wellness is expected to prove immediate financial return. She also critiques the rigid...
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Waking up at 4 a.m. is not required for success
The Podcast by KevinMD
Physician, former health care executive, certified coach, speaker, and organizational consultant Laura Suttin discusses her article "." Laura shares her personal struggle with the popular productivity advice that claims early rising is the only path to high performance. She describes the fog and misery she experienced while trying to force her body into a rhythm that did not match her natural energy patterns. The conversation highlights the dangers of comparing your internal reality to the curated highlight reels of gurus on social media. Laura explains how she learned to drop the...
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Invoking your rights is the only way to survive a federal investigation
The Podcast by KevinMD
Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article "." Muhamad shares a terrifying but essential guide for any doctor facing an unexpected visit from federal agents or investigators. He explains why the physician's natural instinct to educate, reassure, and be helpful is actually a liability that can lead to a prison sentence. The conversation highlights the critical legal distinction established in Salinas v. Texas which means silence alone is not enough to protect you without a verbal invocation of rights. Muhamad...
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World Health Organization reframes fertility care as a fundamental right
The Podcast by KevinMD
Fertility specialist and founder of Montgomery Fertility Center Oluyemisi (Yemi) Famuyiwa discusses her article "." Oluyemisi examines the historic release of global guidelines that reframe infertility as a matter of social justice rather than a luxury concern. The conversation highlights the practical strengths of these recommendations for low-resource settings while acknowledging critical gaps regarding environmental toxins and cultural nuance. Oluyemisi argues that addressing the emotional toll of fertility struggles requires a shift in how health care systems prioritize reproductive...
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Racial disparities in pancreatic cancer screening cost Black lives
The Podcast by KevinMD
Internal medicine physician Earl Stewart, Jr. discusses his article "." Earl examines the devastating pattern of pancreatic cancer claiming Black cultural icons like John Lewis and Aretha Franklin while the medical establishment fails to implement race-specific screening guidelines. He highlights research showing that high-risk individuals undergoing surveillance have a 50 percent five-year survival rate compared to just 9 percent for those diagnosed through usual care. The discussion challenges the current medical inertia that demands perfect data before acting and proposes a three-tier...
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Hidden financial dangers of wRVU thresholds in medical employment agreements
The Podcast by KevinMD
Health care attorney Dennis Hursh discusses his article "." Dennis explains the critical distinction between a guaranteed salary and a draw against future earnings where failure to meet production targets can lead to clawbacks. The discussion covers how employers often set unrealistic wRVU thresholds that exceed historical data or MGMA benchmarks while failing to provide adequate marketing support to meet those goals. Dennis highlights the importance of ensuring new physicians have guaranteed income during their ramp-up period and warns against contract language that credits productivity only...
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Healing chronic illness requires treating the mind alongside the body
The Podcast by KevinMD
Internal medicine and functional medicine physician Shiv K. Goel discusses his article "." Shiv explores the limitations of conventional medical models that focus solely on acute intervention while ignoring the emotional roots of chronic conditions. He shares the compelling story of Linda whose physical ailments were deeply connected to decades of suppressed grief and trauma. The conversation delves into the science of psychoneuroimmunology and how unprocessed emotions get stored in the body's tissues eventually manifesting as disease. Shiv explains why true healing involves not just...
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Medicare cuts are destroying independent rural medical practices
The Podcast by KevinMD
Saravanan Kasthuri, medical director at Northwest Endovascular Surgery, and Jason McKitrick, executive director at the Office Based Facility Association, discuss their article "." Saravanan and Jason analyze the critical economic forces dismantling independent medical practices and threatening patient access in underserved areas. They highlight the personal story of Mr. G to illustrate the human cost of broken reimbursement models while explaining how the outdated Physician Fee Schedule forces doctors to sell to hospitals or private equity firms. The conversation details how consolidation...
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Artificial intelligence demands that doctors become architects of digital health
The Podcast by KevinMD
Family physician Tod Stillson discusses his article "." Tod explains how his career evolution revealed that artificial intelligence is not a threat to the medical profession but a necessary tool for reshaping care delivery. He argues that physicians must actively lead the integration of AI to ensure that clinical judgment is amplified rather than overridden by automation. The conversation covers the necessity of digital fluency, the shift toward structured asynchronous data collection, and how these technologies can actually restore the human connection by relieving administrative burdens....
info_outlineNationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article "How deprescribing in psychiatry offers a path to safer care." Muhamad explores the growing movement to reduce unnecessary medications in mental health care, a practice that has long been established in geriatrics but is now gaining traction in psychiatry. He describes the "prescribing cascade" where side effects are treated with more drugs, leading to patients feeling trapped in a cage of routine and chemical dependency. The conversation highlights the critical importance of having an exit plan for every prescription and distinguishing between withdrawal symptoms and relapse. Muhamad advocates for a culture shift where clinicians are empowered to stop interventions when harm outweighs benefit, ensuring that medicine remains a tool for healing rather than a permanent burden. Learn how a disciplined approach to deprescribing can restore patient agency and rebuild trust in the medical system.
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