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The DOSE trial compared low‑dose versus high‑dose IV furosemide and bolus versus continuous infusion in 308 stable acute‑on‑chronic heart‑failure patients. High‑dose therapy (≈2.5 × oral dose) increased the proportion switching to oral diuretics by 48 hours without worsening 60‑day outcomes, while renal function differences were transient. No significant interaction was found between dosing strategy and administration mode, indicating bolus and infusion are equally effective for symptom relief. The study clarifies that aggressive diuresis is safe in hemodynamically stable patients.
Cultural humility is emerging as a core competency in modern medicine, urging clinicians to value patients' cultural, spiritual, and socioeconomic contexts alongside clinical science. By actively listening and integrating safe traditional practices, providers build trust that improves adherence and outcomes....
Dr. Diane Shannon outlines three time categories—productive, enriching, and numbing—and observes that physicians overwhelmingly occupy the productive zone while neglecting enriching activities. The pandemic intensified reliance on numbing leisure as a coping mechanism, deepening the imbalance. She highlights sleep hygiene...
Kaylan Baban, an internal‑medicine physician, recounts his first solo enucleation as a senior resident, performed on a trauma patient who survived a bar‑stool injury. The patient, Mr. Krueger, expressed gratitude and asked the resident whether he had learned anything, turning the...
The author, a 26‑year hospitalist, argues that world leaders should emulate the way diverse medical teams collaborated during the COVID‑19 pandemic. He recounts personal friendships with physicians of varied ethnicities, religions, and sexual orientations who united around patient care despite...
A physician who received a lifetime American Board of Internal Medicine certification in 1983 argues that the Maintenance of Certification (MOC) program adds little value for experienced doctors. He points to decades of continuing medical education, teaching, publishing, and patient...
Physicians are turning to translational fertility experts to rescue IVF patients with poor egg quality or recurrent embryo failures. By applying a revised ovulation paradigm, clinicians extended stimulation cycles and fine‑tuned hormone dosing, leading to viable embryos and live births...
Orthopedic surgery remains one of the most competitive specialties, with 916 residency slots across 218 programs and a 74.3% match rate for U.S. allopathic seniors in 2024. Dr. John Klibanoff emphasizes that Match Day marks the start of a broader...
A third‑year medical student describes how point‑of‑care calculators like MDCalc translate evidence‑based scores into actionable decisions during an emergency medicine clerkship. While these tools improve consistency, the author warns that they can solidify into rigid protocols, turning probabilistic aids into...
The article argues that trust is the "secret sauce" for high‑performing health‑care teams, linking neuroscience to better collaboration, reduced burnout, and superior patient care. It presents Harvard Business School professor Frances Frei’s three‑pillar framework—authenticity, logic, and empathy—as practical levers for...
The authors propose a three‑level framework for psychiatric care that integrates biological, psychosocial, and moral‑existential interventions. Biological treatment with medication corrects neurochemical disruptions, while psychotherapy addresses social and psychological stressors. The moral‑existential layer, delivered through the therapeutic relationship, fosters meaning,...
The article condemns the growing wave of violence against health‑care workers, underscored by the 2026 murder of nurse Alex Pretti in Minnesota. It blends personal testimony from a retired nurse with a broader call for systemic change, arguing that assaults...
![Why Early Detection Matters: Transforming Lung Cancer Care [PODCAST]](/cdn-cgi/image/width=1200,quality=75,format=auto,fit=cover/https://kevinmd.com/wp-content/uploads/unnamed-2-7.jpg)
Early detection of lung cancer, especially through low‑dose CT screening, can cut mortality by 20% and prevent one death per 320 screened. Yet only 18% of eligible U.S. patients undergo screening, due to awareness and access barriers. Eli Lilly’s senior oncology...
U.S. medical schools allocate fewer than 20 hours to nutrition education, leaving many GI fellows without formal diet training for inflammatory bowel disease. A one‑hour online module dramatically improved fellows' knowledge, confidence, and intention to refer patients to nutrition services....
Physician residents are forming unions to confront entrenched hierarchies, unsustainable workloads, and a culture of silent endurance in academic hospitals. The article rebuts a recent JAMA Viewpoint that framed unionization as a perk‑seeking entitlement, emphasizing that burnout persists because systemic...
