
Hosted by Kevin Pho, MD · EN

Robert C. Smith is best known for arguing medicine lost its mind. This episode he explains why he is still proud to be a doctor. Primary care physicians deliver 75 percent of the nation's mental health care without training for it, and Smith has spent his career trying to fix that. But before the fix, he makes a case that may surprise his own readers: modern medicine has been astonishingly effective at what it was built to do. This episode is based on his article "How the mind-body split in medicine shaped modern clinical care," published on KevinMD. You will hear how 2,500 years of four humors and bloodletting gave way to a physical-disease framework that doubled life expectancy from 40 to 80. You will also learn why that same framework now leaves psychiatry stalled. Hear why the reformer who wants to overhaul mental health care still says medicine has never been better at the thing it was built to do. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

A federal agency recognized food allergy as a disability, then limited boarding protection to one allergen category. Lianne Mandelbaum, a leading advocate for airline safety measures to protect food-allergic passengers, returns to explain how the March 2026 DOT ruling created a hierarchy within a single medical condition, leaving passengers with egg, sesame, milk, shellfish, and wheat allergies without the same pre-boarding rights granted to those with peanut and tree nut allergies. This episode is based on her article "How the new DOT ruling on food allergies threatens air travel safety," published on KevinMD. You will hear about a Southwest captain who removed a passenger for asking to pre-board with a pistachio allergy, an allergen that is covered under the new ruling. You will also hear why a Northwestern survey of 4,704 food-allergic travelers found that 98 percent experience flight anxiety and 70 percent were promised accommodations that never arrived. Hear why the guest says this ruling cements airline inconsistency as federal policy, and what physicians can do to push back. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

What happens to your body and clinical judgment when you're managing a code blue at the exact hour your biology demands deep sleep? Chinyelu E. Oraedu is an academic hospitalist and nocturnist with 17 years of post-residency experience who has dedicated her career to understanding the science and human reality of night shift medicine. In this episode, based on her KevinMD article "How night shift medicine exposes the reality of physician stress," she breaks down why the 2 to 3 a.m. window is the most dangerous period for both patients and providers, when melatonin peaks, alertness bottoms out, and emergencies keep coming. You will learn practical strategies for surviving and thriving on night shift, from the right timing for caffeine intake to using light therapy at your workstation to suppress melatonin secretion. Oraedu explains why sleep is the single most important factor for night shift workers and why she tells every resident to protect it above exercise, meals, and everything else. She also shares surprising early data from her own research showing that night shift workers who build intentional structure around their schedule report high satisfaction. Whether you are an incoming intern about to start your first night float rotation or a seasoned nocturnist still battling fragmented sleep, this conversation offers a practical framework for reducing the hidden health risks of working against your circadian rhythm. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

What happens when you match into a residency but it still feels like a loss? Kathleen Muldoon is a coach and medical educator with 20 years of experience partnering with medical students through some of training's most high-stakes moments. In this episode, based on her KevinMD article "What Match Day teaches us about unexpected life paths," she unpacks the hidden emotional weight of Match Day, the moment when a plain white envelope determines what kind of doctor you get to be. You will hear about the student who quietly told her "you won't understand" because they did match but not into the future they had pictured, and why that subtle disappointment deserves just as much space as celebration. Muldoon explains how medical training conditions future physicians to perform success while hiding vulnerability, widening a gap between personhood and performance that fuels physician burnout later in careers. She shares coaching techniques that help students stop treating feedback as an indictment of identity and start treating it as useful data, a skill that translates directly to sitting with patients whose lab results bring unwelcome news. If you work with trainees or remember your own moment of tearing open that envelope, this conversation reframes disappointment as an invitation rather than a verdict. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Why do patients refuse statins backed by decades of data in millions of people yet eagerly inject peptides tested in fewer than 20? Emergency medicine physician and longevity practitioner Vikas Patel confronts this paradox head-on. In this episode, based on his KevinMD article "Why the FDA regulations on peptide therapy matter," he breaks down what compounds like BPC-157 actually promise, what the evidence really shows, and why the gap between anecdotal hype and clinical proof should concern both physicians and patients. You will learn how the erosion of trust in medicine through the COVID years fueled demand for unregulated therapies promoted on podcasts and social media, why physicians who take an absolutist stance risk pushing patients further from reliable guidance, and how reframing long-term statin data dramatically changes the risk conversation. Patel also shares his practical approach to meeting patients where they are without compromising scientific integrity, and why he believes at least a handful of popular peptides will eventually prove their worth if anyone bothers to study them. If you want to have smarter conversations with patients about peptide therapy and rebuilding trust, press play. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

What keeps millions of people from sitting in a dentist's chair, even when modern technology has made procedures more comfortable than ever? Kaushal Shah is a general dentist and dental director managing multiple practices in the Dallas area with 15 years of clinical experience. In this episode, based on his KevinMD article "Overcoming dental anxiety for better oral health care," he explains why dental anxiety remains the single greatest obstacle to routine oral health care and what clinicians can do about it. You will hear how anxiety starts as early as infancy, why the entire office team from receptionist to assistant plays a critical role in calming nervous patients, and how simple techniques like using epinephrine-free anesthetic or computer-guided injection systems such as STA can dramatically reduce needle fear. Shah also shares his approach to sedation options ranging from nitrous oxide to general anesthesia, including how his practice screens patients and ensures safety with a physician anesthesiologist always present. He offers a direct message to physicians whose patients avoid dental visits until infections force them into a primary care office. If you or your patients have been putting off dental care out of fear, this episode lays out a practical path forward. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

What if the cure for physician burnout isn't a wellness workshop but a 10-minute exercise you can do alone in a quiet room? Brian Sayers is a rheumatologist in Austin, Texas, with nearly 40 years in private practice who founded an anonymous counseling program that has funded almost 4,000 visits for fellow physicians. In this episode, based on his KevinMD article "Finding meaning in medicine: Reconnecting with your childhood calling," he makes a case that reconnecting with your origin story in medicine can realign you with the purpose you may have lost under paperwork, frustration, and systemic pressure. You will hear how he traces his own calling back to a homemade doctor's smock his mother sewed him as a child, how watching physicians care for his dying father shaped his vision of what a doctor should be, and why he asks physicians in small groups to write and share the moment they first wanted to practice medicine. He also tackles the controversy around calling medicine a "calling" and whether that language enables exploitation. If your daily practice no longer resembles the dream that launched it, this conversation will remind you where to look. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

What if the biggest threat to your success in medical training has nothing to do with how much you study? Vance Lehman, professor of neuroradiology and chief of neuroradiology education at the Mayo Clinic, spent over two years researching why capable trainees stumble despite strong clinical knowledge. In this episode, based on his KevinMD article "The hidden curriculum: What medical school does not teach you," he explains how unspoken expectations, invisible social dynamics, and stealth influences shape evaluations and career trajectories far more than most trainees realize. You will learn why making a strong first impression on a new rotation triggers a powerful psychological feedback loop, how generational biases from attendings quietly distort trainee evaluations, and why years of excelling at test scores can actually leave you blind to the skills that matter most in clinical settings. Lehman also shares practical steps any medical student or resident can take tomorrow to stop leaving their reputation to chance. If you are in medical training or teach those who are, this episode reveals the forces you feel every day but have never had a name for. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

What if the real driver of aging isn't your mitochondria or your telomeres but the tiny capillaries you never think about? Double board-certified emergency and internal medicine physician Kenneth Ro returns to the show to make a compelling case that microvascular decline is the overlooked upstream force behind nearly every disease of aging. In this episode, based on his KevinMD article "How the microvasculature drives the human aging process," he explains why your body shuts down capillaries you stop using through a process called capillary rarefaction, and how that quietly starves tissues of oxygen long before symptoms appear. You will hear how microvascular disease connects diabetic complications, heart failure with preserved ejection fraction, and even sepsis under one unifying framework. He also shares why exercise works at a level deeper than most clinicians discuss, what GLP-1 agonists may be doing to your pericytes, and why VO2 max and heart rate variability are your best windows into microvascular health. This episode will change how you think about what it truly means to age well. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

What if one of the most common escalation strategies for acute heart failure doesn't actually improve outcomes? Internal medicine physicians Benjamin P. Geisler, Jeffrey L. Greenwald, and Kathy May Tran, editors of 50 Studies Every Hospitalist Should Know, join the show to break down what the DOSE trial really tells us about managing diuretics on the wards. Based on their KevinMD article "Managing acute heart failure: evidence from the DOSE trial," they explain why continuous furosemide infusions showed no clinical advantage over intermittent boluses for decongestion, and what that means for your daily practice. You will hear how headline-driven medicine can mislead clinicians, why knowing who was excluded from a trial matters as much as the results, and how evidence-based medicine teaching is evolving in the age of AI. Whether you are a hospitalist, a trainee on the wards, or a primary care physician managing heart failure transitions, this episode will sharpen how you read and apply the studies that shape patient care. Tune into our episode "2026 Cholesterol Guidelines: LDL goals, lipoprotein(a), and coronary calcium scoring," brought to you by Novartis Pharmaceuticals Corporation. For the first time in eight years, LDL cholesterol goals have changed, and preventive cardiologist Seth Baum says the new guidelines are a long-overdue course correction. He breaks down the new LDL targets for your highest-risk patients, why the LDL hypothesis should be retired in favor of the LDL fact, why lipoprotein(a) screening finally belongs in every patient's workup, what a coronary calcium score over 300 really means for how aggressively you treat, and how to talk to statin-skeptical patients without losing their trust. Listen now at KevinMD.com/cholesterol. VISIT SPONSOR → https://kevinmd.com/cholesterol Partner with me on the KevinMD platform. With over three million monthly readers and half a million social media followers, I give you direct access to the doctors and patients who matter most. Whether you need a sponsored article, email campaign, video interview, or a spot right here on the podcast, I offer the trusted space your brand deserves to be heard. Let's work together to tell your story. PARTNER WITH KEVINMD → https://kevinmd.com/influencer SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended