Otolaryngologist Brian F. Worden discusses his article, "The surprising link between migraine and tinnitus [https://kevinmd.com/2025/10/the-surprising-link-between-migraine-and-tinnitus.html]." He reveals that for the 26-47 percent of tinnitus patients who also report migraines, the tinnitus may actually be an atypical migraine symptom, even without a headache. Brian explains how migraine, a complex neurological disorder, activates the trigeminal nerve, which can affect the inner ear and amplify sensory hypersensitivity, putting existing auditory hyperactivity into "overdrive." He outlines how to identify fluctuating, migraine-related tinnitus (which worsens with stress or sleep disruption) versus constant tinnitus. The discussion covers practical migraine-specific therapies that can reduce tinnitus severity, including trigger avoidance, nutritional supplements, and medications. Learn how treating the underlying neurological disorder, not just the ear, may be the key to managing tinnitus.

Our presenting sponsor is Microsoft Dragon Copilot [https://aka.ms/kevinmd].

Microsoft Dragon Copilot [https://aka.ms/kevinmd], your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click.

Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise, and it's built on a foundation of trust.

It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Why your migraine might be causing your tinnitus

Urologist William Lynes discusses his article, "Teaching medical students what it is really like to be a physician [https://kevinmd.com/2025/10/teaching-medical-students-what-it-is-really-like-to-be-a-physician.html]." He confronts the tragic reality of physician burnout and suicide, arguing the culture of overwork is bred into medical training from day one. William proposes a critical shift in medical education: a continuous course led by practicing physicians to teach students that maintaining their own mental health is essential to providing excellent clinical care. He shares his powerful personal story of learning this lesson "too late," urging for systemic change to address physician mental health before it becomes a crisis. Learn why prioritizing clinician well-being is the most important lesson medical schools are failing to teach.

Our presenting sponsor is Microsoft Dragon Copilot [https://aka.ms/kevinmd].

Microsoft Dragon Copilot [https://aka.ms/kevinmd], your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click.

Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise, and it's built on a foundation of trust.

It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Preventing physician burnout before it begins in med school

Medical student Chuka Onuh and orthopedic surgery resident Ogechukwu Onuh discuss their article, "A sibling's guide to surviving medical school [https://kevinmd.com/2025/10/a-siblings-guide-to-surviving-medical-school.html]." They share lessons learned as siblings navigating medical training, focusing on the critical need to be intentional with time and avoid the "illusion of productivity." Chuka and Ogechukwu emphasize that study habits must be adaptable (like switching from Anki to practice questions for USMLE exams) and that students must learn to advocate for themselves. The conversation also explores the biggest challenge of the medical school journey: protecting your identity outside the white coat, prioritizing relationships, and building resilience to avoid burnout. Learn the habits and mindset shifts necessary to survive medical school with your sense of self intact.

Our presenting sponsor is Microsoft Dragon Copilot [https://aka.ms/kevinmd].

Microsoft Dragon Copilot [https://aka.ms/kevinmd], your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click.

Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise, and it's built on a foundation of trust.

It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Sibling advice for surviving the medical school marathon

Retired nurse practitioner Heidi Sykora discusses her article, "The case for regulating, not banning, kratom [https://kevinmd.com/2025/10/the-case-for-regulating-not-banning-kratom.html]." She provides an evidence-based perspective on why kratom (Mitragyna speciosa) should not be treated as a dangerous opioid, clarifying the significant pharmacological difference between the natural kratom leaf and the potent, synthesized 7-OH. Heidi explains that while kratom dependence is possible, its addiction and withdrawal profile is much milder than classical opioids, and that severe psychiatric risks are rare and often linked to adulterated products. This discussion centers on the failure of prohibition and advocates for sensible regulation, like the Kratom Consumer Protection Act (KCPA), to ensure consumer safety, product purity, and accurate labeling. Learn the science-based facts about kratom regulation and why banning it might increase public health dangers.

Our presenting sponsor is Microsoft Dragon Copilot [https://aka.ms/kevinmd].

Microsoft Dragon Copilot [https://aka.ms/kevinmd], your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click.

Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise, and it's built on a foundation of trust.

It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

How should kratom be regulated?

Family physician Rebecca Thompson discusses her article, "The weight of genetic testing in a family [https://kevinmd.com/2025/10/the-weight-of-genetic-testing-in-a-family.html]," an excerpt from her book. She shares a profoundly personal story from the memoir about a woman who is a carrier of the Huntington's disease mutation and an expectant mother facing the agonizing wait for her baby's genetic test results. Rebecca explores this powerful narrative, the emotional detachment used as a shield during the pregnancy, and the devastating impact of Huntington's disease on the family described, particularly the grandmother. The discussion explores the complex, personal ethics of genetic testing, the burden of knowledge, and the stark memory of a young boy in a neurology clinic that shaped the protagonist's views on motherhood and this incurable disease. Learn about the impossible choices and emotional weight carried by families facing a devastating genetic mutation.

Our presenting sponsor is Microsoft Dragon Copilot [https://aka.ms/kevinmd].

Microsoft Dragon Copilot [https://aka.ms/kevinmd], your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click.

Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise, and it's built on a foundation of trust.

It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

How genetic testing redefines motherhood

Emergency physician Resa E. Lewiss and health care executive Jake Horowitz discuss their article, "Why women ER doctors earn $21,000 less than men [https://kevinmd.com/2025/10/why-women-er-doctors-earn-21000-less-than-men.html]." They reveal staggering new data that shatters the myth that the gender pay gap does not exist in emergency medicine, showing how it persists even after controlling for hours, experience, and patient volume. Resa and Jake explore the hard numbers: women ER physicians earn $21,000 less annually, a salary disparity that widens to over $40,000 late in their careers. This is not about output, it is about systemic inequity in the health care system that contributes directly to physician burnout and attrition among women physicians. The discussion moves beyond the problem to focus on solutions, highlighting the critical need for pay transparency, hospital audits, and collective action to demand pay equity. Learn how data can expose the truth and finally help fix the systemic issues robbing women doctors of millions in career earnings.

Our presenting sponsor is Microsoft Dragon Copilot [https://aka.ms/kevinmd].

Microsoft Dragon Copilot [https://aka.ms/kevinmd], your AI assistant for clinical workflow, is transforming how clinicians work. Now you can streamline and customize documentation, surface information right at the point of care, and automate tasks with just a click.

Part of Microsoft Cloud for Healthcare, Dragon Copilot offers an extensible AI workspace and a single, integrated platform to help unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise, and it's built on a foundation of trust.

It's time to ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

New data reveals the massive pay gap for women ER doctors

Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article, "How insulin resistance may cause Alzheimer's disease [https://kevinmd.com/2025/08/how-insulin-resistance-may-cause-alzheimers-disease.html]." Muhamad introduces the paradigm-shifting concept of Alzheimer's as "Type 3 diabetes," arguing that insulin resistance in the brain is the root cause. He explains how this metabolic dysfunction starves neurons (especially in the memory-critical hippocampus), leading to the toxic beta-amyloid plaques and tau tangles associated with cognitive decline. Muhamad highlights the crucial link between diabetes and Alzheimer's risk and discusses breakthrough diagnostic tools (like new blood tests) that can identify the disease before memory loss begins. Discover the practical lifestyle and medical interventions (from diet to new diabetes medications) that may prevent, manage, or even reverse cognitive decline by treating its metabolic underpinnings.

Our presenting sponsor is Microsoft Dragon Copilot [https://aka.ms/kevinmd].

Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can.

Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise, and it's part of Microsoft Cloud for Healthcare, built on a foundation of trust.

Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Alzheimer's link with insulin resistance

Health care executive Ronke Lawal discusses her article, "Digital mental health's $20 billion blind spot [https://kevinmd.com/2025/09/digital-mental-healths-20-billion-blind-spot.html]." Ronke explains how the booming digital mental health industry is systematically failing 40 percent of the U.S. population (racial and ethnic minorities), ignoring a $20 billion market opportunity. She argues that the "one-size-fits-all" model, based on Western-centric care, is a product failure that leads to algorithmic bias, misdiagnosis in diverse patients, and culturally incompetent artificial intelligence (AI) chatbots. This failure in digital mental health doesn't just alienate users; it creates real financial consequences for health systems, including higher emergency department use and readmission rates. Ronke makes the ironclad business case for embedding "cultural intelligence" into technology, arguing it's the only way to fix systemic bias and build effective digital mental health tools.

Our presenting sponsor is Microsoft Dragon Copilot [https://aka.ms/kevinmd].

Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can.

Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise, and it's part of Microsoft Cloud for Healthcare, built on a foundation of trust.

Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

How algorithmic bias created a mental health crisis

Fertility specialist Oluyemisi (Yemi) Famuyiwa discusses her article, "How timing affects chemical exposure risks [https://kevinmd.com/2025/10/how-timing-affects-chemical-exposure-risks.html]." Yemi introduces her fascinating concept of "chrono-exposomics," explaining how the time of day you are exposed to environmental chemicals may be as important as the dose. She reveals how our body's circadian rhythms (like liver detoxification and skin permeability) change over 24 hours, meaning the same exposure at 8 p.m. is not the same as at 8 a.m. Using the example of a manicure, Yemi explores how endocrine-disrupting chemicals (like phthalates and TPO) in nail products might be absorbed more heavily in the evening, posing a unique risk to fertility and hormonal health. Learn the practical, evidence-informed adjustments you can make to align your self-care routines with your body's natural schedule.

Our presenting sponsor is Microsoft Dragon Copilot [https://aka.ms/kevinmd].

Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can.

Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise, and it's part of Microsoft Cloud for Healthcare, built on a foundation of trust.

Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Daily chemical exposure timing and your fertility

Psychiatrist and author Arthur Lazarus discusses his article, "Finding integrity at the end of a career [https://kevinmd.com/2025/09/finding-integrity-at-the-end-of-a-career.html]." Arthur shares the poignant narrative of Dr. Raul Morales, a community internist facing retirement with a deep sense of despair, questioning if his forty-year medical career truly mattered. Through the powerful fable of the "cracked pot," Arthur explores how a physician's perceived failures, regrets, and "leaks" are often the unrecognized source of their greatest impact and legacy. This episode reframes the concept of professional integrity: moving it away from perfection and toward the simple, profound act of presence. Learn how to find meaning in a long medical career and see the flowers that grew from your own "cracked pot."

Our presenting sponsor is Microsoft Dragon Copilot [https://aka.ms/kevinmd].

Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can.

Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise, and it's part of Microsoft Cloud for Healthcare, built on a foundation of trust.

Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Understanding the cracked pot theory of a medical legacy

Social media's leading physician voice, Kevin Pho, MD, shares the stories of the
many who intersect with our health care system but are rarely heard from. 15
minutes a day. 7 days a week. Welcome to The Podcast by KevinMD.

Kevin Pho

Shows