The Podcast by KevinMD

Social media says to spike your fiber intake as fast as you can. That is where the bloating starts. Lisa Talamini is a registered dietitian nutritionist and senior vice president of clinical solutions at Wondr Health. This episode is based on her article "How to eat more fiber without the bloating," published on KevinMD. You will hear why fibermaxxing with pills, powders, and fortified bars tends to bring gas, bloating, and sometimes diarrhea while delivering few of the nutrients whole food carries. Lisa explains fiberlayering instead, adding one small whole food at a time to meals you already eat, and why water decides whether the fiber you add helps or hurts. You will also hear the roughly 25 grams a day she works from, why the Mediterranean pattern is layering in practice, and how to raise the subject in the few minutes a primary care visit leaves for nutrition. She closes on the red flags to watch for in the next fiber video, and the case for the middle ground over the maximum.

This episode is brought to you by ModMed.
Welcome to your new AI-Powered Practice from ModMed. We're transforming specialty care by embedding AI Assistants across your entire workflow. Our all-in-one platform of EHR, patient engagement, practice management, and RCM helps reduce repetitive work while keeping you firmly in control.
Trained on de-identified data from nearly a billion patient encounters, this isn't just smarter software. It's a new way of working for specialty medicine, more efficient and more connected to the patient experience.
Start building your AI-Powered Practice at modmed.com.
VISIT SPONSOR → https://www.modmed.com/
SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

A man told his doctor he was struggling with addiction. The doctor told him this was not something he could help with. Devika Bhushan is a public health physician and a former acting surgeon general of California. This episode is based on her article "How addiction stigma in health care costs lives," co-written with medical student Taylor Moss and published on KevinMD. You will hear what happened when about 500 clinicians read the same patient described two ways, as a substance abuser in one version and as a person with a substance use disorder in the other. Devika explains why fewer than 1 in 5 people with addiction ever get appropriate treatment, why they receive 30 percent less guideline-based care for conditions like heart disease and diabetes, and why life expectancy can run up to almost 24 years shorter. You will also hear which words open doors in addiction care and which close them, plus six things patients and families can do when a clinician will not listen.

This episode is brought to you by ModMed.
Welcome to your new AI-Powered Practice from ModMed. We're transforming specialty care by embedding AI Assistants across your entire workflow. Our all-in-one platform of EHR, patient engagement, practice management, and RCM helps reduce repetitive work while keeping you firmly in control.
Trained on de-identified data from nearly a billion patient encounters, this isn't just smarter software. It's a new way of working for specialty medicine, more efficient and more connected to the patient experience.
Start building your AI-Powered Practice at modmed.com.
VISIT SPONSOR → https://www.modmed.com/
SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

In a lot of towns there is only one health insurer left, and that is starting to show up in patient care. Rita Agarwal is a pediatric anesthesiologist who started asking why colleagues in a specialty she loves are heading for the door. This episode is based on her article "Insurance consolidation is a patient safety problem," published on KevinMD. She explains why anesthesiology went from a top residency choice to the specialty with the highest intent to leave, and what happens to a team when the people in the room have never worked together. You will hear how a single-payer market leaves a hospital with no room to negotiate, why federal Medicaid cuts hit rural and pediatric hospitals hardest, and what it looks like when patients drive hours for care that used to be down the road. She is candid that most physicians, including her, sat out this fight for years. Press play to hear why she thinks this is unsustainable, and what she is asking physicians to do about it.

This episode is brought to you by ModMed.
Welcome to your new AI-Powered Practice from ModMed. We're transforming specialty care by embedding AI Assistants across your entire workflow. Our all-in-one platform of EHR, patient engagement, practice management, and RCM helps reduce repetitive work while keeping you firmly in control.
Trained on de-identified data from nearly a billion patient encounters, this isn't just smarter software. It's a new way of working for specialty medicine, more efficient and more connected to the patient experience.
Start building your AI-Powered Practice at modmed.com.
VISIT SPONSOR → https://www.modmed.com/
SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

Ketamine made headlines for the wrong reasons, and people who could be helped by it are staying away. Jim Ellwood is an anesthesiologist who has given ketamine in the operating room and taken it himself for depression that nine medications failed to touch. This episode is based on his article "The truth about ketamine: an anesthesiologist explains drug safety," published on KevinMD. He explains what the research shows about how it works in the brain, and what to ask before you walk into a clinic. You will hear why he compares the panic around ketamine to what happened with propofol and fentanyl, how to find out who is actually writing the prescription at a clinic that advertises to you, and what he tells patients about how long the relief lasts and what it costs. He is candid about the stigma of a physician saying out loud that he has depression. Press play to hear a physician who has used ketamine both ways describe what a safe setting actually looks like.

This episode is brought to you by ModMed.
Welcome to your new AI-Powered Practice from ModMed. We're transforming specialty care by embedding AI Assistants across your entire workflow. Our all-in-one platform of EHR, patient engagement, practice management, and RCM helps reduce repetitive work while keeping you firmly in control.
Trained on de-identified data from nearly a billion patient encounters, this isn't just smarter software. It's a new way of working for specialty medicine, more efficient and more connected to the patient experience.
Start building your AI-Powered Practice at modmed.com.
VISIT SPONSOR → https://www.modmed.com/
SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

You can have five doctors and still have no one actually in charge of your care. That gap is where patients get lost. In this episode, retired surgeon and patient advocate Alan P. Feren walks through a common case where the surgeon, primary care, and specialists each assume someone else is directing the plan, and no one is. This episode is based on his article "Fragmented care needs clinical direction, not more data," published on KevinMD. You will hear why coordination is not the same as clinical direction, how disconnected medical records leave patients to piece their own care together, and why confusion can look like progress from the outside. He also explains where AI can genuinely help patients and where it falls short. Hear the exact questions he says every patient with multiple doctors should be asking.

This episode is brought to you by ModMed.
Welcome to your new AI-Powered Practice from ModMed. We're transforming specialty care by embedding AI Assistants across your entire workflow. Our all-in-one platform of EHR, patient engagement, practice management, and RCM helps reduce repetitive work while keeping you firmly in control.
Trained on de-identified data from nearly a billion patient encounters, this isn't just smarter software. It's a new way of working for specialty medicine, more efficient and more connected to the patient experience.
Start building your AI-Powered Practice at modmed.com.
VISIT SPONSOR → https://www.modmed.com/
SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast