The Podcast by KevinMD

A cardiologist who helped set national cholesterol and weight targets for 40 years now says those numbers can mislead. Richard M. Fleming, a physician specializing in cardiovascular and inflammatory disease, argues that weight loss on a GLP-1 does not automatically mean a patient is getting healthier, and that some patients who never lose a pound are already metabolically well. This episode is based on his article "GLP-1 agonists and weight loss: Treating the disease, not the number," published on KevinMD. You will hear why body mass index was never built to diagnose individuals, why inflammatory and thrombotic markers track disease more honestly than the scale, and how clinical trials from CAST to ACCORD have shown what happens when medicine treats the surrogate instead of the patient. He walks through which inflammation tests a primary care physician can run before, during, and after GLP-1 therapy, including high-sensitivity CRP, homocysteine, and fibrinogen. Hear why a 40-year insider says precision medicine requires precision measurement, not precision weighing.

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

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