Dr. Keith Roach

Dr. Keith Roach is an academic physician and syndicated health columnist whose work at USA TODAY centers on answering concrete medical questions from individual readers. He writes a long-running Q&A column, often under titles such as Dear Doctor and To Your Good Health, in which patient letters anchor discussions of both everyday complaints and complex disease. His coverage is distinguished by its clinical detail and direct recommendations grounded in evidence, instead of general wellness tips or health-policy news. Recent columns range across infectious disease, chronic illness, mental health, and aging, but each piece turns on what a specific patient should understand and discuss with their own clinician. As an associate professor of clinical medicine, he consistently filters reader questions through research findings, diagnostic reasoning, and careful weighing of risks and benefits.

Dear Doctor and To Your Good Health Q&A

Roach’s core format is the letter-and-reply column, where readers write “DEAR DR. ROACH” and describe a symptom, diagnosis, or treatment dilemma in detail.

He answers in plain language, but with the structure of a clinical consultation, defining the condition, outlining differential diagnoses, and explaining standard-of-care options. In one column he addresses rheumatoid arthritis when a patient reports years on multiple medications without adequate pain relief, describing how biologic therapies work and where they fit in treatment plans.

In another he takes up a case where doctors leave a stroke patient without treatment options, unpacking how comorbid lung cancer and stroke complexity shape what interventions are realistic. The mosquito-bite piece under the Dear Doctor banner follows the same pattern, using a common annoyance to explain immunologic sensitivity and what reactions merit medical attention.

This steady focus on individual letters, rather than institution- or system-level stories, distinguishes his coverage from a generic health beat reporter and makes the Q&A format the spine of his work.

Chronic disease, aging and quality of life

Many of Roach’s recent columns deal with chronic conditions that evolve over years, emphasizing how symptoms affect daily function as much as lab values or imaging. He writes about hypercalcemia, explaining that high blood calcium has multiple causes and can damage kidneys, heart, nerves, and muscles, then walks through how patients and clinicians should investigate the source.

In pieces on rheumatoid arthritis and degenerative knee joint disease, he covers both medication and non-surgical strategies, from biologics to physical therapy, showing how treatment choice depends on pain, mobility, and comorbidities. Aging-related concerns appear frequently, including a column on word-recall difficulty in a 70-year-old, where he distinguishes normal cognitive aging from signs that warrant further evaluation. He also writes about persistent weakness after gallbladder removal and lingering leg cramps and spasms tied to lactose intolerance, giving readers a sense of how postoperative recovery and dietary issues intersect with long-term quality of life. Across these topics, the common thread is reassurance coupled with firm guidance on when chronic symptoms are acceptable, when they signal disease progression, and when a change in therapy is needed.

Explaining tests, lab results and treatment risk

Roach devotes substantial space to demystifying numbers and technical terms that can intimidate patients, turning raw test results into actionable information. He breaks down DEXA scan Z- and T-scores, explaining how they relate to bone density, fracture risk, and decisions about starting treatment for osteoporosis or osteopenia. In a column on low ferritin and symptoms of fatigue and dizziness, he details how iron storage, total iron-binding capacity, and anemia fit together, and why even non-anemic patients can feel significantly unwell.

Other pieces tackle high blood calcium, clarifying the role of parathyroid hormone and the difference between benign and dangerous causes, and vitamin D deficiency, where he addresses how genetics, sun exposure, and supplementation interact. He similarly unpacks the rare but feared phenomenon of tumor seeding during biopsies, stressing how uncommon it is while still explaining the mechanism and the contexts in which it occurs.

On the treatment side, Roach evaluates drugs for anxiety and depression, GLP-1 agonists for obesity and possible benefit in alcohol use disorder, and hormone injections for prostate cancer, consistently outlining side effects, evidence strength, and where shared decision-making fits. This emphasis on tests and therapies gives his columns a diagnostic and pharmacologic depth unusual in general health reporting.

Evidence over anecdotes and new interventions

Roach’s columns repeatedly return to the theme that scientific evidence, not testimonials, should drive care decisions.

In a piece explicitly titled “Testimonials are not how science advances,” he contrasts personal success stories with clinical trial data, warning readers against overvaluing individual experiences when weighing treatments. His work on the new mRNA flu vaccine discusses who should and should not rush to receive it, framing the issue in terms of trial results, risk profiles, and existing vaccine options rather than novelty alone. Coverage of prion disease, sometimes called “mad cow disease,” uses a tragic case to explain pathophysiology and the limits of current treatments without suggesting that rare conditions should reshape routine practice.

Infectious disease topics such as cytomegalovirus reinfection and allergic reactions, including heightened sensitivity to mosquito bites, are addressed with similar restraint, acknowledging uncertainty while staying grounded in known immunology. Across these columns, Roach’s distinguishing habit is to meet reader concern head-on but pull the conversation back to established data, clinical guidelines, and the incremental nature of medical progress.