If it’s time to establish your first practice or change to a new one, don’t make the mistake of thinking it’s no big deal where you go. The decision you’re about to make will positively or negatively impact the rest of your life. If you don’t choose right, the correction can be very expensive and take a high emotional toll. The cost attributed to one of my friend’s moves to …
When looking for a new physician job, location matters most
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
“I said, ‘Somebody should do something about that.’ Then I realized I am somebody.”
– Lily Tomlin
Each day, family, work and extracurricular activities all compete for our attention. They are positive aspects of our lives but can be overwhelming at times. When legislative or regulatory …
Become somebody: The importance of physician advocacy
A response to “You signed up to be a doctor, not a martyr.”
Dear next patient,
I appreciate your letter and your advice. I would sincerely like to follow all your advice concerning exercise, eating right, and spending more time with family. I try to make every effort to do so. Unfortunately, I am in the middle of transitioning for the third time to a new EMR system and managing …
Dear patient: I need your help to change the health care system
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I’m a physician, part of the enormous all-consuming machine called modern health care. This machine is driven by value-based best practice and end results. Literal life and death decisions are required daily, so naturally I become impatient when my son can’t decide between chocolate and vanilla or which movie to watch.
My cultivated Achilles’ heel of impatience has a tendency to interfere with daily interactions or decisions because of the dreaded …
The momentous power of sincerity and good communication
If the act of organ donation is among humanity’s greatest gifts, what can be said of living donors who undergo surgery to extend and improve the life of another? It’s truly a courageous and inspiring sacrifice.
I was honored recently to be able to perform my first living-donor liver transplant. Jason Clark, 28, donated about 60 percent of his liver to his father, Lynn, 57, who had been sick for many …
Why I’m doing one of the riskiest surgeries in medicine
Two weeks before my oldest cousin’s twenty-third birthday, he shot and killed himself. It scarred our family. The kind of jagged, gnarled scar, like a poorly-filled pothole, that — even though it’s been nearly twenty years — you still run your fingers across from time to time and feel the sting of a fresh wound.
We weren’t all that close, but as a 14 year old, sorting through my own perceptions …
Our country should keep talking about guns
I’ve held many hands, been generous with my hugs, and tried to treat every patient as though they were my mother. I lost my mother to leukemia almost one decade ago. I know what it’s like to feel defeated by the health care system, by health care providers, by medications, and by the human body’s response to all of the above.
A patient will never forget a health care provider that …
Make a patient’s journey easier with a simple act of kindness
Talking to health care professionals about the importance of loving your patients and colleagues — as I often do — might raise eyebrows.
How can we be expected to love our patients during a 15-minute clinic visit? How can love form among hospital teams coming together for a surgical procedure but then moving on to other work? Perhaps most importantly, how will this love make any difference in our patients’ lives …
Maybe the key to patient care is a little love
I recently had an enormous kidney stone. Well OK, it seemed enormous to me. But in terms of kidney stones, it was reasonably large; 9 mm, in fact. Large enough that I had to have lithotripsy (the use of sound waves to break up the stone) performed by my friend and most excellent urologist, Dr. Robert McAlpine in Seneca, SC.
As uncomfortable as the whole experience was (and it wasn’t my …
Don’t forget the power of over the counter remedies
Nothing brings out the mama lioness in me more than seeing one of my cubs not being treated as well as I think it should be.
Recently I had the unusual experience of accompanying my oldest daughter into an unfamiliar hospital for a minor surgical procedure. Now, this daughter isn’t exactly a cub; she’s a full-fledged adult, with a master’s degree in health care administration, a husband, and two small boys of …
The family member in the corner may be paying more attention than you think
This is the first letter I’ve ever written to a political figure, and I pray that someone on your staff will bring this letter to your attention. I have been a physician for close to 30 years. I am a second-generation pediatrician struggling to keep an independent solo practice alive. Not one politician has addressed what I feel is the major threat to health care: the physician-patient relationship. Without this, …
A pediatrician writes to the politicians about the state of medicine
Just three weeks earlier, she had noticed something strange about one of her breasts. An irregular shape. Her daughter brought her to the doctor, and soon the patient, I’ll call her Amanda, was diagnosed with breast cancer, stage “to be determined.” In fact, she was now in an oncologist’s office, learning what tests she would receive to determine the extent of her tumor. And sitting between her and the …
When patients cry, please don’t do this
Ran into a radiology colleague today. He will retire soon, and was happy to discuss the stress on radiology. I have observed more interpretation errors (or at least I think I have) over the past five years. We now strongly stress that the learners review all films and question radiology reads.
My friend opined that volume expectations have become unsustainable. We order too many imaging studies. When you ask physicians to ramp …
Patients are suffering while physicians are suffering
Dear future self,
Remember that day on surgery you stepped into the OR for the first time? How you had no idea you were supposed to pull your own gloves for the scrub nurse from the supplies cabinet, or that you needed to stand an arm’s length away from the equipment table to avoid breaking sterility? Remember how scared you felt? How clumsy you were when you scrubbed in, in a …
Residents should pay it forward to medical students
Like an anthem, a holy grail, the word appears in every journal, every proposal, and every health strategic plan.
“Quality.”
We say, read and hear it so often we are developing quality fatigue. Like iterative hackneyed phrases such as “out-of-the-box”, “deep-dive” and perhaps even “personalized medicine,” quality has begun to feel like water torture and risks being deprived of flavor or meaning. However, do not so fooled or bludgeoned that you lose …
Quality is another word for absolute control
I was talking with a few friends not long ago. Our conversation somehow got to the issue of authority, and what exactly respect for authority looks like. One of them, trying to make a point, turned to me and asked: “So you surely deal with people who don’t listen to what you have to say. What do you do when your patients don’t take the medications you prescribe?”
I think he …
Why we should welcome questions from our patients
My longtime patient Brenda let the top of her exam gown drop to her waist, stepped down off the exam table and turned to look at herself in the mirror. As I watched, she cupped her seventy-eight-year-old breasts in her palms and unceremoniously hoisted them up to where they’d probably resided when she was in her twenties.
“I’m thinking about having my boobs done,” she said. “My girlfriend had hers done, …
A geriatric patient with questions her doctor never heard before
When he turned 45, Mitch Alsup bought a red Corvette.
Mitch is a quick-talking guy with dirty blonde hair and a short, trim physique. He has a ready smile and is willing to share his story.
“As a kid, I use to go down to the Chevrolet dealership and sit in a Corvette,” he recalls. “I wanted one when I turned 18, but I came from a poor family. I had to …
Midlife crisis may be a myth, but midlife purpose is real
Guilt was not a huge part of my vocabulary until I became a mom. I never felt much guilt about how I spent my time. Didn’t feel guilty about sleeping in, or working out, or having a girls’ night out. And so on and so forth.
And then I became a mom. You know, that moment when you get shoved into the most beautiful world; a place more beautiful than you could …
Conquering guilt as a trauma surgeon mother
In a recent post, I wrote about the iCOMPARE research study that is comparing the effects of increasing medical residents’ consecutive duty hours with observing the currently prescribed limits on their shifts. According to the study protocol, the primary hypothesis of the research addresses the safety of patients: that mortality under the increased residents’ duty hours will not significantly exceed patient mortality under the current mandated standard for medical residents on …
Why a study of medical resident hours was unethical
