Doctors with mental illness don’t need more suicide awareness — we’re aware. And we don’t need confidential treatment opportunities. What we need is assurance from all invested parties — our employers, credentialing bodies, and licensing officials — that it will be OK if we need help, we can get what we need, and that everything for the job can be sorted out once we’re well. Because it turns out, in …
Physicians with mental illness shouldn’t hide
I applaud the efforts of several states that have enacted legislation to make it easier for physicians to get mental health treatment without incurring the wrath of physician health programs (PHPs). PHPs, while well-intended, are notoriously disruptive to the lives and careers of physicians struggling with depression, substance use disorders, and other mental health conditions. PHPs have a reputation for implementing unreasonable requirements and being coercive, sometimes worsening …
Mental health is a slippery slope when it comes to physicians’ well-being
Talk to physicians in private medical practice today, and you will discover that they will affirm that their medical practice is financially satisfactory, stable, and doing well financially.
Private practicing physicians know that they have no measurable standard to use to verify what they just told you except for their profit and loss statements from their CPA. And even if they believed they could be in a much better position financially, …
Why physicians never reach their career potentials
I just got this email from a physician: “Hi, Pamela. I wonder if I could curb you on seeking mental health services as a physician. I am not suicidal or impaired but considering a consultation with a psychiatrist for medication. Any chance you would be able to chat with me for a short bit to discuss tips for seeking consultation while avoiding stigma and labeling?”
Sadly, most medical professionals fear seeking …
13 tips for depressed doctors who need confidential mental health care
There is something to the movie The Secret Life of Walter Mitty that I just love. Every time I hear the music, I feel the sky of possibility opening as a melancholy feeling simultaneously hits. And today, while finishing my ACLS recertification, I realized another reason why: Walter Mitty finally starts designing his way forward. And you can too.
While sitting in between cases, one of my partners asked me why …
How prototyping your life can save medicine
As a pediatrician, you’d think that I’d be a pro at celebrating growth. After all, I celebrate the growth of children in the office as they meet their developmental milestones and grow physically. I celebrate their academic and social growth.
What I hadn’t celebrated: my own growth. I thought for years that I was beyond that. Even my own professional growth had become tedious: Check the boxes on CME …
A physician celebrates her growth
As we continue our third year of the pandemic, there have been reports of hostile treatment directed at public health officials and medical personnel. This is escalating a crisis of burnout among health professionals, but there is an insidious, chronic hostility that lurks within hospitals between those who are supposed to be on the same team.
Bullying within health care has been a longstanding challenge. It is pervasive enough that the …
We need to talk about the bullying in health care
I had a fairytale courtship, engagement, and wedding to my Prince Charming. We came home, starry-eyed, ready to start our forever together. Within weeks, I began to struggle. Always an extrovert, suddenly going to my family medicine rotation took extraordinary effort. I began to worry about my every word and action. Some days, I said nothing — unsure whether I could form a coherent sentence. I decided to take time …
How major depression strengthened my practice and my faith in God
You recently told me that I have the physician’s group’s highest patient satisfaction scores. This doesn’t surprise me. I know what makes me great: I take time. I let patients tell their stories. I listen, educate and collaborate. When I don’t know something, I find the answer. I am the poster woman for “AIDET.”
Recognizing that time is finite, I strive for efficiency. I delegate. I refer. I use order sets. …
26 hours in a day: the impossible math and timing of providing quality care
Between producers and consumers, you’ll find a cadre of professionals who broker deals, facilitate transactions, and move goods and services along.
They’re called “middlemen,” and they thrive in virtually every industry — from real estate and retail to finance and travel services. If not for middlemen, houses and blouses wouldn’t sell. Banks and online booking sites wouldn’t exist. Middlemen are the reason a tomato grown in South America makes it aboard …
The middleman mentality is killing American medicine
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
The health care landscape has never been more complex. A deadly and enduring pandemic; health care delivery challenges that leave some communities at higher risk for adverse outcomes; an opioid crisis that takes nearly 200 American lives per day; and an ever-evolving regulatory …
The perioperative surgical home: a model to tackle today’s pressing health care issues
When I quit my clinic job after four waves of the COVID-19 pandemic as an intensivist, I decided not to work in direct patient care for a while. I expected harsh criticism from my colleagues. Surprisingly, that never happened. The feedback was unexpected, at least for me. Most of my colleagues admired my decision. They called me brave for taking the leap, and many admitted thinking about the same for …
Physician burnout: a lack of resilience or a lack of control?
An excerpt from Fifty Years a Doctor: The Journey of Sickness and Health, Four Plagues and the Pandemic.
It took me years to fully realize what a unique residency program I had enjoyed in my one-year general surgical training in Honolulu.
Early in this residency, we had state-mandated education in leprosy. All …
Singing doctors in the operating room
The COVID-19 pandemic ushered in many insidious handmaidens among its foul equipage. From Zoom meetings and school closures to masks and lockdowns, our world was torn asunder and, eventually, rendered anew into a place where almost everything has been changed, by large degrees and small, perceptibly and imperceptibly. It will come as no surprise that medicine is foremost among the more obviously perceptible areas of life that have been irrevocably …
I’m a pediatrician and have been practicing for 29 years. I currently own a solo practice.
Here is a story I wrote years after a patient encounter during my residency in 1993. I didn’t know it at the time, but it was an experience that would shape my career in general pediatrics.
Marcus is the worst case of child abuse I’ve seen to date. He’s two years old. His mom’s boyfriend dips …
A story that changed this pediatrician forever
Why should you be more productive? Because time is money? Not only that. I prefer time is family or time is go-home-sooner.
Being more productive in medicine isn’t working more hours or faster; it means working better.
Take breaks. Doctors rarely take breaks during their workday. Yet most employees do take two 15 minutes breaks each day. Do you feel like 15 minutes is too long? Take at least five minutes per …
Tips to be a more productive, less stressed physician
Whenever asked, I hesitate to tell people what I do because when a young man says: “I’m a gynecologist,” he never seems to be taken quite so seriously. “No, really, I am” – “Oh.” Instead, I opt for the more charming “I deliver babies” line. Works every time.
And why is that? What about birth and babies triggers a sense of astonishment in people? Whatever it is, it seems to magically …
Four years ago, as chairman of the hospital ethics committee, I was asked to convene an emergency meeting brought by a distraught family as medical decisions had to be made for their ill loved one. The hospital, HMO lawyers, the family, three adult children, and their mother were at the meeting.
The father had arrived at the hospital unconscious and was admitted to the intensive care unit, where medical care was …
Next of kin in the medical decision making process
My relationship with my cultural identity has always been a complicated one. As many children of immigrants can relate, I often felt disconnected from my parents’ country of origin in an attempt to assimilate to American life.
I was born in Manhattan, New York, and have always defined myself as a New Yorker first and an Iranian-American second. From a young age, I have watched from the periphery as Iran has …
My motherland is burning, but patient care can’t wait
Current medical education promotes and encourages the textbook approach to learning, while interactive patient-centered learning rarely happens. Although rote learning plays a critical role in medical education, applying what is learned deepens the understanding and application of rote-learned materials. Undergraduate students can learn with supervision from instructors and patients, so they are prepared to practice medicine with excellence.
These trainees are learning the latest available techniques but lack the experiential wisdom …
For a better practitioner and better outcomes, we need to start teaching this
Get free updates delivered free to your inbox.
