You start off your morning by receiving the patient handoff, then you “pre-round” on the EHR (furiously scribbling down information), then you physically pre-round on patients (or at least the “sick” ones), then you move onto some form of “proper” rounds that are generally attending specific (walk rounds, sit-down rounds, family-centered rounds, etc.), with the aid of the EHR or flying by the seat of your pants (a.k.a. depending on …
The merry-go-round of rounding
An excerpt from Influenced: The Impact of Social Media on Our Perception.
During the COVID shutdowns, my medical practice—like that of most doctors—dramatically slowed down, giving me a lot of unaccustomed downtime. One day, my twin daughters approached me and urged, “Dad, there are some really good doctors on TikTok. You …
Being an influencer has the potential to be destructive: a physician’s cautionary story
The field of pediatrics has always been known for advocating and caring for the most forgotten and disadvantaged in our communities. The American Academy of Pediatrics was founded at a time when children were seen as lesser members of society.
Through the efforts of this organization and tens of thousands of dedicated pediatricians, we have changed the narrative. Several examples include:
1. Care of abused and neglected children. One of the first …
It is time for non-confrontational discussions of the unborn child’s humanity
The recent case of a fourteen-year-old girl being denied her medications for arthritis highlights that the Roe v. Wade decision has far-reaching consequences for women and girls. Disturbingly, the Supreme Court’s decision allowing for abortion bans also contains several factual errors. As a doctor, I think it is important that we understand the facts about abortion. I want to share the top 10 misconceptions about pregnancy termination that I have …
A doctor explains 10 misconceptions about abortion
Health care has changed dramatically in the last decades, from the introduction of electronic medical records to the COVID-19 pandemic serving as a catalyst for telehealth and virtual care options to the increased familiarity with digital therapeutics, etc. Just as the industry has transformed over time, the physician’s role has similarly evolved.
Traditionally, those of us who attended medical school have had just a handful of career options to choose from …
The evolving role of physicians in health care
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
A nurse is assisting the attending physician in placing a central line in the intensive care unit.
It’s 3 a.m., and the attending is clearly tired, having admitted eight patients so far on her shift. The nurse notices the physician pushing her eyeglasses up her nose – after …
Speak up for safety in health care
After a couple of hours of back and forth, I can finally complete an oxygen assessment on a patient ready to be discharged home. The conversation had concluded on a somewhat sarcastic note. I was left feeling guilty of having almost coerced someone to stay beyond their designated duty hours to attain a desirable outcome for a patient. While this was not entirely true, the encounter had brought forth a …
A hospitalist’s struggle to find teamwork in academic medicine
I am not your provider.
There are days I loudly scream silently within the profundity of my soul, “Lord, please do not let them call me ‘provider’ one more time.”
I do not merely present to you to give you something you can use for your own personal subsistence.
Provider comes from the Latin verb “providere,” which means “to foresee.” Our beloved and storied profession’s effective and evidence-based practice does not merely imply …
If you are considering accepting an academic appointment, you need to be cognizant of the special issues involved in contracts in academia. You must know these things before signing an academic physician employment agreement.
An academic physician employment agreement is usually light on provisions.
Unlike most hospital physician employment agreements, an academic physician employment agreement tends to be very sparse on contractual provisions. Typically an academic physician employment agreement will just be …
Things to know before signing an academic physician employment agreement
Getting into medical school is only the first step of an intense journey. Undergoing the admission process and being accepted into medical school can be an exceptional challenge, especially as a student of color, but it isn’t the only hurdle. In a previous article, I outlined the medical school admission process, its reliance on MCAT scores, and key experiences, which are highly influenced by unequally distributed opportunities. I also shared …
Who gets to graduate from medical school?
Medical students are an odd bunch. At least in my day. Warning: The following may seem a little distasteful, violating the doctrine of proper decorum expected of medical professionals. I feel your anguish for those bent to the more sensitive side, but to sugar-coat a narrative only robs it of its essence.
I attended the Medical College of Wisconsin in the late 1980s, so what follows may not represent medical training. …
An excerpt from Saving Grace: What Patients Teach Their Doctors about Life, Death, and the Balance in Between.
In my third year at LSU Medical School, we dove headfirst into full-time patient care, taking required nine-week rotations on internal medicine, pediatrics, obstetrics and gynecology, and general surgery. In the fourth year …
Falling in love with the heart
Imagine delivering testimony to practicing emergency medicine for 30 years on the TEDx stage and my “Real Serious Illness Conversations with Parents” being condemned with this NOTE FROM TED: Please do not look to this talk as a substitute for health advice. This talk only reflects the speaker’s personal views and beliefs. It’s as if to say, “Beware of the doc”… who lets individuals decide how they’ll die …
Giving medical advice with moral values is deeply personal and takes courage
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For the first time since graduation from medical school, stirred by the courage of my colleagues in the ICUs and emergency rooms during the COVID pandemic, I looked back at the Hippocratic oath to reassess its charge to physicians. My wife and I, both doctors, studied and trained for a long time, and we considered the years spent and the effort put forth to be a calculated sacrifice. But amidst …
Coronavirus and the duty to treat
An excerpt from Absent-Father Syndrome: Overcoming the Trauma of a Fatherless Childhood.
“I’ve sat face to face in front of many adults who were crying their eyes out,” says Rachel Norman, founder of A Mother Far from Home. “They needed healing tools and positive coping mechanisms. They had low self-worth, nonexistent …
Overcoming the trauma of a fatherless childhood
I was standing outside the patient room, feeling slightly restless that day. A few days ago, I had just received some news from my doctor that I was not expecting. My mind sifted through the various possibilities and directions this could take me. When will I get to see my doctor to discuss this? What does this mean? As my brain was walking through the various unknowns, my physical body …
On my hard days, my patients are my heroes
I was sitting in front of a panel of six people for my psychiatry training interview in Wellington, New Zealand. Two community members, two psychiatry consultants, and a senior psychiatry registrar, all of which were of Caucasian ethnicity.
I can recall talking about cultural differences in my upbringing and how that has helped me to connect to some of the most vulnerable people in our community. Samoan culture is adherently based …
Institutionalized racism in psychiatry: a doctor’s experience
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
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