How sad when a PCP calls, saying, “My chief warned me that if I don’t dramatically improve my productivity, I’m going to be terminated.” Such doctors are often patient-centered listeners who cannot bear to shift from healer mode to assembly line mode.
Some of these docs learn how to better balance healing with task completion; others make a beeline for concierge or direct primary care practices; still others …
The joylessness of harried medical leaders
The current era of health care delivery has been aptly compared with going to war against an invisible enemy that can attack anywhere, at any time and with novel means.
This invisible enemy was attacking the civilians as well as the “front line” with vigor.
We have attempted to learn on the fly and use our intelligence to develop a defensive strategy against the enemy’s ever-changing tactics and learn from prior battlefronts.
This …
You need a break from the front lines of health care
“No offense to you, Doc, but I hate coming to the doctor.”
I hear these words at least once a week when I walk into a patient’s room.
In 15 years of practice, that means about a thousand times.
And that does not include my training years.
There will be variations of the theme, of course:
“I really don’t like coming to the doctor.”
I get anxious in the doctor’s office. That is why my blood …
Why do patients hate going to the doctor?
This is not a story about the before. It is about the after.
When I blew the whistle on the gender harassment I experienced and witnessed within my workplace, I naively thought doing so would help. I thought opportunities and experiences for women would get better. I thought it would be worth the risk.
And yet, two years into the after, I am still struggling. My experience taught me that I am …
Questions of a canceled whistle-blower
The landscape of medical practice has changed dramatically over the many decades I have been in practice. Most of these changes are intensely discouraging and depressing and are negatively affecting the physicians of today. The government, hospitals, networks, even our own professional organizations are working to establish and enforce new regulations — new hoops for doctors to jump through, mainly in the furtherance of their profit and their power over …
Why I became a doctor: reflections on a calling
My friend (I’ll call him Dr. Mensch) reached out to me because he fears that a gender war is unfolding in his division. He is worried that current cultural concerns about gender equity are degrading the previously harmonious relations between male and female professionals on his team and that the mounting tension could have a negative impact on patient care.
Mensch told me that several female physicians, including residents and fellows, …
Mansplaining in medicine and how to solve it
How is your ego serving you?
Medicine is a hierarchical entity. More so in surgery.
There is a linear line of command from the chief to the junior to the intern to the med student to the aspiring med student.
“Shit rolls downhill,” we said as interns while we powered through the 29th-hour on-call or the seven pending discharge summaries we had to finish, while a nurse was yelling or paging us 12 …
It sounds like a long time, but it really wasn’t. It was actually a very short period of time. My perspective of time changed with this number. I was close to my 9th birthday when my dad passed. He was only 48, and he had been diagnosed with lymphoma only a few years earlier. He passed after losing his battle to cancer. I remember saying my goodbyes in the hospital …
When Elvis Presley rolled up his sleeve and received the polio vaccine backstage at The Ed Sullivan Show in 1956, most Americans knew about it. At the time, the only stars hotter than rock ‘n’ roll itself were Presley, the genre’s de facto king, and Sullivan, the host who brought its biggest headliners to the American people.
By 1957, polio incidence dropped by 85 to 90 percent because …
Our niche world demands a new approach to health
High pitched alarms, low pitched beeps, the rhythmic inhale and exhale of the ventilator – those were the sounds in my emergency department one year ago. There were no kids running down the hall, no friends making light of their 50-something-year-old friend whose LeBron James delusions resulted in an ER visit and sutures, and no, not even worried family members.
Texas, like much of the country, was headed for …
America’s path to reopening: an emergency physician’s perspective
Like most, our family decided that we had outgrown our current home a few years ago and wanted to move into a larger house that offered more square footage and land. It had been nearly twenty years since living in the house we have owned since the end of the residency, and the house-hunting effort seemed more bewildering and confusing than two decades ago. At the time, I was too …
Why physician-owned businesses need our attention and support
An excerpt from Act of Negligence. Copyright © 2021 by John Bishop. All rights reserved. Published by Mantid Press.
Beatrice Adams
Monday, May 15, 2000
“Morning, Mrs. Adams. I’m Dr. Brady.”
There was no response from the patient in Room 823 of University Hospital. She was crouched on the bed, in position to leap toward the end of the bed in the direction of …
It’s not every day the head nurse on a medical floor accompanies a physician on a consultation
In the last year, amidst COVID-19 news, animals have gained their place: cats harboring the virus, pet abandonment and, paradoxically, rising adoptions. Cats and dogs are now in the spotlight. I’m a physician, and my personal animal-related COVID-19 story changed the way I practice medicine.
During lockdown in 2020, we decided to adopt a kitten. As both animal abandonment and adoption were on the rise, we brought home a three-month-old orange …
My pet taught me how to be a better physician
With the COVID-19 pandemic inflicting havoc on everyone, there is no doubt that physicians and other health care workers are most affected. The looming fear for yourself and your family adds to the current burden of responsibilities you encounter and conquer every day.
When the pandemic started in 2020, the struggle was about finding a cure and controlling the spread of the virus. With the advent of vaccines in 2021, the …
Surviving a thousand cuts: How to address physician burnout
In the “Show-Me State” of Missouri, physicians receive their licenses from the Board of Registration for the Healing Arts. Seriously! This quaint term harkens back to a time when newly minted doctors had a relatively easy time realizing their desire to meld compassion, knowledge, and skill in order to relieve human suffering.
Armed with credentials suggesting that we have the right stuff to avoid doing harm, many of us are drawn …
Toward the end of my clinical career, I didn’t feel like I had control over much at all. The patient safety issues loomed large. We used ridiculous workarounds for broken processes. The constant vigilance to provide excellent care in a suboptimal environment was exhausting. I didn’t see anything I could change. Based on my work with physicians as a coach, I think that the sense of powerlessness and being a …
The sense of powerlessness and being a cog in a wheel is now at an all-time high
Programs and applicants displayed incredible adaptations during the 2020-2021 virtual residency interview season despite the adversity they faced due to COVID-19.
Moving forward, virtual features may be integrated with traditional methods for a more equitable and favorable experience. We present here a discussion on the pros and cons of the 2020-2021 “virtual” residency interview season — and ways of hybridizing virtual and in-person practices that reimagine modern interviewing and improve applicant …
The future of residency interviews
“Something’s wrong with Eddie.”
In four words, my entire wedding day collapsed around me. I’d just arrived at a beautiful Gothic chapel in a rented 1950 Rolls Royce, mom and dad on either side of me, prepared for a picture-perfect first look with my groom. As his mother’s words echoed in my ear, I immediately thought of all the scenarios that could be easily remedied so we could move forward with …
How a doctor fell in love with a drug addict
In my first year as an attending hospitalist, I personally discovered what Hippocrates realized millennia before, “Life is short and the art long.” Clinical reasoning is an intellectual labyrinth that can only be mastered with deliberate practice, introspection, and perseverance.
However, I soon found that spending hours poring through manuscripts and cases was not only cumbersome, but often counterproductive. It dawned on me then that athletes faced a similar predicament, one …
How photography made me a better doctor
Most of us have heard the phrase “success is about who you know,” and that couldn’t be more true. The people we surround ourselves with are a direct reflection of our life and success. One thing that affects this is emotional intelligence, or EQ for short. It’s not just about how smart you are; it also has to do with your ability to understand and manage your own emotions and …
Why physicians should care about emotional intelligence
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