Physicians writing on KevinMD about the life of the profession: the work itself, the exhaustion, what women physicians are paid and asked to carry, the losses the profession has been slow to name, and who decides how physicians work. Five maintained records draw on this archive: Physician burnout: what physicians say, in their own words, Primary care: what physicians say, in their own words, Women in medicine: what women physicians say, in their own words,, Physician suicide: what physicians say, in their own words, and Physicians and administrators: what physicians say about who runs medicine, in their own words.
Remember in Jurassic Park when Ian Malcolm describes Chaos Theory to Ellie Satler, watching a drop of water roll down her hand? It might roll to one side or the other based on any number of differences in the hair on her hand, subcutaneous blood flow, imperfections in her skin, all tiny variations in a complex system, affecting the outcome. The scene came to mind last week when in 24 …
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Please don’t stop fighting for what brought you to medicine: a tale of 2 physicians
I’m angry. The sound cut out again, for the fifth time in the last hour. “Why can’t I get through one telemedicine visit without some technical problem?” I ask myself. I can feel the chest discomfort, my shoulders tense, I start to flush, tell-tale signs of frustration and anger bubbling up. I did not go to medical school to become tech support. After 12 patients, it’s finally time for lunch. …
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Telemedicine exhaustion is real
Pediatric cardiac anesthesiologist, woman, mother, wife, friend, mentor. I can’t remember a time when I wasn’t trying to “work smarter, not harder” to get it all done and feel good about myself, only to begin climbing the mountain with a fresh list the next day. My goals were simple: peace of mind and a sense that I was in control of my life and doing a good job for all …
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The new rules of time management
Every primary care provider has been there. A patient comes in requesting a pre-operative evaluation or places a phone call or EMR message expressing the need for “clearance” before having a surgical procedure. Sometimes, we even get a request from the surgeon’s office with paperwork for “clearance.” Time is always, seemingly, of the essence regarding these evaluations, and either the patient or the operating surgeon requests this be done expediently …
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I’m sorry, but I can’t “clear” your patient
The majority of my coaching clients are physicians. It isn’t easy for them these days. For the most part, doctors are rational types who believe in science, data, and facts. They have trouble understanding why so many of their patients seem to have signed on as extras in the unreality show of a skilled Pied Piper with a large and devoted following. How sad that so many people have followed …
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Doctors have had it with tall tales (and those who tell them)
If you knew we are like the “Two Fridas,”
that our hearts are connected,
would you change your mind?
Would you stop
as you are about to cut
the artery feeding your heart and mine?
If you knew that when you cry because of your loneliness,
because of your longing for your family,
that I cry, too, (though behind your back,
after I have comforted you)
would you change your mind?
If you knew that your isolation,
with the tubes and gadgets
coming …
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Unrequited: love in the time of COVID-19
I’m a small-time doc in a small town, and I work at a small hospital in the Midwest, and I’m proud of it. The huge university hospitals (like Cleveland Clinic) get all the glory (especially in society and in the press), but small hospitals like mine drive this country.
It has been really weird working at a small hospital, where it seems like …
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A shout out to small hospitals
I stare at the sharply rising line in front of me, its stark outline harshly highlighting the data–data that shows that we are in the midst of yet another surge. That graph haunts me, intruding upon my thoughts, hovering at the edges of my life. I hold my breath, not knowing when this sly encroacher will become an intruder that will disrupt the normalcy of these last few months, …
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I go on because I must: for my patients and for my children
When can a patient say “yes” or “no” to a recommended colonoscopy? A blood transfusion? A COVID vaccine?
As 2022 opens, health officials predict a tsunami of new coronavirus cases worldwide due to the Omicron and Delta variants. For more than a year, official messaging has been that vaccination is the way out of the pandemic.
But ongoing vaccine hesitancy has hindered progress. The Centers for …
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Can patients just say no to treatment?
More than half of all physicians in the United States are employed by health care organizations, and the numbers have been trending upward since 2019. Recruiters who work for health systems are tasked with finding the best physicians available, and their roles have become more important than ever. In-house job recruiters, and recruiters contracted with health systems, represent the face of the organization. They are often …
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A message to physician job recruiters: First impressions count
The most memorable books have twists, turns, and surprises. A plot twist is a literary technique involving a radical change in an expected outcome. It involves withholding critical information until the time is right, changing our perception of preceding or current events. There are often hints along the way, foreshadowing what is to come, but realization does not come until the twist happens, and often only appreciated in retrospect. Red …
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How do we embrace the plot twists in our life?
Before there was doom-scrolling, there were sad books. For me, it was Chapter 18 in Life and Fate by Vasily Grossman. The chapter is a fictional portrayal of Mr. Grossman imagining his mother’s last words. The protagonist—modeled on the author—and their two mothers have the same fate at the hands of the Nazis. I tried several times to get through that chapter, through that letter, and through the book. I …
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The letter this physician wants to write to her patients
Since the first cases of COVID-19 started trickling into the U.S. in January 2020 (or December, depending on what sources you believe), leaders have made confident statements promising containment, to eradicate the virus, to provide resources for hospitals in need, to research and identify treatments that work, etc.
I think that we can agree that no matter what side of the aisle you are on, having a highly charged controversial presidential …
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A booster shot of humility
As I plug in the microphone and check the link, I imagine them on the mountain, kicking frozen boots into the night ice as the wind explodes over the ridge and rifles through the down of their parkas. I imagine the anemic glow of Jeff’s headlamp against the expanse of the Himalayas and Erik bending into the incline as he follows the nylon rope; he can hear the sharp tinker …
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The physician and the podcast interview
In a world where everything is fast-paced, I believe we miss out on some stuff that deserves our attention.
Just like we need to stop and smell the roses, we need to stop and pay heed to the little life traumas that hit us daily. For today, I will jot down the list of small things that disturbed me and that I didn’t pay attention to.
My patient and colleague suffering from liver …
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Pay heed to the little life traumas that hit us daily
A 2012 letter to Mr. Leonard Pitts, a Pulitzer Prize-winning journalist.
I am not sure why I feel so compelled to write you. You probably will not even see this email, but I still must do so. I am a 56-year-old Christian white male physician living in North Carolina. I am a graduate of the United States Military Academy at West Point and the University of Alabama School of …
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I am tired of the racism that remains embedded in our culture
A colleague announces he is retiring.
Unknown at the time is the fact that there were a series of fires and suicides committed by patients at the psychiatric facility where he was chief medical officer during the year prior to his departure. State investigators condemned the incidents and found an array of policy failures and procedural errors compounded by staffing shortages due to the coronavirus pandemic.
Another colleague announces his retirement. Unknown …
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When retirement is code for “You’re fired!”
