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.
It began simply enough.
There were 12 of us at the spacious table, gathered for a tasty, albeit unconventional Christmas meal of soup and salad. My adult son was seated to my immediate left. Meal completed, compliments and gratitude expressed to the preparer, my son turned to the fellow on my right.
“You want some coffee? I’m going to Starbucks.”
“Do you have to go out? Can’t you make it here?”
My daughter had …
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My left foot is fine. My left arm? Well, maybe not so much.
There’s a lot of hubbub about The Great Resignation right now.
Millions of Americans are quitting their jobs each month. It’s happening in medicine and other sectors such as education, tech, and fast food. Interestingly, it’s not the typical younger employees driving the massive numbers; it’s mid-career workers.
In our household, we have seen both sides of the resignation. At the same time that my teen son quit his first job at …
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Why we should celebrate the Great Resignation
In a world of delightfully fit health coaches who gleefully snack on kale chips during the holidays, I am not one of them! I like to splurge. Holiday cookies are my weakness, and pecan balls did not disappoint this season! Did you stray from your health goals? I am right there with you. But as a coach, I believe in celebrations. There is no shame in indulging in treats on …
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3 New Year’s resolutions that always get results
So I am on the road again — sort of. What I do is work away from home, which isn’t quite the same thing. Where I work as a radiologist is not within commuting distance, so I stay at a nearby hotel. In general, that has worked out fairly well.
Not long ago, however, when I went to start the car after breakfast, I became immediately aware of a roaring sound.
The …
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The world according to Steinbeck
This article is satire.
Good morning and thank you for flying SkyAnesthesia. I am your flight attendant, Dr. Jablonski, and my co-pilot this morning will be Attending Dr. To-Be-Named. This Boston-based flight crew is honored to serve you.
While our Team SkyAnesthesia, or TSA for short, does not utilize metal detectors, please remove all jewelry and body piercings prior to boarding. Please be sure to securely stow your belongings in the provided …
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Good morning and thank you for flying SkyAnesthesia
When I was married to a physician, dinner was often delayed. When he finally came home, I was hungry if I hadn’t already eaten with the kids. Our dog would greet him with her whole body of yearning and relief, tail wagging furiously, whining, smiling, crying. She was the embodiment of what I felt but could not express. So I watched with jealousy as our dog received from my husband …
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The difficulty in coming home: What doctors and soldiers have in common
I spent the past year and a half of this pandemic getting a degree in quality, safety, and leadership. Though there were days, nights, and weeks where I simply did not know how I could finish the work or go on, I never realized how much I needed the work to help me process what is happening around us. To help me navigate my rage at the state of our …
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We have been forced into a mass casualty scenario
Despite protests from the medical community contained in multiple amicus curiae briefs, the Pennsylvania Superior Court recently ruled that the term “cause of death” on death certificates is ambiguous and should include any physician errors that contributed to the death — they were correct.
What they failed to consider was that, without an autopsy, the listed cause of death is often wrong, so using it to determine precipitating …
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Do we really know why they died? The inaccuracy on death certificates.
There is value in reflecting on the most difficult experiences, as it affords an opportunity to examine how we act, react and change in response to the forces around us. The most difficult experiences in medicine are often not discussed, as there is typically not a space in which to begin such stories. So, without further preamble or justification, here is my worst experience in medicine, one which I’ve never …
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The worst code I ever ran
As I write this, a rapidly spreading COVID-19 variant called Omicron is the uninvited guest this holiday season. I’d hoped that the vaccine would have had more widespread acceptance, and we wouldn’t be in this situation, but this is our unfortunate reality now. In addition, COVID-19 has metastasized the already inherent bureaucratic cruelty of the U.S. medical system into death by a thousand slashes of red tape. I will explain why …
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The bureaucratic cruelty that is modern medicine
One of my favorite passages from sacred writings is the story of Moses, still tending his father-in-law’s sheep, an ordinary day in an ordinary place, suddenly encountering God, the ground he stood on now consecrated into holy ground, admonished to “Take off your sandals, for the place you are standing is holy ground.” All of the world’s religions speak of holy ground. For Muslims, even the simplest prayer rug in …
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You are standing on holy ground
Nurse: “I need help with the computer; patient transfer needs to be completed.”
Me: “Ma’am, the patient’s medications are on ‘MAR HOLD,’ which means Medication Administration Record Hold. Therefore, we cannot administer medication unless an attending physician releases this hold. Can we get the physician on the phone for him to reconcile the meds?”
Nurse: Reluctant to call the physician, insists on completing the transfer at the unit manager screen. Finally, she …
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Physician informatics demystified
I just wanted to tell you that I had a wonderful patient as a consult today. She had a pretty bad prognosis and was a recently diagnosed hepatobiliary cancer patient. Pretty aggressive disease with wild metastasis. From her time of diagnosis to my consult was less than two weeks. But her cancer was advancing at a remarkable pace, and the oncologist was recommending no further chemotherapy if she remained this …
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The price of love is loss. But still we pay.
I opened my email recently and blurted out a heartbroken expletive that I can’t print here. Another member of our health care family had died by suicide. I didn’t know them well, nor had I known our colleague who died from suicide just a few months before, but I felt as though I had been punched in the gut. An image came again that has been arising in my head, …
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We must start looking for drowning colleagues
I recently had an email exchange with a friend and psychiatric colleague, Dr. Michael Myers, on the topic of professional courtesy. It’s a topic I’ve written about before. However, one of my essays stirred considerable controversy, so much so that readers’ comments turned ugly and unprofessional, and the commenting section on the host website was closed. It seems my op-ed struck a raw nerve primarily among millennials, many of whom …
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Professional courtesy means being a “doctor’s doctor”
I complain about my job all the time. The frustrations are endless. For example, EMR changes that seem pointless and create more clicks, instead of fewer, the constant barrage of patient emails in my inbox that start with “I have a question about X result” because results are released immediately to patients before I have seen them, patients that arrive late without having filled out medical history form ahead of …
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I loved my job yesterday, but I don’t love it every day
Over 12 months, I rebuilt my practice workflow to solve the problem of inefficient knowledge transfer between me and my patients. Now with a new system incorporating a library of leveraged digital assets I’m saving time and improving patient experience. Here’s how it happened:
“Hey, Picasso! That patient wants to keep your drawing to show her family!”
My secretary shouted down the hall to my office. An elderly patient asked to keep …
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How to convert medical knowledge into digital assets that work for you
