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.
Like any stressor, COVID-19 has revealed great strengths in science and medicine. But it exposed weaknesses that could have been tolerated before but now are untenable.
Perhaps the best example of both is COVID vaccines — the success they have had against the COVID pandemic and the fuel they have provided for an equally dangerous pandemic: the misinformation pandemic.
There was no guarantee that a COVID vaccine would even be possible, and …
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How to end the misinformation pandemic
Recently I have been more quiet than usual. Less writing. Less fire and brimstone. Quiet, at least for me. But anyone who is paying attention knows that when the most passionate and the most invested get quiet, something is truly amiss. Whether it be a looming threat or a very real and present crisis is unknown, but the fact remains that in that silence lives the very real possibility of …
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Health care has crossed into a realm of moral injury and systemic collapse
Recently, I finished reading a book about Dr. D.S. “Doc” Ping titled The Legend of Doc Ping. Doc, a former United States Marine and Vietnam veteran, mentored me for a near-decade from my adolescence through early adulthood. As I was reading this book, I could not help but reflect on my time training with him, and the lessons I learned from “Ping’s Dojo,” especially as they pertain …
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What I learned about medicine in the House of Pain
My 13-year-old daughter inspired this article. If you parent a middle school volleyball player, you know that overhand serving is the holy grail of the game at that level. My daughter has a solid underhand serve that works well for her, but a consistent overhand serve would give her a big boost. To my consternation, she prefers to practice passing, i.e., bumping the ball back and forth. Why would she …
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What change are you resisting? What should you deliberately practice?
One patient down. Nine more to go.
My attending politely closed the door behind him and walked back to his computer to chart his patient. His pen crossed off a line from the list that he pulled from his pocket. His schedule was listed in 15-minute intervals.
As we got to the workroom, he sat down, and under his breath, I heard him sigh. It was barely ten o’clock in the morning. …
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We must help physicians at the brink of burnout, depression, and high stress
For the last couple of decades, I was trained to save lives. I sat shoulder to shoulder with others who drilled this in me when I was green, sometimes even through humiliation. I learned to perceptively read patient cues, develop quick reflexes, and think on the spot in critical moments, wherever and whenever life was compromised. I always threw lifebuoys into the ocean when I was called into action. This …
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It’s not an easy thing to unlearn how to save a life
Once again, at 1 a.m., I was knee-deep in patient charts and the cacophony of messages that our “user-friendly” EHR employs to allow various staff members to reach us. One of these was about a simple, inexpensive radiologic test I had ordered which the insurance company denied for my patient. Not surprisingly, I was exhausted, and I lost it.
With some minor edits, I wrote the following in response to this …
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A physician’s rant. Written but not sent.
This article is satire.
As an orthopedic surgeon, it has always been clear that our specialties benefit from a somewhat symbiotic relationship. We feed you patients, and you often return the favor by providing us with the needed confirmation to operate. However, I feel as though there is a deepening rift between our two specialties. It has been developing gradually, almost imperceptibly, over time. Perhaps it is perpetuated by the belief …
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An open letter to radiologists from a jilted orthopedic surgeon
I’ve been struggling to find the right way to highlight how relentlessly misinformation is killing us. I could say that another World War II would only be 60 percent as deadly for Americans as this misinformation-fueled pandemic. I could say that if the deceased victims of COVID-19 were their own state, they’d have a larger population than Wyoming, Vermont, or Alaska.
But these examples fall short in two important ways.
First, they …
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A dark corner of Reddit shines light on how misinformation kills
There are several major transitions in a person’s medical career. The first occurs when you leave behind undergraduate life for medical school. The first term as a medical student will test your resiliency and confirm whether you are prepared to make the necessary sacrifices to be a physician. The next transition occurs as you leave the academic portion of medical training and enter clinical rotations. This process culminates with the …
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Free association on lessons learned as a new attending psychiatrist
How do you learn to deliver the worst news anyone will ever hear?
And equally important, how do you find the resilience to go on when difficult conversations don’t go well?
My profession for the past 15 years has been to train the next generation of physicians as an inpatient clinician-educator. A key piece of my work revolves around communication with patients and their families. On each new resident team, I coach, …
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Letting your resident break the bad news
It felt like watching a train go by with no control over its destination and no way to stop it. We simply had to watch our loved one as he made his way towards death.
The doctor said he had a traumatic brain injury with herniation. His pupils were fixed and dilated on arrival to the emergency department, which meant that he was not a candidate for any neurosurgical intervention. And …
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Every patient is someone’s loved one
I had surgery recently, and as most physicians do at some point, I found myself on the other side of the bed. Definitely not the side where I have the most experience or feel most comfortable, but it is what it is. The whole process makes a person feel vulnerable and out of control: not a feeling most doctors are accustomed to. But I knew the procedure, so I peed …
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Should the Doctor Card make a difference?
After a minor bike accident, you go to the emergency room with a broken wrist. While you’re being triaged, you tell the nurse you take blood thinners because you had deep vein thrombosis a few years ago. The doctor treating you says he’s read your medical records, so you assume he knows what medications you take.
When you tell the doctor about the blood thinner, however, your doctor says that’s not …
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3 strategies to lower the risk of fragmented medical care
Some things in a physician’s life are perpetual. Nowadays, COVID-19 has become one of these inescapable crises that doctors must deal with.
At this point, everyone – including medical practitioners – is exhausted to the core. It feels as though we haven’t slept for weeks or that we’re repeatedly being hit by a train. Every movement feels as if we’re running a marathon.
Even so, my career as a medical professional gives …
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Understand the power of words when curing and harming
The old man sat at the front of the drift boat as it swayed gently, anchored at the river’s edge. The guide sat behind him, making final preparations for the day’s float downriver. The man had fly fished for nearly 40 years; he even tied his own flies and made fly rods such was his love for it. Age and unwelcomed health problems, though, were slowly bringing an end to …
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Savoring the last time and enjoying the moment
Go to the store, support small businesses … But my children are not vaccinated.
Go out to eat; buy local … But my children are not vaccinated.
Go back to work; go travel… But my children are not vaccinated.
Come celebrate, please enjoy … But my children are not vaccinated.
Kids need people; they need play … But my children are not vaccinated.
Kids need sports and activities … But my children are not vaccinated.
Kids …
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But my children are not vaccinated
I’m a doctor passionate about public health and public policy born and raised in Wisconsin and educated at the Medical College of Wisconsin (the same institute that bestowed Mr. Rodgers an honorary degree in 2018). I’m also a Packers shareholder, as is my father, a practicing physician in the state. I cheered you on for your 2011 Super Bowl win from my college dorm freshman year and even had an …
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To Aaron Rodgers, from a physician and Packers fan
A 65-year-old female presents to the emergency department (ED) with contusion from a fall at work. She has no loss of consciousness. Two other employees at her workplace, the cardiac floor of the same hospital as the ED, witnessed the fall. The patient has a previous medical history of fatigue, GI issues, and appetite loss for the last two days. She also has anemia which her primary care physician is …
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A patient caught in the middle of a communication crisis
