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.
This morning, while scrolling through social media, I encountered a resounding theme. Multiple physicians posting about being challenged, disrespected, and made to feel worthless by the very people they were trying to help: their patients. Being brought to tears by the disrespect of the patient’s family members. Physician expertise blatantly questioned. Advice ignored.
Patients telling doctors – to their faces – that they “don’t like their tone” and then telling nurses …
Read more…
Honor your oath. Set boundaries. Demand respect.
While I lack certainty in my faith, a church has always been a sanctuary. And while I land in church rarely, and even less in this pandemic, when I’m in one, in any country across the globe, a certain feeling comes to me. My favorites are old, gothic, with a musty smell and an imposing altar, windows of colored glass, and soft candlelight—a hushed sense of solitude, of peace. I …
Read more…
Unyielding physicians. My congregation. Hold me up.
Patients die. This is a tragic truism in the world of medicine. Usually, the patients who die are elderly. Patients die from diabetes and kidney disease, or from alcohol abuse and liver failure, or from heavy smoking and lung disease. Or patients die from cancer.
As a physician, I take these deaths in stride. I try to provide comfort care as they lay dying. Patients often pass into a dreamlike state, …
Read more…
Patients should never underestimate the self-flagellation of the physician
She was an ICU downgrade. Hospice care is what they told me. We added her name to our list, and my senior resident told me she was now my patient. I did not have a clear story. Sepsis? Complications? The ICU note was lengthy. Rounds were coming up, and I needed to see all my patients.
I went into her room. She was breathing slow. Oxygen saturation dipping. Unconscious. I asked …
Read more…
“Call the family. Let them know she passed away.”
Nothing like a tragic global pandemic to make everyone rethink their careers. This past year and a half have brought a lot of changes to the workplace. Many of us don’t want to go back to the way things were. According to a Pew Research Center survey from late 2020, of the 71 percent of employees working from home because of the pandemic, more than half, given …
Read more…
Can medicine transcend beyond the clinic walls? I’d like to see us try.
In the past week alone, I have heard the following comments from pediatricians on the front lines: “I’ve been practicing for 21 years, and I’ve never seen things this bad”; “I have been called uncaring because my patient had to wait an hour. But I couldn’t tell my patient that I was running behind because of a suicidal patient”; “I’m considering leaving clinical medicine because it seems like there is …
Read more…
The pediatricians are not alright
Sometimes I really look forward to something new. An alien race arriving on earth would be a nice start. I think we could all use a change in the news cycle. Because I am very tired of thinking about, talking about, and especially treating COVID-19.
In all of my years of medical practice, I have never seen anything that taxed the system and caused so much mayhem, while simultaneously producing such …
Read more…
Trapped in a cauldron of suffering, medical staff are weary
According to the Smithsonian Magazine, diamonds are formed deep within the earth, about one hundred miles down in the upper mantle. As you might imagine, it is quite hot in that part of the planet, and there is a tremendous amount of pressure bearing down in that location. The brutal combination of pressure and heat is what it takes to form diamond crystals.
Now, we can’t actually travel there or even …
Read more…
Clinicians are diamonds in the rough
When medical historians write about the coronavirus pandemic, they’ll likely focus on the slow U.S. response and failures of leadership that led to a tragically high death toll. But that will be only part of the story.
From the wreckage and devastation will emerge something few contemporary observers would expect: a brighter future for American health care.
Five technologies, all previously underappreciated and underutilized, will help …
Read more…
5 technologies that will transform medicine post-COVID
Guess what, everyone, I am a health care hero. I have been applauded by strangers. The Blue Angels flew over the hospital once in the pitch of COVID to salute us. I once sifted through a giant box of free chapsticks delivered to the hospital basement and grabbed one for my colleagues.
First of all, let me clarify: There is no such thing as a “hero.” It’s a social construct laypeople …
Read more…
Being a health care hero means we get free ChapStick
There are many reasons why you should seek a second opinion. A second opinion can help you:
- Make sure your diagnosis is accurate, lowering your risk of misdiagnosis and the harms that can cause.
- Ensure that you’re choosing an appropriate, evidence-based treatment that has been shown to achieve better outcomes.
- Learn about all appropriate treatment options, both medical and surgical, so you can make an informed decision.
One study conducted by …
Read more…
How to overcome the roadblocks to getting a medical second opinion
Are you a woman, and your sanity has been questioned? Congratulations: You are now an activist.
There is such a thing as implicit bias in which we may not be aware of how our subconscious thoughts are affecting our conscious thoughts, opinions, or actions we have daily.
They manifest in all aspects of life. Whether you come to see me for a surgical consultation and when you walk into the room, you …
Read more…
Women are still being “burned at the stake” in medicine
Thirty-five years ago, as a first-year student, I (DWS) wrote an article for my medical school’s student-run newspaper titled, “Sexism in Medical School.” The article highlighted three examples of sexism:
- In the middle of a pathology lecture, the professor projected a photo of a woman in a skimpy bikini lounging on a sports car to “liven things up.” He then showed a photo of a kitten, “So you ladies don’t …
Read more…
Sexism in medicine: Alive and well or a dying breed?
Every day I read stories on the Internet and in the newspaper of the deaths of previously healthy people who died of COVID-19. They were good people, caring parents, working people who seemed like responsible citizens. What they all shared was not being immunized against COVID-19.
Maybe they were just “vaccine-hesitant” — one of those who wasn’t convinced of the value and safety of the vaccines. Maybe they didn’t understand the …
Read more…
Why this physician is running out of sympathy
Anniversaries are usually joyous occasions to celebrate – a wedding date or a date of independence, for example. Other anniversaries invoke solemn occasions, such as the end of a war or 9/11 after the bombing of New York. But there is another type of anniversary some of us in the medical profession commemorate because each year it reminds us of a traumatic experience we endured earlier in our career, often …
Read more…
Physicians attacking physicians online: trauma of the second order
I woke up this morning to a flood of ballerina pink emails for Breast Cancer Awareness Month. The irony was not lost on me as I rolled over in bed, protecting my body from the healing scars of where my breasts used to be. “I don’t even like pink,” I muttered to myself, while swallowing feelings of guilt. I shifted my mind to focus on gratitude … for awareness of …
Read more…
Pink ribbons and murder boobs
The anti-vaccine movement has led to a profound increase in disease and deaths, overtaxed hospitals, and drastically marginalized care for others with serious illnesses. This reality reflects a more profound cultural problem in our country. Namely the need for more innovative and creative ways to rediscover our obligation to each other to get vaccinated and to follow the best that science can offer.
No longer do we share what Alexis de …
Read more…
Getting vaccinated as a gift to others
I finished residency in 2020, during the height of the pandemic. We had a ceremony limited to just the graduating class; no family or friends could attend. Then my four other colleagues of the past three years and I embarked on our next steps as physicians.
Family medicine is my passion – I went to medical school loving the idea of caring for a whole family, from pregnancy through birth to …
Read more…
Working in a rural emergency department during the pandemic
“Where do you find the most joy in your life?”
This is one of the questions the Knowledge and Evaluation Research Unit at Mayo Clinic asks people living with ongoing health conditions. Their answers give a sense of each person’s purpose, reason for being, and for doing something difficult.
The answers are myriad; typical responses include “providing for my family,” “being there for my grandchildren,” or “taking care …
Read more…
Why we need to end social COVID and establish care to replenish joy
