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.
As a parent who also happens to be a hospital-based pediatrician, lots of people have asked me my opinion on back to school and/or daycare.
I am sharing my thoughts. I’m only one person. These are just my thoughts. Feel free to take what is helpful to you and trash the rest. It won’t hurt my feelings.
I think it’s important to frame this conversation by stating loudly and clearly that there …
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Putting my kid back in school: the right decision for this pediatrician
First, you turn off your phone. You can’t have any interruptions. As you walk to your patient’s room where the family is waiting for you, pick up a box of tissues and put it in your back pocket. Don’t hold it in your hand as you meet them. It’ll betray their new reality.
When you enter the room, you introduce yourself to everyone as the doctor. You find a seat to …
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How to tell someone their loved one died
“We can’t sit in the stands – we have to get messy and play on the field.”
The casual observer, the season ticket holder, the player, and the coach have very different levels of knowledge, skill, and passion for a professional sport. The casual observer may be confused, not even understanding the fundamentals of the game. The season ticket holder likely has some experience with the sport, possibly playing as a …
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Getting messy in the game of health care
But seriously, who needs scientists? It’s not like we listen to researchers or pay attention to the warnings. The world is burning up with record ground-breaking temperatures. These so-called scientists predicted these warnings decades ago, with great details. Who do they think they are? They got lucky! They are fear mongers and not to be believed. Look at the fake media! Landslides, earthquakes, fires, flooding, drought, and the list goes …
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Who needs scientists? It’s not like we listen to them anyway.
For most care providers, having conversations about end of life comes with certain challenges. Most medical education prioritizes diagnosis and treatment of illness with the goal of extending life; therefore, it can be quite difficult to acknowledge when curing illness or prolonging life are no longer achievable goals. On top of that, it’s certainly not easy to witness the pain and sadness of families when their loved ones are nearing …
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Why it’s important for physicians to talk about death
Pick out any company’s mission, vision, and value statement, and you are very likely to find a call to innovate. Companies understand they must produce more high-quality widgets, ideally at a lower cost. Adherence to the status quo will only get in the way of this pursuit: Innovation is the name of the game.
Consider a company that makes cake, and the current version of the cake isn’t selling as well …
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What has leadership accomplished by asking for innovation?
My husband and I recently had a bit of a wobble in our marriage. In truth, it was more than a wobble, and it had been building for years. I am pleased to say that we have traversed the turbulence. Not only are we once again sailing in smooth waters, but we are sailing in more idyllic waters than ever before.
Why did it happen?
For so many reasons, but I need …
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Why this physician and her husband almost divorced
We in Southern Oregon saw how the pandemic raged in other areas of the country. We were waiting. It would hit here, eventually, we knew it. It came to our city slowly, and then we had a spike. Still, it was much milder than many other places, and we were grateful to be spared the worst of it.
People started getting vaccinated. It was like a baptism of sorts, and the …
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We are all out of ideas for how to convince you to get vaccinated
Last March, I was working in a small primary care practice on the west side of Denver. COVID-19 came to town. On Thursday, March 12, we were told the schools would be closing. On Friday, we were told that clinic staff had to wear masks — and the clinic had to start testing patients for COVID-19.
The only problem? There were no medical-grade masks to be had. Not through the state …
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I was thinking about retiring, and COVID-19 gave me a push
You are 19 years old, standing in the mud and mire that are the trenches of World War I. You are cold, hungry, filthy, emotionally, mentally, and physically exhausted. You stare straight ahead, eyes vacant, not revealing deep inside you a visceral fear that defies description; a fear that only those who have faced the horror of combat know. This is your reality. You know what awaits when the order …
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Surviving the first 100 yards: How do you do it? Why do you do it?
When I started my career 15 years ago, I naively said I would like a job where there aren’t a lot of politics. Little did I know that my job and profession would be so strongly affected by national politics a decade and a half later.
I study human behavior and can usually conceptualize behaviors fairly easily. I have been stumped in the past four months. Truly stumped. Four months ago, …
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I am not asking you to do anything my family and I haven’t done
Four years ago, I was ready to throw in the towel. I practiced for 22 years in a large metropolitan hospital, became very involved in resident education, clinical program directorship, medical staff affairs, in addition to a busy hospital-based surgical practice. I watched as the environment of care for clinicians and the quality of the relationship between the medical staff and system administration steadily deteriorated.
My small, single-specialty surgical group merged …
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Ageism and the mid-career physician
COVID-19 has raised many ethical challenges for health care providers, including the level of risk they must take when providing patient care. Early in the pandemic, the ability to mitigate these risks was relatively limited, especially when caring for hospitalized patients. Shortages of personal protective equipment rendered mitigation even more challenging.
As a result, it has been reported that 3,607 frontline health care workers died of COVID-19 in the U.S. from …
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Is it ethical to force unvaccinated patients to use telehealth only?
My day started out great; my dad called to let me know he had received the first dose of the vaccine. I let out a whoop of joy! One cannot imagine the sense of relief that passed over me. As a physician and an advocate for the vaccine, it has been a struggle to see that my efforts fell short when it came to my home. My husband and I …
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Parenting my parents during COVID: Navigating from a distance
Although Pride Month is over, awareness and advocacy for equity among the LGBTQ+ community must continue to be prioritized. This is especially important in health care settings. Many LGBTQ+ people feel uncomfortable and unwelcome in doctors’ offices, and more than 40 percent have experienced discrimination in health care environments. As a result, LGBTQ+ people postpone or avoid care at a rate that is 2-3x greater than the broader U.S. population. …
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How to make LGBTQ+ patients feel welcome during in-person and virtual doctor’s visits
Everybody dies. And doctors can’t change that reality.
But we’ve created a system where we lead people to believe immortality is possible. We expect clear-cut answers to health questions. We’ve been trained to look for multiple-choice questions with an answer key that tells us the correct solutions. As doctors, we’re expected to be selfless, altruistic superhuman helpers who always know the answers and will sacrifice ourselves to benefit everyone else. And …
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Doctors are humans, not heroes
Does this scenario sound familiar? You bring your car into the dealership for routine servicing. The service representative (patch on his shirt says his name is “Bob”) checks your car history. He tells you they will do the routine service check, but he also recommends the “manifold inspection,” a “carburetor cleaning,” and a “transmission flush.” Now you have no idea what the hell a manifold is or does, but you …
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Are you a part of “The Upsell” in health care?
As a practicing surgeon for 30 years in the super-specialized field of otology, neurotology and skull base surgery, I have been privy to some of the most disturbing realities of surgical care. Often, these realities are bleaker than most people expect. One thing physicians, and the general population, need to be more aware of is the very real racial disparity in surgical care.
Are the outcomes for Black and Hispanic patients …
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The bleak reality of racial disparity in surgical care
The problem with feeling like an imposter is thinking there’s something wrong with it.
I know this is different from any way you have thought about it, but humor me. What happens when we are offered an opportunity but we feel like an imposter?
We hide.
We overwork to compensate.
We look around at our colleagues and resent them. Because why do they get to feel so secure? Why aren’t they feeling insecure? They …
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Stop resisting the imposter
