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 was the blanket that killed me. Made for a child. Cushy, colorful, and crisscrossed with cartoon quarterbacks, clean-up hitters, and cheers like “Rah” and “Go Team.” What father doesn’t want their son to be the high school hero?
Under the blanket was no toddler. He was 31, emaciated, and wheezing. His contracted limbs poked out like thorns. He was dying.
I can’t remember what horrific disorder the genetic lottery chose for …
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He would never be ready. This was his son.
Like most, our family decided that we had outgrown our current home a few years ago and wanted to move into a larger house that offered more square footage and land. It had been nearly twenty years since living in the house we have owned since the end of the residency, and the house-hunting effort seemed more bewildering and confusing than two decades ago. At the time, I was too …
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Why physician-owned businesses need our attention and support
Like many primary care practices, after a hasty transition to a year of phone calls and video visits, my practice is slowly transitioning back to “normal,” meaning that we are now seeing more patients in person than by video. However, as I reflect on the past year, I wonder how central this notion of the “in-person office visit” is to the delivery of primary care.
One of the unanticipated consequences of …
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Do we still need the traditional office visit?
In the last year, amidst COVID-19 news, animals have gained their place: cats harboring the virus, pet abandonment and, paradoxically, rising adoptions. Cats and dogs are now in the spotlight. I’m a physician, and my personal animal-related COVID-19 story changed the way I practice medicine.
During lockdown in 2020, we decided to adopt a kitten. As both animal abandonment and adoption were on the rise, we brought home a three-month-old orange …
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My pet taught me how to be a better physician
The pendulum in the physician wellness space continues to move, and for good reason. When mindfulness started becoming more mainstream in medicine, it was often touted as the solution to burnout and, subsequently, led to a lot of mandatory workplace mindfulness programs. (For me, personally, my meditation practice is what ended my burnout, but I am fully aware that isn’t the case for everyone.)
Building resilience became a wellness box-to-check that …
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Tap — yes, tap — to relieve stress
I have heard from more than one retired anesthesiologist about becoming aware of the weight of the pager after it is relinquished. I imagine other physicians engaged in critical care, trauma (physical and emotional), other emergencies, and obstetrical care might have heard similar descriptions. Have I left anyone out? We do a pretty good job of negotiating chronic professional anxiety at a subacute level. In fact, we are so accustomed …
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The weight of the pager
Last month marks one year since the killing of George Floyd, and over that often-tumultuous timespan of public outrage, nationwide street demonstrations, and protest, Americans have been forced to take a critical and introspective look at ourselves as a nation of a diverse citizenry.
In the last year, we have confronted how racism in the day-to-day practices of our police and overall criminal justice system impacts the Black community. …
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How to combat racism in the American medical system
“Consciousness.”
What is it?
Are we aware of it?
We deal with it every day as surgeons. We are on the other side of the drapes while our anesthesia colleagues put our patients out of “consciousness” and under anesthesia.
The other day, I had a young, nervous, 41-year-old patient call to ask me: “Will I be asleep or awake for surgery?”
I replied to my nurse that it would be general anesthesia and that he …
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Are we anesthetized to our consciousness?
“Hi, my name is Kristin Yates, and I am the OB/GYN doctor.” This is how I greet most patients for the first time.
It has never really felt natural to introduce myself as “Dr. Yates,” even now that I have been an attending physician for more than five years. To be fair, for the first several years of my career, it felt uncomfortable to refer to myself as “Dr. Yates” because …
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Don’t call me “doctor”
With the COVID-19 pandemic inflicting havoc on everyone, there is no doubt that physicians and other health care workers are most affected. The looming fear for yourself and your family adds to the current burden of responsibilities you encounter and conquer every day.
When the pandemic started in 2020, the struggle was about finding a cure and controlling the spread of the virus. With the advent of vaccines in 2021, the …
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Surviving a thousand cuts: How to address physician burnout
Some clinicians say we have lost the art of physical examination with medical technology having increased presence in our practices. In my cardiology practice during a patient examination, I must remain mindful so as not to miss something unexpected or new, despite often knowing the echocardiogram results before entering the room. Sir William Osler might very well think this is like putting the cart before the horse, and perhaps the …
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The case of the yellow sticky note
For 15 days, we lived at Children’s National Medical Center when our daughter Evelyn was diagnosed with leukemia. As a physician, I had felt like I had lived at the hospital before, but this was different. The first few days were a blur – long days followed by sleepless nights at home alternating with sleepless nights next to Evelyn’s hospital bed. My husband Kevin and I dressed in layers those …
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The world should be more like a children’s hospital
I had a crazy thought.
Each time I walked into a room to see a patient, I would ask them a question that would be more in line with this blog than with the usual “Where does it hurt?” and “What’s wrong with you?” taught in medical school.
Remember that the room I was walking into was often a virtual room (seeing a patient via Zoom) or an audio room for a …
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What is a positive that has come from the pandemic?
In the “Show-Me State” of Missouri, physicians receive their licenses from the Board of Registration for the Healing Arts. Seriously! This quaint term harkens back to a time when newly minted doctors had a relatively easy time realizing their desire to meld compassion, knowledge, and skill in order to relieve human suffering.
Armed with credentials suggesting that we have the right stuff to avoid doing harm, many of us are drawn …
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Are you a healer or a widget?
I rarely cried growing up. The time I remember most, I was twelve. I was pitching in the semifinals of the Tennessee State Dixie Youth Baseball tournament to qualify for its equivalent of the Little League World Series. In the first inning, I gave up a walk and two hits, including a three-run home run.
However, in the next five innings, I pitched hitless, scoreless ball striking out 15 batters total. …
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What makes you cry? Better yet, why not cry?
“Sticks and stones may break my bones, but words will never hurt me.”
This childhood rhyme aims to teach children to be resilient, that not all words have to hold power. As psychiatrists, we know this is a lofty goal. So much damage and hurt can come from a simple word. Here is an example of how the word “behavioral” has hurt me.
I work at a large statewide nonprofit organization as …
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How one word may have harmed my patient
I love science. I enjoy studying the human body and its amazing ability to adapt, heal, and restore. I love critical thinking, problem-solving, and forward progress, but the practice of medicine is not a science experiment. In medicine, I manage people with heavy burdens and complicated stories. I juggle laundry lists of problems. I stare at suffering, in its many forms, in the face. And despite my greatest desire to …
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4 questions that made me become a health coach
Although people think of medicine as a science—the facts reveal the diagnosis, the diagnosis dictates the treatment—most physicians acknowledge that medicine is as much an art as a science. It’s not like a simple math equation with one undeniably right answer. Even when the diagnosis is clear, there may still be multiple appropriate treatment paths that deliver similar outcomes. And there are many cases where the diagnosis is not definitive, …
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Why people diagnosed with cancer should get a second opinion
Toward the end of my clinical career, I didn’t feel like I had control over much at all. The patient safety issues loomed large. We used ridiculous workarounds for broken processes. The constant vigilance to provide excellent care in a suboptimal environment was exhausting. I didn’t see anything I could change. Based on my work with physicians as a coach, I think that the sense of powerlessness and being a …
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The sense of powerlessness and being a cog in a wheel is now at an all-time high
