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.

Choice is a charged word in medicine

Physician
August 8, 2020

Choice is always available to us. Choice is a charged word – fueling political debates and challenging concepts of freedom. Many would argue that there are unavoidable obligations, legal and cultural limitations that revoke choice, but at the core of human existence is free will that cannot be revoked. While there may be consequences for choices that seem undesirable, unjust, even inhumane, and ultimately unavoidable, choice remains infinitely available, and …

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Choice is a charged word in medicine

The act of being there for our patients is an act of love

Physician
August 7, 2020

She started crying. This tough, capable, juggernaut of an ICU nurse looked just a little broken for a second while she cried. “It’s not fair. It’s immoral—or unethical. I don’t know—I know it’s the right thing. We have to protect the patients and staff but … if it were my dad! I just … I can’t go tell them that she can’t come see him when we know he’s going …

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The act of being there for our patients is an act of love

No, I won’t play politics. I’m a doctor.

Physician
August 7, 2020

Sneeze, and you miss it: the public’s love for health care workers. This relationship has felt like a true Coronacoaster.

Pre-COVID: physicians were disparaged for the sins of insurers and hospital C-suites.

COVID appears: I was gifted a yard full of signage announcing “Heroes Live Here.”

COVID escalates: the World Health Organization is …  defunded?

We’re held in high suspicion, yet …

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No, I won’t play politics. I’m a doctor.

A discussion about unprofessional behavior: a play in 1 act

Physician
August 6, 2020

Setting: An impersonal, windowless conference room within a hospital

Characters: A nurse in charge (NIC), a department chair (DC) and me (ME)

***

NIC: Thank you for joining us to discuss the report you made of unprofessional behavior in the operating room. We’d like to start by letting you know that in this institution, we have a culture of informality. When I first got here, I found it unsettling that doctors were called …

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A discussion about unprofessional behavior: a play in 1 act

COVID and schools: Our only certainty is uncertainty

Physician
August 6, 2020

Amidst the tangle of mail consisting of grocery ads and a retirement fund quarterly report and the membership renewal form for the botanical gardens, I spot a small manilla envelope emblazoned with the return address of my children’s school. This is what I have been waiting for with equal parts hope and dread.

Last year was supposed to be the beginning of a new era for me — the year that …

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COVID and schools: Our only certainty is uncertainty

4 pitfalls that run through the minds and daily realities of primary care doctors

Physician
August 6, 2020

I looked at a free book chapter from Harvard Businesses Review today and saw a striking graph illustrating what we’re up against in primary care today, and I remembered a post I wrote eight years ago about burnout skills.

Some things we do, some challenges we overcome, energize us, or even feed our souls because of how they resonate with our true selves. Think of mastering something like …

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4 pitfalls that run through the minds and daily realities of primary care doctors

The key to physician job security

Physician
August 5, 2020

It’s something we are taught from when we are very young and is a core middle class belief: work hard, get a qualification, and then you’ll be able to find a good employer who will send you a nice paycheck every month.

On some levels, this seems like an attractive option. Yet on so many others, it falls apart. For physicians in the United States, the concept of “employment” is relatively …

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The key to physician job security

The skill doctors need to have, but haven’t been taught

Physician
August 4, 2020

Physicians handle thousands of questions annually. We respond to inquiries from patients, their families, insurance companies, nurses, professional colleagues, pharmacies, pharmaceutical representatives, our staff, and even strangers. This is, of course, a part of our job, and it consumes a substantial amount of our time and energy.

And, responding to questions is not as easy as you may think. Words matter, and a clumsy choice or omission can wound instead of …

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The skill doctors need to have, but haven’t been taught

Physician-moms fight back against anti-maskers and anti-vaxxers

Physician
August 4, 2020

Recently, the nation was riveted by photos of the wall of Portland moms who were tear-gassed while forming a human shield of linked arms and bodies to protect Black Lives Matter protesters from federal agents. These moms represent the instincts that all mothers have — fiercely protective with a drive to stand up for what they believe in, especially when it comes to the safety of …

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Physician-moms fight back against anti-maskers and anti-vaxxers

The case for compassionate communication

Physician
August 3, 2020

A majority of physicians see between 11 and 20 patients per day, and among all practices, the majority of doctors spend between 17 and 24 minutes with each patient. Assuming a five-day workweek, this translates to more than 900 patient interactions per year and over 1,066 minutes spent communicating with patients. Today, many of these interactions fall short of effective communication so pivotal to building rapport, trust, and loyalty with patients …

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The case for compassionate communication

The culture of medicine forces us to ignore our health

Physician
August 3, 2020

It’s the first day of fellowship, and everyone’s getting to know each other.

“Oh, you won’t have time to work out here.”

I’m not the small, scrawny kid I was back in high school anymore, even if that’s the person I still see in the mirror. I’ve added roughly 50 pounds since college, and it shows with the things people say. Being told I won’t have time to work out has been …

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The culture of medicine forces us to ignore our health

4 ways to break the COVID-19 compassion walls

Physician
August 3, 2020

A few days after my dad flew to Salt Lake City from California, he developed a small cough and fatigue, and then started getting fevers. At that time in late February and early March, we were only testing people who had come from high-risk countries (like China or Japan). After a confusing trip to urgent care and an overnight stay at the University of Utah emergency department, he subsequently tested …

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4 ways to break the COVID-19 compassion walls

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7 habits of highly resilient physicians

Physician
August 2, 2020

Before the pandemic, we had an epidemic of physician burnout, with many physicians caught in a cycle of exhaustion, cynicism, and loss of purpose. All the change and uncertainty the virus has brought certainly doesn’t help! It’s now more imperative than ever that physicians build resilience to all the pressures and stress of our careers.

In the decade I’ve worked as a physician coach, I’ve seen seven habits, thought patterns, and …

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7 habits of highly resilient physicians

The quest for external worthiness is exhausting. The experience of internal worthiness is exhilarating.

Physician
August 2, 2020

We often think something will or someone can make us feel better. When the system appears broken, the culture toxic, the space unwelcoming, we are uncomfortable. To feel more comfortable, we seek to change the surroundings and, when that seems impossible, change ourselves to fit in. We quiet our inner voices to create an external voice that joins in with the choir around us. We shift our appearance to more …

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The quest for external worthiness is exhausting. The experience of internal worthiness is exhilarating.

The hidden danger to physicians in the ongoing COVID-19 pandemic

Physician
August 2, 2020

acp new logo

A guest column by the American College of Physicians, exclusive to KevinMD.

Practicing medicine has always been hard, and as all of us have experienced over the past several months, living and working through a (hopefully) once-in-a-lifetime pandemic has only made it more challenging.

For those on the front lines of patient care, the added stresses …

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The hidden danger to physicians in the ongoing COVID-19 pandemic

We are women in academic medicine, and we are doing enough

Physician
August 2, 2020

A conversation with friends and family usually starts with, “How are you holding up?” My answer is not usually about work, but rather a response of …”Well, it’s going OK, but I wasn’t really meant to be a homeschool teacher.” As the pandemic marches on, many areas of the country have discussed the delayed reopening of schools, furthering the burden of at-home education.

Articles are being published commenting on …

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We are women in academic medicine, and we are doing enough

The weaponization of professionalism

Physician
August 2, 2020

It’s not every day you see hundreds of doctors flooding Twitter with pictures of themselves in swimwear. The trending hashtag #MedBikini arose when health care professionals began posting in solidarity to demonstrate how maintaining a life outside of the clinic, shockingly, does not detract from one’s merit as a physician. In fact, it makes them more human.

This past week, an article published in the Journal of Vascular …

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The weaponization of professionalism

The current COVID-19 testing climate is unnecessarily complicated

Physician
August 1, 2020

It’s 7 a.m. on a Monday morning, and my wife and I had canceled our family vacation to the beaches of Cape San Blas, Florida, where we had planned on spending our week off, relaxing on an isolated beach. My daughter wakes up at 7:15 a.m. on that Monday, and my wife immediately after nursing her thinks, “she feels warm.” Mom thermometer is almost always accurate, and with two different …

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The current COVID-19 testing climate is unnecessarily complicated

My new normal moral injury

Physician
July 31, 2020

Whatever we call it—burnout, moral injury, disillusionment, work fatigue, hopelessness—these did not appear to apply to me before the COVID-19 pandemic. I tried to keep up on discussions about how moral injury is a pervasive and destructive force leading health care workers to feel helpless, leave medicine, or, at worst, become suicidal. I tried to educate myself about the forces behind moral injury, such as lack of control of work, …

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My new normal moral injury

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