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.
I wanted to go the extra mile for my patient. The resistance I found was unexpected.
She was young. Her life — an incredible journey in diplomatic circles — was crippled too soon by a recurring disease that would ultimately prevail. Day after day, I’d round on her in what seemed like a pointless exercise, waiting for the inevitable to come. Another round of chemotherapy would have to wait for her …
Read more…
Doing extra for a patient or overstepping boundaries?
Because everything around us usually works, it can be easy to forget how fragile some of the workings are. My patients see this with their bodies, as they fail, but not so apparent to them are the fragilities of the health care system that we doctors get to see.
Despite what the if-it-bleeds-it-leads press might have you thinking, our health care system is pretty good. Good, however, is never good enough, …
Read more…
Warning: The medical system is fragile. And that’s OK.
As a fourth-year orthopaedic surgery resident, we had some surgical autonomy. Always at arm’s length from the attending oversight, this was just enough to push us past our comfort zones.
My problem was I loved my comfort zone.
The single most influential day in my career happened late one evening as a PGY-4. I was about to start a complex ankle fracture by myself. The ankle fracture involved the fibula and the …
Read more…
Why intangible skills are so important for surgeons
Empathizing with others’ suffering is one of the most human expressions in life. For empathy to nurture, like any other emotion, it needs time and space, and in none other professions, this maxim is codified as profoundly as in medicine. Even in the times of pre-modern medicine, humans had the temptations to heal fellow humans’ suffering from ailments about which they knew little and had no therapeutics to offer. Nevertheless, …
Read more…
To err is human, to empathize is to heal
I found this note waiting for me this morning in the kitchen.
It was from my daughter, who is home for the holiday week from New York. I made her a cup of coffee yesterday morning, and it was waiting for her on the table when she woke up and meandered sleepily into the kitchen.
Seeing the warm and happy …
Read more…
Why gratitude is a superpower
Medicine is for the birds, or it should be. Hear me out.
A day before I wrote this, I was on the trail in northwest Ohio, binoculars in hand, trying to tell one warbler from another. This was the final weekend of the biggest week of birding in Magee Marsh on the shore of Lake Erie. Birders converged here from neighboring states and even from foreign countries …
Read more…
Medicine is for the birds, or it should be
Time is of the essence. The very utterance of this phrase connotates a sense of urgency for an impending crisis or adversity if some essential action is not taken. I find myself most unexpectedly at this crucial junction. I am a seasoned, experienced general internal medicine physician, trained traditionally in hospital medicine, and subsequently evolved into outpatient care of comorbid complex chronic disease management. From everything I read and hear …
Read more…
A primary care physician at his peak is forced into early retirement
An excerpt from Long Walk Out of the Woods: A Physician’s Story of Addiction, Depression, Hope, and Recovery.
As a young child’s heart rhythm faded to a stop, I walked off the hospital floor and got in my car with a plan to end my own life. For weeks, I had watched the life drain out of her due to a progressive, unforgiving cancer. Day after day, …
Read more…
A physician’s story of addiction, depression, hope, and recovery
Graduation from my residency program was a bittersweet experience. At the time, my specialty was suffering from a crippling job shortage, so our futures were uncertain, and a dark mood had come to permeate my radiology residency. We were disgruntled with the specialty, with the system, and with medicine in general. I attended my graduation without any guests and only stayed long enough to receive my certificate.
I was, however, honored …
Read more…
The sad demise of an idealistic family physician
I work in the ER. It’s not an easy job. Not glamorous either. At least not as glamorous as my mother-in-law used to think.
Years ago, when I declared I was going into emergency, she looked at me askance. She didn’t ask why. She looked at me with her wise old eyes. “Let me tell you about ER,” she said. “I know all about it. I watch every show.”
She was politely dismissive …
Read more…
What’s the hardest part of a physician’s job?
Everything in life starts as a dream. Big or small. My dream was to become a physician since I was quite young — the first one in my family to walk the path. I wanted to understand the science of the human body and help the sick. Heal with my skills, knowledge, and empathy. Hold my patients’ hands with care and confidence. My work was to be like none other. …
Read more…
My dream as a physician
Recently, a fellow physician mom ended her life. While outwardly, a very vibrant, lively, and happy woman, she fought her own internal demons for some time. From what we know, she struggled with depression but was still committed to being a good mom, physician, and wife. Sadly, a few days before her birthday, she could no longer bear her sadness and decided to end her agony. I know many physicians’ …
Read more…
Who are the doctors who end their own lives?
Imagine if your bank handled all your online transactions for free but charged you only when you visited your local branch — and then kept pestering you to come in, pay money and chat with them every three months or at least once a year if you wanted to keep your accounts active.
Of course, that’s not how banks operate. There are small ongoing charges (or margins off the interest they …
Read more…
Most medical offices are hopelessly old fashioned
As a practicing surgeon that has one foot in the world of teaching and the other in corporate health care delivery, I enjoy speaking to students and residents about the future. We often discuss topics like the shift from volume to value, consolidation, insurance models, and specialization.
Often this information is new to them, and overwhelmingly they ask some form of the question: “How will this affect my career?” The following …
Read more…
5 tips on choosing the right medical specialty for you
I’m an ER doc, and I spent my last two decades in the house of medicine. First, training to become a doctor. Then, trying to be a better doctor. No matter how hard I tried, I’ve never been the “perfect doctor.” I started wondering: what makes one a “perfect doctor”?
The perfect doctor lives in the moment, focusing on the here and now: This patient. This case. This encounter. They devote …
Read more…
What makes the perfect doctor?
Burnout is a big and burgeoning problem in the United States. According to a recent Mayo Clinic report, it affects 28% of the general working population. Among physicians, however, the rate is markedly higher, ranging from 44% to 54% in most studies.
More concerning are the consequences: Doctors who report burnout symptoms are twice as likely to …
Read more…
Physicians are suffering, and they need help
The theme of the conference is the medical humanities. After Lawrence Hill’s keynote speech, the lineup of people waiting to speak with him is long. At the end of the day, I’m inspired by the lectures I attended, but disappointed that I didn’t get the chance to speak with Dr. Hill. I should have just stood in line. While waiting on my Uber outside in Hamilton, Ontario, Dr. Hill emerges from the …
Read more…
Medicine needs to buy into the idea of storytelling
Our organization, like most health care providers, is working hard to improve the care we provide to our patients, while also striving to improve the lives of our physicians. All too often, a narrow view of the former can create conflict with the latter. For example, a reductionist view of clinical quality, which equates good care with performance on a small number of “objective” measures like mammography rates and hemoglobin …
Read more…
Let’s stop trying to change what doctors do
“Let me order some labs, and then we’ll discuss where we go from there once I have the results.”
I walk out of the patient’s room and right into one of my nurses. “Zoe, can we start that lady on pressors like we talked about? Her blood pressure is still low after the fluids. I need you to put the order in so the pharmacy can send it up.”
I smile my …
Read more…
The difference between shallow and deep work in medicine
