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.
One of the least motivating requests I received routinely as a new intern was something like, “… and can we make sure this is a discharge before noon?” I recall a particularly eager nursing manager surveying the resident teams on her unit to gauge our interest in arriving even earlier each morning (5 a.m., perhaps?) in order to prepare potential discharges before pre-rounding. We shared a nice laugh.
Read more…
The tension between hospital administrators and medical residents
A physician health program, PHP, is a state agency that is responsible for advocating, treatment referral and physician monitoring, residents and medical students who have substance abuse disorders, psychiatric disorders and/ or boundary issues. There are two ways of becoming a part of these programs, self-referral or be reported. Currently, 47 states have a PHP, and the issue is that there is no set guideline and several variables in the …
Read more…
A physician got a DUI. The physician health program didn’t help.
Your medical training has failed you. When it comes to leadership, acting as the supreme commander — large and in charge — is not solving your problem.
You are racing from patient to patient, running as fast as you can to keep up. You see your income falling while your workload increases and the joy you used to derive in helping people to live healthier lives evaporating. How much longer can …
Read more…
Acting as supreme commander is not leadership
It’s hard to explain what we do. And so maybe, it’s hard for others to sympathize with our situations. I mean, physicians, mid-levels, and nurses in emergency departments are tied to computers in often cramped work-spaces, even as they are required to be at the bedside almost constantly for the latest emergency or (in other cases) the latest bit of pseudo-emergency drama.
If you haven’t worked there, or haven’t for a …
Read more…
Taking food and drink away from doctors and nurses is just cruel
My brother and I are both physicians. He is a pediatrician; I am a geriatrician and palliative medicine doctor. We are both getting older.
My brother has been a practicing pediatrician for almost 50 years. He had a remarkably successful solo practice in the city where he lived. He recently retired but continued to work at a free clinic several days a month. When it became time for him to renew …
Read more…
Aging out of being a physician
My 20-year medical school reunion was a time to reflect: Have we aged more gracefully than medicine? The Class of 1999 carried books and wore pagers while scrambling to gather paper charts for rounds. Residency did not prepare us for the explosion of managed care, EHRs, health systems, and allied health providers. What do I wish I knew then? The hardest part of medicine isn’t becoming …
Read more…
3 tips for physicians to become better leaders
In our office, sometimes our secretaries listen to background music. A few days ago, while walking through the office, I heard an iconic song, written and performed by a songwriting legend. Even someone like me, who was never deep into the music scene, automatically recognized the song. I asked our receptionist, a young lady in her 20s, if she knew the song that was playing. She didn’t. I identified the …
Read more…
How generations can learn a lot from each other
“The hospital room was as cold as dead skin, the hallway crowded with lost souls and reeking of illness.”
― Raquel Cepeda, “Bird of Paradise: How I Became Latina”
Once upon a time, I met a young lady who wanted to be a doctor. I could see the naked determination and resolve in her eyes. Her older sister, who was a friend, asked her to talk to me about her dream.
I asked …
Read more…
Sometimes, medicine isn’t elegant
What really makes a person complete?
What do we want in our lives, and what is it like to become our best, most fulfilled selves?
In the 1960s, psychologist Abraham Maslow tried to answer this question. This eventually led to his well-known hierarchy of needs. You might be familiar with the pyramid.
The premise of the theory is that once we fulfill our basic needs …
Read more…
How physicians can become self-actualized
As a woman physician, practicing for over 31 years, I have faced many misogynistic occurrences as well as misperceptions about my career choice. This blatant devaluation of women within medicine may be similar to what other women have had or continue to face daily. At large, these experiences resulted in a journey not always easy, nor welcomed, but in the end, accepted for the maturity obtained.
My hope is that by …
Read more…
Misogyny in this physician’s medical career
Becoming a physician in 2019 presents its share of challenges.
Providers must deal with reimbursement rates that remain a fraction of their previous levels, adapt to a fee-for-value model, adopt ever-advancing technology as an integral part of care delivery and accommodate a patient-provider dynamic that favors patients — who now demand choice, autonomy, affordability, and transparency.
These developments starkly contrast conditions at the turn of the century. Still, they don’t seem to …
Read more…
4 strategies for success as an aspiring physician
“She is too direct.”
“She sounds overprepared.”
“She is just not that lovely to hear.”
These are just a few pieces of “feedback” that podcast producer Dr. Shreya P. Trivedi has heard about women’s voices over the years. And then suddenly it occurred to her, she had never heard any comments on a man’s voice or the way he speaks.
Though women have come a long way from …
Read more…
Female voices: Achieving the lovely therapeutic range
It’s that time of year when the weather outside is growing colder, the evenings seem to kick off way too early in the day, and the decorations around town remind all of us all of the fast-approaching holiday season.
But for many of us obstetricians, this can often translate into anxiety over how often we’ll be pulled away from long-scheduled holiday activities to rush to the hospital …
Read more…
There’s no place like labor and delivery for the holidays
There are many disparities in health care. Black mothers have a much higher rate of maternal death than do white women. All women are less likely to get guideline-advised cardiac care than do men. Among the many such examples, perhaps the hardest disparity to solve is that of the poorer access to health care faced by rural communities. People living in rural counties have higher death rates from cancer and …
Read more…
Can rural health care be saved?
Dear Congress:
For the vast majority of you, I am not your constituent. But you should listen to me anyway. I am writing to show you that health care in America is not a political issue; it is a human one. The same can be said for immigration or education or any other issue that you work on. Let my patients explain this for me.
I walk into clinic to a full …
Read more…
My patients are America
This time last year, I took the podium at conferences as far away as Dubai to deliver my keynote speech entitled, “On The Cusp Of Life And Death, Choose Life.” My talk highlighted the professional and personal development opportunities that show up as doctors, nurses, and parents navigate the challenges in the neonatal intensive care unit (NICU) caring for preterm and term newborns on the cusp of viability due to …
Read more…
3 lessons physicians can learn from adversity
Harvard Medical School student Chloe Li typically dressed in scrubs or an efficient, professional outfit as she went about learning to care for patients in the intense, year-long clerkship program where I teach.
For her capstone presentation on graduation day, though, she wore a cream-colored wrap-around dress of luscious silk, tasteful jewelry, and an up-do hairstyle. She had clearly put a lot of care into these preparations. She …
Read more…
The unintended consequences of #MeToo in medical education
There is always that one patient. The one with the over-attentive, aggressive family member, who writes a complaint. The one you tried to help, but no matter what, the wait was too long, the nurse too unfriendly, you didn’t sit enough, you didn’t reassure enough, pain meds took too long, you didn’t make them feel important. That one patient who has the time, negative energy, and physical health to write …
Read more…
There is always that one patient
Back in 2016, my hospital, also my employer, changed the EMR. I was fully integrated into another EMR, so changing was not on my to-do list in the later part of my career as a diabetologist.
As you would expect, the transition was a nightmare and took me to a new low in my life. Crying in my wine became my new norm. I became distraught, felt imprisoned, and felt that …
Read more…
What car racing taught me about physician burnout
I’ll admit it. I’m a medical-TV junkie, addicted to 21st-century doctor and hospital dramas (most of which are now streaming on Netflix and other services).
Although some physicians are bothered by sensationalized depictions of their profession, I appreciate these shows for what they deliver: equal parts entertainment and insight. On the one hand, medical dramas are made for our amusement. They’re theatrical escapes from reality, meant to be enjoyed from comforts …
Read more…
Doctors on TV: today vs. 20 years ago
