Physician

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.

A physician’s perspective on California’s Camp Fire

Joshua Elder, MD, MPH

Physician

November 20, 2019

Working as an emergency physician at a level 1 trauma center and as an Army reserve officer, you learn to expect the unexpected – but working as the ER doctor taking care of patients impacted by the most deadly and destructive wildfire in California history last year changed me.

As I walked into work last year to start my clinical shift as the attending emergency physician, our hospital began receiving multiple …

Asking physicians this one simple question may hold the answer to burnout

Dianne Ansari-Winn, MD, MPH

Physician

November 20, 2019

Many health care organizations across the country are taking leaps to address burnout. There are advisory boards formed solely to tackle the issue, access to yoga and meditation, as well as online programs and interactive workshops — just a few examples of efforts aimed at curbing this epidemic. These are steps in the right direction. However, physician burnout is a systemic problem, rooted deep in medicine’s culture, and these steps …

How this physician does less in primary care and accomplishes more

Hans Duvefelt, MD

Physician

November 19, 2019

So many primary care patients have several multifaceted problems these days, and the more or less unspoken expectation is that we must touch on everything in every visit. I often do the opposite.

It’s not that I don’t pack a lot into each visit. I do, but I tend to go deep on one topic, instead of just a few minutes or maybe even moments each on weight, blood sugar, blood …

Choosing family over medicine: Why I decided to leave clinical medicine

Kelli Randell, MD

Physician

November 19, 2019

When my obstetrician told me I was not going back to my clinic that afternoon due to severe preeclampsia, I was so indoctrinated that my first thought was of the inconvenience to my patients who would need to be rescheduled. Only a few minutes later did it register that I would be giving birth sooner than I had anticipated, and my new life as “working mother” would begin.

I was due …

3 things every hospital should invest in

Christine Lau, MD

Physician

November 18, 2019

In the current health care system, patient outcomes, and patient satisfaction are increasingly important. With the hospital value-based purchasing program, Medicare adjusts payments to hospitals based on the quality of patient care they provide. Hospital consumer assessment of health care providers and systems scores are tied to Medicare reimbursements. Under the hospital-acquired condition reduction program, hospitals in the highest quartile of hospital-acquired conditions are subject to a 1 percent payment …

Does the patient come last in health care?

Xrayvsn, MD

Physician

November 18, 2019

In the service industry — which as physicians, we certainly are a part of — a popular saying is that the customer always comes first.

The implication is that in order to thrive in an industry, you have to cater to the customers/patients as it is they who will ultimately decide where they take their business.

In medical school, the emphasis on prioritizing the patient was evident, culminating in the Hippocratic Oath …

Great books make better doctors

David Rosenfeld, MD

Physician

November 18, 2019

After spending much of the first 40 years of my life poring over textbooks and medical journals, I decided to start reading literary fiction. At the time, I had no ulterior motive — only a vague sense that I had been missing something important, a metaphoric vitamin without which my development would not be complete. I certainly did not expect that the great novels would make me a better doctor. …

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Great books make better doctors

Don’t judge patients for researching their health issues

Suneel Dhand, MD

Physician

November 17, 2019

It’s difficult to imagine a world now without Google and the internet. It’s also strange to think that most people alive right now received the bulk of their education in the pre-internet era. I remember in the United Kingdom, where I went to medical school, Google only became a thing perhaps midway through university. Since then, of course, the internet has exploded and penetrated every facet of our lives. And …

“How are you doing?” A simple question with a big impact.

Johanna Vidal Phelan, MD, MBA

Physician

November 17, 2019

From October 25 to October 29, 2019, more than 10,000 pediatricians from all over the world gathered in the city of New Orleans, Louisiana, to attend the American Academy of Pediatrics (AAP) National Conference and Exhibition.

As the world’s largest pediatric medical education event, the AAP National Conference draws pediatricians, like me, to network with mentors and colleagues, learn about the latest clinical guidelines and policies, and be inspired to renew …

Don’t forget to manage your patients’ dignity

Nana Dadzie Ghansah, MD

Physician

November 16, 2019

Just before I induced anesthesia, he said, “Doc, I want to apologize beforehand. I am incontinent due to a previous surgery so I might wet the sheets.”

I told him not to worry and that we understood and that “these things do happen.” His response has stuck with me: “Doc, but there is still some shame.”

I nodded, told him not to worry since he was going to get a catheter anyway, …

Doctor by day, law student by night

Melanie Heniff, MD

Physician

November 16, 2019

I am a middle-aged, full-time emergency physician, and part-time law student. Usually, I practice medicine during the day and attend law classes in the evening. Sometimes I have law classes in the afternoon or early evening then work in the emergency department all night.

So, what’s harder: medical school or law school?

Absolutely the most common question I am asked by physicians, attorneys, and students at all levels of training.

The other most …

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Doctor by day, law student by night

A physician reflects on the worth of a decade

Ankita Sagar, MD, MPH

Physician

November 15, 2019

At first, I thought the light was reflecting off the mirror. But no. There It was – my first gray hair. I did not expect to live to see the day. I was ecstatic! At six months old, I was diagnosed with a severe illness called thalassemia major and was incorrectly expecting to have passed by now. (Google told me so!) Yet, this year, I complete ten years beyond my …

Lawyers have figured out what doctors haven’t

Allison Edwards, MD

Physician

November 15, 2019

Dear lawyers:

You got it right. Your operations make sense. I know this is wrong for me to say — doctors and lawyers are often at odds with one another — but I have to tip my cap here. I have this unsettling feeling that — from a professional standpoint — your billing practices make sense. And the way you do your documentation also makes sense. Your delegation and hierarchy make …

Fight burnout with a higher power

Cristina Carballo-Perelman, MD

Physician

November 14, 2019

As physicians, we are constantly faced with a daily barrage of meeting minimum RVUs, while keeping up with EMRs as part of the necessary components to successfully practice medicine. This has resulted in a decrease in personal interactions with patients, which has caused an increase in physician burnout and suicides. Attempts to reverse these negative impacts have resulted in instituting wellness and meditation clinics and debriefing after traumatic clinical events …

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Fight burnout with a higher power

From a neurosurgeon: You need a family doctor

John Spitalieri, DO

Physician

November 14, 2019

One of my favorite scenes in the recent Apollo 11 IMAX film was a dramatic panning shot of mission control moments before lift-off. Row after row of mission specialists, engineers, astronauts, communications technicians — all looking ahead in silent, unbreakable focus. All 100 percent dedicated to the three men about to lift-off into history. It was a truly mesmerizing portrait of teamwork.

While astronaut safety is the focus of every individual …

Here’s why you need to find compassion for yourself

Heather Krantz, MD

Physician

November 13, 2019

Self-compassion. Perhaps this sounds like a contradiction in terms. Compassion is expressed for others, not oneself.

Compassion, as defined by the Merriam-Webster dictionary, is the “sympathetic consciousness of others’ distress with a desire to alleviate it.” Compassion is about allowing oneself to be with the emotional discomfort of someone else’s suffering with the hope of lessening it. Health care personnel do this every day.

It is part of being human to have …

Why this physician wanted to be a head and neck surgeon

Bruce Campbell, MD

Physician

November 12, 2019

Head and neck cancer surgeons know when “the questions” are coming. A casual conversation eventually turns to, “What do you do for a career?” The pleasant exchange is replaced with talk of disfigurement and life-threatening illness. The person’s brow furrows. “How can you deal with that day after day? Isn’t it depressing? Why didn’t you pick something happier for a career?”

These are legitimate questions. As a medical student many years …

What it really means to support your female colleagues in medicine

Maricela Schnur, MD, MBA

Physician

November 12, 2019

I always knew there were disparities regarding men and women in the field of medicine. However, at the beginning of my training, these inequalities seemed so fictional to me, I could only compare them to dragons and unicorns. The fact that this topic was only occasionally mentioned seemed to solidify my belief that inequalities between female and male physicians were rare. My mind was solely focused on the various aspects …

Debunking the myth that life gets easier once you finish medical training

Brent Lacey, MD

Physician

November 11, 2019

Residents and fellows around the country have bought into the “medical training myth.” The myth states: “Life will get so much better when I finish residency/fellowship.”

Sadly, too many house staff buy into this false belief and experience tremendous letdown when they graduate.

Residents often see their attending stroll into the team room with a cup of coffee at 8 a.m., ready to round. Meanwhile, they think, “I’ve been …

How race plays a role in palliative care

Eve Makoff, MD

Physician

November 10, 2019

“Black life remains unexpected.”

I have been mulling over these words written by Ibram X. Kendi, in The Atlantic. This followed his piece exploring the “anniversary” of slavery in 2019. He experiences this 400-year marker both with hope and concern given the persistence of a split America: “Black death matters to racist America. Black life matters to African America.” He writes, “there may be no more consequential white …

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