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.
When I was on staff at a large medical center, the CEO established four core values for the institution which he arranged in a diamond pattern: safety at the apex — think of yourself as a patient expectedly at the bottom.
While it seems hard to assess how seriously this widely displayed mission statement was taken, or if anyone really remembered which value went in which corner, the institution expanded. Thinking …
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When a physician becomes the control subject in a study
Physicians and health care providers across the world are trained to treat disease processes and disease states. Often, this approach becomes technical. And while directed towards the patient, it paradoxically distances itself from the patient. The distance created between the patient and the physician through diagnostic and therapeutic approaches is related to the patient’s dissatisfaction with their medical journey.
Being sick and ill, whether it is a major or minor illness, …
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5 things I learned from being a “high-maintenance” patient
Have you heard of the book The 5 Love Languages? My wife will tell you my love language is “words of affirmation,” and I agree. I feel most appreciated when I’m told that I’ve done something well or when my hard work and efforts are recognized, as is the case with most of us.
Gary Chapman, author of The 5 Love Languages, also wrote a book called The 5 Languages of …
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Show your staff you care. Here’s how.
This time of year, I like to walk down memory lane. I remember my first rotation in the neonatal ICU. I was up all night doing heel sticks on preterm neonates, only to have to repeat them when the results came back because the K’s (potassium levels) were elevated from squeezing the heel. The life of an intern and resident on a NICU rotation has changed since I trained. We …
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Plan for your life and medical career with these 3 steps
Nothing quite prepares you for the American cemetery in Normandy, the final resting place for 9,380 lives cut short in World War II. Even if you’ve seen “Saving Private Ryan,” you can’t help feeling an emotional gut punch, a combination of awe, sadness and respect when you see those simple white marble gravestones on the gently curving hills of Colleville-sur-Mer, stretching as far as you can see.
This June marked the …
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Remembering the lives lost — and lives saved — in Normandy 75 years ago
Thirty-six years ago, I arrived an hour early for my first medical school patient care rotation at the East Orange, NJ, VA hospital. Over the years, ‘I’ve seen and learned (and unfortunately also forgotten) a lot about medicine and life. I have been writing down wise nuggets since that first year and keep reviewing and adding at times.
Here are 36 random reflections in honor of these 36 years that I …
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36 things I learned in 36 years of medicine
Being a first-generation college student is hard. Being a first-generation college student and being pre-med is even harder. And since education and income are closely linked in the U.S., it’s no surprise that many first-generation college students also come from a low-income background.
I fell into this category.
My parents did not finish high school, and money was always tight. I had never heard of pre-med until I got to college. I …
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To first-generation college pre-medical students: Your future patients need you
How do you respond when patients with a good prognosis want to delay chemotherapy to try an anticancer diet for a few months or visit an unregulated clinic for unproven therapies? I’m asking because of an alarming finding of ASCO’s 2018 National Cancer Opinion Survey: “Nearly 4 in 10 Americans believe cancer can be cured solely through alternative therapies …” Clearly, we have a problem in today’s discussion about cancer treatments. …
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Alternative cancer therapies and the promise of false hope
After finishing the pitch for my book at a recent Harvard Writers’ Conference in Boston, I felt relieved and encouraged by the judges’ comments. As I waited for my turn at the podium, I glanced above my notes over the faces of 300 of my fellow attendees who had accomplished so much in their respective fields of medicine, nursing, and counseling.
The pitches made by these would-be authors revealed an amazing …
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A physician writes for catharsis
I am a mid-40s female rheumatologist. Fortunately, I consider myself to be fairly healthy; my diet and weight are OK, I run 30 to 35 miles per week, and my only medication is a low-estrogen oral contraceptive that I have been self-prescribing for years. Work and life are busy, and my health maintenance could be better. I have been getting regular mammograms since age 40 (some self-prescribed), maybe I see …
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Why doctors should never practice self-primary care
I recently graduated from residency and fellowship. The last week in-house was a second adolescence. My moods have been up and down. I’d giddily return a parking pass, then surrender IT access in tears. No one could feel this — my — moment as deeply, specifically, or correctly as I could. What word is there for that? There’s song.
Influenced by the new film Yesterday, I melodramatically equated my break-up with …
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4 Beatles playlists for your residency emotions
To fill an assignment in an undergraduate medical sociology class, my friend and I made an appointment with the assistant administrator in a local hospital. After the interview, we proceeded towards the exit by cutting through the obstetrical wards. We passed an exhausted young doctor with a stethoscope draped over his neck and hunched over a stack of charts. He glanced up as we passed, and we introduced ourselves as …
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The secret to ending cynicism in medicine
A lot has been written about board recertification requirements. Physicians have grumbled and moaned for years. The objections have caused changes. Some specialty boards have abandoned the tests. And yet — for most specialties, we still find ourselves turning over our credit card numbers, blocking off a day of our incredibly busy lives and heading for a professional testing center.
On the surface, the process is absurd.
Oh, I get that we …
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Medical board tests are worse than airport security
I am one of those lucky souls who actually likes their job. Since I completed my pediatrics residency two years ago, I have been working in urgent care settings. What’s not to like? I get to see a wide variety of patients, I’m always learning something new, and I get to finish my encounters with a high-five from an overeager toddler. If you’re a general pediatrician like me, that’s the …
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The scourge of the pediatric urgent care fellowship
Every morning, after rounding on Mr. Gregory, I felt like an imposter. As I reported on the worsening crackles in his lungs, his decreasing urine output, the mottling of his hands, we continued to simply give him Dilaudid for pain and continued to ensure that he was “comfortable.”
In this case, I was at a loss for what this “comfort” meant. Mr. Gregory was the first hospice patient I had. And …
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What is the best way to care for a dying patient?
I am a small-town family physician, and I am blessed enough to be living my dream.
You see, I have always wanted to be a doctor. I cannot think of one other occupation choice that has ever entered my brain. I have wanted this since I was four-years-old, and I can remember in vivid detail telling the world this was what I was destined to be.
So what happens when your dream …
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Medicine is my passion. I love my job, but I am human.
After years of being busy taking care of critically ill and recovering neonates in the neonatal ICU, then coming home to take care of my children, I’m making new decisions. One of them is to learn how to relax and be still. It’s a new experience for me. It’s taken years and many shifts to get to this place. And it’s becoming a self-care practice that I really enjoy.
For the …
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Rest is not enough for a busy physician
The way I learned the Golden Rule was: “Do unto others as you would have them do unto you.” Basically, it’s from the New Testament, but the concept goes way back to pre-Christian ancient civilizations in Babylonia, Egypt, India, and China.
So here I am, just trying to do my best as a spousal caregiver, and I started to realize that if I were to take the Golden Rule literally — …
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Do substituted decisions break the Golden Rule?
In family medicine residency back in the early 2000s, we had a then-novel curriculum in narrative medicine. During inpatient rounds, we would sometimes get a few minutes to write down our thoughts about a patient’s experience. I remember how cathartic even refreshing at times that felt, to write my feelings about my first patient on the wards with severe heart failure or that sweet toddler I had to put an …
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Doctors die. But the good ones leave a legacy.
