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.
Several years ago, my daughter Emma introduced me to some videos on YouTube of a dermatologist from California who posted her sometimes shocking but always intriguing encounters with patients who suffered from a variety of dermatologic issues. Of all of these videos, it seemed like the ones which made Emma happiest to watch were the videos in which this doctor’s treatment resulted in gallons of pus draining from some part …
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When Dr. Pimple Popper teaches us something more
Many organizations solicit private donations from benefactors and philanthropists. Is there a stadium in the country that does not bear the name of a prominent donor? There are also anonymous donors who are not cursed with egos that require their names to be emblazoned in giant font on a building’s façade. But, most donors want recognition which is often used as an incentive when soliciting the donation.
Donors understandably receive perks …
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The problem of physicians and nurses connecting patients with hospital fundraisers
From the sublime to the ridiculous.
That’s sort of how my day went yesterday.
It started out with an early morning meeting with a colleague who has been implementing a telehealth program at one of our institution’s practices, learning about how they have been using this technology, some of the bumps in the road they’d hit, and how they’d been able to …
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In the age of EHRs, why are we still asking patients to fill out paper forms?
“Sometimes sh*t just happens.”
Just a few days ago, I finished yet another string of four hectic shifts in the ER of our incredibly busy trauma center. After saying my goodbyes to my coworkers and transferring the care of my remaining patients to my partner, I left the building through our ambulance doors, avoiding the main pedestrian entranceway where the hectic waiting room sat.
It was a safe choice to leave this …
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The man who defecated outside the ER
No matter what profession you are in, having uncomfortable and difficult conversations is something you have to get used to. Tim Ferris said in his bestselling book, The 4-Hour Workweek (which I’d highly recommend), “A person’s success in life can usually be measured by the number of uncomfortable conversations he or she is willing to have.”
It could be with another colleague, a client or customer. Even in your personal …
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A key strategy to use for difficult conversations: Ask questions
I recently read an article in a peer-reviewed journal citing the benefits of a few eggs per week as part of a low carbohydrate dietary intervention for Type 2 diabetes. The information was so meaningful about a controversial food source of protein that I decided to write about it in my blog and pass it along to my patients. Three days later the American Heart Association and American College of …
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The tension between guidelines and individualized treatment
I keep thinking about the dichotomy between covering a lot of ground and getting to the point.
The other day I saw my bosses at one of my clinics stop in their tracks when I suggested that a lot of the things we are measured on as physicians could be turned into standing orders and simply get shifted off my plate. I have just created a letter that anybody can send …
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Physicians are problem solvers and artists
The Match is complete, and now the fourth-year medical students are preparing to make their move to residency and chief residents are preparing to start their new career as an attending. The next phase of their lives is about to begin.
The Match got me thinking about a comment I read recently from a doctor who decided to not become a general surgeon, which she had always wanted to be, and …
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Your home life is what you make it. Don’t let your specialty control you.
How doctors treat patients’ need for information has changed significantly over the past decades. Sixty years ago medical practice was much more paternalistic than it is now, although some would say it continues to be so in important ways. Still, not too long ago it was common for doctors to tell patients or their families next to nothing about what was going on. The presumption always was: the doctor knows …
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What to do with physicians who don’t explain
Our practice will no longer see nursing home patients in our office. If a nursing home patient is already established with us, then we will see him; but, we have decided not to accept new patients.
Of course, we believe that these individuals — like the rest of us — deserve medical care. This demographic not only deserves care, but has the greatest need for medical services. Our practice will see …
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Why this physician will no longer see nursing home patients
I’ve known Pat McCann (identifying information changed) for many years. He carries a diagnosis of COPD and has a preventative and a rescue inhaler, but he has never really had any serious flare-ups.
He fell and broke his hip. Then he went to skilled rehab, one of a half dozen near Cityside Hospital. His stay turned longer than expected because he fell, luckily didn’t break anything, but had to go back …
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A diagnosis of pneumonia in a rehab facility: We can do better
If you’re done with your residency or fellowship, you’ve paid your dues. And I am excited for you. Life is about to get better. A lot better.
If you read my prior article about going unmatched, you know that things have not always gone smoothly for me. But now, after a reasonably good first year out of training, I feel compelled to reflect on why things are going well, and also—to offer any …
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10 tips for success after you finish residency
A piece of advice I would give to any younger physician, especially one who is just graduating residency, would be to expect a whirlwind ride into the realities of frontline medical practice. It’s something that you are totally not prepared for in the controlled environment of education and residency training. A steep learning curve awaits you once you start practicing medicine. And one of the biggest things you will have …
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Physicians: Do not be intimidated by administrators
I received an email from our hospital accreditation coordinator/quality coordinator in a manner that wasn’t clear if it was directed to me personally or if it was sent to the entire medical staff. It said that she was reviewing the Joint Commission’s recent survey which found that the charts did a poor job of reflecting the patient’s “code status.” The institution only received a 40 percent rating.
Some patients were listed …
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Don’t ask caregivers to be data entry clerks for the Joint Commission
For centuries, doctors felt that their notes were their property, and none of the patients’ business. This attitude slowly shifted, and the Health Insurance Portability and Availability Act (HIPAA) of 1996 put into law the fact that patients must be allowed to review and get copies of their medical records. Despite this, access to records has remained a daunting task for many. A study done in 2017 of 83 hospitals, …
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Why patients should read their medical notes
“I want to see the doctor. Not you. I don’t like your kind. I want to see a white doctor, a man,” a patient gasping for air in an emergency room says to the dark-skinned resident assessing her vitals.
“Speak slowly, I don’t understand you people,” a male patient says as an ethnic attending discusses a complicated procedure to obtain consent.
“Are you sure you are old enough to be a doctor?” …
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Discrimination against doctors is costing us
