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.

How this physician does her job while grieving

Dr. Caroline Macari

Physician

May 23, 2019

Two years ago, something happened that — not to be overly dramatic — changed my life, including my everyday experience of my job as an emergency specialist.

My older brother, Martin died of a rare and aggressive form of non-Hodgkin’s lymphoma that spread despite every treatment that was thrown at it.

When he was dying, I managed to unleash in myself a raging anxiety, which caught me by surprise. In the year …

Physicians shouldn’t get too attached to the organizations they work for

Suneel Dhand, MD

Physician

May 21, 2019

One of the biggest changes to health care over the last 20 years has been the corporatization of medicine, from small independent physician practices, to large corporations that now run the show. Medicine has gone from good old Dr. Johnson’s office around the corner, to a world of boardrooms, megamergers and takeovers. This has enormous downstream effects — not least to the way physicians practice medicine and their …

Celebrities are bringing a myriad of health conditions into the public consciousness

Joshua Mansour, MD

Physician

May 21, 2019

It seems now as if every day and every month is associated with a “national day” or an “awareness month.” Some such as “national taco day” may be less important than others, well depending on one’s priorities. Although many illnesses now also have a dedicated day or month, many of these diseases will go unnoticed. They will rarely be discussed — that is until a celebrity or someone in the …

Avoiding medicine’s Boeing 737 Max

Marc Braunstein, MD, PhD

Physician

May 20, 2019

I’m sitting on a cross-country flight to California with utmost respect for the professionalism of the crew, especially considering my life will be in their hands for the next 6 hours. Despite understanding the physics, I am still amazed by flight, and even more so by the coordination required to manage the logistics of shuttling so many people and their luggage around the world.

As health care leaders apply a business …

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Avoiding medicine’s Boeing 737 Max

Is primary care an unnecessary roadblock?

Hans Duvefelt, MD

Physician

May 20, 2019

A lot of Americans think they should be able to make an appointment with a specialist on their own, and view the referral from a primary care provider as an unnecessary roadblock.

This “system” often doesn’t work, because of the way medical specialties are divided up.

If belly pain is due to gallbladder problems you need a general surgeon. If it’s due to pancreas cancer, you need an oncologic surgeon. If the …

Even the most seasoned patients are no match for the Medical Insurance Industrial Complex

Michael Kirsch, MD

Physician

May 19, 2019

“Does my insurance cover this?”

I cannot calculate how often a patient poses this inquiry to me assuming wrongly that I have expertise in the insurance and reimbursement aspects of medicine. If I — a gastroenterologist — do not even know how much a colonoscopy costs, it is unlikely that I can speak with authority to a patient’s general insurance coverage issues.

Of course, patients assume that we physicians have an expansive …

Should we write that patients are “pleasant” in medical notes?

Paul Sax, MD

Physician

May 17, 2019

When writing medical notes, some clinicians include an appreciation of their patient’s personality and disposition in their opening line (the “chief complaint”), or when they’re wrapping up (in the “assessment and plan”), or in both locations.

You know — it goes like this:

“CC: Ms. Smith is a very pleasant 62-year-old woman admitted with …”

or:

“A/P: To summarize, Mr. Jones is a delightful 89-year-old man presenting with …”

or:

“CC: This lovely 74-year-old retired school teacher was in her usual state of health …

This story happens every week in clinics like mine and it’s got to stop

Hans Duvefelt, MD

Physician

May 17, 2019

Jeanette Brown had lost twenty pounds, and she was worried.

“I’m not trying,” she told me at her regular diabetes visit as I pored over her lab results. What I saw sent a chill down my spine:

A normal weight, diet controlled diabetic for many years, her glycosylated hemoglobin had jumped from 6.9 to 9.3 in three months while losing that much weight.

That is exactly what happened to my mother some years …

Doctors, stay human

Lizbeth Hingst, DO

Physician

May 17, 2019

She was a middle-aged female who was life-flighted from an outlying facility to the tertiary care hospital in which I worked. As she quickly rolled out of the elevator, I ran toward her and saw her blood pressure was tanking with her mentation fluctuating. My hair mindlessly placed in a ponytail, my blue scrubs wrinkled, and my nerves a jumbled mess, EMS briefly gave me an account of her history: …

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Doctors, stay human

How music changed this physician’s life

Cory Fawcett, MD

Physician

May 16, 2019

We have all received many gifts throughout our lifetime. Most are long gone and forgotten, but a few gifts stand out as favorites. As kids, we are given so many toys that we don’t even remember most of them. As we get older, practical gifts like ties and socks are given. Sometimes people don’t know what to give us, so we get gifts we don’t even want or need. There …

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How music changed this physician’s life

An experiment in removing the heart from medicine

Janice Boughton, MD

Physician

May 16, 2019

I delight in learning my patients’ stories and giving them exactly what they need when I take care of them in the hospital. Who they are and what is the best approach to their problem is the primary mystery to be solved, my Sherlock Holmes moment. This is why, if somebody asks me, I will tell them that doctoring is the best job in the world. The opportunity to connect …

The inspiring story of how a physician fought MOC against all odds

Meg Edison, MD

Physician

May 16, 2019

Well, I won. Six years after I started down the very slow process to end forced MOC in my state, it happened. On December 27, 2018 Michigan governor Rick Snyder signed HB 4134 and 4135 into law. The harm BCBS caused me and my patients will never happen to another pediatrician in Michigan.

I know. Crazy. I’m still in shock. It’s taken a while to process it enough to …

How a Minnesota Supreme Court decision could affect curbside consults

Christopher Johnson, MD

Physician

May 16, 2019

“In a case that could have wide-reaching implications for medical practice in Minnesota, the Minnesota Supreme Court issued a ruling on April 17 in the case of Warren v. Dinter holding that the existence of a physician-patient relationship is not a prerequisite for a medical malpractice action. Rather, a person may sue a physician for malpractice – even if that person was not a patient of the physician – if the harm …

Second victim syndrome: a doctor’s hidden struggle

Harry Karydes, DO

Physician

May 15, 2019

As physicians, we have embraced a calling where we help others. A commitment many of us fully relish. We are grateful for our patients and the families who put their trust in us as we diagnose and treat their sometimes incredibly complex illnesses. I have been genuinely inspired by the stories I have heard from patients and my colleagues on the work we do.

Yet, in spite of the incredible advancements …

Sexually discriminatory language used against our trainees: There is no grey area

Kate Wonneberger Gardner, MD

Physician

May 15, 2019

“Thanks baby, I mean doctor … Doctor baby …” he finished uncertainly.

I washed my hands, gave him a quick nod, and walked out of the emergency department exam room with my smirking attending following behind me.

Speaking to a group of my female colleagues, it seems everyone has a story or two like this. Starting as medical students and continuing through our practice today, for female physicians there seems to be …

Lawmakers should stop trash-talking health care professionals

Niran S. Al-Agba, MD

Physician

May 15, 2019

Washington state Sen. Maureen Walsh (R-Walla Walla) became a national headline for alleging that “[nurses] probably play cards for a considerable amount of the day” during debate on legislation mandating break periods. Many nurses have mailed decks of cards to Walsh and posted pictures of blood-spattered emergency department walls in order to call attention to “last night’s card game,” driving home the point that they aren’t “playing” anything …

Share your stories and experiences, in written, visual, or media form. Stories matter.

Alya Ahmad, MD

Physician

May 15, 2019

Narrative medicine: I have heard of that, but what is it? I often get asked this question. As a master’s student of narrative medicine, I am still trying to hone in on the best response to that question.

For many, narrative medicine (NM) is not a novel concept. We have watched movies or read books of doctors helping, listening or learning from patients as they wrestle with their illness. Many writers …

Fee for service is not the root of all evil

Richard Young, MD

Physician

May 14, 2019

Some people think that the solution to better-supported primary care is in direct primary care/salaried physician payment models. I don’t think it is the best answer. I realize money is not the only motivator explaining why people perform work. Meaningful work matters too. But meaningful work that is not respected and paid for will not sustain or be the source of burnout and resignation, not only for physicians. I think …

Burnout vs. moral injury: Does it matter what we call it?

Camille Adair, RN, William Norcross, MD, Sam Slishman, MD, and Tami Berry, MD

Physician

May 14, 2019

Yes, we think it does. And the time to act has come. The time is now.

We — physicians and nurses — work side-by-side caring for patients, every single hour of every single day. But we don’t often talk to each other about the (seemingly insurmountable) deep and serious issues and challenges we as clinicians face, practicing in today’s broken health care system. That has to end. We must unite.

We are …

Treating a VIP benefactor of a hospital

Steven Reznick, MD

Physician

May 13, 2019

My local hospital has been petitioning the local city zoning board for permission to build an on-site parking garage for years now. The city zoning board is very strict about the height of buildings and has turned the requests down repeatedly.

This past fall, the hospital administration announced that it needed a capital partner to expand and stay solvent. Most of the members of the hospital medical staff have absolutely no …

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Treating a VIP benefactor of a hospital