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.
Beeeeeeeeeeep.
The unmistakable long beep of my bright-red code pager broke the rhythmic sound of my trusty breast pump. I grabbed the pager silently praying it was a “test page.” No such luck. As I read the Code 45 message, I heard the overhead announcement echo: “Code 45, East Tower.” I quickly disconnected the breast pump, whipped off my pumping bras and was mostly dressed as I ran from the lactation …
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Having a baby makes you a very different physician
About two months ago, a 15-year-old Native American male was riding around in a stolen car on the reservation. “M” and the driver were drinking. And somehow, after he exited the vehicle at 4 a.m., the car struck him. Hours later, it became clear that something was wrong. M was transferred to our pediatric hospital as a trauma and was found to have an unstable vertebral fracture. Conservative treatment with …
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Non-therapeutic relationship or human kindness?
2016, Kenya
I arrived in casualty (the emergency department) to see a minimally responsive Kenyan boy with a body wasted from malnutrition. His mother stood at the bedside cradling his head, her eyes full of fear. His parents had traveled for days over rugged mountain roads in the rains to get to the hospital. My colleague told me his blood sugar was 10 mg/dL, and the nurse had gone to gather …
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It is time for emergency medicine to expand its circles
My dad flew to California in the spring to meet his grandson, who was about five months old at the time. He wasn’t that interested in baby care. He mostly wanted to sight-see and spend the evenings watching TV. One weekday morning, he ventured out on a hike alone, while I was at work. He left at 9 a.m. and never came home.
We live at the base of a dusty …
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A radiologist saved my father’s life
“Does a rock float on water?” I asked the haggard woman lying in the ICU bed.
I was an intern, in the first rotation of my medical residency, and Mrs. Jones had been my ICU team’s patient for the past week. Over that time, she’d looked more and more uncomfortable, constantly gesturing for her breathing tube to be removed.
Mrs. Jones tried to form words in response to my question, but the …
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What do you do when all else fails with a patient?
I am just another average physician.
It wasn’t my first return from maternity leave, but this busy ED shift wasn’t going well. I kept putting off breast-pumping to complete “just one more thing.” Then my son’s school secretary called. I had told our nanny the wrong pick-up time. She wasn’t answering her phone. I was disappointed in myself and frustrated that I couldn’t leave. But I am a physician — I …
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Average physicians are extraordinary
1. Murphy’s Law as it applies to the ER: If something can go bad, it will do so in a hurry. If it can’t possibly go bad, it will still find a way.
2. Clock’s First Rule: All the patients will crash at the same time. Usually when the computer system goes down.
3. Clock’s Second Rule: The sickest patients will come just before the shift change.
4. Haste’s Theorem: The healthier the …
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68 laws of the ER
Yes, med-peds is a real residency! It is a real specialty! And it is a practicing profession by many physicians today! It can open doors for so many wonderful professional opportunities. It is a discipline that can provide patients and communities extremely comprehensive medical care. People need to know more about this unique and sometimes under-recognized field. And here is why:
Like many people today, I didn’t even know what med-peds …
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The myths and truths about med-peds physicians
It is a known fact, but every generation feels that they had it worst and that other generations have it made.
“When I went to school we had to walk uphill in the snow both ways!” says every grandparent
I identify myself with the Generation X physicians, finishing medical school in 1997 and my radiology residency and fellowship training in 2003.
During this time I have seen quite a change in the medical …
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The generational differences of physicians
I have had several dealings with the benefits managers/HR managers of large corporations and other large organizations over my career. I have one over-arching conclusion about what motivates these people: They will never be a source of disruptive innovation in health care.
I find them to be passive people. They are fundamentally people pleasers. They derive joy from helping their employees navigate their insurance plans, figure out deductibles and co-pays, explain …
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Why managers will never be a source of disruptive innovation in health care
A few days ago, I made a call to my neurologist’s office. The fourth call about the same issue. I needed my migraine medication and wasn’t able to get it. I was almost ready to give up and give in to having migraines on a daily basis. None of the usual preventative medications have worked for me, so I am on one of the new, hi-tech injectable medications for migraine …
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Too many moving parts: Physicians can’t own it all anymore
This weekend was bliss. I went from Friday night to Monday morning without a single phone call. No nursing homes were needing to send a patient to the emergency room: no new fevers or unexpected falls. I can honestly say that it is the first time in more than a decade that I have gone a whole weekend without doing some work. The thing about my half retirement is …
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After a partial retirement, what this physician misses the most
“Red” McDougall had terrible leg pains soon after going to bed. He did have a bad back, and some mild spinal stenosis, but I hadn’t heard much about that in the past few years. He was dealing with the ache in his legs when he was on his feet too long.
A few months ago he saw his vascular surgeon for a routine followup. He’d had a femoral-popliteal bypass to restore …
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When the buck stops with primary care
So many people are suggesting that if only doctors practice self-care we could deflect burnout before it overtakes us. Yes, physicians are probably the worst professionals for taking care of ourselves. We work long hours, answer calls at all hours of the night, take little vacation, work in stressful situations, and often face hostility in the workplace. But this is not the reason we are burning out at high rates; …
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Solving physician burnout requires so much more than self-care
I was having dinner with somebody not so long ago, and the conversation turned to what life is like as a physician. I always find it interesting to have these conversations with people who are not in the medical field, especially those who have got their ideas from watching medical shows on television! The person I was speaking to on this occasion, however, wasn’t about to go down that route, …
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Health care professionals must always be on their A game
In the last year of medical school, all medical students are faced with important decisions about where they would like to complete their residency. For osteopathic students, one key element of this decision is to what extent do they want to be a minority within their program. I am an osteopathic physician. Osteopathy is core to my identity and pride as a physician. I am one of two osteopathic physicians …
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Applying to residency as an osteopathic medical student: myths and realities
