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.
It has been suggested that once leadership of an organization is made up of 30 percent women, integration and increased success are enjoyed. As an orthopaedic surgeon, the feeling of being surrounded by so many women is not something that I have experienced. But last week I felt something close.
The International Pediatric Orthopaedic Symposium (IPOS) has been held in Orlando, Florida, for the past 12 …
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A tipping point for women physicians at the podium
Veterans do not only matter one day of the year. Beyond Veterans Day, it is not only important to reflect on the lives lost and the sacrifices made by those who served our country, but to ask: are we doing enough as a nation to give veterans the support and care that they need? Veterans deserve to be more than a political football. We discuss “supporting our troops” and “honoring …
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Leaving no veteran behind when it comes to health care access
Physicians receive rigorous medical training for the better part of a decade. However, we emerge unprepared for the real-world job application process to which our friends in other professions are accustomed. One of these logistics includes credentialing and verification for hospitals and clinics where your group intends to practice — a process that can take up to three months.
There are a number of items that are requested during the credentialing …
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12 things you’ll need for a smooth credentialing process
In the mid-1990s, I was working as the medical director for a national computer processing company that had the medical policy and utilization review contract for many Medicaid programs in the United States. Within the first few weeks of being hired, I was invited to attend an IT meeting where the computer project supervisor was going to show off a beta medical reporting program the company had developed for an …
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A physician was barred from attending any future IT meetings
A few years ago, after doing the work and mom thing for five-plus years, I noticed I was becoming increasingly cynical. I was, more often than not, in a bad mood — and I felt exhausted. One day I sat down and asked myself: “What the hell is going on with you?” I realized that I was working all day, only to come home (when I wasn’t working nights) to …
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Take care of you so that you can make a difference for others
A lot has been spoken and written about clinical documentation already. In spite of that, many hospitals still struggle in getting the best out of their doctors when it comes to documentation quality. And although we can cite various reasons for this, we can all safely agree that the hospital EMR is the single biggest influence when outcomes to efficiency and quality of documentation — both in terms of compliance …
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The 3 goals of clinical documentation
I have received several phone calls in the last few weeks from young adults requesting information about their last vaccinations. They are traveling to areas of the world that suggest or require certain vaccines and do not remember if they had them or not. Others are applying for positions of employment which require travel and the employer’s human resources department needs the patient’s updated vaccination records.
When we tell them that …
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When consumerism and convenience goes wild for no good reason
I stood at the doorway of the funeral home, a 26-year-old woman lying in the open casket off to the side. Standing out among the crowd of mourners was a tall man holding his one-year-old daughter, her curly locks of hair bouncing as he moved.
It was only two years ago that I first met her. “We were just married a couple months ago. I must have gotten pregnant on our …
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When a physician attends the funeral of a patient
I recently completed my internal medicine residency training. Three years, thousands of hours, thousands of patients, thousands of decisions. I certainly learned a lot from the past three years: everything from what “HFrEF” means and how to manage it, to treating recurrent C. difficile colitis, to how to share decision-making with patients about whether or not to start anticoagulation in atrial fibrillation. Despite the multitude of lessons I have learned from my co-residents, …
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3 lessons this physician learned from her patients
A New Mexico woman, suffering from Dercum’s disease (adiposis dolorosa) which causes painful fatty tumors, is suing a Santa Fe hospital and an emergency physician claiming she was the victim of two negligent acts in 2016.
One, according to the Albuquerque Journal, she told hospital personnel she was allergic to Dilaudid but went into cardiac arrest after receiving an injection of the drug.
Two, despite the presence of a lawfully …
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A patient sues when a DNR is ignored
5,177.
That’s the current number of “cc’ed charts” as of this morning in my electronic health record in-basket.
While it might sound like a lot, this is not at all an unusual accumulation, partly due to the fact that I receive a notation every time a patient at our practice gets a flu shot, and also every time one of my patients or …
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Electronic health records: Separating the signal from the noise
Stefania was a 17-year-old Russian girl who presented herself to a port of entry in the United States seeking asylum. Stefania’s journey to this point was an unimaginable one. In her home country of Russia, she was a happy high school student living with her mother. Her father died of a heart attack six months prior. Then one day on her way home from school, she was kidnapped by the …
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The value of an immigrant child
For the last 25 years, I have had the privilege of being a designated airman medical examiner by the Federal Aviation Administration. To earn that privilege, it required flying to FAA headquarters and taking a one-week training course followed by refresher training material every three years.
The FAA grades medical examiners annually by our judgment and decision-making. The nature of the questions we are required to ask the pilot candidates, and …
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The rewards of being a designated airman medical examiner
I recently attended a cardiology conference where a speaker proudly presented a case of shared decision-making. It involved a young female athlete who had survived a cardiac arrest and was diagnosed as having an anomaly in her heart conduction system, putting her at risk for arrhythmia during exercise.
She had received an implantable cardioverter-defibrillator, and the decision in question had to do with whether she could resume sports activities or not. …
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Is shared decision-making applicable to only a minuscule fraction of encounters?
My heart broke a little this week.
When you want to grow a muscle, you have to damage it first. You have to lift something heavy and overextend it. It’s sore for a few days — and then it grows stronger.
That is what happened to my heart.
My oldest son started high school. I got up early to exercise and was running back to the house to have a quick cup of …
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A physician mother and how her heart shattered
I am a mother. A wife. A daughter. A sister. A friend. I am a doctor. I am a runner. Just like everyone, there are many pieces to my core identity. These are the traits that encompass the fixed view I hold of myself. These ring true for me, even when (at times) reality paints a different picture.
I just went for my first run in over three months. Viewed from …
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We can empower patients by validating their perceptions
I’ve always believed in looking the part as a physician. So much so that I even write about it! You may have read my piece that became widely circulated online, about why physicians should always dress to impress. The article generated quite a response, and I received a lot of interesting comments and emails. Of course, not all physicians are in a specialty where they can do …
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Why this physician doesn’t dress down when rounding on weekends
Three years ago, I had a massive, life-changing event. It passed with little notice; it was beyond banal and happened while eating sushi with a colleague in a landlocked state.
Here I am with a young patient at the direct primary care practice I opened in Kansas City, Kansas, after residency.
We were in our last year of residency (he in internal medicine, myself in family medicine) and had realized that we …
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Why we need more physician entrepreneurs
In family medicine, there’s a minor obsession with the word “pipeline.” The term makes me want to scream. Just think about a pipeline. The “line” part is superfluous. A pipeline is actually just a pipe. Our goal is to stuff prospective mission-driven family physicians into a big pipe, confine them there and apply large amounts of pressure to push them through this pipe as quickly as possible, lest the pressure …
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A minor obsession with the word, “pipeline”
