We should consider a new position in our primary care teams — that of the scrum master. “Scrum” is a rugby term that comes from agile, a work methodology for software development that now is being applied to industry and health care.
In rugby, a scrum is a huddle where the teams come together with interlocked arms to regroup and start play again. In agile, scrum masters facilitate team huddles and …
A scrum master for primary care
A few weeks ago, I was giving a day-long seminar in California on improving communication skills, optimizing the patient experience, and how this is all ultimately linked to better proven outcomes. Part of the day involved doing role plays, playing the part of doctors and patients in various difficult hypothetical scenarios.
My experience of this type of group exercise is that all clinicians usually really enjoy it, when it’s done in …
Imagine yourself treating a celebrity
School is back in full swing. The kids are packed up, scheduled and loaded with notebooks, pens, pencils, computers, and calculators. Long lines form outside school drop-off areas. Tired, pajama-clad parents drop off bleary-eyed children, accustomed to sleeping and playing all day, now headed off to fill their little brains with knowledge.
Of course, it isn’t just the little ones. All of our children were home over the Summer. Now our daughter is a high school …
Why it’s important to give your children the talk about marriage
Earlier this week, I was pleased to learn that my practice had achieved a statistically significant increase in box clicking.
In reviewing data from our accountable care organization, graphs were shown to us demonstrating improved compliance with several of the measures that they’ve instituted institution-wide for the purpose of reporting back to Medicare on how well we are taking care of our patients.
One of these measures is the ever popular “falls …
Clicking checkboxes doesn’t meaningfully improve care
I do not feel that I truly survived my lawsuit. Sure, I am alive, but the emotional toll it took on me during the four years that we co-existed was tremendous. That being said, I do feel that it taught me several things that may be helpful to others.
My lawsuit occurred very early in my career. The series of events that led up to it happened when I was a …
How to survive a medical liability lawsuit
A guest column by the American College of Physicians, exclusive to KevinMD.com.
It can be as blatant as a public argument between a hospitalist and emergency medicine physician about whether a patient requires admission. But most commonly it is more nuanced and subtle. Such as members of one speciality “bad-mouthing” another or a subspecialist criticizing …
When doctors behave badly: a call for civility
Combating loneliness as a non-medical spouse to a surgical resident is my current struggle.
I do not just mean the absence of his physical self — which do not get me wrong is frustrating– but the complete absence of his mind when he gets home from a long day at the hospital.
Absolutely no one gave me the proper and direct heads up that I needed as to what it would feel …
What you need to know as a non-medical spouse to a surgeon
The National Taskforce of Humanity in Healthcare recently published research showing physician burnout is impacting quality safety, and health care system performance — estimating that “costs for burnout-related turnover may be as high as $1.7B annually among hospital-employed physicians, and $17 billion across all U.S. physicians.” At Stanford Medicine, physician burnout costs at least $7.75M yearly.
These numbers are staggering. Growing numbers of physicians are leaving medicine (surely impacting the physician …
It’s time to advocate for a new culture in medicine
It’s my first day at a new facility — and I’m prepped with food, snacks and a closed-lid container for my morning coffee and to refill it in the afternoon with water. You never really know how stringent the policies will be for water containers at your new workstation or whether food or snacks are allowed. You might even be lucky enough to get a surprise Joint Commission inspection, or …
The issues physicians face when changing their name
Doctors spend their early adulthood preparing for medicine. In college, we take classes to satisfy prerequisites and prepare for the MCAT exam. Medical school has a life of its own. The volume of material to master is extensive, and the pressure mounts to be your best. Next is the interview process for residency training and the anticipation of Match Day.
Then life will begin. Maybe?
Now, you are in your late 20s …
7 keys to having a medical career that serves your life
I introduced myself to the family sitting anxiously in the private room away from the chaotic symphony of beeping monitors in the main ER. When I opened the door, four pairs of bewildered eyes landed squarely and intensely on me. I wanted to look away so as not to betray my own emotions but instead stepped in and introduced myself again — one by one making eye contact. After a …
Your son is dead. How will you remember me?
The other day I felt like a used car salesman.
I was carefully phrasing my words, picking out just the right ones — the kind that really pack a punch — and delivering them at the right moment, with the perfect momentum. I was trying to make a sale.
Now, my cadence happened to be spot on, as I approached the finish line: the part where I get to package it all up. …
Your doctor may need lessons from a used car salesman
My country rotation as a medical student was overshadowed by a heated argument between the general practitioner and his wife. She was sacrificing her life in this “hole of a place” and angrily stormed out to visit her children in boarding school in the city. Decades later, I now understand the frustration and challenges of rural general practice for a doctor, who is also a mother:
Being ignored in the street …
Where this physician finds joy in medicine
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I have a confession.
I didn’t enter my profession to help people. I know. It’s shocking.
Don’t get me wrong. I take my professional responsibility extremely seriously. I’m only admitting that the primary reason for choosing my profession was not altruistic. I made a practical decision to go down this path because of a junior high career day event. Otherwise, I had no real connection to any health care profession other than …
The myth of compassion in health care
About two years ago, I made a big career move — I took a leap of faith. I left full-time clinical practice as a neonatologist to become a national medical director for a neonatal resource team. The job was appealing because it was a new challenge for me. I had the opportunity to use my skill set as a neonatologist while learning the business aspect of medicine.
The job also provided …
A physician takes a leap of faith
This article is sponsored by Careers by KevinMD.com.
Nurse practitioners and physician assistants are both advanced-practice providers with considerable autonomy, but they’re not interchangeable. Each brings something slightly different to the table, and if your practice is considering hiring an advanced-level practitioner, it’s important to understand the differences so you can hire appropriately for your need.
Because medical facilities are …
Should your practice hire a physician assistant or nurse practitioner?
This past week was one of those weeks looming ahead of me that I was already dreading as I entered into it. I was to be working through another holiday and following a string of nights, and I would have a quick turnaround into a mid-shift. As a nocturnist by choice, I rarely work mornings or mid-shifts. I find the nights busy but also less intrusive — i.e., less administrative …
I’m thankful that medicine is a small world
“Wisdom is nothing more than healed pain.”
–Robert Gary Lee
One of the recurring expressions I heard throughout training, from preceptors and attendings to doctors ignoring a lowly medical student/resident eating lunch in the doctor’s lounge, was: “I’m living the dream.” It didn’t take long for me to realize that it was a code meaning anything but. In the last few weeks, I’ve discussed what steps I’m taking towards personal healing and …
Let’s heal the health care community
I practiced general internal medicine from June 1979 until November 2003. Immediately after training, I became an employed physician of an older internist covering my employer’s patients and building my practice for two years before embarking on my own.
I saw 20 or more patients per day in addition to providing hospital care and visiting patients as they recovered in nursing homes. As managed care made its clout felt by kidnapping …
A physician celebrates 15 years in concierge medicine
As you sit here in the office, waiting for this visit to be over, I wonder if you would let me share just a few things with you. Despite your impeccable eyeshadow, your impressive GPA, and the smile you flash so readily, I sense that there are things left unsaid. I am curious if there is more to your story that you wish could be told. But I know that …
You are more than an eating disorder
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