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.
Physicians are overwhelmed by patient loads, 10-minute visits, the wealth of documentation dictated by health insurance requirements and the overwhelming overtaking of medicine by non-physician personnel.
Wellness programs abound, which addresses the symptoms of a problem.
As medicine changed from patient to profit-centered, it marked the beginning of the end. We see articles on physicians fired or coerced into resignation for speaking up about non-physicians overstepping boundaries putting patients at risk. Physicians …
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The demise of medicine: A neurologist advocates for patients and is silenced
So last week, I did the bravest thing I have done in a very long time — I quit my job. Yes, I put in my 60-day notice. This was my dream job post service in the U.S. Air Force. I had dreamed of working in this establishment for months before my service time was up. I could not have been happier when I joined their team, a group practice …
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Why this physician quit her job
The upgraded responsibility and authority given to starting residents is both a blessing and a curse. Suddenly, the need for co-signatures vanishes. There is greater autonomy in clinical practice. Residents get paid. However, residency can also be a time of significant stress. Residents are forced to navigate the demands of preceptors, other residents, medical students, nurses, patients, family members, and administrators. Residents have very little control over what they do, …
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10 ways to make residency less stressful
“It kind of strips you of any pride that you have. It was very humbling.”
As a care manager, Mary helps patients follow their care plans by coordinating medical visits and community resource referrals, but this was the first time Mary shadowed one of her patients out in the community. At the food bank, Mary watched her patient, who was living with diabetes, receive one box of macaroni along with other …
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How to be aware of patients’ non-medical needs
1. Our health care system is broken, and there isn’t going to be an easy way out. Costs are too high and our outcomes too poor. There’s a lot of finger-pointing in how we got to this point, but one thing is for certain — physicians must lead the way to a better system. The heart of health care is still the doctor-patient relationship and that needs to be protected at …
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10 things I’ve learned 10 years after I finished medical school
Fourteen hours into their shift, the intern headed down to the lobby to pick up the delivery. Today it was Indian food. He struggled to push the elevator button while holding the bags but managed to make it up to the top floor ICU. The rest of the surgeons gathered around the table cluttered with spent pens, journal articles and unused bottles of lidocaine to eat. Someone offered up their …
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Time is a gift in the ER
Imagine spending days or even weeks in an emergency room without treatment for a broken leg or painful kidney stone.
Patients in psychological crisis across the country are living this exact scenario. Long waits in an ER, hospital room or prison for an inpatient psychiatric bed, otherwise known as psychiatric boarding, are their unfortunate reality.
Rewind to over 50 years ago — as institutionalized patients were gradually integrated into communities, the availability …
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Let’s talk about the psychiatric boarding crisis
I began practicing as an internist/nephrologist in the early 1960s. Having rented an office in Los Angeles, I introduced myself to the local medical community and set out to build a practice.
With a growing family, a mortgage and an office to support, I was hungry for patients. Hospital emergency rooms were good referral sources, so I took ER call at three different hospitals.
Late one Friday night, I got a call …
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You can’t always expect a miracle, but you can always hope for one
Can the health system survive?
It comes down to the people. It is not about their work, but how they feel: feeling valued, feeling their work is valuable to those they serve, and feeling valuable doing the work. It is work as an extension of what you believe, what you love and how you want the world to be reflected back to you.
For 22 years, I have watched systems work to …
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Want to change the health system? Find your why.
I have a fantastic leader as our chief. He develops a certain softness in his voice and demeanor when he has to sit down with me and share some concerns. It’s like he is on my side. It’s like he believes in me. He thinks this was an act, but this is not who I am. I am trying to emulate this quality in me as a person and a …
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What do you do when you’re criticized?
There’s this prevailing theme in modern medicine that I don’t understand. It’s called: “Do no harm to others, but neglect yourself.”
It’s perpetuated by ridiculous working hours, emotional, psychological and sometimes physical stress, minimal vacation and maximum pressure to always do a little more. Did you overwork yourself as an undergrad, watch your hair fall out during MCAT studying, then give up family and friends for a fire hydrant of information …
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Doctors: First, do no harm to yourself
A colleague recently sent me a link to the American College of Cathopathic Physicians a new organization whose mission “is to protect the professional autonomy and advocate for a full, broad scope of practice for DNPs as a ‘cathopathic physician’ completely equal in every way to our MD and DO counterparts.”
I was, I admit, so stunned by the statement that I thought the whole thing might be an elaborate joke. It was only …
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Not all doctors are physicians
Walking through the dark construction zone of my now demolished kitchen, I made my way to the garage and out into the still, hot, humid July night. The air felt so thick, it was hard to breathe. At 1 a.m. I was headed to the hospital for a patient that just arrived in active labor. On the drive in, I had the air conditioner blasting to cool off the car …
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Addressing physician self-care means getting doctors more sleep
Burnout has been a descriptive term for years, but lately, psychologists and others have assigned it specific characteristics with a view toward being able actually to study and measure it. One common definition of burnout is a state of chronic stress that leads to physical and emotional exhaustion, cynicism, detachment, and feelings of ineffectiveness. The PICU environment is often one of high stress, so it’s a place where this …
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Burnout in pediatric intensive care physicians
Believe it or not, the topic of work-life balance can be quite controversial. It’s a concept that can seem almost impossible to attain, so some people regard it as a myth: “a pie in the sky” idea of sorts. As surprising as it seems, work-life balance is very much attainable, and my personal experience is a testament to that.
This concept is the best thing since sliced bread. Honestly, why would …
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Work-life balance doesn’t have to be a myth
Match Day is the culmination of a medical student’s education: the day all graduating seniors and non-traditional applicants find out where they will spend the next three to seven years to train in a desired specialty. I fell in love with obstetrics and gynecology (OB/GYN) as it was the perfect way to combine my passion for women’s health with medicine and surgery. I also liked that the patients were relatively …
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What’s life like after not matching? A physician’s story.
Recently I was saying goodnight to my oldest son, who is now 14 and about to enter high school. I was standing in his bedroom looking at his midnight blue walls, which are covered in each of the planets. He looked up at me from his Pottery Barn bunk bed and said, “Mom, I need a new bed … and new walls.”
I stared at him, realizing my son was no …
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A physician mother and her son
This was the end-of-the-hallway conversation with an elderly patient after wrapping up a recent office visit, as we walked away from the exam room toward the front desk to schedule her follow-up appointment, and she realized that we were “celebrating” 20 years together.
I met her when she was admitted as an inpatient when I was on service as a junior attending just starting out, and after going home she came …
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It’s time for an army of people to help take care of our patients
A natural part of life is emotionally growing (hopefully) with experience. If I was to look back at my own journey, when I was in medical school and just graduating, I would say that without doubt, one of the biggest things I would tell my younger self, would be to not take things too personally. This would be particularly true in professional situations.
I look back at how personally I used to …
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Physicians can’t take things personally. Here are some tips.
