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.
Death and dying — it is one of the first topics I was taught about in medical school. I was fortunate to attend a medical school that only made us spend half our time falling asleep in lectures. The other half we were in small group sessions, working our way through real patient scenarios, trying to learn to think like a physician.
As part of our first-year curriculum we had to spend time doing …
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A physician explains the afterlife to his child
Writing in Annals of Family Medicine a few years ago, Chicago obstetrician Benjamin P. Brown vividly described his mentor’s interaction with a patient who had just emigrated from Mexico and had no family support. “When he asked earnestly how she was doing, her hard-won defenses seemed to crumple, and all of a sudden she was sitting on the exam table, sobbing,” Brown wrote. “I watched, rapt, as Dr. Gonzales — …
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A strong doctor-patient relationship: why it matters
The past decade has seen an enormous upheaval in the practice of medicine. The private independent medical practice is in danger of extinction. Management overhead and red tape has skyrocketed due to government regulations and private insurance and pharmaceutical benefit rules. Added to that are multiple electronic medical records that need to be implemented, vary from one hospital to another, and often do not “talk” to one another. Thus, it …
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Why doctors don’t like to retire
“I love what I do. I hate what I have to do.”
It’s a quote that doctors attribute to their profession behind closed doors. As patients, we are so overwhelmed with our own problems. We fail to notice that our doctor may be battling her own problems with a complicated system.
But what do we care? Our meeting with the doctor is a paid transaction. We are owed our money’s due. Empathy …
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Remember that your doctor is also human
Three years ago, I left the only path I had ever known to pursue uncertainty on the other side of the world. But let me back up. In July of 2011, five years into my career as an academic hospitalist, the residency work hours changed. Although the intent was obviously to benefit the well-being of the residents and the safety of patients, it took a tremendous toll on attending physicians …
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Fight burnout by following your fear
Mr. Smith was a sixty-eight-year-old man who came to the Veterans Affairs hospital where I was a medical student complaining of chest pain.
“With chest pain, it’s all about the story,” my resident, the physician in charge of our team, said. We talked to him to find out what he was doing when it started, how long it lasted, how intense it was if it was still there.
His electrocardiogram hadn’t shown …
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A case for at-home hospital care
“Oh, you’re a psychiatrist? I hope you won’t analyze me!”
I never know what people actually mean when they say that upon learning that I work as a psychiatrist.
I think they’re saying, “I hope you’re not going to spend our time together trying to discern my flaws.” Nobody wants people to seek out, highlight, and exploit their vulnerabilities and faults, so I can understand that. Of course, that’s not what psychiatrists do.
Anyway, …
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Don’t worry, this psychiatrist won’t analyze you
Gratitude may be more beneficial than we commonly suppose. One recent study asked subjects to write a note of thanks to someone and then estimate how surprised and happy the recipient would feel – an impact that they consistently underestimated. Another study assessed the health benefits of writing thank you notes. The researchers found that writing as few as three weekly thank you notes over the …
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Behold the power of gratitude
Following one of my recent articles on how physicians can improve their communication skills and ultimately help attain better patient outcomes, I received an interesting comment from a physician. It went something like this: “Sorry, but I’m not an actor.”
This response typifies a small (but not insignificant) subset of responses I get when I’m discussing and promoting techniques that any doctor can utilize to better their skills in this area …
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Sorry doctor, you’re already an actor
Dear science,
Today my sons, Oliver and Victor, are 15 years old.
It is not a miracle; it is thanks to you.
Unable to get pregnant I needed infertility therapy. If you had not isolated the hormones, developed tests, and then designed medications for ovarian stimulation and to trigger ovulation I would never have become pregnant.
If ultrasound had not been developed I would not have known I was pregnant with triplets and then …
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Dear science: an appreciation
Doctor: (from Latin docere “teach” Greek phusikḗ epistḗmē “knowledge of nature”) a specially trained and skilled person who holds an advanced medical degree and is licensed to practice the healing arts.
My definition of doctor keeps evolving. As a child, I was cared for by FPs who helped set bones, suture skin and fight infections like measles, chicken pox, and strep. Though I didn’t like going, I usually experienced healing on …
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The evolving definition of doctor
I subscribe to a financial newsletter that happens to be written by a non-practicing physician in a highly specialized field. His daily updates are a mixture of financial and health advice, and he is a proponent of evidence-based medicine. Based on the letters from subscribers, they are willing to follow his advice eagerly, and when he gives some references to support his medical opinions this seems logical. But he is …
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The nuances of a primary care visit aren’t always appreciated
It’s been a gut-punch kind of time for many of us, and I want to say a few things that I think are important.
First of all, I really love working with you guys. It is the best part of my job, hands down. I have taken stock of my career lately, and I keep coming back to that. You are young and optimistic and funny (so, so funny). You are …
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To my residents after a suicide
Last year, my high school aged son took an interest in healthy eating. He began examining nutrition labels and scrutinizing the foods that we routinely keep around the house and came up with a list of criticisms and suggestions — some well-founded, and others a bit extreme. At first, my wife and I were quick to debate him on certain choices like eliminating any breakfast cereal that has enough sugar …
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What parenting has taught me about doctoring
“Yes, you are like that,” said my husband one night as I was lamenting criticism I had heard about myself that day. “I am?” I asked, shocked, a little hurt, and angry. “You are, “ he replied. “Everyone who knows you knows this.”
Gulp.
No one likes to hear criticism. Our lives are so busy, so over-extended, that stopping to hear that something we said or did upset or annoyed someone is …
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Embrace the gift of criticism
Fake news is a term that’s become notorious over the last couple of years. For notorious reasons perhaps. But there’s actually another serious arena where there is inadvertently an awful lot of “fake news” on a daily basis. And that is, well you guessed it: in health care throughout our nation’s hospitals and offices!
Let me explain, and I suspect anyone who works in health care will be familiar with the scenario. …
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The best way to fight misinformation in health care
I was a little taken aback when Dr. C. changed my patient from warfarin to one of the novel anticoagulants. And one I seldom use, at that.
I have only worked with her for about three years, and we seem to come from the same mold: seasoned family docs with a penchant for teaching and patient empowerment. I had not imagined she would step in and completely change my treatment plan …
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Changing the treatment plan when covering for another doctor
