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.
Physician burnout is increasing at an alarming rate. According to a January 2017 AMA Wire report, physician burnout rate has increased from 2013 to 2017 across every specialty in medicine. Greater than 50 percent of primary care providers are burned out. Therefore, every patient at the entry point of medical care is, more likely than not, going to be treated by a burned out physician. The question is why are …
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A relatively simple solution to physician burnout
Physician burnout is the depression of the medical world. We are aware of its presence and the detriment it can cause, but yet, we don’t really like to talk about it. The problem is, just like depression, if we don’t talk about it or seek to address it, it persists and leads to a number of unwanted outcomes including decreased productivity, decreased patient satisfaction, and increase in medical errors. And …
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Burnout: Don’t blame the clinicians; blame the system
The words were like bitter candies that I had been sucking on, hoping to come to a sweet center. I had walked the hallways of the hospital holding them in the silky pocket of my cheek for weeks. Finally, afraid I would choke, I spit them out into the middle of the dinner table.
“I think I’m depressed.”
I stared down at the tablecloth, moisture collecting on the base of my water …
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Fight depression during residency by fostering connections
Recently, I was asked to give a talk on resilience and its role in reducing physician burnout. I was excited by the opportunity, but asked if I could focus more on cultural change and institutional solutions for burnout. When they said no, I declined. Why?
Well, it’s not that I don’t see the value in resilience. A lot of physicians that I really respect write and speak about resilience. I think …
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Physician burnout shouldn’t be linked to resilience
Change and health care are closely interconnected. Health care organizations are continually faced with the need to adapt to change, whether it be advances in medical care or technology, growing demand for care delivery, a patient population that is increasingly active and involved in their own health and well-being, or evolving reimbursement and cost models. By recognizing that change is inevitable in the health care sphere, organizations can focus on …
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What makes you an effective change agent in health care?
The two-page letter of complaint was typed on crested letterhead. The words “utter disappointment” jumped off the page, bold-faced and caps-locked. “The doctors left me to bleed,” she wrote, banging on the exclamation key as if she was firing lasers in a game of Space Invaders. “I was hemorrhaging, and they did nothing except pop in and tell me it would stop.” The tirade was directed toward me and the …
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When the nurses’ work goes unnoticed in the ER
The “Great Man Theory” of history was popularized by the Scottish author Thomas Carlyle in the mid-19th century. In his 1840 “Lectures on Heroes,” he famously wrote: “The history of the world is the biography of great men.” Carlyle claimed that history was made by “great men” possessing personal courage, vision, charisma and political or military genius. Our more egalitarian age has favored mass movements, social forces and “great ideas” …
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Barbara Bush: The First Lady of palliative care
Do you ever feel like time is always slipping away? Do you feel like you hardly get time to enjoy the things you love? For example, do you feel like you get enough time in your day to spend with your kids? If your answer is “no,” welcome to the club. You are not alone! I am a physician mom of young kids who used to feel like I never …
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A physician’s guide to getting more time with family
I’ve written in the past about how words are powerful — that they can have multiple meanings, how they can change depending on context. I am often reminded of how true that is in everyday oncology practice, especially when it comes to meeting new patients. Some are diagnosed with cancers that carry a relatively good prognosis, …
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Words are powerful. Use them carefully.
We are living in times of extreme political polarization in the United States. In fact, it’s a trend sweeping the Western world right now. I’ve always considered myself somewhat middle-of-the-road, and I vote much more for the candidate than the political party. Of course, I have my own strong views on certain issues, but I’m probably the type of swing voter that parties want to target because admittedly my voting …
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This physician explains why he’s a moderate voter
May lay in a hospital bed, her wrinkled skin covered with sensors that monitored her every breath and heartbeat. Her husband sat at her bedside gently stroking her withering gray hair as her chest moved slowly up and down accompanied by the soft whoosh-whoosh of the ventilator that breathed for her.
He stared expectantly at her face as if at any moment she would rise and free herself from the multiple …
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When someone is not dead but not alive
We had no choice in becoming the “crazy” family that left a hospital against medical advice. Our four-day-old daughter was completely helpless, her condition deteriorating and the staff was ignoring our concerns. I carefully turned off the blue lights, removed her from the isolette, placed her in a car seat and eloped from the pediatrics unit.
As a hospitalist, I constantly obsess over medical errors. The majority are more subtle than …
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How I saved my daughter from a medical error
A few months ago a nurse I know vented her frustration at a misperception she had received several times, unfortunately. She recalled a conversation in which someone had asked her in a condescending manner if she does anything else at work besides “handing out pills.”
I became visibly irritated at this, not only was this person purposely making disrespectful comments to bring her down but was also perpetuating her own biased …
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Never undermine the work of a nurse
Multiple strokes, respiratory failure. Cardiac arrest — twice.
At first glance, I thought that I was reading the medical chart of an elderly person or at least one who had some other predisposing medical conditions to explain her current state.
But I was staring at the body of a 28-year-old woman. She had a youthful face and frizzy hair from being propped up on the same static-charged pillow for the last few …
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A different kind of Mother’s Day
I was a foreign medical graduate who in addition to some clinical practice, had begun a career first in managed care as a utilization management coordinator and then as a clinical researcher after finishing medical school and then pursuing a public health degree.
A few years ago, life took some unexpected turns, and I found myself in a rather new field of health care known as clinical documentation improvement (CDI). I …
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Is this a medical miracle or a medical error in documentation?
I’m an ED physician, so I’m used to patients screaming at me — sometimes with earsplitting demands for heavy-duty painkillers, morphine drips and similar remedies that will numb or “fix” them. I can deal with this. What I can’t deal with is a health system that incentivizes physicians like me to medicate adult patients, especially those at high risk for substance abuse, with little thought given to their long-term wellbeing.
As …
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Addressing the health care system flaws that feed the opioid crisis
“A teacher affects eternity; he can never tell where his influence stops.”
– Henry Adams
Mrs. Jones (identifying information changed) is a vibrant woman in her eighties who has been admitted to the hospital with swallowing problems and a fever. The CT scans show some swelling next to one of the major blood vessels and our team has been asked to see her and decide if she would benefit from surgery. She …
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A surgeon channels his mentor
It all started out with Malaysian methimazole, and didn’t end until two highly trained medical professionals sat on opposite ends of a telephone call, scratching their heads and wondering how two digits being transposed could lead to so many problems.
Those two transposed digits caused a thyroid uptake scan to become a bone marrow scan (whatever that is). But look at all it took to get there.
Mystery illness, mystery medicine
It started …
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Insurance denials: the law of the land
