Physician

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.

Here’s what’s wrong with time-based billing in the hospital

David M. Mitchell, MD, PhD

Physician

April 17, 2018

Consider this hypothetical addendum to a hospital discharge summary:

”ADDENDUM @10:56 a.m: In considering the accurate billable discharge time involved in this case (as I have recently been instructed by hospital coders that I must record the exact time required for a patient discharge, rather than simply “greater than 30 minutes” or “less than 30 minutes”), I feel I have stumbled upon a troubling quandary, having failed to note the exact …

Physician well-being must be the standard of medicine

Dianne Ansari-Winn, MD, MPH

Physician

April 17, 2018

I’ve interviewed many doctors on my podcast The Doctor’s Life. They share their stories of how they came to medicine and how they developed into the physicians that they are today. There are three common themes in these “origin stories”:

The first is that many of the doctors were mentored by a physician who inspired them to pursue medicine. The second is that they were “called” …

The human touch in medicine: good or bad?

Dana Corriel, MD

Physician

April 17, 2018

Humans need human touch

Patients sometimes need a shoulder to cry on. When I say that, I normally mean it on a completely figurative level.

However, at times, it needs to be interpreted differently. There are instances in a medical encounter where an actual shoulder could be of service — a physical crutch that takes off an emotional load — and that’s when the popular adage can be beneficially carried out in …

Lunch shouldn’t be so controversial in medicine. But it is.

Patricia Martin, DO

Physician

April 16, 2018

In some circles of medicine, going long periods of time without eating a meal is considered a rite of passage and one’s ability to forgo his or her basic metabolic needs is considered a badge of honor. In other circles of medicine, there are gourmet lunches of kale salad and lobster bisque being delivered by pharmaceutical company representatives on a daily basis.

No one in either circle seems quite comfortable with …

Sexual assault in the emergency department: What can you do?

Kari Sampsel, MD

Physician

April 16, 2018

It has been documented that 1 in 3 women will experience rape in her lifetime, and this is most common in women under the age of 25. Over 95 percent of victims of sexual assault are women worldwide, while in North America estimates place that at 85 percent. These are the assaults we know about — generous estimates say that, at most, 10 percent of rapes are reported to police …

Emergency physicians are glorified secretaries with medical degrees

Edwin Leap, MD

Physician

April 15, 2018

We had a pretty busy shop when I was in residency. So busy, in fact, that we had three secretaries working simultaneously — one for paging, one for order entry, and one for admissions. I haven’t been back there in a long time, but I hope the secretarial staff has grown commensurately with the volume and acuity of the ED. But from what I’ve seen around the country in my …

A new directive for National Healthcare Decisions Day

Kevin Haselhorst, MD

Physician

April 15, 2018

Other than taxes, the only other certainty in life is death. People don’t like to pay taxes or think about dying. But on April 16th, National Healthcare Decisions Day (NHDD) reminds people to complete their advance directives. Like a passport, an advance directive permits an individual to proceed from one world to another with an easy stamp of approval. Without the proper paperwork, patients at the end of life are …

The momentum to treat in America is unmatched around the globe

Samuel Harrington, MD

Physician

April 14, 2018

The momentum to treat in America is unmatched around the …

Heal thyself before others

Shalu Ramchandani, MD

Physician

April 13, 2018

Alice wept in my arms as she described her father’s last days. He died of metastatic prostate cancer. She felt lighter as she shared beautiful memories of him. It will never be the same for Alice, nor will it be for me. I was running behind for my next patient, a healthy 86-year-old woman. I apologized for keeping her waiting. She did not mind; she knew I would give her …

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Heal thyself before others

When the doctor becomes the victim

Shaili Jain, MD

Physician

April 13, 2018

Years ago, the police brought a middle-aged man to the hospital for evaluation on a day when I was the on-call psychiatrist. Earlier that morning, the man had walked into his psychiatrist’s office without an appointment asking to see his doctor immediately. When his demand was not met, he caused a raucous in the waiting room, tossing over tables and chairs and alarming the other patients. He refused to leave, …

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When the doctor becomes the victim

Push back on toxic behaviors from other doctors

Todd Rice, MD, MBA

Physician

April 13, 2018

“Don’t get tired! Don’t f*cking move! Don’t you f*cking move, or I’ll f*cking die!”

That’s an excerpt from an OR in St. Louis on March 12th. This is just one of the outbursts that was reported from a single, multi-hour surgery — an attending’s toxic mandate to her resident, who was poised in a precarious situation under the drapes. The rest of the OR staff caught plenty of its own abusive …

Just care less: That’s something many doctors cannot do

Millennial Doctor, MD

Physician

April 13, 2018

For the last week and a half, I’ve been lost.

After experiencing compassion fatigue and realizing I wasn’t even close to pulling myself out of burnout, I’ve been racking my brain trying to rethink my situation yet again.

I reached for my old faithful habits. I became more consistent with my lunchtime mindfulness sessions and re-instituted exercise, yoga and hiking. I even went phone free for the weekend, though admittedly this …

What this physician misses the most

Jordan Grumet, MD

Physician

April 12, 2018

Empathy

My eyes glare across the table. I can feel his shoulders hunch forward as he subconsciously recoils in preparation for my response. The room becomes thick. Nurses, social workers, a chaplain. Everyone waiting for the doctor.

Not just the doctor, but me. Sixteen years out of residency. Battle-scarred and warn by PTSD. The images from residency still so clear. A gasp, a gurgle, flat line. Wailing family members, angry nurses, and …

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What this physician misses the most

The drama of a C-section: It takes a team

Andrea Eisenberg, MD

Physician

April 12, 2018

She pushes her cleaning cart into the bright room. “Looks like the usual mess,” she mumbles to herself, pushing a loose piece of hair back into her blue cap. Methodically, she cleans the room beginning with the operating table, stripping off the bloody sheets. Then cleaning the floor of blood-stained shoe prints, amniotic fluid and bits of paper, needle caps and such, that managed to escape hands and land on …

How writing fiction can free physicians

Sandra Miller, MD

Physician

April 12, 2018

Every person working in medicine has stories to tell, and sharing those stories is a great way to process grief or stress, celebrate triumphs, vent, move on or think more deeply.

Occasionally, writing about an experience helps others facing a similar situation. True narratives of and reflections on medicine are now encouraged, honored, promoted — and sometimes required of medical students.

This is a commendable trend, though the exercise can be affected by …

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How writing fiction can free physicians

How physicians dress matters. Here’s why.

Suneel Dhand, MD

Physician

April 11, 2018

Anybody who has ever been to Europe, knows that fashion trends and the way people dress are very different from the United States, and generally more formal and fashion conscious (not to make a generalization — but it’s true). Growing up in England, every school has a uniform from an early age. (There are pictures of me wearing a tiny little shirt, tie, blazer, and hat to preschool when I …

A physician thanks those who made her who she is today

Maria Yang, MD

Physician

April 11, 2018

To the intern on the trauma surgery service when I was a medical student: Thanks for occasionally wearing leather pants to work. Thanks for smiling and having a sense of humor despite having to round on thirty patients. Thanks for teaching us medical students while running a significant sleep deficit.

To the internal medicine resident who wanted to become a cardiologist: Thank you for indulging me and telling me how you …

What happens to the kids of child abuse when they grow up?

Linda Girgis, MD

Physician

April 11, 2018

As he sat in the driver’s seat and started to whistle that dreaded Willie Nelson song, my heart started racing, and my world started to spin. While most kids may be annoyed hearing their father whistling that toneless noise, terror started seeping into my very bones. I knew what that sound meant and it was no Pavlovian response, but rather a foretelling of the horror coming. Simply put, it meant …

The follies of health insurance preauthorization

Michael Kirsch, MD

Physician

April 10, 2018

A few weeks ago, I saw a patient some gastro issues. So far, nothing newsworthy here since I am a gastroenterologist. I ordered a CT scan colonography, a special CT scan that is designed to view the colon in detail. It’s the CT scan version of a colonoscopy. Why didn’t I simply perform a colonoscopy, which, unlike a CT scan, would contribute to my retirement fund? That’s an easy one. …

Take 2 broccoli and call me in the morning

The Fit Physician

Physician

April 10, 2018

We live in a pill-popping society. The first line treatment for many of the medical problems that walk through our doors is a medication. Have heartburn? Forget about avoiding the foods that cause your symptoms — just take a pill. New diagnosis of diabetes? We give lip service to lifestyle modifications and then start patients on Metformin. Hypertension? Diuretics, ACE inhibitors, ARBs, beta blockers — take your pick, and I …

Physician

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