A guest column by the American College of Physicians, exclusive to KevinMD.com.
A number of years ago I had an older patient, John, who had just been diagnosed with acute myelogenous leukemia. In discussing his diagnosis, he asked me if I thought that his exposure to radiation in the past might be responsible for his …
“I had no idea”: the power of patient stories
I was on my honeymoon in Colombia when I first became aware of the true extent of my post-traumatic stress disorder. My husband and I were walking across a smooth, granite platform to take a closer look at a fountain in downtown Cartagena. As we neared the structure, mist from the fountain’s jets dampened the ground …
I experienced trauma working in Iraq. I see it now among America’s doctors.
The other day a colleague and I were discussing a topic to be presented at an upcoming conference: “How much wellness is too much wellness?” This got us contemplating. What exactly is “wellness?” Can you ever spend too much time pursuing wellness? Or is “too much wellness” merely a surrogate for a much bigger problem with the way we’re approaching wellness in the health care setting?
According to the 2018 Medscape …
Why your physician wellness programs aren’t working
Physician burnout rates hover around 50 percent, and the adverse consequences are serious. Burnout is associated with increased medical errors, suboptimal care, turnover and personal costs, including substance use, depression, and suicide.
The financial cost to health care organizations is significant: replacing a physician is estimated to cost at least $500,000. Plus, physician turnover results in care disruption, patient access issues and lost revenue for hospitals to which the physician referred …
Want a resilient organization? Address physician burnout now.
I am an assistant professor of health communication. Since 2008, as a volunteer, educator and researcher, I have been active in hospice care. As many people know, hospice teams (nurses, social workers, doctors, chaplains, volunteers) help dying patients and their families live as fully as possible during their remaining days together.
In November 2016, right before the presidential election, I started a project aimed at identifying the best practices in communicating …
Is compassion a two-way street?
Few people can argue that health care is a business these days. Medical services are attached a price tag and patients are now customers. However, intrinsic to health care is a very high ethical code that doesn’t exist in other sectors. For example, if a patient shows up in the ER, they cannot be denied service, whether they are wearing shoes or not. While McDonald’s and other top companies are …
These McDonald’s practices should be avoided in health care
Today a physician told me she lost three colleagues to suicide in the last two months.
Loma Linda Hospital just lost three young doctors to suicide in 6 months.
Mount Sinai had 3 docs jump in less than 2 years — from the same building.
An anesthesiologist recently told me he lost 8 of his colleagues to suicide.
Each suicide should be fully investigated, …
Physician suicide is also a problem in India. Here’s what you can do.
In 2017, the flagship multispecialty practice of Oregon Medical Group, moved into its new digs — a 46,000 square foot redesigned medical office building. Practice leaders and the 30-odd clinicians in six different specialties were committed to a coordinated patient experience. They wanted to ensure that patients could move smoothly between sequential visits with different care providers — on the same day. To this end, the group invested in a …
The many benefits of self-rooming patients
I need your help.
I’m trying to figure out how to get rid of something that’s terribly broken in our process of taking care of patients, and I can’t do it alone.
It’s time to kill the referrals process, get rid of them altogether.
Every day, a huge proportion of the messages we receive through the electronic health record are requests for us to “put in a referral.”
Patient has low back pain, has …
The referral system to specialists: It’s a nightmare
I always warn my medical students to be careful what they say in front of patients, or patients’ families or friends. “You never know who’s listening!” I add. They may think that I’m exaggerating — but I have my reasons.
Early in my career as an internist/nephrologist, if I had a free moment, I’d head for the emergency room. I might get a referral, and the coffee and conversation were usually …
Watch what you say around patients
Have you ever wondered why most people who volunteer have an overall more positive outlook on life? Giving back to your community and serving others through volunteer work can benefit your life a variety of different ways. My list below outlines the power of volunteering and its surprising benefits.
1. Volunteering affects your thoughts. Being able to connect with others, even animals, can improve your mood. Humans are social beings who require …
5 surprising health benefits of volunteering
“The ones you leave behind …”
That phrase often connotes loved ones who have lost a family member, friend or colleague through death.
I have thought of the same phrase often lately in a different context — one of increasing prevalence.
Here, I refer to the patients and colleagues left behind by the loss of a primary physician.
No one would begrudge the retirement of a physician who has served his or her patients …
When you leave primary care, you leave people behind
As a physician, is it acceptable to say no? After working as a hospital medicine physician across five different states and internationally, I’ve realized that saying no is actually imperative. Physicians are stretched thin, abused, demonized and expected to be superhuman when it comes to patient care. We secretly complain in online forums, we commiserate with other physicians in on-call rooms, sometimes we even seek mental health help, but rarely …
Physicians must learn to say no
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When we first met and got married, my husband Josh wanted to be a math teacher. Since I was also pursuing a career in teaching, I thought this was a great idea. I envisioned both of us teaching together in the same school district for forty years, becoming local superstars! We would know all the kids in town and spend our summer vacations traveling to exotic locations around the globe. …
Doctors wear white coats. But what do their spouses wear?
When we look back on the last century, the pace and number of advances in our ability to treat disease and injury is truly astonishing. The exponential growth of technology has contributed to this greatly, as we see new advances often come in the form of new technologies. Amazing innovations in the fields of endoscopy, catheterization, robotics, imaging, navigation, 3D printing and more allow us to do things that were …
Is surgical training stuck in the past?
Editor’s note: This story contains a racial slur crucial to the writer’s story.
Life has a funny tendency of unexpectedly throwing things your way. We, physicians, deal with this regularly. You never know what’s lurking about to put a huge dent in your day. Particularly vexing are ugly circumstances that rock your core. And few strike such a nerve as bigotry.
When encountering a confrontational individual, our natural response — via human …
Bigotry in medicine: facing conflict with empathy
I decided to become a doctor at the tender age of eight when I met my first patient — my grandmother, Grandma Sylvia. After spending two years in the midst of the Liberian civil war, she arrived in the United States with diabetes, hypertension, obesity and nearly blind due to glaucoma. One of my new chores was helping administer her daily insulin injection.
I also had the privilege of accompanying Grandma …
The future of primary care is as bright as we choose to make it
“I want you to be my doctor. You don’t judge me,” Mr. L said. “I left my last doctor because of the way he treated me. He did not understand me and could not care for me. I was born a woman, but I am a man,” he said.
When it comes to providing patient care, I think the most important part comes from a principle we are taught as children: …
Caring for trans patients: Treat others as I would want to be treated
Remember when you were a kid out grocery shopping with your parents when suddenly, smack dab in the bread aisle, you spot your 5th-grade teacher Mrs. Smith? It is almost an out-of-body experience when your eyes lock, and you realize for the first time that your teacher is an actual person that exists outside of your classroom. The same thing applies to your white-coat-wearing, stethoscope-toting, bedside-manner-lacking (wait … I hope …
Physicians aren’t robots in a white coat
1. Clinical history is important. What did you see when you took the biopsy? Was there a mass there? Does the patient have a history of malignancy? These are all important questions, and they help pathologists arrive at the most accurate diagnosis possible. Rarely, the best we can give you is a differential, but the more clinical information given to us, the more likely we can narrow things down and pinpoint …
5 things pathologists want other doctors to know
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