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.
Although I consider myself an extrovert, I find it more than a little intimidating to talk to strangers. Yes, like many of us, perhaps I was warned as a child not to talk to strangers. That may have had an effect, but I think it is most likely due to the fear of rejection.
However, I recognize that it’s a fear that needs to be overcome. While my skills have improved …
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The secret to a better life? Talk to strangers!
Every day, I see and hear physicians sharing and complaining about how burned out they are. However, I am struck by the fact that while we coach our patients to get help when they are suffering, sick, depressed or in a state of hopelessness, we refuse to follow our own advice. Furthermore as physicians, when presented with potential avenues to alleviate our pain and suffering, we find reasons to be …
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8 reasons burned out doctors refuse help
Let’s talk about the cycle of abuse. No, I am not referring to the very serious issue of domestic violence. Instead, I am talking about the graduate medical education system. No one is a resident forever: the duration of each residency is predetermined with a wide range of three to nine years. The self-limited nature of this experience decreases the incentive for participants to advocate for changes. And the attitude …
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End the resident physician abuse now
What would medical education that is relevant for the here and now — for America in the early 21st century — address? It is impossible to teach the content relevant for an entire career. It is important to educate practitioners able to adapt to the changing landscape of medicine. We must consider what the future might hold.
Watching science fiction may serve to prompt future physicians to practice preventive medicine for …
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Are post-apocalyptic disaster films inspiration for doctors?
Something was missing as I walked into the house, something was just not right. It took me a moment as I closed the door to realize. My greeter was not present. And then I remembered, she would not be coming to see me any longer. Her time with us had come to an end. And at that moment, the sorrow that had been lurking near the edges of life came …
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How this doctor deals with loss
The question was recently posed on Twitter about how long it takes to recover from burnout, even when positive changes have been made. I have considered burnout from many angles, both personally and professionally, and had not really considered this question specifically before.
Physician burnout has come to the forefront of discussions in the medical community for both physicians and organizations. With burnout cited as impacting over 50 percent of practicing …
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Can doctors recover from burnout?
At this place again.
Place: Neonatal ICU.
Time: 3 a.m.
Location: Bedside of a sick preterm female. She is intubated and on the ventilator. Antibiotics course through her veins. Blood transfusions, IV fluids and vasopressors support her in the fight of her life. Lab tests are checked, and adjustments are made to meet her needs.
Her parents sit beside her isolette. They watch the monitor, silently begging the numbers to give them some sign, …
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Here’s how to take care of yourself in difficult times
Monday
I walk into your room in the pediatric intensive care unit as two nurses are repositioning you. Your parents stand nearby — your dad in his frayed baseball cap and khaki cargo shorts. Your mom in baggy jeans wrinkled with the same worry as the lines near her eyes. Your little sister sits near the window with a blue hospital mask over her mouth and hugging her knees. Grandma sits …
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I’ll never understand why some patients end up as percentages
As an internist with “added qualifications in geriatric medicine” I care for a great many elder individuals. In most cases, these are individuals I met 20 or more years ago and have been privileged to share their lives with them as they aged.
The circle of life is relentless and unforgiving, so there comes a time when these relationships end. In some cases, it comes when they can no longer care …
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When you lose someone, it takes a piece of your being with it
I have good days and bad. Some days I am content, connected, focused, and motivated. On those days I enjoy my job, I enjoy the people I’m with, I am willing to be inconvenienced by interruptions.
On other days, not so much. I wake up as grumpy Rob and (despite multiple cups of coffee) the old codger doesn’t leave me alone. I keep score of all the ways in which life …
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A doctor saved a patient’s life. Twice.
I consider myself lucky to be the father to three wonderful kids: My oldest is now 15 and my twins are 9. They are indeed the light of my life. I get asked every so often, why did you want kids? It is a fair question, I suppose. After all, my partner and I relied on …
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The power of family at the end of life
In a recent episode of the television series, The Good Doctor, a patient played as Robbie Ato does not tell his doctors he has a history of cancer. You can see his surgeons stare in disbelief as one consulting surgeon recognizes the patient’s name and then alerts the team leader that she treated him three years ago for cancer.
This is one of the very most troubling and dangerous acts of …
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The Good Doctor shows us the value of time
As doctors, we simply want to spend more time with our patients. As a doctor for 13 years, and someone who now recruits doctors as a large part of my job, I’m witnessing the battle for more time with patients wage on, but there are no winners. Patients are waiting longer for hurried appointments. We spend more of what little time we have, prescribing and referring out because we’re racing …
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What I learned as a house call physician
The complaint was constipation. In the exam room, a quiet girl stood in a too big johnny, her eyes staring down at the floor. The 13-year-old was here with her “aunt.” Like over 50,000 children before her, she’d made the fifteen hundred mile plus journey from El Salvador to escape the violence of government and gang fighting, perhaps not knowing Mara Salvatrucha and the other gangs hung out only a …
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To this physician, thankfulness is his lifeline
The senior psychiatry resident at the University of Washington School of Medicine warned me ahead of time. She laughed as she said, “He’s weird. You’ll get used to him.”
When I first met with him, the psychiatrist lazily spun in his chair, his left hand tucked into his pants, his thumb hanging out. After he told me his expectations as my supervisor, he patted my right thigh as he ended the …
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#MeToo in medicine. This is one physician’s story.
It used to be that doctors knew best. We told you what to do, and you obediently complied. The world has changed, and the paternalistic system of yore has given way to the shared decision model where patient autonomy is respected.
The old way: “Well, I’ll be setting you up for surgery soon.”
The new and improved way: “Let’s discuss all of the reasonable options with their respective advantages and drawbacks. Then, …
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Is autonomy really better for patients?
Primary care doctors don’t usually have scheduled blocks of time to read incoming reports, refill prescriptions, answer messages or, what we are told the future will entail, manage their chronic disease populations. Instead, we are generally expected to do all those things “between patients.”
This involves doing a little bit of all those things in the invisible space between each fifteen-minute visit, provided we can complete those visits, their documentation and …
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The myth of multitasking in primary care
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
