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.
This open enrollment season, patients will be considering their health care coverage for the coming year. To ensure they are fully utilizing their primary care benefits and building relationships with health care teams that will keep them healthy, we need to encourage them to connect with a primary care practice or medical home.
A medical home is a place where a patient can seek treatment from primary care physicians and other …
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Prioritize primary care this open enrollment season
While doing my doctoral dissertation research at a clinic for kids with diabetes, I observed the attachment that some of them had to the physician faculty member who directed the clinic. I particularly remember one teenager who complained that this doctor “did not care” about her, as he sent “fake doctors” (residents) to take care of her, not coming himself. She was refusing to cooperate. When I suggested to the …
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The doctor-patient relationship is everything
I was recently interviewed on a podcast and was asked the simple question, “Why are you in medicine?” In retrospect, that’s the exact question I silently ask myself in frustration and exhaustion a little bit too often while I’m in the hospital. In those moments I recognize that I feel burnt out. In those moments if someone told me that I had to repeat intern year in order to finish …
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Why are you in medicine?
Periodically we should reflect on what challenges face patients and physicians. Over the past few days, I have worked on a list of the issues that concern me the most. I welcome suggestions for expanding the list.
1. Diagnostic errors. All patient care requires that we make the proper diagnosis. Too often we make errors. A recent paper estimated that 30 percent of cellulitis admissions did not have cellulitis. A similar …
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These are the biggest medical issues of 2017
He struggled to hear when people talked to him. He asked the same questions over and over. He fell asleep when really important conversations were going on around him.
But it wasn’t until he missed an emergency call that I knew I had to act.
I spoke to a higher-up about this elderly doctor out of concern for patient …
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Reporting an elderly doctor. And suffering from snitch guilt.
Many physicians have become world famous writers, and in Greek mythology, Apollo was the god of both poetry and medicine. I can personally think of many prominent physician writers I have come across in my reading over the years:
There was the 12th-century rabbi Maimonides, Copernicus in the 15th century and the poet John Keats in the 1700s.
In the late 1800s to early 1900s, there were Anton Chekhov, Sir Arthur Conan …
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EMRs are robbing physicians of their writing skills
October is the epitome of academic conference season. Returning home, suitcase laden, and a belt-hole wider from lost promises of exercise, and plans to “watch what I eat” while on the road, I am ready to get back into my routine. All the same, I come back refreshed by a new flavor to the mundane routine of conference experiences past. At the three conferences that I attended this fall, women …
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Women as leaders: reflections from the conference trail
Measuring metrics is a common catch-phrase in health care. The goal of capturing certain data is to improve patient outcomes. But, as doctors, we were taught to treat the patient and not the numbers. While optimizing clinical outcomes is a needed goal with all the complexities in medical treatment currently, the system seems to have gone too far in its quest for targeted numbers.
If, for example, a patient suffers metastatic …
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Good doctoring transcends numbers
The presidential symposium at this year’s Annual Meeting of the Child Neurology Society of America in early October in Kansas City raised many eyebrows. The first presentation of this symposium focused on burnout rates among neurologists around the country.
Many of my colleagues felt that this was an inappropriate choice, especially with so many trainees and young child neurologists in the audience. Typically, the presidential symposium at a conference of such …
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How burnout is plaguing doctors and harming patients
I first noticed this phenomenon while watching the world news on a weekday after work. It was a commercial for a new diabetes medicine that showed overweight people dancing at a barbecue, cooking and enjoying life. How different this was from my day in the wound clinic, where I saw patient after patient with obesity, diabetes, and nonhealing wounds, as well as other dire medical complications.
So I tucked this image …
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The new battleground of prime time media, disease, and death
As a corrections physician I frequently heard the question, “How can you take care of those people?” I understood what they were asking, after all, I was caring for people convicted of such crimes as murder, rape and child abuse.
And yet I had very little difficulty providing the same care to inmates that I provided to everyone else. In fact, the corrections environment was generally easier to work in and …
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What I learned as a corrections physician
Here it comes — another email about “physician wellness,” advertising mindfulness training, an ice cream social, or a volunteer day. As a psychiatrist, I can attest to the importance of tending to one’s own mental and physical health in order to strive for wellness. However, the trend of implementing physician wellness programs throughout the U.S. is nothing more than putting proverbial lipstick on a pig. Or, stated differently, this may …
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Physician wellness programs are lipstick on a pig
A little ways back, I was at a gathering of friends and family and was in the kitchen setting out a dish of black bean and quinoa dip. Suddenly, I heard someone from behind me exclaim: “What is that? If that’s something healthy, I am not eating it.”
Although somewhat intended as a joke, there was no doubt a truthfulness to what was said, just as exists in similar comments which …
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Here’s why we don’t care about our health
Recently, I was challenged by the mother of a trauma patient. She had read about traumatic spleen injuries online and was concerned about the risk a hematoma presented and wanted the ultrasound to look at the hematoma. I found myself floundering around trying to explain how this study was unnecessary. In frustration, I turned to my nurse practitioner and said, “Heather, can you translate for me?”
This is a common problem. …
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Maybe the reason patients don’t understand us is because we don’t speak in plain English
Why do we want to become doctors? What was our main motivation that we have written in our motivation letters and repeated in our interviews? Regardless of the specific incident or the general motivation, it can be all summarized in one sentence: We are here to save lives. After all, this is what the physicians do, isn’t it?
Preventing deaths is actually hinted to by the original Hippocratic Oath, written between …
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We need to accept our failure as doctors
Here’s some advice for your career in health care: Leave the country as soon as possible.
This has nothing to do with the president’s attempts to euthanize the Affordable Care Act. Or with EMRs, Medicare reimbursements, or the burnout surveys you get from your employer, who also sends emails aimed at getting you to work faster and more efficiently.
It’s none of that. You need to leave the country, just for a …
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Do yourself a favor: Leave the country and see how health care is abroad
When looking at why we as an industry have been largely unsuccessful in combating the epidemic of burnout that is plaguing our community, we must deal with our approach to solutions.
One of the biggest things to distinguish about burnout is that it’s not a problem to be solved. It’s not a diagnosis to be made, and it’s not a condition to be treated. Burnout is a perplexity; a vicious cycle …
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Understanding physician burnout: It’s a perplexity
Giving birth and running a marathon. They are two seemingly different entities but have many similarities. The inevitable pain, the highs, the lows, the feeling that you may falter or can’t survive the pain and, in the midst of it all, that you will never do it again … but then you do.
Marathons take months to train for by growing your strength and endurance as you increase your training miles. …
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Giving birth is like running a marathon
