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.
Do you know we have record rates of physician burnout, dissatisfaction, and suicide? Ongoing shortages in primary care, without improvement in sight? Physicians exiting medicine earlier than in the past?
What about burnout? Do you know it affects patients as well as their doctors? Affects physicians’ families and friends? Increases mistakes and malpractice risk? Affects patient adherence and outcomes? Is costly to the entire system?
How do we start to fix this? …
Read more…
Physician wellness at the personal, institutional, and cultural levels
In the movie Malice, Alec Baldwin plays Dr. Jed Hill, a surgeon who gives a famous speech during a deposition in a medical malpractice case. “”If you’re looking for God, he was in operating room #2 on November 17th, and he doesn’t like to be second-guessed … I am God.”
No one wants a doctor like that. And yet, maybe we do. We yearn for someone capable of healing all of our …
Read more…
It’s time for medicine to share its power
The practice of medicine is a lot like the practice of parenting. It is full of highs and lows, moments of pure joy and those of devastating heartache.
When I talk to my friends who are parents, they agree with me. Some of the most difficult times as a parent is watching your kids fail. When your child is hurting, it hurts far worse than if you had experienced it first …
Read more…
The practice of medicine is a lot like parenting
I have no business background: zero, zilch, nada. Growing up, I was the kid who bought the lemonade, not the one who set up shop on the busy street corner. My parents bought the cookie dough, coupon book and every other school fundraiser from the kid next door instead of their own child. Job interviews? Never had them. All the jobs I’ve ever had I got because I knew the …
Read more…
Physicians: Want to overcome burnout? Start studying business.
“How did you know what to say to her?” asked the resident, “We have been trying to figure her out all morning and have gotten nowhere.” An expression of mixed curiosity and frustration crossed her face.
“I try not to focus on how she is acting, as much as I try to talk to the part of her Jesus would love,” I found myself answering. This catchphrase would find its way …
Read more…
Want to make meaningful connections with patients? Here’s how.
After about the first week of anesthesia residency, I was told, “Don’t get pregnant, you are going to ruin the call schedule.” Initially, I took it as a joke because I was getting married that year and I wasn’t thinking of having children yet, but I did think, “what if it happened accidentally?”
After it’s told to you over and over again by your male co-residents and even some of my …
Read more…
Physicians: Be nice to your pregnant colleagues
Earlier this week, one of the residents and I saw a new patient who apparently had been sent in to see us for a pre-op visit, an evaluation to make sure that her medical conditions were well controlled and that the surgery was safe for the surgeons to proceed with. She reported that she forgot the paperwork they gave her. All she knew was that whatever we wrote had to …
Read more…
Let’s get one thing clear: pre-op comments from primary care
An excerpt from Worthy.
“Breakfast ready? Bacon smells good!” Mark finished buttoning his shirt and joined Linda at the kitchen table.
“I Googled funding for my clinic, but I didn’t find what I was looking for,” Linda said, filling their mugs with steaming coffee. “There has to be something out there for me!” She banged her fist on …
Read more…
“Thank you for being who you are”: an excerpt from a novel
To accomplish certain tasks, we need a little help from our friends. No one can do it all, although many of us are more resourceful than others. Some folks are adventurous and dive into a new arena with excitement. They may be tinkerers who aren’t afraid to play with new gadgets. Sure, they might break some china, but they are apt to widen their skill set and enrich their lives. …
Read more…
The rise of patient navigators is a sign that medical billing needs to be reformed
T was the last patient of a busier than usual morning. “New patient, establish care” was her reason for visit. As I would soon find out with the help of our remarkable Arabic interpreter, T and her family recently moved to our area after spending the better part of 3 years moving from refugee camp to refugee camp trying to escape the ravages of the civil war in their native …
Read more…
The patients that make you realize that we are part of a larger human family
When I walked into the hospital room with my team to meet him for the first time, what struck me was how young he looked. He was listed as 26 years old, but he looked younger than that. He looked so young that it was hard to believe he had served a tour in Iraq a few years prior, or that he likely saw things there that no one would …
Read more…
Veterans deserve our full attention
In loving memory of my grandfather, my first physician mentor.
Earlier this year, my 90-year-old grandfather passed away unexpectedly after undergoing transcatheter aortic valve replacement (TAVR). Similar to many elderly patients who die each year in the United States, his death was preceded by a litany of costly and time-consuming tests and treatments. Despite this extensive workup, the end of his life was shadowed by suffering left unaddressed. But, unlike the …
Read more…
We all treat the whole patient. We must avoid tunnel vision at all costs.
It is not unusual to see a patient for a timely transition of care visit after a hospital admission and within a minute of entering the exam room know with all the bones in your body that this person needs to go back into the hospital.
The funny thing is that when that happens, if the patient has Medicare, we may indirectly suffer financially from such “avoidable readmissions.” We belong to …
Read more…
A patient readmission: Could it have been avoided?
I have picked up Mr. Reynolds (not his real name). He is a frequent visitor to the ED for alcohol intoxication. He was found drunk on a street making a scene, and a good samaritan called him in.
Paramedics bring him in. He is not bashful about showing his discontent for his arrival to the ED. He promptly flips off the charge nurse and continues to verbally berate the paramedics. The …
Read more…
This emergency physician is the drunk whisperer
As physicians, our patients generally look up to us as people who make a great impact on their lives and sometimes even save them. But over the last year, I’d have to say that it’s my patients who have repeatedly saved me, starting with a four-month-old baby girl on November 9th, 2016.
The morning after election day, I walked into my first patient’s room at 9 a.m. Like most of the …
Read more…
In today’s political era, my patients save me. Here’s how.
I ran a 5K last weekend. I succumbed to peer pressure. The more others talked about running it, I decided I could be a runner too.
My patients describe their HIIT workouts (high-intensity interval training, for those of you not in-the-know), PiYo classes (Pilates-Yoga combination), increasing mileage for an upcoming duathlon/triathlon/marathon, and now I can proudly share my measly 5K experience with them. Of course, I will leave out the small …
Read more…
Being a doctor has saved my life
You’ve probably heard this story before: a young physician, who has spent all of his or her life succeeding and building goals, stumbles into a career without meaning or enthusiasm. Indeed, my story about burnout is much like the rest.
Like so many before me, I entered into a career in medicine motivated and eager to change the world through the care of my patients. I grew up in a family …
Read more…
Burnout during residency? Yep, and here’s what it taught me.
Looking at how incredibly expensive the last few months of life are for anyone in this country, I think most would be quite shocked. In 2014, there were approximately 2.6 million deaths in the U.S. According to a Keiser Permanente study, 2.1 million of those deaths were Medicare related. Medicare’s annual budget is right around $600 billion, and it has been revealed that one-third of that total is spent in …
Read more…
Why we need a new approach to end of life care
Let’s get one thing straight: You already have kick ass skills as a physician, skills that are valuable outside of clinical care settings. So whenever my physician friends turn to me for advice on making a transition in their career, I have to remind them: It’s not about learning new skills, it’s about translating your existing skill set to new business applications. Think digital health startup CEO, chief medical officer, …
Read more…
3 skills that make physicians excellent in business
Recently, I took a few minutes to fill out a survey on physician burnout. A slew of studies offer estimates of physician burnout of up to 50 percent. In my field of primary care, the documentation and regulatory burdens may cause the number to soar even higher.
I am rounding out my fifth year in a busy suburban private practice and I am not burned out. These questions moved me to …
Read more…
This doctor isn’t burned out. Here’s her advice.
