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.

A physician’s experience with burnout, and what she learned about it

Janice Boughton, MD

Physician

October 19, 2017

Physician burnout and physician suicide have been getting more attention in the last several years. Suicide among physicians is horribly tragic, and maybe moreso because of several factors. Suicide is the quintessentially most preventable fatal event. In order to prevent suicide, the person killing him or herself needs only not do it. To anyone who knows the victim/perpetrator, it seems that if only the right words had been spoken, the …

We are all spiders making our webs

Rob Lamberts, MD

Physician

October 18, 2017

I recently went hiking in a beautiful national park outside of Columbia, SC. This park was in a swampy area and contained all sorts of wildlife (called “critters” down here) and plant life (called “trees and those other things” down here). When I was young, my dad would take us kids on hikes through the Adirondack Park in New York, and so being on hikes in nature hits my soul …

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We are all spiders making our webs

As a leader, you can be liked or respected. But rarely both.

Sasha K. Shillcutt, MD

Physician

October 18, 2017

I want to talk about the word everyone seems to use: drama. This word is used in many facets, to describe conflict, negative interactions with others, disagreements, or obstruction to a new idea.

No one likes drama. Yet some people seem to instigate it, and others seem to have to deal with it on a rotating basis.

We all wish we could ignore it, avoid it, and leave it for people who …

Why are you seeing the gastroenterologist?

Michael Kirsch, MD

Physician

October 18, 2017

Gastroenterologists, as specialists, are called upon by other doctors to address digestive issues in their patients. For example, our daily office schedule is filled with patients sent by primary care physicians who want our advice or our technical testing skills to evaluate individuals with abdominal pain, bowel issues, heartburn, rectal bleeding and various other symptoms. The same process occurs when we are called to see hospital patients. If a hospital …

The high cost of hospitalists

Richard Young, MD

Physician

October 18, 2017

Hospitalists, doctors who only see patients in the hospital, almost always in a shift work model, are the fastest growing “specialty” in medicine, from nothing about 15 years ago to about 50,000 today. There were some studies that I won’t review much here that showed some benefits from hospitalists compared to “usual care” in highly controlled environments, outcomes such as a 0.4 per day decrease in length of stay with …

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The high cost of hospitalists

Death is certain. How you choose to die isn’t.

Mark McLaughlin, MD

Physician

October 17, 2017

“It is not for me to judge another man’s life. I must judge, I must choose,
I must spurn, purely for myself. For myself, alone.”
-Hermann Hesse, “Siddhartha”

What does it mean to die with dignity? As a neurosurgeon who faces life and death decisions routinely, I ponder this question often. When a terminally ill person decides to choose death over suffering, we perhaps recognize the ensuing act as a dignified death. But …

Could being vulnerable lead to better health?

Heather Hansen, JD

Physician

October 17, 2017

Long ago, I represented a doctor who was … difficult. He was a phenomenal surgeon, world famous in his field, but he was not warm and fuzzy — not even close. Cold and hard were more his speed. We spent two weeks together, on trial in city hall. It takes about two years from the time a case is filed to the time the case goes to court. During that …

People, not computers, make health care work

Jason J. Han, MD

Physician

October 17, 2017

Every morning around 5 a.m., the overnight intern updates me on what happened to the patients on my service. In a hospital where disease knows no hour, the nights can often be just as busy as the days.

“Just letting you know, his wound seemed a little wet to me. Maybe it’s starting to get infected.”

“Good to know. We may have to change the dressing more frequently.”

“And this patient had constant …

Being the doctor he set out to be

Hans Duvefelt, MD

Physician

October 17, 2017

“Jag ska bli doktor,” a four-year-old boy announced to his family sixty years ago.

Somehow, everything he did after that moment seemed to move him in that direction, even when, on the surface, his path through life seemed to be meandering.

As a student, he was just as interested in literature and philosophy as he was in scientific subjects. He even failed his first quiz in organic chemistry just after receiving the …

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Being the doctor he set out to be

Doctors are dangerously tired, and health care leaders aren’t taking action

Suvas Vajracharya, PhD

Physician

October 17, 2017

Do you want your surgeon to work back-to-back overnight 12-hour shifts and then perform brain surgery on you the next morning? There’s currently no regulation prohibiting this kind of dangerous scheduling in medicine.

Physicians are human. Like truck drivers or airline pilots, their fatigue can lead to dangerous consequences for those around them. A recent study showed that even mild sleep deprivation causes the same levels of impairment …

The hurricane in Puerto Rico is leading a shortage in saline bags

Deep Ramachandran, MD

Physician

October 17, 2017

“Doc, you mind switching that to an oral preparation?” our clinical pharmacist inquired during multi-disciplinary rounds as intravenous infusion devices beeped annoyingly in the background. Taking care of ICU patients can be extraordinarily complicated, so doing it as part of a team helps make sure that all bases are covered.

Like many hospitals, ours uses a multidisciplinary model which makes rounds on all patients in the ICU. An ICU nurse, clinical …

How not to argue with your kids about marijuana

Laurence M. Westreich, MD

Physician

October 16, 2017

An excerpt from A Parent’s Guide to Teen Addiction: Professional Advice on Signs, Symptoms, What to Say, and How to Help (Skyhorse Publishing; October 2017).

Marijuana, the illegal drug most commonly used by teenagers, is widely accepted as harmless, but is it? Its effects range from the trivial—silliness, bloodshot …

This psychiatrist does most of her work outside of the traditional system

Maria Yang, MD

Physician

October 15, 2017

Every now and then, when some people learn what kind of work I do, they say, “You’re doing God’s work. Thank you.”

They mean well, so I accept the compliment, though I also tack on, “I also like what I do. It’s meaningful work for me.”

So many of the people I see, whether in my current job or in my past jobs working in other underserved communities, have a lot going …

Emergency medicine can be exhausting. Here’s what this doctor does to unwind.

Edwin Leap, MD

Physician

October 15, 2017

So I’ve finished up at one job and moved on to another. I was a director for a year, and it was a learning experience. Right now I’m nearing the final approach after working a long run. Last week I had five nights, 12 hours duration each. I stayed in a hotel near the hospital. Then, after two days off at home, I started a run of five days, of …

Why veterans deserve special recognition

Jarret Patton, MD

Physician

October 14, 2017

November brings fall weather, raking leaves and one of my favorite holidays. No, not Thanksgiving, it is Veteran’s Day. Veteran’s Day is a day reserved to celebrate members of the U.S. armed forces for their service. Thank you, veterans. Veterans are found in all segments of our society. Some are retired, some have started second careers, and some are struggling with health issues as a result of their service. They …

Alternative medicine for cancer: Greater scrutiny is needed

Skyler Johnson, MD

Physician

October 14, 2017

As the calendar turns to early October, I’m reminded that this is the 6th anniversary of Steve Jobs’ death. At the time of his death, I was a medical student and my wife had just completed six months of chemotherapy. I was surprised to learn that Jobs had died from complications of cancer and shocked to discover that he had initially refused conventional cancer treatment in favor of alternative medicines. …

Always ask your patient this one thing

Dr. Natasha Khalid

Physician

October 13, 2017

8:00 a.m.: Monday mornings are abhorred by almost everyone, but they are gloomier if you work as an intern. For me, this Monday was an anticipated work-free day — hence, it wasn’t too bad.

I had spent a long time at breakfast catching up with friends and later grabbed my books and went to the library to catch up on my studies. This happiness was short lived. And in the afternoon, …

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Always ask your patient this one thing

A story from a physician’s journey to burnout

Franklin Warsh, MD, MPH

Physician

October 13, 2017

An excerpt from The Flame Broiled Doctor: From Boyhood to Burnout in Medicine.

“So what did my bloodwork show, Doctor?” asked Liz. Liz was friendly and polite, but a textbook example of the Worried Well … healthy but neurotic patients I didn’t need to see as often as …

4 ways doctors put themselves last

Maiysha Clairborne, MD

Physician

October 12, 2017

As physicians, we are conditioned to put ourselves last. This long-standing tendency likely began way before we hit medical school. But certainly, our training reinforces it. Think about it: the personality type that goes into medicine is typically a caretaker. And while medical school reinforces this personality pitfall, It doesn’t end there. Residency brings a whole other dimension of self-neglect. We think, “If I can just get out of residency …

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4 ways doctors put themselves last

How do you fight racism in medicine?

John Junyoung Lee, MD

Physician

October 12, 2017

I bleed blue and gold. No, I am not talking about Michigan, West Virginia or Notre Dame. I am definitely not talking about UCLA Bruins (by the way, UCLA fans, a bruin is a brown bear). That’s right — I am a die-hard Cal Bears fan.

Thanks to Cal football, and particularly to legendary Marshawn Lynch, my college days were filled with excitement. (I am counting on you, Coach Wilcox.) Marshawn, …

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How do you fight racism in medicine?

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