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.
In this current era of health care, patients are increasingly being labeled as “customers” to provide a landscape suggestive of the need to provide customer satisfaction. Many health care providers grow increasingly frustrated with that terminology. It demeans the relationship that is fostered in the patient-physician encounter; belittling it to a transaction that occurs as the exchange of goods for an expected outcome. Perhaps a more appropriate corollary to the …
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Why patients should be investors, not customers
It’s 5:50 a.m. and my alarm is buzzing. It’s been going off intermittently since 5:30 a.m. Even though I really don’t need to be out of bed until 6:00 a.m., I’ve lived with myself long enough to know my biggest vice is the snooze button.
I roll out of bed and get ready for the day — blue scrubs, messy bun, enough makeup to feel like I tried, freshly clean teeth …
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A day in the life of an OB/GYN chief resident
Next month when our youngest child leaves for college, the biggest change may not be in his life but in ours.
We are done with dropping them off at school, or giving them driving lessons, or helping them with difficult homework assignments: We will officially become “empty nesters.”
My wife and I ponder sitting at the dinner table and standing by the kitchen counter, where exuberant political dialogue takes place, and common …
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How this physician transitions to becoming an empty nester
I missed a drug interaction warning the other day when I prescribed a sulfa antibiotic to Barton, a COPD patient who is also taking dofetilide, an uncommon antiarrhythmic.
The pharmacy called me to question the prescription, and I quickly changed it to a cephalosporin.
The big red warning had popped up on my computer screen, but I x-ed it away with my right thumb on the trackball without reading the warning. Quite …
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Alarm fatigue is problem. Here’s a pragmatic solution.
The age-old saying is that knowledge is power. But what happens when you are overwhelmed with the information you need to make a decision without the understanding of how that information fits together to answer your question? It’s like trying to put together a large, complex puzzle without a finished picture for comparison. Oh, and by the way, you also aren’t sure you have all the pieces. This situation can …
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We are clinicians in the era of information overload
Prologue
It’s 1:30 p.m. on a beautiful Saturday afternoon. You’re on call, and hungry, and having not had the forethought to make food ahead of time, you decide you’ll take your chances and see what the hospital cafeteria has to offer. You bustle your way past screaming children, harried caregivers, and distracted hospital staff with their heads buried in smartphones, following signs for the fork and knife.
Finally, you arrive. After considering the stack of soaking wet trays …
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Hospital sushi and the 5 stages of grief
Being a physician is hard. Really hard. Four years of medical school, multiple years of residency and perhaps fellowship training add up to years of working endless days in a row and powering through exhausting nights. For many of us, this need to be able to power through continues even when we finally make it as an attending.
But being a patient is harder. Being the daughter or son or husband …
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A reminder of how important bedside manner is
To listen to all those desperate to reform health care, you get the impression that physicians are pretty horrible people. We are all sexist, greedy, money grubbing tyrants who will perform unnecessary tests and procedures just to make money. We don’t care about quality or cost. We are killing off 250,000 patients every year with our ignored “errors.” We purposely keep our patients in pain, or we addict them to …
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9 reasons the “golden age of medicine” was golden
It was an ordinary day in clinic — I had gotten very behind schedule when a 90-year-old gentleman, who was in for his third visit in a month related to falls, came in with his equally frail wife. We had to spend extra time discussing his placement in a nursing home for safety concerns.
I hastily entered the room of a 46-year-old attractive female, who was here to meet me as …
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A patient becomes the teacher
I work in a male-dominated field. As a cardiac anesthesiologist, I work with mostly male cardiac surgeons in a department where the majority of my fellow anesthesiologists are male. I work with some fantastic male colleagues. They are caring, skilled doctors, and I consider many of them to be friends.
While most of them know how to handle emergencies, trauma and difficult work situations, many times they clam up when we …
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15 tips for working with women
In Houston, all of my colleague’s offices are closed, and there is limited access to the Texas Medical Center due to Hurricane Harvey. As a virtual medical doctor, there was only one thought on my mind this entire weekend, “How can I help?”
As a Floridian, I have certainly faced my share of natural disasters beginning with Hurricane Andrew, a category 5 hurricane in 1992. Living through Hurricane Andrew gave me …
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5 ways virtual doctors can help during a natural disaster
Recently, there have been many times when you may have gotten a news alert on your phone or checked the latest Twitter hashtag and wanted to scream. Or you were too busy to even check until later that day and did not know what to say other than to lurk and watch a train wreck in progress. You may have thought about saying something, but paused and wondered, “Is this …
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Physicians: Use your voice to make the difference
White nationalists and neo-Nazis marched through Charlottesville, President Trump addressed the nation in what should have been a straightforward call for unity against racism and bigotry. Instead, he left us perplexed, wondering if he had just insinuated anti-racist counter-demonstrators were to blame for the violence that ensued. Trump then made explicit his intentions by attempting to spin an argument of moral equivalence between white supremacists and racial justice advocates. He …
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After Charlottesville: What are physicians responsible for?
We all practice medicine for different reasons. Of course, it’s almost reflexive to say we practice medicine because we care about people. I’m sure this is true for many physicians. However, if I were being honest, I think I went into medicine more because of the educational challenge. In addition, the profession yielded respect, status, money (back in the day!) and yes, an opportunity to help. I won’t challenge my …
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What I learned as a hospice director
We are all guilty of having biases. Some of them we know about and proudly flaunt. Some of them have been ingrained so deeply that we do not even know they exist. Weight is an issue that brings out strong biases, and multiple studies have demonstrated a high level of bias from physicians against overweight and obese patients. Obese patients are often treated rudely and are not given the same …
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Doctors must stop fat shaming their patients
When I finished my medical training almost sixty years ago, I was like many new graduates: I thought I knew it all.
I opened a private office in Los Angeles and paid courtesy calls on the local physicians to let them know my qualifications and my availability for consultation, as both an internist and a nephrologist. (The treatment of kidney disease was then in its infancy, and I was the area’s …
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Good clinical care takes more than medical acumen
There is a definite finality to the decision of which specialty a physician pursues. The reasons are as vast as they are individual. Hopefully, the med student has done due diligence and has a solid grasp on what their future entails, at least for the future as far as anyone can confidently foresee. Here is my story.
1. Challenge. No day is quite like another, and life as an emergency medicine (EM) …
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4 reasons to choose emergency medicine
“F*ck!”
I pried my eyes open and had the realization of exactly what time it was. I was going to be late — again. I jumped out of bed as fast as my stiff and weary body would allow, threw scrubs on I was mostly sure were clean, ran a brush through my hair so I didn’t look totally disheveled when I had to look like professional in a few minutes …
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A surgeon makes a mistake, and couldn’t stop crying
An on-call weekend: 48 hours of being at any moment “on,” of being edgy, of being exhausted. This weekend included a full house of patients to see in the hospital, a patient list of three pages to be exact. As I went from patient to patient, room to room, each held its own unique story filled with the yin and yang of life. I realize too, this may be a …
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48 hours in the life of an on-call gynecologist
