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.

New doctors lack the skills necessary to transition into practice

Physician
February 8, 2017

I was recently part of a panel aimed at helping physician trainees make the transition to becoming full-fledged independent practitioners, and a member of the panel said something that struck an important chord with the audience when he mentioned that new doctors are probably the most developmentally delayed professionals in society. When you think about the fact that for some of us, the first “real” job we have starts as …

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New doctors lack the skills necessary to transition into practice

Young physicians: Don’t repeat my generation’s mistakes

Physician
February 7, 2017

My generation of physicians was much like yours.

My were also “the best.” We’d risen to the top of every academic pyramid: middle school, high school, college. We could be anything we wanted to be.

We chose medicine, partly for noble reasons. Our bodies were wondrous and we got to help people. But also for some not so noble reasons: the money was good, everyone would look up to us, and we’d …

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Young physicians: Don’t repeat my generation’s mistakes

Should we treat anti-vaxxers with more respect?

Physician
February 7, 2017

Years ago, when I was less flexible, I took up Pilates. My instructor, Jim, a charming chap with an infectious laughter, was a 9/11 truther. I’d egg him on to hear about his conspiracy theories. Jim believed that 9/11 was concocted by Bush and Halliburton so that the U.S. could invade Iraq to capture their oil. He thought that United Flight 93 never took off. Whatever happened after 9/11 became …

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Should we treat anti-vaxxers with more respect?

My case for no-fault medical care

Physician
February 6, 2017

As a physician with a strong sense of calling, I always see myself working for each patient, regardless of who pays the bill. Following in the footsteps of role models like Hippocrates and Osler, how could I do anything else?

Ted has been my patient for decades. He can’t seem to lose weight.

John has admitted he doesn’t know how long he can keep doing the kind of work that has supported …

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My case for no-fault medical care

How do I fix communication with my patients?

Physician
February 6, 2017

There is a basic communication gap between you and me. How could there not be? It’s not what you expect. I say you have cancer, or heart failure, or emphysema. Full stop. A conversation ensues. This is not what I’m talking about.

It’s more like when I report to you a series of normal lab results, and at the end flippantly mention a slight elevation of the white blood cell count. …

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How do I fix communication with my patients?

Building a career and a life around the difficult moments

Physician
February 6, 2017

“An expert is a person who has made all the mistakes that can be made in a very narrow field.”
– Niels Bohr

Five experienced, well-published, and widely respected head and neck cancer surgeons are sharing the dais at the national medical meeting to explore the topic “Can We Be Better?” The panel represents a spectrum of experts from around North America, and they have served as program leaders, department chairs, and …

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Building a career and a life around the difficult moments

What this physician learned from teaching his kids to ride bikes

Physician
February 5, 2017

Sometimes the minuscule moment is the most relevant; the least anticipated becomes the most profound.  Endless searches for wisdom and insight fade with each passing day, only to be shadowed by an unintentional conversation or event.  Wisdom is profound in the simple, while often hidden, complicated or forgotten in the complex or intentional.  This ironic phenomenon is as old as time, obvious in God’s creations and man’s discoveries.   I’ve reached …

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What this physician learned from teaching his kids to ride bikes

Why I would still encourage my daughter to go into medicine

Physician
February 5, 2017

There was an article recently published in Forbes titled “Mamas, Don’t Let Your Babies Grow Up To Be Doctors.” It was a well-written piece that outlined the multitude of reasons that many physicians have become disillusioned with a field they once felt a passionate draw to. The reasons listed in the article were accurate and included the loss of autonomy, mental exhaustion, and asymmetrical rewards.

Many physicians feel …

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Why I would still encourage my daughter to go into medicine

A pediatrician, silently screaming for the Syrian children

Physician
February 5, 2017

On the eve of President Trump signing an executive order on immigration, I lay here awake, silently screaming for the Syrian children. What will become of the hundreds of children I met recently at the Zaatari camp in Jordan whose hopeful eyes searched my own for answers? Unable to return home because of a war that has stretched more than 5 years, where will they go if we turn our …

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A pediatrician, silently screaming for the Syrian children

A man halfway between worlds

Physician
February 4, 2017

Alfred is 95 years old, and sits quietly in his wheelchair, rocking back and forth.  His strength is gone, and his veins and tendons bulge through fair, translucent skin, stretched over muscles of long lost size and use.  His greatest foe is gravity, which holds his lithe, bird-like form in the chair enough to cause sores on his hips, but only barely.  It looks as if he might float away.

He remembers little, but …

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A man halfway between worlds

We all have glitches. I know I do.

Physician
February 3, 2017

He was a small but very intelligent and articulate young man. I had seen him before, but it had been quite a while. He came to me complaining (as did his family) that he was having some trouble controlling his anger, dealing with quarrelsome students at school, and not always getting his assignments inside or outside of school completed in a timely manner.

We discussed the usual ways to approach this, I …

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We all have glitches. I know I do.

Schools should discontinue support for football. Here’s why.

Physician
February 3, 2017

Should school boards discontinue support for high school football?

That’s the provocative title of a recent article in Pediatrics, the journal of the American Academy of Pediatrics. The background to this controversy is the increasing recognition that chronic traumatic encephalopathy (CTE), a severe and debilitating brain problem first identified in former professional football players, can have its beginnings in college or even high school football …

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Schools should discontinue support for football. Here’s why.

The doctor fired for having cancer speaks up

Physician
February 3, 2017

I recently reported on Stephanie Waggel, the doctor fired by a prestigious U.S. hospital for getting cancer (story also the Washington Post). In a transcription of her whistleblower video, Stephanie describes how she nearly died due to obstruction of medical care:

It started during my intern year of residency. Which, bizarrely, was the happiest year of my life. And all my friends are …

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The doctor fired for having cancer speaks up

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Have a mean patient? Don’t take it personally.

Physician
February 3, 2017

My brother-in-law, Ron, was a curmudgeon; grumpy, sullen, even downright mean at times.

By blood, he and my husband Bill were cousins. In the 1950s, when Bill was just a child, his mother died unexpectedly, and Ron’s mother took Bill in to live with her and her four children. They were an African-American family living in the midst of a middle-class, predominantly white Connecticut township. Their home, located on a wealthy …

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Have a mean patient? Don’t take it personally.

On National Women Physician Day, how far have we come? 

Physician
February 3, 2017

I was thrilled when I found out that February 3rd is officially National Women Physician Day. Then I realized that February 3rd coincided with the 195th birthday of Elizabeth Blackwell, the first woman to receive a medical degree in America. Dr. Blackwell had the strength and determination of a superhero. She faced extreme opposition, was rejected numerous times, and was still seen as an oddity and inferior when she was …

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On National Women Physician Day, how far have we come? 

A physician’s first code. See how it turned out.

Physician
February 2, 2017

“CODE BLUE, 7 SOUTH. CODE BLUE, 7 SOUTH.” I’m up and out of my call room bed before fully regaining consciousness from my light sleep. It’s 4 AM. I should feel ready: I’ve trained with simulations labs, mock codes, and test questions. I passed my CPR and ACLS courses. I’ve done chest compressions as an intern. But this is different. I’m the resident on call, and if I get there first, I’ll be running the …

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A physician’s first code. See how it turned out.

The ethics of procedures on the nearly dead

Physician
February 2, 2017

The report from the field was not promising by any stretch: extensive trauma, and perhaps most importantly unknown “downtime” (referencing the period where the patient received no basic care like CPR). The patient remained pulseless en route; we were all aware of the markedly poor prognosis.

On arrival, the patient was swarmed by providers. Trauma surgeons at the foot of the bed cut down at the femoral artery to deploy a …

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The ethics of procedures on the nearly dead

If you are not already opposed to MOC, the time is now

Physician
February 2, 2017

Maintenance of certification (MOC) is on the minds of most doctors, and the majority of them oppose it. This is a program where doctors are enforced to comply with certain “educational” mandates to stay compliant with their board certification requirements. The largest number of doctors did not start off following this program but rather were shackled onto it later in their careers.

Being one of the earliest voices speaking out against …

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If you are not already opposed to MOC, the time is now

I march for my daughter and son everyday

Physician
February 2, 2017

On January 21, 2017, the day after the 45th President of the United States was inaugurated, hundreds of thousands of women and men marched in thousands of cities across this country and others to stand up for rights of women, men, and countless groups that have been ostracized or are at risk for losing rights, representation, or critical funding. I watched my Twitter, Facebook, and Instagram feeds throughout the day. …

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I march for my daughter and son everyday

A letter from doctors to our patients

Physician
February 1, 2017

Dear patients,

We are happy to have you in our lives.  We came into medicine to take care of you.  Some of us because we wanted to help you to win the fight against cancer.  Others of us because we love delivering your babies.   Others because we wanted to have the skill to make sure you survive that heart attack or that terrible accident.  Others because we wanted to do our …

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A letter from doctors to our patients

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