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.
Bashing the Veterans Administration (VA) health care system has become a familiar pursuit following the 2014 expose regarding concealed wait times and concerns for substandard care. In the aftermath of the ensuing national scandal, Congress passed reformative legislation, and President Obama appointed Robert McDonald Secretary of the VA. A 2016 report from the Harvard Business School indicates that the Secretary has “made impressive progress over the past year.” Numerous veterans …
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Stop bashing the VA: The culture of respect at our VA
Pain is usually considered a symptom, not a life-threatening medical problem.
But for Army veteran Richard Dejarnette, 52, constant excruciating pain in his right leg made his life intolerable, and he believes he wouldn’t be alive today if a physician anesthesiologist at the VA West Los Angeles Medical Center hadn’t been there to help him.
On December 14, the Department of Veterans Affairs announced the wise decision to keep physician anesthesiologists …
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America’s veterans deserve the best, and safest, pain treatment
Another year passed by, and I was going to write about my wishes for the New Year as a hospital doctor. But then, remembered that I did something very similar a couple of years ago. I went back and read over my wishes and found that they are identical to my wishes now! That’s not to say we haven’t made some great progress but — as anyone in health care …
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My top 5 wishes for health care in 2017
You won’t at first. But then, you will.
It will start innocently. Probably even before medical school. You will have a morbid curiosity about passing ambulances and motor vehicle accidents. Your original empathy for the victim will disappear when you begin to think of them as patients … as test cases.
The commodification accelerates during the early years of medical school. Anatomy, pathology and physiology provide you a vocabulary to replace human …
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This is how doctors evolve
So let’s step outside our traditional arguments when discussing the health care problem of gun violence in this country. We all know the entrenched opinions of both sides: The second amendment is inviolable vs. there are over 30,000 deaths from guns per year in this country, and why on earth does anyone need an assault weapon? But the city with the strictest gun laws, Chicago, has the most gun deaths, …
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Gun violence and the limits of human performance
Every medical couple knows that the lifestyle and career choice brings with it adjustments and sacrifices. Physician spouses and partners often take on more housework and childcare to accommodate long working hours. Physicians may work unusual hours that lead to late-night arrivals, missed bedtime tuck-ins, and less face-to-face time. This can lead many couples to blame medicine for their struggling relationship.
Take the example of a resident who has been working …
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Medicine is not destroying your marriage
Burnout is a tragedy. It terminates careers, friendships, marriages and sometimes lives, prematurely. It threatens the well-being of individuals, families, patients, organizations and our society. The current media focus on the crisis of physician burnout is appropriate and timely, but the industry itself needs a reality check. While burnout is experienced by the individual, it is the manifestation of a dysfunctional environment that only we as physicians and leaders in …
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Forget burnout. Let’s address physician dissatisfaction.
In the interests of full disclosure, I acknowledge with delight that I have a non-time limited board certificate from the American Board of Anesthesiology (ABA), issued before the year 2000. I can just say “no” to recertification.
The more I learn about the American Board of Medical Specialties (ABMS) and its highly paid board members, the more disillusioned I’ve become. It’s easy to see why so many physicians today have concluded …
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The real danger of maintenance of certification and what to do about it
Our recent paper on differences in outcomes for Medicare patients cared for by male and female physicians created a stir. While the paper received broad coverage and mostly positive responses, there have also been quite a few critiques. There is no doubt that the study raises questions that need to be aired and discussed openly and honestly. Its limitations — which the paper highlights — are important. Given the …
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Men and women doctors versus correlation and causation
The day I got into medical school, my uncle said to me, “You are going to be a doctor! We finally have a doctor in the family. You are going to take care of your uncle in his old age.” Other family members echoed the same sentiment. First doctor in the family. Now, we will all have free medical advice.
As I progressed through medical school, then internship and residency, then …
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Why this physician can’t be her family’s doctor
One of the privileges of medicine is the chance to meet people from every walk of life — many of whom you might never get a chance to know otherwise. Of course, such meetings are never spontaneous. In medicine, we are brought together by illness, and the people coming to see me are seeking advice on treatment for …
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Being an oncologist is a privilege, even if it’s sad
Dear hospital executive,
If you are like many of the hospital leaders with whom I regularly talk, you’re probably concerned that your hospitalist program isn’t delivering the value you need in this metrics-driven and cost-constrained environment. You may see your hospitalists as disengaged free agents who either don’t know or care too little about contributing to the success of your organization beyond seeing the patients on their list. They may repeatedly …
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7 ways hospital executives can support their staff
In the year it has taken for me to finish my medical residency as a junior doctor, two of my colleagues have killed themselves. I’ve read articles that refer to suicide amongst doctors as the profession’s “grubby little secret,” but I’d rather call it exactly how it is: the profession’s shameful and disgusting open secret.
Medical training has long had its culture rooted in ideals of suffering. Not so much for …
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There is something rotten inside the medical profession
Food. Such a universal sign of love. For me, a gift of homemade food is the ultimate gift of love. So when a patient brings me food, not like a box of chocolates, but something they have spent time considering and preparing, I know I have touched them in a unique and special way. These are a few of those special stories.
Chex mix
Every December I see her for her yearly …
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A gift of homemade food is the ultimate gift of love
Last week I was in a session with one of my coaching clients, a successful black female physician who is the owner of her own practice. As we were concluding she made a statement to me “I feel like medicine has just sucked the feminine right out of me.” Immediately I related.
As women in the professional world, we are always in competition with men whether we are aware of it, …
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Being a woman doctor in a man’s world
I have a breathtakingly difficult confession to make. A confession that on its face seems rather innocuous but in many ways shakes the foundations of who I always thought I was, and how I identify myself.
I no longer love being a physician.
There — I said it. I winced even as I strung the words together to write the sentence. You see, to admit this is almost inconceivable. So much of …
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Why this doctor no longer loves being a physician
I was sitting next to two of my co-residents during a break in conference this morning, answering emails on autopilot and half-listening to the buzz of conversations around me, when their muffled laughter caught my attention.
“What’s so funny, guys?” I asked them, thinking that a good joke or funny story might break up the monotony of hours of lecture. The reply I got stunned me.
“It’s man talk,” one of them …
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How subtle sexism is isolating female residents
It is clear that the anti-vaccine movement is born out of concern for children and their well-being, and I sympathize with the fear and uncertainty of parents. I do not, however, sympathize with President Trump’s decision to meet with the out-spoken vaccine critic Mr. Robert. F. Kennedy Jr., or his reported decision to have Mr. Kennedy chair a commission investigating the safety and efficacy of vaccines. It is not merely …
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How a meeting between President Trump and Robert F. Kennedy, Jr. puts lives at risk.
