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.

I’m sorry your mom died, but I cannot help you now. Here’s why.

Jordan Grumet, MD

Physician

January 12, 2017

Dear Mrs. J,

I would like to express my deepest condolences on the passing of your mother. She was a magnificent woman, and I had the pleasure of being her doctor for almost a decade. It was a pleasure. During our short visits, she regaled me with stories of childhood and often gently sprinkled in advice gleaned from years of experience. Even as she began to decline, we would sit together …

Let’s make vaccines great again

Niran S. Al-Agba, MD

Physician

January 11, 2017

Robert Kennedy, Jr. is an activist, author, and attorney specializing in environmental law. He is the son of Robert “Bobby” Kennedy, a former U.S. attorney general, and the nephew of former President John F. Kennedy. Kennedy is president of the board of Waterkeeper Alliance, a non-profit focused on protecting and enhancing waterways worldwide. He has written a book about the damaging effects of vaccinations due to thimerosal, and to round …

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Let’s make vaccines great again

We must tell sad medical stories too

Richard Young, MD

Physician

January 11, 2017

This post is based on a “friend of a friend” situation. Important details have been changed to protect anonymity, but not the basic realities I want to discuss.

A 49-year old man was diagnosed with a rare form of lung cancer about a year and a half ago. This sad situation is compounded by the fact that he was in a stable marriage with a wife and two children, ages 10 …

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We must tell sad medical stories too

Why is my medical oncologist never on time for my appointment?

Prateek Mendiratta, MD

Physician

January 11, 2017

My daughter’s biggest fear before starting kindergarten was would she have enough time to finish her lunch in the time allotted. Luckily, she is not a busy medical oncologist in clinic. A medical clinic is not set up for those who take their time. Modern medicine is predicated that within a fifteen-minute visit, you are expected to see the patient, address their issues, place orders, and come up with a …

America needs more Michelle Obamas

Keith Pochick, MD

Physician

January 10, 2017

As a presidency draws to a close, it is natural to consider the legacy it etches upon the pages of history. For the most part, a first lady’s legacy is a sidenote. There are a few exceptions, of course. Eleanor Roosevelt, Jackie Kennedy, and Nancy Reagan come to mind. I believe that Michelle Obama’s legacy will be one of the more notable of the modern era.

For better or worse, race …

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America needs more Michelle Obamas

The double meaning of despair in the hospital

Kjell Benson, MD

Physician

January 10, 2017

How can a doctor resist an essay entitled, “The Sickness Unto Death?” Kierkegaard, the darkest of the bleak existentialists, begins by asking, “Is despair an excellence or a defect?” Can despair be an excellence?

It is December in Oregon, the rain comes down in sheets, with only a few hours daily of half-light. Kierkegaard’s winters in 1840 Denmark must have felt a lot like this, so I press on.

“In despairing over …

What a radiologist learned about a thoracentesis from a pulmonologist

Cory Michael, MD

Physician

January 10, 2017

It was 1989. While alternating between NCAA basketball tournament games on broadcast television, reruns of an older version of the game show Wipeout on cable, and the 8-bit Nintendo game Top Gun, a child sat in a hospital bed in the middle of rural America wondering why he was there. All he knew was that he had a sharp pain in the left side of his chest and that couldn’t …

How this doctor went from meek to confident

Geoffrey Rubin, MD

Physician

January 10, 2017

At 5:07 p.m. on July 27 of last year, my pager’s beep pierced the bustle of the hospital hallway: “CARDIAC ARREST. 6GS room 356 bed 2. Need cards STAT.”

It was only seven minutes into my first overnight call as a cardiology (“cards”) fellow, and I felt like I’d received a code-dose shot of epinephrine. In a most un-doctorly manner, I sprinted up the four flights of stairs to the ward.

Panting, …

Why physician engagement is code for physician control

Michael Breen, MD

Physician

January 10, 2017

Are physicians unruly children?

That’s the attitude I see at hospital C-suite meetings. (As in, “Our doctors are protesting our new unproven proton beam therapy center. How cute! They think they know how hospitals work: Even cuter, they think their opinion matters.”) Chuckles all around.

That smiling dismissiveness doesn’t surprise me. Call me cynical, but when people have power over other people, they become contemptuous. And in today’s world hospital executives have that power …

Massachusetts should reject naturopaths: A message to Governor Charlie Baker

Britt Marie Hermes, ND

Physician

January 9, 2017

I learned recently that the Massachusetts legislature passed the latest installment of the naturopathic licensing bill S.2335 in the final minutes of the 2016 legislative session. The bill is currently sitting on Governor Charlie Baker’s desk. He has a few days to sign the bill, which would make Massachusetts the 19th state to license naturopaths. If he does nothing, S.2335 will die from a pocket veto.

Senate Bill 2335 is asking a …

Stop being surprised: I’m a physician and a mother

Miriam A. Knoll, MD

Physician

January 9, 2017

“So, what’s your story?”

I knew right away what the medical oncologist was really asking. She and I were meeting for the first time while caring for a mutual patient. While getting to know each other, she asked me if I had children; when I answered in the affirmative, she asked me, “So, what’s your story?”

The question meant many things …

Planned Parenthood and my decision to go to medical school

Melanie Jay, MD

Physician

January 9, 2017

As my co-workers and I peered out the window of the Planned Parenthood in Philadelphia, we saw over 200 protestors chanting the name of a man who had killed 2 people and injured several others at reproductive health centers the day before. They kept coming closer and padlocked the entrance gate so that we were trapped. We worried they might have weapons. The stand-off lasted for three terrifying hours. As …

Involuntary discharge from dialysis: A health care practice like no other

Robert Allan Bear, MD

Physician

January 9, 2017

Chronic kidney failure is a serious disease. When progression to end-stage renal disease (ESRD) occurs, dialysis is required to sustain life.

It is shocking, then, that in the United States, it is estimated that over 1,000 patients annually are involuntarily discharged from their dialysis clinics. Further, they are often “blackballed” from other local clinics. The consequences for such patients, predominately African-American, are dire. A patient may be unable to find a …

Do primary care physicians increase life expectancy?

Niran S. Al-Agba, MD

Physician

January 9, 2017

U.S. life expectancy declined in 2015 for the first time in more than two decades, according to a National Center for Health Statistics study released last week. The decline of 0.1 percent was ever so slight ― life expectancy at birth was 78.8 years in 2015, compared to 78.9 years in 2014. However, this reversal of a long-time upward trend makes these results significant.

While many researchers are scratching …

Rule #1 of emergency room diagnostics

Lawrence Schlachter, MD, JD

Physician

January 9, 2017

An excerpt from Malpractice: A Neurosurgeon Reveals How Our Health-Care System Puts Patients at Risk.

It is not possible to live life in a way that every choice and decision awaits a definitive, double–blind study with a statistically significant …

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Rule #1 of emergency room diagnostics

Are women doctors better than men? Maybe they just see fewer patients.

James Block

Physician

January 8, 2017

Do women make better doctors than men?

A recent study in JAMA Internal Medicine claims that they do. According to the authors, there is a 4 percent risk reduction in mortality for elderly patients treated by women. There is also a small but clinically significant reduction in readmission rates. By their analysis, this difference could translate to approximately 32,000 lives saved “if male physicians could achieve the same outcomes …

A hospital gown to remember

Juliet B. Ugarte Hopkins, MD

Physician

January 8, 2017

“Orange is his favorite color. It’s all orange, all of the time in there.”

And, indeed it was. Like the deceptively soft glow from a garish, neon storefront light, passing his room, it was impossible for one’s eyes not to be drawn inside. Hunter blaze bedspread, pumpkin spice robe, marigold slippers, and even a persimmon beanie — wavelengths of orange permeated the otherwise drab, muted colors of the space.

It became a …

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A hospital gown to remember

A young child’s diagnosis of celiac disease. And her mother’s reaction.

Kimberly Greene-Liebowitz, MD

Physician

January 7, 2017

“Do you think she’ll have it?”

My husband and I lay in bed the night before Kol Nidre, cocooned by darkness. In the adjacent room, my son muttered as he dreamed. Further away, my daughter slept silently. During the Days of Awe, I should have been thinking about repentance, and being inscribed in the Book of Life, but I was distracted.

He turned towards me, though he couldn’t really see me, even …

Every patient is an athlete

Timothy E. Paterick, MD, JD, MBA and Elizabeth Ngo, MD

Physician

January 6, 2017

An excerpt from Physician—Time to Invest in Yourself: Work-Life Balance, the Needs of the Patient, and Medical-Legal Risk Management.

With advances in biotechnology, the average life expectancy is significantly longer today than in the past. As practicing cardiologists, we observe firsthand that even though there are artificial means to prolong our patients’ lives, they are still prematurely aging at an alarming rate. Many are sedentary, overweight, deconditioned, and apathetic. Consequently, they experience …

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Every patient is an athlete

When administrators shadow doctors and nurses, good things happen

Diane W. Shannon, MD, MPH

Physician

January 6, 2017

I want to share a cool idea used at Mission Health in North Carolina. I recently interviewed Dr. Ron Paulus, CEO of the health system. Three years ago the organization launched “Immersion Day,” when board members leave their corporate meeting rooms to shadow the doctors and nurses in their hospitals.

Journalists and legislators are also invited to join. They don scrubs, go through an orientation, sign privacy forms, and spend 9 …