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.
The wrong body was cremated by the county coroner’s office in Los Angeles. Jorge Hernandez died of an overdose, and the body of another Jorge Hernandez, an indigent patient, scheduled for cremation, was also present in the morgue.
The distraught family of overdose victim Jorge Hernandez had planned a funeral with a viewing and were shocked when they were told his body had been cremated by mistake because a morgue attendant …
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Identifying patients by more than their names
When I was heading to a retreat held by the physician who started the ideal medical care movement, Dr. Pamela Wible, I expected an orderly and structured program on how to improve the current culture of medicine. I knew, with about 40 physicians and 10 other medical students, there would be a lot of Type A personalities since that’s typically the sort of people that go into medicine. While I …
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Are nudists, nature, and hippies the cure for an uptight doctor?
A young man with chest pains, shortness of breath and heart palpitations had come back for his follow-up visit.
His thyroid test and blood count were well within the normal range. His EKG was normal, and his chest X-ray was declared normal by the radiologist.
We talked some more about his anxiety and poor sleeping habits. We talked about his late shift at work, and we talked about his late gaming habits …
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Be the kind of parent you wished yours were
“If you do not cooperate, doctor, we will have no choice but to label you as being ‘disruptive’ and take whatever steps are necessary to remedy the situation.”
What physician does not dread hearing these words? Over the past several years, the term “disruptive” has been increasingly used to characterize and intimidate a physician who is perceived as not being a “team player.” With hospitals increasing the difficulty in navigating a …
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Get disruptive: 8 ways doctors create change at work
Madame Theriault refused a rectal exam but agreed to get me some stool cards, the first one the next morning, Saturday. Sadie, the lab tech, had enough blood to send off a B-12, folate and iron studies. We agreed to be in touch Saturday morning and Tuesday. If she gets worse, she will go to the emergency room.
The man who felt bad all over had a bilirubin twice the upper …
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Doctors are teachers too
When patients and their families seek hospice care, they are thinking about how they will die. They want to be without pain, shortness of breath, loneliness and, above all, fear. They want to end their lives with those they love, in a place they know, with respect and support. They want control. They want dignity. We all know this, and try to provide it as friends, family and caregivers. Nonetheless, …
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Dying holds as much meaning as living
“It’s strange how the worst day of your life often starts just like any other.”
– Joanna Cannon
I prepare for each clinic by reviewing the tests and scans of the patients who will be seen that day. Today, I am dismayed as I read a report for a longstanding patient. The news is not good; his scan shows that his cancer has returned.
Twenty years ago on a day like today, I …
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This is one of the most difficult tasks that physicians perform
It’s August. I’m looking out the windows of our log house and across the immense variety of green leaves, on oak and birch, mountain laurel and sycamore, magnolia and honeysuckle. It’s a rain forest here. Indeed, after a long dry spell, we’ve had days and days of soaking rain, with breaks in the clouds so that the sun raises steam from the earth like water coming up in the garden …
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Time is fleeting and doctors must focus on what’s important
This morning, I diagnosed a 49-year-old female with stage 4 colon cancer. She will probably not be alive in 5 years. She could have possibly prevented this diagnosis if she had known her family history. Many people don’t know the health history of their family. This holiday season is a perfect time and opportunity to delve into this history and prevent more senseless deaths.
The apple really doesn’t fall too far …
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This holiday season, pass the family history
In a time of rising health care costs, it’s hard to talk about the financial strife of physicians, who as a whole over time do very well financially. We see the bills from our doctor’s office, and it’s hard to imagine why anybody would complain about the upfront investment of a medical education, when the payoff seems so good.
Many recent articles make the case for why becoming a physician is …
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Why you should care about medical student debt
Just a minute before, I had been in surgery checking on the status of a patient who was undergoing an exploratory laparotomy. She had been doing OK, but deteriorated relatively quickly that afternoon while still in the hospital recuperating from an unrelated operation. The anesthesiologist popped out of the room to tell me what the initial findings looked like. It was not good. That’s when I went to speak to …
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The decision a family can’t make
Every day, millions of women across the United States find themselves in predicaments confronting the quality of their appearance. And their makeup. While this may seem a non-issue in the emergency medicine world, it is something that you, as a female professional, or that your female colleagues, have no doubt encountered. Before walking out the door, you have to consider not just what means of transport to take to …
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Makeup and the female physician
The pain is silent, subtle and gnawing, like that of being overlooked for a promotion, or being rejected by your dream college. Over 60 million Americans who voted for Hillary Clinton may be groping for a way to overcome such a pain after the stunning loss of their presidential candidate.
For thousands of years, sages have guided us on how to find comfort in a time of …
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4 ways to deal with post-election disappointment
Not long ago, I overheard a frustrated hospital leader ranting about the poor performance of a physician. It was not that the doctor was screwing up surgeries, ordering the wrong drugs or missing obvious diagnoses. Actually, the physician was rather adept at healing his fellow man.
The doctor’s failures concerned length of stay (far too long), sloppy medical records (incomplete, loaded with cut-and-paste) and a temper, which while not directly abusive …
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Doctors are taught how to balance blood pressure, not budgets. Don’t blame them.
I often avoid putting my politics on my sleeve, as I don’t want that to get in the way of our relationship. I want you to know that I treat you as a fellow human being, no matter your race, gender, sexual orientation. With the election results, what will change about how I treat you at the bedside? Nothing.
I may know about your criminal past. I see that tattoo underneath …
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The hospital is a microcosm of what I want the world to become
The election result shook the world. As the vote counts started to come in, most of the country descended into a state of collective shock and disbelief — even Mr. Trump’s own supporters. Nobody seemed more surprised than the political pundits on all the cable news channels, who had for months incorrectly predicted the opposite result.
Let me take a step back for a moment before I sound like somebody who …
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Can a Trump revolution happen in health care?
The Internet revolutionized the way we search for information as well as how we conduct business in our everyday lives. Everything can be purchased online: cars, clothes, groceries, vacation packages. Just about anything. Most people now research products before committing to them, and that now includes health care. It is estimated that 87 percent of adults in the U.S. use the Internet. Approximately 72 percent of Internet users seek health …
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Where do patients search for online health care information?
A recent story in Crain’s New York Business cited the difficulty small independent medical practices face coping “with declining reimbursement rates from insurers, rising overhead costs and a torrent of new regulations that have come into play in recent years.”
According to the article, only 26 percent of New York state physicians now own their own practice, compared with national rates of physician ownership of 76 percent thirty years ago. …
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Is independent practice better for doctors or patients?
