Is it possible to break down a complex phenomenon like professional burnout into a simple triad? We do it for exotic diseases all the time, so why not?
I still remember my salad days in med school vividly. Bouncing between the cockiness of amassing an entirely new body of knowledge and the awkwardness of having nary a clue how to use it, it was excitement I hadn’t felt before or since. …
The 3 killer B’s of physician burnout
“Medicine is not for boys.”
That’s what my 7 year old recently very emphatically told me. My son is not interested in becoming a doctor because it is for girls. He then suggested I discuss medicine with my 3-year-old daughter because she’s a girl.
My son instead prefers to be a fire fighter, soccer player, or superhero, or maybe a dentist because some boys still actually do that — but definitely not a …
Are we losing our boys in medicine?
I’m in the midst of a run of shifts in the emergency department. I’m doing locums away from home. Last night, I left work at about 3:30 a.m. (My shift was 6 p.m. to 2 a.m.) It was busy — not “crazy busy,” just “normal busy.” I finished my last note, wrapped up the information about the one patient I was leaving behind with the valiant night doctor and headed …
A frazzled doctor finally learns how to relax
As she lay on the gurney telling me she was tired and having vaginal bleeding yet again, I was doing my own biopsy of her medical record.
It stated very clearly that palliative care and hospice had been recommended to her for her end-stage gynecologic cancer. So, why, I’m thinking, highly annoyed, is she now in the ER, late at night, creating problems for me? Why could she just not accept …
A physician’s compassion well has run dry
My father worked as a middle manager in the textile industry for many years after he graduated with a degree in textile engineering from Georgia Tech in Atlanta. As far as I know, he was the first to graduate from college in his family. I can only imagine how exciting it was for him to leave the little town of Cochran, travel to the big city of Atlanta, work to …
What happens when a community loses its health care providers?
Do you know what the operator or person at the front desk is saying about palliative care? When people call, saying the want palliative care, how are they responding?
A study being presented in abstract form at the palliative care and oncology research symposium addresses this simple but critical question.
Researchers at Duke (Kathryn Hutchins, third-year medical student first author, Arif Kamal, oncopal researcher, senior author) cold called 40 major comprehensive cancer centers. They …
Do you know what your staff is saying about palliative care?
It is one of the most boring truisms on the planet: “Practice makes perfect.” It is also one of the most misleading. Practice merely ingrains certain patterns after deciding on the best course of action after constant criticism and problem-solving. Performance requires that the body forget the work required to ingrain the pattern and let the pattern happen. Performance requires that we drop all criticism and technical considerations. These two …
Does practice really make perfect?
“You must respect the body you are trying to heal.”
I heard this said twice into my headphones, the second time more slowly and firmly than the first, while I sat on the runway about to take off. It continued to echo in my head over the course of the flight. As a physician, the reference to healing a body has obvious resonance. However, as I embarked on yet another gathering …
Use generous orthodoxy to drive health care change
Fall brings school buses, a freshening breeze and an avalanche of meetings. There are seasonal sales, myriad projects and the splendor of colored leaves. The season is also announced, again and again, by a particular peculiar and perilous decision, which, no matter how much I try, I do not fully understand. Frankly, I just don’t get it.
“Jane, it is time to start chemotherapy.”
“What are the side effects?”
“Well, this is powerful …
Why do patients accept chemotherapy, but not flu shots?
Someone told me that the reason certain others don’t respect my advocacy on behalf of physicians more is simply that I am a woman. I am seeing this the more I speak up on issues facing doctors these days. It is now the 21st century, and there are a large number of women practicing medicine. In fact, the number of men and women entering medical school these days is nearly …
Eliminate the stereotypes about female doctors
Her 17-year-old legs dangled over the edge of the exam table. She had come for a prescription of oral contraceptives. Her boyfriend, she said, had been patient. He wasn’t ready to be a father, and so they were waiting. But lately he had started to put the pressure on and asked her to come in. She wasn’t eager for this change in their relationship, but it seemed like the next …
Why this physician stopped prescribing birth control
You won’t find me at any haunted houses this weekend. I don’t need any costumed creeps jumping out at me when I least (or most) expect it. I’ve never been a huge fan of strobe lights, fog machines, bad makeup, or canned Vincent Price laughter.
My day job is scary enough.
Some like to say that anesthesia is 99 percent boredom and 1 percent terror. They’re half right. The 99 percent is rarely boring. …
Boo! Being a physician can be downright scary
If you attended medical school, you learned in week one that American health care started becoming scientific in 1910, with the publication of the Flexner Report. Before then, only some medical schools were authentic while many others were anything from carnival booths to outright frauds.
Abraham Flexner, a respected educator, had been hired by industrial barons John D. Rockefeller and Andrew Carnegie, who were determined to bring health care out of …
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Sometimes an interesting thing happens on patient rounds. Rounds are a traditional exercise in hospitals going back at least a century. In the old days, this meant the physician going from patient to patient. He (it was nearly always he back then) went over the patient’s progress with the bedside nurse, examined the patient, reviewed pertinent test results, made an assessment, decided on a plan for the day, and gave …
A game of broken telephone in the hospital
When I graduated from medical school, my dad gave me several hundred dollars with instructions to buy something special. It was a kind gesture, but the pressure to self-select a meaningful gift was almost too much.
I wanted something to commemorate my transition from student to doctor. Books, stethoscopes, and the like seemed so uninventive. I wanted something for residency that would be …
The pink bag that symbolizes how far this physician has come
I read another post about the poison of GMO, corn syrup, baby formula. One more post in an extensive newsfeed. It is opinion, and I can scroll past, but it feels like another not so subtle reminder of the “breast is best” undercurrent that permeates everything baby related.
As a physician, I feel that breastfeeding is ideal. When I was a third-year resident, and I had my first baby, I was …
Breast is best shouldn’t be absolute. Here’s why.
My physical therapy education occurred within Harvard Medical School. My college, Simmons College, worked with Harvard in those days to prepare us (13 women) to enter the field with knowledge and respect for the roles and rules of clinical medicine.
In 1966, I was taught to stand up when a physician entered the room, to hand over the chart and open the door. There was never any doubt who was who. …
We owe our physicians the promise of satisfying careers
I’m a psychiatrist. I’ve been practicing for 30 plus years. I’ve worked in inpatient and outpatient settings seeing the typical mix of general psychiatric patients. About five years ago, I was asked to take the training for a buprenorphine license to serve as a backup for our addiction psychiatrist in her suboxone clinic. I did the training, doubting that I would every really use it on a consistent basis. But …
Why this doctor is drawn to the treatment of addiction
One of the latest trends in health care is “patient choice,” meaning the patient is in charge of their own care. Our job as a physician is to educate patients about the diagnosis, discuss the various treatment options, go over risks and benefits, then allow the patients to choose the best course of action. Of course, this assumes that patients always make the right choices and are solely motivated to …
Patients are in charge of their own health care ship
As we drown in the overwhelm of modern day health care duties, most physicians I know, including myself, fail to follow their own advice. Far too many of us have become overly tired, irritable and resentful about our workload. It is difficult to look forward to the dawn of the next work day.
Medical journals and blogs label this as “physician burnout” but the reality is very few of us are …
Advice physicians should follow. But don’t.
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