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.

Direct primary care physicians are trying to rescue other doctors

W. Ryan Neuhofel, DO, MPH

Physician

September 2, 2016

In a recent interview, Dr. Farzad Mostashari (former national coordinator for health IT and current CEO, Aledade ACO) gave some advice to physicians on how to avoid burnout and “restore their role as caregivers”:

The key is two things. One, if you’re in a kayak in the rapids, you have to lean in and dig your paddle in and push ahead. If you lean back, you’re done. You’re going to flip …

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Direct primary care physicians are trying to rescue other doctors

How a board of optometry is restricting eye care to homebound adults

Helen Kao, MD

Physician

September 2, 2016

This spring, the California Board of Optometry shut down the only optometrist providing services to homebound patients in the San Francisco Bay Area. I learned about this because affected patients included several referred from our UC San Francisco Housecalls program, one of a few non-profit, non-concierge home-based practices in the state providing geriatrics care to homebound adults.

With over 1 million adults homebound in California, why would any board deliberately limit …

This is what my ideal EHR looks like

Niran S. Al-Agba, MD

Physician

September 1, 2016

Give me technology which improves my life and that of my patients, or give me death. Medical records must be informative, efficient, and flexible; like the physicians they serve. For me, a medical record does not contain just a collection of problem lists, prescribed medications, and immunizations; it is a noteworthy account of the health care provided to another human being over a lifetime.

Recently, I attended a baby shower of …

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This is what my ideal EHR looks like

Vaccine hesitancy: It’s time to go on offense

John Merrill-Steskal, MD

Physician

September 1, 2016

The term “vaccine hesitancy” is a relatively recent term in medicine, a term used to describe patients who are worried about the safety, efficacy, or necessity of receiving immunizations. Vaccines are safe and have a proven track record of saving lives. As a result, doctors been caught somewhat off guard by the notion that anyone would have second thoughts about the benefits of immunization.

Recommendations commonly publicized on how to respond …

Physicians are the emotional punching bags of society

Jean Robey, MD

Physician

September 1, 2016

The Washington Post featured an article by Dr. Michael Stein, “We all want doctors to be kind. But does kindness actually help us get better?” He presented intriguing but inconclusive data regarding the benefits of a “kind” doctor on control of diabetes or on perceived duration of colds for instances. In the end, Dr. Stein concludes, “At the moment, the best answer to the kindness contrarian is: Even …

Why psychiatrists should stop diagnosing presidential candidates

Maria Yang, MD

Physician

August 31, 2016

The New York Times and NPR recently published articles related to the Goldwater Rule. In short, a magazine sent a survey to over 12,000 psychiatrists in the U.S. with the single question of whether they thought presidential nominee Mr. Barry Goldwater was fit to serve as president. Few psychiatrists responded. Of those that did, more than half — still over 1,000 — said that …

A wonderful hour of being a real doctor

Justin Reno, MD

Physician

August 30, 2016

Sometimes the business plan completely falls apart. I look at my clock; it’s 11 a.m., and I only have two patients remaining for the morning? Something must be wrong. Every fail safe measure to keep the assembly line going must have failed. The initial card with the appointment time to carry in the wallet? Failed. The reminder phone call the day before? Failed. Even the insurance company gift card to …

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A wonderful hour of being a real doctor

To the doctors struggling with depression: You are not alone

Elisabeth Poorman, MD

Physician

August 30, 2016

By the end of my first year of residency, I knew I was in trouble.

I was overwhelmed by the 15-hour days, the unbearable sadness of the tragedies I witnessed, my feelings of impotence and my fears of making a mistake.

My life was my work, and everything else seemed to be falling apart: my physical health, my relationships, my ability to sleep after months of night shifts.

Yet, I came to work …

How the power of song connected me with a patient

Pepi Granat, MD

Physician

August 30, 2016

She smiled fetchingly and threw her arms around me. She was so happy to have someone to hug. She was large, obese, kyphotic and almost bent double while edging slowly with her walker toward the examining room. She had sent a Christmas card and a birthday card, and I thanked her for them, while secretly praising myself for remembering she had sent them.

She was diabetic and hypertensive and 88 years …

Jess Jacobs: Thank you for what you taught me

Fatima Z. Syed, MD

Physician

August 29, 2016

I never knew Jess Jacobs, and she never knew me. Everything I know about her I have learned from her Twitter feed, her website, and articles written about her. She was the same age as me when she died recently. She was educated. She knew the health care system inside and out, as an expert in insurance and policy and as a patient. But she was more than …

We are nurses: Stop the bullying in health care

Debbie Moore-Black, RN

Physician

August 29, 2016

The surgeon is doing a tonsillectomy on a 4-year-old boy. Dr. Jones drops an instrument on the floor of the OR. The instrument is now contaminated and has to be sterilized by a special machine called an autoclave. This was a small hospital, so they did not have a large inventory of duplicate surgical instruments. So the circulating nurse put the instrument into the autoclave. As this machine locked in …

Instead of training more doctors, why don’t we keep the ones we have now?

Jaclyn van Nes, MD

Physician

August 28, 2016

In an article from the Pew Charitable Trusts, an upcoming scarcity of OB/GYNs in the U.S. is predicted with a potential shortage of 22,000 OB/GYNs by the year 2050. Reasons given for the shortage are a growing population, female OB/GYNs retiring early and working part-time, residents entering sub-specialties and changing physician attitudes about work-life balance. Suggestions in the article to combat the shortage are increasing OB/GYN residency spots and supporting …

Physicians will rise to take back the bedside

Jean Robey, MD

Physician

August 28, 2016

Art explains medicine by explaining human needs. In December of 2015, Dr. Michael P. Jones wrote a piece that had 27K shares: “We’ve killed the way physicians should be.” It is interpreted that 27K readers or more identified with what Dr. Jones wrote.

In his essay, he claimed the identity of a physician was being “killed” by the reality of practice demands. The essay referenced an image of the …

A failure in transition of care

Hans Duvefelt, MD

Physician

August 28, 2016

Alvion Barr had a four-month delay in his diagnosis.

He is technically a patient of my colleague. But he had drifted between two of our regular doctors and a locum tenens physician we hired to work during March, when both other doctors were on vacation.

I saw him late Thursday afternoon for a rash, but he also asked what he could do about his heartburn.

“Tell me more about your heartburn,” I said.

What followed …

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A failure in transition of care

How words create bridges to a therapeutic relationship

Anne Katz, RN, PhD

Physician

August 28, 2016

I am sensitive to language and the way we use it in health care; as the editor of the Oncology Nursing Society’s premier research journal, the Oncology Nursing Forum, and as a sexuality counselor, words are my business and the tools I use to educate, inform, and disseminate knowledge.

The conversation typically goes like this:

Me: “Hello, can I speak with Mr./Ms. X …

The true essence of what it means to be a companion

Amanda Sommerfeldt, MD

Physician

August 27, 2016

The world can be a lonely place. Despite technology designed to bring us closer, it seems we’ve become more isolated. We view profiles rather than embrace complete individuals. We spend hours crafting a persona, a smooth and unblemished public face. Raw, unattractive emotions: grief, insecurity, jealousy. We mask those from others and even hide them from our deepest selves. Ultimately, rather than becoming more connected, I suspect we are cast …

Politics in the exam room? Here’s what this doctor does.

Steve Schlozman, MD

Physician

August 26, 2016

When I was 17 years old, I insisted that my father, a pulmonologist, join Physicians for Social Responsibility. I had just read about the organization in my history class, and I was feeling increasingly hopeless that I would live to see my 30s if the world continued its march toward nuclear Armageddon.

My father refused to even have the discussion.

I’ll get to why he refused in a minute, but first, a bit of …

The bureaucratic hassles physicians face are extraordinary

Peter Ubel, MD

Physician

August 25, 2016

Left to our own devices, most of us physicians try our best to provide high-quality care to our patients. But almost none of us provide perfect care to all of our patients all of the time. In fact, many of us get so caught up in our busy clinic schedules we occasionally forget to, say, order mammograms for women overdue for such tests, or we don’t get around to weaning …

Donald Trump’s medical letter has so many things wrong with it

Jennifer Gunter, MD

Physician

August 25, 2016

Donald Trump is talking about Hillary Clinton’s health as are two doctors who have never evaluated Clinton. This attention on Clinton has renewed some interest in the letter Donald Trump released last year from his personal physician.

Many outlets have picked it apart, but I want to tell you as a doctor exactly how bad it is. I would never write …

Why we should remember our moments of vulnerability

Michelle Zhang, MD

Physician

August 24, 2016

During my first rotation of intern year, we took care of a woman who walked into the hospital with a kidney stone and never walked out. 52 years old, diabetic but otherwise healthy, she had been vacationing in Vermont with her son and extended family when she became sick with high fevers. When her symptoms didn’t improve, her son rushed her to our emergency room where an imaging scan revealed …

Physician

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