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.

Healing at the hospital begins with peace and quiet

Pallabi Sanyal-Dey, MD

Physician

July 31, 2016

The space can make a difference. I had already spent over two years working as a hospitalist at San Francisco General Hospital, and I had become accustomed to the old building and all its challenges. Fast forward to the end of May 2016 to one of my first shifts working in the new building, a.k.a “The Zuck”: Zuckerberg San Francisco General (ZSFG). Change had never felt so good.

I walked across the …

The worst thing about being an internal medicine intern

Marc N. Katz, MD

Physician

July 31, 2016

The only thing I love more than complaining about being a doctor is actually being a doctor. Intern year sucks. There’s no way around it. I wake up at 5:15 a.m. to get to the floor at 6:00 a.m. and I rarely leave at 5:00 p.m. when my shift is scheduled to end assuming I’m not on call until 9:00 p.m.

I often feel my stomach growl at 9:00 a.m. and …

Should doctors and nurses wear scrubs outside the hospital?

Skeptical Scalpel, MD

Physician

July 29, 2016

Every few months when things are slow, someone publishes an article about the imaginary dangers associated with doctors wearing scrubs in public. A recent version is from The Atlantic. An associate editor saw some people in scrubs having lunch in a restaurant and was, of course, horrified. She questioned the magazine’s medical editor, Dr. James Hamblin, whose response was remarkably reasoned (until the end).

He pointed out that it …

A doctor turns to social media for organ donation

Yul Ejnes, MD

Physician

July 29, 2016

A guest column by the American College of Physicians, exclusive to KevinMD.com.

A couple of months ago I received a Facebook invitation to “like” a page. That was not unusual, and usually the pages are on silly or obscure topics, but this page was different. The name of the page was New Kidney for Stu.

Stuart …

The word “burnout” perpetuates medicine’s cycle of abuse

Pamela Wible, MD

Physician

July 29, 2016

burnout2

Illustration by Jorge Muniz, PA-C.

We enter medicine with our hearts and souls on fire ready to serve humanity. By the time we complete medical training many of us have anxiety, PTSD, depression — even suicidal thoughts. Why? Medicine is stressful. Many of us work 100-hour weeks surrounded by suffering and death. We may deliver a stillborn, try to save a teenager with a …

Anticipatory guidance for dark times

Alexandra Iacob, MD

Physician

July 28, 2016

As a pediatric resident, I have the joy of building relationships with families and watch their children grow while providing them with anticipatory guidance at every visit. From newborn visits to toddler visits to teenager visits, they come, and we all grow together. (They grow chronologically and as a family, I grow in my experience and knowledge.)

The questions come in such a wide, but expected, variety: “When can I introduce …

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Anticipatory guidance for dark times

A physician’s response to Islamophobia

Mike Stillman, MD

Physician

July 28, 2016

I recently wrote an email to two Muslim colleagues apologizing for our nation’s political tenor. I shared with them my embarrassment over suggestions that our government bar Muslims from immigrating and monitor those who live here, my concern that a presidential candidate’s support congeals rather than erodes when he brays that “Islam hates us” and suggests that mosques be closed, and my dismay that so few …

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A physician’s response to Islamophobia

Direct primary care: Being different is the biggest asset of all

Josh Umbehr, MD

Physician

July 27, 2016

“The road to success isn’t productivity, it’s differentiation.”
– Tony Crabbe

That statement is invaluably true — especially for direct primary care (DPC) professionals. Your patients aren’t coming to you because you’re the same as everybody else. In fact, they’ve chosen you for the exact opposite reason. You’re gloriously different. The other guys force patients into the mold they’ve created: restrained by long waits, life-sucking insurance battles, and reduction to nothing more than a chart to be …

What I learned from the 2 Mikes, and why physicians should be like them

Scott Krugman, MD

Physician

July 27, 2016

They were both named Mike. Both were superstar physicians and educators at MedStar Health. Both had a wife named Pam, a son, and a daughter. And both died untimely deaths within a year of 50 at the mid-point of their ascending careers, 18 months after being diagnosed with cancer. I don’t believe they knew each other, but having worked with each of them, they will be forever linked in my …

The story behind removing the satisfaction score barrier from safe prescribing

Roneet Lev, MD

Physician

July 27, 2016

CMS announced that they will remove questions related to pain from the hospital consumer assessment of health care providers and systems (HCAHPS), commonly known as patient satisfaction survey. This means that hospitals would continue to use the questions to survey patients about their inpatient pain management experience, but these questions would not affect the level of payment hospitals receive. This is a big victory for patients and the house of medicine.

Here …

Residency doesn’t prepare you for these 7 important topics

Robert Frantz, MD

Physician

July 26, 2016

There’s no doubt physicians entering practice today leave their residency programs with a tremendous amount of medical education and training; what seems like a lifetime’s worth of knowledge crammed into just a few, intense years of instruction.

Unfortunately, all the time residents spend on rotations, lecture, journal club, and myriad other obligations leaves little opportunity for getting oriented to the more mundane, yet absolutely critical components of practice. As a result, …

Psychiatry is a field in upheaval about diagnosis

Robbie Fenster, MD

Physician

July 25, 2016

Ms. C was one of my first patients with schizophrenia. I saw her on the inpatient unit of a psychiatric hospital where I was training as a psychiatry resident. Ms. C suffered terribly from what we call the negative symptoms of schizophrenia; she sat mute for much of the day in her bed, staring out of the window. She would occasionally respond to a question with a one-word response, but …

The story of the man who could see the invisible

Mark E. Williams, MD

Physician

July 25, 2016

Once upon a time long, long ago there lived a man who could see things that other people simply could not see. He was not born with this skill but cultivated it slowly and continuously with years of focused attention.

He worked as a physician in a large hospital and would sometimes have students go with him to see patients. As far as the students were concerned, he could really see …

A letter to my son, the surgeon

Tracey Delaplain, MD

Physician

July 25, 2016

It is too easy to lose your way as a physician when faced with the daily stress of real medicine. Spending time with the next generation of physicians gives me faith that we will always have a few doctors who stand out as not just competent, but caring healers.

My son is currently a surgical resident. After the break, is a letter I wrote to him when he was an intern. A …

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A letter to my son, the surgeon

What does the opioid crisis have to do with patient satisfaction?

Tanya Feke, MD

Physician

July 25, 2016

The chief medical officer for Press Ganey Associates, Dr. Thomas Lee, recently posted a blog article in the New England Journal of Medicine, “The Pain That Results From Pain Management.” It is no surprise that Dr. Lee takes a stand in defense of patient satisfaction surveys. His company is one of the leading companies in the medical survey industry. With the emphasis placed on the opioid …

A reminder that there are no guarantees with cancer

Don S. Dizon, MD

Physician

July 23, 2016

Most times, I feel excited to be an oncologist. Oncology research is accelerating and every week brings more news, whether it be a deeper understanding of tumor genomics, a broader understanding of cancer genetics and risk, and, it seems, more ways to provide precision therapy. Studies are coming out showing gains in survival in many different cancers, and …

What we can learn from old school physicians

Suneel Dhand, MD

Physician

July 23, 2016

The term “old school” in many facets of life has negative connotations. We live in a modern, technologically advanced and fast-paced world — and there’s no room for certain people who appear to hold us back.

Last year I wrote an article about an experience I had with an “old school” physician. That experience really caused me to reflect on the situation the medical profession finds itself in, …

Today happens once. And we are guaranteed nothing.

Michael P. Jones, MD

Physician

July 22, 2016

As I sat next to her bed in the intensive care unit, I wondered if she knew that today was her last day when she woke up this morning. I didn’t think she knew that it was her last day now. I was sure that she knew that something was wrong but did she know that she’d be dead in a few hours?

One of the most profound things about being a …

This is why hospice work is so fulfilling

Laura Patel, MD

Physician

July 22, 2016

I make my way down the aisle of the plane, squeezing past my fellow passengers and plop down in my assigned seat. Sitting next to me is a middle-aged woman with a kind smile. As the plane takes off, she begins making small talk: ”What do you do?”

I silently debate, do I adopt my travel persona or answer truthfully? Answering honestly will result in one of two things; either we …

How maternity leave cost this physician

Alicia Welder, MD

Physician

July 22, 2016

When I had my first baby, I was a busy resident trying to complete my residency on time. I didn’t want to extend my residency even if it meant sacrificing time with my newborn. In order to get my 8-week leave, I banked days whenever I could. There was one period I worked 45 days straight (well, not straight, I did get the mandatory 24 hours off between once a week) so …

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How maternity leave cost this physician