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.

My job as a doctor is to take data and apply it to real people

Abigail Schildcrout, MD

Physician

April 12, 2016

A friend posted an article on her Facebook page discussing a recent research study out of Sweden showing that people on the autism spectrum have a decreased life expectancy. This friend has a child with autism. Autism coupled with learning disability, according to this study, is associated with the largest decrease in life expectancy. This friend’s child has learning disabilities along with autism.

My friend is scared.

On top of her worries …

Dear health care administrator: Physicians are your friends

Hans Duvefelt, MD

Physician

April 12, 2016

Dear health care administrator,

I am writing to you in a spirit of cooperation, because the way health care works today, it is too complex a business to manage on the side while also taking care of patients. And I hope you don’t have any illusions about medicine being so simple that non-physicians like yourself can manage patients’ health care without trained professionals who understand medical science and can adapt the …

Most of the care you’re receiving isn’t patient-centered. Here’s why.

Rob Lamberts, MD

Physician

April 12, 2016

My last post discussed the wide gulf between health care and the rest of the world in the area of customer service. To sum up what took over 1,000 words to express: Customer service in health care totally sucks because the system promotes that suckiness and does nothing to penalize docs who make people wait, ignore what they say, rush through visits, and over-charge for their care. We …

Who are the patients that stay in the hospital for a very long time?

Janice Boughton, MD

Physician

April 11, 2016

I just finished reading a very delightful A Piece of My Mind essay in JAMA. JAMA is primarily a research journal, filled with new scientific or semi-scientific studies and comments on those, plus reviews of the literature and editorials on science or politics. There are also letters and announcements and educational sections for doctors or patients, even poems, but the part I like to read all the way through is …

The best way male physicians can help their female colleagues

Will Flanary, MD

Physician

April 10, 2016

The consult was for “decreased vision and eye pain.” Inpatient consults at the VA hospital come up infrequently, but when they do, it’s inevitably something interesting. As soon as I access the patient’s medical record, a flashing rectangular box encasing a smattering of phrases such as “warning,” “inappropriate behavior,” and “female employees” pops up on the screen. I’m accompanied by one of our female residents, Dr. Smith. Once we leave …

Why I stopped prescribing narcotics, and never looked back

Alan G. Berg, DO

Physician

April 10, 2016

I was never a big prescriber of narcotics. I grew up “country,” in a tougher world where your parents taught you to accept pain as a part of life. Pain is how you know you’re still alive. They’d tell me, “if you’re hurtin’ you ain’t dead yet.” You fell down; it was going to hurt. You learned not to fall. Twisted your ankle doing something stupid (and it was always …

Making your own infant formula at home is a recipe for disaster

Alexandra Sowa, MD

Physician

April 9, 2016

Recently, former reality television star Kristin Cavallari released a potentially lethal recipe for homemade baby formula in her new lifestyle book, Balancing in Heels. Cavallari, who rose to fame as high-schooler on MTV’s Laguna Beach, is attempting to rebrand herself as an all-organic Suzy homemaker and offering dangerous medical advice along the way.

In her book, Cavallari goes against all conventional medical wisdom, advocating for feeding young babies a homemade concoction instead …

Women surgeons can do it all

Brittany Bankhead-Kendall, MD

Physician

April 9, 2016

“Beautiful girl, you can do hard things.”

I saw that quote on my favorite Facebook group recently, called Physician Moms Group (or PMG). This is a group of women who, like all of us, are just trying to “do” life every day. Because of our integrity and intellect, we are trying to do it better than anyone else. I think that’s from a Type A personality, combined with leadership and wanting …

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Women surgeons can do it all

Primary care has a dual meaning

Megan Chock, MD

Physician

April 8, 2016

One year ago (read: before intern year), pretty much the most exciting part of my fourth-year emergency medicine rotation was having my pager go off. BZZZZ! I leapt into action, excitingly reading the text page: “Leg lac in E9.” I was on it.

Suture kit in hand, I burst through E9’s thin emergency department curtains with abandon; I was going to fix this. The “leg lac” turned out to be a …

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Primary care has a dual meaning

American health care has a customer service problem

Rob Lamberts, MD

Physician

April 7, 2016

No, customer service in the U.S. is terrible when it comes to health care. No, the customer service in the U.S. health care system is horrendous. No, health care has the worst customer service of any industry in the U.S.

There. That seems about right.

What makes me utter such a bold statement? Experience. I regularly hear the following from people when they come to my practice:

“You are the first doctor who …
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American health care has a customer service problem

This is what life is like for a gastroenterologist

Matthew Moeller, MD

Physician

April 7, 2016

An excerpt from What It’s Like to Become a Doctor: The Year-by-Year Journey From Medical Student to Practicing Physician, Greenbranch Publishing, 2016.

I passed the board exam in November 2011 to become a gastroenterologist. This is the last exam I have to take until I recertify in internal medicine in 7 …

Want to fix MOC? This is one idea to do it.

Andrea Paul, MD

Physician

April 6, 2016

There has been a significant amount of outrage over the past few months of the maintenance of certification process. The anger has not only been targeted towards the ABIM, but also towards the other specialty boards. Pediatrics, for example, now requires ABP approved quality improvement (QI) projects that have been widely criticized.

While these MOC requirements are a major nuisance for most, the implications may actually run much deeper. A number …

The opioid epidemic: It’s time to place blame where it belongs

Ronald Hirsch, MD

Physician

April 6, 2016

The media is full of stories about the current opioid crisis. But unlike many national crises, such as the Flint lead-contaminated water crisis, the focus is on solutions, not blame. A few weeks ago, the Centers for Disease Control and Prevention issued guidelines for prescribing opioids in chronic pain. Congress approved funding for prevention and treatment, and the US HHS released a “National Pain Strategy.”

So to fulfill …

Compassion on the inpatient oncology service

Don S. Dizon, MD

Physician

April 5, 2016

She had been admitted overnight: a previously healthy 62-year-old woman who had been blindsided by acute onset of abdominal bloating and pain 6 months prior. A flurry of tests showed she had pancreatic cancer, and that it was advanced. She had started chemotherapy, but the regimen was so toxic; she suffered from unrelenting nausea and fatigue to …

Ask your doctors how they are doing. Please.

Julie Wei, MD

Physician

April 5, 2016

It’s Tuesday around 9 a.m., and I, a pediatric ear, nose, and throat surgeon on my third or fourth patient at a satellite clinic an hour away from home when the abdominal pain started. It feels as if someone is repeatedly stabbing a knife, and twisting it around, right below my breastbone.

I barely got through that encounter, then moved to the next patient. It will stop, it has to. There were 14 …

Patient-centered perioperative checklists to improve surgical care quality

Fred E. Shapiro, DO

Physician

April 4, 2016

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

With the recent expansion of ambulatory surgical centers, the number of outpatient surgical procedures has increased at an exponential rate. Coupled with the rise in volume has been the increasing complexity of procedures and underlying diseases of patients. The convergence of these factors …

You can’t compare health care to the airline industry. Here’s why.

Suneel Dhand, MD

Physician

April 4, 2016

There’s been a lot of talk for quite some time in health care quality improvement circles about why health care can’t be as safe as airline travel. Some of the reasons behind asking this question are very valid, as there are many things health care can learn from the aviation industry. Others, however, are complete fallacy; because on so many levels, it’s like comparing apples to oranges.

Over recent weeks, I’ve …

It’s time to instill a positive culture in medicine

Robert Centor, MD

Physician

April 4, 2016

This year marks 33 years of administrative positions in academic medicine. When I first started, I suspect I made many major mistakes. I learned through the time-tested school of hard knocks. As I reflect on my own career, and those whom I have observed, I have come to believe the famous saying, “Culture eats strategy for breakfast.”

Look at ward attending physicians. The same attendings have “good teams” every …

Why paying doctors more is a win-win

Jonathan D. Gelber, MD

Physician

April 3, 2016

With the upcoming presidential nominations on the horizon, one of the go-to topics for candidates has been health care. What’s wrong with it. How we can fix it. Is it Obama’s fault? But there is actually one key piece of the puzzle missing which actually can create a win-win situation. It’s a very simple strategy: Pay doctors more.

When the idea of paying doctors more money for their work is proposed, …

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Why paying doctors more is a win-win

The unknown impact of changing a person’s genetic makeup

Justin Morgan, MD

Physician

April 1, 2016

In February 2015, the British Parliament approved the creation of a human embryo from the DNA of three people: mother, father and a donor mother. The modified in-vitro fertilization (IVF) technique, called mitochondrial replacement therapy (MRT), would help some mothers with known rare mitochondrial mutations avoid passing on unhealthy defects. These defects can cause severe or deadly diseases, which are often incurable, such as muscular dystrophy, heart and kidney disease, liver …

Physician

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