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.

Young doctors need to spend time in Veterans Affairs hospitals

Briana Buckner, MD

Physician

March 14, 2016

For most of residency, I missed the opportunity to care for veterans — mainly for selfish reasons, including my unwillingness to learn a new EMR and hospital. Once I became a chief resident, I realized that I would be spending four months at our local VA hospital. When I first came to the VA as a chief, my goals were similar to that at any other site at which I work: Get …

Concierge medicine isn’t right for this doctor. Here’s why.

Lucy Hornstein, MD

Physician

March 14, 2016

Apologies to Mark Twain, but reports of the death of private practice are somewhat exaggerated. There are still plenty of us around, and most of us are making out quite well. Not all, though. I’m quite sure the murmurs of discontent have reached many ears by now. So much so that many doctors unhappy with the status quo have taken action. One such action is to “go concierge.”

Concierge practice, also known …

Is there a Donald Trump at your hospital?

Suneel Dhand, MD

Physician

March 14, 2016

When Donald Trump announced that he was running for president last summer, most people didn’t know quite what to think. Was this serious or some sort of publicity stunt? Would he be in the race for more than just a few weeks of intense media spotlight? Would he be able to stand on a stage and debate other politicians? No matter what side of the political spectrum you fall on, …

A female physician is murdered. A call to action to end intimate partner abuse.

Esther Choo, MD, MPH

Physician

March 13, 2016

This week, the community of women physicians was rocked by the death of one in our midst, an anesthesiologist, intensivist, medical school faculty member, and mother, in an apparent domestic violence homicide. Dr. Casey Drawert (yes, we will say her name) was a highly accomplished physician married to a “prominent businessman” adding to the media-stickiness of the story. Her success clashes with our deeply entrenched biases about the demographics of domestic violence victims.

Yet …

I hated breast-feeding. How that helped my patient.

Monique Tello, MD

Physician

March 13, 2016

There have been many times when I have struggled to empathize with the patient. There are certain health care issues, and certain patients, that I have found consistently frustrating over the years.

I’ve written about this, and been pretty well chastised by readers. I don’t mind, because I know that 99 percent of physicians have their kryptonite issues, and just don’t talk about it. I’ll take the heat for being honest.

My …

Are volunteer study patients making a free choice?

Michael Kirsch, MD

Physician

March 13, 2016

There was a tragedy in France recently: Innocent French citizens were taken down by a profession whose mission is to heal and comfort. A medical clinical trial careened off the rails and crashed. Were these volunteer study patients properly informed? Are medical study patients here in the U.S. truly making a free choice?

From time to time, friends, patients, and relatives ask my advice if they should participate in a medical …

What’s the best way to evaluate surgery residents?

Skeptical Scalpel, MD

Physician

March 12, 2016

It comes as no shock to me, and probably many other current and former program directors, that a recent study showed faculty overall performance evaluations of residents do not correlate with their scores on the yearly American Board of Surgery in Training Examination.

According to the JAMA Surgery paper, faculty evaluations encompassed technical skill and the six core competencies — medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning …

Women may experience more pain than men, but receive less treatment for it

Padma Gulur, MD

Physician

March 12, 2016

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

That men and women are different has been discussed since Adam and Eve. That they experience and cope with pain differently has been consistently described in research studies.

It is concerning, however, to learn that women may experience more pain than men, but receive …

How to do a no hands-on physical in 3 minutes (or less)

Pamela Wible, MD

Physician

March 12, 2016

Pamela-Wible-Big-Box-Medicine2

Step 1: Greet patient.

Step 2: While chatting, check all boxes in electronic medical record for a complete review of systems and physical exam. Copy and paste parts of previous chart note while looking at patient every once in a while. Smile if possible.

Step 3: Tell patient to do yoga.

Step 4: Bill insurance company for complete physical exam.

Welcome to big box assembly line medicine.

Ever wonder what …

Two powerful words that more doctors should use

Neil Baum, MD

Physician

March 11, 2016

Sticks and stones may break my bones but two words — thank you — will not hurt you but will certainly help you.

We, myself included, are often so busy and always in a hurry rushing from one task to another that we often forget common courtesies. I believe that we can accomplish so much more with our patients, our staff, and even in our personal lives by not forgetting to …

This doctor quit medicine. It saved her life.

Errin Weisman, DO

Physician

March 11, 2016

I quit medicine. I was five months out of residency, and I was leaving medicine. I had dedicated my heart, soul, several years of my life along with weekends, holidays, special events, and my children’s first words to this honorable profession. Medicine was never suppose to “just be” my job. It was suppose to be my calling, and it had betrayed me.

I was finally a full fledged physician, and I …

I’m an emergency doctor and I’ve become human

Jeffrey McWilliams, MD

Physician

March 9, 2016

We walk down the halls, time and time again, each encounter a new discovery, mystery, or typical presentation. As ED providers, we see new faces, entwined with “frequent flyers” that have become in a weird way part of the family. Our job is often loosely entangled with our identity and existence. It becomes hard to have dinner conversations without discussing therapies, changes in health care, Obamacare, or “unusual cases.” We …

How palm reading helps this physician today

Divya Yerramilli, MD

Physician

March 9, 2016

I grew up in a house of spirituality, homeopathy, palmistry, astrology, art, and science alike. My father, with a masters degree in statistics, is a computer systems architect. He also fancies himself an amateur palm reader. The irritation with which I reluctantly used to give my hands over to my father, before the SATs, college decisions, medical school admissions, and my residency match results was real, but I was always …

Should doctors marry doctors? Here are the challenges they face.

Tanika Forestal

Physician

March 9, 2016

Fifty years ago, it was very uncommon to find doctors married to other doctors. Why? To answer that question, we need to explore the sociology of the time. Fewer women went to college, which meant fewer female doctors. Many couples married early, right out of high school or right after college. If the wife had career aspirations herself, these were often put aside in order to help her husband get …

The heartbreak of dating an exhausted medical resident

Ruth Diaz, PsyD

Physician

March 8, 2016

When I was finishing my fifth year of studies as clinical psychology doctoral student, I fell in love with a second-year medical resident; a wanderer at heart with the softest smile and a way of listening that made me feel like the whole world stopped when I spoke. Whenever possible, we found ourselves in the forest exploring the world on foot or, if the weather was bad, on long drives …

How a young doctor treats young patients

Chiduzie Madubata, MD

Physician

March 8, 2016

On a typical day in a major hospital, patients pass through the emergency room with different ailments. Some of them are coming in to check out minor aches and pains, and others are coming in barely responsive with a life-threatening condition. Outside of the pediatric ward, all of the patients coming in are adults, and the majority of them are advanced in years, showing signs of chronic conditions taking effect …

Spare your loved ones from this dreaded scenario

Alberto Hazan, MD

Physician

March 7, 2016

What if you woke up tomorrow and learned that your grandmother had been kidnapped overnight by a couple of strangers, thrown in a white van, and taken to a distant warehouse where she spent the subsequent forty-five minutes being tortured before finally succumbing to her death?

Where she was repeatedly beaten in the chest, where a tube was shoved down her throat, where she was tasered with high voltage, where a …

Why we need to build bridges between primary care and anesthesiology

Karen S. Sibert, MD

Physician

March 7, 2016

The numbers haven’t changed significantly in several years — only five percent of the U.S. population consumes a full 50 percent of annual health care spending, and just one percent is responsible for nearly 23 percent of spending.

Within the top 10 percent of high spenders, most (nearly 80 percent) are age 45 or older. About 42 percent are persistent high consumers year after year, while the majority requires high spending …

Society must decide what it wants from health insurance

Mark Lopatin, MD

Physician

March 7, 2016

Jeffrey Lurie is the owner of my beloved Philadelphia Eagles. He pays the players. He picks the coaches. But I think we would agree that his checkbook should not allow him to be the one who calls the offensive plays. The coach should do that.

So why is it different in health care?

I have a patient who was diagnosed with polymyositis. Polymyositis is an autoimmune disease that causes inflammation of muscles …

Why Sir William Osler is the cure to online cynicism

Janice Mancuso

Physician

March 6, 2016

Comments have again morphed into an essay. And, once again, they’re in response to a blog post by Dr. Suneel Dhand: When it comes to positive change, physicians are their own worst enemy. I thought it was excellent and spot-on. My first comment read in part: