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.

Pay primary care doctors what they’re worth

Allen Frances, MD

Physician

February 17, 2016

“It’s more important to know the patient who has the disease, than the disease the patient has.” This was true when Hippocrates said it 2,500 years ago — and it remains true today.

Unfortunately, doctors no longer know their patients. GPs are overworked, underpaid, and must shuttle patients in and out of the office in less than ten minutes. Specialists tend to treat the test, not the patient, and earn their …

The value of moving through grief to healing and growth

Claudia M. Gold, MD

Physician

February 16, 2016

(The following story was told to me by a friend; details have been changed to protect privacy.)

An early winter snowstorm left Janet with an unexpected whole day alone with her 17-year-old daughter Ally. As was typical for the pair, they spent the morning in comfortable separateness. Janet took advantage of the opportunity to catch up on paperwork, while Ally stayed in her room working on college applications. In Janet’s view …

This is what I’m wearing instead of a white coat

Kristin Prentiss Ott, MD

Physician

February 16, 2016

Hospitals are places of long-standing hierarchies where some people are made to feel important and others … not so much. A long time ago, I was told nurses used to stand when a white coat walked into a room. (Imagine that now. Laugh. Snort. Choke. Cough.) In those days, in the patient care setting, white coats were synonymous with importance.

These days, non-clinical hospital administrators, various technicians, and Clinique make-up counter …

Dr. Mona Hanna-Attisha is a hero. Here’s why.

John Schumann, MD

Physician

February 16, 2016

I have a new hero. Her name is Mona Hanna-Attisha, MD, MPH.

Dr. Hanna-Attisha is a pediatrician in Flint, Michigan. She grew up in a suburb of Detroit. She graduated from the University of Michigan before attending medical school at Michigan State University. During her clinical years (the 3rd and 4th years of medical school), she spent many months at Hurley Medical Center in Flint, which serves as a clinical training site …

Do physicians who go on long vacations lose their skills?

Michael Kirsch, MD

Physician

February 16, 2016

Years ago, I was having dinner with two members of the Cleveland Orchestra, one of the finest orchestras in the world. I asked them, with my kids present, how much time they devoted to their craft. As many parents know, getting kids to commit to practicing a musical instrument is about as easy as splitting the atom. The musicians told us how much time they practiced, which was mind boggling, …

The racial slurs didn’t hurt. Other things have hurt much more.

Maria Yang, MD

Physician

February 15, 2016

You could feel the air rushing out of her lungs and into your face if she was screaming at you.

“STOP CALLING ME A WHORE! I AM NOT A WHORE, YOU DIRTY N-GGER!”

No one, in fact, was calling her a whore.

“DON’T LIE TO ME, MOTHERF-CKER! I HEAR ALL OF YOU CALLING ME A WHORE! I HEARD IT, JUST NOW!”

Her best defense was a loud offense that included liberal use of racial …

Maybe God made teenagers difficult so we can let them go

Claire McCarthy, MD

Physician

February 15, 2016

It happens each time one of my children enters the teenage years (sometimes a little bit before). I go from having a lovely child and feeling like a reasonably pleasant parent to having a moody houseguest and becoming a shrew.

You’d think, having gone through this now four times, that I’d figure out how to avoid it. Or that I’d expect it. Or not let it bother me so much. Nope. …

The games drug companies play can dramatically raise costs for patients

Rob Lamberts, MD

Physician

February 14, 2016

I had a patient last week who was a real pain in the ass. Wait. No. He was actually a really nice guy. He wasn’t a pain in the ass; he had a real pain in the ass. Literally.

I was initially concerned about a pilonidal cyst, given the unfortunate fact that he was previously afflicted with this condition (which I consider to be incontrovertible proof of Satan). But, fortunately to …

When it comes to positive change, physicians are their own worst enemy

Suneel Dhand, MD

Physician

February 14, 2016

Physicians are an interesting and eclectic bunch of people who have sacrificed a lot to get to where they are. Just getting into medical school alone is an academic achievement to be proud of. And that’s just the start of the journey. What follows is one of the most rigorous courses of study in existence. Test after test, exam after exam. And when you’re finally done with medical school and …

How my cardiology practice changed with a click

Ami B. Bhatt, MD

Physician

February 13, 2016

I was a bit nervous as I had never done this before. I wasn’t even sure what I was going to do once I saw him. The only certainty in my mind at that time was that this was not the Norman Rockwell image of the physician-patient encounter that I proudly displayed in my office. He was my age, 40 years old, living on Nantucket with his wife and two …

Can we truly heal another if we can’t heal ourselves?

Dr. Eunice J. Minford

Physician

February 12, 2016

“Liver Transplant Surgeon Addicted to Alcohol” — reads like a headline from a tabloid paper selling sensationalism.

How could it be?

How could a liver transplant surgeon, someone who sees up close and personal the devastating effects of alcohol on the body, be addicted to alcohol? Surely the diseased, fibrosed, hard, shrunken cirrhotic livers with dilated and engorged veins that can rupture and bleed catastrophically; the yellow eyes and skin of the …

Is there any hope for physician-only anesthesia groups?

Karen S. Sibert, MD

Physician

February 12, 2016

Today is a remarkable day for me. I’m officially leaving private practice after almost 18 years, to return to academic medicine with a faculty position in a highly regarded California department of anesthesiology.

Why would I do that?

There are many positive reasons. I believe in the teaching mission of academic medicine: to train the anesthesiologists of the future, and the scientists who will advance medical care. I enjoy teaching. The years …

In defense of variation: A neurosurgeon takes on Atul Gawande

Ahilan Sivaganesan, MD

Physician

February 12, 2016

In 2012, celebrated surgeon-cum-writer Atul Gawande penned an incisive essay for the New Yorker entitled “Big Med.” Deliberately provocative, yet disarmingly reasoned, it suggests that American health care should borrow management practices from the Cheesecake Factory.

To set the stage, Gawande paints an unflattering picture of the status quo: medical costs are too high, quality is not reliable, service is often poor, and physicians differ widely in their approaches and outcomes …

Is a punitive culture contributing to physician burnout?

Jamie Coleman, MD

Physician

February 11, 2016

Burnout, burnout, burnout. It seems like that is all anyone wants to talk about these days. And I admit, some days, I can get burnt out on burnout. But, all the attention on the subject got me thinking. Did burnout not exist 30 years ago? Why is this such a hot topic now?

And that is what brings me to this post; I came to the realization that burnout very much existed …

Will cardiologists become slow and methodical internists again?

Hans Duvefelt, MD

Physician

February 10, 2016

When I started my first internship, back in Sweden in 1979, I worked under a fifty-something cardiologist who spoke slowly with a southern drawl — yes, there is a southern drawl there, too, slightly reminiscent of Danish, spoken not far from where my supervisor grew up.

He epitomized the old school of cardiology, before it became a procedural specialty. He diagnosed heart murmurs by auscultation with his stethoscope, and he even …

A potential real-life consequence of alarm fatigue

Jordan Grumet, MD

Physician

February 10, 2016

I felt like the stack of charts rose past my head and all the way to the ceiling. I pulled out my pen, opened the first, and started charting. I took a moment before each note to collect my thoughts. The patients were complex, the problems sometimes insurmountable. The nursing station at the facility was buzzing with activity around me. Phones were ringing, alarms were crying for attention.

On the desk …

Physician engagement scores are poor. How hospitals can improve them.

Richard Gunderman, MD, PhD

Physician

February 10, 2016

Many hospitals around the nation have been stung by dreadful physician engagement scores. Engagement is a problem not only for demoralized physicians, but for health care organizations, their employees, and everyone they serve. They should take note, because low levels of engagement are associated with higher physician turnover, increased error rates, poorer rates of patient cooperation in treatment, and lower levels of patient satisfaction.

Definitions of engagement vary, but it generally …

10 ways to become a physician entrepreneur

Natasha Deonarain, MD, MBA

Physician

February 9, 2016

I find myself standing in front of six first-year medical students. They’re waiting for me to tell them something about how to become a physician entrepreneur.

These students are now elite amongst their peers. They’re the ones who’ve had the courage to sign up for my course. And, perhaps unbeknownst to themselves, they’re also among the 1 percent of early adopters to lead the way for health care change.

How do I …

Surgery for your child is scary. This pediatric anesthesiologist is here to help.

Emily Knipper, MD

Physician

February 8, 2016

The parental drive to protect your child is passionate, and learning that your child needs surgery is jarring at best and terrifying at worst. As her guardian and provider, your instinct is to prevent harm to her at all costs, and even if you know that surgery is ultimately in your child’s best interest, the thought of her going through an invasive procedure, combined with the presence of illness or …

Why are female physicians scared to be women?

Nisha Mehta, MD

Physician

February 7, 2016

Women physicians are a testament to evolution; they’ve spent years, decades even, navigating through systems that do anything but cater to their unique needs, and actually find a way to thrive within these systems.

My question is this: Why haven’t these systems really evolved with them? It’s now been 167 years since Elizabeth Blackwell became the first woman to graduate with a medical degree in the United States. Nowadays, just shy of …

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