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.

The imaginary line between doctor and patient is truly precarious

Laura Patel, MD

Physician

January 28, 2016

As I sat in my hospice interdisciplinary group meeting, reviewing the many patients who have died in the past two weeks as well as our new patients, there was a slight break in the discussion. Being ever the multitasker, I clicked on a New York Times article I had been meaning to read and scanned the first two sentences: “When my husband died from cancer last March at age 37, …

Dying is a vexing problem for the medical profession

Dr. Saurabh Jha

Physician

January 26, 2016

Thomas Hobbes described life as pitifully “nasty, brutish, and short.” Thanks to the free market and the state, life is no longer a Hobbesian nightmare. But death has become nasty, brutish, and long.

Surgeon and writer, Atul Gawande, explores the medicalization of ageing and death in Being Mortal. Gawande points to a glaring deficiency in medical education. Taught to save lives and fight death, doctors don’t bow out gracefully and …

Will the real doctor please stand up?

Kristin Prentiss Ott, MD

Physician

January 26, 2016

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In 2006, graduate nursing programs started granting doctorates of nursing practice (DNP degrees). In a media fact sheet, the American Association of Colleges of Nursing (AACN) explains the thrust for the change this way:

Some of the many factors building momentum for change in nursing education at the graduate level include: the rapid expansion of knowledge underlying practice; increased complexity of …

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Will the real doctor please stand up?

True confessions of a surgeon: What’s the best question you can ask her?

Starla Fitch, MD

Physician

January 25, 2016

Picture this: You’re in the operating room, performing a challenging procedure. (If you’re not a doctor, roll with me here and play along. You’ll get it soon.)

You’re feeling pretty good about how the surgery is going.

You’re grateful that your usual team is with you, because that always makes you feel more confident.

Then something happens …

Right at the most critical part of the procedure, crisis ensues and the instrument you’re using …

The physician’s ultimate calling faces pressure

James C. Salwitz, MD

Physician

January 24, 2016

In the fall of 1980, in my final year of medical school, I sat in the main ward of Saint Vincent’s Hospital, Greenwich Village, Manhattan. Filling the vast space were twenty-four beds, in four rows, with twenty-four patients. The prow of the open nursing station thrust from one wall into the center. A high ceiling vanished above. Yellow light filtered through ancient rippled glass windows and distant fluorescent bulbs made …

The heartbreak of physician mommies. How this doctor learned to let it go.

Wendy Woolley, DO

Physician

January 24, 2016

After a stressful morning, a physician colleague receives a note from her 4 year old that read, “MOMYOUFORGOTTOGIVEMEAKISSTODAY” in classic large, space less toddler scrawl. She shared it knowing that other physician mommies can relate.

We’ve all been there. The heartbreak that is a part of life as a physician mommy takes many forms. Whether a pout, a stare, a cry, a comment, a scowl or a note, no one can …

How this doctor beat burnout. You can, too.

Vania Manipod, DO

Physician

January 23, 2016

2015 was a year to regroup and reassess my professional goals. Immediately after residency, I did as most physicians do — apply and hope to get a job that pays well and is in a good location. Similar to the personalities of most physicians, I am a workaholic and overachiever. Therefore, since graduating residency, I strove to perform well at my job, treated my patients to the best of my ability, passed my …

A side of doctors patients usually don’t see

Dhruv Desai, MD

Physician

January 23, 2016

“What is your personal experience with human suffering?” he asked. Fellowship interview season. Interviewing for pulmonary and critical care, one may expect such a question. I thought I was ready for it. But the simple truth is that I didn’t really have the right answer; I probably never will.

During the morning rounds, my attending physician heaved a weary sigh: “150,000 people die every day!” Out of the blue. I quizzingly …

The rise of workplace confrontation in medical practices

Anonymous

Physician

January 22, 2016

The workplace environment can be full of many obstacles, especially in the medical field. These obstacles range from difficult patients, to navigating insurances, to burnout, and so on. One problem, however, appears to be worsening over time and seems to go without discussion. As life has progressed and I have transitioned from a medical student to attending physician, I have noticed an increase in workplace confrontation between employees. Is this …

I’m grateful to be open for business. This doctor is in.

Emily Gibson, MD

Physician

January 21, 2016

I have the privilege to work in a profession where astonishment and revelation awaits me behind each exam room door.

In a typical clinic day, I open that door up to thirty plus times, close it behind me and settle in for the ten or fifteen minutes I’m allocated per patient. I need to peel through the layers of each person quickly to find the core of truth about who they …

Healing patients shouldn’t be killing doctors

Amaryllis Sánchez Wohlever, MD

Physician

January 21, 2016

Healing others shouldn’t be killing you. This warning in a physician recruitment ad pulled me in, while an image of a choking stethoscope triggered flashbacks of my years in medicine. Many physicians feel like they’re choking. Squeezed in from every angle. Stretched to the max. Spent.

And they feel this way right as they open the door to greet their next patient.

I know of a prominent office that lost three superb …

4 reasons to go vegetarian in 2016

Shivam Joshi, MD

Physician

January 20, 2016

If you have been thinking about becoming a vegetarian, there’s no better time to make the switch than the beginning of a New Year. For those of you have been on the fence, 2015 provided us with a few more reasons — like saving money and losing weight — to make the dietary transformation.

Reason #1: Vegetarian diets increase metabolism. Vegetarians have a lower body mass index compared to those eating meat, …

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4 reasons to go vegetarian in 2016

Reducing hospital readmissions shouldn’t be that difficult

Stephen C. Schimpff, MD

Physician

January 20, 2016

Part of a series.

Among Medicare recipients, those discharged from the hospital incur about a 20 percent risk of an unplanned readmission within 30 days. The number is higher for some conditions such as heart failure. This is the result of a terribly dysfunctional health care delivery system. Of course some patients will need readmission; the number can never be pushed down to zero, but 20 percent is appalling.

Why …

Is the sports physical hazardous to your child’s health?

Hugo Scornik, MD

Physician

January 19, 2016

I am old enough to remember standing shirtless on a chilly afternoon in the school gym lined up with my fellow teammates while a volunteer doctor went down the row clearing us for school athletics in a medical assembly line. This scene has been a familiar rite of passage for generations of student-athletes. However in this day of modern preventative medicine, is the sports physical the best we can do …

Physicians should invest time in work-life balance: It’s priceless

Eve Shvidler, MD

Physician

January 19, 2016

“As a mom and a doctor, what advice would you give a third-year medical student trying to choose a specialty?” the bright-eyed med student asked me.

Her smile was ear to ear, and I didn’t want to burst her bubble. This is a complicated question to ask and the answers change as life changes. I chose OB/GYN because it was the only specialty I truly fell in love with. For me, …

It’s often a bad idea when patients order treatment

James C. Salwitz, MD

Physician

January 19, 2016

I was confused. Perhaps, I needed another cup of coffee. The chart did not make sense. Ellen, who I was about to see because she was transferring her care, was receiving medication for cancer that was a simple pill; inexpensive, with few side effects. What confused me is that it was obvious the therapy would not work.

Baffled, I called the oncologist who had been treating Ellen for two years. A …

Patient satisfaction often forces doctors to “do something”

Marjorie Stiegler, MD

Physician

January 18, 2016

Recently, I read an article about a new mother’s experience taking her toddler to the emergency room after a face-first fall onto an iron table, bleeding profusely. After her child was evaluated, it was determined that no serious injury was sustained, and no further intervention (i.e. stitches) was needed, and the toddler was discharged home with some wound care instructions and a popsicle. When the mother subsequently …

What you don’t know about medical training and culture can kill you

Pamela Wible, MD

Physician

January 18, 2016

An excerpt from Physician Suicide Letters — Answered.

When is a taboo topic no longer taboo? When is it OK to stop hiding behind euphemisms? When is it safe to tell the truth? The answer is now.

This week I uploaded 53 chapters of physician suicide letters in …

Don’t replace your pediatrician with a smartphone

Chad Hayes, MD

Physician

January 17, 2016

There’s no doubt that technology is changing the face of medicine. Today, surgeons can perform minimally-invasive procedures with the assistance of a robot or replace missing limbs with bionic ones. Radiologists can read imaging studies from halfway around the world. There are specialists providing remote services to patients with strokes, women with high-risk pregnancies, and critically ill neonates. Mental health professionals are now able to offer life-changing care to patients …

Primary care doctors are specialists in diagnostics

Hans Duvefelt, MD

Physician

January 17, 2016

Every primary care physician has had this experience: We refer a patient to a cardiologist, pulmonologist or gastroenterologist and get a note back that says our patient’s symptoms are not cardiac, pulmonary or GI related. “Not my department,” in essence.

Medical specialties are organized by organ or organ system, and not by symptom. This really leaves primary care doctors in the default role of being specialists in diagnostics. I often say …

Physician

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