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.

Incident reports aren’t very helpful. Why are they still being filed in hospitals?

Skeptical Scalpel, MD

Physician

December 10, 2015

Incident reports are frequently submitted by hospital personnel. Did you ever wonder what happens to them? I have.

Over the years, I estimate that I’ve heard of hundreds of such reports being filed, but rarely have I heard of a problem being solved or for that matter, any action being taken at all.

In fact, I don’t even know where they went or who dealt with them. When I was a department …

Good medicine is based on friendship

Michel Accad, MD

Physician

December 10, 2015

Whenever I have the opportunity to suggest that good medicine is based on friendship, I usually get a nod of approval mixed with a quizzical look. What’s that supposed to mean?

At a recent meeting of an editorial board on which I serve, the reaction to my suggestion was more forceful and perhaps more honest. The topic of the day concerned patient education, and how hard it can be to move patients to do things …

Read more…

Good medicine is based on friendship

Why a patient panel is an outdated concept in primary care

Lucy Hornstein, MD

Physician

December 10, 2015

“How many patients do you have?”

I’m not sure what you mean. How many patients do I see on average each day? About twelve.

“No. How many patients do you have?”

Let’s see: Last week I saw about sixty patients altogether. Five of them were new patients.

“No, no. How many patients do you have on your panel?”

My panel? I don’t know what you mean by that. I don’t work as an employer in …

When thinking about vaccines, remove the gut feelings

Roy Benaroch, MD

Physician

December 9, 2015

I’m struck, sometimes, by the vehement tone of some of the antivaccine comments you see out there. People who hate or distrust vaccines proudly proclaim that their Googling and life experiences have taught them that vaccines are bad. They don’t care what the science or the evidence shows. They know what they know.

Me? I’m not so much into vehemence and dogmatism. I’ll follow the evidence. Show me solid science that …

Dear Justin Timberlake: An open letter from a pediatrician

Natasha Burgert, MD

Physician

December 8, 2015

Dear Mr. Timberlake,

I was not expecting to see you and I together. As a long-time fan, our names sharing space in the celebrity gossip column of In Touch Weekly was truly a surprise.

Now, JT. Can I call you, JT? I know that you remember me from a few months back. We shared some time in a darkened auditorium with a few thousand of my friends …

Society’s health should not be doctors’ responsibilities

Justin Reno, MD

Physician

December 8, 2015

I thoroughly enjoy my 65-year-old male with his horrendous diabetic foot ulcer. But there’s not enough insulin in the state of Tennessee to cover the two bacon, egg, and cheese biscuits he eats every morning.

And I adore my 57-year-old female with COPD. But the inhalers won’t work until she stops smoking two packs of cigarettes per day. I laugh every time I see that hilarious 32-year-old with hypertension. But the …

Survival of the fittest in the ER

Nadine Himelfarb, MD

Physician

December 7, 2015

An observation that I and many of my emergency medicine colleagues have made about vacations: We need them. We need them for wellness, to recharge, to recover. Great saves, terrible tragedies, we witness it all and it can wear on you. Unfortunately, when vacation plans are made, it is not uncommon to find oneself working even more shifts before the break to offset our absence on the schedule, making the …

Read more…

Survival of the fittest in the ER

A physician reflects on her experience in Rwanda

Frances Grimstad, MD

Physician

December 7, 2015

The optimism of a Rwandan in 2015 will strike you. Take a population that has seen or been raised in the wake of more horror than the average Westerner can imagine, and bring up a problem or something negative. Too short to reach the top shelf? It’s OK, you’ll fit under doors better. Hair stands out when bright red? Easier to pick out in a crowd. Mother has had 3 …

Stop the hostility among health care professionals

Marjorie Stiegler, MD

Physician

December 5, 2015

The amount of hostility among health care professionals seems to be at an all-time high. Are “scope of practice” and “turf” battles really escalating, or is it just more palpable in the modern era of anonymous comments and viral online posts? I don’t know for sure, but lately, the conversation seems louder and uglier to me.

In medical school, I heard derogatory comments (“jokes”?) from physicians and nurses alike about pretty …

What it’s like to talk to patients, then cut them open

Anonymous

Physician

December 5, 2015

Every time I walk through the automatic sliding doors, that strong smell of ammonia stings my nose. The lobby is clean — too clean — with a vast amount of open space leading to the front desk. The just-below-comfortable air brushes against my skin, raising the hair on my arms and legs. Almost cold enough to be a morgue — but that’s later. The room is silent, except for the …

The general radiologist is still valued. Here’s why.

Dr. Saurabh Jha

Physician

December 4, 2015

In times of shortage, we find out what we value most. And in these times of relative penury in the job market for radiologists, it appears that employers value — above and beyond anything else — the general radiologist.

Yes, the general radiologist. The radiologist who is able and willing in one shift to perform a barium enema, follow the intricate anatomy of the inner ear on an MRI of the …

Physicians need to recognize the power of vulnerability

Sanj Katyal, MD

Physician

December 4, 2015

One of my best friends from high school is battling with leukemia. I remember days hanging out in my room, listening to music (we were both huge REO Speedwagon fans), shooting Nerf hoops and talking about life (mainly girls at that time). We were not sure of what life would bring, but we knew we were destined for big things.

Denny was always more confident than I was at the time …

You have a dysfunctional hospitalist group. Can it be fixed?

Tracy Cardin, ACNP

Physician

December 3, 2015

I was talking with a colleague in another section today, and she was noting the difference between our hospitalist group and her section. She has somewhat intimate knowledge of our section because she did a year with us before moving on to her specialty fellowship. She is a bit frustrated with her new home and its team members because she feels like there are a lot of “B’s.” You know …

The child is father of the man

Samuel M. Chen, MD

Physician

December 3, 2015

It was several decades ago when my father, not long retired from a lifetime of denominational service as a chemistry professor, noticed pain in his abdomen. Initially attributing this to ingestion of some excessively hot tea, he ignored it for a time, hoping that, like many ailments, it would dissipate on its own. When it did not, he sought medical attention.

He ended up at the hospital where I worked, and …

Read more…

The child is father of the man

Dealing with my patients’ losses. And the losses in my own life.

Monisha Vasa, MD

Physician

December 3, 2015

My patient sat in front of me, silent. She was a beautiful, elderly woman, always well dressed in bright, matching outfits, and not a single hair out of place. Her lipstick was perfectly applied. She normally had a quick wit, joking about how she might drop a few knickknacks from my office into her handbag on her way out.

Not today. Today her tears flowed. Today was the day she grieved …

Do psychiatrists have value? Yes, they do.

Maria Yang, MD

Physician

December 2, 2015

While slogging through a crappy first draft of a document about the value of psychiatrists in mental health and substance use disorder services, I did a literature search for supporting evidence.

I found nothing. (1)

“So how exactly are we helpful?” I mused out loud. Maybe we aren’t: There are groups out there who do not believe that psychiatrists can or do help anyone.

I am an N of 1. …

Listening to the patient is the first part of the physical exam

Ira Nash, MD

Physician

December 1, 2015

The first posting on my blog explained why I chose to name it “Auscultation.” I wrote that I wanted to promote a conversation, and that listening was essential to doing so. I went on to write: “With an obvious nod to my being a cardiologist, I believe auscultation has long been an act that defines us as physicians and connects us in a profound way with our patients. The act of …

With some planning and collaboration, small practices don’t have to sell to a hospital

Yul Ejnes, MD

Physician

December 1, 2015

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

Recently, I rummaged through some old files to throw out things I did not need. While marveling at how we stored documents back in the 20th century (and how little of what I saved I ever used), I came across a couple of interesting items. …

This holiday season, ask the elderly what they’re thankful for

Edwin Leap, MD

Physician

November 30, 2015

It’s a well-known reality of health care economics that Americans spend a lot of money in the last year of life. I suppose that almost goes without saying, since serious illnesses and injuries that result in death are costly, at whatever age they occur. Being hit by a car and dying means you were hit by a car … in your last year of life. And that two weeks in …

Physicians are not providers: An open letter to the AMA and medical boards

Suneel Dhand, MD and William J. Carbone

Physician

November 30, 2015

Dear AMA and state medical boards,

The last few years have been a period of unprecedented change in the world of health care. The need to reign in costs, expand access, and ensure higher quality care — all at a time of rapid medical and technological advancements — has changed innumerable aspects of the practice of medicine.

Throughout this, one common theme has been the dedication and determination of hundreds of thousands …