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.

Remember to ask about praying with patients

Earl Stewart, Jr., MD

Physician

November 30, 2015

He stood still. He was virtually stymied at the request she made. I, as a visiting medical student rotating on the cardiology consultation service over which this brilliant, accomplished attending cardiologist with advanced interventional training presided, myself stood befuddled when he, in essence, appeared like a deer caught in the headlights after his patient asked him one simple question: “Doctor, could you please pray with me?”

The truth is he, like …

I may be the only advocate for my dying patient

Monica Williams-Murphy, MD

Physician

November 29, 2015

Medical school and medical training attempt to teach subjective humans how to think and practice medicine objectively. This may be one of the unique fallacies of modern medicine, but that’s a subject for a different blog.

Nevertheless, even in the highly emotional field of emergency medicine I’m usually pretty chill. That is, until someone’s dying, and then all of my equanimity can go flying out the window, for better or worse.

Such …

Thank you for healing a part of me that is grieving

Eki Abrams, MD

Physician

November 29, 2015

As I entered the exam room to meet my new patient, I initially thought of the orange-haired heroine in the animated kid movie, Brave. Although the middle-aged woman’s hair was not quite as orange as the heroine’s, it was long, expansive in breadth and wavy in texture. Her hair seemed to engulf her petite frame. As I looked at her more closely, she appeared rather slim. Her layering of clothing …

What I want to be when I grow up

Anjoli Anand, MD

Physician

November 28, 2015

June, 2003, and I am 18 years old, just a few days from graduating from high school. In his home in Bridgehampton, Kurt Vonnegut is sitting at his kitchen table railing against the injustices of the American health care system. When he finishes, he takes my hand and says, “Don’t worry, you’re going to make a fine doctor.”

November, 2015, and my feet are blocks of cement as I slowly make …

Read more…

What I want to be when I grow up

If urgent care centers don’t innovate, how long will they last?

Stephen C. Schimpff, MD

Physician

November 27, 2015

Part of a series.

Urgent care clinics provide a useful service to the community, but their days may be numbered with survival questionable resulting from intense competition from the chain pharmacies and soon from Walmart.

Urgent care companies began to proliferate 30 years ago but have gained traction in recent years as emergency room wait times rapidly lengthened. Urgent care is less expensive than the ER, is open 24/7 or …

Physicians looking for a new job should beware these 4 red flags

Eve Shvidler, MD

Physician

November 26, 2015

Recruitment season is my favorite time of year. The CVs pile into the database, and we sift through the resumes, searching for candidates that would make a great fit for our organization. Next, I get on the phone and assess their level of interest and try to sell them on everything we have to offer. We fly them out for a live interview, and the negotiations begin.

Last year was a …

Why this specialist went to a direct patient care model

Joel Kahn, MD

Physician

November 26, 2015

September first was a big day for me. After over 25 years of practicing invasive cardiology, I sent an affidavit to CMS to indicate for the next two years I was opting out of their insurance program. As of October first, I have begun accepting patients on a direct patient care (DPC) model that will not involve insurers, ICD-10, or billing fees. Why would a specialist consider this dramatic move?

Practice enjoyment …

This Thanksgiving, remember the importance of gratitude in medicine

Chiduzie Madubata, MD

Physician

November 26, 2015

As we enter into the Thanksgiving season, the question of what we are thankful for is frequently asked. Perhaps it is a good reminder for us to take a step back and express gratitude for events that or people who have made a true impact on our lives. I think that for us as medical professionals, it is all the more important, since conditions in the hospital may make it …

Our health care system makes physicians hypocrites by enabling addiction

Amy Faith Ho, MD

Physician

November 25, 2015

I do a strange thing as a physician almost daily. I go to alcoholics and have them promise me they’ll go home and continue drinking. Then I release them back into the wild to do just that.

I’m an emergency physician at an urban hospital, and I see alcoholics every single shift, brought in by the ambulance “found down” — that is, found passed out in public places or belligerent on …

Why older adults need geriatricians

Elizabeth Eckstrom, MD

Physician

November 25, 2015

In his post, “The geriatrician shortage: The problem isn’t what you think,” I completely agree that the current gap in health care professionals’ skills to care well for our aging population is exceedingly complex, reaching well beyond lack of medical school training or funding. Funding for graduate medical education needs to be transformed to match the workforce needs of the nation, with special …

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Why older adults need geriatricians

Who’s in charge of the patient? It’s a question increasingly difficult to answer.

Ira Nash, MD

Physician

November 24, 2015

I spent a couple of hours today discussing a topic that has become increasingly important in the world in which we live, and which would have completely mystified an earlier generation of physicians. The subject was attribution. Simply put, how should one decide which patients “belong” to which doctors? On a more technical level, what algorithms should be employed to connect patients, or episodes of care for those patients, or …

The question about education that this doctor asks every new patient

Greg Smith, MD

Physician

November 24, 2015

“How far did you go in school?”

This is a question that I ask every new patient as a matter of course.

Granted, I have gotten some very odd answers, including hearing from a very successful businessman who only finished the seventh grade, or a very psychotic person who has a double master’s degree. Not implausible, but certainly not expected or the mainstream answer from the majority of my patients.

Now, leaving the …

The joy has been sucked out of medicine. Here’s why.

Peter Ubel, MD

Physician

November 23, 2015

She came to the urgent care center with a sprained ankle. The primary care provider gave her excellent care, expertly applying evidence-based evaluation guidelines to her situation, and, thereby, avoiding unnecessary x-rays. By all measures, the provider’s care was excellent, but the interaction still ended up reducing his salary. You see, that patient’s only medical interaction that year was for this ankle sprain, and the provider was therefore held accountable …

What worries me about husbands and wives in the exam room

Hans Duvefelt, MD

Physician

November 23, 2015

When a wife suddenly comes in for her husband’s appointment, I usually worry a little; when a husband shows up for his wife’s visit, I sometimes worry a lot.

I have come to expect that when I enter an exam room, and a male patient has his wife with him in the room, she is there to make sure I hear some part of his symptom history that he has never …

What physicians call burnout, others call PTSD

Edwin Leap, MD

Physician

November 23, 2015

“Gunshot wound to chest, pulseless, 20 minute ETA.”

When that’s the EMS report, it gets your attention. Despite the wonderful theatrics of modern medical shows, and the best efforts of real-world, sweat-drenched paramedics, those of us who have done this long enough can translate that report. For the layperson it means: “Dead.”

I saw that last week. And the week before I saw another tragic, unexpected death in a man not much …

For the most part, doctors get it right. Remember that.

Jordan Grumet, MD

Physician

November 22, 2015

I have two refrigerators.

The full size, expensive version, sits in the usual location in the kitchen. The small black one rests idly in the basement. Excluding this morning, of course, when I dragged it up the steps and begrudgingly coaxed it back into action. Let me explain.

Six months ago my old refrigerator started acting up. Somewhere around year five, it’s motors groaned, its coolers moaned, and all the sudden the …

The stress of being a caregiver to an elderly parent

Val Jones, MD

Physician

November 22, 2015

My patient’s son stood vigil outside her hospital room day and night. His eyebrows were frozen at an anxious angle. Although his mom was healing well from her injury, I could see that he was worried about next steps. He asked staff repeatedly about his mom’s pain management, and reviewed every therapy session she attended.

His mom, on the other hand, was deceptively charming. She was a thin, well-groomed elderly woman …

We lose a medical school full of physicians every year to suicide: An interview with Dr. Pamela Wible

Pamela Wible, MD

Physician

November 21, 2015

TEDMED-WIBLE-PHOTO-shrink

Christine Sinsky, MD, from the American Medical Association interviews Pamela Wible, MD, after her TEDMED talk. Watch periscope video here. Fully transcribed below:

Dr. Sinsky: This afternoon we’re here in Palm Springs, and I’m delighted to be here with Dr. Pamela Wible, who gave a terrific TED talk last night. I’m Dr. Christine Sinsky, the vice president of professional satisfaction at …

The palliative caregiver shines a balanced and soft compassionate light

Kevin Haselhorst, MD

Physician

November 21, 2015

I never realized the true meaning of palliative care amidst the harried practice of emergency medicine. The pressure being placed on me to do more often becomes the same expectation I place on patients to receive more treatment.

Gloria, the wife of my patient with terminal mesothelioma, shed a light on palliative care for me with the insightful words, “We know that there is no cure — we just want to …

A physician puts his welfare in the hands of others

Samuel M. Chen, MD

Physician

November 20, 2015

“I have always depended on the kindness of strangers.”
– Blanche DuBois, A Streetcar Named Desire, Tennessee Williams

It was near the end of 2008 that I developed symptoms that I recognized as sciatica. The Internet is a wonderful source of information (and some misinformation). I decided to educate myself. In my reading, I encountered one study that indicated that patients who underwent surgery were better at one year, but about the …

Physician

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