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 patient experience: 4 observations from a physician

Thomas D. Guastavino, MD

Physician

November 8, 2015

Last year, I retired from full-time practice and moved to a new area. At about the same time, my wife was diagnosed with breast cancer, and because she was in good health prior, she had relatively little contact with the health care system as a patient.

Before our move she worked as a part-time school nurse, so we were able to share provider horror stories from different perspectives. Since we moved …

Physician, heal thyself. A reflection on physician self-care.

Chiduzie Madubata, MD

Physician

November 6, 2015

Another workday comes to an end. 11 a.m. rolls around and freedom from the hospital beckons after another 24-hour call is finished. In the span of the preceding day, it is likely that numerous important decisions had to be made with the expectation that all of your mental faculties would be used, irrespective of what time of day it was or how much sleep was obtained. It is a day …

Failure to communicate is a patient safety issue

Steven Reznick, MD

Physician

November 6, 2015

My 66-year-old professional athletic patient had a history of a scar tissue related small bowel obstruction seven years ago related to a previous appendectomy. He now had similar symptoms with cramping, lower abdominal pain, and some nausea.

Since his office was next door to his longtime friend and gastroenterologist, he called over there. He was given an appointment with the junior partner since his buddy was out of town. Thirty years …

Why a doctor stopped taking a particular health insurer

Lucy Hornstein, MD

Physician

November 6, 2015

For the moment, I still take almost all insurances in my practice. And as long as I see enough patients (i.e., as long as the phone rings) I’m doing OK. I’ve been billing electronically with a free clearinghouse for about five years now, and things are pretty good.

Over all these years, I’ve only dropped one insurance company. It covered a fair number of patients, including many of my …

The geriatrician shortage: The problem isn’t what you think

Richard Young, MD

Physician

November 5, 2015

I’ve read several articles recently reporting on a shortage of geriatricians. The writers have some clear misunderstandings of who actually cares for our elderly and where they come from.

Susan Jaffe writing for Kaiser Health News stated that the American Geriatrics Society (AGS) estimates that the nation will require 30,000 geriatricians by 2030 to serve our aging population. This is probably true, what the AGS believes. She goes on …

Here are 10 patient suggestions for hospitals. Let’s make them happen.

Peter Pronovost, MD, PhD

Physician

November 5, 2015

Since undergoing a double-lung transplant at the Johns Hopkins Hospital in December 2011, Podge Reed Jr. has had four medical admissions, two surgical admissions, eight outpatient procedures requiring anesthesia, more than 100 outpatient appointments, and 700 labs and other tests. He’s amassed enough experiences with the health care system to write a book. So far, though, he’s mostly kept it to two letters, totaling 12 pages, to our patient relations …

Physicians are not providers: It’s time to wake the sleeping giant

Suneel Dhand, MD

Physician

November 5, 2015

I wrote a piece about the word “provider,” and how physicians have been a bit blindsided to what’s fast becoming their new title. It started something of a social media wave. It was good to see the article encouraging lots of healthy debate, and I was also grateful for the large volume of supportive messages.

As we continue this important discussion, I wanted to specifically address five follow-up issues:

1. This …

Playing a little game in the nursing home

Jordan Grumet, MD

Physician

November 4, 2015

It was a little game we played.

My shoes squeaked quietly down the hallway of the nursing home as I approached her room. I knocked gently trying to avoid any particular rhythm or dissonance.

Go away!

Her voice was at once stern, and then followed by peels of laughter. She only saved such greetings for me. And I tried to trip her up. I varied my visits by time and pattern. Sometimes I …

It’s time for more doctors to practice mindfulness. Here’s how.

Manoj Jain, MD, MPH

Physician

November 4, 2015

A few summers ago during a week-long vacation, I started playing a mind game. In the mornings, I would sit outside on a comfortable deck chair, surrounded by the shrill call of cicadas, and gaze across the lawn into the trees. After getting settled, I would close my eyes and bring my body to complete stillness except for the rhythmic rise and fall of my chest with each breath.

Then I’d …

The first time I pronounced someone dead

Chrisse Henneberg, MD

Physician

November 3, 2015

It’s easy to get lost in the hospital. I’m only an intern, and already I know it like the hallways of my old high school, every doorway, and doorknob. But overnight, as I float between the floors and the units, answering pages, I quickly lose track of where I am, what time it is, what day it is.

I am vaguely aware that I’m on the fifth floor, the top floor …

Credulity and skepticism exist in a dynamic balance

Steven Reidbord, MD

Physician

November 3, 2015

As we grow into adulthood, each of us develops a personal comfort zone located on the continuum between paranoia and gullibility. A few of us are highly suspicious by nature, a few are unwitting dupes; most of us are in between. Mental health professionals are no exception, and it shows in our work. Is a request for tranquilizers or stimulants legitimate, or are we abetting a substance abuser? When told of horrific past abuse, do we believe every word, …

5 ways radiologists can reduce unnecessary tests

Dr. Saurabh Jha

Physician

November 2, 2015

The Lown Institute advocates rational use of medical resources. This is a noble goal and worthy of the attention of radiologists. It was recently RightCare Action Week: Here are five simple things any radiologist can do that week, and the following weeks. This will improve patient care by avoiding unnecessary tests.

1. Speak to the referring clinician, at least sometimes, if not often, perhaps twice a day. The conversation need not …

Physicians suffer the personal toll of corporate medicine

Rose Kumar, MD

Physician

November 2, 2015

I am a board certified internist. I am Stanford trained and have been practice for nearly 25 years. I have a very busy practice. I love my patients. To help, heal and to love them every day is a daily gift. I want to help them make sense of their suffering, to help awaken and empower them and help them gain health. I have also been a lifelong seeker. I …

#ILookLikeASurgeon, not an imposter

Dzifa S. Kpodzo, MD

Physician

November 2, 2015

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Born to a family of scientists — my father an engineer and my mother an oral surgeon — I was given a clear message that I could do anything. Case in point: At age nine when I declared my career goal of being “president of the world” nobody batted an eyelash. Their unwavering confidence followed me through college at UC Berkeley and …

Read more…

#ILookLikeASurgeon, not an imposter

An emergency physician goes to the ER, and is shocked at the care she receives

Karen Shackelford, MD

Physician

November 2, 2015

I have lately been discussing the state of health care with a lot of doctors. I’m a doctor, and I’m also a consumer of health care services.

Imagine my surprise when I visited a local ER on a three day weekend, hoping to get some advice from someone who might be able to use the panoply of diagnostic tools available in the ED to help me mitigate the pain of a …

A physician’s open letter to Medicare patients

Rebekah Bernard, MD

Physician

November 1, 2015

Dear patients,

This is a hard letter to write, but it is important that you know about a major change that is coming for both of us in 2017, just a short year away.

As you recall, last year I left a large hospital group practice and opened my own office, and I want to thank you for your faithfulness in following me to my new location. With the newfound freedom of …

Physician assisted suicide is our moral indicator

Stephen Kamelgarn, MD

Physician

October 31, 2015

On September 12, 2015, the California Legislature passed a controversial bill legalizing physician-assisted suicide. California would become the fifth state to allow doctors to prescribe lethal medication to terminally ill patients who request it, after Oregon, Washington, Vermont and Montana. During the debate over the passage of the bill, everybody weighed in: patient’s rights advocates, dying patients and their advocates, religious groups. The one group that I didn’t hear about …

Share our stories and let the world know that health is primary

Jay W. Lee, MD, MPH

Physician

October 31, 2015

The U.S. health care system is under intense pressure to change from volume to value. Primary care physicians must become the leaders our health system needs us to be: finding solutions to the problems that continue to plague this system. Costs continue to rise, access to physicians is quite limited in many locations, care often remains fragmented, and quality is uneven. To provide excellent care across the country and ensure …

An episode of low-value care delivered to my father

Victor Lee, MD

Physician

October 30, 2015

My father recently visited his internist with complaints of vague chest symptoms and was referred to a cardiologist who recommended coronary CT, ultrasonography, and angiography. A cardiac workup would seem to be a reasonable course of action given that he has a history of coronary artery disease (CAD) with prior angioplasty.

However, upon further exploration, I felt that his chest symptoms were due to stress and were not of cardiac origin. …

The discovery period regarding the existence of life

Kevin Haselhorst, MD

Physician

October 29, 2015

What do I need to know as I age? While scientists ponder the questions of water existing on Mars and if it can essentially sustain life, my duty it to assess if there is life left in Oliver — a nursing home patient transferred to the ER. Oliver was not oxygenating well but appeared to be resting comfortably. Reportedly, Oliver had fallen that day and EMS discovered a sizeable bruise …

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