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.

A little girl stopped this physician from asking why

Physician
September 10, 2015

It is not uncommon for doctors to question the reasons why we do what we do.  The journey is long. The debts often seem insurmountable.  The harsh lessons learned from a mistake made with best of intentions are an unforgiving punishment for “life without forgiveness.” Memories may fade, but the scars always seem to linger. On the one hand, like a relief pitcher in major league baseball, we must forget …

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A little girl stopped this physician from asking why

I started singing in the procedure room. And it reshaped my view of professionalism.

Physician
September 10, 2015

In medical training, one of the main things that is emphasized is the importance of acting professionally. We encounter patients who have a particular idea of how doctors are supposed to act during the patient-physician encounter, and for the most part, I expected that they would want a doctor who is caring, but serious, at the same time.

In those encounters, we are focusing on the health of patients, a very …

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I started singing in the procedure room. And it reshaped my view of professionalism.

Is your hospital a miserable place to work? Here are 14 clues.

Physician
September 10, 2015

Earlier this month I read a Wall Street Journal article about Zeynep Ton’s Good Jobs Index. Who is Zeynep Ton? She is a professor at the Massachusetts Institute of Technology’s Sloan School of Management who has ranked retailers on employee happiness. This was so positive. It was good to hear about businesses concerned about employee happiness and not just about profits and shareholders.

Two weeks later I was dismayed to …

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Is your hospital a miserable place to work? Here are 14 clues.

Informed consent defines 21st-century medicine

Physician
September 10, 2015

I walk into a tiny ER room and shut the glass door behind me. The smell is dizzying. I look down and see a frail man lying on a stretcher. A soiled bandage on his left leg is halfway unfurled. He is diaphoretic. He sleepily opens his eyes when I say his name. For me, I have barely begun my assessment, but the writing is on the wall. This man …

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Informed consent defines 21st-century medicine

Before visiting the doctor, consider these 5 things you may not know

Physician
September 9, 2015

A trip to the doctor’s office usually isn’t something we look forward to. Many people have shared their frustrations with me regarding their experiences with doctors, and it occurred to me that there are many things that go on behind the scenes that people may not realize.  Here are five things to know to help you avoid having a disappointing experience.

1. Doctors want to be able to spend more time with you. Frustrated on having to wait …

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Before visiting the doctor, consider these 5 things you may not know

Getting patients and physicians to ask the right questions

Physician
September 9, 2015

Overtesting — it’s an epidemic threatening consumers of U.S. health care. The notion that testing can be anything but beneficial belies the common assumption that more information is always better, as exemplified by billionaire Mark Cuban’s proclamation earlier this year that he obtains “baseline” quarterly blood tests and encourages others to do so. Knowledge is power, right? Not always. Aside from adding economic strain to our already beleaguered health care …

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Getting patients and physicians to ask the right questions

Finding compassion for the choice a patient made

Physician
September 8, 2015

Yesterday my friend Sophie asked me to accompany her to a Miami hospital intensive care unit to see her older brother, Guillermo. He’d been admitted the previous night with seizures and cardiac arrhythmia.

Joined by my husband, we made our way to the ICU. When she saw Guillermo lying immobile, swollen and unresponsive, with a breathing tube in his mouth and other tubes snaking into his chest from IV poles, Sophie …

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Finding compassion for the choice a patient made

Being your doctor is exhilarating. Being your doctor is excruciating.

Physician
September 8, 2015

Being your doctor is exhilarating.

Every day I wake up to a schedule brimmed with purpose. The door of my office is a portal into the richness of the human experience. I become a thread in the tapestry of other’s lives. I bear witness to the joy and pain, laughter and heartache, and mundane daily routine.

I spend my days bouncing between art and science. Paid to be the wily detective, my …

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Being your doctor is exhilarating. Being your doctor is excruciating.

You can easily become the physician that you judge

Physician
September 7, 2015

A recent paper in the Annals of Internal Medicine has sparked a large media response.

In it, two incidents are described: In one, a male OB/GYN is prepping a patient’s vaginal area for surgery, which involves running a brush soaked in Betadine or ChloraPrep solution over the labia, mons pubis, perineum, and inner thighs when the patient is already put to sleep by anesthesia.  He makes an appalling joke, “I …

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You can easily become the physician that you judge

Avoiding a senseless, costly coda to a mother’s life

Physician
September 7, 2015

“Tell me about your mother.”

That is always how it begins. There was never quite enough time the last few years, time to put her affairs in order, time to talk about the unpleasantness that comes at the end of life. Now here we were, standing watch beside her stretcher in the emergency room. Upstairs was the grim certainty of the intensive care unit, the ceaseless beep-beep-beep of the life-support machines, …

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Avoiding a senseless, costly coda to a mother’s life

Do physician health programs increase physician suicides?

Physician
September 7, 2015
YouTube video

How do we care for the people who care for us? As doctors, we’re immersed in pain and suffering — as a career. We cry when our patients die. We feel grief anxiety, depression — even suicidal — all occupational hazards of our profession.

A recent Medscape article on physician health programs suggests the people who are here to help us may actually be doing more harm than …

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Do physician health programs increase physician suicides?

An emergency physician stops at a roadside accident. He finds out he’s not needed.

Physician
September 6, 2015

My family was driving to see our new niece this past Saturday. While passing through a town on the way, we came upon a motorcycle accident.  The rider had been hit by a vehicle and was lying on the pavement with a growing crowd of people who wanted to help.  I’ve done it before.  I did CPR at the scene of a wreck when I was in medical school, and …

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An emergency physician stops at a roadside accident. He finds out he’s not needed.

Why physician burnout and work-life balance is a first-world problem

Physician
September 5, 2015

Did it ever occur to some of today’s physicians that many people work awfully hard and complain a lot less than they do about “burnout” and “work-life balance”?

Did it ever occur to them that “work-life balance” is the very definition of a first-world problem, unique to a very privileged class of highly educated people, most of whom are white?

Every day, I go to work and see the example of the …

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Why physician burnout and work-life balance is a first-world problem

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The time for medical liability reform is now. Here’s why.

Physician
September 4, 2015

Have you been injured? Call us at this number! You may be entitled to a reward!

We have all seen these advertisements on TV. Our society has become conditioned to expect perfection. If a patient suffers a known complication from a condition or dies, there is a feeling that someone must be held accountable — even if everything was done perfectly from a medical standpoint. Medical malpractice litigation has exploded over …

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The time for medical liability reform is now. Here’s why.

Is patient-centered care part of the problem?

Physician
September 4, 2015

What is the difference between a health care system and a Burger King? In a health care system, you can’t always have it your way.

At some point in our training, most physicians are introduced to the Institute of Medicine’s landmark report on Crossing the Quality Chasm. The report outlines 6 key elements that are necessary for providing high-quality care: safety, timeliness, effectiveness, efficiency, equitability and patient centeredness. Although I recognize …

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Is patient-centered care part of the problem?

Bedside ultrasound should be used by more doctors. Here’s why.

Physician
September 4, 2015

The trauma doors flew open, and a middle age man was rushed into the room. All we knew in those moments was that a seemingly lifeless body lay in front of us. There was no pulse and chest compressions were started. After several minutes of no response, another physician hurried out of the room and returned with an ultrasound. Within seconds of placing the probe on the man’s chest, the …

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Bedside ultrasound should be used by more doctors. Here’s why.

6 questions parents don’t ask their pediatricians but really should

Physician
September 3, 2015

As a pediatrician, I get lots of questions from parents — but sometimes I wish they would ask different ones.

That’s what check-ups are for, really: questions. Aside from questions about illnesses (obviously my purview, as a doctor), I get questions about just about every aspect of a child’s life. The parents of babies and young children ask the most — here are some of the most common:

Should my baby’s poop …

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6 questions parents don’t ask their pediatricians but really should

Patient empowerment: Scaffolding has a place in health care

Physician
September 2, 2015

A colleague complained that during a particular type of critical conversation his advice is ignored. Women with breast cancer deciding whether to have mastectomies disregard his guidance and seem to have reached a conclusion before he discusses the issue. Given that this physician has committed his career to the study and treatment of breast cancer, communicates clearly and patiently, projects caring and compassion, I thought that his observation warranted discussion.

Some …

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Patient empowerment: Scaffolding has a place in health care

The doctor-patient relationship is even more complex than you think

Physician
September 2, 2015

asco-logo I am often asked by friends and acquaintances how I am able to do what I do for a living, which is care for patients with advanced lung cancer. Depending on the setting and how well I know the person asking, I might say that the treatments are improving all the time (i.e., the casual dinner party response), that the …

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The doctor-patient relationship is even more complex than you think

It’s time for physicians to be leaders in corporate medicine

Physician
September 2, 2015

“I want to explore employment opportunities with you.”

He is looking at me. Trying his hardest. Passion, yet anger, in his eyes.

Everything I know about him and his tenure in the community helps me understand how difficult this conversation is. Everything I see in his eyes helps me understand how painful this is.

Private practice is dying, on the vine, in America.

The practices fold or reach a critical point, and they come …

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It’s time for physicians to be leaders in corporate medicine

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