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.

How hospitals can kill. Here’s what we can do about it.

Robert Pearl, MD

Physician

July 11, 2015

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Imagine an institution where the occupants are routinely left immobile, deprived of sleep and fed a diet that is tasteless and nutritionally marginal. Imagine further that they experience the indignity of losing any semblance of privacy and get stuck multiple times a day with needles.

Sounds like a brutal prison, right? Yet the same description could apply to a typical U.S. hospital.

As …

A quiet day in the doctor’s office: And that’s the way it’s supposed to be

Rob Lamberts, MD

Physician

July 10, 2015

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It’s been a very slow week in my office. Today we almost pitched a no-hitter, having only one patient come in toward the end of the day. Overall, we’ve been quiet in nearly every way: few phone calls, few patients stopping by, few appointments, few secure messages.

What’s wrong?

That was a trick question. This is exactly what should be happening when things are going …

What a plastic surgeon learned from a man he couldn’t save

Jonathan Kanevsky, MD

Physician

July 9, 2015

You could hear a pin drop. The awkward silence at a dinner table after my pager went off. Eyes locked on me. For a split second, the laughter ceased, forks held in mid-air, chewed food, half-swallowed.

The nervous system of every doctor adapts to the sound of his or her pager during residency. Early in training, widening pupils and hair-raising palpitations fade …

Why this provider continues to see “difficult” patients

Anne Katz, RN, PhD

Physician

July 9, 2015

We all have our fair share of so-called “difficult” patients. And, I would suggest that how we define “difficult” is as diverse as we are as health care providers and as individuals. Some patients come to us with that reputation — perhaps, a vague descriptor in a referral letter or …

A doctors lifehack: Leave early

Rocky Bilhartz, MD

Physician

July 9, 2015

Leave early.

Two words. Simple concept. But, one worth thinking about.

James Altucher explains it well, but this is the same guy who also thought he could save his business by becoming more like a Jedi Knight. Admittedly, the Jedi thing seemed to work for him, and his businesses, as well as the uncountable number of people he’s helped since then. …

Read more…

A doctors lifehack: Leave early

It’s time to talk to your patients about high value care

Darilyn Moyer, MD

Physician

July 9, 2015

Last night, one of my close and friends told me the story of her recent trip for her annual gynecology appointment. Her longtime gynecologist had retired, and she was meeting her new physician. After taking a history, the first new physician explained to her that since she always had normal Pap smears, including recent ones from the past several years, she …

Dr. Robert Wachter: In defense of the ABIM

Robert Wachter, MD

Physician

July 8, 2015

“What’s up with the ABIM?” “I just got a note about an alternative board. Should I join it?” “Aren’t you glad to be off the Board?”

These days, I get these questions from friends and colleagues regularly. When I first joined the board of directors of the American Board of Internal Medicine (ABIM) in 2004, the organization was a …

What is pediatrics? It’s more than just runny noses.

Chad Hayes, MD

Physician

July 8, 2015

When I chose a career in pediatrics, everyone had something to say about my decision. While most of my friends and colleagues were supportive, there were more than a few that just couldn’t understand why I would sign up for a lifetime of “ear infections and runny noses.”

Even among other medical professionals, it’s not uncommon for pediatrics to be viewed as a less-than-serious …

The problem with medical TV shows. A surgeon sets the record straight.

Dr. Nikki Stamp

Physician

July 7, 2015

I never really watched medical shows, even before and during medical school. I watched maybe one season of ER, a couple of seasons of Grey’s Anatomy and House MD and maybe one episode each of Private Practice, Chicago Hope, Emily Owens MD and other random medical shows. The only medical show I made an exception for was Scrubs, because it was …

Poker face: The complex psychology of the patient-doctor interaction

David Jones, MD

Physician

July 6, 2015

Patient-doctor communication often has many facets, wrinkles, and twists. Medical school prepares a doctor minimally for the ups and downs of these patient interactions. There is no mannequin who can train each medical student how to deal with every personality, response, or even outburst by each patient. On the job training is sine qua non.

During and after medical school, it took …

There is no shame in honest work, no matter what the job description is

Erica McCaleb Camp

Physician

July 6, 2015

When my sister, Jessica, was a nurse anesthetist student at the University of New England, she had the opportunity to rotate at Johns Hopkins, and she seized it. She was young and fairly new to the medical world and so she did not recognize at first the name of the neurosurgeon with whom she would be working — Dr. Ben Carson. After receiving multiple comments from numerous people about how great it …

An inappropriate use of medical jargon: Words do matter to patients

Laura Withers, MD

Physician

July 6, 2015

My patient had suffered a terrible, crushing injury to his chest leaving many ribs and his sternum fractured, his lungs and heart badly bruised and his body on the edge between life and death. He was on a ventilator, the tube through his mouth into his windpipe pushed air into lungs that couldn’t draw for themselves. He was on constant medications for pain and to sedate him while we used …

Mad Libs for medicine. Do you think you can use these?

Edwin Leap, MD

Physician

July 5, 2015

Do you remember Mad Libs from when you were a child? A story is filled with blanks, and as you fill them in with inappropriate and ridiculous words, you laugh until you can’t see straight. You laugh until you can’t breathe, and your parents beg you to stop! Let’s be children again. Share these with the nurses, and give the shift a little levity.

Pain medication. You see, doctor, my pain specialist …

Telemedicine: Why professional concern shouldn’t be dismissed

Steven Reidbord, MD

Physician

July 5, 2015

The current state of telemedicine — that is, teleconferencing with a physician over one’s smartphone — worries many critics because it assumes patients can be evaluated without a physical exam. The critics are right that those with a financial interest in “disrupting” health care typically minimize the trade-offs. Convenience and lower cost are trumpeted, while risks of misdiagnosis and mismanagement are waved off. The concerns of practicing physicians are dismissed …

A physician enters rehab. What happens next should disturb you.

Anonymous

Physician

July 4, 2015

I’m a physician, and I’m adrift. I am pretty much lost at sea. I’ve often thought of writing this column, but afraid I’d be recognized, I’ve hesitated for years. Even now, I’ll most likely remain anonymous, because I’m in a vulnerable position. Let me preface my remarks with the reassurance that I’m not a bad person.

I developed dependence on opioids several …

The intersection of illness and incarceration: How racism makes us sick

Jennifer Tsai

Physician

July 4, 2015

Despite rates of drug use similar to white counterparts, black men are 11.8 times as likely to be arrested for drug offenses compared to whites. African Americans constitute 14 percent of regular drug users, and yet represent 37 percent of people arrested for drug offenses, 55 percent of drug convictions, and 74 percent of people sent to prison for drug possession. One in Read more…

The intersection of illness and incarceration: How racism makes us sick

Music is better than medicine. This physician-musician gives you 10 reasons why.

Joel R. Cooper, DO

Physician

July 3, 2015

1. You don’t have to make an appointment with your doctor, or sit in a crowded waiting room for hours, to get music — you can just download it instantly from iTunes or pick up an instrument and play it.

2. Music costs far less than a medical office co-pay or out-of-pocket fee-for-service charge. And for many acute conditions, outcomes are probably pretty …

Practice models may change, but relationships with patients endure

Yul Ejnes, MD

Physician

July 3, 2015

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

A few weeks ago, my partners and I held a “going away” dinner for one of our partners who retired in late March. It was a great evening. We reminisced, discussed how medicine has changed over the …

Despite the Internet, doctors still have to memorize. Here’s why.

Gurpreet Dhaliwal, MD

Physician

July 3, 2015

There is an assumption that is creeping into discussions about medical education, just like primary education: that memorization is outdated and doesn’t matter in the Internet era. That’s a mistake. The goal of education is to create an expert thinker. Memorization is at the core of that endeavor.

Practicing medicine requires constant problem solving. Every patient is different and requires a bit …

Calling attention to the disparity in surgery: Here’s what I learned

Andrea L. Merrill, MD

Physician

July 3, 2015

On Monday, June 1st, I awoke with a mixture of butterflies and excitement. Every 30 minutes I checked online to see if it was up. My heart pounded every time I clicked the refresh button. Finally, around noon, there it was — my first piece of medical writing, published on KevinMD.com.

In medicine, we often present objective facts. We …

Physician

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