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.

Waiting for problems to become emergencies is terribly expensive

Rob Lamberts, MD

Physician

March 12, 2015

“I’ve been getting winded lately.”

He’s a middle-aged man with diabetes. This kind of thing is a “red flag” on certain patients. He’s one of those patients.

“When does it happen?” I ask.

“Just when I do things. If I rest for a few minutes, I feel better.”

Now the red flag is waving vigorously. It sounds like it could be exertional angina. In a diabetic, the symptoms of ischemia (the heart not getting …

5 things patients say that should make doctors sit up and listen

Suneel Dhand, MD

Physician

March 12, 2015

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In the busy world of hospital medicine, where doctors and nurses find themselves rushed off their feet for most of the day, time to sit down and actually listen to patients is at a premium. Every doctor knows that our primary focus has to be on the most important aspects of the history and clinical examination in order to get to …

A surgeon will always have two spouses

Robert Sewell, MD

Physician

March 12, 2015

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I’m an old school general surgeon. I graduated from med school in 1974 and after a five-year surgical residency in San Antonio, Texas, I started out on my own, ready to cure the world. Boy, was I raw. Like many of my peers, I got married during medical school, and like every surgeon back in those days I told my wife, …

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A surgeon will always have two spouses

I broke my own rule when giving bad news

James C. Salwitz, MD

Physician

March 11, 2015

For 25 years, I have taught medical students how to give bad news. Step one: Be prepared. Step two: Find a safe, personal, quiet environment. Step three, and this is most important: Before you speak, ask. What do the patient and family understand? Fail to follow this vital rule and reap the whirlwind. So, therefore, you might ask, if I have such wisdom and experience in this critical area …

Ease the transition to hospital medicine

Tracy Cardin, ACNP

Physician

March 11, 2015

I came to hospital medicine from the land of pulmonary-critical care. I had spent ten years dealing with septic shock, respiratory failure, and acute renal failure. I had intubated, withdrawn life support, placed central lines, performed thoracenteses, and even placed a couple of chest tubes. I had changed tracheostomy tubes; I ran codes. In short I was a critical care bad ass. I thought I was hot stuff. But I …

With vaccines, pediatricians walk a thin line

Justin Morgan, MD

Physician

March 11, 2015

It’s 2015, and we’re talking about measles. Not Enterovirus. Not Ebola. Not RSV. Not influenza. Instead, we’re talking about a historical virus that was declared eradicated from the United States in 2000. Most pediatricians who began practicing within the last 15 years have never even seen the disease.

Measles starts as a high fever followed by a cough, runny nose (coryza), red and watery eyes (conjunctivitis), and tiny white spots inside the mouth …

Doctors: Is it time to love the F word?

Lisa Chu, MD

Physician

March 10, 2015

As a physician, you have endured many years of schooling, and you have received many A’s on your report cards. You have passed exams with flying colors, and you have pleased your higher-ups in the food chain. You have come so far, and you now find yourself in a rarefied position that most people only dream about.

So what’s standing …

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Doctors: Is it time to love the F word?

Why can’t physician anesthesiologists, nurse anesthetists, and anesthesiologist assistants just get along?

Karen S. Sibert, MD

Physician

March 10, 2015

American anesthesiology reached a significant milestone last year, though many of us probably missed it at the time.

In February, 2014, the number of nurse anesthetists in the United States for the first time exceeded the number of physician anesthesiologists. Not only are there more nurses than physicians in the field of anesthesia today, the number of nurses entering the field is …

It’s time to think about how we’re affecting patient morale

Val Jones, MD

Physician

March 10, 2015

Many of the patients that I treat have brain injuries. Whether caused by a stroke, car accident, fall, or drug overdose, their rehab course has taught me one thing: nobody likes to be forced to do things against their will. Even the most devastated brains seem to remain dimly aware of their loss of independence and buck against it. Sadly, the hospital environment is designed for staff convenience, not patient …

Don’t forget to seek out the beauty in your life

Ahmad Bailony, MD

Physician

March 9, 2015

One of the cornerstones of the practice of medicine is finding imperfection in things. When the doctor encounters the patient, the latter expects the former to find out what is “wrong.” In fact, I often see a patient and find nothing wrong, and when I voice this out loud the parents often ask, “Are you sure?”

I completed medical school over 7 and a half years ago. During that time I’ve …

An informed patient is a safer patient

Fred E. Shapiro, DO

Physician

March 9, 2015

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

The health care landscape is changing, and now more than ever we as physicians should be focused on quality of care and ensuring the safety of our patients. Anesthesiology was the first medical specialty to champion patient safety as a specific focus. Over the past century, physician …

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An informed patient is a safer patient

Medicine: A profession of sacred trust

Chiduzie Madubata, MD

Physician

March 9, 2015

I remember one day a few years ago when I was talking with one of my friends about the challenges of being a doctor after a tough day at work. I had seen a large number of patients within the span of a few hours, and in addition to many of them being sick, I dealt with family members who had so many questions and who wanted to provide me …

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Medicine: A profession of sacred trust

Pay doctors and nurses for the time they spend charting

Edwin Leap, MD

Physician

March 9, 2015

I have a unique perspective as a physician. Having traveled to many hospitals in the past two years, working as a locums emergency physician, I can comment on a variety of issues with a reasonable amount of experience.

One of those issues is EMR, or electronic medical records. I have spent plenty of time writing about this in the past, and I …

Assisted physician suicide: Are doctors killing doctors?

Pamela Wible, MD

Physician

March 9, 2015

Standing on the edge of his hotel balcony, a doctor describes the rolling hills. He tells me, “It’s a beautiful place to die.” Ten minutes later, he agrees not to injure himself — for now.

I’m not running a physician suicide hotline. But doctors keep calling me.

It’s midnight, and I’m speaking to a psychiatry intern. Bullied by residents and her attending, she …

Real-life examples of ultrasound in the developing world

Janice Boughton, MD

Physician

March 8, 2015

In the last year and a half, I’ve been able to go to Africa 4 times and Haiti once, for which I give thanks that the world still produces abundant fossil fuels. That much airplane travel does make me feel a bit guilty, even though I’m not actually vacationing.

Going to far away places to practice medicine has always been something I hankered after, and it turns out that knowing how …

The prescription painkiller epidemic has changed the face of medicine in America

Vincent DeGennaro, Jr., MD, MPH

Physician

March 8, 2015

“The patient’s pain is still 9/10, doctor. We’ve already given morphine IV and then changed to Dilaudid IV and then we increased the dose of Dilaudid. Can we give it every two hours instead of every three hours?” the nurse asks me over the telephone. I sigh heavily into the receiver, unsure what to do, feeling more like a drug dealer than a doctor. The patient is on horse-sized doses …

Physician anesthesiologists do more than just “put you to sleep”

Paul Yost, MD

Physician

March 7, 2015

There have been huge advances in patient safety, but that doesn’t mean there is no risk when it comes to having surgery and anesthesia. Each year there are more than 100 million operations and procedures performed with anesthesia. Doctors who specialize in anesthesia — we’re known as physician anesthesiologists — play a critical role in keeping patients safe and comfortable before, during, and after surgery.

Before surgery, a physician anesthesiologist checks …

Why is MOC necessary?

Robert Centor, MD

Physician

March 7, 2015

Dr. Wes has written passionately against MOC: ABIM Pleads for Mercy.

But perhaps we should ask first: Why MOC at all?

Contrary to years of propaganda promoted through pseudo-science and journal article citations on the ABIM’s website, might MOC have really been created because the ABIM’s consolidated fund balance dropped 43.2% from $54,009,086 on June 30. 2001 to $30,691,329 by June 30, 2013 while the Standard and Poors 500 index increased 37.7% …

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Why is MOC necessary?

It’s important that we get our stories right

Shirie Leng, MD

Physician

March 7, 2015

In order to interpret the world, we tell ourselves stories. All day long. About everything. That guy in the grocery store who clipped your heels with his cart? A jerk. The car that cut you off at that intersection? A jerk. A little old lady stopping in the middle of the aisle at the grocery store? Senile.

It is automatic, it takes no effort, and it is completely egocentric. It is …

What physicians can learn from tying their shoes

Neil Baum, MD

Physician

March 6, 2015

Have you ever tied your shoes and found that the bow unraveled and you almost tripped over your own laces? Learning to tie your shoes is a life skills task that you learned as a toddler unless you were trained on Velcro straps! You performed the task of tying your shoes nearly every day of your life believing that you were …

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