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.

About to be discharged from the hospital? Here’s 3 things you should know.

Suneel Dhand, MD

Physician

January 21, 2015

The world of health care has made tremendous progress in the last several years in raising the quality and safety of clinical medicine. Despite this, the discharge process (when patients are discharged from hospital) is still fraught with potential pitfalls and opportunities for things to “slip through the net.”

If you ask most patients who are discharged — particularly the elderly with multiple medical problems — they will tell you that …

Industry and academia: There is some educational value

Adam Bitterman, DO

Physician

January 21, 2015

In the academic world, there is an unspoken rule under which faculty, residents, and fellows collectively live and work. Educational programs are to be separate from industry and its financial stronghold.

I understand the rule and its application in certain scenarios and clinical departments. But I would like to challenge it within my specialty of orthopedic surgery.

As I finish up residency and look ahead to fellowship, I am constantly thinking about …

Friendly fire from physician thought leaders

Val Jones, MD

Physician

January 20, 2015

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It’s no secret that medicine has become a highly specialized business. While generalists used to be in charge of most patient care 50 years ago, we have now splintered into extraordinarily granular specialties. Each organ system has its own specialty (e.g., gastroenterology, cardiology), and now parts of systems have their own experts (hepatologists, cardiac electrophysiologists) Even ophthalmologists have subspecialized into groups …

What can be done to improve our level of physician happiness?

Starla Fitch, MD

Physician

January 20, 2015

There’s a lot of talk these days about patient satisfaction. Physicians are being measured in so many different ways. What concerns me is there’s not much talk about physician happiness. With levels of physician burnout and discontent growing, why not pull back the curtain on how to improve physician happiness?

Let’s think back to what life was like in grade school. For those of you who have children, what is the …

The Dzhokhar Tsarnaev defense: Will marijuana play a role?

Judith G. Edersheim, MD, JD

Physician

January 20, 2015

January marked the start of what promises to be a four-month public reckoning: the trial of alleged Boston Marathon bomber Dzhokhar Tsarnaev. If the press reports about the evidence against him are accurate, most of the trial will not be about guilt or innocence; it will be about sentencing. Not a who-done-it, but a why-done-it.

If Tsarnaev is found guilty, the death penalty will be on the table, and the proceedings will …

End-of-life care in America is broken at every level

Angelo E. Volandes, MD

Physician

January 19, 2015

Like most doctors, I was a young resident, fresh out of medical school, when I had my first experience with the American way of mistreating the dying.

Taras Skripchenko was a frail, bed-bound 78-year-old man with inoperable lung cancer who was admitted to my service during my first year of residency training. Skripchenko was too confused to have a lucid conversation and lacked family members to guide his decision-making. His oncologists hadn’t …

A new way for insurers to give doctors headaches

Fred N. Pelzman, MD

Physician

January 18, 2015

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The insurance companies have discovered a new way to give me a headache.

About a month ago, a number of providers in our practice received an email with instructions about a new task to which we had been assigned.

Apparently, we were supposed to log on to some website, create an account, and fill out a SOAP note on about a dozen of …

Telemedicine is a growing practice model, but beware of the risks

B. Tilman Jolly, MD

Physician

January 18, 2015

Health care in the United States is often compromised by fragmentation in its delivery, limited patient access due to a shortage of primary care doctors, long wait times (even for patients who have appointments), and spiraling costs. As a result, innovative approaches to delivering health care are becoming increasingly important in America’s continued pursuit of improved outcomes and reduced cost of care.

Health care delivery models such as telemedicine aim to …

Maybe Dr. Oz is part of the health care solution. Wait, what?

Rocky Bilhartz, MD

Physician

January 18, 2015

Dr. Oz is going to love this one.

At least, I think that he will. I’ve never actually met him. To be honest, I wouldn’t have a clue as to whether he’s really a good guy or not. In fact, I suspect that he’s never read my book, but I did devote almost an entire chapter to him, because he intrigues me …

5 tips for future physician leaders

Edward R. Mariano, MD

Physician

January 18, 2015

Our health care system needs more physician leaders. Physician-led accountable care organizations have been shown to improve the quality of patient care while reducing overall costs. Physicians, by their nature, tend to be goal-oriented, have the ability to gather and assimilate evidence, and make difficult decisions, but these traits do not always translate naturally into leadership skills. We are trained to make a diagnosis and map out a treatment plan …

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5 tips for future physician leaders

E-patients need e-doctors. Here’s why.

Matthew Katz, MD

Physician

January 18, 2015

Everyone deserves a chance to be healthy. Physicians, of course, focus on helping patients. Unfortunately, I often see patients’ frustrations with the health care system itself directed toward doctors.

Meanwhile, doctors are under increasing pressures on multiple fronts. Yes, we’re imperfect, but making physicians the primary focus of patient anger will not solve problems we all face as humans who will, at some point, need health care. (Note: I’m using doctors …

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E-patients need e-doctors. Here’s why.

Are CT scans ordered too often? Well, consider the leaf blower.

Jay Baruch, MD

Physician

January 17, 2015

To critics who admonish emergency physicians like myself for our excessive use of CT scans, I’ll ask them to consider the leaf blower. I’m sipping my morning coffee on our front porch, a bright, idyllic autumn day in New England, the tranquility ripped apart by the landscapers across the street. For many jobs, a powerful leaf blower might prove superior to a rake or broom. But in my neighborhood known …

How to drive doctors to suicide: A step-by-step guide

Lucy Hornstein, MD

Physician

January 16, 2015

It’s really quite easy to kill a doctor. Here’s a step-by-step process guaranteed to succeed at least 400 times a year:

Start early.

Be sure to denigrate medical students whenever possible. Even if they’ve come to the profession later in life and have accomplished all kinds of amazing things personally and professionally (which don’t count, of course, since those are other professions) they don’t know squat …

Sexism in STEM: Don’t base conclusions on flawed data

Timothy Lahey, MD

Physician

January 16, 2015

Sexism is a major problem in education around sciences, technology and engineering. The first step in addressing this problem is awareness.

A new study suggests many men deny that sexism is a problem in STEM fields. A study in Psychology of Women Quarterly says that that among 423 respondents in an online forum, men were more likely to suggest sexism isn’t a problem even when confronted with evidence it is.

Wow, men are …

In the airport for a routine flight. And an adventure with urine and an AED.

Deep Ramachandran, MD

Physician

January 16, 2015

I arrived at my designated gate at Chicago’s O’Hare Airport. After handing over my crumpled boarding pass for scanning, I made my way down the jetway and onto what appeared to be a small but fairly packed little jet. Passengers on each side of the aisle eyed me as I walked past, a few noticed that my jeans were soaked from …

MDs and CRNAs: Highlighting each other’s expertise

Shirie Leng, MD

Physician

January 15, 2015

A front page entry in a recent issue of Anesthesiology News: “Physicians Versus CRNAs: Redefining Roles in the Changing Landscape of Health Care.” Sounds like a prize fight or a gang war: Crips vs. Bloods. I immediately got my boxing gloves on, readying myself for another bout of vitriol and dislike thinly disguised as concerns for patient safety. But the author, Michael DeCicca, a second-year anesthesia resident, surprised me.

He writes: “Logically the number …

Why other professions can’t relate to medicine

James C. Salwitz, MD

Physician

January 15, 2015

Doctors have a difficult time adjusting to other cultures and because of this flaw, patients, and the medical profession suffer. By culture, I do not mean religious or philosophical background, socio-economic difference, country of origin, nor even the silence created by language and education barriers. I am referring to the communication and comprehension chasms that exist between different occupations and physicians.

What …

Want to know what Atul Gawande thinks? Read this interview.

Robert Wachter, MD

Physician

January 15, 2015

Atul Gawande is the preeminent physician-writer of this generation. His new book, Being Mortal, is a runaway bestseller, as have been his three prior books, Complications, Better, and The Checklist Manifesto.

One of the joys of my recent sabbatical in Boston was the opportunity to spend some time with Atul, getting to see what an inspirational leader and superb mentor he is, along with being a warm and menschy human being. In my continued series of …

Stuart Scott and his fighting words

Christian Sinclair, MD

Physician

January 15, 2015

ESPN sportscaster Stuart Scott’s recent death has given the American public a chance to reflect on what it means to live with a cancer diagnosis. His speech at the ESPY awards in the summer of 2014 was widely hailed as an inspiration to people with cancer. Obviously, the Jimmy Valvano Award for Perseverance with the ties to cancer research (Jimmy V Foundation) and Scott’s public image as someone being treated …

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Stuart Scott and his fighting words

Remembering the humble profession of taking care of each other

Jordan Grumet, MD

Physician

January 15, 2015

It was a rather unlikely place to begin my clinical career.

Shortly after starting medical school, I signed up to volunteer in the hospice unit of my academic medical center. The first few visits I relegated myself to fairly banal activities. I shredded old medical records, or I might do a load of laundry for a family member who had been waiting tentatively by their loved one’s side and was …

Physician

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