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.

Ebola: Local hospitals cannot be prepared

Manoj Jain, MD, MPH

Physician

October 25, 2014

Recently at our community hospital, after we concluded a nearly two-hour standing room only Ebola preparedness meeting, I practiced donning and doffing the personal protective equipment (PPE) for Ebola cases.

PPE is the protective wardrobe health workers wear when examining a patient with a contagious infectious disease. Each disease has a different level of transmission and requires an appropriate level of protection. I wear gloves 25 times a day to examine …

Helicopter emergency services: A disparity between aviation and medical proficiency

Michael K. Abernethy, MD

Physician

October 25, 2014

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As the helicopter emergency services (HEMS) industry enters its fifth decade, there is an 800-pound gorilla in the room and nobody is talking. The average EMT, fireman and emergency physician too often make the flawed assumption that when it comes to HEMS, the industry is a uniform, high quality, strictly regulated entity. They assume that all HEMS programs use state of …

Quit smoking: It takes a community to spread the word

J. Leonard Lichtenfeld, MD

Physician

October 24, 2014

You never know when something special is going to happen, as in one of those times when you just wish you had a camera rolling to capture a moment, a comment, a statement about the way the world is — and the way the world could be.

This past weekend my wife and I were attending a meeting in …

The lack of joy at the doctor’s office, and a reason why

Jordan Grumet, MD

Physician

October 24, 2014

Ruth was problematic. Well into her seventies, her body may have dulled but her tongue was sharper than ever. And she used it to lash me with complaint after complaint. If it wasn’t her knees, it was her ankles. If it wasn’t her ankles, it was her hips. I battled the impossible month after month, year after year. Our interactions left a bitter taste in my mouth. Nothing makes a …

Lesson learned: Not everyone is crazy

Edmund Messina, MD

Physician

October 23, 2014

An excerpt from The Spattered White Coat: Intense experiences which formed a young doctor.

I’ll never forget one of the first patients I interviewed. When I went to get him, I could see him sitting in the waiting room, looking around and scratching his arms repeatedly. He was a very large middle-aged black …

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Lesson learned: Not everyone is crazy

A case that illustrates the good, the bad and the ugly of American medicine

Ira Nash, MD

Physician

October 23, 2014

I had a recent conversation with an old friend about her elderly father that encapsulates a lot of what is both great and terribly wrong with health care in America today.

Here are the basic facts: the man is in his mid-80s, retired from teaching school, and is active and vigorous, living in the community; he is cognitively intact. He has a …

After a child leaves for college, the music changes

Abigail Schildcrout, MD

Physician

October 22, 2014

Recently, my eldest son came home from college for a couple of days. Our home was in perfect harmony and rhythm. The duets (and quartets, if you count us parents) that had played over the prior month-and-a-half were once again trios and quintets. Five or six hands on the piano at a time. The clear brass joining in again with the bright woodwind and the deep bass. The voices in …

Pamela Wible: A eulogy to her father

Pamela Wible, MD

Physician

October 22, 2014

I believe we choose our parents before we are born. I hit the jackpot.

I picked an unlikely pair — a radical feminist and a guy named Ted Krouse. Mom wasn’t home much (she was finishing up her psychiatry residency) so I became head of the household. Dad always kowtowed to the strongest woman in the room. I was two at the …

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Pamela Wible: A eulogy to her father

When hospice is about living, not dying

James C. Salwitz, MD

Physician

October 21, 2014

Not too long ago I suggested hospice to a patient who had progressive cancer, although she likely had months to live. “I don’t think it is time,” she replied, “hospice is for morphine.”

“That is not how I see hospice,” I replied, “I think hospice is about getting the best care and support, even if there is no real treatment for the disease. It is about living well, maybe better. Even …

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When hospice is about living, not dying

When treating neo-Nazis, should physicians have a choice?

Alberto Hazan, MD

Physician

October 21, 2014

What I found most disturbing about the man’s arm was not the deep, stellate laceration on the underside of his biceps.

It was the swastika tattoo next to it.

“Sir,” I said, “we’ll have you fixed up in no time. I’m going to numb up the wound, irrigate it, then repair the laceration with sutures and send you home on antibiotics and pain …

Quantified health and the great digital divide

Kevin R. Stone, MD

Physician

October 21, 2014

Go into any hospital today and notice that between every great nurse and patient sits a computer terminal. The quantified health movement has created the great digital divide, between the patient and everyone else.

The nurse of old used to actually touch the patient. No more. Now, they wheel in a computer console, sit down and record the digital output of the wired up patient, every vital sign, every drug order or …

What I love about being an anesthesiologist

Edward R. Mariano, MD

Physician

October 20, 2014

I wear a lot of hats in my job. Though I’m a physician who specializes in the practice of anesthesiology, I don’t spend all day every day at the head of an operating room table.

Many days I spend in an administrative leadership role or conducting research studies. These functions support the best interests of my patients as well as the science …

The long, tragic odyssey of a HMO patient

James Ong, MD

Physician

October 20, 2014

Every so often you have a patient in your practice that you sort of know, but really don’t. You’ve seen the name somewhere, but your mind draws a blank when asked about him. You may even have a vague idea of what he looks like, but if he were to bump into you on the street, you won’t even recognize him, despite the fact that you’ve been inside his heart …

Working in an ER in Liberia: A physician shares his story

Antonio Webb, MD

Physician

October 20, 2014

In June 2014, the first patient with Ebola arrived at Liberia’s county hospital, Redemption. As tensions grew around the city of Monrovia, administrators at JFK Hospital began to devise plans for handling patients with suspected Ebola. Officials from the CDC then came and gave us lectures. They discussed prevention of spreading and what our plans would be in the event of a potential outbreak. Before that moment, there were no …

8 tips to survive the marathon of a physician career

Steve Adelman, MD

Physician

October 20, 2014

Many physicians are discouraged by the state of medical practice in 2014. Maintaining job satisfaction and well-being for the duration of a decades-long medical career can be as daunting as completing an uphill marathon. In addition to keeping up with the explosion of medical knowledge and maintaining certification in your specialty, what concrete practices can you adopt to insure that you will make it to the finish line in good …

To medical students and residents: It really does get better

Trina E. Dorrah, MD

Physician

October 20, 2014

I recently attended my 10-year medical school reunion class party, and I have to admit, I had a great time. From the beginning, my class was special. We had 104 amazing people who were truly inspired to make a difference.

However, regardless of how talented and hard working you are, medical school is one of the most challenging things you will ever …

Why doctors are afraid of their patients

Robin Dickinson, MD

Physician

October 20, 2014

We all start out as idealistic medical students, downright puppy-like in our devotion to our patients, eagerly bounding to their rescue and spending hours listening to their concerns. Somewhere along the way, we start shutting down, seeing patients as demanding and feeling as if we’re always fighting them off.

I used to do it too; hide behind my layers of staff, complain to …

A retired cardiologist goes back to work. Paperwork greets him.

David Mokotoff, MD

Physician

October 19, 2014

On July 1, 2014, I retired after 35 years in practice. Or at least so it seemed. Before and after retirement, my cardiology group asked if I might be interested in part-time work. At first I said no. Due to my retirement, a physician’s poor health, and one partner’s departure due to chronic complaints of being overworked and under-appreciated, the group found itself without three doctors. As my retirement approached …

Running a code is a team sport

Denitza Blagev, MD

Physician

October 18, 2014

“They need you in room 13,″ she said when I answered the phone and I ran back to the ICU. The patient was coding and for each minute that felt like an hour, we tried, and failed, to save her. She wasn’t breathing, her heart wasn’t working, and despite the 30 people gathered in the room, in the end, she died.

Running a code, as we call it, means that someone is …

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Running a code is a team sport

Rating health care: There are limits to every method

Craig Chen, MD

Physician

October 17, 2014

You can find reviews on almost anything; we “Yelp” restaurants before we try them, we scrutinize customer feedback when we purchase products on Amazon and we check out how many stars a dry cleaner or car mechanic has. Medicine is, for better or for worse, becoming the same way. You can Google a hospital or physician and find comments or reviews, and this worries many doctors.

Most physicians don’t like the …

Physician

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