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.

Too many health coordinators means less care for patients

P. J. Parmar, MD

Physician

October 17, 2014

How many health coordinators does it take to screw in a lightbulb?

Four. But none actually do any screwing. One is your point of contact for screwing lightbulbs. One helps the bulb get screwed. One goes between those two. And one manages the other three, raises funds and writes reports.

My office strives to cut all barriers between the patient and provider. The patient calls me to schedule and comes in, or …

We can make a difference: Lessons from the Buckyballs recall

Bryan J. Rudolph, MD

Physician

October 17, 2014

As practicing pediatric gastroenterologists, my colleagues and I remove a fair number of esophageal and intestinal foreign bodies (i.e., things kids accidentally swallow).

A couple of years ago, several physicians across the country began noticing serious injuries in children who swallowed high-powered magnets. The issue was raised in an email forum for pediatric gastroenterologists and the response was overwhelming. There were hundreds of cases — throughout the world, as we later …

Why health reform will destroy the e-patient movement

Jordan Grumet, MD

Physician

October 16, 2014

The e-patient movement represents everything that is positive in medicine today. This grass roots force has introduced shared decision making and empowered both physician and patient. The quality of health care dialogue has risen meteorically both in the exam room and out. Today’s health care “consumer” is more engaged, more intelligent, and more agile at wending their way through the confusing maze of sickness and health.

It’s awfully sad that it …

Reading about health care online: Is it really that bad?

Suneel Dhand, MD

Physician

October 16, 2014

It’s funny to think that the internet and the online world, so entrenched in our modern day lives, is still a relatively new phenomenon. When I first started medical school (not really that long ago) we hardly used the internet and the concept of a web search barely existed. It only became widely available on home computers shortly after that.

The invention of social media is newer still. If any of …

California’s proposition 46: What motivates doctors and lawyers

Gregory Kurio, MD

Physician

October 15, 2014

Is it about physician drug testing? Is it about allaying the pain and suffering of families of patients whose outcomes have been devastating and tragic? Is it about the compensation of the legal counsel who represent those families and patients?

Truthfully, I don’t want to talk about 46. I think the issue is very much deeper and the process that underlies medical malpractice litigation has consequences for individuals and society that …

An ER missed Ebola. Here’s how it could happen to you.

Edwin Leap, MD

Physician

October 14, 2014

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How did the emergency department staff of a Texas hospital see, and discharge, a patient infected with Ebola? Despite the fact that blame spreads through hospitals faster than hemorrhagic fever viruses, I’m not interested in pinning down a single person or a single thing, which may have allowed that to happen. I am very interested, however, in offering a few insights …

Spurring a movement for patient and family-centered care

Peter Pronovost, MD, PhD

Physician

October 14, 2014

Earlier this year, our hospital staff was weighing a new 24/7 family presence policy to allow immediate family members to stay with patients 24 hours a day. We knew this was a step in the direction of delivering patient- and family-centered care.

We presented the proposal at a meeting of our patient and family advisory council. One of the members of the council told a story that drove home the importance …

What the Dallas Cowboys cheerleaders can teach us about hiring doctors

Trina E. Dorrah, MD

Physician

October 13, 2014

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I’ll admit it. I like reality TV. In fact, one of my favorite reality TV shows is Dallas Cowboys Cheerleaders: Making the Team. It shows what it takes to become a Dallas Cowboys cheerleader (DCC). Why am I talking about cheerleading in a health care blog? Because the Dallas Cowboys cheerleaders put more effort into hiring cheerleaders than most health care …

Why do doctors still use pagers?

Fred N. Pelzman, MD

Physician

October 12, 2014

I was on call last night.

Don’t get me wrong, this is not as bad as it sounds.

With over 20 partners sharing evening call, and residents getting the calls first, we do not have it bad at all. And certainly nothing like my obstetrician friends, who seem to go in every time they are on call for labor and delivery and then …

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Why do doctors still use pagers?

Don’t call me a “prescriber”

Maria Yang, MD

Physician

October 12, 2014

Please don’t call me a “prescriber.” Yes, I know it’s easier to say “prescriber” than “psychiatric nurse practitioner or psychiatrist.” The word “prescriber,” however, puts severe limits on what I can do and how I can help.

You may believe that, because I have a license to prescribe medications, that’s all I choose to do. In fact, you may believe that’s all I know how to do.

Psychiatrists can do a lot more than that.

As a …

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Don’t call me a “prescriber”

The choice between motherhood and medicine

Nelly Schottel, MD

Physician

October 12, 2014

As the birth of our first child loomed on the horizon, I couldn’t help but worry. As a first time mother and a pediatrician, I found the uncertainly coupled with too much knowledge of all manner of possible problems particularly unsettling.

In addition to worrying about my baby’s health, I grew increasingly concerned about how I would handle the balancing act that all working mothers must perform. Having put motherhood off in order to complete …

Do you want a culturally competent practice? Here are 15 tips.

P. J. Parmar, MD

Physician

October 11, 2014

Over the last few years I started a family practice serving refugees, and have seen 10,000 refugee patient visits. With regards to culturally competent medicine, medical schools teach about traditional remedies such as coining, and maybe role play with interpreters, but stop short of practice design ideas. The AAFP provides a checklist of qualities, which I feel could …

The ER demonstrates the inverted priorities of American society

Edwin Leap, MD

Physician

October 11, 2014

We fling open the doors of America’s emergency departments to help those who can’t afford health care. We have legislated this protection: No person can be turned away for financial reasons. This is very compassionate and represents the higher angels of our culture. Alas, it also is emblematic of the stupider demons of government. You see, the ER demonstrates the inverted priorities …

More stuff will not make kids happy: Take them outside instead

Roy Benaroch, MD

Physician

October 11, 2014

The Journal Psychological Science just published a complicated, long, and fascinating study about happiness. The full text is tucked behind a paywall, but it’s great reading if you can get your hands on it.

The authors arranged four separate experiments, looking at the effects of getting things versus experiencing things, and how the anticipation of waiting might affect happiness. Some of the studies involved just imagining a future purchase or vacation; …

Large lab companies contribute to high patient bills

David P. Smith, MD

Physician

October 10, 2014

It used to be that the greatest cost at a doctor’s visit was paying for the visit itself. Nowadays, the office visit is just a drop in the bucket compared to what medications cost. Medication costs were already starting to rise, but have risen to unprecedented levels since Medicare Part D became law about a decade ago and with the latest government attempt to help with the un-Affordable Care Act. In the last few …

Health information on the Internet: 5 questions to ask

Neil Baum, MD

Physician

October 10, 2014

Many of our patients are besieged with unsolicited Internet advertisements offering them unbelievable solutions and cures to most of mankind’s medical maladies. Patients come to and ask for advice about these promises to magically restore their health.

Since I receive so many requests from patients to evaluate these offerings, I have put together five questions that patients should ask themselves before proceeding to buy from websites offering outlandish claims, including restoring …

Doctors should be challenged to explain what they are charging and why

Ira Nash, MD

Physician

October 9, 2014

About a year ago, I shared details of my own out of pocket medical expenses and concluded that we have to have to be more transparent with our patients (and potential patients) about the costs they will face for our services. The urgency of price transparency as a business imperative and a professional responsibility has only increased since then.

Consider that we are now a year in to the implementation of the …

The last visit: Turning off the defibrillator

Wes Fisher, MD

Physician

October 9, 2014

He had called the other day to update me up on his condition. He did not sound upset, but resolute. “They offered me peritoneal dialysis,” he said, “but I decided against it and figured I’d just let nature take its course. The hospice people are so wonderful — I’ve got things all set here at home, but I have two questions. What should I do about my warfarin? You know, …

When treating seriously ill patients, learn to suppress The Look

James C. Salwitz, MD

Physician

October 8, 2014

A friend of mine plays a mean game of poker. She comes out ahead in Atlantic City, finishing near the top in hold ’em tournaments. She is a poker savant. Not long ago I asked her secret to playing the game so well.

“I learned to play cards when I was being trained to treat cancer.”

“Oh,” I said, “the discipline, memorization, patience and statistics?”

“No, that is when I learned not to …

I will build a practice, but I will also build a life

Adrianne Westmoreland, DO

Physician

October 7, 2014

She grasps her chest dramatically and falls to the floor. Her eyes flutter as she tries to hold them closed. Her one arm across her chest the other flailed in theatrical fashion to her side. She’s dead. Her heart is broken. The other jumps from the bed, and after landing, reports her leg is broken. She hops about the room, unable to use the leg and there are no crutches …

Physician

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