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.

Physician wellness: Take time to find what works for you

Sara Taylor, MD

Physician

August 23, 2014

I wholeheartedly support the message behind the project, What Works For Me. As health care professionals, we continually encounter human suffering and work under stressful conditions. As a family physician for the past 14 years, I have been fortunate enough to work in a variety of clinical settings, including several in general family practice.

Currently, I practice family medicine in the sexual health clinic of a community health center. …

Before you retire, see your doctor first

Edward T. Creagan, MD

Physician

August 23, 2014

The big day has finally arrived. Your boss shakes your hand and wishes you well. Your colleagues gather around a cake and make small talk about landing the big fish in your retirement, or joke about what you’ll do now that you don’t have to come to the office.

A cardboard box is filled with the contents of your desk: your family pictures, desktop trinkets, snowball paperweight, and stale candy. Your …

Robots and health costs: Can either be tamed?

Catherine Musemeche, MD

Physician

August 23, 2014

There are many reasons why the costs of delivering simple, uncomplicated health care in this country keep increasing while quality lags and value fails to keep pace with that of most major industrialized countries. But as a surgeon, I have a one-word answer for all that is wrong with health care: “robots.”

Surgical robots, costing an estimated 1.2 to 2.5 million dollars each with matching maintenance fees of $125,000 per year, …

Like it or not, urgent care centers are here to stay

John Schumann, MD

Physician

August 22, 2014

The New York Times had a front-page story about the growth of urgent care clinics nationwide.

These are the places that are often referred to as “minor emergency rooms,” or “doc-in-a-box” outfits. Their value proposition is simple: You don’t need an appointment. The costs are “reasonable,” and much more transparent than usual medical care at a doctor’s office, emergency room, or hospital. Best of all: They can treat a majority of acute conditions …

Delivering bad news: Don’t pass the buck

Don S. Dizon, MD

Physician

August 22, 2014

When I was a fellow, part of our training involved doing consults for patients, most of whom had just learned they had cancer or recurrence of disease. These consults were never easy, but the importance of sitting with someone who had just learned of their diagnosis was an integral part of learning the medicine and art of oncology.

Even after many …

Dealing with physicians who have lost empathy and compassion

Val Jones, MD

Physician

August 22, 2014

I am a regular reader of patient blogs, and I find myself frequently gasping at the mistreatment they experience at the hands of my peers. I recently had the “pleasure” of being a patient myself, and found that my professional ties did not protect me from outrageously poor bedside manners. I suppose I’m writing this partly to vent, but also to remind health care professionals what not to do …

Why do doctors ignore their own self-care needs?

Starla Fitch, MD

Physician

August 21, 2014

Most busy doctors completely forget (or ignore) the importance of integrating personal downtime and self-care into their schedules.

It’s no surprise so many doctors wrestle with overwhelm. Downtime is crucial for stress management.

What about you? Are you guilty of skipping your “you time?”

No, I don’t mean attending a seminar, reading an article, or talking about stress reduction at a staff meeting.

I mean, when is the last time you scheduled some real …

How to move the needle on wellness

Dean Ornish, MD

Physician

August 21, 2014

When it comes to preserving health and prolonging life, study after study shows that prevention is essential. From type 2 diabetes to early-stage prostate cancer, clinical trials have demonstrated that countless diseases can be avoided or even reversed through (often simple) lifestyle changes. We know the solution. Yet the challenge is reaching it. For example, tens of millions of overweight Americans are dieting at any given moment, but only a …

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How to move the needle on wellness

How we cope with a cancer diagnosis starts in childhood

James C. Salwitz, MD

Physician

August 21, 2014

A baby’s smile reflects the purity in their heart. An infant’s world is a marvelous place of possibility and love. Children see themselves as special, capable, even omnipotent. Time teaches failure, loss, and mortality. How much we lose of that original perfection, that first excitement, that natural confidence, determines how we face the challenges and tragedies of life; whether we will be happy. It may even determine how we cope …

Top 10 ways to know it’s time to quit your job as a doctor

Pamela Wible, MD

Physician

August 21, 2014

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Attention all doctors: The first three are mine. The rest are from miserable colleagues. All true. And common. If you’re a doctor and you recognize anything on this list, please quit your job.

10. You feel nauseated when you see your clinic logo; you alter your commute to avoid streets with your clinic’s billboard.

9. Discouraged by the general despair among staff, you …

What a golf course taught me about patient satisfaction

Suneel Dhand, MD

Physician

August 20, 2014

Over the last year I’ve become rather addicted to golf. Having always been more into cardiovascular sports I’m actually quite surprised with how much I’ve taken to it. Fresh air, outdoors, lots of walking in beautiful nature and spending time with friends — what is there not to like?

Anyway, I’ve frequented several different courses in the Boston area in just the last few months. Last week, we were due to …

A physician reflects on Robin Williams

David L. Katz, MD

Physician

August 20, 2014

I was shocked and deeply saddened when my daughter announced at the dinner table that Robin Williams had died of an apparent suicide. My wife and I and the three of our children home at the time all pretty much gasped audibly in unison, and then for a moment after, you could have heard a pin drop.

For a bit after that, we talked about our shock and sorrow. And then after that, …

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A physician reflects on Robin Williams

Why do some patients go to the doctor in the first place?

Jordan Grumet, MD

Physician

August 20, 2014

William was doing great. His C. Diff was finally gone after a month taper of vancomycin. He was stronger. The nursing home staff reveled in how much progress was being made over such little time. It seemed every one was ecstatic, except for, of course his family. Every step this octogenarian took forward was accompanied by a litany of concerns and complaints from his daughter.

If he was not gaining weight, …

Being a good parent means being unpopular sometimes

Claire McCarthy, MD

Physician

August 20, 2014

I see it again and again in my practice: parents who seem to have forgotten that they are in charge.

“You can say no,” I find myself saying to family after family. Which is kind of an amazing thing to have to say, if you think about it. You’d think that parents would know that they can say no when their child asks for yet another toy, to watch more television, …

Teach the basics of practice management to medical students

Raymond Tsai, MD

Physician

August 20, 2014

For three years before I applied to medical school, I worked in post-Katrina New Orleans helping to rebuild school-based health centers. One of the main challenges, however, was how to create a sustainable safety net for at-risk youth to whom we were hoping to provide much needed health services — key word being “sustainable.”

All too often, there isn’t funding to carry out primary care’s mission of improving the health of communities and …

Oncologist pay and chemotherapy: Buy and bill needs to stop

Robert Pearl, MD

Physician

August 19, 2014

Today’s article highlights the lingering problem of physicians buying and selling prescription medications to patients — at a profit.

The medical profession has struggled with this controversial practice for more than 150 years.

In George Eliot’s 1874 novel “Middlemarch,” an idealistic young doctor named Tertius Lydgate questions the ethics of fellow physicians who make handsome profits prescribing and dispensing their own remedies to the townsfolk. His medical colleagues shun him for it.

Around …

A pediatrician’s weight loss journey

Randy Rockney, MD

Physician

August 19, 2014

When I was in medical residency, more than thirty years ago, I ran with a pack of fellow residents, all guys who were fit to varying degrees. Once, on an outing, we discussed the — hopefully — hypothetical question: “If the need arose, which one of us would we eat first?”

“Randy!” my friends gleefully concluded.

“His meat would be the most marbled,” one added.

I’ve never been fat. More accurately, my body …

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A pediatrician’s weight loss journey

Marcus Welby won’t survive today

Steve Jacob

Physician

August 18, 2014

An excerpt from So Long, Marcus Welby, M.D.: How Today’s Health Care Is Suffocating Independent Physicians – and How Some Changed to Thrive.

A 30-ish public-relations executive representing a large, modern physician practice was shaking her head in puzzlement.

Her physician client liked to talk about how his practice was not “a …

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Marcus Welby won’t survive today

The blonde minority: Sexism is alive in medicine

Elizabeth Horn, MD

Physician

August 18, 2014

While demographic data may suggest otherwise, I still consider myself a minority, albeit a less common one. I am a young woman in medicine, and I am a natural blonde.

I barely qualify for a prescription for eyeglasses, but I have found they give credence to my words and patients seem to take me more seriously. Perhaps three years of residency training …

Does direct primary care improve quality measures?

Stephen C. Schimpff, MD

Physician

August 18, 2014

Part of a series.

In earlier posts, I have described direct primary care (DPC) in its various forms called membership, retainer and concierge. There are some concerns with DPC. Does more doctor-patient time really mean better quality care? Does it really mean lower total costs? It seems logical that closer care means better care, fewer referrals to specialists and fewer hospitalizations. Most DPC physicians will tell you this is the case …

Physician

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