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.

Arizona lawmakers have stepped into the doctor’s office

Jennifer Gunter, MD

Physician

April 18, 2014

Imagine you want health care. You go to your doctor who recommends a medication. Your doctor tells you that the medication used to be prescribed one way 14 years ago, but very rigorous, more recent studies indicate a lower dose is just as effective. And has fewer side effects. And is less expensive.

You are pleased because a) your doctor is up on the latest medical therapies, and b) the least …

Technology and confidence: Working with surgeons in Kenya

Bruce Campbell, MD

Physician

April 18, 2014

Confidence is contagious. So is lack of confidence.
-Vince Lombardi

“So, can you leave this here with us?”

I was part of a group of U.S. surgeons traveling to Eldoret, Kenya, seeing patients and helping the Kenyan ENT surgeons learn surgical techniques. Our two week mission allowed us to work across-the-table from Kenyan colleagues, discussing surgical approaches, demonstrating techniques, and reviewing all aspects of surgical care.

“I have never seen such a thing!” my …

If a doctor isn’t face to face with a patient, is he still a doctor?

Hans Duvefelt, MD

Physician

April 18, 2014

It’s a strange business we are in.

I can freeze a couple of warts in less than a minute and send a bill to a patient’s commercial insurance for much more money than for a fifteen minute visit to change their blood pressure medication.

I can see a Medicaid or Medicare patient for five minutes or forty-five, and up until now, because I work for a federally qualified health center, the payment …

Make a personal connection in the ER

David Klein, MD

Physician

April 18, 2014

After a relaxing weekend with my daughter, son-in-law and 2-year-old grandson, my wife and I made our way to the Atlanta airport to begin our trip home. The end of a trip — even a short weekend — is always sad. I never look forward to the travel home and usually want to snap my fingers and skip the travel.

My wife and I have trouble packing light and so, when …

Read more…

Make a personal connection in the ER

When free preventive screening tests aren’t really free

Kenneth Lin, MD

Physician

April 17, 2014

I recently spoke to a class of undergraduates about the benefits, harms and politics of screening smokers for lung cancer using low-dose CT scans. Afterwards, a student asked how I felt about the Affordable Care Act’s requirement that Medicare and private insurers cover U.S. Preventive Services Task Force “A” and “B” recommended screening tests and other preventive services without co-payments or deductibles, making them free at the point of care.

I admitted that …

The conundrum of communication and uncompensated care

PalMD

Physician

April 16, 2014

Going to the doctor starts as a disconcerting experience: Getting naked, physically and emotionally; talking about your weight, your smoking, your divorce. You count on your doctor’s ear and her discretion. Often enough, a patient will apologize for taking my time or for crying or whatever. I remind them that this is what the exam room is for, this is what they pay me for.

How far does this special relationship …

5 ways to improve hospital medicine

Suneel Dhand, MD

Physician

April 16, 2014

Hospital medicine has rapidly become one of the largest specialties in the United States. As the number of practicing hospital medicine doctors soars above the 30,000 mark and health care reform takes hold, the specialty finds itself at the forefront of American medicine. And for good reason. It is a young, dynamic, varied and flexible specialty that can be practiced in a number of different settings. Hospital medicine doctors are …

Read more…

5 ways to improve hospital medicine

The role of integrative medicine in primary care

Stephen C. Schimpff, MD

Physician

April 16, 2014

Next in a series.

Beginning with a deep understanding of medical science and years of training and experience, the primary care physician (PCP) needs to delve deeply into the patient’s personal, family and social setting in order to fully understand the context and causes of the patient’s illness. The PCP also needs to know when it is important or even critical to call upon others with specific knowledge, techniques or …

Why should practicing medicine be compared to any other occupation?

Skeptical Scalpel, MD

Physician

April 15, 2014

A while ago, Atul Gawande, the noted surgeon-author, wrote a long piece in the New Yorker on why health care should look to a restaurant called the Cheesecake Factory for some guidance on how to standardize things.

This was met with some derision by a number of physicians who pointed out, among other things, that the food at the Cheesecake Factory is not great and is loaded with calories. But I …

To emotionally survive cancer, we must create perspective

James C. Salwitz, MD

Physician

April 15, 2014

Hegira: To take flight to escape. To travel from a place of danger to a place of safety.

“You have cancer.”

You hear the words. Your mind does not understand.

“You have cancer.”

Shock. Distance. Isolation. Someone else. A mistake. A lie. Bizarre, strange, you float above the room. Everyone speaks; nothing is said.

“You have cancer.”

A fog-like curse, a venomous reality, a phantom idea. A cold ghost foreign to the soul. I must run. …

Physicians should not be expected to blindly follow guidelines

Jordan Grumet, MD

Physician

April 15, 2014

Barron Lerner thinks he understands doctor’s motives. In his recent article in the Atlantic he laments that physicians act on tradition and emotion over adopting new science. In defense of his position, he sites the example of how cardiologists use angioplasty and coronary artery bypass to treat coronary disease.

He states,

… cardiologists have been remarkably slow to abandon the old hypothesis, continuing to perform hundreds of thousands of bypass operations …

Read more…

Physicians should not be expected to blindly follow guidelines

A patient nearly died to save him $1110

Robert Gray, MD

Physician

April 15, 2014

Where I’m from, you can have someone killed for $5000. I will do it for $1110. I’m a hand surgeon.

I practice (or practiced, by the time you read this) in an area that is what we often refer to as “underserved.” Rather, the area isn’t, but the people I treat are. I work in a large urban referral center that has a very high proportion of Medicaid as well as …

Read more…

A patient nearly died to save him $1110

Did ProPublica unfairly target Dr. Yoav Golan?

Ford Vox, MD

Physician

April 14, 2014

A recent ProPublica expose co-published with the Boston Globe typifies a growing gotcha genre of health journalism that portrays doctors as the enemy in a struggle for honesty and openness in medicine. These reports make unfounded leaps in their efforts to subject doctors to levels of skepticism once reserved for politicians and lawyers. They’re going to end up doing patients a disservice. For this particular hunting expedition ProPublica set its sights on …

Caught between patient satisfaction and prescription drug abuse

Karen S. Sibert, MD

Physician

April 14, 2014

The creatures cause pain by being born, and live by inflicting pain, and in pain they mostly die.
–C. S. Lewis

The problem of pain, from the viewpoint of British novelist and theologian C. S. Lewis, is how to reconcile the reality of suffering with belief in a just and benevolent God.

The American physician’s problem with pain is less cosmic and more concrete. For physicians today in nearly every specialty, the problem …

Why doctors treat patients as drug addicts

Pamela Wible, MD

Physician

April 14, 2014

1797322_10202053927164294_2111408475_n

Fact: Doctors want to help people.

Fact: Some people take advantage of doctors.

A doctor in Oregon shares this case:

I had an old man with cancer. He kept complaining of pain as I was increasing his opiate pain medication, Oxycontin. I was at, I forget, about 40mg four times a day or some fairly substantial dose. I ran a urine drug test. Negative …

Read more…

Why doctors treat patients as drug addicts

Providers should be active in helping patients follow directions

Donald Tex Bryant

Physician

April 12, 2014

Many times I have heard physicians and other providers lament that the outcomes for their patients would be so much better if they could “get them to listen and follow instructions.” They understand that they can be most effective in treating patients if the patients would follow all of their directions.

Do the physicians’ or care providers’ responsibilities end with this wish? Can physicians do more than just hope and pray …

Why so many Americans believe in health care conspiracy theories

Deceased, MD

Physician

April 12, 2014

There is a JAMA article out that is very telling: Medical Conspiracy Theories and Health Behaviors in the United States. It is a must-read article for anyone who wonders why the public does not seem to advocate for themselves when it comes to their medical care in the US.

The first theory studied in the article states that the FDA is purposely preventing the public from getting natural cures …

Doctors didn’t sign up to fill out forms

Michael Edmond, MD, MPH

Physician

April 11, 2014

There are reports from across the country regarding severe influenza in young people. In addition to mechanical ventilation, many are requiring extracorporeal membrane oxygenation (ECMO). Given the severity of illness and the presence of multiple organ dysfunction, relying on an oral antiviral for influenza therapy seems unwise. However, at this point, the only option for intravenous therapy is IV zanamivir, which is not approved by the FDA, but available on …

Electronic medical records: Questions journalists should ask

Jan Gurley, MD

Physician

April 11, 2014

It’s rare for doctors to turn out en masse for a public protest. But that’s what happened at “Doccupy” in Contra Costa County, California in 2012. A group of safety net physicians testified before county supervisors — in what they only half-jokingly called “Doccupy” — that the cumbersome move to electronic health records (EHRs) had taken an enormous toll on patient care. The doctors saw half their usual number of patients. …

Some people will be hospital-dependent despite our best efforts

Janice Boughton, MD

Physician

April 11, 2014

The New England Journal of Medicine recently published an article by David Reuben, MD and Mary Tinetti, MD, both academic gerontologists, about patients who are unable to stay out of the hospital. The two physicians study the problems of old people, and are of the opinion that most of these “hospital dependent” patients are elderly. Certainly some of them are, but in my experience a surprising number are just chronically ill, …

Physician

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts