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.

Should doctors ever Google their patients?

Joyce Ho, MD

Physician

January 16, 2014

I recently read an article in the New York Times titled “When Doctors ‘Google’ Their Patients,” which details one physician’s thoughts on whether or not doctors should look up their patients on the Internet.

What struck me was the fact that despite growing up with the Internet and being able to find information about practically anyone using Facebook, LinkedIn, Google, or Instagram, I have never once been tempted to find out …

Developing a culture of cost effective care

Jessica Jou

Physician

January 15, 2014

During the four weeks of my ICU rotation, I came to know Mr. S well. I was the medical student on the intensive care team, managing patients alongside the primary surgeon. Mr. S was on the road to recovery when I started to follow his hospital course.

Every morning we rounded, one more of the numerous tubes attached to his body were removed. He grew stronger, gradually able to speak clearly …

A gracious note, letting a doctor know she made a difference

Emily Gibson, MD

Physician

January 15, 2014

Several years ago, a young woman I’d been seeing in clinic weekly for about a month to initiate treatment for depression called late Friday afternoon to cancel an upcoming appointment for the following Monday and did not reschedule. The receptionist sent me a message as is our policy for patients who cancel and do not reschedule. It gave me a bad feeling that she was not following through on her treatment plan and …

How I changed my private practice glass from half empty to half full

Yul Ejnes, MD

Physician

January 15, 2014

A guest column by the American College of Physicians, exclusive to KevinMD.com.

A few months ago, I attended a social event and ran into a few colleagues whom I had not seen in a long time. In the interest of privacy, I won’t reveal their specialties but I will note that I was the only primary care specialist in the group. As …

A patient trapped in his own body

Edward Thompson, MD

Physician

January 14, 2014

Donald is large. Very large.

At more than 600 pounds, he is a mountain of flesh with a small opening at the top through which he speaks.

“My stomach hurts,” he says, his voice surprisingly high and childlike.

It is 10:00pm in the emergency room, and I am already swamped with patients I’m trying to move through the ER before my shift is over.

Asked if he’s ever felt this kind of pain before, …

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A patient trapped in his own body

When doctors disagree: What should you tell patients?

Zackary Berger, MD, PhD

Physician

January 14, 2014

A recent research article in the Journal of General Internal Medicine, and the gap between its findings and the real world, helps point up the usefulness and limitations of research. The article, by Susan H. McDaniel, PhD, and coauthors, set out to determine how often doctors speak about their colleagues in supportive or critical ways.

Their method is one widely used in the field: simulated patients, actors, were prepared with lifelike …

Reflections of a new mother in medicine

Ishani Ganguli, MD

Physician

January 14, 2014

Months before my life was upended, a doctor friend tried to explain my forthcoming role in terms I’d understand. “Imagine being on call 24 hours a day, seven days a week,” he said. “You’re in charge of a single patient, but she is needy as hell.”

Medical training prepared me for motherhood in some ways (the assortment of facts blurrily retained from my pediatrics rotation in medical school; the skill, or delusion, …

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Reflections of a new mother in medicine

What are politicians doing about the shameful infant mortality rate?

Jennifer Gunter, MD

Physician

January 13, 2014

The infant mortality statistics are out again. This always depresses me because: 1) The rates are atrociously high, and, 2) There is so much legislation passed to restrict abortion in the name of “life,” but politicians and judges seems awfully silent on infant mortality.

In the United States 6.4 infants out of every 1,000 born will not reach their first birthday. This is more than 24,000 infant deaths a year. The United States is also the leader …

A culture of contempt has led to medicine’s downfall

Luis Collar, MD

Physician

January 13, 2014

“Doctors are crooks.”

“They’re getting worse than lawyers.”

“I don’t go anymore. They’re just out for a buck, and they don’t really do anything for you anyway.”

“I stopped getting checkups when my old one retired. He was good, took his time. I haven’t found anyone like him since.”

“They always think they know everything … a bit too much self-importance there, without ever walking in my shoes.”

“They all say the same thing; it’s …

A nurse masters the art of medical slang

John F. Hunt, MD

Physician

January 12, 2014

An excerpt from ASSUME THE PHYSICIAN: Modern Medicine’s “Catch-22”.

“What did you learn today?” I asked, fearing the answer.

I was suspecting a recitation about the new methods of documenting nursing competencies, or a delineation of the process by which she helped the hospital maintain its “magnet” status to attract …

Bringing health care technology to the developing world

Varun Verma, MD

Physician

January 12, 2014

This post is a question, an invitation and a challenge. How can we bring technologies we take for granted back home to those in the developing world? Many before me have spoken with outrage about the reality of two worlds: one of abundance, and the other where people live like they have in centuries past.

The situation is more complicated since even poor people may have some technologies like cellphones now, but vital lifesaving technologies …

Increase patient and provider satisfaction by reducing phone messages

Rosemarie Nelson

Physician

January 12, 2014

Incoming telephone calls should be a good thing in a medical practice, right? Requests for appointments from new patients and established patients are the lifeblood of the practice. But for many practices, the phones are an overwhelming burden for everyone, from the receptionist and nurse to the provider with an inbox full of patient messages to sort through.

In general, approximately 25% of incoming calls to a medical practice are repeat …

For the medical home to be successful, listen to the patients

Fred N. Pelzman, MD

Physician

January 12, 2014

Standing in the middle of a massive hotel convention center hallway with thousands of people wearing name tags.

Not where I usually spend my days.

I have been asked to join senior management at a national client conference for the company that is providing patient survey data to our institution, those surveys patients get in the mail asking about their “experience” during their visit to our practice.

Everybody here wants the same thing, …

Medical students should get excited about direct primary care

Brian Lanier

Physician

January 11, 2014

You’ve heard the story before: a young man or woman with idyllic dreams of practicing primary care goes off to medical school, only to have their dreams crushed by the realities of 7-minute visits, “production goals,” and unstable reimbursement — you’ve heard of the Medicare sustainable growth rate, or SGR, right? Every time you turn around, there is someone talking about primary care physician burnout or complaining about practicing on …

The stigma of becoming a psychiatrist

Angela Marie Andrich, MD

Physician

January 11, 2014

I’m coming out, but it isn’t what you’re thinking. I’m writing this to finish answering a question that I was asked 25 years ago by an attending physician. He was a Scotsman with a ruddy complexion and it was early in my third year of medical school. I had been up since 4am rounding on patients and then assisting on a general surgery case.

Answering the esoteric questions the Scotsman posed had …

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The stigma of becoming a psychiatrist

Pizza or insulin: What does our society value more?

Vipan Nikore, MD

Physician

January 11, 2014

Recently, I treated a young patient with diabetes in the hospital. Throughout her young life she had struggled with glucose control, and on this day her struggle left her in a state of diabetic ketoacidosis (DKA). DKA is a life-threatening condition that diabetics often face when their body is unable to uptake enough glucose, leading to utilization of fat and consequential build up of acidic ketones, which cause blood levels …

Rural medicine reminds physicians of their value

Edwin Leap, MD

Physician

January 10, 2014

Recently, while on a locums assignment in a very small, rural hospital, I cared for a gentleman with chest pain. His discomfort seemed classic for an MI, but his EKG did not. So I treated him as normal with aspirin and nitrates, and waited for his cardiac markers to come back from the lab. In the interim, his chest pain worsened. Sure enough, he developed an anterior MI. The tombstones …

3 digital resolutions for 2014

Claire McCarthy, MD

Physician

January 10, 2014

I love digital media. I love my iPhone and my iPad. And as much as I admire those who go on digital vacations, I’m not going to do so anytime soon. But I had two moments recently that made me realize that we all need to take a closer look at our digital habits.

The first was when I was leaving work one evening. As I waited at the crosswalk outside …

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3 digital resolutions for 2014

The legacy of Kenneth Edelin

Suzanne Koven, MD

Physician

January 9, 2014

The exam room and hospital bedside are usually non-partisan zones. Though there have been exceptions — anti-nuclear activists Dr. Benjamin Spock and Dr. Bernard Lown come to mind — physicians tend not to be particularly political people. And even when they are, their politics don’t usually intersect with their clinical work. When President Reagan was shot and joked with surgeons, “I hope you’re all Republicans,” the response from one doctor (a Democrat) …

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The legacy of Kenneth Edelin

A patient falls off the OR table: Who’s to blame?

Skeptical Scalpel, MD

Physician

January 9, 2014

An anesthetized patient fell to the floor headfirst from an operating room table during a laparoscopic appendectomy in Scotland. The table had been tilted into an extreme head down position to facilitate the operation. Fortunately, no injury occurred.

The Edinburgh Evening News account says that there were 10 staff members in the room at the time the case started, but no one had placed a safety restraint on the patient.

A …

Physician

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