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.

Why can’t we be more proactive in discharging patients?

Skeptical Scalpel, MD

Physician

January 13, 2013

The recent hurricane in New York City and the closures of some hospitals requiring the transfer of a large number of patients reminded me of something that happened on 9/11/2001.

I was working at a hospital near New York. You may recall that among the many problems that day was a breakdown in communications. Reliable information on the number of casualties and extent of injuries was hard to determine.

Late on the …

Medical journals are shifting from science to politics

Wes Fisher, MD

Physician

January 13, 2013

Medical journals aren’t what they used to be. Just ten short years ago, medical journals were places to report scientific study, interesting cases or clinical updates and reviews. They were, for the most part, about science and discovery.

Now, there is a dramatic shift of scientific content in our journals to politics and policy.

No where is this more evident than the much-heralded and widely read New England Journal of …

Why the medical professions should be color blind

Peter Ubel, MD

Physician

January 12, 2013

The role of race in college and graduate school admissions remains controversial in the U.S. In fact, the Supreme Court is currently taking up a challenge to a University of Texas program that considers race in its admission decisions. Critics of race-based admissions question whether educational institutions would serve the goals of affirmative action better by relying exclusively on non-race based criteria, such as socioeconomic status and family …

Regulate medical research so that it can help patients

Kevin R. Campbell, MD

Physician

January 11, 2013

Recently, my middle school daughter has been learning about the use of the scientific method in science class. In her school laboratory, she and the other sixth graders learn how to ask a question, perform background research, formulate a hypothesis, design and execute an experiment to test the hypothesis, and ultimately synthesize conclusions. She is being taught to accurately record and interpret data; the concept of manipulating data to suit …

My father had let me in and had allowed me to help him

Kendra Peterson, MD

Physician

January 11, 2013

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I approached my father in the yard of his most recent home, a small, run-down duplex shack. His hair was whiter than I remembered, his old blue sweater shaggy. He was clipping the hedge in his careless but enthusiastic way; when finished, it wouldn’t look good, but it would look clipped.

One of his eyes was red and tearing up. A splinter …

Finding a cancer cure: Maybe we should shift gears

James C. Salwitz, MD

Physician

January 11, 2013

Now here is a novel idea to save lives and stop the cancer plague; stop trying! Sounds as crazy to me, as it does to you, but this idea actually may have merit. Some smart people are saying that we have spent too much money for little gain, thus it is time to give up and by retreating win more battles in the war on cancer, than by charging ahead.

The …

Towards patient and family centered care: Bridging the gap

Jonathan R. Welch, MD

Physician

January 11, 2013

How can hospitals and clinics deliver care that is patient and family centered? As an emergency physician, I’ve often pondered this question after my mother died of an untreated systemic infection in an out-of-state hospital. The experience, which I write about in the January 1 edition of the Washington Post as well as the December issue of Health Affairs, convinced me that healthcare still has room to grow …

What if I told you that you were going to die tomorrow?

Monica Williams-Murphy, MD

Physician

January 10, 2013

Please raise your hand if you are not going to die.

If you haven’t found the fountain of youth and we haven’t perfected anti-aging technology, then you my friend are going to die. But you are not alone, so am I, and so is your mother and your father and your brothers and sisters and even little Johnny down the street.

Now that I have reminded you of your own mortality. Does …

Don’t get frustrated with the uncertainties of medicine

Shirie Leng, MD

Physician

January 10, 2013

A few months ago, when I thought I should throw it all away and go to law school, an acquaintance who is a lawyer said something unexpected. He said “law school is learning how to think like a lawyer and deal with the uncertainty within the law.” Uncertainty? A law is a law right? Don’t speed. Don’t drink and drive. Write thank-you notes. Turns out the law often requires interpretation, …

We speak volumes to our patients without opening our mouths

Kathy Nieder, MD

Physician

January 10, 2013

All professions need good communication skills. Obviously in healthcare the ability to communicate with patients should rank high in a physician’s list of talents. These days that interaction occurs in a number of ways: face-to-face, direct telephone contact or though a staff member, via emails, patient portals, or even texting. Because the communication is in the arena of medicine, the protection of an individual’s health information is paramount. Enter HIPAA, …

Physicians have an obligation to eliminate waste

Benjamin T. Galen, MD and Christopher T. Erb, MD, PhD

Physician

January 10, 2013

Physicians and the public are urging doctors to bring cost into consideration at the bedside when ordering laboratory tests and imaging studies. Although diagnostic testing represents an important component of the rising cost of medical care, asking what a test costs is the wrong question.

Cost-saving shouldn’t begin at the bedside, it should begin by training the next generation of doctors to think in terms of value; not bang-for-buck or potential …

Build your network by writing a timely note

Neil Baum, MD

Physician

January 9, 2013

In my medical practice, I’ve used note writing extensively, to communicate with patients, with families of patients and with referring physicians. And yet, when I received a note, which is not related to patient care, it is always a little surprising and uplifting, and emphasizes why note writing (and note receiving) is so appealing.

In this Internet age and the age of information, we are bombarded with electronically conveyed messages, television …

Belichick, Brady and what healthcare can learn from the Patriots

Davis Liu, MD

Physician

January 9, 2013

It is always a treat, particularly when living on the West Coast, to watch the New England Patriots football team play on national television in their home stadium, Foxborough, Massachusetts. On Monday Night Football, the match-up was between the Patriots and the Houston Texans, which had the best record in the AFC and undefeated in all away road games. As previously …

People are fallible, but health systems need not be

Kenneth Lin, MD

Physician

January 8, 2013

When I heard in October that Superstorm Sandy was projected to make landfall somewhere in the vicinity of DC and Maryland, I prepared for the worst. I stocked up on non-perishable goods and evacuated to higher ground. (The rest of my family was already coincidentally out of town and harm’s way.)

I put fresh batteries into two flashlights and installed a flashlight app on my smartphone for good measure. Although I …

Medical malpractice: Equating standard of care to best practice

Shadowfax, MD

Physician

January 8, 2013

I review a lot of cases in my professional life. Some of them are just ones that our QA group comes across in our practice. Some are cases related to our liability policy. Some are cases I’m sent for review, or educational cases I present. We see a lot of cases which could have been done better, or in which the …

The transition to direct care: Considering the consequences

Rob Lamberts, MD

Physician

January 8, 2013

“This could be big,” he said after I told him about the company who wants me to cover their 100+ employees. I pay him to give me the stark reality of things, but his optimism made me uncomfortable. ”You’ve got to go for this. I know you don’t feel ready for it yet, but this could really be huge for your business, and I don’t think you should pass this …

Balancing honesty and optimism in critical care

Christopher Johnson, MD

Physician

January 8, 2013

A recent little essay entitled “Do patients bond best with doctors who misinform them with optimism” got me thinking about balancing honesty and optimism in practicing any medical specialty in which patients not infrequently die.

Tragic things can happen in the pediatric intensive care unit. Anyone who works there — doctors, nurses, respiratory therapists, and many others — see these …

When physicians don’t communicate about their patients

Michael Kirsch, MD

Physician

January 7, 2013

One of the gripes that patients have about the medical profession is that we physicians don’t communicate sufficiently about our patients. In my view, this criticism is spot on.

Patients we see in the office often have several physicians participating in their care. The level of communication among us is variable. While electronic medical records (EMR) has the potential to facilitate communication between physicians’ offices and hospitals, the promise has not …

The recipe for a great hospitalist program

Janice Boughton, MD

Physician

January 7, 2013

Internal medicine is the branch of medicine that deals with diseases of the internal organs in adults. It also involves dermatology, minor surgical procedures, general psychiatry and preventive care of well people. It is an excellent field, full of opportunities to think and feel and connect with people, mysteries to be solved and an endless variety of stuff to be learned. …

The role of alcohol in health costs

Edmund Kwok, MD

Physician

January 6, 2013

Defined as someone “having the faculties impaired by alcohol, those of us who work in an acute healthcare facility are witness to many illustrious examples of drunk patients coming through our doors.

Underaged kids passed out at a house party? Yup. Raging alcoholics who are brought into the ER at least once a week? Sure. Elderly women who secretly binges on wine …

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The role of alcohol in health costs

Physician

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