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.
Faith. A simple word with complicated meaning. It is a seed buried deep within our spiritual cores, ready to be nourished and blossom with the sprinklings of tragedy. It is a belief that things will work out, despite our lack of vision for fate’s secretive reasons of the bumpy journey we must endure. It is an inherent hope that has either sustained us or has failed us miserably. Yes, to …
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I have seen faith present its various faces many times
With all of its frustrations and challenges, I love my job. In fact, the very things that make primary care so difficult and often times exhausting are also what make it in my opinion the most awesome field in medicine.
When I was in grade school, I wanted to be a physician. My parents would take me to the pediatrician for routine check-ups or when I wasn’t feeling so great and I remember …
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It is both a privilege and an honor to be a primary care physician
I’ve been asked to appear on a radio talk show to discuss one of my blog articles. It seems that the producers of the show were impressed by my article on the beauty of medicine when it works the way it’s supposed to.
“When It Works Right, It’s a Thing of Beauty” was published this summer and is one of my favorite articles. The practice of medicine is a beautiful thing. …
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Our medical system needs more positive stories
Let’s all agree on two things.
First, that energy independence is good for our country. Second that clean drinking water is also good for the country.
The development of America’s huge stores of natural gas, have given us a remarkable opportunity to accomplish the former. In particular, the process of “fracking” has made it possible to increasingly tap those huge natural gas stores. Natural gas sits in rock formations, but releasing it …
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Why doctors should care about fracking
Over the past several decades medical costs in the United States have escalated rapidly, exceeding the pace of inflation and threatening bankrupt to Medicare. As we heard in last week’s presidential debate, different solutions have been proposed on how to slow Medicare’s growth and reduce cost. President Obama highlighted his administration’s success in tackling fraud and waste within the system. This strategy appears to be supported across party lines. On …
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Why upcoding isn’t necessarily fraud
It happened again three times in clinic today. In the middle of a patient visit, a parent picked up their cell phone. To answer a call, to text a friend, to read their email. The trend of being always connected and available has reached the exam room. When this first started happening I was sort of incredulous. I mean, I’m there, talking to you about your child’s health, and you’re …
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Why using your cell phone during a visit distracts me
Some cases burn into your brain like a hot branding iron, for whatever reason, and never really leave. This was one of those cases.
One hectic morning before my shift, my wife and I rushed around the house trying to get our kids ready for school. On this day, my daughter was to go on a field trip where the teachers would walk the kids through the city to the local …
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My worst nightmare was not coming true, someone else’s was
Health care reform is a locomotive barreling down America’s tracks. In two years, the Affordable Care Act (ACA) will cover some 30 out of 50 million of us that currently lack health insurance. Political beliefs aside, it would seem that supplying insurance to protect the health of more people is a societal good. Though the costs of reform will be debated for years to come, one major question remains that …
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Having our own doctor treat us in the hospital is a thing of the past
Because someone rammed her SUV half-head-on into my car, this physician-surgeon has, of late, been a patient at physicians’ offices and outpatient surgical centers; and while medical sights, sounds, and sharp scalpels don’t scare me, one thing I’ve discovered about electronic medical records does. They may not be accurate.
I love my profession. I am a stickler for accuracy, and I like reviewing patient charts. I always secure a copy of …
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Find out whether your electronic medical record is accurate
I’m sorry.
I really am. No one deserves breast cancer. Especially the kind that spreads to your liver, lungs and brain. The fact that you lived to your eighth decade doesn’t detract from the sadness. You deserve to live. I can’t blame you for not being ready to go.
I apologize that our meeting was so abrupt. I was consulted to see you in the nursing home to address various issues. I …
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I’m sorry I was your last memory before dying
I never gave my hands much thought until a few years ago. They were never pretty, but they were functional serviceable hands that did what they were asked—I could examine a patient, type fast and accurately enough, and everyone always told me that my handwriting was outstanding. That has always been a point of pride for I knew that I was never going to kill a patient because a pharmacist …
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I am proud to have my father’s hands
I struggle every time I’m ill. This week, it’s not so much my own illness that’s been the major problem. It’s the kids. Because they can’t sleep. And if they can’t sleep, we can’t sleep.
It started last week with this upper respiratory bug that’s going around. Cold viruses mutate just enough over time that every few years, I get hit hard. I call it the “three year cold.” This one …
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When can a doctor call in sick?
An excerpt from Pet Goats and Pap Smears.
Joy is a vibrant twenty-six-year-old woman who comes in for a physical. On her exam, she shows me a worrisome mole on her left shoulder. I recommend she return for removal. After the excision, I call her back to my office for results.
“You have a melanoma. We got it just in time, but I’m sending you to a dermatologist who …
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Did you do your Pap prayer?
One of my biggest problems of the RVU system is that it decided by a secret society composed of specialists. Nobody seems to have a problem that a “secret society” decides how much work and how much cost should be allocated to a medical service.
Medical procedures are very dangerous and have a lot of risk, but so is trying to provide healthcare to a complicated 2-year old that can’t tell …
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Why the RVU system gives a false sense of productivity
My heart is blighted like grass, and withered, for I forget to eat my bread.
–A patient’s prayer, Psalm 102
I diagnose and treat medical problems. I love doing it. Sometimes I make a big difference in someone’s life. More often, I just reassure them that they’re going to be ok. Or I give them advice about what they need to do to live healthier. But what I do has limits, and …
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Some patients need absolution, not medicine
I am starting a prize-linked smoking cessation program for my medical practice. Like most family docs, I constantly remind my smokers about the risks of tobacco and my ability to help them quit when ready. And like most physicians I probably have a false belief that pestering “enough” will spur action. As an unofficial student of economics and official student of public health (MPH), I should know better.
Sure, I have …
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I’m paying my patients cash to quit smoking
Good, it’s about time that these greedy doctors get smacked down for being the financial rapists that they are. Medicine in this country is the biggest, most destructive SCAM going on today. Doctors think they are entitled to RIDICULOUS amounts of money for simple routine procedures.
– Johnathan Blaze
It is generally agreed upon that the more one values a good or service, the …
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To the patients who resent greedy doctors
Since the earliest days of medical school, I learned fast to bring my computer wherever I went. Not only did my laptop function as my personal entertainment center through the dullest parts of lectures, but it also proved to be a source of instantaneous and infinite medical knowledge via the click of a mouse. Four years later and here I am, one hand on the shoulder of patients whilst listening …
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This generation of doctors has permanently lost their physician brains
There’s a big discussion going on in the health tech community about a controversial keynote speech given by Vinod Khosla at the Health Innovation Summit (HIS), in which he stated that 80% of what doctors do could be replaced by machines.
If you’re a doc like me who has no idea who the heck Vinod Khosla is (he’s a venture capitalist and co-founder of Sun Microsystems), why he’d be a keynote speaker at a …
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Doctors need to be part of the digital revolution
