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.

The Surgeon places hands on belly and the diagnosis is clear

Jeffrey Parks, MD

Physician

October 14, 2012

The call comes in at 9pm or so. The patient sounds sick as all hell. The Surgeon listens to the random assortment of numbers and vitals the nurse provides and clicks off his cell. He finishes reading a boring Berenstain Bear story to his daughter and tucks her into bed. He looks at the clock and runs some mental numbers. By the time he arrives at Hospital, close to ten. See the …

Do drugs aid and abet genius or does genius lead to drugs?

George Lundberg, MD

Physician

October 13, 2012

Who is your favorite addict? I guess we have to talk about addiction as a preface to that question.

Everybody I know takes psychoactive drugs, except maybe some Mormons, Seventh Day Adventists, and the like.

All drugs are habit-forming, but only a subset of psychoactive drugs can produce psychological and physical dependence, tolerance, and withdrawal symptoms when taken away, the usual definition of addiction.

Most people who become addicted to one drug often …

Why Marissa Mayer deserves our respect

Wendy Sue Swanson, MD

Physician

October 12, 2012

I recently saw a number of tweets from parents and fellow pediatricians on Twitter criticizing Marissa Mayer for announcing that she’d return to work within 1-2 weeks of the delivery of her first child.

First off, I’ll start with my assumptions:

I’m authoring this post in the belief that Ms Mayer has access to quality health care–that is, she has the ear of a board-certified obstetrician, a board-certified pediatrician, and access to a …

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Why Marissa Mayer deserves our respect

How our children turn out isn’t really up to us

Claire McCarthy, MD

Physician

October 11, 2012

My two oldest children recently left for semesters abroad: Michaela went to Paris, and Zack to Beijing. I have all sorts of Mommy nervousness about this, but in my heart I know they’ll be fine. They are adults now, at 21 and 20—and not just adults, but capable, responsible, great people.

I don’t know how that happened.

I know that sounds stupid. And it’s not like I have no clue at all. …

Viagra for women: Prescribe 50 Shades of Grey to your female patients

Sara Stein, MD

Physician

October 11, 2012

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Could “mommy porn” have value in the doctor’s office? Unless you live in a cave (and we physicians sometimes do), you have heard of British author E.L. James’ modern erotic 50 Shades of Grey trilogy, 30-plus million copies sold, overwhelmingly to women. The trilogy is an erotic love story about a naïve college graduate who rescues an abused billionaire – a …

Reform needs more than expanding health care coverage

Steve Balt, MD

Physician

October 10, 2012

Whatever your opinion of the Affordable Care Act, you must admit that it’s good to see the American public talk about reducing health care costs, offering more efficient delivery systems, and expanding health care services to more of our nation’s people. There’s no easy (or cheap) way to provide health care to all Americans, particularly with the inefficiencies and absurdities that characterize our current health care …

10 reasons for physician burnout

Rob Lamberts, MD

Physician

October 10, 2012

It happened again. I was talking to a particularly sick patient recently who related another bad experience with a specialist.

“He came in and started spouting that he was busy saving someone’s life in the ER, and then he didn’t listen to what I had to say,” she told me. ”I know that he’s a good doctor and all, but he was a real jerk!”

This was a specialist that I hold …

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10 reasons for physician burnout

My flirtation with the ER has made me more sympathetic to patients

Leana Wen, MD

Physician

October 10, 2012

As emergency physicians who are trained in acute resuscitation and thrive in high-stress situations, we tend to roll our eyes at the less acute complaints our patients come in with. “Back pain for three months? Headache for a week? Why are they here now?”

Patients, too, complain about this. “Can’t they see it’s not a real emergency and go see their primary care doctor? This must be costing our healthcare system …

How a drug addicted scrub tech changed my life forever

Kate O'Reilley, MD

Physician

October 10, 2012

It was a cold winter day in 2009 when my life changed forever, however, it would be months before I figured that out. On that fateful day, a drug-addicted surgical scrub tech assigned to my operating room stole syringes of fentanyl, a potent intravenous narcotic, from my anesthesia cart. According to news reports, investigative summaries, and the scrub tech’s confession, once she took the syringes, she used them on herself.

It’s …

National Primary Care Week 2012: What makes this year different?

Andrew Morris-Singer, MD

Physician

October 9, 2012

It’s National Primary Care Week, an annual celebration when members of the primary care community come together across the country in events largely organized by trainees to celebrate, promote and advance primary care. So what makes this year different?

Put simply, the momentum for advancing primary care in the US has never been stronger. Those of us who believe that a robust foundation of primary care is essential to the health …

10 tips for new college students with chronic disease

Kitty O'Hare, MD

Physician

October 9, 2012

For some of my patients, going to college is especially nerve-wracking because it will be their first time living away from home with a chronic disease.

I deal with teen health daily. I care for a lot of adolescents and young adults with chronic disease, everything from asthma to diabetes to congenital heart defects. As my patients grow up they have a lot to deal with because of medical issues: taking …

Why Lance Armstrong will always be a hero

J. Leonard Lichtenfeld, MD

Physician

October 9, 2012

Like many of you, I have been reading the various news stories about Lance Armstrong, especially one recently in a major newspaper, which went into great detail about the allegations surrounding Lance Armstrong’s cycling career.

But what I didn’t see in all of that coverage was much mention of the other side of the man, the side that I …

Watch team based primary care in action

Kirsten Meisinger, MD

Physician

October 8, 2012

When I walked into the exam room, the mom was almost crying because her son’s fever wouldn’t go down. I already knew that this was a simple virus – the kind that gives a high fever for a few days and then a rash. This mom was from Brazil, however, where this sort of infection is barely seen. In Brazil, a high fever that won’t go down equals a good chance …

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Watch team based primary care in action

In the OR during an appendectomy, an unexpected visitor

Jim deMaine, MD

Physician

October 8, 2012

It was Trevor’s first weekend to relax since moving to Seattle. He was out in a park walking Bailey, his year old lab, when his pager unexpectedly beeped. He called in to the operating room office, where the frantic head nurse told him he had to come in. The scheduled anesthesiologist was very ill with the flu, and no one else was available. He had to come in for at …

What if the patient’s choice is frustratingly ill advised?

Michael Todd Sapko, MD, PhD

Physician

October 7, 2012

My mother is stubborn. She occasionally approaches me for medical advice and, since I owe her more than words can adequately describe, I am happy to do what I can. Unfortunately, she is a stoic. She is also no fan of pharmaceuticals. She believes in baptism by fire, that pain purifies the soul, and what doesn’t kill you makes you stronger. So while she sometimes wants my medical advice, she …

Want to be a physician executive? 8 things you need to know

Kent Bottles, MD

Physician

October 7, 2012

1. You will have to move a lot. I went to medical school in Cleveland and did my pathology residency in San Francisco at UCSF. I was on the medical school faculty at UCSF, Iowa, Allegheny University of the Health Sciences, and Michigan State.

Since leaving academic medicine, I have worked at a bio-tech start up in Cambridge, an educational and research institute in Grand Rapids, a $2 billion integrated delivery system …

How America’s healthcare system will keep you sick

Natasha Deonarain, MD, MBA

Physician

October 7, 2012

Have you ever worried about how you’re going to get healthy these days? Has your doctor recommended diet and exercise? Well, if you’re like millions who are struggling to find health, you’re going to need a lot more than just diet and exercise. You’re going to have to fight like crazy against a mind-set of disease that’s paradoxically disguised as health care.

America’s healthcare system – health insurance companies, government health …

Why going to a board certified plastic surgeon is important

Usha Rajagopal, MD

Physician

October 6, 2012

The popularity of plastic surgery today is no secret; 13.8 million cosmetic procedures were performed in 2011 alone. Unfortunately, however, an increasing (and unsettling) number of people in the United States are undergoing procedures conducted by unlicensed, so-called “underground,” individuals these days—individuals who have no business billing themselves as plastic surgeons.

The primary factor leading people to the doors of these backdoor doctors is, of course, cost. There’s no way around …

Resilience is critical for a healthy life

Dennis S. Charney, MD and Cheryl De Jong-Lambert

Physician

October 6, 2012

It’s been reported that James Eagan Holmes, more infamously known as the movie-theatre gunman who killed 12 people during a midnight showing of Batman in Aurora, Colorado, sent a text to a classmate asking whether she knew what “dysphoric mania” was. (It is a bipolar condition that in its extremes, can include mania and paranoid delusions.) Did he have it?

Similarly we wonder whether a near-death accident in childhood, one that …

Cause of death: Defensive medicine

BirdStrike, MD

Physician

October 5, 2012

1. A 40-year-old female sees her family physician for burning chest pain after she eats hot peppers. She had it only once while exercising. Her family physician sends her to the emergency department and she gets admitted for chest pain. Rather than going home with treatment for her GERD, she ends up dead. This never should have happened, but the family never learns what really killed her.

2. A 33-year-old father of …

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Cause of death: Defensive medicine