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 always saying yes could be dangerous for you and your patient

Jock Hoffman

Physician

August 14, 2012

Encouraging patients to be more engaged, may also encourage more people to go beyond assertive to demanding care unsupported by good clinical judgment. Of course, physicians worry that saying “no” to a patient increases their risk of being disliked, dismissed, or even sued for medical malpractice.

Greater transparency in health care means patients are more aware of options for screening, testing, procedures, and medications—often via direct advertising or public service campaigns. …

Used needles on the sidewalks: Why we need needle exchange programs

Erin Marcus, MD

Physician

August 13, 2012

On a recent afternoon, Hansel Tookes stood on a sidewalk in downtown Miami, peering into a thicket of scraggly weeds. “I found a bunch over here,” he said, edging toward an overpass. A small orange plastic cap came into sight, and next to it two slender insulin syringes, with the needles exposed. Scattered about were tiny plastic zipper bags — evidence that the needles had been used to inject heroin …

For health care to be better, doctors must lead the change

Davis Liu, MD

Physician

August 13, 2012

Recently New Yorker staff writers and best-selling authors Malcolm Gladwell and Atul Gawande addressed the question of whether the problem in health care is that patients are too reliant on doctors and don’t have the ability to make decisions. In reading between the lines, is that the reason health care is not affordable and care not commoditized or consumer driven like other industries?

At a conference for America’s Health Insurance Plans, …

Work-life balance in medicine: Is it possible?

Karen S. Sibert, MD

Physician

August 13, 2012

Unless you’ve lately returned from a retreat at a remote Cistercian abbey, if you’re interested at all in women’s issues you’ve probably read Anne-Marie Slaughter’s recent article in the Atlantic, “Why Women Still Can’t Have It All.” The author eloquently tells how she left her dream job in the State Department as the first woman director of policy planning in order to return to her husband, her two …

Why are so many doctors complete jerks?

Eric Van De Graaff, MD

Physician

August 12, 2012

shutterstock_16082512

As odd as this might sound, my mother was upset when I declared my intention to go to medical school.

It wasn’t the mountain of debt I was sure to incur since I’d already figured out how to get Uncle Sam to pick up the bill (a small deal that put me in a military uniform for a decade). It wasn’t the …

Read more…

Why are so many doctors complete jerks?

Apply folk wisdom to your family practice patients

Peter Elias, MD

Physician

August 12, 2012

“The best defense is a good offense.”

This folk wisdom is variously attributed to Sun Tzu, Carl von Clausewitz, Mae Zedong, and the heavyweight prizefighter Jack Dempsey. Regardless of origin, it deserves its place in the pantheon of behavioral truths.

During a recent conversation with a patient about her irritable bowel syndrome, I asked about possible stressors.

“So, tell me, I know it’s hard to manage both full time school and a part …

An American oncologist looks at health in China

Richard Just, MD

Physician

August 11, 2012

In today’s China, both eastern and western medical philosophies and practices exist relatively harmoniously. Patients with minor, usually self limited problems are treated initially with a seven day course of seven liquid herbal preparations taken each day. If symptoms subside, usually treatment is discontinued. If improved but not resolved, formula may be modified. If worse, regimen can be changed and/or referral to specialists arranged. There are hospitals that practice purely …

Doctors leaving the clinical practice: The fear of being irrelevant

Ashley Wendel, MA

Physician

August 10, 2012

I’m always surprised at the number of physicians I work with who worry about, discount, or do not see their relevance outside of clinical practice. I do, of course, recognize their relevance – the trick is to get the docs to.

For many physicians, venturing into positions of leadership, becoming a Department Chair, VP Medical Affairs or even Chief Medical Officer) is a logical step for those looking to expand their skills …

In pediatrics, no visit is a wasted one

Denise A. Somsak, MD

Physician

August 10, 2012

The last patient of the day rushed to the office before closing time. When I entered the room, the dad was texting as the nurse finished recording the child’s temperature. He shook his head in disbelief and confessed that he just sent his wife this message, “I feel stupid. No fever here.”

Parents apologize to me everyday because they feel like they wasted my time and/or their co-pay. Coordinating a doctor’s …

Read more…

In pediatrics, no visit is a wasted one

The moments when we recognize the brevity of life

Danielle Rosenman, MD

Physician

August 9, 2012

Recently I learned that my friend Hester had been suddenly diagnosed with Stage 4 cancer. She had been focused on daily living, her long road stretching out to the horizon, attending to friends, creativity, work, and related pleasures and struggles. Within days, her life abruptly made a hairpin turn into a new path, narrow and poorly lit, and short. One week after I spoke to her, she died.

It is at …

You’re seeing the wrong gynecologist: 6 red flags

Jennifer Gunter, MD

Physician

August 9, 2012

As a doctor, I appreciate that I am at an advantage when I seek medical care. Knowing terminology and basic medical principles helps a lot. In addition, when you’ve been practicing medicine for a while you get a feeling from how a doctor discusses options if the care seems valid or if a second opinion is in order. Other things I look for are board certification and a doctor …

As a doctor, I’m going to keep asking about guns

Suzanne Koven, MD

Physician

August 8, 2012

Let’s set aside for the moment the question of whether it’s appropriate to talk about gun control in the wake of the shootings in Aurora, Colorado (though I can’t think of a more appropriate time to talk about it). And let’s not consider whether it makes sense that it’s legal to buy thousands of rounds of ammunition on-line in the U.S, without any background check (though could it, really?) And …

Is the death of Rory Staunton really the result of a simple mistake?

Skeptical Scalpel, MD

Physician

August 8, 2012

If you pay attention at all to news about medicine, you must have heard about the tragic death of a 12-year old boy who was seen and discharged from the emergency department of the prestigious New York University Medical Center. He had developed sepsis from what appears to have been a small cut and the diagnosis was missed. When he eventually returned to the ED and was admitted, it …

I am a physician and guns are a disease

James C. Salwitz, MD

Physician

August 8, 2012

I feel guilty about the killings in Colorado. As a doctor, those horrid events are a personal failure. I have spent a career fighting illness, often investing hundreds of hours in a single cancer case, yet in minutes, a dozen people vanish and 58 are grievously wounded. Another 32,000 will die this year from gunshots, over 76,000 will be crippled and …

Read more…

I am a physician and guns are a disease

Beating the 30 day readmission: Why there’s little to celebrate

Shabbir Hossain, MD

Physician

August 6, 2012

30 day hospital re-admission rates.

It’s a statistic that keeps hospital administrators up at night. Whether you agree or disagree with the use of this statistic as a quality and reimbursement metric, if it creates change, reduces hospital re-admissions and improves patient care, then in theory I support it.

I’m reminded of Mrs G. She is emblematic of today’s chronic disease patient. She was admitted to our hospital for a congestive heart …

Patients who receive test results instantly: Doctors need to be ready

Emily Gibson, MD

Physician

August 6, 2012

Patients are increasingly demanding, and understandably so, that since they pay for their medical tests, they should receive results directly and immediately without waiting for physician review or interpretation. Recent articles in the lay press about this issue are accompanied by scores of online patient comments insisting that physician reporting and interpretation is too often unreasonably delayed, often inaccurate, or just plain unhelpful, so why bother waiting at all?

Dr. Google …

Why health journalists need medical training

Dr. Martin Young

Physician

August 4, 2012

I recently followed a brief spat on Twitter between a journalist and a doctor. It did not go further than a few irritable tweets, but I had to agree with the doctor’s point of view.

The journalist had written an article about the death of a South African shack fire victim, admitted to hospital with 100% burns, and the contrast in perceived care he received compared to that of a …

The public needs access to federally funded research

George Lundberg, MD

Physician

August 4, 2012

“I gave at the office.”

I am an American taxpayer just like most of you, the audience. My tax dollars, and yours, fund the great majority of health-related research in the United States, mostly through the National Institutes of Health.

Thus, I, and you, the taxpayers, own the results of that NIH funded research. We paid for it.

Then, why, for goodness sake, do I, the owner, or my physician, another owner, have …

Well meaning improvements can hurt critical healing relationships

James C. Salwitz, MD

Physician

August 3, 2012

Steve is lying almost flat in the hospital room, an IV attached to his arm. I am happy to see he is more comfortable, last night’s crisis has passed. He smiles as I enter and walk to his side. I touch his hand as I sit down on the pressed clean blanket. And then … a shrill loud wail breaks the silence … lights flash above his bed … fear …

Many doctors fail to understand the math of cancer prevention

Peter Ubel, MD

Physician

August 2, 2012

All too often the most powerful illusions seduce us through truthful whisperings. Let’s start with an obvious truth: Living a long and happy life after a cancer diagnosis is better than living a short miserable one.

Given a choice between receiving a diagnosis of metastatic cancer—an incurable life-ending-it’s-already-spread-to-your-brain neoplasm—versus the diagnosis of a localized, snip-it-out-and-it’s-done tumor: Who wouldn’t choose the latter?

And yet this simple truth causes doctors to embrace unproven screening …