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.

Risks and benefits of direct access to lab results

Patricia Salber, MD

Physician

January 5, 2012

I am a big fan of DIY (do-it-yourself) healthcare, at least for the bulk relatively minor issues that plague people. I think the days when doctors were needed to control, interpret and dole out health data and information are waning. There are simply too many ways, primarily via the internet, to get good, reliable, easy-to-understand information about our own health.

The Quantified Self (QS) people who use sensors, mobile apps, …

ACP: Making transitions better for patients

Fred Ralston Jr., MD

Physician

January 5, 2012

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

Many patients see multiple doctors and receive care in a variety of settings. Some patients receive care in more than one hospital. As an internist who is in the process of transforming into a patient-centered medical home, I have been taking steps to help my patients when they …

Requiring doctors to give orders on patients they have not seen

Steven Reznick, MD

Physician

January 4, 2012

To meet Federal patient satisfaction goals, our hospital administration is requiring community based physicians to give patient admission orders before we have a chance to see the patient. Patients who self-refer themselves to the emergency department, are evaluated by the emergency room staff, and who are determined to require admission must be admitted by their community physician within 20 minutes of receiving a call from the ER staff advising the …

How our emotions can affect our decision making ability

Peter Zafirides, MD

Physician

January 4, 2012

In a recent therapy session, one of my patients described her emotions in a way that totally blew me away. I really felt compelled to share her story with you.

A little background however before we go any further. Mary (not her real name) is in her mid-50s and has struggled her entire life with both chronic depression and obsessive-compulsive disorder manifesting itself as hoarding. She has struggled with these emotional …

It’s time to look critically at the concept of board certification

Edwin Leap, MD

Physician

January 4, 2012

In 1994 I was thrilled to become certified by the American Board of Emergency Medicine. I had worked very hard. I studied and read, I practiced oral board scenarios and even took an oral board preparatory course. It was, I believed, the pinnacle of my medical education. Indeed, if you counted the ACT, the MCAT, the three part board exams along the way and the in-service exams, it was my …

I wish my patients could see what I see

Stewart Segal, MD

Physician

January 3, 2012

I wish my patients could see what I see. I see through a lens sharpened over 30 years of experience. I see the present and often the future. Yes, I’m a fortune teller! Many times, the picture of the future I see is bleak.

It’s my job to predict the future and then try to change it. A friend once told me that he believed life was a movie playing on …

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I wish my patients could see what I see

Should healthcare providers hug their patients?

Dominic A. Carone, PhD

Physician

January 3, 2012

Imagine this scenario. You are a male health care provider and you complete an evaluation of a woman close to your age. You establish good rapport as you always do, she laughs at some of the same jokes you make with all patients, and she expresses delight that you are listening to her problems (unlike those other providers she says she has seen), feels you are helping her, and is …

Advice for doctors who want to change careers

Franz Wiesbauer, MD

Physician

January 2, 2012

An interview by MedCrunch with Ashley Wendel, MA, CMC, PDC, a Physician Executive Coach and Healthcare Organization Consultant dedicated to helping physicians create meaningful and sustainable change that positively impacts their professional lives.

MC: Thank you so much Ashley for your time!

Ashley: Thank you, I’m really happy to share anything I can.

MC: You are a physician coach, what are the most common problems you encounter in your practice?

Ashley: Well, for many …

What kind of shoes should you wear in the hospital?

Mary L. Brandt, MD

Physician

January 1, 2012

I got home recently after a 14 hour day in the operating room with (predictably) a pair of really tired feet, which lead me to think about shoes, foot rubs, and the fact that no one ever talked to me about this in my training.

What kind of shoes should you wear in the hospital?

There’s a lot of walking in the hospital, but there’s even more standing. Running shoes don’t provide …

Being a good doctor is more than writing prescriptions

Jay Parkinson, MD

Physician

December 31, 2011

As doctors, we have pills to treat infections and high cholesterol. We have scalpels to replace hips and open clogged arteries. But beyond pills and scalpels, what tools do we have? Walking out of the doctor’s office without a prescription is a rare occurrence these days. And the famous surgeon tagline has always been “a chance to cut is a chance to cure.” We see people when they’re sick and …

The positive effects of palliative care on quality of life

Kohar Jones, MD

Physician

December 30, 2011

“I’ve been a fighter all my life,” said my new patient, a middle aged man with thinning hair, a worried wife, and a dismal prognosis. He had worked all his life as a plumber with no health insurance. When he was healthy, it was okay. But now he was sick.

I was meeting him for the first time in the community health center where I work as a family physician, tending …

Balancing precaution and the apparent risk in medicine

Maurice Bernstein, MD

Physician

December 30, 2011

One will find many examples of precaution and their corresponding examples of risk in how medical care is provided by physicians and accepted by patients. In fact, not only do these two elements correspond but at times the price, itself, of precaution becomes the risk.

Risk is everywhere in medical practice. Risk is present when a patient is selecting a physician. The risk is becoming the patient of a doctor whose …

Simulation is a disruptive and transformational technology in medicine

Stephen C. Schimpff, MD

Physician

December 29, 2011

Incredible innovative and entrepreneurial skills have led to many new techniques and technologies in medicine. Some are both disruptive of the old way of doing things. Others are transformational. Over the next few weeks I will review some of those that I believe are among the most disruptive and transformational. Medical simulation is such an advance. It is dramatically transforming the way medicine, especially medical procedures, are taught and it …

Is ethical for parents to refuse surgical treatment for their child?

Christopher Johnson, MD

Physician

December 27, 2011

The principle of autonomy is one of the four guiding principles of medical ethics, the others being beneficence, nonmaleficence, and justice. It means that patients have the right to decide what is done to their own bodies. For children under eighteen, the age of majority, this means their parents decide for them. What happens when parents refuse a treatment that their child’s doctors recommend? (The right of a minor child …

I’m proud that I’ve never had an MRI or CT scan

George Lundberg, MD

Physician

December 26, 2011

What is your personal experience with MRIs? Was your last one fun? How much did it cost whoever paid for it? Did it make a real difference in your outcome?

I am a 78-year-old American man in robust general health and with good comprehensive health insurance all my adult life and I have never had an MRI.

Until 2010, I had also never had a CT scan. And I’m proud of that.

Why …

A good attitude is necessary when transitioning away from medicine

Michelle Mudge-Riley, DO

Physician

December 22, 2011

Do you feel like you have nothing to show for the efforts you’ve put into your career change?

It’s easy to feel frustrated and lose motivation when nothing seems to be coming from all the work you put into things like LinkedIn, calling recruiters, revising your resume or networking.

There are two possible reasons why things might not be working for you. Maybe you are doing the right things but you …

My audacious goal for family medicine

Jennifer Middleton, MD

Physician

December 21, 2011

I have a BHAG (Big Hairy Audacious Goal).

I want people to hear “family medicine” and know that it refers to a medical specialty dedicated to providing relationship-based, patient-centered health care.

I want people to know that family docs take care of a lot of complicated, challenging diseases – and not usually in isolation. Our patients have high blood pressure, complications from type 2 diabetes, congestive heart failure, depression, chronic kidney disease, …

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My audacious goal for family medicine

Isn’t it time for a patient rating system for doctors?

Dr. Martin Young

Physician

December 21, 2011

Here’s a devil’s advocate position.

Historically doctors have held power over patients as compensation for the responsibility of that position, and the epatient and other patient advocacy movements seek to address that imbalance with good reason, arguing that the doctor-patient relationship should be equal. I don’t mind that. But let’s be truly equal partners then.

The patient’s right to choose a doctor and be informed of the best ones via doctor rating …

The fifties woman has many reasons to get better

Greg Smith, MD

Physician

December 20, 2011

“51-year old female presents today with …”

Funny, the vast majority of my clinical notes last week began with that phrase, give or take a year or two. Women in their fifties who saw me in the clinic, who I spoke to via television in my telepsychiatry practice, or who I interacted with in some other way. It struck me as odd that so many women of similar age came to …

Reduce sedation in critically ill patients

a medical resident, MD

Physician

December 20, 2011

I sit here today, in this small, windowless call room with its low twin bed that is covered in untouched hospital blankets and sheets. Tonight is one of my last nights on a 30-hour call shift in the medical intensive care unit. Yet another mile-marker on this long journey of residency. My day began at the break of dawn, when I and another resident passed each other in the parking …

Physician

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