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.
Radiology is the cornerstone of any hospital. An efficient, high-quality, well-run radiology department increases patient satisfaction as a result of its ability to improve patient care. Over time, a well-run radiology department adds significant patient volumes to the hospital, which, of course, favorably enhances the hospital’s bottom line. Regardless of whether the hospital is not-for-profit or for-profit, a smooth-sailing radiology department vastly increases the profitability of the hospital. The …
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Why radiology is the cornerstone of any hospital
The recent New England Journal of Medicine article, highlighting burdensome healthcare transitions in a subset of nursing home patients, is certainly of documentary value. However, for many of us with real-world experience in the nursing home medical care venue, the article certainly falls short of newsworthy. Not even mildly surprising really.
Too many of our nation’s nursing home staffs suffer from a lack of onsite MDs for evaluating acute …
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Why nursing homes need more doctors on site
We understand the problem: the VBAC (vaginal birth after cesarean) rate is too low. It’s time for a bold solution. We need a “VBAC Court.”
VBAC is a safe option for most women, and almost 3/4 of women who opt a VBAC will deliver vaginally and avoid another C-section. But we also know that approximately 0.8% of women attempting VBAC will end up with a ruptured uterus, a catastrophic complication …
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It’s time for a VBAC court
Sexual harassment in the workplace is an important topic to discuss, one that is all too often swept under the rug. I recently had an uncomfortable encounter with a clinician in the doctor’s lounge – I work at many hospitals so think I can say this pretty anonymously. He introduced himself, and asked me immediately if I was married. The way he did it – body language and demeanor, mostly …
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Sexual harassment in the medical workplace
The art of practicing medicine is dying, soon to be replaced by the art of template medicine.
Modern medicine is based on laudable terms: “quality,” “outcomes,” “cost effective,” and “evidence based medicine,” which all sound good when sold in infomercials to the medical world and public. When examined closely, all are vague and open to abuse.
Each of these terms is intent on taking the human factor out of medicine. Each …
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The art of practicing template medicine
Groupon and other similar social sites, like Living Social and CoupTessa, are all the rage now. But is it legal for doctors and dentists to advertise their services on these websites?
Groupon is a deal-of-the-day website that features discounted gift certificates usable at local or national companies. If a certain number of people sign up for the offer, then the deal becomes available to all; if the predetermined minimum is not met, no one …
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Is Groupon legal for doctors?
As I greeted my next patient of the morning, I knew from the early folder number that I had seen him six or seven years before. I no longer expect to remember everyone I have ever met professionally. The man before me was tall, fit and well built. There is usually some inkling of recognition, but nothing about him was familiar to me at all.
We made small talk for some …
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The rewards of medicine can be overwhelming
It is my strong contention that patients facing cardiac surgery should choose an institution, not a particular heart surgeon. Although individual judgement and technical dexterity are obviously important, best surgical outcomes reflect the performance of many medical providers before, during and after the operation. Professionalism and a competitive business environment both stimulate open heart centers to continuously focus on quality assurance programs to improve patient safety. Also, continuing medical …
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Cardiac surgery is a team sport
A guest column by the American Medical Association, exclusive to KevinMD.com.
There are several upcoming deadlines that are critical to physicians who care for Medicare patients. November 1, November 23 and January 1 are dates that should be marked on all of our calendars.
The deadline for physicians to apply for a hardship exemption in order to avoid the 2012 Medicare ePrescribing penalty …
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AMA: Act quickly on Medicare deadlines
Congratulations! You are an amazing group of young men and women. In college, medical school and residency your dedication and discipline, but most of all your idealism helped you to persevere and conquer some difficult challenges. In college, your friends studying philosophy and literature and history wondered how you had the endurance to study biochemistry and organic chemistry and calculus. Not to mention the Krebs Citric Acid Cycle.
You studied hard …
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Inspiration for new primary care doctors
Every medical student goes though a process of elimination when deciding what kind of doctor they want to become. We hear the old saying, “Internists know everything and do nothing; Surgeons know nothing and do everything; Psychiatrists know nothing and do nothing; Pathologists know everything and do everything but it’s too late.” We hear that pediatricians wear bow ties, are short, and love to laugh and play; that surgeons …
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The decision not to become a surgeon
Ask most patients, and they say their doctor has a good reason for ordering tests and prescribing treatments. Turns out their doctor may secretly disagree. That’s the conclusion of a new study. The implications are more than a bit disturbing.
Researchers from the Dartmouth Institute for Health Policy conducted a survey of more than six hundred physicians. Forty-two percent of family doctors admitted that patients in their own practice receive too much care – meaning …
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The impact of unnecessary testing and treatment on patients
Doctors are in the cross-hairs of the nation’s politics more than ever. We’re all being asked to achieve more with less. We must cope with nightmare scenarios precipitated by cracks in the social and healthcare infrastructure so often these days that medical schools insist students become effective patient advocates as well as healers. Practicing good medicine necessitates navigating a minefield of competing interests. Doctors are increasingly tempted to just walk …
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Doctors who cross the line by protesting too much
As physicians, we all dread missing a diagnosis: indigestion that turns out to be angina, back pain that signals an aortic aneurysm, migraine that proves to be a brain tumor. Although it is only an estimate, several studies in the medical literature indicate that misdiagnosis occurs in 15% to 20% of all cases, and in half of these, there is serious harm to the patient.
Researchers have found that the vast …
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Three major cognitive errors physicians make
Why is a trip to the doctor’s office more like going to the DMV than to Disney World? Both the DMV and Disney World involve waiting in long lines, but Disney has made the entire experience fun and exciting, while the DMV has made it cold and frustrating.
“But medicine is different,” you may say. After all, seeing the doctor was never meant to be a fun or exciting experience. When …
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Time to put a little bit of Disney into medicine
Our kindergarten teachers and Hippocrates taught us to share. But after school, capitalism takes over among American medical researchers.
Eric Campbell writes in “Data Withholding in Academic Genetics” that it was frequent for investigators to be denied access to data. The reasons for denials include “too much effort” and protecting potential publications of students and themselves.
The respondents expressed only a little worry about protecting the commercial value of results: …
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Why medical scientists should share data
A doctor’s primary responsibility is to heal, and all of our efforts and resources should be devoted to that goal. At times, it is impossible to restore a patient to perfect health and he or she must unfortunately deal with some degree of chronic disability. Still other times, though, the line between “perfect health” and “disability” is blurred, and nowhere is this more problematic than in psychiatry.
To illustrate, consider …
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Psychiatry should not be a tool for social justice
