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.

Physicians need to understand data to provide better and safer care

Donald Tex Bryant

Physician

October 6, 2011

Patients expect excellent care from their physicians. Unfortunately, not all receive such care and most of us realize this. Many who do understand the wide variation in patient care probably believe it is due to the clinical knowledge and attitude of the provider—a very knowledgeable physician or nurse who is passionate about his or her job will deliver the best care. Although these ingredients are necessary for excellent patient …

A doctor cannot be on time and take care of your needs

Stewart Segal, MD

Physician

October 6, 2011

Today’s article addresses a common complaint about physicians.

“Freewheel” responded to a previous article by writing the following, “you will not make me wait more than 10 minutes. My time is important, too.” One of the most common complaints I hear is “I waited over an hour to see you!” Waiting for an appointment, particularly when you are sick, is frustrating. Once you have that appointment, waiting for a doc who …

Calling yourself Doctor and what that now means

Bradley Flansbaum, DO

Physician

October 5, 2011

In New York State, the issue of scope of practice is at the fore. Mainly, what activities can non-physicians (NP’s) engage in, with or without physician supervision? It is a heated subject here where I reside, but not the one I will address below.

The New York Times discusses a similar matter, although altogether more controversial. Many of you are aware nurses are obtaining doctorate degrees and advancing their training.

The divisive …

The use of a signing bonus as tool for physician recruitment

Bo Claypool

Physician

October 5, 2011

As someone whose livelihood is dependent upon successfully recruiting physicians to various practice opportunities, whenever possible I use the tool of a “signing bonus” and it may not be for the reason you think.

If you have found yourself in the role of recruiter for your practice, you should be open to use of this valuable tool within the physician recruiting process.

Now, I must say, that whenever this is brought …

The words we choose can have impact on those we interact with

Kate Land, MD

Physician

October 4, 2011

Language matters. The words we choose can have far-reaching impact on those we interact with. This is arguably more true in medicine than in any field.

Ryan Madanick wrote a recent blog post on the use of descriptor terms used by physicians in patient’s charts. He felt that the use of phrases like “is a very pleasant 52 y/o woman” or “is an unfortunate 16 y/o boy” is inappropriate. I agree. …

Keith Ablow on Chaz Bono and the outrage that follows

Ford Vox, MD

Physician

October 4, 2011

Dr. Keith Ablow is an assistant clinical professor at Tufts University School of Medicine. So am I. Ablow has a problem with transgendered people. I do not. I first learned about Ablow’s well publicized stance Wednesday via an email to the Tufts community, signed by the university’s president, the dean of the medical school and the chair of the psychiatry department.

The university reaffirmed its commitment to the complete inclusion …

Lawsuits are more of an emotional issue than a financial one

Richard Young, MD

Physician

October 3, 2011

Doctors love to talk about tort reform – states passing laws to put limits on awards such as non-economic damages for harms such as pain and suffering, and on the legal process of suing a doctor for malpractice. They speak of defensive medicine – the practice of ordering extra tests, treatments, and days in a hospital to cover their medical-legal butts.

Texas passed a comprehensive tort reform law in 2003 …

Use a beginner’s mind in your medical practice

Philippa Kennealy, MD, MPH

Physician

October 2, 2011

As a mom and first-time parent, I marveled at my tiny daughter’s curiosity about and interest in the world. Her quest for knowledge was insatiable and her ability to sit absorbed in what she was doing and the moment enviable. Now that she’s 8 (“8 and a quarter, mom!”, said with a sigh and an attitude), she seems to have morphed into a smart, verging-on-sassy pre-tween who’s beginning to think …

I concentrated to distill all that I had learned about death

Jordan Grumet, MD

Physician

October 1, 2011

The recycling container was already full. But I had two more bags to stow before lugging the bin through the gate and into the front yard for pick up. My button down shirt untidy and bulging out from the waist. My long khaki pants felt like a fur coat in the ninety plus Chicago humidity. It was 4pm and I had just arrived home from work, dropped my computer in …

Physicians lack harmony in this age of health reform

Gary Oftedahl, MD

Physician

September 30, 2011

At every turn, we in health care are being told we must fundamentally change the way we deliver care to the patients who come to us for assistance, advice, and decisions as to how they can, if not maintain health, at least survive in an increasingly burdensome world. Whether referenced as medical home, health care home, advanced primary care, patient-centered approaches, or accountable care organizations, it all sounds the same …

Doctors should not treat every patient like their mother

James Logan, MD

Physician

September 30, 2011

Physicians recommend different treatments for patients than they would choose for themselves. The preceding statement is true according to a similarly titled article recently published in the Archives of Internal Medicine, and has, I will argue, important implications for how we view the doctor-patient relationship.

In the study, one group of physicians was asked to choose between two hypothetical treatment alternatives for either avian flu or colon cancer as …

Is medical tourism a dire threat to American surgeons?

Richard N. Fogoros, MD

Physician

September 30, 2011

In an earlier post, DrRich offered several potential strategies for doctors and patients to consider should healthcare reformers ultimately succeed in their efforts to make it illegal for Americans to seek medical care outside the auspices of Obamacare. To those readers who persist in thinking that DrRich is particularly paranoid in worrying about such a thing, he refers you to his prior work carefully documenting the efforts the Central Authority has already made …

How to isolate problems in your scheduling system

Adam Alpers, DO

Physician

September 29, 2011

Though there will always be times when an emergency disrupts your schedule, there is usually little reason for patients to wait more than 20 minutes for their visit. You will also find that continually double booking, arriving late, or having general mayhem in your office will inevitably result in everyone having to stay later than expected. Rather than experiencing all of these problems, you will be well served by isolating …

The only anesthesiologist in this vast hospital

Felicity Billings, MD

Physician

September 29, 2011

His blood pressure disappeared. The arterial tracing, a red line on the monitor reassuringly undulating with every beat of his heart, falling from 122/83, 99/64, 80/50, 67/42, then a flat line at 48.

I had just come off the elevator, ushered in by the surgery resident who found me in the hallway searching for the right room.

Epinephrine. Get the code cart. Check for a pulse. The nurse screwed the two halves …

A hospital board needs to understand generative thinking

Kent Bottles, MD

Physician

September 29, 2011

Hospital systems and physician groups are faced with unprecedented change demanding decreased per-capita cost and increased quality in American health care. Boards of directors are underutilized resources that must be tapped more effectively in order for such organizations to survive in a time of industry consolidation. Generative thinking is a tool that can help organizations innovate in order to improve patient care and the financial bottom line.

Generative thinking is …

It is a rare medical news story that gets high marks

George Lundberg, MD

Physician

September 29, 2011

Like you, I receive a whole bunch of breaking medical news every day, from television, radio, newspapers, direct mail, email alerts, press releases, and multiple websites.

Is any of it worth my time, my attention, or even a change in my knowledge, attitude, behavior, or medical practice? How can I quickly tell?

A medical journalist from Minnesota named Gary Schwitzer recognized this problem many years ago and created a service that …

Doctors with great bedside manner can also provide great clinical care

Davis Liu, MD

Physician

September 28, 2011

The New York Times recently published an article titled, Finding a Quality Doctor, Dr. Danielle Ofri an internist at NYU, laments how she was unable to perform as well as expected in the areas of patient care as it related to diabetes. From a New England Journal of Medicine article, Dr. Ofri notes that her report card showed the following – 33% of patients with diabetes have glycated hemoglobin …

Honesty between doctors and patients goes both ways

Stewart Segal, MD

Physician

September 28, 2011

Yesterday, someone asked me, “Can I be perfectly honest with you?” I wanted to reply, “No, just be dishonest, I like it better that way!” “Can I be” implies that, in past conversations, my patient has been dishonest. Dishonesty is a relationship breaker. Dishonesty leads to distrust and if I cannot trust what a patient is telling me, I cannot be effective; the doctor-patient relationship is terminated.

Am I being too …

Father and son, doctor and grieving family member

Jordan Grumet, MD

Physician

September 28, 2011

The edges of Cameron’s lips rise undeniably toward the clear blue sky. His legs move methodically. One motionless on the scooter and the other periodically kicking to propel himself forward. He weaves in and out dodging my shadow as I jog beside him.

I struggle to keep pace. My breathing unsteady and labored. My joints aching. And my brain foggy from lack of sleep and replaying the events of the day.

***

The …

If you need to say you’re all about the patient, you aren’t

Sanford C. Sharp, MD

Physician

September 27, 2011

Sir William of Ockham has achieved a degree of mortality via the wide promulgation of an aphorism, now generally known at Occam’s Razor (I’ll use the more economical spelling). There are many iterations of the razor, but my favorite is this: “simpler explanations are, other things being equal, generally better than more complex ones.” That trips off the tongue more easily than, say, “plurality should not be posited without necessity.”

In …

Physician

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