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.

Mental health and the shortage of psychiatric help in the ER

Edwin Leap, MD

Physician

May 12, 2011

Every day, mental health clinics, emergency departments, psychiatric hospitals, physicians’ offices, counselors’ offices, school counselors and police officers are faced with an almost impossible responsibility. It is a responsibility, a burden, often highlighted retrospectively, after a tragedy. Their job is this: identify every dangerous person, treat them properly and avoid horrific events like the recent murders in Tuscon.

I sympathize greatly, since I work in the emergency department of a hospital …

Why the ophthalmologist and optometrist conflict should concern patients

Ford Vox, MD

Physician

May 10, 2011

If you need laser eye surgery in the state of Kentucky, or a little cosmetic work around the eyelids, it now behooves you to ask your prospective surgeon the following question before signing the operative consent form:

“Say doc, did you go to medical school?”

Kentucky joined the company of Oklahoma earlier this year as the second state to conflate optometrists and ophthalmologists. Only ophthalmologists are the sort of doctors who graduated …

Physicians coping after a medical error

Jock Hoffman

Physician

May 10, 2011

A failed treatment, a surgical complication, a medical error, a patient death. When the going gets tough, even the toughest clinicians should get help.

Physicians and nurses who feel personally responsible for a medical error or a patient’s injury face an immediate quandary—their next patient. In the midst of your angst and guilt, do you suck it up and soldier …

Read more…

Physicians coping after a medical error

Our personal commitment and social engagement as physicians

Kevin

Physician

May 9, 2011

by Synphen H. Wu, PhD

Mr. C is a 46-year-old Chinese immigrant restaurant worker who came to Bellevue Hospital after two weeks of fatigue, malaise, right upper quadrant (RUQ) abdominal pain, and progressive jaundice.

He was referred from a Chinatown clinic, where his blood tests showed hepatitis B surface antigen, a hepatitis B viral load of 133 million copies, and elevated liver transaminases and bilirubin levels, …

Honored to care for many priests and nuns in my practice

Michael Kirsch, MD

Physician

May 8, 2011

Our society thrives on tension and competition.

GOP vs Democrats
Civil Libertarians vs Eavesdroppers
Ohio State vs Michigan
Creationists vs Darwinists

Ideas, like sports teams, compete to win. We are the referees of these contests. Many of these competitions in the public square are ongoing. Some of these duels are locked in a dead heat. Others are in overtime. Some are ‘challenge matches’ when a vanquished idea wants another shot to change the original outcome. …

Where do we draw the line on criminalizing mistakes?

Jeffrey Knuppel, MD

Physician

May 7, 2011

Eric Cropp was a pharmacist who was sent to prison for a mistake that resulted in the death of a child.

This was a high profile case, but it was just one of many examples of a disturbing trend I’ve seen in the U.S. in recent years: a person commits a mistake–with no malicious intent and without being under the …

Be like a circus ring master when seeing a patient in the clinic

Jill of All Trades, MD

Physician

May 7, 2011

When I was a little girl, attending the circus was the highlight event of the year. I remember looking forward to it each year – perhaps because it was something fun, and each year something new. Never the same show twice. Very busy behind the scenes, yet at the same time, quite organized and appearing smooth on the surface.

In the same way, the clinic can be a truly hectic scene. …

Recovery may be predicted with a perception of the inner pulse

Kevin

Physician

May 6, 2011

An excerpt from The Inner Pulse: Unlocking the Secret Code of Sickness and Health.

by Marc Siegel, MD

The Pulse of Recovery

People are like stained-glass windows. They sparkle and shine when the sun is out, but when the darkness sets in their true beauty is revealed only if there is light from within.
–Elisabeth Kübler-Ross

The inner pulse can keep beating—loudly—long after doctors, researchers, and their monitors …

Medical students are part of each patient’s health care team

Matthew Gibson, MD

Physician

May 5, 2011

I realized last week one of the hardest mindset transitions that I’m having to make as a medical student. It has to do with not really feeling like I belong, and the need to really make my patients … well, MY patients!

As a medical student, you can actually function reasonably well without ever having to actually see a patient.

You can read …

New ACGME work hour regulations for interns: friend or foe?

angienadia, MD

Physician

May 5, 2011

On the night of October 4, 1984, a young girl named Libby Zion was admitted to New York Hospital in Manhattan for fever, agitation and strange jerking movements. No one knew that her death the next morning would, 27 years later, drastically change the quality of physician training, for better or worse.

When Libby was evaluated in the emergency room that night, neither the ER physician nor her family physician Dr. …

Cooperation between patient and doctor is essential today in health care

Paul Dorio, MD

Physician

May 4, 2011

There are many aspects to being a doctor. Just as important are the many aspects that go into being a patient. Of course, the difference is that one has been perceived as being a position of power and the other one has not. I don’t believe this distinction is useful or true in today’s world.

Patients and doctors work …

Why patient satisfaction scores won’t decrease health care costs

Edwin Leap, MD

Physician

May 4, 2011

So now, in addition to the many other bits of medical meddling we have from CMS (Centers for Medicare and Medicaid Services), there’s this.

Reimbursements to hospitals, from Medicare, will be partly tied to patient satisfaction scores. We’ve seen payments already being tied to ‘quality indicators,’ as dictated by the federal government; rewards for doing a better job on care for heart attacks, pneumonia, etc. At least that’s quantifiable, whether scientifically …

ACP: National immigration policy and health care

American College of Physicians

Physician

May 2, 2011

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

by John Tooker, MD, MBA, MACP

There are over 11 million undocumented immigrants in the United States — about 3.7% of the U.S. population — according to a 2011 report from the Pew Hispanic Center.

Although there are many reasons why immigrants elect to come …

How a model of multidisciplinary team based care may save primary care

Eric Lu

Physician

May 2, 2011

I didn’t expect to bump into “Max” on the streets.

“I was kicked out of the house by my wife,” he sighed. Max shifted around on his feet, eyes puffy and cheeks pink.

“Did you start using again?” I asked.

Max looked down and didn’t say anything. In the three years I had known Max, an alcoholic and former drug user, he had been clean. But recently he had started struggling. He lost his …

A simpler coding system proposal with a focus on primary care

Paul Fischer, MD

Physician

May 2, 2011

In a recent Wall Street Journal article, Barbara Levy, Chairwoman of the Relative Value Scale Update Committee (RUC), commented on the American Medical Association’s (AMA’s) decision to have minimal primary care participation on the RUC, saying the committee is an “expert panel” and not meant to be representative.

Since the committee is made up of 27 specialists, one …

Why do people decide to become doctors anyway?

Michelle Au, MD, MPH

Physician

May 1, 2011

An excerpt from This Won’t Hurt A Bit (and other white lies): My Education in Medicine and Motherhood. Copyright © 2011 by Michelle Au. Published by Grand Central Publishing.

Let’s look at this first purely from the perspective of personal investment and expectation. To practice medicine, …

Interviewing a primary care doctor to better understand her professional day

Pearl Korn

Physician

May 1, 2011

As a young primary care doctor in Kiev, Ukraine (then part of the Soviet Union), Dr. Elena Rogova learned her craft well, working in a hospital that catered to scientists, celebrities, artists, musicians and senior government officials.

As a top medical student, this hospital had sought her services, and she enjoyed her work there. Dr. Rogova had no intention of leaving …

A neurosurgeon considers stepping out of her comfort zone

gcs15, MD

Physician

April 30, 2011

There are few things I enjoy more than talking about the spine and the brain.

Therefore, it stands to reason that I enjoyed our state neurosurgical society meeting recently. I don’t like big national meetings, being an introvert at heart. Our state meeting, however, is small; this makes for a more intimate atmosphere and more outspoken dialogue. Colleagues from across the state can exchange ideas, new techniques, and opinions. We also …

How a family conference affects the decision for surgery

Kevin

Physician

April 29, 2011

by Chris Porter, MD

“Treat your patients as you would your own loved ones,” is advice taught throughout training in health care.

Great advice. I use it constantly. Mr. Davis is dying of multiple organ failure in the ICU after exploratory abdominal surgery. His siblings and children trickle in from Florida and Montana.

I’m always sorry for the last to arrive, who visits his dying brother’s bedside minutes before …

Social workers can reduce preventable readmissions

Vineet Arora, MD

Physician

April 28, 2011

I just finished another 2 weeks on service. This time, I had also had a shadower, but one of a different kind. As part of our Institute for Healthcare Improvement (IHI) Open School, we are making an effort to have collaborative learning opportunities for our medicine and health administration program students. Achieving true interprofessional learning is challenging for schools like ours without …

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