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.

Alcohol does not discriminate when it destroys the human body

The American Doctor, MD

Physician

April 28, 2011

There was a time when Herb was living the American dream in the sunny state of California. He was married with 2 children, a big house in the suburbs, a golden Labrador retriever, and a well-paying job as an executive in a book publishing company.

His two sons were stellar athletes and students, both moving on to attend nationally ranked colleges upon graduation from high school. They were the pride and joy …

9 websites that savvy medical practices use

Rosemarie Nelson

Physician

April 28, 2011

It’s easy to get caught in the surf on the Web. But plug these URLs into your browser and explore some simple tools that can help not only keep your practice above water but help it ride high.

www.digitalassent.com

Digital Assent automates the patient intake process with a PatientPad instead of the clipboard and an online tool for advance registration. It does integrate with EMR systems, but it provides another strong operational …

The advance directive is only a part of end of life decision making

Richard N. Fogoros, MD

Physician

April 27, 2011

On January 1, the White House announced a new policy that would have paid doctors for discussing end-of-life planning during their Medicare patients’ annual wellness visit.

Under this policy, physicians would be paid to encourage their patients to establish an advance directive, which would guide medical care if the patient became incapacitated from illness, and could …

Advances coming in medical science that will have a high impact

Stephen C. Schimpff, MD

Physician

April 27, 2011

There are a series of medical megatrends outlined in my book The Future of Medicine – Megatrends in Healthcare that will profoundly affect health care in the coming five to fifteen years and beyond. Some are due to the explosion of basic understandings of cellular and molecular biology. Others are related to advances in engineering and computer science. Here is a very brief overview.

These are the megatrends in medical …

A physician assistant writes to the doctors of America

David Mittman, PA

Physician

April 27, 2011

I’m a physician assistant, having graduated from PA school over thirty-six years ago. There is angst in my profession, but many PAs don’t openly voice it. I felt compelled to write to you because I still believe in my profession, and I believe in yours, as well. Sometimes I think it might be time to embrace a new belief system. …

Should a hospitalist be given more information on hospital costs?

David Williams

Physician

April 27, 2011

In Today’s Hospitalist, Jeremy Graham, DO discusses implications of research he’s published about hospitalists and costs: How much is that bed on the ward? Hospitalists are clueless about patient charges.

Not surprisingly, hospitalists, like almost everyone in the hospital, have no idea what anything costs.

That’s no real shock, as Graham points out:

It’s often hard for hospitalists to know these charges, …

Read more…

Should a hospitalist be given more information on hospital costs?

The exhaustion of emergency physicians, and its toll on patients and family

Jessica Freedman, MD

Physician

April 26, 2011

When I advise students about how to choose a specialty, I suggest that they seek out advice from physicians who are at least 10 years out of residency and leading the type of life they hope to have in the future.

It is difficult, and perhaps impossible, to anticipate in your late 20s or early 30s what practicing a certain specialty will be like when you are 40, 50, or 60.

Find …

Specialty hospitalists joining forces with the generalist hospitalists

Robert Wachter, MD

Physician

April 24, 2011

I recall with fondness many meetings in 1996-98, when the hospitalist field was still in its infancy. We had invented a new medical specialty, and our gatherings were vibrant and purposeful.

We were determined to remake the healthcare system, learn from each other’s triumphs and disasters, and chart a course that would improve the care of hospitalized patients. These were heady …

First, do no harm

Kevin

Physician

April 24, 2011

by Alison Block

It’s one of my earliest memories: I’m wrestling with my brother, and I’m losing, because I’m five and he’s seven, and he’s bigger and stronger than I am. So I bite him, hard.

Instantly I know I’ve crossed some sort of line, and I employ my most primitive defense mechanism, shouting out, “He bit me! Jon bit me!” I feel shame, because I am old …

Read more…

First, do no harm

Primary care providers are needed to support health reform

Kevin

Physician

April 23, 2011

by Vanessa Hurley

Like many American patients, the American health care delivery system suffers not only from acute crises, but also from a chronic, poorly managed and debilitating disease.

Primary care is in trouble. Not only are primary care physicians (PCPs) fleeing the profession in droves, but fewer and …

Family medicine is the kind of revolution we want to join

Kevin

Physician

April 21, 2011

by Christina Palmer

It never surprised me when my medical school classmates said they would “never do family medicine.”

I knew exactly how they felt: why would we choose to go into a field where physicians are undervalued, underpaid, buried under administrative paperwork, and where patients do not get the time or attention that they need?

Despite the warnings against it, I am pursuing family medicine as …

Isolated gay people and support from the LGBT community

Loren A. Olson, MD

Physician

April 20, 2011

An excerpt from Finally Out: Letting Go of Living Straight, A Psychiatrist’s Own Story.

by Loren A. Olson, MD

I once cared for an aging lesbian who began to have memory problems.

She went to a neurologist who said bluntly, “Get your affairs in order. You have Alzheimer’s disease.” My patient was confused, devastated, and depressed. She asked a companion to accompany her on her return visit. This time the neurologist said, …

When quality of care becomes customer satisfaction demands

Doc B, MD

Physician

April 20, 2011

The new healthcare reform law appears to be using the idea of improved quality to justify the enormous expense of changing the way care is delivered in the United States.

As a justification for the need for change is the reporting currently being touted as a great measure of quality. This information is gathered in many different ways and …

How obesity is a voluntary epidemic, and why we shouldn’t give up

David Gratzer, MD

Physician

April 19, 2011

As America comes to grips with the disastrous effects of a national obesity epidemic, there’s a new feeling in the air: defeatism.

Former Carter Administration advisor Amitai Etzioni seemed to succumb to it when he wrote an article entitled “dieting gets you nowhere” for CNN recently.

In it, the liberal sociologist citied a recent nutritional study …

Patient centered care and the family physician’s brain

Richard Young, MD

Physician

April 18, 2011

Paul Grundy is IBM’s Director of Healthcare, Technology and Strategic Initiatives for IBM’s Global Well Being Services and Health Benefits.

He has led the development of the Patient-Centered Primary Care Collaborative, which is leading the way to create a more efficient and responsive healthcare system. Before I go any further, let me be very clear by saying that his work is hugely important and I agree with 90% of what this …

Your child is a picky eater, and what to do about it

Melissa Arca, MD

Physician

April 18, 2011

Having a picky eater seems to be the norm these days. I’d almost dare to say that children between the ages of 2-7 more often than not wind up in the picky eater category.

Why the sharp jump in membership of The Picky Eaters Club during this time? Researchers believe it could be evolutionary. That way young “cave toddlers” wouldn’t walk around tasting every potentially dangerous thing in sight. Can you imagine?

Still, there …

Judicious use of complex medical procedures

Kevin

Physician

April 15, 2011

by Shanti Bansal, MD

In the cardiac catheterization lab one Tuesday morning, I encountered a situation that made me reflect on a bit of 18th-century British history.

At that time, the British government was overburdened with prisoners. A plan was hatched for sea captains to transport many of them to Australia. Due to poor conditions, up to one third died on the voyage. Politicians and clergy members …

Can doctors learn surgical skills on YouTube and Facebook?

Dr. Martin Young

Physician

April 15, 2011

I am a self-taught bass guitarist in a church band, and, to be honest, it sometimes shows. I know I need to improve my skills, but time commitments make formal lessons difficult. So two days ago I opened up YouTube and entered “bass guitar lessons” into the search box.

19,000 hits registered. I selected a few that looked good on …

Natural forces within us are the true healers of disease

Hans Duvefelt, MD

Physician

April 14, 2011

In my forays into the history of medicine I came across these six little words by Hippocrates.

They seem strangely modern, almost like something you might find on a Hallmark-card for today’s medical school graduates. I don’t know how old the translation is and I couldn’t understand the original text if I tried – but these simple words really touched me when I …

AMA: Getting the best value for our health care dollars

Cecil B. Wilson, MD

Physician

April 14, 2011

A guest column by the American Medical Association, exclusive to KevinMD.com.

As physicians, many of us realize on some level that our practices contribute to our state and national economies – we just lacked the empirical evidence to understand how much.

That changed last month, when the American Medical Association released a report that studied the economic impact of office-based physicians. While a handful of states have previously studied the economic impact …

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