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.

Dangers of strict adherence to clinical guidelines

Douglas Perednia, MD

Physician

April 1, 2011

Medical guidelines are well on their way to becoming the Law of the Land. Dr. Rich over at The Covert Rationing Blog featured a recent post that highlighted this point.

When a study published in the Journal of the American Medical Association showed that nearly 23% of patients receiving implantable cardioverter-defibrillators (ICDs) received them under circumstances that did not match up with the recommended “guidelines” for doing so, this breach of …

The relationship between parents and pediatricians

Yolanda Wong, MD

Physician

April 1, 2011

It’s strange being on the other side for a change. I remember bringing my son to his first doctor’s appointment. A new mom. No stethoscope around my neck. No patient schedule, replaced instead by the constant grind of breastfeeding.

I knew it was just another routine newborn check for our pediatrician, but every maternal fiber in me believed that my son must be the cutest baby that ever walked through that clinic. …

Diagnostic errors and their role in patient safety

Charles A. Pilcher, MD

Physician

March 31, 2011

American Medical News published an informative essay by Kevin B. O’Reilly on December 13, 2010, about errors in diagnosis and why doctors make them.

According to Gordon Schiff, MD, associate director of the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital, “The problem of diagnostic errors has gotten short shrift in the broader patient safety movement.” The article focused on …

Medical ethics at hospitals and medical schools in China

John Schumann, MD

Physician

March 30, 2011

One of the topics I went to China to discuss was our medical school’s approach to teaching medical ethics.

At Wuhan University they have a first-year course, but I was told by both the school administrators and some of the students that the material is dry and not seen of immediate importance, so students often skip the class.

Here’s how …

A boxing fight physician experience

Steven Reznick, MD

Physician

March 30, 2011

I received a phone call from the Broward Sheriff’s Office Police Athletic League Youth Boxing Program asking if I would help them out and be the fight physician at their upcoming youth boxing tournament.

Their usual physician, a member of the Boxing Hall of Fame, had another commitment. However, he was willing to train me in advance and show me the ropes on the day of the event.

State law and the …

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A boxing fight physician experience

How physician practices can compete with retail clinics

Brandon Betancourt

Physician

March 29, 2011

A reader recently wrote to me: “Brandon, in our area, we’ve seen a few retail clinics pop up. What can we do as a practice to let patients know that visiting retail clinics is not in their best interest?”

We had along discussion. So I put together a summary of our conversation. Below is a rundown, more of less, of what I …

Calling in sick serves as a reminder for compassion for this doctor

Anesthesioboist T., MD

Physician

March 28, 2011

One of my Facebook updates on my private account was that I “have a love-hate relationship with interleukin-6. Yes, macrophages and T cells, I know you are doing your job, but how many proinflammatory cytokines does it really take to fight this thing? What’s that? Be grateful you guys are even working? Oh, all right. I’ll shut up and eat my soup now.”

Yes, I’ve been sick this week. It started …

Reductionism and daily medical practice

George Lundberg, MD

Physician

March 28, 2011

The results of the application of reductionism in modern biomedical research and practice has been nothing short of miraculous, but while wondrous for some things, reductionism alone is incomplete.

The basic premise of reductionism is that by breaking down (or “reducing”) complex biological or medical phenomena into their many parts, one is much more likely to understand a single cause and devise a cure.

Historically, the invention of the microscope, the defining …

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Reductionism and daily medical practice

Developing innovative solutions to battle cancer and disease

Vipan Nikore, MD

Physician

March 25, 2011

There isn’t a country on this planet where there isn’t someone dreaming of curing cancer. What if there was something even more spectacular than curing cancer? What if you could stop cancer right in its tracks and eliminate its existence. Prevent it. Squash it before it starts.

Vincent Tuohy, PhD, an immunologist at Cleveland Clinic, may be on a path toward …

Engage employees in healthcare to enhance patient outcomes

Donald Tex Bryant

Physician

March 24, 2011

It is an axiom of business that employee engagement produces many positive results, no matter what the setting—manufacturing or service. This is true for healthcare as well.

Employee engagement produces a better product or service. In healthcare, engaged employees produce enhanced patient outcomes. When employees are engaged there is less turnover, which reduces training costs. Engaged employees are problem solvers.

How …

Can family medicine really be defined?

Kevin

Physician

March 23, 2011

by mdstudent31

Going into medicine from a suburban community in the northeast, I never really knew exactly what family medicine was as a specialty. I had heard of it before, but did not see it in action until going to undergraduate school in the middle of Pennsylvania. It was there when I began …

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Can family medicine really be defined?

A surgeon on those who understand murderers, rapists and child molesters

bongi, MD

Physician

March 21, 2011

(Editor’s note: reader discretion advised)

Recently I was involved in a discussion with a guy that was explaining how we should understand criminals. The emphasis was on farm murders but we touched on murderers in general, rapists and child molesters. My point of view was that I did not understand them and felt that he was justifying their actions. In the end I was informed that I was smug. Apparently that …

Family physicians who care for underserved patients

Kenneth Lin, MD

Physician

March 21, 2011

One of the ugliest incidents in my career occurred during my faculty development fellowship year, when I spent two days each week seeing patients at several federally qualified community health centers in inner city Washington, DC. Midway through the year, I was transferred from a health center that served an African-American population to one serving a mostly Spanish-speaking clientele.

Nearly all of the permanent Read more…

Family physicians who care for underserved patients

Uncertainty in the diagnostic methods of the obstetrician

Kevin

Physician

March 20, 2011

by Henry Dorn, MD

In 1974, the noted obstetrician Marcus Filshie published a review of the relatively new electronic fetal monitoring in the British Journal of Hospital Medicine. He stated, somewhat fatefully:

Now that the appropriate technology is available, the obstetrician may virtually eliminate intrapartum stillbirths and reduce morbidity to a minimum.

Similar statements were made in the United States by leaders in the obstetrical …

Osteopathic medicine and the growth of D.O. graduates as physicians

Tayson DeLengocky, DO

Physician

March 18, 2011

by Tayson DeLengocky, DO

The landscape of healthcare delivery has changed so drastically over the past three decades with the proliferation of allied health professions, increased in medical specialization, managed health care, and technology advancement.

The direct doctor-patient relations have been relegated to the relations between healthcare providers and patients, in which doctors are only participants among other healthcare givers. A healthcare consumer, patient, can be easily further confused when visiting medical …

Cancer patients get better care than patients in primary care

Shantanu Nundy, MD

Physician

March 17, 2011

Why do my patients with cancer get better care than my patients in primary care? As the senior resident on my hospital’s inpatient leukemia service recently, this question troubled and intrigued me daily.

Despite the sheer complexity of treating leukemia (administration of chemotherapy, bone marrow biopsies, stem cell transplantation), the resources required (transplantation routinely costs $1 million), and the severity of the illness …

The National Health Service Corps impact on primary care doctors

Kohar Jones, MD

Physician

March 17, 2011

Before I had even begun medical school, I already knew that I would enter primary care when I finished. I had successfully applied for and received a scholarship from the National Health Service Corps Scholars program. By the time I graduated, I knew that after my three years of residency training, I would practice in an underserved area for at least four years, one year of service to America for …

When doctors take time off to become parents

Kevin

Physician

March 17, 2011

by Dawn Barker, MD

Until recently, it was easy to reply when an inquisitive acquaintance asked, “What do you do?” I would answer that I was a child and adolescent psychiatrist. Easy.

The most difficult part was trying to explain that yes, a psychiatrist is a medical doctor, and no, I’m not a psychologist and there is a difference. But when …

Your medical career and the waning interest in bridal and baby showers

Jennifer Middleton, MD

Physician

March 16, 2011

I think that I am missing a gene from one of my X chromosomes.

I attended my sister-in-law’s baby shower recently. I love my sister-in-law dearly and was happy to be there to support her. If only I could have supported her in another way.

I detest showers. Once I was engaged, I stated clearly to everyone I knew that I did not, under any circumstances, want a bridal shower. Naturally, everyone …

Should doctors be like workers on factory assembly lines?

Greg Smith, MD

Physician

March 16, 2011

fatigue |fəˈtēg|

noun
1 extreme tiredness, typically resulting from mental or physical exertion or illness : he was nearly dead with fatigue.
• a reduction in the efficiency of a muscle or organ after prolonged activity.

No, this post is not a part of my twenty six installment Psychiatry A to Z series.

You’ll have to wait for the next one in that group, which by the way will be looking at a “T” word. …