I am licensed to practice medicine and surgery in Georgia. But that doesn’t mean I should, or that you ought to let me—at least not the surgery part. I’m actually pretty good at carving a turkey, but that’s pretty much the only kind of surgery that I’m qualified to do.
Don’t let the license fool ya, I’m no surgeon. So what, exactly, does a doctor have …
How to become a licensed, board certified doctor
“I can’t get no satisfaction,” sang the Rolling Stones. And so it goes for many of the physicians who contact me.
I was struck by the fact that the word “satisfaction” in connection with work was used in two separate conversations with physicians recently.
It got me curious. Just what is job satisfaction?
How is it defined by the folks who study this kind of stuff?
And why is it so hard to come …
What is job satisfaction for physicians?
“Doctor Pete” was fifty-one when I started my residency in family medicine. “Family practice” we called it then, and I think I liked that name of our specialty better. It implies continued learning and brings to my mind visions of practicing a down-to-earth craft.
I had interviewed with his predecessor the summer before and was really impressed with him and the program. I ranked it as my first choice in the …
Ode to a family practice mentor
An excerpt from Surviving the Emergency Room.
by Ron Clark, MD
With regard to emergency trauma care, a few minutes can mean the difference between life and death. This first hour of definitive medical care is called the “golden hour.” It is usually this first hour where the patient’s medical fate is sealed. In general, the faster that medical care is rendered, the better the medical outcome will be.
The old adage …
The golden hour and the difference between life and death
Six months down. Six to go. I am officially halfway through what people have told me will be one of the most challenging years of my life. I’ve rotated through Cardiology, Primary Care, Gastroenterology, General Medicine, Psychiatry, Palliative Medicine, the Medical Intensive Care Unit (MICU), and Rheumatology. Finally I have reached every resident’s favorite rotation – vacation.
Intern year has been hard work, but I’ve enjoyed it and am extremely pleased …
Combat compassion fatigue in caregivers to improve patient care
I saw two patients recently that really made me scratch my head.
The first was a 15-year-old girl who was smoking a pack of cigarettes daily and had been for 3 years; the other was a 26-year-old man who smoked 1.5 packs daily for 10 years and had recurrent oral ulcers and bleeding gums. In sitting and talking with these two patients, it became blatantly obvious that the risks of tobacco …
Discussing smoking habits with patients
In a recent series of articles in the New York Times, Walt Bogdanich uncovered an alarming series of radiation treatment errors associated with implementation of new computerized treatment technologies such as Intensity-Modulated Radiation Therapy (IMRT).
Based on this article, reporting hundreds of cases, some of them fatal, it appears that a variety of causes are associated with errors, including inadequate training of physicists and radiation therapists, difficulty physically validating computer-generated treatment …
Radiation treatment errors with Intensity-Modulated Radiation Therapy (IMRT)
There’s a great blog post on Harvard Business Review titled, “Does an Entrepreneur Need an MBA?” I’m now enrolled in business school and I’m pursuing an MBA. I don’t consider myself a traditional entrepreneur, but I’ve started a few things here and there. Someday, I may take a big risk and start a “real” company, but for now I’m comfortable bootstrapping my way through a few little ventures.
The …
Does a physician need an MBA degree?
by Peter J. Pitts
As the saying goes, the plural of anecdote isn’t data. That is unless the anecdote supports your theory. Here’s a personal anecdote — a story of how the system works.
Being adopted, I have no family history, so when I suffered through some late night chest pains I figured I’d better act on the warning signals. I called my GP and got a same-day consultation, resulting in a next-day referral …
A stent anecdote from a former FDA Associate Commissioner
Some research studies just contain too many revelations to not share with the world. The Health Affairs study on the pay gap between newly-trained male and female physicians is just such a study, demonstrating conclusively that:
1. The gender gap in physician salaries is not related to specialty choice or work hours. No matter where women are choosing to work (solo practice vs. hospital, city vs. rural), which specialty they choose …
Why is there a gender gap in physician salaries?
You’ve probably experienced that age-old ritual of cooling your heels in an ER waiting room hoping that it won’t be too many hours before a nurse lets you inside the sliding doors.
Simon Bradley tweeted this to my Twitter Account @WCBADoctorBrian: “My buddy had a deep laceration between the thumb and the index finger – a full layer of skin. Took 10 hours at (name of hospital withheld), fastest in town.”
A …
Can posting ER wait times be dangerous to patients?
Nutrition fascinates me – I’ve been studying it for over twenty years and have a university degree in Dietetics. These days I’m particularly interested in the secrets of high-performance eating; the busier and bigger my life gets, the more I need to be on the ball. Food is an essential part of my success strategy. Put another way: if I didn’t know how to eat right for my brain, I’d …
Food is an essential part of a doctor’s success strategy
An excerpt from The Color of Atmosphere: One Doctor’s Journey In and Out of Medicine (Chelsea Green Publishing, 2011).
We all make mistakes. To err is human—unless you are a doctor. This is a lesson that began in med school. If something went wrong, someone else was to blame. Attending physicians blamed the residents, who blamed the interns, who blamed whomever else was within range—med student, nurse, patient. We gave …
The threat of malpractice means doctors cannot acknowledge their fallibility
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I recently read a post from Jan Gurley, MD on here on KevinMD.com.
Her opinion is that medical malpractice lawsuits are a “crap-shoot”; she notes that “malpractice lawsuits fail when it comes to medical errors-in both directions. People who’ve suffered from errors both don’t sue, and lose suits, in the same percentages that people who sued have no suffered from errors.”
Assuming that information is correct for purposes of this …
Patient-physician relationships in medical malpractice
Doctors vs. nurses (or doctors vs. nurse practitioners, or doctors vs. physician assistants, or what have you). The debate is old, tired, unimaginative, divisive, and wrong-headed–for reasons that are too obvious even to list. Does it get perpetuated because it garners comments (175 of them, to be exact)? Snarkniess is not appreciated by this reader, at least.
The New York Times recently ran a column by one of its editors, “Read more…
Praise nurses without comparing them to physicians
In the very first episode of the TV series Marcus Welby, MD, our hero delivers an after dinner speech to a group of young interns. As he’s introduced, he hastily scribbles the title of his talk and hands it to the hospital director: “The future of the general practice of medicine, if any.” The year was 1969.
In his introduction, the director somewhat tactlessly remarks that many “eminent specialists” have addressed …
Marcus Welby and the relentless growth of specialization
Earlier this month, at the third annual American Medical Student Association Patient Safety and Quality Leadership Institute, I listened with sympathy — and, frankly, a certain amount of discomfort — to a fourth-year medical student’s account of his grandmother’s recent hospitalization at a well regarded inpatient facility in New York City.
Admitted with an initial diagnosis of pneumonia, Cole Zanetti’s grandmother languished in the hospital for almost four weeks.
As the medically …
Patient safety lapses in the hospital
In a hospital setting, administrators love to work with physicians; they make sure whenever a new system is being formulated and implemented, this is discussed with a team of physicians, as they are also an integral part of success. All physicians work with each other in harmony and synchronicity.
Cardiologists never step on each other’s toes, radiologists call admitting doctors for any bizarre findings and hospitalists notify the primary about their …
The void between physicians and administrators in hospitals
I recently headed off to a reception for students from the new Pacific Northwest University of Health Sciences in Yakima, WA who are spending their third year of osteopathic medical school in Puyallup, WA doing rotations with the physicians in our community. I’ve had a student with me recently, and it brings back memories of my third year in med school, and how things have changed. It also leads me …
Seeing a family physician at work is valuable for medical students
As I walked into the ED for my shift, the nursing supervisor was fumbling with a syringe attempting to get medication out of a small vial.
“Ummmm. Looks like you need to adjust your bifocals,” I quipped. We have a running joke about who is older and bust on each other about our ages every chance we get.
When she turned around, the look she gave me signaled that it was no …
Your worth as a physician can be judged by how people invoke God
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