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.

Not all pain patients in the ER are drug seekers

Kevin

Physician

July 12, 2010

by Melissa Velez-Avrach

About eight years ago, I was in an accident that left me with chronic lower back pain and muscle spasms.

Then, about a year and half ago, I was in a car accident. Bad combo for the pain. I’ve been to chiropractors, orthopedic spine specialists, had MRIs, the works and am following my doctor’s recommendations, doing yoga, deep breathing and physical therapy when needed. It has all helped me …

World Cup soccer lessons that doctors can use

Philippa Kennealy, MD, MPH

Physician

July 9, 2010

Not being much of a soccer aficionado, I have nevertheless been captivated by some of the games in the 2010 World Cup Soccer. Probably has something to do with my being South African!

While I hear many Americans bemoan the slow pace of the televised game (“boring!”), the low scores (“where’s the action?”) and the vuvuzelas (“irritating!”), I have been struck by lessons these matches have offered up for entrepreneurial physician …

Tomorrow’s surgeons are today’s video gamers

Dr. Martin Young

Physician

July 7, 2010

As a young medical student I remember the arrival of the first video arcade games very clearly: Asteroids, Space Invaders and Pacman.

I spent whatever spare cash I had on them, never playing long enough to be any good, or rich enough to get any better. When I bought my first computer in my late-twenties, I relived my excitement with the newest computer games, spending a disproportionate amount of time long …

Op-ed: Empowered e-patients are failed by our health system

Kevin Pho, MD

Physician

July 6, 2010

The following op-ed was published on June 7th, 2010 in CNN.com.

“I read all about my condition on the Internet,” a recent patient proudly told me. Like other doctors, I’m seeing more patients research their symptoms thoroughly before setting foot in the exam room.

Patients are using the Web in unprecedented ways for their own health empowerment. According to the Pew Internet & American Life Project, 61 percent of American adults …

Abuse is linked to obesity in children

MedPage Today

Physician

July 4, 2010

by Todd Neale

Children whose mothers reported chronic abuse at the hands of an intimate partner were more likely to be obese at age 5 than those from violence-free families, researchers found.

After controlling for several potential confounders, including maternal obesity and depression, children whose mothers reported chronic violence had 1.8 times the odds of being obese, according to Renée Boynton-Jarrett, MD, ScD, of Boston University, and colleagues.

The association appeared to be …

Read more…

Abuse is linked to obesity in children

Euthanasia in dogs and the moral lessons for doctors

Edward Pullen, MD

Physician

July 2, 2010

We had our dog put down yesterday.

Simon joined our family when our son was 10 years old as a two year old that we adopted from the Purdy Prison Pet Parole Program and was with us until he developed status epilepticus forcing our decision to have Simon euthanized.

Simon had been getting old, lame, nearly blind, and uncomfortable most of the time, but we felt he still had some enjoyment in …

Florida EMTs may go bankrupt because of a malpractice lawsuit

WhiteCoat, MD

Physician

July 2, 2010

An ambulance service was recently held liable for failing to “do what was necessary” before accepting emergency transport of pregnant patient.

A child was born at 25 weeks gestation — 15 weeks premature — and was not breathing. Babies born at this age have a viability of 50-70%. In other words, up to half of children born at this age of gestation die. The family called 911. The paramedics arrived, performed …

A medical home does not guarantee increased patient satisfaction

Steve Wilkins, MPH

Physician

July 2, 2010

One of the more notable findings from the special report on the TransforMED National Medical Home Demonstration project was that “patient satisfaction doesn’t automatically go up.”

Terry McGeeney, CEO of TransforMED, attributed the lack of increased patient satisfaction experienced by the 18 participating physician practices to a variety of factors, chief of which “was the turmoil of change experienced by patients as practices implemented after-hours access, quick access to laboratory results …

Why patients don’t value primary care doctors

Chris Rangel, MD

Physician

June 30, 2010

“Hey doc, all I need is this referral.”

I’ve been encountering more of this lately. A patient who has not been seen in the office for months to years (well beyond when they were supposed to come back for a follow up visit) walks in and requests a “referral” for a specialist visit but they can’t be bothered with actually being seen and evaluated in the office or to be compliant …

Surgeons need to reconnect with patients after an operation

Jeffrey Parks, MD

Physician

June 30, 2010

It’s worth your while to browse through Sid Schwab’s sampler one rainy Saturday afternoon when you get a chance.

The old man can write. I was reading through a couple of his old posts the other day when I stumbled upon this one. It’s a shorter post (for him) but very powerful and moving.

He describes what it’s like to enter an abdominal cavity of a patient, with all its …

Difficult needs to be embraced in medicine

Alex Lickerman, MD

Physician

June 25, 2010

When I was a second-year medical student I remember thinking, after meeting with an attending physician in a physical diagnosis class, how impossible it seemed that my brain would ever contain as much medical knowledge as his.

And even if somehow one day it did, how would I ever be able to call on it, manipulate it, twist it, bend it, and turn it upside down with the same apparent ease …

Obese patients present challenges in the ICU

Ralph Gordon, MD

Physician

June 25, 2010

Obesity is a huge healthcare problem in the United States.

It has reached the proportions of an epidemic and continues to get worse. Multiple medical problems including heart disease, hypertension, diabetes, sleep apnea and cancer are closely associated with obesity. The patients with extreme obesity can reach a body weight of five, six or seven hundred pounds and even higher. Riddled with chronic medical conditions, these patients often end up in …

Healthcare providers still aren’t washing their hands enough

MedPage Today

Physician

June 24, 2010

by Chris Emery

Nurses and other healthcare providers complied with hand hygiene guidelines less than half of the time before participating in medical procedures, results of a new study showed.

Compliance was better after procedures, with 72% following guidelines after procedures compared with 41.7% before procedures, according to a report published in the May issue of Applied Nursing Research.

Overall compliance with hand hygiene guidelines was just 34.3%.

“It is important to note that …

Choose primary care and follow your heart, not your brain

Lucy Hornstein, MD

Physician

June 22, 2010

Reams have been written on how medical students ought to select their field of medicine.

There are even personality-type tests that ask questions about what kinds of situations you like, how you react to problems, and your working style that purport to predict for which specialty you are suited. (I came up as an oncologist or a nephrologist.)

Others have opined that once you crunch the lifetime salary numbers, and then compare …

How transparency reduces malpractice and defensive medicine

Brad Wright, PhD

Physician

June 22, 2010

Physician errors have been the subject of discussions about both health care costs and health care quality.

We are told that if we reform the malpractice system — capping damages — that physicians will practice medicine less defensively and costs will go down as a result. We are also told that the quality of care delivered by our health care providers is less than optimal — there are estimates that nearly …

Treating friends, and when worlds collide in the hospital

Bruce Campbell, MD

Physician

June 21, 2010

All the world is a stage,
And all the men and women merely players.
They have their exits and entrances;
Each man in his time plays many parts.
-Shakespeare

“There’s a consult downstairs, Campbell. Go check it out and I’ll catch up with you later.”

“Sure, OK.” I was a third-year medical student fumbling through my first clinical rotations. The resident headed off to whatever he needed to accomplish and I trotted down the back …

Clinical trial conflict of interest for doctors

Paul Levy

Physician

June 21, 2010

This is a painful story to write.

A close friend of mine, in his 40’s, had a persistent light cough for many months. Finally, when he had an X-ray taken, it showed a large tumor on his lungs. He was diagnosed with stage 4 lung cancer. As a non-smoker and strapping, physically fit man, he was shocked, as you can imagine.

He went to his non-Boston-based medical practice, and he was told …

Heart catheterization worries that every cardiologist face

John Mandrola, MD

Physician

June 18, 2010

Malpractice and heart catheterization have been in the news recently.

A spicy concoction for sure. An epidemiological study published in an online subsidiary of Circulation addresses the role of three major medical issues facing cardiologists today: malpractice, heart catheterization, and medical costs.

It is hard to get more controversial.

Heart catheterization, the invasive assessment of the coronary artery lumen, has always been a hot-potato topic. The “percent-normal” was the buzz word when I …

Measles from rejecting vaccines, and the price society pays

Amy Tuteur, MD

Physician

June 17, 2010

Vaccine rejectionism is based on a profound lack of knowledge about immunology, statistics and science. Virtually every single empirical claim of vaccine rejectionism is factually false, but parents who lack even the most basic understanding of immunology are often incapable of evaluating those empirical claims.

Indeed, those parents most likely to proclaim themselves “educated” on the topic are generally the most ignorant.

A new paper on a recent measles outbreak, Measles Outbreak …

Physicians need to focus on wellness to prevent burnout

Aldebra Schroll, MD

Physician

June 16, 2010

I recently received a bulletin from one of the medical societies to which I belong: the topic was on promoting physician wellness.

My first reaction, “It’s about time “. Historically physicians have struggled with multiple health impacts from the demands of their work, with higher rates of depression, anxiety and suicide than in the general population. Physicians train under circumstances of extreme stress often resulting in unhealthy coping strategies; strategies frequently …

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