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.

Why it’s important to brand your medical practice

Physician
December 7, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

You might be thinking, “Why should I consider branding or marketing?” And your reasoning might go something like this:

1. As a doctor, I already have a powerful, built-in identity;
2. My practice is full;
3. Even if my practice isn’t full, Congress is in the process of putting 40 million more insured people into the available patient pool over the next few years.

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Why it’s important to brand your medical practice

The joys of practicing rural emergency medicine

Physician
November 25, 2009

I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.” It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest. The natural beauty is breathtaking. Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some …

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The joys of practicing rural emergency medicine

Baby boomers don’t receive enough preventive health

Physician
November 25, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Only a quarter of baby boomers take advantage of preventive services such as flu vaccines and cancer screenings, a new report from the government and two powerful interest groups says.

At the same time, states are falling behind goals to increase certain screenings and reduce unhealthy behaviors, according to the …

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Baby boomers don’t receive enough preventive health

Op-ed: Humor can be healing for both doctors and patients

Physician
November 21, 2009

A version of this op-ed, co-written with Doug Farrago, was published on October 26th, 2009 in Medscape.

It’s tough to be a doctor these days. Whether it’s listening to the difficulties of our medical colleagues as they try to best care for their patients, or engaging other health professionals about the uncertainties surrounding health reform, we’ve noticed a tense, sometimes gloomy, atmosphere among physicians.

A recent survey from the Annals of Internal …

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Op-ed: Humor can be healing for both doctors and patients

How a personal injury lawyer views the medical malpractice system

Physician
November 18, 2009

Personal injury lawyer Eric Turkewitz responds to my recent USA Today piece on fixing the medical malpractice system.

In a USA Today op-ed, Kevin Pho tackles the medical malpractice liability system. Some stuff I agree with, but suggestions regarding improvement of the current system are unlikely to work.

Kevin correctly states that malpractice legal fights often go on for years. In New York, it could easily take three years to get …

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How a personal injury lawyer views the medical malpractice system

How teamwork is essential in the emergency department

Physician
November 12, 2009

I recently cared for a patient who raised my heart-rate a bit. Of course, any emergency physician will tell you, the potentially difficult and complicated cases often come at the end of the shift, as you’re trying to clean up all of the paperwork and ‘head for the house.’ Nurse Ginger came to me and said, ‘we need a doctor in room 11.’ I snarled, snatched the paper, grumped and …

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How teamwork is essential in the emergency department

Op-ed: Injured patients deserve medical malpractice reform

Physician
November 7, 2009

A version of this op-ed was published on October 26th, 2009 in the USA Today.

President Obama has acknowledged that changes in the medical malpractice system must be considered with other health reforms, and recently ordered that pilot projects to improve the way we compensate injured patients be implemented.

Reforming medical liability has historically been a source of major contention. Physicians argue that the system is expensive, promotes multi-million dollar awards …

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Op-ed: Injured patients deserve medical malpractice reform

Diagnosing and treating disease is only a small part of a doctor’s job

Physician
November 4, 2009

If asked what a doctor does, most people would probably come up with the standard description of diagnosing and treating disease, usually while wearing an ill-fitting white coat. Before I entered practice, even during my medical training that probably would have been my answer too.

But my years in the trenches of real medicine have altered that definition greatly. I do spend time doing the things I learned in medical school …

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Diagnosing and treating disease is only a small part of a doctor’s job

Does the tort-based medical malpractice system improve patient care?

Physician
November 2, 2009

by Michael Kirsch, MD

Physicians and plaintiff attorneys have philosophically divergent views on our tort system. I know the attorneys’ views on this issue well. There are lawyers in my family who have prosecuted physicians for alleged medical malpractice. Sometimes, there hasn’t been enough antacids in our house to douse my flaming heartburn after some of our discussions.

Obviously, one reason that lawyers support the current system is because it enriches them. …

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Does the tort-based medical malpractice system improve patient care?

Who’s most likely to spread infection in the hospital?

Physician
November 2, 2009

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Good hand hygiene among healthcare workers is an important factor in preventing the spread of disease, but exactly how important depends on an individual’s job, researchers said.

In a mathematical model, so-called “peripatetic” workers — such as therapists or radiologists — were most likely to spread pathogens if they …

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Who’s most likely to spread infection in the hospital?

ACP: How to fix the primary care problem in health care

Physician
October 29, 2009

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

Many would argue that lack of universal coverage is the primary problem with health care in the United States, accompanied by the logistical and financial difficulties of obtaining coverage for someone with a pre-existing medical condition. Others would argue …

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ACP: How to fix the primary care problem in health care

An obsession with making money can be a sign of physician burnout

Physician
October 29, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

Physician burnout has a tremendous effect on the financial bottom line and is far more common than docs want to talk about.

When I say the bottom line, I am referencing studies that have been done on “workaholics,” another softly defined term, that show in spite of increased hours and apparently focused activity, productivity in …

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An obsession with making money can be a sign of physician burnout

The high cost of hiring, and firing, a doctor

Physician
October 26, 2009

Originally published in HCPLive.com

by Jeff Brown, MD

One area we need to look at is the surprisingly high costs of hiring and firing people who work with us. And as always, I rebuke our training programs for their ostrich-like attitudes, ignoring how important managerial and organizational competence is to the quality of medicine that we practice.

We know that recruiting a …

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The high cost of hiring, and firing, a doctor

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How the patient-centered medical home can improve our health care system

Physician
October 17, 2009

Dr. Paul Grundy is on a mission — a mission to promote the patient-centered medical home model that he has been instrumental in developing and rolling out, in his dual role as Director of Healthcare, Technology and Strategic initiatives for IBM Global Wellbeing Services and Health Benefits, and President of the Patient-Centered Primary Care Collaborative.

I had the opportunity to speak with him last month (here’s the transcript and …

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How the patient-centered medical home can improve our health care system

Do HMOs drive blacks to the emergency room?

Physician
October 13, 2009

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Many African-Americans in California enrolled in health maintenance organizations (HMOs) appear to prefer getting medical treatment in emergency rooms, researchers said.

One-quarter of African-Americans enrolled in Kaiser Permanente or other commercial HMOs in California, who would therefore have a range of treatment options, sought treatment in emergency rooms in 2007, …

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Do HMOs drive blacks to the emergency room?

Why rapid viral testing for kids with URIs may not help in the ER

Physician
October 12, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Rapid viral diagnostic testing did not reduce the burden of treating children with respiratory symptoms and fever in the emergency department, according to a Cochrane Review meta-analysis.

Pooling the results of four trials, researchers found a significant reduction in the use of chest radiography (RR 0.77, 95% CI 0.65 to …

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Why rapid viral testing for kids with URIs may not help in the ER

Should doctors be paid to e-mail their patients?

Physician
October 11, 2009

by Michael Kirsch, MD

This is a less controversial issue than patients ‘friending’ their doctors on Facebook, which I oppose. Although most physicians’ offices are not e-mailing with patients, perhaps they should. There are several obvious advantages.

* Decompress phone lines, which are suffocating nearly every medical practice in America.

* Relieve patients of the cruel and unusual punishment of languishing on ‘hold’ listening to elevator music or dead air.

* Allow office staff …

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Should doctors be paid to e-mail their patients?

Will more primary care doctors keep patients out of the ER?

Physician
October 9, 2009

One of the many questions asked in the health-care reform debate is ‘how do we keep people out of emergency departments in order to reduce costs?’ Simply put, we probably can’t. And 16 years into my emergency medicine practice, I think I know why.

Having taken my own children to the emergency department, even I have been surprised at the charges generated. But we should step back and remember that emergency …

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Will more primary care doctors keep patients out of the ER?

Does the bulk of excessive medical care happen in the ER?

Physician
September 25, 2009

by Michael Kirsch, MD

The concept of medical excess is very difficult for ordinary patients to grasp. The medical community has worked hard for decades teaching them that more medicine meant better medical care. The public has learned these lessons well. Physicians who sent their patients for various diagnostic tests or specialty consultations were regarded as conscientious and thorough. Patients approved of doctors who prescribed antibiotics regularly for colds and other …

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Does the bulk of excessive medical care happen in the ER?

How hospitals should deal with disruptive physician behavior

Physician
September 20, 2009

by Mark N. Simon, MD

What can hospital medical staff leaders learn from University of Oregon football coach Chip Kelly? In the morning of September 4th, Kelly had an opportunity to review video tape from the conclusion of his team’s game with Boise State University the night before. What he saw was his senior running back LeGarrette Blount punch an opponent and then lose his cool with the fans …

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How hospitals should deal with disruptive physician behavior

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