There are 168 hours in a week and 8,736 hours in a year. There are 10,080 minutes in a week, and 524,160 minutes in a year. Residents and fellows working in an academic environment often work close to, if not in large part, more than 80 hours a week, or 4,160 hours a year. They work 4,800 minutes a week, and a staggering 249,600 minutes a year. In medicine, it’s …
Where has the loyalty in medicine gone?
As I begin my overnight pediatric emergency department shift, there is one patient waiting to be seen: a six-year-old male with autism who is alleged to have experienced sexual assault. In my first year of pediatrics residency, I haven’t yet managed a sexual assault case, but it’s time for me to learn. I sign up to see the patient and move to find them in the sub-waiting room.
As I round …
A difficult situation a resident faced in the emergency department
Altruism is killing us. Take a second to let that sink in. Truly think about it. Resist your conditioning to refute this claim and try to apply it to your life. Still having trouble? Let me try to explain.
In order to understand the truly destructive force of altruism on medicine, one must first define altruism. This can be difficult to do in the United States as any “good” or “charitable” …
Recently, I entered an essay contest on advice you would give to future medical students. I sincerely believe that the best person to write an article offering advice to younger medical students should come from a person who didn’t match. Also known as me. Why, you say? Well, for everyone else, Match Day is a culmination of four years of mentally, physically, and emotionally taxing work. They might even forget …
Medical students: You are more than your grades
As a medical student, every eight weeks I rotate through a new specialty in a new hospital or health service. This means every eight weeks, I flick over to a new chapter in my textbook, learn a new set of medical lingo, meet a new team of doctors and a new cohort of patients. As a person of color, however, this translates to something far more challenging yet predictable. It …
Fight systemic racism in medicine
I’m writing this piece because I’m finally at the point that I am truly angry. I am angry at how physicians have become devalued in modern health care. I’m angry at how systems of care have participated in this by replacing physicians with lesser trained mid-level practitioners. I’m angry at how our title “doctor” has been hijacked to allow patients to be misled or, in many cases, deceived.
It wasn’t that …
Physicians have become devalued in modern health care
I log onto KevinMD every day to get my much-needed dose of physician commiseration. At least once a day, one of us writes an article about burnout. It typically leaves me feeling quite validated. I particularly enjoy reading the comments section, as many of you make me laugh with your physician reality-based humor.
I am more burned out than I ever hoped to be. I work in primary care, have a …
This burned out physician was happier as a resident
The hardest thing about medical school isn’t learning medicine. It isn’t the hours. It isn’t the tests. It’s that you sign away control over years of your adult life.
When I started my clerkship year in January, I felt like I was stepping onto a conveyor belt and would not be allowed off for twelve long months. For the entirety of 2018, my days are planned for me, my hours are …
To change the culture, start with clinical education
I am a resident in a fancy hospital in New York. We focus a lot on value-based care, and technological innovations, and high reliability. This year, we are opening a multimillion-dollar new facility for specialty medical services. Our outdoor spaces have stone lions and grassy promenades. Our cafe serves world-class food.
Today, during a beautiful new spring morning, I watched my colleagues sit, in disbelief and despair, crying with each other …
Medicine suffers from a culture of silence
Prospective physicians in the United States must undergo a gauntlet of resume-building tasks, in the end, to have little control over their career, and for some, their love life.
We just underwent Match Day, the brain-child of Alvin Roth and Lloyd Shapley who won a Nobel Prize for this accomplishment in 2012. The U.S. has been utilizing this tool since 1952, which was an improvement over the previous disorganization, which resulted …
The medical education system hates families
“The ones you leave behind …”
That phrase often connotes loved ones who have lost a family member, friend or colleague through death.
I have thought of the same phrase often lately in a different context — one of increasing prevalence.
Here, I refer to the patients and colleagues left behind by the loss of a primary physician.
No one would begrudge the retirement of a physician who has served his or her patients …
When you leave primary care, you leave people behind
When did patient satisfaction become more important than appropriate medical care? Medicine has been turned into a service with bonuses related to the patient’s satisfaction score. There is a complete disregard for the appropriate medical care if the patient is dissatisfied with what they’re told. Doctors are so afraid of losing satisfaction scores and getting sued that inappropriate medical care has become the norm. The opioid epidemic is just one …
Online ratings have me scared for the future of medicine
I’m about two-thirds of the way through my 3rd year of medical school, and I have hit my wall. I have become so fed up with the set up of medical school. I think a decent amount of this comes from the fact I am on my 6th week of an eight-week surgery clerkship (an area of medicine that I literally have zero interest in). I’m tired of waking up …
Is apathy needed to survive medical school?
She could have been my charming tiny kindergarten teacher, sitting there nonchalantly in her wheelchair with neatly folded arms in her lap. The delicate, airy cloud of silvery blonde hair on her head resembled Queen Elizabeth’s style. I named her Ms. Elizabeth. A few moments ago, though, she looked like a young child who could not comprehend the meaning of her condition. Whenever she was spoken to, her mind seemed …
There’s more to the story of the fired patient
I work as a pediatrician in a bustling metropolis, in an outpatient setting of a world-renowned academic center. One of those non-profit hospitals you see in television ads. For the last three years, our outpatient encounters have plummeted, and the mothership has put all efforts into recuperating financial losses. Meanwhile, our office phones are ringing off the hook, and we cannot seem to hire enough nursing staff to deal with …
Dear Mom and Dad: Are you calling your pediatrician’s office too often?
As a private practice specialist in an affluent metropolitan area, I am often inundated with requests for consultation by local residents and primary physicians. That’s fine — it’s what I do, and it’s what I enjoy doing. Hey, it pays the bills, and I won’t complain about that.
Concierge medicine has taken a foothold locally, and this means more referrals directly from doctors who insist we take care of their patients …
Concierge medicine sucks for specialists. Here’s why.
It is December 2017. I have been on the road for the last five months, completing my five months of elective rotations. I am a fourth-year medical student aspiring to specialize in family medicine. I also want to learn procedures, so I did two months of surgery, three months of family practice electives. At the beginning of this process, I had wanted to be a general surgeon, but I ended …
Please change the culture of surgery
Even though we have probably 20 years of work remaining as physicians, like a lot of you, I like to think about how we will spend our retirement years. After all, in twenty years we will still only be in our early fifties, hopefully with no dependents and a lot of financial security. Of course, my wife and I are interested in traveling, spending time with grandchildren (hopefully), gardening and …
Do physicians make the best politicians?
Let’s talk about the cycle of abuse. No, I am not referring to the very serious issue of domestic violence. Instead, I am talking about the graduate medical education system. No one is a resident forever: the duration of each residency is predetermined with a wide range of three to nine years. The self-limited nature of this experience decreases the incentive for participants to advocate for changes. And the attitude …
End the resident physician abuse now
I am an Olympian. I am a retired All-American student-athlete. I am a resident. I am burned out.
Let me be clear: I love medicine and the opportunity to have privileged relationships with patients and their families. I thrive on the fast-paced environment, growing to-do lists, and the chance to work in a field with endless learning. I love working in team environments to provide optimal care for patients and their …
This physician is burned out. But not for the reason you think.
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