Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Physician Suicide Letters — Answered and Pet Goats and Pap Smears. Watch her TEDx talk, How to Get Naked with Your Doctor. She hosts the physician retreat, Live Your Dream, to help her colleagues heal from grief and reclaim their lives and careers.
Illustration by Jorge Muniz, PA-C.
We enter medicine with our hearts and souls on fire ready to serve humanity. By the time we complete medical training many of us have anxiety, PTSD, depression — even suicidal thoughts. Why? Medicine is stressful. Many of us work 100-hour weeks surrounded by suffering and death. We may deliver a stillborn, try to save a teenager with a …
Dear Dr. Wible,
Thank you for the work that you do. I have been following your push for humane medical education for several months now. I finally decided to contact you after reading your article about how “burnout” is actually abuse. I am a med student entering my third year. I have been consistently hearing horror stories from other students about the …
Meet Dr. Svetlana Kleyman, a powerhouse chief surgery resident with a heart of gold, who works 16-hour days and runs marathons in her free time. Just 18 months before she was to graduate from SUNY Downstate, she developed a spinal infection that left her paralyzed from the waist down. After months of rehab, she was cleared by her doctors to resume work …
Hi Pamela,
I’m a medical student in the UK. Though I’ve only been in med school since September, it has already taken its toll on me. Before I started, I was so in touch with my emotions, spirituality, and nature. Now I feel so empty and desensitized. I hate that when faced with the horrible circumstances of another person, I just don’t feel …
Pamela Wible, M.D., takes on physician suicide in her TEDMED talk (delivered on November 18, 2015). Learn more about Dr. Wible and her talk at TEDMED.com. Full transcription below:
I love the three things that people fear the most: death, disease, and public speaking. Here’s how it all started. At four, I was so talkative (and bossy) no babysitter would stay with me. So I tagged along with Mom, …
Step 1: Greet patient.
Step 2: While chatting, check all boxes in electronic medical record for a complete review of systems and physical exam. Copy and paste parts of previous chart note while looking at patient every once in a while. Smile if possible.
Step 3: Tell patient to do yoga.
Step 4: Bill insurance company for complete physical exam.
Welcome to big box assembly line medicine.
Ever wonder what …
Dear Pamela,
Question for you in regards to disclosure about mental illness. In every job that I have applied for, as part of the credentialing process, there are questions about felonies, treatment for drug/alcohol abuse and mental illness. Why are mental health questions still allowed to be on there? I have had postpartum anxiety/depression three times now, and I feel like it is …
An excerpt from Physician Suicide Letters — Answered.
When is a taboo topic no longer taboo? When is it OK to stop hiding behind euphemisms? When is it safe to tell the truth? The answer is now.
This week I uploaded 53 chapters of physician suicide letters in a Read more…
Please stop using the word burnout. You are not burned out. You’ve been abused. Let’s get the diagnosis right.
We enter medicine as inspired, intelligent, compassionate humanitarians. Soon we’re cynical and exhausted. How did all these totally amazing and high-functioning people get so f’d up so fast? Attention medical students and doctors: It’s not your fault.
Burnout is physical and mental collapse caused by overwork.
So why …
Christine Sinsky, MD, from the American Medical Association interviews Pamela Wible, MD, after her TEDMED talk. Watch periscope video here. Fully transcribed below:
Dr. Sinsky: This afternoon we’re here in Palm Springs, and I’m delighted to be here with Dr. Pamela Wible, who gave a terrific TED talk last night. I’m Dr. Christine Sinsky, the vice president of professional satisfaction at the …
How do we care for the people who care for us? As doctors, we’re immersed in pain and suffering — as a career. We cry when our patients die. We feel grief anxiety, depression — even suicidal — all occupational hazards of our profession.
A recent Medscape article on physician health programs suggests the people who are here to help us may actually be doing more harm than good. …
Physician burnout is the latest trend among doctors. There are books, workshops, even special breathing exercises for physician burnout. Suddenly every other doctor I meet has burnout. And half of all med students have burnout before they graduate. WTF.
We enter medicine as inspired, intelligent, compassionate humanitarians. Soon we’re cynical and exhausted. How did all these amazing people get so screwed up …
I was a physician employee, many times for many hospitals and clinics. I’d stay a year or two, but eventually I’d quit. Then, in 2005, I opened an ideal clinic designed by my patients. Ten years later, I still love private practice. Why? I’m finally practicing medicine the way I had always imagined.
When I decided to open a private practice, I was …
Medical school graduation: Time to celebrate our brand new doctors!
Except for the families who can’t celebrate their child’s graduation. Or their child’s marriage. Or their child’s birthday — ever again.
Like Michele and John Dietl.
They lost their son, Kevin (pictured above), just weeks before graduation. Now they cling to online condolences and family photos. And to the never-ending question: Why?
I’ve become a sideline specialist …
I’m a physician entrepreneur. In 1998, I opened my first clinic. My malpractice: $500 per year. Then I tried life as an employed physician. Hated it. So in 2005, I opened my ideal clinic. Best. Job. Ever. My malpractice: $1,230 per year. Want low premiums? Here’s how I did it.
A quick tutorial. New malpractice policies mature over five years. So the first …
It’s July 4th! All across the country, Americans are celebrating freedom, liberty, and the pursuit of happiness. Families and friends are relishing potato salad, apple pie, barbecues and parades.
Is your doctor decked out in red, white, and blue enjoying fireworks from his yacht? Probably not.
Have you seen any medical students waving little flags? Unlikely.
The truth is American medicine has little to …
I recently delivered a keynote in St. Louis to 600 health care leaders from a health system with 20 hospitals, 600 clinics, and 30,000 employees. They told me not to be afraid of the 12-foot-tall version of myself following me around stage. No problem. I’m one of the few people who has never been frightened by public speaking. The larger the audience …
I’m a family physician in Eugene, Oregon — a sweet town where folks are pretty darn friendly. I still do house calls. Patients often surprise me with gifts. And nearly every appointment ends in a hug.
Kindness is contagious.
I like to return the favor. So every few weeks I celebrate “patient appreciation day.” I thank patients with balloons and chocolates. Why? For …
Here’s the latest medical fad: Physician resiliency training.
Huh?
Doctors are already the most resilient people on the planet.
Doctors can go days on call without eating. I know. I have.
Doctors can go 24 hours without a bathroom break. (Yes, we even have the most resilient bladders!)
Doctors can work 168-hour shifts with little or no sleep as detailed in this whistleblower …
Not all relationships work out.
My prescription: If a relationship isn’t working, end it. Now.
Recently an insurance plan told me they were sending a nurse to my office for a chart review that would take 3 hours. After 24 years of education, state licensure, board certification, and over 50 hours of continuing medical education each year, I’m not trusted to provide Pap …
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