Physicians writing on KevinMD about hospital practice: employment by health systems and corporate owners, hospital closures after debt-financed acquisition, productivity quotas, the electronic record as hospitalists live with it, from alert fatigue to copy-and-paste, the errors hospitals count and physicians remember, and the nurses physicians work beside. Four maintained records draw on this archive: Private equity and corporate medicine: what physicians say, in their own words, The electronic health record: what physicians say, in their own words, Medical errors: what physicians say, in their own words, and Nursing: what nurses and physicians say, in their own words.
Every doctor and doctor-in-training has a particular thing that drew them toward a career in medicine. Whether it is an interest in science, a passion for service and helping others, a family role model, or a combination of the above, there are many ways to spark interest in the field. From my own experiences and conversations, I’ve found that finding inspiration to enter a career in medicine is rarely a …
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The tension between learning and the illness of others
My first job after residency was in a small mill town in central Maine. I joined two fifty something family doctors, one of whom was the son of the former town doctor. I felt like I was Dr. Kiley on Marcus Welby, MD. I didn’t have a motorcycle, but I did have a snazzy SAAB 900.
Will was a John Deere man, wore a flannel shirt and listened to A Prairie Home …
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Despite the talk about team-based care, physicians today are isolated
Dr. Hasan Shanawani was overcome by frustration. So, last week he picked up his cellphone and began sharing on Twitter his family’s enraging experiences with the U.S. health care system.
It was an act of defiance — and desperation. Like millions of people who are sick or old and the families who care for them, this physician was disheartened by the health care system’s complexity and its all-too-frequent absence of caring …
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A physician family’s enraging experiences with the U.S. health care system
Many organizations solicit private donations from benefactors and philanthropists. Is there a stadium in the country that does not bear the name of a prominent donor? There are also anonymous donors who are not cursed with egos that require their names to be emblazoned in giant font on a building’s façade. But, most donors want recognition which is often used as an incentive when soliciting the donation.
Donors understandably receive perks …
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The problem of physicians and nurses connecting patients with hospital fundraisers
The residency interview trail quickly becomes a lonesome journey, so when I was on it this winter, I’d usually have the hotel room television turned on for some background noise and often find myself watching ESPN’s SportsCenter. On my last interview in Philadelphia, the show was featuring the high flying phenom Zion Williamson, who’s set to be drafted this year to the NBA. When I finally returned to home in …
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The sigh of relief on Match Day quickly changed into a sobering reality
If you’re done with your residency or fellowship, you’ve paid your dues. And I am excited for you. Life is about to get better. A lot better.
If you read my prior article about going unmatched, you know that things have not always gone smoothly for me. But now, after a reasonably good first year out of training, I feel compelled to reflect on why things are going well, and also—to offer any …
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10 tips for success after you finish residency
A piece of advice I would give to any younger physician, especially one who is just graduating residency, would be to expect a whirlwind ride into the realities of frontline medical practice. It’s something that you are totally not prepared for in the controlled environment of education and residency training. A steep learning curve awaits you once you start practicing medicine. And one of the biggest things you will have …
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Physicians: Do not be intimidated by administrators
I received an email from our hospital accreditation coordinator/quality coordinator in a manner that wasn’t clear if it was directed to me personally or if it was sent to the entire medical staff. It said that she was reviewing the Joint Commission’s recent survey which found that the charts did a poor job of reflecting the patient’s “code status.” The institution only received a 40 percent rating.
Some patients were listed …
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Don’t ask caregivers to be data entry clerks for the Joint Commission
“I want to see the doctor. Not you. I don’t like your kind. I want to see a white doctor, a man,” a patient gasping for air in an emergency room says to the dark-skinned resident assessing her vitals.
“Speak slowly, I don’t understand you people,” a male patient says as an ethnic attending discusses a complicated procedure to obtain consent.
“Are you sure you are old enough to be a doctor?” …
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Discrimination against doctors is costing us
We’re all gonna die.
It’s a simple truth that an astounding number of people neglect to acknowledge or accept. Some people die sudden, unexpected deaths, but most eventually fall victim to chronic or terminal conditions like COPD, heart failure or cancer. As a palliative care physician, I often meet patients who have had conversations with their families about their end of life wishes and have completed supporting legal documents.
While I appreciate …
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How to have an exciting death: 5 tips from a palliative care physician
As July draws near, it is a moving day in medicine. For physicians, it signifies entering the next level of professional growth.
Let’s think about what moving entails. When we move from one physical location to the next, like into a new apartment or from one city, state, or country to another one, there is the process of sorting through our belongings. We make two lists: what stays and moves with …
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Packing for the next level of your medical career
Nearly half a million individuals with opioid use disorders are hospitalized each year in the United States. While they are in the hospital, medical providers often treat complications of this disorder, such as bloodstream infections, but rarely directly address their addiction. That’s like pumping up a flat tire without ever looking for the nail that caused …
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How hospitals can help with the opioid epidemic
To my residency class:
The clock is ticking, its hands spinning around its face faster and faster until I feel dizzy and disoriented. The remainder of the academic year can be measured in days, even hours for some. The carousel is slowing down to let some off, some on. Some, like me, will remain in the saddles of their brightly painted ponies. The cheerful calliope melody becomes distorted with the change …
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Words of wisdom to a residency’s graduating class
A patient groans in agony lying atop a rigid spine board, carried by paramedics into the ER, his neck in a protective collar. The paramedics shout a summary of the accident. Monitors are attached to the man, flashing and beeping the cadence of vital signs. Nurses and physicians swarm. Gloved hands comb through brown hair for bumps or lacerations. They remove his clothes, feeling for pulses in the neck and …
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Fasting for Ramadan and being the on-call orthopedic trauma resident
It is honorable to fight a battle in the face of an inevitable ending while not knowing when that end may come.
First day of third year — the year most medical students take a sigh of relief as they put their Step 1 book on the shelf and prepare to face the wards:
I happened to draw the short straw by having my surgical rotation first, one that often brings an …
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A medical student’s reflection of “firsts”
As President Donald Trump was fighting with Congress over the shutdown and funding for a border wall, his administration implemented a new rule that could be a game changer for health care.
Now, hospitals must publicly reveal the contents of their master price lists — called “chargemasters” — online. These are the prices that most patients never notice because their insurers negotiate them down or they appear buried as line …
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A new rule that could be a game changer for health care
As I listened to my attending explain how during her residency training she was on call every third night, I realized how the definition of “call” had significantly changed since that time. For her, it meant her shift started at 6 a.m. and ended at 8 p.m. the next day, totaling the shift to upwards of 36 hours. My call, on the other hand, was a mere 6 a.m. to …
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Should we change resident duty hours?
Halfway into my four-week hematology consults elective at the county hospital during my fourth year of medical school, I was surprised that one of my patients was a 25-year-old woman from Romania — exactly my age. This was highly unusual, as most of the patients I had seen on this service were not this young, especially with a malignancy.
What was even more unique was that she had just arrived from …
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The importance of being there for your patients
In my third year of medical school, I started a rotation at the nearby VA hospital. Walking toward the polished glass doors that morning, I saw my reflection — clean white coat, assured expression to cover up how lost I felt. It was my second clinical rotation ever, and my first time at the VA.
I found my team and soon met a patient I’d be seeing for the next month. …
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Everyone has value. Even the angry man screaming at you.
