It’s 8:00 p.m., and it’s hour 14 in my 28-hour call shift at the large suburban hospital where I’m an intern.
You demand to speak with a doctor now, right now. You cannot wait. Your mother is sick, and you want to know exactly what is going on.
It doesn’t matter that we already spoke at length by phone earlier this afternoon. It doesn’t matter that it’s 8:00 p.m. It doesn’t matter …
I’m not your nurse. I’m your doctor.
Medicine has created a culture where public embarrassment, bullying, and passive-aggression have become pedagogy. How can we seek to care for others, when we treat our own so cruelly?
I recently met Angie (name changed), a young university student who had entered the clinical years of medical school. Like many, she was introduced to medicine as a naive, excited teen immediately out of high school — a high achiever with the …
Why do doctors treat their own so cruelly?
Not knowing what else to do after finishing my pediatric residency 15 years ago, I became a general pediatrician. Not knowing how to find a job halfway across the country and closer to home, I relied on a recruiter from a smallish town in South Dakota to woo me into private practice. Not knowing how to choose my future partners, I let them choose me.
Despite my unbelievably naive approach to …
This physician is a better hospitalist because of the time she spent in the clinic
A vivid memory stands out from my career.
Driving home from the hospital at 3 a.m., I reflected upon my most recent patient’s middle of the night delivery. It wasn’t an easy delivery, as they often aren’t. However, in the end, we had a healthy mom and baby and the family couldn’t have been happier — nor could I.
I felt a sense of gratitude as I was driving in the darkness …
How physicians’ grit is being taken advantage of
Healers, scientists, leaders — these are all terms that we equate with being a physician. As we spend our years if not decades in training, we strive to become all of these components. But when you miss something — the small details, the nuances of a history and these are the clues that could lead to healing it can be disheartening. When it comes to your own family member, such …
My brother, a physician, died. Could I have done more?
The glorious season is upon us. Yes, it is finally autumn. But it is also the season of ERAS with all of its letters of recommendation, USMLE scores, medical school transcripts, and personal statements.
I have dutifully reviewed dozens of applicants whose last names begin with the letters “T” through “Z.” I have noted the test scores and grades. I have considered the caliber of medical school and whether the LORs …
5 tips to medical resident success
A guest column by the American College of Physicians, exclusive to KevinMD.com.
It can be as blatant as a public argument between a hospitalist and emergency medicine physician about whether a patient requires admission. But most commonly it is more nuanced and subtle. Such as members of one speciality “bad-mouthing” another or a subspecialist criticizing …
When doctors behave badly: a call for civility
It’s my first day at a new facility — and I’m prepped with food, snacks and a closed-lid container for my morning coffee and to refill it in the afternoon with water. You never really know how stringent the policies will be for water containers at your new workstation or whether food or snacks are allowed. You might even be lucky enough to get a surprise Joint Commission inspection, or …
The issues physicians face when changing their name
About two years ago, I made a big career move — I took a leap of faith. I left full-time clinical practice as a neonatologist to become a national medical director for a neonatal resource team. The job was appealing because it was a new challenge for me. I had the opportunity to use my skill set as a neonatologist while learning the business aspect of medicine.
The job also provided …
A physician takes a leap of faith
This past week was one of those weeks looming ahead of me that I was already dreading as I entered into it. I was to be working through another holiday and following a string of nights, and I would have a quick turnaround into a mid-shift. As a nocturnist by choice, I rarely work mornings or mid-shifts. I find the nights busy but also less intrusive — i.e., less administrative …
I’m thankful that medicine is a small world
“Education is not preparation for life; education is life itself.”
– John Dewey
I stood there in awe as I watched the trauma team leap into action as the patient was rolled into the trauma bay. “Crush injury,” they said. Vitals were terribly unstable, and the patient was decompensating quickly. The corner of the room shielded me somewhat from the organized chaos that ensued and also gave me a great vantage point …
How will you educate future doctors?
I’m proud to announce that I have partnered with Health eCareers to launch Careers by KevinMD.com: a new, dedicated career center ready to support your career at every stage.
Whether you’re ready to make the leap to a new job or just keeping your ear to the ground, there’s something here for every medical professional.
Here are some …
Welcome to your new career center!
When you or a loved one is sick or injured, health care decisions are fundamentally a matter of trust. You trust your physician will have the answers you need, because you know that, as a highly-trained medical professional, they’re qualified to make the best recommendation for each and every patient under their care.
Physicians receive some of the most rigorous education and training of any profession. They spend the better part …
The practice of medicine has experienced its own version of climate change
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I was walking in the store the other day and ran into a recently deceased elderly patient’s relative. As he walked by, I thought to myself, I better stop to say I am sorry. So I shouted to him, “Hey how are you?” He paused, and I continued to walk over and proceeded to offer my condolences. I stated “I am sorry about the death of your loved one. I …
Medical training can’t prepare us for the loss of patients
Ironically, the same electronic health records (EHRs) initially designed as a tool to help physicians diagnose diseases have largely evaded diagnostic scrutiny. Talk to physicians who utilize them on a daily basis, however, and it becomes abundantly clear that today’s EHRs are ailing. They are adding hours to the physicians’ workday, siphoning attention from patient care, and sowing the seeds of demoralization across the profession of medicine. To address this …
The impaired interactivity of EHRs
The surgical team filed out of the patient’s room. I looked over my shoulder to see a shaken daughter holding the wrinkled hand of her quiet, elderly mother who lay in the bed. I shuddered as I thought of the surgery her body would endure the next day. I knew I needed to return to her room later in the day to find out more about her history. After rounds …
Quality over quantity in life and care
I learn all manner of interesting things from the information sheets posted on the walls of the employee bathrooms at my hospital. I learn, for example, about upcoming CME offerings for advance practice providers, how many seconds one has to scrub the hub of a central line, and what the new process is when nurses need to call in sick. They call a specific phone number and state that they …
Why doctors can’t take sick days
Both in and outside of health care certain buzz words and phrases become so ubiquitously used that a shared understanding is assumed despite conflicting perceptions of what these sentiments actually mean. Examples in health care include: shared decision making, quality of life, professionalism, patient-centered care, and evidence-based. Each sounds positive and intuitive — what health care provider perceives her/himself as not professional and patient-centered or not providing shared, evidence-based, quality …
The hazard of the health care common is communication
My patient
The day I met you was early in my second year of internal medicine residency. After much of my internship had been spent on arduous inpatient rotations, I was finally ready to lead my own team of young doctors and students on a high-acuity wards service. Yet, in my continuity clinic, I was still fresh, insecure, and naive. The day I met you, your abdomen was swollen, your eyes …
Primary care uniquely positions us to be our patients’ best allies
When I’m working in a hospital setting as a physician, part of my everyday job duties involves going over consent forms with patients. I am of course a medical physician, rather than a surgeon, so generally don’t have to go over them as often. But I do have to take consent regularly for certain interventions including blood transfusions and minor procedures. The process of getting consent is something everybody is …
The trust patients place in their doctors
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