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.
Medicine is a calling. And almost all of us went into this profession for altruistic reasons. Unfortunately, it’s no secret that the health care landscape has changed dramatically over the last couple of decades, and practicing medicine is undoubtedly getting more difficult for most doctors.
Fortunately, I’ve found myself in a better place than most. But after hearing feedback from physicians at various stages of their career, there are a number …
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3 signs that you’re ready to leave your job
“There was porn in the call room the first night I slept there.”
The call room is the room where doctors sleep — if they have minutes to catch some sleep — when they are on call. When you’re the first female doctor to ever be on the service, apparently you might find porn in that room.
“I told the partners they could keep the porn if they’d let me paint the …
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3 things women doctors need to succeed
I remember the exact moment I realized the amazing power of women; that together, women can accomplish anything they put their minds to.
I grew up in a household of women. I had no brothers to compete with, and my parents always encouraged us to learn and develop leadership skills. However, even growing up in an encouraging environment, I still developed an unconscious bias. In school and in college, I often …
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The exact moment this doctor realized the amazing power of women
“We are what we repeatedly do. Excellence, then, is not an act but a habit.”
– Will Durrant, historian
For better or worse, all of my high school English teachers were memorable. Each held a precise but non-overlapping image of the perfectly crafted essay; therefore, every September I found myself adopting a brand new writing style. A paper that would have garnered an “A” at the end of one school year routinely received …
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A teacher’s calling never ends
First I noticed it all over my social media feed — the story of Alex Wubbels, a burn unit nurse at a university hospital in Utah who was arrested and manhandled by police for not allowing them to take a sample of blood from an unconscious patient without a warrant. Then came a slew of texts, emails, and calls from people wanting to discuss the incident, asking me …
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How Alex Wubbels reminded this nurse of her calling
Unless you’ve been living under a rock, you’re well aware that the United States is in the grip of a really big epidemic of opioid abuse. The epicenter of much of this has been my beloved Appalachia. My home-town, Huntington, WV, might as well be re-named “Oxycontin,” or maybe “Heroinville.” It’s ugly.
Enormous amounts of ink have been spilled on this topic, and …
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How the pain scale and patient satisfaction leads to death
It was my childhood dream to become an airline pilot. We lived near Heathrow airport in London, and I was a diligent plane spotter (please save the jokes). I had a book when I was nine years old that listed all civil aviation registrations, and I would mark them off as I spotted different planes through my binoculars, coming into land at the world’s busiest international airport. My flying memories …
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Health care is ultimately about our patients. That must remain our focus.
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 58-year-old man is evaluated in follow-up for hepatitis C-related cirrhosis that is complicated by nonbleeding small esophageal varices and ascites. His ascites has recently worsened and has required large-volume paracentesis three times per month. He has been on a low-salt diet, spironolactone, and furosemide.
On physical examination, temperature is 36.8 °C (98.2 …
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MKSAP: 58-year-old man with hepatitis C-related cirrhosis
More than one million women experience pregnancy or infant loss every year in the U.S., yet many stay silent about their experiences. What if we were brave enough to break the silence? Empowered to declare, “My baby existed and mattered?”
In 2011, I was a newly-minted pediatrician and finally living the life I dreamed of after so many years of hard work. My husband and I announced my …
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The worst moment of my life shaped me into the person I am today
It’s 3 a.m., and I’m wide awake. I’m giddy with excitement and scared. I am 41 years old and tomorrow feels like the first day of school all over again. Only it isn’t. Tomorrow is my first day back at the hospital where I work as a surgeon. Tomorrow is also my first day back at work after chemotherapy.
Two months ago, I was diagnosed with breast cancer. I underwent bilateral …
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Please don’t tell me how brave I am
I was surprised when I felt my body stiffen as I became aware that an iPhone had just been fiercely thrown in my direction. “I’m calling security,” shouted a distant voice in the background.
“I want the 10 mg oxycodone pills! I am in 10/10 pain!” The patient shouted this to me as he abruptly got up, violently launched his phone in my direction and stomped toward the exit of the …
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The moment this physician realized she hated the pain scale
The ice storm of 2013 in Atlanta, Georgia made headlines for weeks described as “snowpocalypse” and “snowmageddon.” It looked like something from a sci-fi movie — the end of the world, an alien invasion. It was the subject of social media memes and discourse for quite some time. In the midst of all that human frustration, there were ice-trapped cars, parents who struggled to reach children trapped at elementary schools.
Physicians, …
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5 ways doctors can cope when natural disaster strikes
I enter the corridor of my new workplace. I’m welcomed and introduced all around. For some reason, best known to her, the human resource lady took so much of my time that I am already pissed and looking angry. I don’t feel comfortable in this different setup, and I miss my old workplace. Every single thing about it, which previously used to get on my nerves, I miss.
However, I succumb …
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A new workplace brings a new perspective
Albert Einstein once said, “The important thing is not to stop questioning. Curiosity has its own reason for existing.”
No matter how advanced our artificial intelligence is and continues to evolve, it lacks the reproducibility of the powerful human instinct, sense of curiosity and constant questioning; especially when resulting in that “wow” moment of important scientific discoveries. Were it not for these powerful traits, medical science could not have evolved to …
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Don’t let guidelines guide your curiosity
How do I tell you who I am in a couple of paragraphs?
Well, I was born in 1955, so that makes me 61 years old. My namesake is probably movie star and America’s sweetheart Debbie Reynolds.
My maternal grandfather was straight from Italy; my paternal grandfather was straight from Ireland. Both crossed the Atlantic and landed on Ellis Island in New York Harbor. It was the promised land.
So, that means I …
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A nurse shares who she really is
I was recently at a meeting where some very influential physicians were discussing a question that I’ve been thinking about for a while: how do we find medical staff for rural emergency rooms and hospitals? It’s a tough question, because, increasingly, it seems that young physicians are trained to work in urban hospitals. Those are also the places these young doctors prefer to practice. Big hospitals and teaching centers in …
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How can we solve the rural clinician shortage?
I have spent the last year doing a deep dive into my personal leadership style. I’ve done this for self-improvement and because some great leaders and mentors have challenged me to take a look at my skills. I’ve read countless blogs and books on leadership, specifically women leaders, and how they have succeeded at the helm.
There are a million different things books will tell you to be if you want …
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This is the key to becoming a great leader
When a drug is especially dangerous, or even potentially-maybe-especially dangerous, the FDA requires manufacturers to put a black box warning on the product insert. A black box warning is supposed to very explicitly say “buyer beware,” more than just the typical list of potential side effects mumbled by Mr. TalkFast at the end of a drug ad. It’s easy to ignore the wordy mumbling. The black box: That’s supposed to …
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Do physician rating sites deserve a black box warning?
