Physicians writing on KevinMD about the primary care shortage, the fifteen-minute visit, panel size, what primary care is paid against procedural specialties, continuity, and the administrative load that has grown around the work. Four maintained records draw on this archive: Primary care: what physicians say, in their own words, Direct primary care: what physicians say, in their own words, Prior authorization: what physicians say, in their own words, and Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words.
U.S. physicians continue to struggle to maintain morale levels, adapt to changing delivery and payment models, and provide patients with reasonable access to care. This finding from our biennial physician survey reverberated amongst the members of the Physicians Foundation. But what amazed us the most were the over 10,000 physicians who took the additional time to provide written comment on the concerns they felt most passionate about. That act alone demonstrates …
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Why the physician workforce needs to be rejuvenated
2016 closed around a continued effort to “salvage” the medical profession’s reputation, but the notion that it’s broken continues to be counterproductive.
The brightest students, for example, question the long journey and delayed gratification being a physician entails. They do the math and continue to engage in other professions that are medical but not specifically Medical Doctorate degrees or Doctor of Osteopathic degrees. These same students conclude there is no longer …
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4 reasons why being a doctor is worth it
As I struggle with how best to respond to recent events, one thing has become clear to me: narrative matters. People’s stories matter. Words and how they are presented in written and spoken form matter. I am just a mother, just a doctor, just a writer. My daily life consists of changing diapers, getting my kids to school, managing diabetes in my patients, picking up scattered toys, treating depression, doing …
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Stories matter in today’s world
When I read a case report in a journal or whenever a patient comes in to see me about a new symptom, all my senses are tuned in, and I know there is a diagnosis to be made.
But on regular clinic days with “routine” follow ups, I find myself not being as tuned in as I would like to be. I know my patients well; we are all growing older …
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The big picture is critical, but so are the details
I have been a member of a social network for physicians since 2008 or 2009. It’s a network that bills itself as a “virtual doctors’ lounge” and “voice of physicians.” I joined because I thought it would be a great place to continue to interact with my peers, after I’d left the collegiality of medical school and residency behind for private practice.
I’m not sure what subset of physicians participates, but …
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Anonymous social networks expose the dark underbelly in medicine
The benefits of coaching have long been shown in research, yet is widely underused in the physician community. For decades, executive coaching has been used to in the corporate world for executives, and their teams to increase efficiency and performance. Business and marketing coaching frequently used by small business professionals helps grow and expand their business. Wellness and life coaching is frequently used by individuals to improve balance and well-being. …
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Why don’t more doctors hire coaches?
I love teaching my children about history, and in the process, I often see a clearer perspective of events I learned about at a young age when I had less life experience under my belt.
As I have been revisiting the evolution of our country, the formation and restructuring of our society, and the emergence of periods of oppression, rebellion, and social change, I have been struck by the concept that …
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The Physician’s Bill of Rights
I asked a group of docs I’m coaching how much they’re worth per hour. Interesting question given docs have 11 or more years of specialized training beyond high school. Surgeons spend most of their 20s and 30s in school. By the time these folks graduate, they’ve got 200K+ med school debt — before the kids, spouse or house. Many docs just don’t have time to develop a social life, fall …
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Is your doctor worth more than a plumber?
For those who are not avid followers of President Trump or his decisions, often his decisions have far-reaching consequences that affect lives and people. As a health care provider, I understand quick decision making, but also the importance of risk versus benefit and consequences of your decisions. I would like to tell you my story and how his actions have affected my life, the lives of my patients and their …
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How the government hiring freeze dishonors veterans
I was recently part of a panel aimed at helping physician trainees make the transition to becoming full-fledged independent practitioners, and a member of the panel said something that struck an important chord with the audience when he mentioned that new doctors are probably the most developmentally delayed professionals in society. When you think about the fact that for some of us, the first “real” job we have starts as …
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New doctors lack the skills necessary to transition into practice
My generation of physicians was much like yours.
My were also “the best.” We’d risen to the top of every academic pyramid: middle school, high school, college. We could be anything we wanted to be.
We chose medicine, partly for noble reasons. Our bodies were wondrous and we got to help people. But also for some not so noble reasons: the money was good, everyone would look up to us, and we’d …
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Young physicians: Don’t repeat my generation’s mistakes
In hospitals today, administrators are eager to impose guidelines and metrics onto any facet of patient care they can measure. The sentiment that business people and clinical people are at odds flares with each new initiative. Clinicians feel ignored. Patients complain about how little attention they receive. Administrators try to distill complex pieces of information into smooth line items. We all spend as much time with computers as we do …
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Health care is teaching to the test
As a physician with a strong sense of calling, I always see myself working for each patient, regardless of who pays the bill. Following in the footsteps of role models like Hippocrates and Osler, how could I do anything else?
Ted has been my patient for decades. He can’t seem to lose weight.
John has admitted he doesn’t know how long he can keep doing the kind of work that has supported …
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My case for no-fault medical care
There is a basic communication gap between you and me. How could there not be? It’s not what you expect. I say you have cancer, or heart failure, or emphysema. Full stop. A conversation ensues. This is not what I’m talking about.
It’s more like when I report to you a series of normal lab results, and at the end flippantly mention a slight elevation of the white blood cell count. …
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How do I fix communication with my patients?
I was thrilled when I found out that February 3rd is officially National Women Physician Day. Then I realized that February 3rd coincided with the 195th birthday of Elizabeth Blackwell, the first woman to receive a medical degree in America. Dr. Blackwell had the strength and determination of a superhero. She faced extreme opposition, was rejected numerous times, and was still seen as an oddity and inferior when she was …
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On National Women Physician Day, how far have we come?
Maintenance of certification (MOC) is on the minds of most doctors, and the majority of them oppose it. This is a program where doctors are enforced to comply with certain “educational” mandates to stay compliant with their board certification requirements. The largest number of doctors did not start off following this program but rather were shackled onto it later in their careers.
Being one of the earliest voices speaking out against …
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If you are not already opposed to MOC, the time is now
Dear patients,
We are happy to have you in our lives. We came into medicine to take care of you. Some of us because we wanted to help you to win the fight against cancer. Others of us because we love delivering your babies. Others because we wanted to have the skill to make sure you survive that heart attack or that terrible accident. Others because we wanted to do our …
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A letter from doctors to our patients
Who Retires at 30 to 35?
Retiring after a career of zero or a few years may sound ludicrous, but there are a few scenarios that are not so far-fetched.
The stay-at-home spouse. A handful of physicians complete residency, but never pursue employment, often choosing to start a family instead. I know one physician who made this choice at age 29, actually.
The suddenly wealthy. A large windfall at the beginning of one’s …
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Who are the physicians that retire early?
The problem with health care and drug prices in America isn’t that we spend too much money. The real problem is that we believe we are spending “other people’s money.”
Yes, I was raised in Sweden, but no, I’m not a Socialist. The irony is that “free” health care there is more clearly understood to be directly financed by local(!) taxes that can go up if people in that region consume …
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Health care needs a moral wake-up call
You won’t at first. But then, you will.
It will start innocently. Probably even before medical school. You will have a morbid curiosity about passing ambulances and motor vehicle accidents. Your original empathy for the victim will disappear when you begin to think of them as patients … as test cases.
The commodification accelerates during the early years of medical school. Anatomy, pathology and physiology provide you a vocabulary to replace human …
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This is how doctors evolve
