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.
So let’s step outside our traditional arguments when discussing the health care problem of gun violence in this country. We all know the entrenched opinions of both sides: The second amendment is inviolable vs. there are over 30,000 deaths from guns per year in this country, and why on earth does anyone need an assault weapon? But the city with the strictest gun laws, Chicago, has the most gun deaths, …
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Gun violence and the limits of human performance
Every medical couple knows that the lifestyle and career choice brings with it adjustments and sacrifices. Physician spouses and partners often take on more housework and childcare to accommodate long working hours. Physicians may work unusual hours that lead to late-night arrivals, missed bedtime tuck-ins, and less face-to-face time. This can lead many couples to blame medicine for their struggling relationship.
Take the example of a resident who has been working …
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Medicine is not destroying your marriage
Burnout is a tragedy. It terminates careers, friendships, marriages and sometimes lives, prematurely. It threatens the well-being of individuals, families, patients, organizations and our society. The current media focus on the crisis of physician burnout is appropriate and timely, but the industry itself needs a reality check. While burnout is experienced by the individual, it is the manifestation of a dysfunctional environment that only we as physicians and leaders in …
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Forget burnout. Let’s address physician dissatisfaction.
In the interests of full disclosure, I acknowledge with delight that I have a non-time limited board certificate from the American Board of Anesthesiology (ABA), issued before the year 2000. I can just say “no” to recertification.
The more I learn about the American Board of Medical Specialties (ABMS) and its highly paid board members, the more disillusioned I’ve become. It’s easy to see why so many physicians today have concluded …
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The real danger of maintenance of certification and what to do about it
The day I got into medical school, my uncle said to me, “You are going to be a doctor! We finally have a doctor in the family. You are going to take care of your uncle in his old age.” Other family members echoed the same sentiment. First doctor in the family. Now, we will all have free medical advice.
As I progressed through medical school, then internship and residency, then …
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Why this physician can’t be her family’s doctor
Last week I was in a session with one of my coaching clients, a successful black female physician who is the owner of her own practice. As we were concluding she made a statement to me “I feel like medicine has just sucked the feminine right out of me.” Immediately I related.
As women in the professional world, we are always in competition with men whether we are aware of it, …
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Being a woman doctor in a man’s world
I have a breathtakingly difficult confession to make. A confession that on its face seems rather innocuous but in many ways shakes the foundations of who I always thought I was, and how I identify myself.
I no longer love being a physician.
There — I said it. I winced even as I strung the words together to write the sentence. You see, to admit this is almost inconceivable. So much of …
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Why this doctor no longer loves being a physician
“When companies start unbundling costs, it is a sign of increasing consumer power and weakening market power.”
This is what CEO David Goldhill and author of Catastrophic Care: Why Everything We Think We Know about Health Care Is Wrong told me once. Airlines have unbundled everything that used to be included in a plane ticket. No longer do tickets include meals, in-flight entertainment, and the ability to check in baggage. Today, …
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Moving primary care to the cloud: A bold, new vision
“Afternoon,” the doctor says. “What brings you here today?”
A cough? A cold? A belly ache? Some feelings of dismay?
Well, tell me just what ails you, and I’ll try to do my best,
To sort through all your problems and put your fears to rest.
But give me just a moment — my computer must get started.
Without attention to its needs, your visit goes uncharted.
You say your chest is hurting? And you’re really …
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Patient death by data: A poem
On an ordinary day last month, I saw patients for eight and a half hours. I addressed a dozen computer messages, took four or five calls from outside providers and held innumerable curbside conversations with medical assistants, case managers and colleagues.
I didn’t get to any of the 100+ lab results or 50+ documents in my electronic inboxes. Consequently, the care for several dozens of my patients didn’t move forward.
Many of …
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Let’s leave clerical work to administrators
From the first year of medical school, we are trained in probing into the most personal aspects of patients’ lives; but when it comes to spirituality, we shy away. In a survey of the U.S. general public, the 2008 Gallup Report demonstrated that 78 percent of people believed in God and an additional 15 percent believed in a higher power. Other studies have shown that religious beliefs and …
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It’s time to ask patients about spirituality
“What do you want to be when you grow up?”
It’s a common question we ask our youth, and I remember as young child sharing my aspirations with family members. When I answered “I want to be a doctor when I grow up”, I received positive feedback and praise. As an innocent little girl, I had no idea that there were people in the world who wouldn’t be as supportive of a woman in medicine.
Later …
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What National Women Physicians Day means to me
I grew up studying my physician parents. My dad, a pathologist, was a hard-working hospital employee with multiple odd jobs on the side. He always worried about whether he’d have enough for retirement, though he never really wanted to retire. My mom, a psychiatrist, is more of an entrepreneurial businesswoman. She had her own private practice (even though all the other employed doctors warned she’d never make …
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Physicians! 7 steps to financial freedom
Over the 2016 Christmas weekend, 27 Chicago citizens were shot, of which, 7 were shot fatally. While studying in a Chicago medical school in 2011, I saw the effects of gun violence first. It saddens me to realize that six years later, little, if anything has changed. This past year, Chicago has reported a total 745 homicides, a 56 percent increase since last year and the first time in over …
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Where is the research to inform policy on gun violence?
Yes, suggestions for improvement are coming at you from every angle. Administrators, your patients, your colleagues, your mother, yourself. It’s quite possible that the last thing you feel you need are resolutions. But for those of you that are looking to make some concrete changes in 2017, here are some to consider:
1. Take care of yourself as well as you take care of your patients. 2016 has proven to us …
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7 for ’17: New Year’s resolutions for health care professionals
I bought my first house a few days before starting my second year of residency in St Louis. It was a townhome: two bedrooms, one and a half baths, hardwood floors and lots of wall space. So much wall space, in fact, that I immediately began to look for ways to adorn all those barren surfaces.
After visiting some local art galleries, I came to two conclusions. I knew exactly what …
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Barren walls: When passion becomes a business
Being sick is a horrible enough time without having to worry about how much it’s going to cost you. Unfortunately, the United States is unique among developed nations in not ensuring that the populace has a safety net that will protect them against exorbitant personal health care expenses. It’s a terrible thing to have to deal with as a physician. I went to medical school to learn how to take …
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3 ways you can advocate for better health care
Much of the discussion surrounding the presidential election this year focused on fake news. There were countless stories in newspapers and on television news shows about these obviously biased and fictitious posts that might have affected the outcome of the election. I could not help thinking during this campaign season that if you think fake news is bad for politics, you should try being a physician.
As physicians, we are on the …
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If you think fake news is bad for politics, you should try being a physician
