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.
The ultimate goal of every young physician while in medical school and residency should be to become a remarkable doctor. However, what if one of the biggest factors of being a great doctor was not addressed from the start?
Financial wellness may not directly correlate with being an incredible doctor, but stress can and does, and today’s young medical professionals have a lot on their plates — beginning with $200,000 in …
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It’s time to start teaching financial literacy to young physicians
As a physician from Ghana brought up in a very religious family, I must admit that when it comes to gay rights and other issues related to sexual minorities I was as far to the right as anyone could be. My first experience with openly gay individuals was when I came to the United States. Needless to say, gay behavior in Ghana was so stigmatized as to be nonexistent in …
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My experience as a physician shaped my views on the LGBTQ community
The reason for Chandra’s office visit is to fill out form N-648. Chandra* is a fifty-nine-year-old Bhutanese refugee who has been my patient for the last nine months. Form N-648 is a six-page bureaucratic nightmare that is guaranteed to bring my clinic day to a grinding halt. My refugee patients bring me this form to certify that they are unable to take the test to become a U.S. citizen due …
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How a family physician gets to know her newly arrived refugee patients
I am a family physician who has been in practice since 2007. My practice is broad in scope; immediately out of residency I worked in a community health center where I practiced obstetrics, newborn care, and inpatient medicine and pediatrics, along with my outpatient obligations. Since 2011 I have been a locum tenens physician working in rural Colorado in emergency departments, clinics, and hospitals.
I recently received your American Board of …
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It’s time to stop mandating board exams for family physicians
An excerpt from Physician—Time to Invest in Yourself: Work-Life Balance, the Needs of the Patient, and Medical-Legal Risk Management.
What is an essentialist? What is an essentialist lifestyle? Essentialism focuses on identifying the important signals in life and eliminating the noise. The noises are the distractions that add no value to your life and frequently monopolize time and meaning. When you assume the role of an essentialist you will discover that you …
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Essentialism for health care professionals
Physician burnout has become a popular buzzword in the medical community causing physicians, organizations, and medical education programs to seek solutions to what seems to be a growing problem. The result: Tons of research, new pilot projects, and burnout prevention programs are being implemented to try to “treat the problem.” Yet, for all of the research that is being done, there has been no one good “solution” for doctors burning …
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Why physician burnout treatment doesn’t work
I knew the patient was fuming mad and I could hardly blame him. His symptoms were debilitating and the battle to get a diagnostic test authorized by his insurance company set him over the edge. My staff fought a hard war convincing the insurance company that the patient needed the test and lost. As the patient sat in front of me yelling practically in my face, I felt like the …
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The doctor in the middle feels crushed from all sides
Physicians have long been seen as superhuman — able to jump the academic hurdles required to gain entrance to medical school, willingly delaying many of the gratifications associated with young adulthood, surviving long hours during training and later when in practice, keeping a cool head amidst crisis.
In many ways, we physicians thrive on this image. Personally, I was unaware of how much I enjoyed the mantle of hero until I …
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Doctors aren’t superhuman. Stop treating them that way.
Sir William Osler wasn’t exactly wrong when he said, “Listen to your patient, he is telling you the diagnosis.” But he didn’t mean it literally. His patients did not offer up esoteric and complete medical diagnoses on a silver platter. They left him clues in plain language that he listened to carefully in order to make the correct diagnosis.
He penned his words in an era when medical information was scarce …
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Listen to your patient’s story: It’s their diagnosis
Medicine has become increasingly stressful for all levels of health care providers. Every year, nearly 400 physicians commit suicide, and in a study published in the Journal of Academic Medicine, researchers found that almost 10 percent of final year medical students and first-year residents (called interns) reported having suicidal thoughts. Previous studies from the National Institutes of Health found that physicians were twice as likely to …
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How can doctors avoid burnout?
When I started medical school, my classmates and I attended a special ceremony where we stood in front of our friends, family, and professors and recited some modern version of the Hippocratic Oath. For years afterward, I only remembered the “do no harm” bit, which is a lazy approximation of the actual words. I recently reread the oath, and even though I’d completely forgotten, it also said this: “I will …
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Practicing medicine in the Trump era
I was about 13 years old. I heard that she had cancer and I went to the hospital to visit her. Her name was Sister Pat, and she was my former principal and my favorite teacher from elementary school. I don’t think she had reached her fortieth birthday. I was too young and uninformed to ask about any of the details. However what stuck with me and I remember so …
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The treatment to give people more time
The medical assistant swabbed my nose and my throat multiple times. Pricked my finger too. Then, the phlebotomist (or vampire?) drew bottles and bottles of my blood. Along with the physical discomfort, there was emotional discomfort too. What would the test results show? If they were all negative, would I be satisfied without having an answer?
Being a patient can be extremely vulnerable. Not only do you often divulge to a …
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My experience as a patient has made me a better physician. Here’s how.
I spent the evening of the 2016 presidential election and the morning after on an emotional rollercoaster. It began high and then descended into shock, disbelief and grave concern about the future of our country. Now that we have selected a candidate who intends to take the country in a radically different direction, and I worry about the consequences of reversing the Affordable Care Act, reversing economic assistance programs, and …
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We must cross the political divide for the sake of our patients
For a century, the white coat has been the symbol of the medical doctor. Today, the vast majority of medical schools in the U.S. begin with a white coat ceremony. There, the fledgling, future doctors stand together and recite a modified version of the Hippocratic Oath before being called up one-by-one to receive the white coats that they will wear throughout the upcoming trials and adventures of medical school. The …
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What does a doctor’s white coat really mean?
Physician burnout has received a lot of well-deserved attention lately. Characterized by emotional exhaustion and professional frustration, it’s tied to an array of adverse consequences, from physician suicide to poor patient outcomes. Organizations are waking up to the need to measure its prevalence and ameliorate its impact.
There seems to be two broad schools of thought about the causes — and by extension, the fixes — of physician burnout.
The first focuses …
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What’s at the root of physician burnout?
On November 1973, I had an epiphany. My first week on my internal medicine clerkship, I realized that I had found my specialty: internal medicine.
Prior to medical school, I had worked with emotionally disturbed children in an inpatient hospital. I really enjoyed the experience, and learned a great deal. During my first two miserable years in medical school (I disliked how they taught the basic sciences and even more how …
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Why this physician chose internal medicine
Dear doctor mom,
I’ve been a physician for 13 years. For the past 7 years, I have also been a mom. A growing number of experiences made me decide to write this letter. I hope other moms don’t attack me. I do not mean to downplay their struggles, or to insinuate that doctor moms necessarily all have a harder time compared to other moms. I only focus on you, because I …
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Doctor mom, remember that it is all worth it
Two years ago, I wrote about my experience in a London emergency department with my son Victor. That post has since been viewed over 450,000 times. There are over 800 comments with no trolls (a feat unto itself), and almost all of them express love for the National Health Service.
I was in England again this week. And yes, I was back in an emergency department, but this time …
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An American doctor experiences UK emergency care firsthand
It’s hard to find time to pay attention to all the messages I receive. There are voicemails, emails (work, blog, and personal), and the nonstop notifications from Facebook and Twitter. Post-it Notes on the desk and the refrigerator. I am bombarded with messages.
Urban Meyer, head coach of the Ohio State football team, doesn’t have a lot of time to leave messages. Right now, he’s gearing up for a likely bid in the …
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Urban Meyer has a message for you, doctor
