One cold winter night many years ago, someone dropped off a calico cat and her two kittens in our snowy driveway, and we went from a two cat family to a five cat household. I learned a few things from that.
When I was a resident, two thirtysomething family docs had an office upstairs from the residency program. Ned and Peter precepted us, and they sometimes ran downstairs to ask the …
Why managing physicians is like herding cats
As someone who talks to many physicians about burnout and life in medicine, I find myself having a lot of discussions about the circumstances of people’s jobs. Almost inevitably, there comes a point in the conversation where someone expresses dissatisfaction about an aspect of their contract or an additional responsibility that was placed on them.
As physicians, we’re groomed to take care of patients. During training, we don’t talk about compensation, …
5 things physicians can do to protect themselves
RRegardless of specialty, no physician can truly provide patients with the care they deserve if they practice in isolation. In recent years, the health care system has acknowledged this reality by embracing greater collaboration and team-based care. With an aging population increasing the prevalence of chronic disease and life-threatening conditions, the timing couldn’t be better.
For the field of dermatology, the American Academy of Dermatology’s recent Burden …
It’s time for teamwork in dermatology
1. This is a calling. Physicians do not typically start out undeclared, drink through a couple of semesters and randomly apply to med school. For many, they started dreaming in grade school. They started pushing themselves for straight A’s in third grade, fought for valedictorian, turned down frat party invites to study, and then essentially gave up four years of their lives to med school incurring an average debt of …
10 things a doctor’s spouse wants you to know
We all know what, in 1888, Rudyard Kipling pronounced to be the world’s oldest profession. But what’s the world’s second oldest? Hunter-gatherer? Nah, everybody did that. Primitive politician? That’s a tautology. Neolithic attorney? Nope. Too similar to the oldest.
I strongly suspect that the second oldest profession was healer/magician. Fire up Mr. Peabody’s Wayback time machine, and you’d probably find that the first healers were regarded as magicians, and the first …
Physicians and magicians are not as different as you think
We as women have to stop saying “I’m sorry” for things out of our control. When we apologize for things we are not responsible for, we take a step backwards in the advancement of women in the workplace.
I am a cardiac anesthesiologist, which means I care for patients who are undergoing open-heart surgery. I work in an academic medical center and train doctors to become anesthesiologists. The operating room (OR) can …
Before you say “I’m sorry,” I challenge you to think
According to Wikipedia, “Productivity describes various measures of the efficiency of production. A productivity measure is expressed as the ratio of output to inputs used in a production process, i.e., output per unit of input. Productivity is a crucial factor in production performance of firms and nations.”
Please tell me how this relates to being a physician or a patient. We do not produce anything. Rather we work with individuals to …
It’s time to ban productivity from medicine
“So, I’m getting routine labs on her.”
Wait, what?
Statements like these often make the hair on the back of my neck stand up. One of our residents was seeing a healthy young woman for her “annual physical,” seen just a few days after a routine postpartum visit with her OB/GYN after the uneventful birth of her third child two months ago.
The resident was coming for his afternoon continuity clinic from an …
It’s time to stop it with the “routine” labs
Is the practice of medicine a different experience for male and female physicians? Two recent studies from athenahealth suggest that it is — in ways that should make us rethink what we value in health care.
The first study found that male physicians are more productive than their female counterparts. In an analysis of 47 million visits on the athenahealth network in 2016, male physicians generated 30 to 40 percent more …
For women physicians, is there a connection between productivity and burnout?
Dr. Tara Zandvliet was inundated with calls and emails from parents last year, after California passed a law nixing personal beliefs as an exemption from school vaccinations. Suddenly, many parents sought exemptions for medical reasons.
Someone even faked two medical exemption forms purportedly written by the San Diego pediatrician, copying a legitimate document she’d provided for a patient and writing in the names of students she’d never treated, she said. She …
How anti-vaccine parents are finding doctors willing to exempt their kids
For the last several weeks, I have been working as a medical volunteer on a remote island off the coast of Fiji called Batiki. Home to 234 natives, Batiki has no running water, and no electricity (other than solar generated power). The inhabitants are subsistence fishermen and farmers. They are filled with joy and a real sense of community. While on the island, I found extremely high rates of high …
This South Pacific island will change how you think about health care
One of the biggest points of contention in the ongoing discussion of burnout is that the system of health care is flawed. The endless bureaucracy, decreasing physician pay, and increasing meaningful use requirements that spawn endless clicking on an already inefficient electronic medical record platform have become unbearable by most practicing physicians today.
Furthermore, all the talk about mindfulness only riles up more anger in physicians as they feel they are …
Take back our practices with physician cooperatives
As a second-year family medicine resident, wife of a nurse and mother of an almost-two-year-old, the feeling of just not being enough has a suffocating hold on me some days. Non satis. Sounds like a pretty good gig when I talk with others outside the medical profession and friends from home. Training to be a doctor? Great. Happily married to an amazing man who’s taking time off work to raise …
A resident deals with being a wife, mother, and doctor
It’s a health care buzzword for sure, but when we talk about quality, what do we mean? We can compare the quality of similar things and focus on its absence, but otherwise, putting the idea into words becomes complicated. Context is important. And so is perspective: One’s position within the health care system influences how he defines quality to a larger degree than it does at a restaurant, or in …
When we talk about quality, what exactly do we mean?
Just a year after the Supreme Court rejected a challenge to race-conscious admissions in Fisher v. University of Texas, this issue is being pushed back to the front of the room by none other than the Trump administration’s Justice Department hauling out hoary tropes about “reverse discrimination.” They are preparing cases against Harvard and the University of Pennsylvania, charging to the rescue of the multitudes of …
Let’s not be petty about affirmative action in medical school
This is a letter to everyone who has ever smiled, shrugged their shoulders, or nodded while either hesitantly or enthusiastically uttering the words, “Yes,” “Sure,” “OK,” “I guess so,” or, “Of course,” when a medical student has asked if he or she can talk to and examine you before your doctor comes in. We know that you are busy and that your time has value. We know that you have …
I am not a doctor. (Yet.) I am a novice third-year medical student, somewhat able to perform and document a physical exam on a sleeping child, to dial the correct number to call a consult and to make wild guesses about chest X-rays (“I see a consolidation?”). I write about medicine not from a position of experience, but of malleability. I want to become like the best doctors I see.
Towards …
I vow not to call my patients “difficult.” Here’s why.
Anyone entering medical training is taught that medicine is an art, one that combines scientific knowledge, discovery and application with its practice. It is both art and applied science. It should never become nor has it ever been only all one or the other.
To be medicine at all, the noble vocation that so many brilliant minds sacrifice to pursue in service to their fellow humans, the practice must balance art …
A reminder that physicians are artists
Being a health care provider has always come with personal risk. We care for all patients, which includes patients agitated due to psychiatric issues, dementia, acute medical illness, alcohol or drug intoxication or just anger. Patients can be extremely volatile and lash out unexpectedly causing physical injury to their doctor, nurse or another provider. Besides the physical risk, patients can be emotionally and verbally abusive as well- and both types …
7 ways for doctors to stay safe at work
It’s a scenario that every doctor is familiar with. You are having a busy day and working full steam to get everyone better. You suddenly receive that unexpected message: “Mr. Johnson and his family are very upset and would like to speak with you now.”
Most of the time, any physician’s initial reaction will be one of irritation, disappointment or frustration: “My goodness, I’m working so hard here, and we have …
Your patient is angry. Here are 5 things physicians can do.
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