Physicians writing on KevinMD about burnout, moral injury, depression, and suicide in medicine: what causes burnout and whether the word fits, resilience training and why physicians distrust it, who leaves and why, the fear of seeking help and the licensing questions behind it, what physicians say actually helps, and, on the patient side, psychiatry, access to care, and the arguments over diagnosis and treatment. Three maintained records draw on this archive: Physician burnout: what physicians say, in their own words, Physician suicide: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.
For anyone in the helping professions, compassion fatigue is a common occurrence and a clear signal to take better care of your own needs.
Compassion fatigue is when you find yourself challenged to care about your patients in the way you know is proper and expected in your position. One of the key components of quality healthcare is the ability for you to connect with your patients and for them to …
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Compassion fatigue is an early warning sign of physician burnout
My psych final was this morning, which I am 90% confident I did well enough on to pass the class (which is all I need to be satisfied). Considering I counted watching “Girl, Interrupted” as studying, I say that’s not too bad.
I felt like there were many necessary topics left out of our behavioral medicine and psychiatry course. One of the many: sexual assault.
For the past eight years I have …
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How we treat sexual assault matters more than we will ever know
“Um—Hi there, I’m a, uh, you know. Medical student. First year. For, you know, the Patient-Doctor—err, Patient-Physician course—”
The nurse smiled and turned to a woman of shorter stature with bony, scrunched- up shoulders. “Mary, do you want this first year to interview you?”
Mary was about to set foot in the lounge when she heard this. She let out a sigh and faced me. Her eyes looked worn; I could tell …
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A medical student’s first patient interview
I keynoted at a conference a few weeks ago. As usual, as the date approached I felt the pressure intensify. It’s much better than when I first started public speaking years ago. For my very first paid speech, which was in front of several hundred people, I shook for the three months leading up to it – some days when I got really worked up it was actually a challenge …
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What if stress management was actually ridiculously easy?
The first time I met Tom his head was on the table at the Christmas banquet held by the mental health support program where I worked. He was sitting next to his wife, who worked on the staff.
Tom’s alcoholism soon brought him into the program, fractured his marriage, and I became his first case manager. The alcoholism had roots in childhood abuse. Years of drinking followed, with hospitalizations, chaos and …
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Is managed care worth the price of a life?
As most of the electrophysiology (EP) community is aware, device and lead recalls are a reality in today’s EP practice. In the last 5 years, both Medtronic and St. Jude Medical have had significant lead failure issues. The public responses to these recalls have been varied and quite different. As physicians who care for device patients, we must learn to quickly sort through the rhetoric put forth in the New …
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The emotional effects of device recalls on patients
Even though I love my job, I’ve been feeling a little burned out lately. I think it comes from being stretched too thin, which is something I’ve coped with off an on ever since med school.
As the saying goes, there are never enough hours in the day, and sometimes that really gets to me. While my practice is incredibly important, I also place a lot of value on my family. …
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Tips to fight depression during medical residency
The healthcare needs and challenges presented by the nation’s returning veterans are complex and critical.
That’s not news to all, yet not all clinicians realize how close and relevant the issues actually are. More than half of all returning veterans are treated outside of the military healthcare system and the VA, which means community-based clinicians are on the front lines of care delivery to veterans.
Very often, this also now means that …
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Improving healthcare for veterans on college campuses
According to an article entitled, Binge Drinking Common Among Adults, “about one in every six U.S. adults binges on alcohol.”
According to the article, “binge drinking — defined as at least four drinks in one sitting for women and five drinks for men — carries substantial risks and high costs. It accounts for more than half of the estimated 80,000 annual deaths and three-quarters of the $223.5 billion in economic …
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The hidden crisis of binge drinking
In the old days, bullying used to consist of name calling or physical aggression from someone in a position of power over another, typically from a roughly similarly aged peer group. The bullying could be mild such as occasional name calling and having one’s books knocked down when walking in the hallway. This does not mean the effects of the bullying were mild but comparatively speaking, this is generally not …
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Impersonal communication on the Internet fuels cyberbullying
I started working with a new coaching client the other day. I’d already been following the twists and turns of her life saga for about a year, via excited emails she’d been sending me ever since reading my book Live a Life You Love.
“As you know, I’ve made all kinds of wonderful changes in my life,” she told me over the phone, “I left a job I couldn’t stand, sold …
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A physician shares her anxiety management tips
If you are like most people, you have probably never heard of Morgellons disease or Morgellons. The first reason you have likely never heard if it is because it is so bizarre and uncommon. Most of what is known about it is based on rare case reports or anecdotal stories. The second reason is because it is not recognized in the medical community as a legitimate medical disease. It is …
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The psychological basis of Morgellons disease
I’m reluctant to write a post about ADHD. It just seems like treacherous ground. Judging by comments I’ve read online and in magazines, and my own personal experience, expressing an opinion about this diagnosis—or just about anything in child psychiatry—will be met with criticism from one side or another. But after reading L. Alan Sroufe’s article (“Ritalin Gone Wild”) in the New York Times, I feel compelled to write.
If …
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Why we should eliminate the diagnosis of ADHD
Malingering is the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives such as avoiding military duty, avoiding work, obtaining financial compensation, evading criminal prosecution, or obtaining drugs. The word “malingering” comes from the French word “malinger” meaning “poor or weakly” as these are the characteristics feigned or exaggerated by the malingerer. Malingering has been documented as far back as in the Bible when …
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Physicians should be concerned about malingering
Editor’s note: Please read Dr. Yang’s entire Red Herring series for background prior to reading this post.
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The patient really is fine.
She returned to the gastroenterology clinic several times for treatments to widen her esophagus. (It’s a neat procedure: The GI doctors insert a small balloon into the esophagus. They gently inflate the balloon to stretch the stricture a few millimeters. With repeated stretching, the esophagus will remain open.) The patient ate more. …
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Physicians must advocate for their patients
The answer is yes and they do it by building resilience. University of North Carolina professor Barbara Fredrickson has spent the past two decades looking into why we have positive emotions and what we do with them. She even has her own term for her work: positivity.
To quote an old commercial, “Why ask ‘why’?” when it comes to positive emotions? Shouldn’t we just enjoy them while they’re around? Sure, but …
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Do positive emotions increase life satisfaction?
In a recent therapy session, one of my patients described her emotions in a way that totally blew me away. I really felt compelled to share her story with you.
A little background however before we go any further. Mary (not her real name) is in her mid-50s and has struggled her entire life with both chronic depression and obsessive-compulsive disorder manifesting itself as hoarding. She has struggled with these emotional …
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How our emotions can affect our decision making ability
“51-year old female presents today with …”
Funny, the vast majority of my clinical notes last week began with that phrase, give or take a year or two. Women in their fifties who saw me in the clinic, who I spoke to via television in my telepsychiatry practice, or who I interacted with in some other way. It struck me as odd that so many women of similar age came to …
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The fifties woman has many reasons to get better
One of my most vivid memories of medical school was during my internal medicine rotation, when it had become apparent to me that, despite spending my pre-clinical years studying complex pathophysiology and pharmacology, and the fine art of history-taking and the physical exam, the actual clinical work seemed to be more like a numbers game. I felt like I was always responding to a data point: a blood pressure reading, …
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The erosion of psychiatric training has consequences
Whether you call it Health 2.0, Medicine 2.0, or e-Health 2.0, the Internet is changing medicine in ways that challenge the status quo. This article explores how a group of amateurs who call themselves “health hackers” and “citizen scientists” are trying to use the Internet to connect with other patients, run experiments, and conduct clinical trials on their own diseases.
Dr. Gunther Eysenbach states “Medicine 2.0 applications, services and tools are …
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The rise of citizen scientists and patient initiated research
