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Mean Patients: The Real Reason Why Physicians Are Quitting Medicine?

A "Medical Service Provider"

As I sat in my orthopedist’s exam room, the discussion quickly turned from my chief complaint to his: “I don’t know why I’m doing this anymore,” he said. “Medicine is just not what it used to be, and I don’t enjoy my work anymore. The bureaucracy and regulations are bad enough, but what really gets me is the hostility. My patients are chronically angry and mean. The only comfort I get is from talking to other doctors. Because they all feel the same way.”

Perhaps this sentiment strikes you as the spoiled musings of a physician who is lamenting his demotion from “god” to “man” – reflecting the fundamental change in the public perception of doctors that has occurred over the past ~50 years. Or maybe you wonder if this surgeon’s patients are mean because he is a bad doctor, or isn’t respectful of their time? Maybe he deserves the hostility?

I’ve found this particular surgeon to be humble, thoughtful, and thorough. He is genuinely caring and a proponent of conservative measures, truly eager to avoid surgical procedures when possible. He is exactly what one would hope for in a physician, and yet he is utterly demoralized.  Not because of the hours of daily documentation drudgery required by health insurance and government regulators, but because the very souls he has been fighting to serve have now turned on him.  Their attitudes are captured in social media feeds on every major health outlet:

Doctors? I no longer afford that kind of respect: I call them “medical services providers.” They and their families and the medical cabal created this mess when they got control of med schools so that the wealth of a nation would remain in the hands of a few medical elites and their families. The very notion that doctors are smarter, more productive, more anything than others is ludicrous. They are among the worst sluff-offs of our society, yet the richest at the same time. It is an unreal world they have created themselves and they are now watching the natural outcome of such a false system.

The very best physicians have always been motivated primarily by the satisfaction of making a difference in their patients’ lives. That drive to “help others” is what makes us believe that all the sacrifices are worth it – the years of training, the educational debt, the lack of sleep, the separation from family, the delay (and sometimes denial) of becoming a parent, the daily grind of administrative burden, the unspeakable emotional toll that death and disease take on your heart… All of that is offset by the joy of changing and saving lives. But when that joy is taken from you, what remains is despondency and burn out.

What patients need to realize is that they have been (and still are) the primary motivator of physician job satisfaction. Patients have the power to demoralize us like no one else – and they need to take that power very seriously. Because if negative attitudes prevail, and hostility spreads like a cancer in our broken system, the most caring among us will be the first to withdraw.

And in the end all that will be left is “medical service providers.”

What Is Distracting Doctors More Than Electronic Devices?

I admittedly snorted out loud when I read a New York Times article earlier last week regarding increased physician distraction due to electronic devices, especially with the advent of the smartphone with its emails, text messages, calls, and other alerts that ping intermittently throughout a typical work day.

There is no question that electronic devices distract physicians as the article pointed out… But that’s like complaining about a leaky faucet when there’s a flooded basement and a hole in the roof.

The bigger problem that should be mentioned is hospital bureaucracy which probably creates just as much if not more unintended distractions for physicians and nurses.

What many patients and lay public may not realize is that Read more »

*This blog post was originally published at Fauquier ENT Blog*

Should Hospitals Manage Their Physicians’ Online Reputations?

I spoke to a group of academic physicians recently.  Afterward I was and asked, “Shouldn’t my hospital be responsible for my digital footprint?  I don’t have time to look after that sort of thing.  And wouldn’t it make sense for them to promote my research?”

4 thoughts:

1.  Online reputation management of academic physicians should be an individual, not institutional, responsibility. The question reflects a belief that your reputation is the job of “the marketing people.”  No institution will ever be as invested in your future as you are.  While there are hospitals that do a good job supporting their faculty and staff, you can’t assume it to be the case.  No one looks after you like you.

2.  Dig your well before you’re thirsty. That’s the name of a brilliant pre-digital book written by Harvey Mackey.  He suggested that the time to invest in relationships is before you need them.  Medicine is changing fast and you’ll never know how long you’ll be where you’re at.  Better yet, you never know what opportunities could come your way when people find you.  And if you want to experience the land before time when people used colored pencils, Rolodexes, and rotary phones, read Dig Your Well. Read more »

*This blog post was originally published at 33 Charts*

The Tired Medical Blogger

Ever feel like you’re kind of stuck and you need a change? I was there last week. With the upcoming Thanksgiving week, life was adding more stress that was difficult to handle. For weeks now, I felt like I was taking all my efforts and playing catch up. Don’t get me wrong. I’m very happy where I’m at right now professionally and personally. I was just tired.

“Social Media Fatigue” is a dirty little secret that the early adopters never write about – especially those in health care social media. That’s why I was surprised when a few months ago, my good friend, Seattle Mama Doc wrote the post “Online Sabbitical.”

I’m taking an online sabbatical this month. Consider this an act of both self-reflection and self-awareness but also an act of self-preservation. As any blogger knows, blogging every few days, taking photographs daily, approving and responding to comments 24 hours a day (7 days a week), while authoring content in your head every few paces, is an entirely consuming experience. Blogging has completely changed my life. And this job is an utter privilege… But I’ve been consuming media, blogging, and authoring content without reprieve since November 11, 2009.

Now, my blogging frequency and my podcast frequency have Read more »

*This blog post was originally published at Family Medicine Rocks Blog*

Family Physician Makes The Switch Back To The White Coat

I have not worn a white coat since I opened my own practice more than twenty years ago.

Not that I had anything against white coats in principle. I wore my short white one in med school with pride, and the longer one in residency too; their pockets filled to bursting with the 4 x 6 inch six-ring binder emblazoned with my name in gold, courtesy of Burroughs-Wellcome, the long-defunct pharma giant, which had presented one to each medical student in the US for many years, as well as assorted pens, note cards, alcohol wipes, hemoccult cards, and so forth. I even had a tiny teddy bear pinned to my lapel, my own way of personalizing the impersonal.

When I went out on my own, though, I made the conscious decision not to wear one. I confess that all these years later, I don’t completely recall my thought processes on the subject. It seemed Read more »

*This blog post was originally published at Musings of a Dinosaur*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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