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When A Vacation’s Not A Vacation

I just got back from extended time off, which brings to mind a post I wrote two years ago:

Here’s an observation: most physicians in private practice don’t take enough vacations. I am often (rightly) accused of this sin. My staff, colleagues, and even patients regularly encourage me to take time off, but still I find it hard.

Why is this? Is it that I love my job so much that I can’t tear myself away from it? Is it that my self-worth is wrapped up in being “the man” for my patients, and being away from this makes me feel insecure? Is work my addiction –- the one place that I have control of my circumstances and positive reinforcement? Perhaps. But I think the reasons are more basic than that. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Physician Burnout: When Being A Doctor Makes You Sick

Do doctors take care of themselves? Sometimes patients may better follow the advice of physicians who aren’t obese and don’t smoke. That was a question asked in a post last year, entitled “When fat doctors talk to obese patients.”

According to studies, as reported in the Wall Street Journal, it’s a mixed bag:

Physicians as a group are leaner, fitter and live longer than average Americans. Male physicians keep their cholesterol and blood pressure lower. Women doctors are more likely to use hormone-replacement therapy than their patients. Doctors are also less likely to have their own primary care physician—and more apt to abuse prescription drugs.

Clearly there’s room for improvement. Read more »

*This blog post was originally published at KevinMD.com*

Physician Burnout Isn’t New

Dr. Wes and Kevin, M.D. have both written reviews of the documentary film “The Vanishing Oath.” I started the process rolling of trying to get the film shown locally. No date yet, but looks like it will happen before the year is out. 

This is not a new phenomenon in medicine (or any profession). Dr. Robert Goldwyn wrote a nice essay on the some of the issues that can lead to burnout, though not once did he mention burnout specifically. The title says much:

“I Bargained on Working Hard as a Surgeon, Not Working Hard to Be Able to Work Hard as a Surgeon”

The preceding title is a quote from a letter written by a resident in the last year of his training (S. A. Teitlebaum, August 20, 1994). It reflects the gloom besetting the young in particular but certainly not them exclusively. We all are uneasy about our futures, professionally and economically. Bandied in the corridors at a national meeting was a dismal figure: 1:100,000, the presumed proper ratio, as determined by Health Maintenance Organizations, of plastic surgeons to population. That 1 million Americans need only 10 plastic surgeons seems wrong and idiotic to me, but it makes good economic sense to health providers and insurance companies. Their coffers swell as they collect the same or higher premiums while curtailing what they provide. Read more »

*This blog post was originally published at Suture for a Living*

On Leave From The “Life-Inflicted” Battle

Here on this balcony, in Hilton Head, South Carolina, the wind is cool, the air typically thick with humidity, my wife reading a novel by my side. Inside the rental, our children are winding down after days of sun, sand and sea. Their bodies scrubbed pink by salt water and ocean breezes, their faces glowing with sun. My daughter’s lovely blonde hair is more blonde than usual.

I am on leave, in a sense. I am not, however, in the armed forces. Furthermore, I am not at a conference or working at all (except for a little writing, which is as much breath as work.) I am, in fact, celebrating my 20th wedding anniversary on a trip suggested and planned by my love. 

I have accomplished little that the world would view as substantial this week. I have viewed it as a kind of sabbath. I have enjoyed my family, played on the beach, eaten far too much and delighted in every single, solitary minute…and Oreos.

“Sabbath,” “on leave,” “R&R” — however one describes it, we must remember to do it — we need it — because life is a kind of battle. Many well-educated, peaceful post-moderns think that’s far to bellicose a description, but the truth remains: Life is a struggle that rises to the description of battle with stark regularity. Read more »

*This blog post was originally published at edwinleap.com*

Finding Work-Life Balance In Medicine

Paging Dr. Mortis, Dr. Rigor Mortis!

Paging Dr. Mortis, Dr. Rigor Mortis!

This is a sample section from a new book I’m writing on the transition from residency to practice.

When you die:

A) The house of medicine will collapse, and only recover by remembering your compassion and sacrifice.

B) Patients and staff will wail in sack-cloth and ashes

C) Someone may name a procedure or drug in your honor

D) People will walk over your dead body, take your vacant day-shifts and go through your pockets for change.

The answer is D. Although I’m using some hyperbole, the point is that when you die, some people will be sad; your loved ones will miss you. But life will go on. The hospital will not close, and the sick will not stop being sick. So conduct your life with this in mind. Medicine, for all it’s wonder and value, must not be a rock on which you wreck yourself. Let it enhance, not overwhelm, your life. Read more »

*This blog post was originally published at edwinleap.com*

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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