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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*

Keeping The “Primary” In Care

He came in for his regular blood pressure and cholesterol check. On the review of systems sheet he circled “depression.”

“I see you circled depression,” I said after dealing with his routine problems. “What’s up?”

“I don’t think I am actually clinically depressed, but I’ve just been finding it harder to get going recently,” he responded. “I can force myself to do things, but I’ve never have had to force myself.”

“I noticed that you retired recently. Do you think that has something to do with your depression?” I asked.

“I’m not really sure. I don’t feel like it makes me depressed. I was definitely happy to stop going to work.”

I have taken care of him for many years, and know him to be a solid guy. “I have seen this in a lot in men who retire. They think it’s going to be good to rest, and it is for the first few months. But after a while, the novelty wears off and they feel directionless. They don’t want to spend the rest of their lives entertaining themselves or completing the ‘honey do’ list, but they don’t want to go back to work either.”

He looked up and me, “Yeah, I guess that sounds like me.” Read more »

*This blog post was originally published at ACP Internist*

Will Physician Education Be Valued In The Future?

The future of American healthcare will not value physician education. Perhaps it’s time to abandon the medical school model and train millions of nurses instead at a fraction of the cost. This comment was left on my blog over at NP=MD:

I don’t even compare NPs and MDs. Their models differ. One is not better than the other. The schooling — minus the residency — is nearly equivalent in terms of time spent. The problem is that NPs don’t get a long enough residency. If you take a NP and a MD, both with 20 years clinical experience, the MD does not know more than the NP. Sure, he had a few extra classes 20 years ago — which he doesn’t remember — but that’s about it.

NPs aren’t trying to steal MDs’ meal tickets, they’re attempting to better serve patients. Read more »

*This blog post was originally published at The Happy Hospitalist*

Herbal Remedy For UTI? If You’re A Lab Rat, Maybe

Lab ratA patient came into the office the other day carrying a small clipping from a reputable women’s health newsletter touting new research on an herbal remedy for urinary tract infection. Having recurrent bladder infections, my patient naturally was wondering if this was something she should try.

The article was entitled “Herbal Remedy Effective for Urinary Tract Infections” and began with this startling revelation:

The common herbal extract forskolin can greatly reduce urinary tract infections and could potentially help antibiotics kill the bacteria that cause most bladder infections. 

But the article advised that the “popular” remedy was not FDA approved for this indication, so you should “ask your doctor.” Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

Pay Patients To Take Their Medicine?

The New York Times reported recently on efforts by providers and payers to increase patient medication adherence through the use financial incentives paid to patients. The article cited the use of small financial payments (<$100), awarded via lotteries, to patients that take Warfarin –- an anti-blood clotting medication.

There is certainly nothing wrong with financial incentives. Incentives have been proven successful in changing selected provider (quality and safety improvement) and patient behavior (stop smoking, weight loss and taking health risk surveys). But paying patients to take their medication is different. Actually, the evidence suggests that it is a just plain stupid idea for a whole lot of reasons. Read more »

*This blog post was originally published at Mind The Gap*

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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