Saturday, July 27, 2019

Physician burnout and medical breakthroughs: a patient's story - STAT

I entered my doctor's exam room worried about my health. I exited worried about his.

A lack of pressure when he placed the stethoscope over my heart. His ghost-eyed look when I spoke. His nearly inaudible voice. All of this registered as the most severe depletion of spirit — or what is sometimes and inadequately referred to as burnout — I'd seen in one of my doctors. And I've seen a lot of doctors over the years.

When I was 32, I was diagnosed with ovarian cancer. Lucky enough to survive, I spent several years housebound as I grappled with the fallout from chemotherapy. Tanking blood pressure levels. Hours spent lying on my hardwood floor to avert blacking out instead of legging it out the door to work. Innumerable texts to family and friends that started with "V sorry to cancel."

Trying to identify why my pre-cancer health had not returned and how to get it back, I gunned it to doctors' offices with an I'll-do-anything-to-get-better mindset.

I believe that the diagnoses and treatments I ultimately and thankfully received would have been made years earlier had my doctors been empowered to dedicate themselves to my case with a singular focus instead of being pulled in disparate directions. In a nutshell, I was unable to get well while my doctors' wells were empty.

Although faced with what three primary care physicians described in a recent First Opinion as "the corporatization and bureaucratization of medical practice, which impinges on our professional autonomy, leaving us less flexibility to do what needs to be done for each patient," most of the doctors I saw have done what Dr. Danielle Ofri referred to in her nerve-hitting New York Times op-ed last month: "An overwhelming majority do the right thing for their patients, even at a high personal cost."

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This college dropout was bedridden for 11 years. Then he invented a surgery and cured himself - CNN

Doug Lindsay was 21 and starting his senior year at Rockhurst University, a Jesuit college in Kansas City, Missouri, when his world imploded.

After his first day of classes, the biology major collapsed at home on the dining room table, the room spinning around him.

It was 1999. The symptoms soon became intense and untreatable. His heart would race, he felt weak and he frequently got dizzy. Lindsay could walk only about 50 feet at a time and couldn't stand for more than a few minutes.

"Even lying on the floor didn't feel like it was low enough," he said.

The former high school track athlete had dreamed of becoming a biochemistry professor or maybe a writer for "The Simpsons."

Instead, he would spend the next 11 years mostly confined to a hospital bed in his living room in St. Louis, hamstrung by a mysterious ailment.

Doctors were baffled. Treatments didn't help. And Lindsay eventually realized that if he wanted his life back, he would have to do it himself.

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Thursday, July 25, 2019

American Medical Students Less Likely To Choose To Become Primary Care Doctors | Kaiser Health News

Despite hospital systems and health officials calling out the need for more primary care doctors, graduates of U.S. medical schools are becoming less likely to choose to specialize in one of those fields.

A record-high number of primary care positions was offered in the 2019 National Resident Matching Program — known to doctors as "the Match." It determines where a medical student will study in their chosen specialty after graduation. But this year, the percentage of primary care positions filled by fourth-year medical students was the lowest on record.

"I think part of it has to do with income," said Mona Signer, the CEO of the Match. "Primary care specialties are not the highest paying." She suggested that where a student gets a degree also influences the choice. "Many medical schools are part of academic medical centers where research and specialization is a priority," she said.

The three key primary care fields are internal medicine, family medicine and pediatrics. According to the 2019 Match report, 8,116 internal medicine positions were offered, the highest number on record and the most positions offered within any specialty, but only 41.5% were filled by seniors pursuing their M.D.s from U.S. medical schools. Similar trends were seen this year in family medicine and pediatrics.

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