#Pamela Wible MD

[bisexualmoses]

Bro... not to be like two weeks before I start medical school I no longer want to be a doctor but this makes me really scared

https://www.idealmedicalcare.org/physician-friendly-states-for-mental-health-a-review-of-medical-boards/

[musicmanstuff]

13 Reasons Doctors Die By #Suicide 1,103 Doctor Suicides & 13 Reasons Why...

Posted on October 10, 2018 by Pamela Wible MD ~ 29 Comments

https://www.idealmedicalcare.org/1103-doctor-suicides-13-reasons-why/

[ratthewrodent]

In today's medical culture, are we undervaluing physicians by tolerating the status quo? The status quo of rising medical school costs, poor mental health, mistreatment in residency, broken technologies, inflated administrative costs, etc?... We limit medical student postgraduate options to internship and residency, yet we graduate NPs and PAs to begin supervised practice with a starting average salary of $105,000.[1,2](https://ift.tt/3bMhxpI) Meanwhile, medical students graduate unable to practice medicine without an internship (that pays an average starting salary of $56K.)[3](https://ift.tt/37uW01m) I'm not arguing against physician extenders or residency. I'm arguing against the status quo in medicine.To be licensed as a physician in most states, you must complete a year-long internship.[4](https://ift.tt/37ALkhA) California is requiring multiple years of post-graduate training.[5](https://ift.tt/3bNpg6X) Our status quo provides no in-between licensure options for medical students, while we are simultaneously graduating NPs and PAs into supervised practice. In 26 states, NPs can practice autonomously in their field immediately.[6](https://ift.tt/320deSS) Why are physicians that graduate from a US medical school and cannot match into a residency (for whatever reason) less able to practice medicine than NPs and PAs? Is it just the status quo?Right now, of the medical student graduates who do not go to residency, some become scribes, MAs, and consultants. [7](https://ift.tt/3bHiqjd) Very few find research jobs, and even fewer gain a temporary license that allows them to practice at the level of a mid-level under the supervision of a physician like you can in Missouri.[8](https://ift.tt/37zwkAs) So what are you, the physician, to do? The Flexner report of 1910 gave us the gold standard of medical training for the time,[9](https://ift.tt/39FYqvy) yet we act like no future improvements are needed today.[10](https://ift.tt/321daT4 you're like me, you have some changes in mind. I can list several improvements I'd like to see. First, rising school costs are trapping students.[11,12](https://ift.tt/2SwQEyb) Medical school graduates have, on average, $251,600 in debt these days.[13](https://ift.tt/31XV1p2) The debt doesn't disappear, either, for those who cannot match into a residency. Medical schools are increasing tuition annually and federal loans accrue interest from the beginning.[14](https://ift.tt/2uHXVCq) Why do we allow interest to begin accruing so many years before employment is possible, and why do we pay so little?Medical schools should aim to produce autonomous physicians, but not every graduate can achieve an internship. What are they supposed to do? Physicians should create a "supervision-required" midlevel-style license for medical school graduates that haven't completed an intern year. Otherwise, less painful routes to the top of medicine will continue to gain steam. Administrators need to fill gaps in their hospital systems with providers from somewhere, after all.We have a physician shortage, despite an increasing number of medical schools and residencies.[15](https://ift.tt/2HqrL0X) In fact, the total number of residencies available has increased at the same rate as medical school enrollment.[17](https://ift.tt/2HsDjRd) However, in 2019 there were still 44,603 students competing for 35,185 PGY-1 spots.[18](https://ift.tt/39I1DLc) You have a huge discrepancy between PCPs and subspecialists, so applicants are unevenly applying to the higher-paying fields. Also, IMGs are applying for US residency positions.Then there is the status quo of mental health crises among trainees and other physicians. Still, physicians and students commit a substantial number of suicides every year.[19–23](https://ift.tt/37wSN15) That's not a fun fact. Perhaps you're like me and have known someone to take their own life. Medical training and practice are toxic because of the high stakes. There are board exams used as gatekeepers to certain competitive specialties. You are often sleep-deprived and stressed. Not to mention, if you are careless then someone dies (no pressure). Also, healthcare costs are skyrocketing due largely to administrative expansion.[24](https://ift.tt/2Hr7CYw) Overall, there are fewer and fewer resources for physicians to utilize.[25](https://ift.tt/2OYCHqG) It's a tough environment right now. We have to buck the status quo.You can fix the illogical things we are doing in medicine, medical education, and healthcare policy without sacrificing quality. Where to start? Talk to each other. Share your goals, struggles, and challenges. Join together. Drop the poisonous attitudes, the fights, and the competition. Smell the roses. It just takes some common sense, optimism, and compromise. It takes all of us.Physicians need to get more active in politics. Policymakers aren't going to require changes without pressure from a coordinated movement by you, the physicians. For example, we have 1,100+ EHR vendors, in 2020, that cannot communicate data between each other. That is the status quo. However, if forced to do it, I argue EHRs could share data. How? If policymakers mandated some standard changes to the requirements for all EHRs. We would need to mandate the creation of a unique identifier that all healthcare providers use to find common patients, a mapping between coding languages, and a system to distribute stored data storage between systems.[26–28](https://ift.tt/2UXZo2a, I'm hoping to encourage all of you to remember your leadership roles in the hospital, the community, and beyond to seek progress. Physicians need to acknowledge this responsibility before things worsen. If we can do that, we don't have to worry about anything. The problem is, there are very few physicians with enough of a spine to stand up to the status quo. Perhaps you're discouraged, isolated, and overworked. You're not alone. We are waiting for others to fix medicine, but it's got to be us. It's got to be the physicians.The status quo has got to go. How will you stand up to it?​​References:Pa-C, S. P. Physician Assistant Salary Comparison Table | 2019 Pay by State | The Physician Assistant Life. The Physician Assistant Life https://ift.tt/38z8EgT (2019).Nurse Practitioner (NP) Salary Data | All Nursing Schools. All Nursing Schools https://ift.tt/2SzlhTU Up. Glassdoor https://ift.tt/37toN6h a medical license. American Medical Association https://ift.tt/2UVcey0 Physician Professional Licensing Guide - Upwardly Global. Upwardly Global https://ift.tt/3bJt4Gc Practice Environment. American Association of Nurse Practitioners https://ift.tt/2vzn9D5 Things To Do If You Did Not Match Into A Residency Position • Student Doctor Network. Student Doctor Network https://ift.tt/2HvJKDg (2018).Assistant Physician Law. Missouri State Medical Association | Jefferson City, MO | https://ift.tt/39PoULh, T. P. The Flexner Report--100 years later. Yale J. Biol. Med. 84, 269–276 (2011).Francis, C. K. Medical ethos and social responsibility in clinical medicine. J. Urban Health 78, 29–45 (2001).Kessler, S. Average Medical School Debt In 2017 - Student Debt Relief. Student Debt Relief | Student Loan Forgiveness https://ift.tt/2UWtmTW (2018).Greysen, S. R., Chen, C. & Mullan, F. A history of medical student debt: observations and implications for the future of medical education. Acad. Med. 86, 840–845 (2011).Carter, M. Average Student Loan Debt for Medical School for 2020. Credible https://ift.tt/3bKzULp (2019).Learn about interest and capitalization. Sallie Mae https://ift.tt/2UY758f Findings Confirm Predictions on Physician Shortage | AAMC. AAMC https://ift.tt/38z8Exp. medical school enrollment rises 30% | AAMC. AAMC https://ift.tt/2HvllgR, S. et al. Ten Year Projections for US Residency Positions: Will There be Enough Positions to Accommodate the Growing Number of U.S. Medical School Graduates? J. Surg. Educ. 75, 546–551 (2018).Main Residency Match Data and Reports - The Match, National Resident Matching Program. The Match, National Resident Matching Program https://ift.tt/37CUudG Suicide: Overview, Depression in Physicians, Problems With Treating Physician Depression. https://ift.tt/2PqNIPx (2019).1103 doctor suicides & 13 reasons why | Pamela Wible MD. Pamela Wible MD https://ift.tt/38z8FBt (2018).Farmer, B. When Doctors Struggle With Suicide, Their Profession Often Fails Them. NPR (2018).Kalmoe, M. C., Chapman, M. B., Gold, J. A. & Giedinghagen, A. M. Physician Suicide: A Call to Action. Mo. Med. 116, 211–216 (2019).Is your physician colleague at risk for suicide? Signs to look for. American Medical Association https://ift.tt/31ZyCYt, A. The U.S. Spends 2,500 Per Person on Health Care Administrative Costs. Canada Spends 550. Here’s Why. Time (2020).The shift to managing more patients with fewer resources. Healthcare IT News https://ift.tt/31XE5PL (2016).Stephen H. Hanson, P.-C. EHRs Need to Talk to Each Other. (2016).Knowles, M. Patients likely to suffer when EHR systems can’t talk to each other, researcher says. https://ift.tt/2UVcf52 to share information across systems remains major EHR failure. (2017). via /r/medicine

[abdallahalhakim]

A physician thinks about his future

Lately, I have been seeing a lot of writing from Pamela Wible, MD. And today, I re-read her article about doctor suicides. As I read and reflected on how medicine has changed during my lifetime, I am struck by the degree to which the humanity scrubbed out of the system. I think about the times when I thought, “You know, it is not worth it anymore to do this, I should just go.” It is not so much that I wanted to be dead, really, I just wanted out. The urge just to get out, I have heard that urge voiced by many people, they have not wanted to die, they wanted an opportunity to leave a life that lacks good choices, opting to start over. There have been times, where I was, in fact, one of those people.

Lots of doctors kill themselves in hospitals.

When I look at the “causes” she has assembled, they ring true. I feel the pain of losing a patient, still remembering the first patient who ever died “on my watch.” The family had already gone ahead to Salt Lake City, we waited for the helicopter, and I remember how we worked to keep her alive. I remember sitting in my office afterward, crying hard because I had let her down, I had failed her, her family, myself. Each death has held a little more sorrow for me; each has given me the opportunity to see suffering up close and notice how it flows within my system as well as those around me.

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[q-u-i-c-k-s-i-l-v-e-r]

Do physician health programs increase physician suicides? —Pamela Wible, MD Reblogged on WordPress.com Source: Do physician health programs increase physician suicides? ---Pamela Wible, MD

[q-u-i-c-k-s-i-l-v-e-r]

Do physician health programs increase physician suicides? ---Pamela Wible, MD

Do physician health programs increase physician suicides? —Pamela Wible, MD

The “impaired physicians movement” often uses William Halsted as an example of how doctors can continue practicing medicine while impaired and how the “code of silence” allows it. Multiple sources document his behavior when he was addicted to cocaine including his behavior in the OR. This is what led him to treatment at Butler in Providence where Morphine replaced cocaine.and to which he was…