Kevin MD?

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mwsapphire

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Does anybody here follow KevinMD, on Facebook or twitter?
He writes about the struggles of doctors and nurses today, what's wrong with US healthcare, what's wrong with the way we train med students, etc.
The posts are actually a bit dark, and make you feel like being a doctor won't be as satisfying as you though it would be.
It seems weird to post this here, I know, but I can't help but wonder if any of you undergrads/med students read it. It's definitely interesting, just a different perspective on life as a doc.
 
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Everything I've read from that site is heavy on sob story and light on facts or actionable suggestions. Hyperbole is the rule for writing for Kevin MD, it seems. You don't see nuanced arguments there, only poorly written soap opera-level sob stories. Yes there are problems in medicine, problems which some articles there touch on, but, as in any field, the discussion is not going to be advanced by overblown anecdotes about the horrible cold-heartedness of the field. And when the articles aim towards "solutions" or a "call to action," they often provide vague "wish upon a star" dreams that aren't workable, at least in the short term. They seem to lack the long perspective, the idea that change takes time, and happens incrementally. They call for sweeping changes to medicine that read more like fantasies than actual practical suggestions. Or, they suggest some attitude change in medicine (a recent article about resident mental health comes to mind, where the author suggests that physicians show more "empathy" towards residents), but give no concrete suggestions on how to achieve this (not just "be nicer to residents" but "specific policy change XYZ to allow residents more time off for mental health/access to mental health treatment while assuring that they are still ultimately fit to practice").
 
When I read the articles, Ive asked myself on more than one occasion, "Is this person really a practicing physician?" Its like they don't understand the basics of how training or practice works.

(I don't have the answers to the world's medical problems either but at least I'm not writing some junior college level essay about it and then proposing unfeasible or untenable solutions).
 
When I read the articles, Ive asked myself on more than one occasion, "Is this person really a practicing physician?" Its like they don't understand the basics of how training or practice works.

(I don't have the answers to the world's medical problems either but at least I'm not writing some junior college level essay about it and then proposing unfeasible or untenable solutions).
So medicine isn't that grim, right? It's just a blatant exaggeration?
That makes me feel a bit better- everytime I read one of those articles I wonder if I'm "strong enough"
( Coming from a practicing Doc is even more relieving lol 🙄)
 
KevinMD is a platform for people to air complaints. It freaked me out before I started med school, but most physicians aren't really that unhappy. Many of the article do have a valid basis, but it gets spun out into negativity. I've stopped reading it because of that.
 
Does anybody here follow KevinMD, on Facebook or twitter?
He writes about the struggles of doctors and nurses today, what's wrong with US healthcare, what's wrong with the way we train med students, etc.
The posts are actually a bit dark, and make you feel like being a doctor won't be as satisfying as you though it would be.
It seems weird to post this here, I know, but I can't help but wonder if any of you undergrads/med students read it. It's definitely interesting, just a different perspective on life as a doc.
Being a doctor is pretty dark and depressing. Our suicide, depression, and divorce rates don't just come out of nowhere. But it's only as dark as you make it in the end, I've had a petty good time even if I struggle every now and then to maintain a sense of purpose and reason in the madness of medicine.
 
Being a doctor is pretty dark and depressing. Our suicide, depression, and divorce rates don't just come out of nowhere. But it's only as dark as you make it in the end, I've had a petty good time even if I struggle every now and then to maintain a sense of purpose and reason in the madness of medicine.
But are you *really* a depressed, angsty person floating through time and space and drowning a life of too much meaning? ( the last article I read from KevinMD read like that)
 
Personal opinion: KevinMD is the HuffingtonPost of medical media.

Does medicine have a more professional critical publication? Not like JAMA or NEJM or anything gated behind the ivory tower but a real critical publication for public discourse?
 
Being a doctor is pretty dark and depressing. Our suicide, depression, and divorce rates don't just come out of nowhere. But it's only as dark as you make it in the end, I've had a petty good time even if I struggle every now and then to maintain a sense of purpose and reason in the madness of medicine.
Physicians have very low divorce rates, over 10% below the national average (24% vs 35%), which is also almost the lowest divorce rate of all healthcare workers, second only to pharmacists at 23%. Just fyi.
 
I followed on Facebook awhile back but it seems like all the articles have click bait-y headlines (which make me not want to click them).
 
Physicians have very low divorce rates, over 10% below the national average (24% vs 35%), which is also almost the lowest divorce rate of all healthcare workers, second only to pharmacists at 23%. Just fyi.
It's actually more complicated than that. Specialty, gender, educational status of partner, etc all have a role. Psychiatrists, for instance, have a 51% divorce rate. Female physicians married to lesser educated men have incredibly high divorce rates. The most tried and true pairing is a dual physician relationship, which has a divorce rate of around 10%. Marriages that are started prior to completion of residency have substantially higher divorce rates, while ones after residency have substantially lower divorce rates. Basically, you're using one number without having actually looked at the data. I've looked at the data pretty thoroughly- being a physician can have a substantial impact on your chances of starting and maintaining a successful marriage prior to the completion of residency, but is a good bet in the long term if you aren't female. If you are female, it comes down to specialty choice and partner education level, and can be a bad choice for ultimately your entire dating life forever (surgeons and psychiatrists), or can be relatively benign (dermatologists and pediatricians).

https://www.sciencedaily.com/releases/1997/03/970313111952.htm
 
I used to love KevinMD, but I have found the articles in the last year to have really changed to a pile of slobby tears.

It used to be a lot better.

There is one series from a medical student named Jamie Katuna, she makes these videos that are virtually unwatchable if not for the comedic value. They are so blown over the top, and come from someone who is just not qualified to speak intelligently about what she is talking about.
 
It's actually more complicated than that. Specialty, gender, educational status of partner, etc all have a role. Psychiatrists, for instance, have a 51% divorce rate. Female physicians married to lesser educated men have incredibly high divorce rates. The most tried and true pairing is a dual physician relationship, which has a divorce rate of around 10%. Marriages that are started prior to completion of residency have substantially higher divorce rates, while ones after residency have substantially lower divorce rates. Basically, you're using one number without having actually looked at the data. I've looked at the data pretty thoroughly- being a physician can have a substantial impact on your chances of starting and maintaining a successful marriage prior to the completion of residency, but is a good bet in the long term if you aren't female. If you are female, it comes down to specialty choice and partner education level, and can be a bad choice for ultimately your entire dating life forever (surgeons and psychiatrists), or can be relatively benign (dermatologists and pediatricians).

https://www.sciencedaily.com/releases/1997/03/970313111952.htm
Right, I get all that, but when you say "Being a doctor is pretty dark and depressing. Our ... divorce rates don't just come out of nowhere," it seems that you're unfairly suggesting that doctors have high divorce rates, when there are large subsets of doctors for which that couldn't be further from the truth. If you don't like that I used one statistic to describe doctors' divorce rates, you shouldn't have used an incorrect, vague, and suggestive blanket statement in the first place.
 
Personal opinion: KevinMD is the HuffingtonPost of medical media.

Does medicine have a more professional critical publication? Not like JAMA or NEJM or anything gated behind the ivory tower but a real critical publication for public discourse?
The Pharos is great, not really public, sadly.
 
Right, I get all that, but when you say "Being a doctor is pretty dark and depressing. Our ... divorce rates don't just come out of nowhere," it seems that you're unfairly suggesting that doctors have high divorce rates, when there are large subsets of doctors for which that couldn't be further from the truth. If you don't like that I used one statistic to describe doctors' divorce rates, you shouldn't have used an incorrect, vague, and suggestive blanket statement in the first place.
Let's just put it this way- It's much more complicated than a simple number, and for the kinds of competitive perks that frequent SDN, don't plan to enter a competitive specialty and not have it negatively impact your relationship. And expect that any relationship prior to completion of residency will have a substantially greater incidence of failure. So basically, expect a higher chance of an unhappy love life until the end of residency, or if you are female. A major shortcoming of the average stat is that the female physician workforce is smaller and substantially younger than the male one because of historical matriculation trends- looking at the stats by sex shows females basically have to cut back their hours or settle for a divorce rate nearly 50% higher than the national average.
 
I used to love KevinMD, but I have found the articles in the last year to have really changed to a pile of slobby tears.

It used to be a lot better.

There is one series from a medical student named Jamie Katuna, she makes these videos that are virtually unwatchable if not for the comedic value. They are so blown over the top, and come from someone who is just not qualified to speak intelligently about what she is talking about.
Oh that blonde basketball player woman? Yeah, besides being funny they're dumb.
 
Let's just put it this way- It's much more complicated than a simple number, and for the kinds of competitive perks that frequent SDN, don't plan to enter a competitive specialty and not have it negatively impact your relationship. And expect that any relationship prior to completion of residency will have a substantially greater incidence of failure. So basically, expect a higher chance of an unhappy love life until the end of residency, or if you are female. A major shortcoming of the average stat is that the female physician workforce is smaller and substantially younger than the male one because of historical matriculation trends- looking at the stats by sex shows females basically have to cut back their hours or settle for a divorce rate nearly 50% higher than the national average.
I think a very educated and successful woman marrying a "less successful" man is always rocky, whether the woman is a doctor, an investment banker, a lawyer, etc . I don't think it's unique to docs. But n=1 I'm really young so idk.
 
I think a very educated and successful woman marrying a "less successful" man is always rocky, whether the woman is a doctor, an investment banker, a lawyer, etc . I don't think it's unique to docs. But n=1 I'm really young so idk.
It is well documented that heterosexual men are less likely than heterosexual women to value high social/economic status in a romantic partner. Unfortunately, that doesn't seem to be changing very fast.
 
I used to love KevinMD, but I have found the articles in the last year to have really changed to a pile of slobby tears.

It used to be a lot better.

There is one series from a medical student named Jamie Katuna, she makes these videos that are virtually unwatchable if not for the comedic value. They are so blown over the top, and come from someone who is just not qualified to speak intelligently about what she is talking about.

Just looked her posts on the site... I'm sorry I did.

Jamie Katuna | KevinMD.com

Some gems:

Jamie Katuna about the Match said:
Why do we have a system that creates unemployed physicians in a society where there is already a physician shortage?

Why are we still using a system from 1952?

Bigotry in Medicine said:
The surgeon told me: “No offense, but girls really aren’t cut out for this work. They’re too fragile. They get too emotional. It’s not your fault; it’s biological.”

Yes — health care is sexist. And it is racist.

And just like our country, it is divided.

Brilliant people face an uphill battle against prejudice as they work to become healers. Abuse within the system is rarely punished or even noticed.

This has to change.

Everyone — patients included — would benefit from a system that honors compassion, diversity, and inclusivity. We must stop abusing the future of medicine.

And those are just two of her many posts.
 
I think a very educated and successful woman marrying a "less successful" man is always rocky, whether the woman is a doctor, an investment banker, a lawyer, etc . I don't think it's unique to docs. But n=1 I'm really young so idk.

You've got a long way to go in both education and maturity.

Just keep an open mind.
 
You've got a long way to go in both education and maturity.

Just keep an open mind.
No I read about this somewhere. Like, I don't think the point that was made about physician women marrying non physician men suffering having a relatively high divorce rate is isolated to doctors! That's the point I was trying to make.
My mind is open!I literally said " I know I'm very young."
 
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It's actually more complicated than that. Specialty, gender, educational status of partner, etc all have a role. Psychiatrists, for instance, have a 51% divorce rate. Female physicians married to lesser educated men have incredibly high divorce rates. The most tried and true pairing is a dual physician relationship, which has a divorce rate of around 10%. Marriages that are started prior to completion of residency have substantially higher divorce rates, while ones after residency have substantially lower divorce rates. Basically, you're using one number without having actually looked at the data. I've looked at the data pretty thoroughly- being a physician can have a substantial impact on your chances of starting and maintaining a successful marriage prior to the completion of residency, but is a good bet in the long term if you aren't female. If you are female, it comes down to specialty choice and partner education level, and can be a bad choice for ultimately your entire dating life forever (surgeons and psychiatrists), or can be relatively benign (dermatologists and pediatricians).

https://www.sciencedaily.com/releases/1997/03/970313111952.htm
First of all, there is a HUGE caveat to the end of that article. They looked at physicians who graduated medical school between 1948 and 1964, and marriage data through the 80s. Something tells me the social situation surrounding dating and marriage may have changed since then. This isn't to say that the study doesn't have some telling insights, but many of the statistics may have changed drastically since then. Particularly the statistics about women, since the sample size for female physicians was likely quite small, considering the time period. Therefore the data on female physician divorce rates could be substantially skewed for a number of reasons. For one, I imagine that the few women driven enough to pursue a career in medicine back then, amid a society that espoused much more rigid gender roles, and likely discouragement from family, friends, and colleagues, were probably much more career-oriented than most people, even most medical students. Thus they may have been more likely to forego romantic relationships, or put them second to their career if they did get married. Another huge factor was probably that men were not as accustomed to seeing females as peers back then, and this may have led to males (particularly those without similar educational achievement) to feel insecure and dissatisfied in their marriages with physician women. When you grew up with a working father and housewife mother, as was more the norm in the early to mid twentieth century, you're less likely to be accepting of a relationship where your wife takes over what you see as a masculine role in the relationship.

Today, many of these social factors are vastly different. While there is still disparity between male and female educational and career attainment at the highest levels, and the primary breadwinner of the household is still more likely to be male, a huge amount of progress towards equality has been made. There are roughly equal numbers of male and female medical students across the country, and fewer barriers (both social and institutional) for women to attend medical school and become successful as physicians. Thus, it may now be more possible for women to have a stable marriage and excel at their jobs, whereas before it may have been extraordinarily difficult. Additionally, dual-earner households are much more common today than when this study was conducted. The man working, female staying at home dynamic is far from ubiquitous now, and many if not most men have grown up in households where both parents worked. And while having the female be the one in the relationship with the higher educational attainment/higher salary is still uncommon, it's not unheard of, and probably wouldn't shake the foundation of a marriage the way it would have in the fifties and sixties.

Basically, I think and hope that the statistics, particularly those about gender, have changed since the mid-twentieth century. Primarily because it represents progress, but also because I am a woman in a long term relationship with a man who has a lower degree of education than I will, and who I will eventually out-earn, and I don't want our relationship to be statistically less likely to succeed just because of my chosen profession.
 
Personal opinion: KevinMD is the HuffingtonPost of medical media.

Does medicine have a more professional critical publication? Not like JAMA or NEJM or anything gated behind the ivory tower but a real critical publication for public discourse?
Gomers blog is a good alternative
 
It's actually more complicated than that. Specialty, gender, educational status of partner, etc all have a role. Psychiatrists, for instance, have a 51% divorce rate. Female physicians married to lesser educated men have incredibly high divorce rates. The most tried and true pairing is a dual physician relationship, which has a divorce rate of around 10%. Marriages that are started prior to completion of residency have substantially higher divorce rates, while ones after residency have substantially lower divorce rates. Basically, you're using one number without having actually looked at the data. I've looked at the data pretty thoroughly- being a physician can have a substantial impact on your chances of starting and maintaining a successful marriage prior to the completion of residency, but is a good bet in the long term if you aren't female. If you are female, it comes down to specialty choice and partner education level, and can be a bad choice for ultimately your entire dating life forever (surgeons and psychiatrists), or can be relatively benign (dermatologists and pediatricians).

https://www.sciencedaily.com/releases/1997/03/970313111952.htm
All excellent points, and I just wanted to bring up one more situation that wouldn't show up anywhere as an actual statistic. I personally have known quite a few physicians who are estranged from their spouses, but both partners chose to stay married for financial reasons. When you're carrying a ton of debt, it sometimes makes more sense not to try to split up all the finances (until it makes sense, at least) unless one or both people want to remarry.
 
the overwhelming majority of posts are, as others have said, overwrought navel-gazing from pre-meds and interns who lack the perspective to make big-picture pronouncements on the medical field.

I don't necessarily feel it's completely unhelpful to be reminded of what life feels like when you're an intern, though. It's a nice reminder for me, and one of the reasons why I read KevinMD occasionally. Not as in a "this is why we need to change medicine!!" way but in a "aww, I remember what that was like" way.

I see a large dearth of posts, though, from doctors like me who are incredibly happy in their field, who wake up every morning excited to go to work, who find a specialty that they are passionate about and want to teach, mentor, and contribute in/to that field. I would love to see articles by female physicians who aren't hand-wringing over the fact that someone disrespected them by calling them a nurse, but are instead talking about meal-planning, strategies for fitting in workouts during a workweek, healthy snacks for your office fridge, comfortable heels for clinic, etc. Not to mention strategies for mentoring students/residents, advice for juggling building a practice with academic productivity for young academic attending, and advice for establishing oneself in a new community for those of us changing jobs or taking a new job in a new geographic area.

I think there is a lot of existential angst in training, and I see a lot of that reflected in the KevinMD posts. It's easy to sometimes lose sight of the gold ring at the end of training, and wonder why you're torturing yourself through the "best years of your life". But I would love to see the site provide more of a counterpoint to this, because the reality is, finding a career that you enjoy and that compensates you reasonably well is hitting the top 10% of the American Dream.

Anyway... that was a kind of long-winded way of saying if you read KevinMD you are getting a wildly skewed perspective on the field...

(edit: I would like to thank @Mad Jack for reminding me multiple times in one thread that the odds are stacked against me finding true love as a female surgeon....)
 
I am an avid reader of KevinMD. Truly profound content. I am so passionate about the inequities we face as physicians I have chosen to moonlight every chance I get, to live in a cardboard box, and to scrimp and save so that one day I'll be able to hire Sarah McLachlan to follow me on rounds singing "in the arms of an angel". That way maybe my patients will understand, maybe put themselves in my caramel brown mantellassi shoes and omega timepiece, and live the nightmare that is today's practicing physician.
 
I am an avid reader of KevinMD. Truly profound content. I am so passionate about the inequities we face as physicians I have chosen to moonlight every chance I get, to live in a cardboard box, and to scrimp and save so that one day I'll be able to hire Sarah McLachlan to follow me on rounds singing "in the arms of an angel". That way maybe my patients will understand, maybe put themselves in my caramel brown mantellassi shoes and omega timepiece, and live the nightmare that is today's practicing physician.
I just laughed in class
:laugh:
 
First of all, there is a HUGE caveat to the end of that article. They looked at physicians who graduated medical school between 1948 and 1964, and marriage data through the 80s. Something tells me the social situation surrounding dating and marriage may have changed since then. This isn't to say that the study doesn't have some telling insights, but many of the statistics may have changed drastically since then. Particularly the statistics about women, since the sample size for female physicians was likely quite small, considering the time period. Therefore the data on female physician divorce rates could be substantially skewed for a number of reasons. For one, I imagine that the few women driven enough to pursue a career in medicine back then, amid a society that espoused much more rigid gender roles, and likely discouragement from family, friends, and colleagues, were probably much more career-oriented than most people, even most medical students. Thus they may have been more likely to forego romantic relationships, or put them second to their career if they did get married. Another huge factor was probably that men were not as accustomed to seeing females as peers back then, and this may have led to males (particularly those without similar educational achievement) to feel insecure and dissatisfied in their marriages with physician women. When you grew up with a working father and housewife mother, as was more the norm in the early to mid twentieth century, you're less likely to be accepting of a relationship where your wife takes over what you see as a masculine role in the relationship.

Today, many of these social factors are vastly different. While there is still disparity between male and female educational and career attainment at the highest levels, and the primary breadwinner of the household is still more likely to be male, a huge amount of progress towards equality has been made. There are roughly equal numbers of male and female medical students across the country, and fewer barriers (both social and institutional) for women to attend medical school and become successful as physicians. Thus, it may now be more possible for women to have a stable marriage and excel at their jobs, whereas before it may have been extraordinarily difficult. Additionally, dual-earner households are much more common today than when this study was conducted. The man working, female staying at home dynamic is far from ubiquitous now, and many if not most men have grown up in households where both parents worked. And while having the female be the one in the relationship with the higher educational attainment/higher salary is still uncommon, it's not unheard of, and probably wouldn't shake the foundation of a marriage the way it would have in the fifties and sixties.

Basically, I think and hope that the statistics, particularly those about gender, have changed since the mid-twentieth century. Primarily because it represents progress, but also because I am a woman in a long term relationship with a man who has a lower degree of education than I will, and who I will eventually out-earn, and I don't want our relationship to be statistically less likely to succeed just because of my chosen profession.

I was under the impression that high education/income men are generally more willing to date someone of lower SES than women are. That could eventually create an imbalance in terms of availability of "preferred" partners if more professional fields are now graduating at a 1:1 gender ratio.

But I suppose the SES preference in women could be partially influenced by them thinking that lower SES men will be be more insecure with a high SES partner. Are there any recent studies on this that look at young physicians specifically?
 
KevinMD is okay. I think SDN can be just as sappy and discouraging as KevinMD. Keep in mind that there are a ton of contributors, not just Kevin. But there is truly no one like ZDoggMD, 10/10 recommend.
 
I was under the impression that high education/income men are generally more willing to date someone of lower SES than women are. That could eventually create an imbalance in terms of availability of "preferred" partners if more professional fields are now graduating at a 1:1 gender ratio.

But I suppose the SES preference in women could be partially influenced by them thinking that lower SES men will be be more insecure with a high SES partner. Are there any recent studies on this that look at young physicians specifically?
I haven't gone digging for more recent studies, but the topic interests me, so maybe I should (with what time though haha). Even the observation that women are less likely to date/marry someone of lower SES also stems from these old gender roles. For centuries, women needed to marry someone who would have a comfortable income, because they sure as hell weren't able to support themselves. Those attitudes are hard to get rid of, and can probably still be seen to an extent today. But as women gain more and more income parity with men, they no longer need to discriminate against men of lower SES, education, or earning potential. So while social attitudes almost always lag behind economic realities, I predict that we will see this preference even out (or come close) in the coming generation or two.

Your second point is also valid. Why indeed would women want to chance a long term relationship with a guy who society and (maybe experience) tells them will be insecure in the relationship and ultimately leave? This thinking may push women to forgo relationships with lower SES men completely, or to not take them as seriously as a relationship with an equal/higher SES man. I feel like a similar dynamic may occur with height in dating preferences. One aspect of women's preference for taller men (generally) may be that they feel a shorter man will be too insecure in the relationship to continue it. (I was in a relationship with someone like this once. I'm a tall woman, and I dated a guy who was barely shorter than me, and he commented on it all the time.)

Additionally, I think that higher rights and visibility for LGBTQ+ couples is helping to change the landscape, even for straight couples. Same-sex couples, or couples in which one or both partners is gender-nonconforming, don't have centuries old rules about what "role" each person is supposed to play. They have to figure it out on their own, based on personal preference and ability, rather than what sex chromosomes they have. Seeing this could lead straight couples (or straight people in general), particularly those who live in urban areas with high exposure to LGBT culture, to become more flexible in the roles they take on in their own relationships.

Again, I need to do research on this if I have time, but the social landscape is changing in unprecedented ways, and this will absolutely have some effect on the rate at which women marry (and stay with) partners of lower SES or earning potential.
 
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