A budget is a guide that helps you increase your awareness of where your money is going and how much you are saving. It’s important to develop a budget early on as part of a strong financial foundation. It’s a common misconception that budgeting gets easier when you have more money. As the rapper Notorious B.I.G. famously said, “Mo’ money, mo’ problems.” Why is it important to develop a budget …
4 tips for starting a budget in residency
What is evidence? How do we gather evidence of patient harm? More importantly, what is the evidence that counts?
A research paper dating back to 2004 suggests that besides research evidence, clinical and patient experiences, as well as contextual information also constitute evidence. However, the only currency of science is data collected through systematic and rigorous research.
But when it comes to the business of medical error, Read more…
The currency of science and the value of stories
Sepsis, the body’s self-destructive inflammatory response to severe infection, is the leading cause of death in U.S. hospitals, particularly among the elderly. It starts as mild sepsis, advances to severe sepsis, and all too frequently blossoms into septic shock. More than 1.5 million Americans get sepsis each year. More than 250,000 die of the illness. One in three patients who die in a hospital have sepsis. 62percent …
Sepsis awareness: Should there be different awareness goals for the young and the old?
I have been working in pediatric primary care for nearly 5 years post-residency and truly love my work. I currently am dealing with very painful post-herpetic neuralgia and many people with this quit working. At some personal cost, I have continued my practice because I find my work day so rewarding I simply can’t imagine not being a practicing pediatrician.
On a given day I might see a newborn fresh from …
Primary care pediatrics is more than medicine : It is a calling
The landscape of health care has changed nearly beyond recognition in the past decade. If you’re a veteran of the profession, you’ve seen the other side of things — you once had the chance to live the dream, to swim in the pool of autonomy and self-employment, to call the shots and act on behalf of the patient without the constant supervision of bureaucracy. If you are new to the …
The effect of private equity in medicine
American medicine is in trouble, and the men and women who run our country’s medical societies are just the ones to save it.
Think about the trouble, the confusion, the upheaval. Some call it reform. Some call it progress. Some call it just more damn, unnecessary change. Health care is such a politically volatile phrase that it’s tough to have a civil conversation about what’s working and what isn’t. In Texas, …
How medical societies can save American medicine
Recently, a male physician made public a common, inaccurate, and appalling opinion: Women are paid less, because they don’t want to work hard.
The comment, in the September issue of the Dallas Medical Journal, asserts that women are paid less, because they see fewer patients. This is because women physicians “choose to or they simply don’t want to be rushed.” He writes that “most of the time, their priority is something …
Maybe men should have their salary reduced to the lowest paid female physician in their practice
Nobody punched me in the face. Maybe I would have preferred being punched in the face, though. And yes, I was bullied. I’m not going to talk about my own experience in this post however, because I already have post-traumatic stress disorder from the experience. I’m not ready to revisit it in detail yet.
I don’t need to talk about myself to tell you about bullying in the medical arena. I …
These are the stories of how physicians are bullied
My baby was crying non-stop as soon as we got her home. She tried to latch and did well, but I had no way of knowing how much nutrition she was getting. I counted the diapers, and the numbers were just barely on track, and she was making small quantities. I was trying to Google more tips with one hand and nurse her with the other. She was suffering, and …
The story of a new physician mother
As luck would have it, I flew (figuratively speaking, of course) down the highway to work this afternoon while listening to the sweeping saga of Harry Potter.
As you may know, not unlike the medical students we teach, no student enters the hallowed halls of Hogwarts without a gift. All possess the potential to master — after years of study and practice, of course — the art and science of magic.
Despite …
Teaching attendings: Are we Dolores Umbridge?
Jerry and his wife, Pam, were not “medical people” and wouldn’t be considered high achievers. They seemed to be taking life in stride with a “mom and pop” disposition. Jerry had Alzheimer’s disease and was returned to his care facility after having a pacemaker inserted. The staff noticed Jerry slumped in his chair and called 911. Jerry’s blood pressure was low, and EMS transported him to the nearest hospital. He …
The lost art of reassurance medicine
It was 5:27 p.m. on a Friday evening when the pager went off. “Ahh,” said the intern, “Three minutes before shift change, and the ER is paging for another admission!”
I could see the dismay on his face as he dreaded the thought of staying late on yet another Friday night. I decided to take care of this patient myself and relieved the intern of his duties. As I went downstairs …
Establishing a medical career inevitably requires signing a number of contracts along the way that we are not trained to evaluate, leaving us at risk for malignant retention strategies. At the beginnings of our careers, we were obligated to sign all contracts offered to us without question. The medical school match did not leave much choice, and salary negotiations were nonexistent. This lack of choice later changed, as most of …
3 malignant retention strategies in health care contracts
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We are human, we are not indestructible. We have feelings and emotions that can get hurt, probably more than the average person based on the careers we have chosen. Yes, we will pass up on our well-being (such as sleep, hygiene, exercise, relationships with family and friends) to be there for our patients. To receive our critical training to be able to care for others. This is our sacrifice, and …
We’re doctors, but we’re humans too
“Yes, there is a pay gap. Female physicians do not work as hard and do not see as many patients as male physicians. This is because they choose to, or simply don’t want to be rushed, or they don’t want to work long hours. Most of the time, their priority is something else … family, social, whatever. Nothing needs to be “done” about this unless female physicians actually want to …
Pay women physicians equal pay for equal work
I’ve been river rafting just one time in my life. We paid for a guided trip down Idaho’s famous “River of No Return — the Salmon,” and spent the day traveling stretches of rapids and stretches of calm. It was exhilarating enough for a newbie but not enough to ever feel like my life or livelihood was seriously at risk.
But I’ve also seen that same river at flood stage, and …
Let’s reshape the river of burnout
Do you ever wonder
what compels someone to walk away from their current life
to leave all they worked for — jobs, spouses, kids — behind?
The community around them are caught off guard
of how unhappy or unfulfilled or
the silent suffering
that made their life so hard.
We say it is shocking and act so surprised.
But that seems a pretense.
It’s no secret that compassion fatigue and physician burnout
are both on a steady rise.
For us in …
Physician resilience: cause or symptom?
Recently, a patient came in around 11 p.m., just as the chaos of the day had settled, and I was thinking of rest after 16 hours of work. He was an older gentleman with vague and concerning complaints that would demand a thorough workup. I suspended my thoughts of self-preservation and stepped in to evaluate him.
After an hour and a half, I had found a source of infection that explained …
A day in the beautiful life of this doctor
The pay gap between men and women has been a subject of interest recently, particularly in 2018 reports by Doximity and Medscape.
Notably, the gap favors men, is not explained by obvious factors such as hours worked or choice of specialty, and does not seem to be improving. In-depth studies published in the medical literature have examined the relationship between gender …
The antiquated conversations on the gender pay gap
Will physicians go extinct? Artificial intelligence, legislation, profit motives in the health care industry, and clever lobbying by non-physician providers may all contribute to our demise. However, I believe the existential threat to our profession stems from the ranks of physicians themselves.
1. Unwillingness to embrace activism
Pathologist and writer Rudolph Virchow once said: “The physician is the natural attorney of the poor.” Like most physicians, my goal is to provide evidence-based …
4 reasons why physicians will become extinct
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