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How our relationship with money can help or hinder physician burnout

Physician Finance

July 8, 2019

In one of the recent physician burnout and depression surveys, doctors were asked to name the causes of their burnout. The typical culprits were listed: lack of autonomy, EMRs, lack of support from administrators, insurance companies, lack of time with patients, and so on. However, when they were asked what would improve their burnout, getting paid more was the number 2 cause. Apparently, I am not the only …

A medical student before exams: the danger of neglecting the people she loves

Orly Farber

Medical Education

July 8, 2019

A couple weeks ago, I called up my family and non-med-school friends: “For the next couple months, pretend like I’m backpacking in the Himalayas,” I said. Pretend, I stressed, because, in reality, I don’t even intend to leave Palo Alto much in the coming months.

I’ve now entered one of the most-dreaded phases of med school: preparing for the first licensing exam, Step 1. During this time — which can last as long …

5 mistakes new physicians make when investing in real estate

Passive Income, MD

Physician Finance

July 7, 2019

We seem to get a ton of questions on the Passive Income Docs Facebook group about how to start investing in real estate. It can initially be a very intimidating venture.

I remember when I started with a $5,000 investment in a crowdfunded deal. It was downright scary. I’ll be honest, I didn’t have a great grasp of what I was investing in. However, I knew that …

The truth behind the care at a skilled nursing facility

Steven Reznick, MD

Physician

July 7, 2019

Reuters recently published an article on skilled nursing facilities and post-hospital stays. They discussed the often-lengthy time between hospital discharge and the patient being seen by a physician or “an advanced care practitioner.”

Older, more infirm and cognitively impaired patients tend to be seen later than other patients. The later you are seen, the more likely it is that you will be sent back to the acute care …

When “do no harm” is no longer textbook

Jim deMaine, MD

Physician

July 7, 2019

A call came about noon a few years ago that a patient I’ll call Stella was being admitted once again. She had come into the ER from her nursing home to receive transfusions. These were now needed every two weeks to keep her alive. The problem was that every time Stella was moved she decompensated. Her Alzheimer’s was severe. She no longer recognized her family. She was now 83 and slowly …

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When “do no harm” is no longer textbook

The physician part-time blues

DocG, MD

Physician Finance

July 7, 2019

The solution to most of my work related problems was half retirement. By leaving clinical practice and taking a less arduous administrative role, I was able to divorce myself from the worst part of doctoring. Being financially independent helped, but wouldn’t have been the complete solution. I am not ready to retire. I would be remiss, however, if I didn’t also point out the downsides. The part-time blues …

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The physician part-time blues

What’s the biggest lesson of intern year?

Sara Walker, MD

Physician

July 6, 2019

Even during medical school, there was always the running joke about getting kidney stones. With the frenetic pace of many rotations, it was always difficult to squeeze in bathroom time, and I suspect many of us adopted the same solution – drink less water. That is certainly how I survived my month on vascular surgery. After a nine-hour case, I was told by one of the residents that everyone was …

Is the journey in medicine leading me to my best self?

Scott Hippe, MD

Physician

July 6, 2019

“Medicine robbed me of my 20s.” I’ve heard the line many times in my medical training. It often comes accompanied by a long sigh, a slow sip of coffee, and a glazed stare off into the distance. “Imagine what could’ve been,” the seasoned physician muses, “if I had my 20s to do over, without medicine.”

But now, I am mere months away from leaving my 20s behind. To be completely honest, I often feel similar …

Take a break from all the bad news, and praise hope

J. Leonard Lichtenfeld, MD

Physician

July 6, 2019

Reading the headlines in the morning newspaper lately can downright depressing. It was with that feeling that I recalled three conversations I had recently with people who have various cancers. And I realized that despite all the chaos around us, maybe it’s time to say something in praise of hope.

Hope is very real, especially when you or a loved one or someone you know is diagnosed and treated for cancer. Hope …

MKSAP: 69-year-old man with chest pressure and dyspnea

mksap

Conditions and Diseases

July 6, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 69-year-old man is evaluated during a follow-up visit. He initially presented with a 3-month history of chest pressure and dyspnea that occurred primarily with exertion. Despite maximal medical therapy, his symptoms have not abated and adversely affect his quality of life. Medical history is significant for type 2 …

American physicians deserve timely payment

Peter Ubel, MD

Health Policy

July 5, 2019

Health care reimbursement in the U.S. is frighteningly complex. We have federal payers, like Medicare; state/federal payers, like Medicaid; private, for-profit insurance companies, like Aetna; private, not for profit insurers, like many local Blue Cross Blue Shield networks. Oh yes, and we have private insurance companies managing reimbursement for many Medicare and Medicaid recipients.

This complexity comes with costs. Doctors and hospitals need to hire armies of people to process bills …

Thinking about changing jobs? Here’s what physicians should consider.

Smart Money, MD

Physician Finance

July 5, 2019

A large percentage of doctors end up switching jobs within the first five years of practice. This really isn’t surprising given that the medical training experience doesn’t necessarily correlate with the medical practice experience. Many doctors work hard throughout their entire training only to realize that their expectations do not necessarily align with reality. Is it our fault that we don’t really know what we got ourselves into?

Perhaps taking q3 …

8 incredible side effects of being debt free

Cory Fawcett, MD

Physician Finance

July 5, 2019

Most Americans live their lives on borrowed money, constantly spending a little more than they make, leaving them with a growing debt. These debt payments, and the added interest they must pay on their debt, decreases the amount of money that they have available to spend on future needs. Paradoxically, borrowing to buy depreciating items, decreases one’s net worth.

Stop the madness this year. No more spending more than you make. …

What to do with disparaging doctors

Christopher Johnson, MD

Physician

July 5, 2019

Doctors who disparage, or even ridicule, what parents tell them are, fortunately, rare. Nevertheless, sometimes parents may infer from what the doctor says or how he acts that he does not value what they are telling him, even though he did not mean to imply such a thing. All physicians have had the experience of overly touchy parents inappropriately assuming from our questions that we do not respect their ability …

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What to do with disparaging doctors

Understanding the distinction between universal health care and a single-payer system is critical

Niran S. Al-Agba, MD

Health Policy

July 4, 2019

The World Health Organization describes universal health coverage — a system coupling health care access with financial protection for all residents — as the “single most powerful concept that public health has to offer.” The goal of universal care is to give all people the equal opportunity to enjoy the best health possible.

I wholeheartedly endorse universal health care, though not a single-payer system like “Medicare for all” because there is …

Practicing medicine full-time in America is very difficult. It’s time to think outside the box.

Suneel Dhand, MD

Physician

July 4, 2019

Talk about physician burnout and job dissatisfaction is everywhere right now. If you are a doctor, you cannot escape the news. Within the last couple of weeks, organizations in Massachusetts (a mecca of healthcare and hospitals) declared physician burnout a “major public health crisis.” This all sounds rather dramatic. On the surface, physicians are reasonably well paid, still enjoy a good degree of autonomy (certainly compared with many other …

Should doctors quit or retire?

DocG, MD

Physician Finance

July 4, 2019

There seems to be one question that drives the financial independence community. Not for everybody, but a large percentage of the group are chomping at the bit. The question is simple yet infinitely complex. It drives at the heart of what it means to be financially independent and evokes our greatest hopes and fears. It is often the reason we stumbled across the idea of financial freedom in the first …

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Should doctors quit or retire?

When Dr. Pimple Popper teaches us something more

StorytellERdoc, MD

Physician

July 4, 2019

Several years ago, my daughter Emma introduced me to some videos on YouTube of a dermatologist from California who posted her sometimes shocking but always intriguing encounters with patients who suffered from a variety of dermatologic issues. Of all of these videos, it seemed like the ones which made Emma happiest to watch were the videos in which this doctor’s treatment resulted in gallons of pus draining from some part …

Why is it so difficult for Americans to make doctors’ appointments?

Peter Ubel, MD

Health Policy

July 3, 2019

Jill Ladkin was already having a terrible autumn. It began with a seizure that put her in the hospital with what seemed like scores of unfamiliar physicians attending to her state of health. The brain scan revealed a mass in the lining of her brain, a location usually signifying a benign tumor; but, given her seizure, the tumor was hardly what you would call a harmless growth. The surgeon had a theory of what …

The problem of physicians and nurses connecting patients with hospital fundraisers

Michael Kirsch, MD

Physician

July 3, 2019

Many organizations solicit private donations from benefactors and philanthropists. Is there a stadium in the country that does not bear the name of a prominent donor? There are also anonymous donors who are not cursed with egos that require their names to be emblazoned in giant font on a building’s façade. But, most donors want recognition which is often used as an incentive when soliciting the donation.

Donors understandably receive perks …

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