On my site, I spend a lot of time talking finances. And I’ve yet to mention what is by far the best investment that I have ever taken part in. It has provided my best return on investment and biggest annual interest growth. It also requires the most work, but this investment is what keeps me in the market and sticking to the plan. In fact, it is “my why” …
Find your why. It makes all the difference.
Today a physician told me she lost three colleagues to suicide in the last two months.
Loma Linda Hospital just lost three young doctors to suicide in 6 months.
Mount Sinai had 3 docs jump in less than 2 years — from the same building.
An anesthesiologist recently told me he lost 8 of his colleagues to suicide.
Each suicide should be fully investigated, …
Physician suicide is also a problem in India. Here’s what you can do.
Q. International stocks are doing really well, so I’m thinking about investing more money into them. What do you think?
A. I grew up playing ice hockey and continued to play in high school, college, and even now. Coaches often gave us the same advice that hockey legend Wayne Gretzky’s dad gave to him: “Skate to where the puck is going to be, not where it has been.”
Ice hockey is …
Don’t chase stock performance. Do this instead.
In 2017, the flagship multispecialty practice of Oregon Medical Group, moved into its new digs — a 46,000 square foot redesigned medical office building. Practice leaders and the 30-odd clinicians in six different specialties were committed to a coordinated patient experience. They wanted to ensure that patients could move smoothly between sequential visits with different care providers — on the same day. To this end, the group invested in a …
The many benefits of self-rooming patients
I need your help.
I’m trying to figure out how to get rid of something that’s terribly broken in our process of taking care of patients, and I can’t do it alone.
It’s time to kill the referrals process, get rid of them altogether.
Every day, a huge proportion of the messages we receive through the electronic health record are requests for us to “put in a referral.”
Patient has low back pain, has …
The referral system to specialists: It’s a nightmare
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 41-year-old woman is evaluated in follow-up after presenting to the emergency department 1 week ago for burning epigastric and chest pain. In the emergency department, a complete blood count and liver chemistry studies were normal, but a radiograph of the chest and upper abdomen demonstrated calcified gallstones. The pain resolved with administration …
MKSAP: 41-year-old woman with burning epigastric and chest pain
Two recent posts highlight the problems facing many medical students today.
The first was by an anonymous rising fourth-year student who has come to the conclusion that going to medical school was “a terrible, terrible decision.” It ended with a comment that medical school “is not fun. It’s jarring, scary, disappointing and absolutely depressing.”
The second was by another anonymous student who described how miserable he (or she) has been …
If you go to medical school, you will be stressed: bigly
In recent years, there has been a push across medical schools to change the grading scale towards that of a pass-fail system. The appeals of a pass-fail system to me were obvious. Instead of worrying about my grades as I had in college to maintain an adequate enough GPA to get into medical school, I believed that merely passing would lessen much of the pressures I faced as an undergrad.
Those …
The unintended meaning behind medical schools’ pass-fail system
A hundred years ago, the practice of medicine was just that: the practice of professionals specially trained to alleviate suffering and heal the sick. Doctors had a fiduciary responsibility to put the needs of their patients before their own. A small town doctor might be paid for his efforts in chickens — living or cooked.
Flash forward.
Medicine is big business. Trillions of dollars are spent every year in the health care …
Medicine could use more common sense
Death is on our floor. It has been there for far longer than I have.
On my first day in the cardiac surgery ICU, I was running late. I hurried past the dimly-lit rooms, their monitors regularly chiming their final lullabies of the night before the receptionist brightly greets the morning shift nurses and flips on all the fluorescent lights outside the twenty rooms on this floor at 7:00 a.m. sharp.
There …
I always warn my medical students to be careful what they say in front of patients, or patients’ families or friends. “You never know who’s listening!” I add. They may think that I’m exaggerating — but I have my reasons.
Early in my career as an internist/nephrologist, if I had a free moment, I’d head for the emergency room. I might get a referral, and the coffee and conversation were usually …
Watch what you say around patients
It’s amazing how frequently I cross paths with doctors who have never taken the time to actually assess where they stand financially. They tend to fall into a few categories; they never thought of it, they don’t want to know, or they feel they just don‘t have the time.
When I work one-on-one with doctors on a financial makeover to get them on track to accomplish their goals, get out of …
Physician debt: If you don’t measure it, you can’t manage it
I’m coming off a string of talks about physician finances and physician empowerment, and despite knowing that physicians are stereotypically financially naive, every once in a while I’ll hear a question that really makes me pause and drives home the need for a better financial education. The latest came up when I was discussing negotiation techniques, and somebody interrupted me to ask, “When you’re earning a six figure …
Financial freedom goes a long way towards addressing physician burnout
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Prospective physicians in the United States must undergo a gauntlet of resume-building tasks, in the end, to have little control over their career, and for some, their love life.
We just underwent Match Day, the brain-child of Alvin Roth and Lloyd Shapley who won a Nobel Prize for this accomplishment in 2012. The U.S. has been utilizing this tool since 1952, which was an improvement over the previous disorganization, which resulted …
The medical education system hates families
Have you ever wondered why most people who volunteer have an overall more positive outlook on life? Giving back to your community and serving others through volunteer work can benefit your life a variety of different ways. My list below outlines the power of volunteering and its surprising benefits.
1. Volunteering affects your thoughts. Being able to connect with others, even animals, can improve your mood. Humans are social beings who require …
5 surprising health benefits of volunteering
The last few years have been marked by public outcry over the costs of novel prescription drugs, such as the hepatitis C medication sofosbuvir (brand name Sovaldi), which are highly efficacious but extremely expensive.
On the one hand, sofosbuvir produces cure rates of >90%, a figure that seemed unthinkable a few decades ago. On the other, it is priced at approximately $1000 per pill ($60,000–$90,000 for a treatment course), making it …
Are hepatitis C drugs too expensive? Analyzing the pros and cons.
The story is almost universal. A guy (or gal) suffers through a horrendous day of work and scours the internet searching for an escape hatch. The magical mix of search words “early” and “retirement” likely leads to Mr. Money Mustache, or Get Rich Slowly, or some other fantastic resource. Hours later, after being fully submerged in the financial independence blogosphere, he resurfaces with haired mussed and rabid eyes. …
This is the key to financial independence
I’ve written a lot about the tough challenges that those of us with chronic illness face (chronic illness includes chronic pain). I thought it would be constructive to take what I tend to think of as negatives and see if I could turn them into positives. Sometimes I had to dig deep to turn a negative into a positive; nevertheless, here are the results of my experiment.
Negative: I don’t look …
Turning negatives into positives when you’re chronically ill
A patient comes to you asking, “Doc, my seizures are getting worse, I really hate the side effects of my medications, I want to go a different route. What do you think about medical marijuana?” You start sweating profusely, fidgeting in your seat, thinking of every single reason why not to recommend it and come up with the standard response, “Uh, well, I’m not qualified to recommend it, and it’s …
It’s time to start thinking about cannabinoids
“The ones you leave behind …”
That phrase often connotes loved ones who have lost a family member, friend or colleague through death.
I have thought of the same phrase often lately in a different context — one of increasing prevalence.
Here, I refer to the patients and colleagues left behind by the loss of a primary physician.
No one would begrudge the retirement of a physician who has served his or her patients …
When you leave primary care, you leave people behind
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