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What physicians should know about Bitcoin but were afraid to ask

Physician Finance

January 4, 2018

2017 has been the year of the cryptocurrency. Of course, the most famous is Bitcoin. It’s been all over the news recently, largely because its value has skyrocketed in a very short time. Since the focus of this blog has a lot to do with investing, particularly in alternative investments, I’d be remiss if I didn’t at least touch on the subject.

Now, making money from currency exchanges is nothing new. …

Here’s what you learn when a young patient dies

Shubham Bakshi, MD

Physician

January 3, 2018

“This is a 17-year-old boy who came in as a category 1 trauma yesterday for a rollover MVC with bilateral uncal herniation, epidural hematoma and subdural hematoma currently intubated and sedated with propofol and fentanyl.”

As the overnight resident presented this patient on PICU, we could see everyone’s early morning smiles fading slowly and beginning to understand the grave consequences anticipated in this severe traumatic brain injury. We could see the …

Why do health care CEOs permit toxic workplaces?

Paul DeChant, MD, MBA

Physician

January 3, 2018

Would patients be admitted, or people be allowed to come to work, in a hospital that had Legionnaires’ disease spreading through its HVAC system or cryptosporidium in its water supply?

When there is an unusual smell associated with headaches and nausea in a surgical unit or emergency department, do people continue to work there and show up for their next shift as though this is status quo?

Of course not.

Why is it …

The door that connects two worlds is still elusive

Andrea Eisenberg, MD

Physician

January 3, 2018

It had been a long gloomy Fall day. When I got home, all I wanted to do was climb into bed and sleep and sleep and sleep. Emotionally, I was spent after a long day at work. But my husband and I had planned to go to services at temple that night – there was a guest singer that comes once a year, and I love his music. So, with …

What’s going to replace hospitals that downsize?

Kenneth Lin, MD

Health Policy

January 3, 2018

I recently rounded on patients at Providence Hospital as the attending physician on the family medicine residency program’s inpatient service. Providence recently closed its maternity ward as the first step in a planned redevelopment of the hospital grounds into a “health village.” In the short term, the hospital’s decision to stop delivering babies may worsen maternal health disparities, as the entire eastern side of Washington, DC is …

Why the social history is important

Maria Yang, MD

Physician

January 3, 2018

From the notes I read, it seems that other medical specialties limit “social history” to whether or not someone uses tobacco, drinks alcohol, or uses drugs.

“Social history” is meant to get a sense of the context in which people live. Where do they live? Who do they live with? How did they come to live there? Where did they grow up? What sort of work do they do? How much …

Read more…

Why the social history is important

Why are so many doctors doing multi-level marketing?

Passive Income, MD

Physician Finance

January 3, 2018

My goal with this post is to try to answer some of the more popular questions that we get asked about multi-level marketing (MLM). Why write about it? Besides the fact that my wife and I are involved in one, and it’s made a significant impact on our income, the number of physicians getting involved these days is huge.

My goal is not for everyone to go out and …

It’s time to make oral contraceptives available without a prescription

Jeffrey A. Singer, MD

Medications

January 2, 2018

At his recent confirmation hearing, Alex Azar, President Trump’s nominee for secretary of Health and Human Services, was grilled by senators who wanted to know where he stands on requiring employers to provide oral contraception coverage in their employee health plans — even if employers object on religious or moral grounds. While avoiding specifics, …

The patients behind the cool cases

Alexander Rakowsky, MD

Physician

January 2, 2018

“Wow, cool case,” was the response from the residents in continuity clinic on Monday morning as I told them about a patient I had seen over the weekend at our main campus urgent care. Ironically, or maybe more tellingly, I thought the same thing; “that was a cool case.”

The “cool case” was a senior in high school who was eagerly looking forward to her college career but woke up with …

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The patients behind the cool cases

The CDC word ban: an attack on the patients I treat

Rachel Alinsky, MD

Health Policy

January 2, 2018

When I read the Washington Post article about the CDC censoring seven words last Friday night, my mind immediately jumped to the youth I take care of every day in my Baltimore clinic. It felt like a direct attack on the very patients I became a doctor to treat: the transgender young person initiating gender-affirming hormone treatment; the young woman seeking inpatient addiction treatment for the first …

A physician helps a retired couple rebalance their portfolio. Here’s what he did.

Physician on FIRE, MD

Physician Finance

January 2, 2018

In January of this year, I wrote one of my favorite posts after helping a retired couple free themselves from their financial advisor, greatly simplify their portfolio, and saving them more than $20,000 per year in the process.

For details, please read “From 28 Funds to 3,” then return here for a follow-up. In summary, the couple previously owned 28 funds (with 48 positions between three accounts). The …

Surgeon suicide-homicide: What happened to Dr. Chris Dawson?

Pamela Wible, MD

Physician

January 1, 2018

Editor’s note: If you or someone you know is in crisis, call or text 988, or chat at 988lifeline.org, to reach the 988 Suicide & Crisis Lifeline in the U.S. It is free, confidential, and open 24 hours a day.

Sometimes there are no words. Not even a eulogy.

Then one courageous family writes this obituary. (This obituary was written by …

Relative risk reduction is a troublesome way to convey the benefits of treatments

Peter Ubel, MD

Medications

January 1, 2018

How excited would you be about a medication that lowered your risk of cardiovascular death, heart attack or stroke by 1.5%? Excited enough to spend a few thousand dollars a year on the drug? I expect not.

What if, instead, the drug reduced those same terrible outcomes by 20%? That’s probably enough benefit to interest some in the drug.

Well, those statistics come from the same clinical trial, evaluating the same drug. …

Why is health communication so poor? Here are 5 reasons why.

Suneel Dhand, MD

Physician

January 1, 2018

Many of the everyday coalface problems we face in health care are simply due to suboptimal communication. It could be the patient or family member who doesn’t know what’s going on in the hospital, the nurse who is confused about orders, or the doctor who doesn’t understand the reasoning behind the seemingly terrible administrative directive they are receiving.

Take it from me, as someone who has seen health care at close …

Should you give up your Starbucks latte?

Wall Street Physician, MD

Physician Finance

January 1, 2018

You’ve probably heard of the Starbucks latte effect.

As the theory goes, small changes, multiplied and compounded over time, can end up becoming big savings.

For example, if you drink 1 Starbucks latte for $3.50 every day for 250 work days a year, then over 10 years, you’ll have spent tens of thousands of dollars on Starbucks coffee. Cut the Starbucks coffee from your life, and you could buy a nice car …

What would you do if you won the lottery? Here’s one physician’s plan.

Dads Dollars Debts, MD

Physician Finance

January 1, 2018

Yup, I won the lottery! $785 million dollars. Pinch me because I must be dreaming. I am a physician finance blogger; I would not recommend buying a lottery ticket. But I did. So screw all the people who said it was a waste of $2.

So here I am, the big time winner: What to do now? Well, that is what this post is about.

(In reality, I did not win the …

Collaboration with hospitalists, rather than competition, improves patient care

Charles Jaynes, MD

Physician

December 31, 2017

It’s been 21 years since Drs. Robert Wachter and Lee Goldman, in an article in the New England Journal of Medicine, first described a new delivery model called “hospitalists” – clinicians whose primary professional focus is the care of hospitalized patients. Since that time the healthcare system has seen rapid growth of hospitalist programs across a variety of specialties.

In the OB world, I have had the opportunity to …

Doctors aren’t just white coats without a face

Devon Romano

Medical Education

December 31, 2017

Doctors are all the same: A sea of uniform “white coats without a face” caring for “patients without a face.”

They heal the sick. They save lives.

And they drive their fancy sports cars to their expensive homes and cushy lives.

Not.

I am embarrassed to admit, as a pre-med/medical school hopeful, this was my perception of physicians and patient care before completing two summer internships at a doctor’s office.

A problem that the majority …

5 ways to get out of the physician burnout black hole

Kathryn Schneider, MD

Physician

December 31, 2017

Practicing medicine with all of its responsibilities often reminds me of a black hole. It seems each time something new is added it gets pushed into the vast vortex of the black hole, hidden from those around you and jumbled with everything you are expected to do.

People around you see the world as you present it. They rarely get a glimpse through the pinhole to the expansiveness that is beyond …

How to choose between a traditional and Roth 401(k)

Live Free MD

Physician Finance

December 31, 2017

In my post, “Use it Or Lose It,” I talked about the awesome benefits of the Roth IRA. You do have to pay taxes on the money now, but it grows tax-free, and you can withdraw the money after age 59.5 without owing any taxes. It’s the only way to win the tax game. It is 100% your money, forever!

In comparison, money in a traditional IRA, traditional 401k, …