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Navigating the broken medical system: challenges faced by foreign medical graduates

Anonymous

Physician

August 25, 2023

As I sit here contemplating the beginning of this unsent letter, I find myself questioning its intended recipient and purpose. The truth is, I don’t have the answers just yet. Perhaps, by the end of these few paragraphs, some clarity will emerge.

When I left my home country to come to the United States, I envisioned hospitals here as being on par with what we would consider “first-world country” institutions. I …

Navigating patient requests: Balancing care and communication

Jennifer Shaer, MD

Physician

August 25, 2023

If you are a practicing physician, then you have definitely come across patients who want something that you feel is unnecessary. Sometimes those conversations escalate and become contentious, and sometimes you reluctantly give the patient what they request even though you know it’s not “best practice.” These demands and interactions can weigh on us and leave us emotionally drained.

In the pediatrics office, that can look like this:

A parent wants …
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Navigating patient requests: Balancing care and communication

Why embracing money conversations is good for your health

Pranay Parikh, MD

Finance

August 25, 2023

Money, a topic often shrouded in secrecy and discomfort, has the power to shape our lives and influence our opportunities. Whether we like it or not, finances play a pivotal role in our personal and professional endeavors. However, our fear of talking about money can become a significant hindrance, limiting our potential for growth and success.

In many ways, discussing finances has become a social taboo. We avoid it at family …

Ensuring compensation during absences

Deepak Gupta, MD and Sarwan Kumar, MD

Physician

August 25, 2023

As human needs continue to evolve, it is essential for our systems to adapt accordingly. One perplexing question is who bears the cost of human work. Do the systems pay for human labor, or do humans contribute to the systems, which, in turn, pay for their work? From an economic perspective, it boils down to humans paying for humans to work through human-devised systems. We won’t delve into the idea …

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Ensuring compensation during absences

Exploring how thoughts shape emotions and perception [PODCAST]

The Podcast by KevinMD

Podcast

August 24, 2023

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

Join Miguel Villagra, a hospitalist, as we explore how our thoughts shape emotions, dissecting cognitive distortions like all-or-nothing thinking, overgeneralization, and more. Discover strategies to break free from negative loops, challenge assumptions, and cultivate a balanced perspective. …

The cost of skipping business education for doctors

Curtis G. Graham, MD

Finance

August 24, 2023

Every business, regardless of type, size, or structure, has one primary reason: to make profits. In economic theory, every business is successful exactly to the extent that it does something others cannot. Business profitability rises to the extent that universal business principles are adopted and integrated into the medical practice business.

Business growth, endurance, and increasing profits over time are possible only when business management principles and marketing strategies are embedded …

Essential postpartum care: lessons from 30 years in OB/GYN

Theresa Mahon, MD

Conditions

August 24, 2023

Almost 30 years ago, as an OB/GYN intern at a large urban medical center, I was privileged to learn from exemplary doctors and midwives. After 4:30 a.m. postpartum rounds one day, a midwife said, “I saw your note. You listened for bowel sounds and examined her abdomen.” I replied, “I did.” She asked, “Did you also check her bottom?” I responded, “No. Why?” She explained, “She delivered the baby through …

Navigating the rising challenges of dermatology residency applications

Hannah Kopelman, DO, MBA

Physician

August 24, 2023

The path to becoming a dermatologist has become increasingly challenging in recent years. This is due, in part, to the competitive environment of residency applications, as well as the increasing emphasis on research output. In their publication, “Research Fever—An Ever More Prominent Trend in the Residency Match,” Dr. Ahmed and Dr. Adashi note that the number of research publications on residency applications has increased significantly over the past decade. This …

Why your physician career needs more than a contract lawyer for maximum compensation

Contract Diagnostics

Finance

August 24, 2023

During my tenure as a practicing physician, I’ve grasped that each patient necessitates and is entitled to comprehensive and unique follow-up care. Fascinatingly, this rule also relates to us, the contracted physicians. I’ve realized that a physician’s employment contract isn’t static; it is subject to deliberate and incidental alterations.

The involvement of attorneys in contract negotiation is imperative, but their influence tends to recede after the contract …

The medical establishment’s fight for and against diversity

Arthur Lazarus, MD, MBA

Education

August 24, 2023

The recent ruling of the Supreme Court of the United States (SCOTUS) to eliminate race-conscious decision-making from college admissions is being openly challenged by the medical establishment. The American Association of American Medical Colleges (AAMC), the Medical Board of California, and the John A. Burns School of Medicine (JABSOM) at the University of Hawaii (among others) are continuing efforts to diversify education and medical staffing despite a 6 to …

Game theory in health care: Deciphering decision dynamics [PODCAST]

The Podcast by KevinMD

Podcast

August 23, 2023

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

Join Jay K. Joshi, a family physician and the author of Burden of Pain: A Physician’s Journey through the Opioid Epidemic, as we delve into the intricate world of clinical decision-making within evolving health care policies. Our …

Terminal illness: Navigating the struggles of acceptance

Linda Thomas, RN

Conditions

August 23, 2023

Reality knocked me for a loop one evening when my father-in-law called from his home in another state and asked for help. This kind of request was very uncharacteristic for him. We responded immediately and drove to his home. After much conversation and many questions from both sides, we eventually came to the hard truth. His cancer had progressed and, to my mind, was most likely terminal. I dug in …

Resisting burnout in health care: Empowering inner practices

Wendy Lau, MD

Physician

August 23, 2023

Burnout isn’t our fault. However, since we can’t change the inner workings of large institutions all at once, if at all, how do we push through? How do we do more than just survive?

“More and more doctors are coming to believe that the pandemic merely worsened the strain on a health care system that was already failing because it prioritizes profits over patient care,” wrote Eyal Press in the New …

Curing ailing health care: Embracing ethical traditions and prioritizing patient care

Shah-Naz H. Khan, MD

Physician

August 23, 2023

The cure for ailing health care lies in returning to ethical traditions, prioritizing patient care over profits, holding physicians accountable, and reforming existing oversight bodies and professional organizations. The ailing health care is curable. To be made whole again, it requires obvious but drastic steps. The crux of the problem is that medicine largely abandoned its own traditions and time-tested modus operandi in favor of the seemingly efficient and shiny …

Battling COVID chaos and recruiting doctors

Samuel Shem, MD, PhD

Physician

August 23, 2023

An excerpt from Our Hospital.

Kush Kare Hospital in Columbia, New York, was the flagship of Kush Kare Private Equity Inc., a for-profit chain of hospitals across America. A for-profit that was listed on a lot of lucrative trading routes. Clearly its workings were murky—maybe not equity at all. A clever …

In the trenches of health care: Facing unbearable strain

Anonymous

Physician

August 23, 2023

I’m so sorry, but the pain was too much, and I couldn’t continue. I have witnessed patients crying themselves to sleep while nurses held their hands, praying for their treatments to be approved, giving them one more chance at life. Nurses try to juggle 8, 9, 10, or more patients during their shifts, holding onto their compassion with the last thread of hope that things will improve. Yet, they’ve also …

Authenticity and bias in recommendation letters [PODCAST]

The Podcast by KevinMD

Podcast

August 22, 2023

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

Heather Furnas, an adjunct clinical associate professor at Stanford and an aesthetic surgeon, joins us as we delve into the intricate world of recommendation letters, biases in evaluations, and their impact on diverse fields. Heather lends her …

When death comes to your job: Grieving what was and moving on

Melissa Welker, MD, MPH

Physician

August 22, 2023

It has been only two weeks since I realized the job I had was gone. As physicians, I think we have this idea of what our work will look like into the future. It is enshrined in pomp and circumstance from the start as we take an oath to “do no harm,” it’s encrusted with an unspoken culture of medicine that often asks us to give more than we thought …

Choosing financial advisors for physicians

Amarish Dave, DO

Finance

August 22, 2023

Did you know that according to research, teachers are more likely than doctors to become millionaires? How is that possible? Well, some of it has to do with the social pressure we face. However, a lot has to do with many of us thinking that because we are highly educated, we can also be effective financial advisors for ourselves. The reality is that for most of us, this is …

DEA’s criteria for identifying pill mills: a physician’s analysis

L. Joseph Parker, MD

Physician

August 22, 2023

Many physicians reading this forum treat pain and addiction and may wonder what criteria the DEA believes to be indicative of a pill mill. The following is from a motion filed in federal court regarding the prosecution of a physician:

The government claimed in the motion that pill mills, “have been found to have common characteristics, including some or all of the following”: