Physician Strong: a private practice journey

Physician
March 5, 2019

Being a primary care physician, I was afraid to start my own practice. There was discouragement from fellow physicians, hospital leaders, business colleagues, and even patients. Many said that the small practice model was not viable. With insurance mandates, mounting bureaucratic pressures from Medicare and Medicaid, increasing regulations by DEA, higher volumes of paperwork, and the health IT requirements, the task of setting up a private practice with primary care …

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How physicians can develop their emotional intelligence

Physician
March 4, 2019

If you’ve browsed the internet recently, you probably have noticed the #10YearChallenge social media trend that has taken over our news feeds. The phenomena have individuals comparing a current photo of themselves, to their former self ten years ago. As I thought about how well (or not) I’ve aged over time, it got me thinking about the two most important advice I would give my younger self (knowing what I …

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What physicians can learn from anthropologists

Tech
March 3, 2019

Since the passing of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, it has been said that health tech would dramatically revolutionize health care and the patient experience. Advocates have claimed time and time again that it would advance disease diagnosis capabilities, improve patient outcomes, and increase patient satisfaction. Belief in this narrative can be seen in the sharp increase in health tech investments, with …

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Physicians should talk about the F word: fertility

Physician
March 3, 2019

My fertility journey is not typical. I have not spent years “trying.” In fact, I have spent years trying not to get pregnant!

My husband has two daughters — and a vasectomy, so getting pregnant was a known challenge. Luckily, I like challenges. We went to an infertility specialist, who told us that reversal was not an option for us, and that IVF was our only option. A bunch of testing …

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Non-medical transportation for postpartum moms is a necessity

Policy
March 2, 2019

This past June, California’s Department of Healthcare Services went live with the implementation of its non-medical transportation (NMT) benefit. NMT is described by the National Health Law Program as “transportation provided to access medically necessary services, which is provided by ordinary forms of transportation (public transportation, taxi, or any other forms of public or private transportation).” While transportation as a benefit has long existed under California’s Medicaid program as …

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5 tips for interns tackling a busy schedule

Physician
March 1, 2019

The rotations on adult medicine and critical care are probably the most challenging ones for the residents doing internal medicine residency. No matter how much we try, we tend to feel overwhelmed, fatigued and swamped sometimes. As we progress into residency, we not only gain knowledge and clinical skills but also learn to tackle the challenges of a busy schedule. Below are some of the tips that might be helpful.

1. …

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The tip of the iatrogenic benzodiazepine iceberg

Meds
March 1, 2019

Life experience gives one an intimate appreciation for the meaning behind the saying “just the tip of the iceberg.” Everyone’s encountered something that turned out to be much larger and more complex than was initially understood. In my experience, medicine has yet to submerge its head underwater to discover the true depths of the sordid underside of what I’m calling the “iatrogenic benzodiazepine iceberg.” My own boat capsized on that …

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A plastic surgeon explains the dangers of the Brazilian butt lift

Conditions
February 28, 2019

The Brazilian butt lift (BBL) is a procedure that enhances the buttocks through fat transfer. Excess fat is harvested from other areas of the body including the abdomen, hips, lower back and thighs through liposuction. BBL is a popular procedure for those seeking to enhance their bodies. However, with the recent reports of patient deaths from undergoing BBL, many have now labeled it as the most dangerous cosmetic procedure.

Dangers of …

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Being a doctor and parent is hard: 10 ways to make it easier

Physician
February 28, 2019

Being a doctor is hard; being a mother is just as hard — if not harder — and being both often seems impossible. Looking back at my medical career it is difficult to fathom not doing both. I was an older, non-traditional student when I came back to college to attempt to complete my prerequisites for entry to medical school. I had just had a baby a few months before …

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A Xanax prescription that should have been rejected

Meds
February 27, 2019

In hindsight, I should have never accepted a Xanax prescription from my doctor. What followed was catastrophic — rapidly developing tolerance and physical dependence on the drug and a prolonged illness. Three-and-a-half years later, I am still slowly tapering off Valium (having transitioned to a longer-acting benzodiazepine to aid in tapering) and experiencing debilitating symptoms daily.

I was unprepared for what happened to me by my medical …

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Physician negotiating: Go get what you’re worth

Finance
February 27, 2019

Nearly five years into practice, I have negotiated my first contract, multiple pay increases, call compensation and independent contractor status. I prepared by researching my market value and reading about negotiation strategy. The following are some points I have learned along the way.

If you negotiate in medicine, you may feel like the only one.

Over the years, my mid-career colleagues confided that they have not received a single pay increase, only …

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Every physician will kill a patient

Physician
February 26, 2019

How did I miss his hypokalemia? Two weeks into my intern year and my patient’s potassium returned at 2.9. Minutes later, he coded. And I felt responsible. As I explained to my partner how my patient had become pulseless after diuresis of his heart failure, she looked at me and said, “Physicians kill patients, it’s inevitable. Has no one told you it’s part of the job?”

There is truth to this …

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Medical schools need to cut their cutthroat culture

Education
February 26, 2019

The United States will be short 120,000 doctors by the end of next decade, according to the latest research from the Association of American Medical Colleges.

That shortage will become permanent unless medical schools make the path to becoming a doctor a bit less arduous.

Some medical schools seem to take pride in imposing a heavy emotional and physical toll on their students. Toughen up aspiring doctors early on, the thinking goes, …

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How a medical student can help the team during clinical rotations

Education
February 23, 2019

Based on my clinical experiences, there are ten pieces of advice I would give to any medical student starting their rotations that will maximize productivity and lead to a robust and thriving work environment (your interns will thank you).

1. Do as complete of a workup on your assigned patients as you can. Be thorough with your admission H&P. Think of all the tests, labs and imaging studies you want ordered. …

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8 ways to go broke as a doctor

Finance
February 22, 2019

So much of personal finance and investing isn’t about winning; it’s about not losing. That’s because investing is a single-player game; it’s you against your goals, not you against your neighbor or your partner or some yahoo on an internet forum. However, there are precious few whose ultimate financial goal is to be broke and if you can avoid doing that, well, that’s one mark of success. There aren’t that …

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How can doctors address patients’ expectations?

Physician
February 20, 2019

No one wants to be sick, especially when no one can tell them what is wrong. In the U.S., we live in a culture where we want instant results; we want easy answers for complex problems. However, in medicine, there are often no easy fixes. Adverse medical events happen, despite our best efforts. For example, a young child was recently diagnosed with Type 1 diabetes mellitus. While he and his …

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An emergency physician with no friends

Physician
February 20, 2019

Every time I call a friend, all I have for them is more work. I’ve never yet called to say: “I hope you’re having a great day. Why don’t you take a break and have some fun? You’ve worked enough.”

Nope. I only call to give them extra work. Whether it’s 2 a.m. or 2 p.m., I need you to get away from your bed/lover/high horse and come take my patient. …

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Physicians: Don’t make these mistakes when looking for your first job

Physician
February 19, 2019

We all have either experienced the fears of starting our first job or will eventually do so at some point in our careers.  It only happens once for everyone.  Those of us who are in the market for a job change will end up reliving some of the challenges in job hunting; hopefully, we all have learned from our past mistakes. As I am advising upcoming graduates during their job …

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Physicians should stop being afraid of getting audited by the IRS

Finance
February 17, 2019

Not only is an audit unlikely to happen — if it does, it’s rarely a huge deal.

Few words inspire such fear in the hearts of Americans as “IRS audit.” But one of the biggest mistakes that taxpayers make is letting fear of the IRS stop them from taking advantage of tax savings they deserve. Especially for locums tenens docs and other 1099 income earners since the 67,000-page tax code favors …

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When depersonalization is necessary in medicine

Physician
February 17, 2019

I could hear the scream from across the room. It was shrill and filled with panic. Any parent can identify the difference between the cries of normal toddler discomforts and a true emergency.

I dropped what I was doing in the kitchen and found my three year old lying motionless on the ground, unable to move his left arm. My five year old was looking sheepishly down at the carpet, afraid …

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