Converting your 401(k) to a Roth IRA after residency or fellowship

Finance
August 8, 2018

Many residents and fellows will contribute to a 401(k) or 403(b) over the course of their medical training. They should be commended for saving for retirement on just a resident’s income.

Often, newly-minted attendings wonder what to do with these 401(k)s or 403(b)s from their training hospitals. In particular, they wonder whether they should convert their 401(k) to a Roth IRA.

4 options: some better than others

In general, there are four things …

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Working in the ER on holidays

Physician
August 7, 2018

As I prepare to go into work for another string of night shifts, I become aware that this is just another holiday that I will be working. It’s the Fourth of July, not a major holiday as is designated by any scheduler, so no credit will be given to those of us who work today. Some previous employers have given extra pay for said days, as little as $200 to …

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Gender bias and the word, “doctor”

Physician
August 7, 2018

When I first began writing about the “doctor” title, I led with my personal beliefs. But as my research expanded, I realized there were so many variables and so many experiences that have shaped other women’s views on being called “doctor.”

Call me “doctor,” please

A few years ago, I was at a charity event for underprivileged kids in Detroit. One of the board members was a well-spoken nurse with a PhD. …

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9 non-medical careers for doctors

Physician
August 6, 2018

With burnout on the rise, many physicians are choosing to leave clinical medicine for alternative careers. Other physicians are wondering if it’s worth it to stay in a workforce that does not pull for the well being of their frontline workers.

Gone are the days where physicians stay stuck suffering in a practice or career that is no longer fulfilling or worse, causing burnout. Those physicians are considered old-school and are …

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The human hand: not really that good for anything

Conditions
August 6, 2018

Long ago primitive sharks had ridges running down their sides from gill to tail. Later, muscles grew into the folds, and eventually, the central portion of each ridge receded while the ends enlarged to form fins both fore and aft. All was well.

Then one day several hundred million years ago, a fish was swimming blissfully in a shallow pool. The tide went out …

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Why doctors don’t call in sick when they should

Physician
August 5, 2018

Recent research from Florida Atlantic University and Cleveland State University have found a direct correlation between preventative health care and the number of paid sick leave days a worker gets. Workers with more than 10 paid sick days annually access preventative care more frequently than those without paid sick days.

Preventative care, in turn, leads to better overall mental and physical health. Doctors that are in private practice function …

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What is your blindspot: managing cognitive bias

Physician
August 5, 2018

I can vividly remember my first day as a real doctor. I started on the pediatric pulmonology service, and recall spending what felt like an hour, deliberating whether I could order Tylenol for my patient. Would it interact with the Pulmozyme treatment? Fortunately, I had very patient senior resident who calmed my nerves and was empathetic to my intern anxiety.  Summer is an exciting, terrifying, rewarding and sometimes frustrating season, …

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Growing up with women in emergency medicine

Physician
August 4, 2018

I come by many things in my life naturally — my stubbornness, my red hair, and my career. I am very fortunate. Unlike many I am the daughter of a female emergency physician. This is something I never really considered while growing up. Yes, my mom was a doctor. Did she save lives? I guess so. She didn’t spend much time talking about life outside of the home, and she …

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Don’t let physician identity define you

Physician
August 3, 2018

When I left clinical practice, I thought I was prepared for the change in my identity.

Wrong.

I was shocked by the degree to which my sense of myself and my value in the world were rocked by leaving the profession. After all, I left practice less than seven years after I could legally write MD after my name. In residency and when practicing (and even to some extent as a medical …

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Is debt-free medical school a financial blunder for doctors?

Finance
August 3, 2018

Education can be expensive. Higher education can be even more costly. Even partial scholarships can be deceptive as one might opt for a more expensive school for the sake of redeeming “free money.”

As a student, I had no financial understanding of return on investment when I was considering higher education. All in, I plowed through more than a quarter million dollars in my college and medical school after substantial scholarships …

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We should all care when patients get too many Z-paks

Meds
August 2, 2018

Many people seem to believe that the Z-pak possesses magical qualities. Patients come in requesting it for the common cold, because it worked for them in the past. Not only do many believe it cures the common cold, but they think it can treat any infection. Have a urinary tract infection? Just ask your doctor to prescribe a Z-pak! Sniffles got you under the weather? Do the same!

Anyone who believes …

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Nurses are always right. And 28 other tips for new residents.

Physician
August 1, 2018

This summer, new resident physicians begin their training all across the United States. Today, our future family physicians and pediatricians, neurosurgeons and emergency physicians, plastic surgeons and laser tattoo removal specialists (OK, not really a specialty, just a sideline) will begin learning how to be physicians, having completed four years of expensive college and four years of even more expensive medical school. Anxiety-filled and debt-ridden, they will embark on four …

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Is double health insurance coverage better?

Finance
July 30, 2018

You have just gotten a job offer that includes health insurance.  You’re lucky enough that your spouse has great family insurance already, but hey that health insurance is going to cover the cracks in the deductible and co-insurance, so you feel great about that double coverage as you sign your contract.

Well, you just got scammed.  That is, double coverage is a scam, and you would have been far better off …

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The double-edged power of the medications we prescribe

Meds
July 30, 2018

My patient, a rugged sixty year old with massively muscular forearms, gray chest hair at the V of his denim shirt, and a voice that suggested years of liquor and unfiltered cigarettes, lowered his voice and leaned forward.

“I’m not usually scared of anything, but for three nights now, ever since I started taking the Levaquin for this pneumonia, I have had the most horrific nightmares. I can’t even talk about …

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Is going to medical school a wise financial decision?

Finance
July 30, 2018

It is no secret that medical school is getting very expensive. Over the past 20 years, the cost of medical school has greatly outpaced the rate of inflation, and medical school debt is rapidly rising.

The average medical student now graduates with over $192,000 in student loans, but with the cost of attendance for the most expensive private medical schools approaching $100,000, there are some physicians who are finishing residency with $300,000 or …

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Urgent care centers prescribe more antibiotics. Why is that?

Conditions
July 30, 2018

Urgent care centers are way ahead in prescribing unnecessary, potentially harmful antibiotics that are doing no one any good – at least no patients any good. The owners of the urgent care centers are the ones who are benefitting. And you and your family are being bilked, misled, and harmed.

A recent study published in JAMA Internal Medicine looked at the proportion of antibiotic prescriptions that were made for viral respiratory …

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The simple, powerful question doctors should ask their patients

Physician
July 29, 2018

As physicians, we are used to asking our patients lots and lots of questions. It’s our job to elicit information, listen, and then come up with a management plan. There’s a standard script every doctor goes through, based on the science of medicine, and we usually have this memorized to a tee. And that’s all very well and good. However, as with many things in life — especially those that …

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What personality type fits your medical specialty?

Physician
July 29, 2018

Both patients and providers realize that an internist is different from a surgeon, but specifically how they differ and how this affects their approaches to patient care is largely under-appreciated. Over the last four years, I have conducted over 250 interviews with physicians across specialties and institutions about what they do and why they do what they do. With each project, I continue finding remarkably distinct, specialty-specific values, perceptions, and …

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The other side of Suboxone

Meds
July 28, 2018

A lot has been written about Suboxone, the buprenorphine treatment drug. For many, Suboxone acts as an effective medication to treat opioid addiction. For others, it’s a highly-valued street drug that is commonly diverted and misused. To understand and acknowledge the darker side of Suboxone we have to look back at its history over the past 16 years.

History of Suboxone

Suboxone was first approved by the FDA in 2002 to treat …

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