Structure case conferences as a primary way to teach and learn

Education
August 14, 2018

When we studied ward attending rounds, the thought process represented the top attribute that learners valued.  Learners can learn facts from textbooks, but using those facts requires experience and role modeling.

I have given many lectures on clinical reasoning, and I have attended many lectures on clinical reasoning.  These lectures can entertain, but one lecture does little to help our colleagues and our learners.

We must structure case conferences as a primary …

Read more…

4 disturbing trends in health care

Policy
August 13, 2018

It’s easy to get excited about technological advances such as nanobots that swim in blood to deliver drugs or 3-D printers that print human tissues. However, in our enthusiasm to find the next fix, we are failing to notice the ground slipping underneath the health care industry.

Here are four trends that are changing health care but on the surface are too unsexy for us to care about.

Trend 1: The doctor-patient …

Read more…

A private equity primer for physicians

Finance
August 12, 2018

“My group has been approached by a private equity company.  It sounds like a great deal!  Any questions I should ask?”

Whether it be through one on one discussions or through the Physician Side gigs group, I’ve found myself having this conversation with increasing frequency.  Part of the reason for that is because I find it fascinating, albeit also sometimes terrifying.  As the trend towards consolidation …

Read more…

Atul Gawande’s prescient 2012 TED talk

Policy
August 12, 2018
YouTube video

Health care is buzzing as Atul Gawande has been selected as CEO of the Berkshire-Hathaway/Amazon/JP Morgan strategic venture. I was thrilled they picked a physician, like myself, in the trenches to run their gig. After hearing the news, I remembered Gawande’s TED Talk from 2012 and decided to catch up on it during my flight to the Healthcare Finance Management Association Annual Meeting and Innovation Lab.

After watching the …

Read more…

New interns: Get ready to be fleeced

Education
August 11, 2018

This one’s for the new interns.

You’re excited, you’re about to start residency. You’re a doctor. No more short white coat. You’ve got the long white coat that you’ve been waiting for. You’ve arrived.

But actually, there’s one more thing you need before you really feel like you look like a doctor. It might be a few months. There’s going to be a long process. Someone in your program, maybe the chief …

Read more…

How to write a medical school diversity essay

Education
August 10, 2018

Now that you’ve turned in your AMCAS (phew!), you’re probably wondering how to tackle the monster of secondaries coming your way. One of the most common questions asked in one form or another is the diversity essay for medical school. Have you ever wondered why diversity is such an important component of the medical school admission process? I’ve heard a lot of pre-med students eager to write this off …

Read more…

How perception can affect your financial situation

Finance
August 10, 2018

An interesting phenomena recurs when I work with physicians to makeover their finances. They almost never believe that overspending is the problem. They believe the reason their credit card balance is growing, and their large monthly income isn’t enough to pay their expenses can’t be due to their own choice to overspend. They always have a reason for the lack money:

They have huge student loans.

They have eight kids.

They are in …

Read more…

The best way to fight misinformation in health care

Physician
August 9, 2018

Fake news is a term that’s become notorious over the last couple of years. For notorious reasons perhaps. But there’s actually another serious arena where there is inadvertently an awful lot of “fake news” on a daily basis. And that is, well you guessed it: in health care throughout our nation’s hospitals and offices!

Let me explain, and I suspect anyone who works in health care will be familiar with the scenario. …

Read more…

Changing the treatment plan when covering for another doctor

Physician
August 8, 2018

I was a little taken aback when Dr. C. changed my patient from warfarin to one of the novel anticoagulants. And one I seldom use, at that.

I have only worked with her for about three years, and we seem to come from the same mold: seasoned family docs with a penchant for teaching and patient empowerment. I had not imagined she would step in and completely change my treatment plan …

Read more…

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 …

Read more…

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 …

Read more…

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. …

Read more…

ADVERTISEMENT

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 …

Read more…

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 …

Read more…

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 …

Read more…

ADVERTISEMENT

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, …

Read more…

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 …

Read more…

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 …

Read more…

ADVERTISEMENT

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 …

Read more…

542
pages