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American physicians deserve timely payment

Peter Ubel, MD

Health Policy

July 5, 2019

Health care reimbursement in the U.S. is frighteningly complex. We have federal payers, like Medicare; state/federal payers, like Medicaid; private, for-profit insurance companies, like Aetna; private, not for profit insurers, like many local Blue Cross Blue Shield networks. Oh yes, and we have private insurance companies managing reimbursement for many Medicare and Medicaid recipients.

This complexity comes with costs. Doctors and hospitals need to hire armies of people to process bills …

Thinking about changing jobs? Here’s what physicians should consider.

Smart Money, MD

Physician Finance

July 5, 2019

A large percentage of doctors end up switching jobs within the first five years of practice. This really isn’t surprising given that the medical training experience doesn’t necessarily correlate with the medical practice experience. Many doctors work hard throughout their entire training only to realize that their expectations do not necessarily align with reality. Is it our fault that we don’t really know what we got ourselves into?

Perhaps taking q3 …

8 incredible side effects of being debt free

Cory Fawcett, MD

Physician Finance

July 5, 2019

Most Americans live their lives on borrowed money, constantly spending a little more than they make, leaving them with a growing debt. These debt payments, and the added interest they must pay on their debt, decreases the amount of money that they have available to spend on future needs. Paradoxically, borrowing to buy depreciating items, decreases one’s net worth.

Stop the madness this year. No more spending more than you make. …

What to do with disparaging doctors

Christopher Johnson, MD

Physician

July 5, 2019

Doctors who disparage, or even ridicule, what parents tell them are, fortunately, rare. Nevertheless, sometimes parents may infer from what the doctor says or how he acts that he does not value what they are telling him, even though he did not mean to imply such a thing. All physicians have had the experience of overly touchy parents inappropriately assuming from our questions that we do not respect their ability …

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What to do with disparaging doctors

Understanding the distinction between universal health care and a single-payer system is critical

Niran S. Al-Agba, MD

Health Policy

July 4, 2019

The World Health Organization describes universal health coverage — a system coupling health care access with financial protection for all residents — as the “single most powerful concept that public health has to offer.” The goal of universal care is to give all people the equal opportunity to enjoy the best health possible.

I wholeheartedly endorse universal health care, though not a single-payer system like “Medicare for all” because there is …

Practicing medicine full-time in America is very difficult. It’s time to think outside the box.

Suneel Dhand, MD

Physician

July 4, 2019

Talk about physician burnout and job dissatisfaction is everywhere right now. If you are a doctor, you cannot escape the news. Within the last couple of weeks, organizations in Massachusetts (a mecca of healthcare and hospitals) declared physician burnout a “major public health crisis.” This all sounds rather dramatic. On the surface, physicians are reasonably well paid, still enjoy a good degree of autonomy (certainly compared with many other …

Should doctors quit or retire?

DocG, MD

Physician Finance

July 4, 2019

There seems to be one question that drives the financial independence community. Not for everybody, but a large percentage of the group are chomping at the bit. The question is simple yet infinitely complex. It drives at the heart of what it means to be financially independent and evokes our greatest hopes and fears. It is often the reason we stumbled across the idea of financial freedom in the first …

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Should doctors quit or retire?

When Dr. Pimple Popper teaches us something more

StorytellERdoc, MD

Physician

July 4, 2019

Several years ago, my daughter Emma introduced me to some videos on YouTube of a dermatologist from California who posted her sometimes shocking but always intriguing encounters with patients who suffered from a variety of dermatologic issues. Of all of these videos, it seemed like the ones which made Emma happiest to watch were the videos in which this doctor’s treatment resulted in gallons of pus draining from some part …

Why is it so difficult for Americans to make doctors’ appointments?

Peter Ubel, MD

Health Policy

July 3, 2019

Jill Ladkin was already having a terrible autumn. It began with a seizure that put her in the hospital with what seemed like scores of unfamiliar physicians attending to her state of health. The brain scan revealed a mass in the lining of her brain, a location usually signifying a benign tumor; but, given her seizure, the tumor was hardly what you would call a harmless growth. The surgeon had a theory of what …

The problem of physicians and nurses connecting patients with hospital fundraisers

Michael Kirsch, MD

Physician

July 3, 2019

Many organizations solicit private donations from benefactors and philanthropists. Is there a stadium in the country that does not bear the name of a prominent donor? There are also anonymous donors who are not cursed with egos that require their names to be emblazoned in giant font on a building’s façade. But, most donors want recognition which is often used as an incentive when soliciting the donation.

Donors understandably receive perks …

It’s time for physicians to stop thinking like dogs

Cory Fawcett, MD

Physician Finance

July 3, 2019

When I sat on the management committee of our surgery center, I was wondering why owners didn’t bring all their cases to the facility. They would clearly benefit financially if they increased their caseload. So why didn’t they? I realized, it was because we all think like dogs.

Dogs will do tricks if you give them a treat immediately after their successful performance. Dogs will not do tricks if you promise …

In the age of EHRs, why are we still asking patients to fill out paper forms?

Fred N. Pelzman, MD

Physician

July 3, 2019

From the sublime to the ridiculous.

That’s sort of how my day went yesterday.

It started out with an early morning meeting with a colleague who has been implementing a telehealth program at one of our institution’s practices, learning about how they have been using this technology, some of the bumps in the road they’d hit, and how they’d been able to …

The man who defecated outside the ER

StorytellERdoc, MD

Physician

July 2, 2019

“Sometimes sh*t just happens.”

Just a few days ago, I finished yet another string of four hectic shifts in the ER of our incredibly busy trauma center. After saying my goodbyes to my coworkers and transferring the care of my remaining patients to my partner, I left the building through our ambulance doors, avoiding the main pedestrian entranceway where the hectic waiting room sat.

It was a safe choice to leave this …

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The man who defecated outside the ER

Technology is corrupting the culture of medicine

Robert Pearl, MD

Health Technology

July 2, 2019

To help then-candidate Bill Clinton remain focused on the No. 1 voter issue ahead of the 1992 presidential elections, political strategist James Carville coined an unforgettable mantra, which he posted inside Clinton campaign headquarters.

It read, “The economy, stupid.”

The quote became famous both for its edginess and wisdom, reminding us to separate the big picture from everything else.

In health care, it can be hard to define the “big picture” issue when …

You’re lucky to have a medical student in the family

Nathaniel Fleming

Medical Education

July 2, 2019

One of the most common experiences faced by a medical student is being asked for health care advice from a friend or family member. My initial reaction to these questions is usually something along the lines of, “Are you sure you want to be asking me that? I’m not even a doctor yet!” This is especially true when the question is about something that I’m not particularly experienced in (which, …

A key strategy to use for difficult conversations: Ask questions

Suneel Dhand, MD

Physician

July 2, 2019

No matter what profession you are in, having uncomfortable and difficult conversations is something you have to get used to. Tim Ferris said in his bestselling book, The 4-Hour Workweek (which I’d highly recommend), “A person’s success in life can usually be measured by the number of uncomfortable conversations he or she is willing to have.”

It could be with another colleague, a client or customer. Even in your personal …

The tension between guidelines and individualized treatment

Steven Reznick, MD

Physician

July 1, 2019

I recently read an article in a peer-reviewed journal citing the benefits of a few eggs per week as part of a low carbohydrate dietary intervention for Type 2 diabetes. The information was so meaningful about a controversial food source of protein that I decided to write about it in my blog and pass it along to my patients. Three days later the American Heart Association and American College of …

Physicians are problem solvers and artists

Hans Duvefelt, MD

Physician

July 1, 2019

I keep thinking about the dichotomy between covering a lot of ground and getting to the point.

The other day I saw my bosses at one of my clinics stop in their tracks when I suggested that a lot of the things we are measured on as physicians could be turned into standing orders and simply get shifted off my plate. I have just created a letter that anybody can send …

Your home life is what you make it. Don’t let your specialty control you.

Cory Fawcett, MD

Physician

July 1, 2019

The Match is complete, and now the fourth-year medical students are preparing to make their move to residency and chief residents are preparing to start their new career as an attending. The next phase of their lives is about to begin.

The Match got me thinking about a comment I read recently from a doctor who decided to not become a general surgeon, which she had always wanted to be, and …

Electronic health records cannot replace a doctor who knows you

Richard Gunderman, MD, PhD and James Lynch, MD

Health Technology

July 1, 2019

The introduction of electronic health records (EHRs) was accompanied by a great deal of fanfare. Such systems, which replace old paper-based charts in doctor’s offices and hospitals, were designed to make patient data more accurate, safer and more accessible. It was also claimed that they would make it easier for doctors and other health professionals to monitor medical care and ensure that guidelines were followed. The federal government was so …

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