Practice Management

Physicians writing on KevinMD about running a practice: staffing and overhead, the payer paperwork that arrives with every patient, ownership and consolidation, the administrators and executives who now employ most physicians, and the models physicians have built to get out from under all of it. Four maintained records draw on this archive: Primary care: what physicians say, in their own words, Direct primary care: what physicians say, in their own words, Physicians and administrators: what physicians say about who runs medicine, in their own words, and Private equity and corporate medicine: what physicians say, in their own words.

How tech can get doctors back to seeing patients

Timothy Judson, MD, MPH and Robert Wachter, MD

Health Technology

September 26, 2017

Rates of physician burnout are rising, and many physicians cite their electronic health record (EHR) as the primary culprit. That’s no surprise, since doctors spend twice as much time on electronic health record (EHR) systems and deskwork as they do directly interacting with patients. Let that sink in for a moment. Imagine if an airline pilot spent six hours documenting every detail of a three-hour flight. Such …

A doctor goes without a white coat. Here’s how his visits changed.

Hans Duvefelt, MD

Physician

September 25, 2017

Something very interesting happened to my patient visits when I changed my office attire.

My clean long cotton lab coats, hanging on the back of my office door, suddenly all seemed dingy when I set out to change lab coat about a week ago. I decided to pretend it was Saturday.

On Saturdays, I usually wear a pocketed button-down shirt instead of one of my usual Jermyn Street ones. I skip the …

It’s time to ban productivity from medicine

Robert Centor, MD

Health Policy

September 25, 2017

According to Wikipedia, “Productivity describes various measures of the efficiency of production. A productivity measure is expressed as the ratio of output to inputs used in a production process, i.e., output per unit of input. Productivity is a crucial factor in production performance of firms and nations.”

Please tell me how this relates to being a physician or a patient. We do not produce anything. Rather we work with individuals to …

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Get up on your bed and stand up straight

Juliet B. Ugarte Hopkins, MD

Physician

September 23, 2017

The invitation was unexpected. Although I would attend the conference as a relatively new member of the community, I knew I was making inroads, so I accepted without hesitation. The prospect of meeting well-established players in the field at dinner with the planning committee was exciting. And, I was equally looking forward to spending more time with a fellow newbie who had already been tapped as a rising star the …

Gain time by slowing down with your patients

Josh Umbehr, MD

Physician

September 20, 2017

We humans can’t help but shove as much as possible into one minute, one hour, one day. We’re rewarded for doing it, too. Society says that the more you check off your list, the more productive you are. And by default, then, the more productive you are, the more successful you are. So, we rush. We search for ways to skip steps and still get the same result. We fill …

An open letter about hate and how to fix it

Sudha Prasad, MD

Physician

September 20, 2017

Most parents have been deeply distressed by the rising violence and streams of hate as a keynote in our national discourse. For a constructive response, I encourage parents to write to their school administrators and partner with the adults in their children’s community to stem the tide of vitriol that has engulfed our views on race, religion, and the study of history in our everyday lives. Here is an edited …

The key to financial freedom: Live and work like a resident

Brad Brown

Medical Education

September 20, 2017

That first paycheck as a new attending means so much more than what is direct-deposited into the bank account. The emotions of finishing medical school and training to finally seeing the fruits of your labor positively affect the bank account is something to be proud of. As a medical student (like myself) and resident, it is the light at the end of the tunnel. You’re probably asking yourself, “Why should …

How a doctor turns life into story

Anne McTiernan, MD, PhD

Physician

September 19, 2017

After almost fifteen years as a research physician, I grew tired of the relentless cycle of applying for grants, failing to obtain funding, and reapplying with variable success. Conducting clinical trials was rewarding, but the responsibility seemed endless. I began to feel burnt out, scorched. It was time for a change. I needed a hobby.

Around this time, I read Frank McCourt’s memoir, Angela’s Ashes. The author described it as a story …

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How a doctor turns life into story

For women physicians, is there a connection between productivity and burnout?

Diane W. Shannon, MD, MPH

Physician

September 16, 2017

Is the practice of medicine a different experience for male and female physicians? Two recent studies from athenahealth suggest that it is — in ways that should make us rethink what we value in health care.

The first study found that male physicians are more productive than their female counterparts. In an analysis of 47 million visits on the athenahealth network in 2016, male physicians generated 30 to 40 percent more …

The surprising sleeping arrangements of an emergency physician

Edwin Leap, MD

Physician

September 15, 2017

I used to practice locums medicine; which for the lay person means traveling to different jobs, sometimes several states at a time. During that time I stayed in a lot of hotels. But, occasionally, I had more unique accommodations. Obviously, if you travel enough, you’ll sleep in an airport here and there. No big deal. I actually like sleeping in airports occasionally. When you’re stuck, you’re stuck. Weather or …

Take back our practices with physician cooperatives

Maiysha Clairborne, MD

Physician

September 14, 2017

One of the biggest points of contention in the ongoing discussion of burnout is that the system of health care is flawed. The endless bureaucracy, decreasing physician pay, and increasing meaningful use requirements that spawn endless clicking on an already inefficient electronic medical record platform have become unbearable by most practicing physicians today.

Furthermore, all the talk about mindfulness only riles up more anger in physicians as they feel they are …

Pay off debt, invest, or both: Advice to young physicians

Another Second Opinion, MD

Physician Finance

September 14, 2017

Let me start by saying that I am a huge Dave Ramsey fan. When I completed residency and began my current position, The Total Money Makeover was the first personal finance book I read, and pardon the cliché, but it changed my life. It instilled in me a strong foundation in money management and offered me a road map to handle the situation I was in: hundreds of thousands of dollar in …

5 keys to a successful long-distance relationship during medical school

Sarah Epstein

Medical Education

August 31, 2017

When my husband Brian started first-year of medical school at the University of Miami Miller School of Medicine, I jettisoned off to Thailand to spend a year teaching English and traveling. We figured if we were going to date long-distance, why not go all in? Why not ensure that we were a full 12 hours apart, on literal opposite sides of the world. What can I say? We like a …

Why patients should be investors, not customers

Vincent C. Thomas, MD

Physician

August 31, 2017

In this current era of health care, patients are increasingly being labeled as “customers” to provide a landscape suggestive of the need to provide customer satisfaction. Many health care providers grow increasingly frustrated with that terminology. It demeans the relationship that is fostered in the patient-physician encounter; belittling it to a transaction that occurs as the exchange of goods for an expected outcome. Perhaps a more appropriate corollary to the …

How this physician transitions to becoming an empty nester

Manoj Jain, MD, MPH

Physician

August 30, 2017

Next month when our youngest child leaves for college, the biggest change may not be in his life but in ours.

We are done with dropping them off at school, or giving them driving lessons, or helping them with difficult homework assignments: We will officially become “empty nesters.”

My wife and I ponder sitting at the dinner table and standing by the kitchen counter, where exuberant political dialogue takes place, and …

Help me help doctors in recovery

Stephen F. Chambers, MD

Physician

August 24, 2017

Approximately 12 years ago, I hired my first physician in recovery. He had temporarily lost his license following a bout with alcohol. After a stint in a rehabilitation clinic, he was ultimately reinstated. My journey to hire this physician was arduous at best. During the interviewing process, I narrowed the field down to two candidates: one with a past and one without. I wrestled with the “in recovery” situation and …

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Help me help doctors in recovery

Stop the patient leakage in primary care practices

Fred N. Pelzman, MD

Physician

August 24, 2017

Yesterday, we had a meeting about leakage.

No, it was not about urinary or fecal incontinence, but it was about care that could have been provided within our institution that ended up, for a multitude of reasons, happening with providers beyond the walls of our institution.

Representatives from our accountable care organization had requested a meeting to go over some issues they’ve been having with our practice, including low levels of usage …

Improving physician satisfaction by eliminating unnecessary practice burdens

Yul Ejnes, MD

Health Policy

August 23, 2017

A guest column by the American College of Physicians, exclusive to KevinMD.com.

In April, the American College of Physicians (ACP) released a position paper titled Putting Patients First by Reducing Administrative Tasks in Health Care, published in the Annals of Internal Medicine. The paper, part of ACP’s Patients Before …

Is the end of disparities in medicine near?

Linda Girgis, MD

Physician

August 23, 2017

The patient looked at me and said that he did not remember the name of the specialist, only that she was a “woman doctor.” As this was completely unhelpful, I pondered the fact that a doctor who was male is never referred to as a “man doctor.” Why is it that woman physicians need the added label, as if the norm is a doctor who is supposed to be a …

Traditional private practice needs to change

TheBossMD

Physician

August 22, 2017

Owning a business is not some pie in the sky deal where you take a phone call when you make the turn at the country club every day. The public at large, however, thinks that is exactly what business owners do.

Owners are the people that collect money while others work right? They are rich people that just happened to be rich, so they bought a business for other people to …

Practice Management

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