Practice Management

Cost segregation: an underutilized strategy for physicians who own real estate

Finance
March 31, 2021

A gastroenterologist client of mine in Florida is very business savvy. From the beginning of our 12-year relationship, we planned to include real estate as part of his overall diversified portfolio alongside the equity investments in his retirement account.

Slowly but surely, with the savings leftover after deferring the maximum amount he could into retirement plans, he built up portfolios of real estate for income purposes that included buying an office …

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Physicians can practice medicine and build wealth through passive real estate investing

Finance
March 28, 2021

I am a trained neurosurgeon with decades of experience. However, I also have a passion for real estate.

So far, I have managed to amass a real estate investment portfolio of over $250 million in assets by working with our investors and co-development partners.

As a medical professional, I can relate to your current financial standing. You’ve managed to work your way into your current, high net-worth position(s) and are earning “good …

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Physicians and the midlife dip

Physician
March 21, 2021

It seems that the midlife “slump,” “crisis,” or “malaise” phenomenon is actually something that has been studied and written about a lot in the last 40+ years. The phrase “midlife crisis” was originally coined in the 1960s, as explains Jonathan Rauch in his 2018 book, The Happiness Curve: Why Life Gets Better After 50.  He describes some fascinating research that shows a definite age-related dip (a U-shaped curve) in happiness …

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PCPs could counter virtual plans by increasing telehealth visits

Policy
March 17, 2021

Primary care physicians already have a lot of competition from retail clinics, urgent care clinics and telehealth services that cater to consumers. Now they’re facing a new threat from the “virtual primary care plans” that insurance companies have launched recently. These are health plans that prioritize virtual visits with doctors hired by telehealth services over in-person visits to primary care doctors.

For years, some insurance companies have been offering online urgent …

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Debunking the myth of the doctor car

Finance
March 14, 2021

Everyone knows about the doctor car. Doctors know about it. Non-doctors know about it. Other than the doctor house, it is the symbol of medicinal consumerism.

But today, my friends, I am going to completely debunk the doctor car myth!

What is the doctor car myth?

This car myth states that a doctor must have a fancy car to legitimize herself or himself as a physician.

To drive a fancy car is to show that …

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Sexual harassment in medicine [PODCAST]

Podcast
March 8, 2021
YouTube video

“I would encourage you to see amazing women on social media for who they are in the future.  Maybe figure out where they have been and what they are working toward.  Maybe even figure out how ways to help each other solve the problems this country faces.  Instead of looking at someone’s appearance, listen to their story. You got unlucky with me; you can’t intimidate someone who has …

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An argument against time management

Physician
March 6, 2021

As I write this, I’m struggling with the fact that I haven’t “finished my work for the day.” My inbox has unread emails. My task list is bursting. I have unfinished laundry/ chores/ dishes. I told myself, “I don’t have time to sit and write an article!”

And yet – the seed had been planted. I could no longer ignore the whisper that said, “You have a story to tell. And …

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Perfectionism is your nemesis, not your superpower

Physician
March 4, 2021

Ballet dancers and doctors are essentially the same people. Long before I entered medicine, ballet taught me the skills that made me successful in my clinical practice.  I was a life-long learner.  I improved my skills with daily practice. I was creative with limited resources. I strived for excellence and was rewarded for these efforts.  The skills I learned as a professional ballet dancer prepared me well for medicine.

There was …

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3 steps for physicians to shift from stuck to unstoppable

Physician
February 23, 2021

Every physician has had the experience.  The moment you ask yourself, “Why am I doing this?”

It could be when you look into the waiting room where there are more patients to be seen and know if you take a break, it will set you back even further.

It could be on the final stretch of the 24-hour shift that redefined the meaning of the word “nonstop.”

It could be the third time …

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It’s never too late for physicians to change directions and land new jobs

Physician
February 19, 2021

Changing direction once established is not easy, but it can be rewarding. I recently read the essay on KevinMD (“How this physician escaped the system“) from a physician who shifted gears to her own business after some discouraging experiences in “the system.” During her residency, her attending physician asked her what her purpose was in becoming a physician. To her credit, she said that her goals …

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Boundaries as a woman physician

Physician
February 17, 2021

When I think about boundaries, I am struck by how individual, varied, and unique each of our own personal definitions of boundaries can be. For one person, it is the physical boundary between the external world and our property. For another, the emotional and relational boundary between physician and patient. For many, the physical, emotional, and energy boundary between work and home. And often the most difficult, the boundary between …

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Physicians need growth days

Physician
February 11, 2021

Physicians are overwhelmed and burned out. We have an epidemic of “too busy.” Many of us think we could get so much more accomplished if we had more time. Why aren’t we taking the time? Doctors need to start taking growth days. These aren’t sick days, mental health days or vacation days. Growth days are days strategically taken during the month that are specifically meant for personal growth. This could …

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The case for physician peer coaching

Physician
February 8, 2021

I love metaphors. I think they can be so powerful and can convey so much, sometimes with just a few words.

One metaphor we use in coaching to describe the coach’s role in a session with their client is that of a swimming pool. The client is in the swimming pool, and as the coach we have the job of not jumping in the pool with them.

Imagine you …

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A physician’s mid-career and mid-life success

Physician
February 6, 2021

A mid-life crisis, re-assessment, re-envision. Hollywood’s cliché version epitomized by Chevy Chase driving the “family truckster” while flirting with Christie Brinkley and later trying to skinny-dip with her. Of course, it is more than that.

Researcher, Brene Brown, calls it the unraveling. It is a pause. Turning off auto-pilot. A re-evaluation of goals. Clinically, it is called a mid-life transition or stage of adult development. It can be midlife or mid-career …

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14 tips when negotiating a physician job

Physician
January 27, 2021

Negotiations are not just for the job interview and annual review. We negotiate every day. Negotiating in place can be a powerful mechanism to make your current job a better fit.

The key to effective negotiations is to think like the boss. What are her concerns, goals, and interests? How can you align your goals with those of the boss and institution so that everyone wins?

At every point where you are …

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The hidden reason you struggle with your charts and what you can do about it

Physician
January 20, 2021

For most clinicians, this will sound familiar:

I can feel the resentment bubbling up as I sit down to chart on a beautiful Saturday afternoon. I’ve got dozens of charts hanging over me, and if I don’t get them closed, there will be yet another miserable head thrashing with my practice admin. My kids are clamoring for my time, and every fiber of my being is resisting getting these charts done. …

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I am an orthopedic surgeon who decided to stop taking insurance

Physician
January 19, 2021

I am an orthopedic surgeon, and I only take cash. When I tell people this, it usually conjures up images of some money-grubbing doctor eager to make a dollar any way they can. Personally, I am not incredibly incentivized by money in and of itself. I try to live a reasonable lifestyle and keep my expenses under control. I started a cash-only practice not for the love of money but …

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When a colleague asks you for nude photos

Social media
January 14, 2021

Dear colleague,

Sorry for my delayed response. I didn’t know if I was going to follow up with you on this issue.  When you initially messaged on LinkedIn, on New Year’s Eve, I was holding my daughter.  She’s five, and she was desperately trying to stay awake for the ball drop.  She was determined to ring in the New Year.  Which, unfortunately for me, meant that I had to keep my …

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