Practice Management

What Karl Marx can teach doctors about burnout

Conditions
January 17, 2020

Professional burnout is widely identified using the Maslach Burnout Inventory, which defines it along psychological lines: emotional exhaustion, a feeling of depersonalization and cynicism, and a low sense of personal accomplishment.

Accordingly, the phenomenon of physician burnout is often framed as a personal problem to be solved by means of self-care. While this approach is undoubtedly helpful, it doesn’t sufficiently address the structural factors that contribute to burnout in the first …

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Can the physician credentialing process be saved?

Physician
January 14, 2020

The physician burnout crisis and a national provider shortage have fueled a growing trend in health technology focused on better utilizing physicians and reducing administrative burdens. I became a surgeon because I wanted to help people, not because I had a strong desire to push paper. The high volume of administrative tasks increasingly consumes a physician’s time that could be better spent with patients. For example, primary care physicians Read more…

Consumerism is killing us with the death of a thousand cuts

Finance
January 10, 2020

School has gotten back into full swing, and thus we begin another cycle. Will this cycle be better than the last? Every year we find ourselves in this same spot. Summer’s over, big vacations are in the bag, back to school shopping is complete, and we start recovering from our summer spending.

We often haven’t yet recovered from the summer splurges before it’s time to start Christmas shopping. Then we begin …

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Why gratitude is a superpower

Physician
January 7, 2020

I found this note waiting for me this morning in the kitchen.

It was from my daughter, who is home for the holiday week from New York. I made her a cup of coffee yesterday morning, and it was waiting for her on the table when she woke up and meandered sleepily into the kitchen.

Seeing the warm and happy …

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8 things to do as a new attending that I didn’t learn as a resident

Finance
January 3, 2020

Here are eight things to do as a new attending that I didn’t learn as a resident (and wish I had).

Establish a budget

There are two times when a budget is a very important tool: when you are struggling financially and when you have a large income or expense change. Now that you have graduated to your new attending income, it’s important to intentionally decide how you will invest, save, pay …

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How setting healthy boundaries can help you regain control in a demanding world

Physician
December 28, 2019

Advancements in technology have blurred the lines between work and home life. This is because modern technology, such as the smartphone has made it easier for others to reach us. Time and location no longer serve as barriers. It is not uncommon for work-related matters to reach us via email or text after hours. People are continuing their work from home rather than enjoying precious time with loved ones.

Physicians are …

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For students with test stress, medical schools leave a void  

Education
December 27, 2019

I’m writing this for my tribe of worriers and self-doubters, people for whom ever-present test stress is inextricable to the med school experience.  Sure, every medical student becomes preoccupied fretting over exams to some degree.  That’s part of what you sign up for.  But our preoccupation is something greater than that—it towers over us and bullies us.  It makes us cower in the corner, begging to be spared from harm.

We’re …

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Alexithymia: patient satisfaction, doctor burnout and health care costs

Physician
December 26, 2019

My next patient was a healthy man in his early 20s following up for eczema.  His case had not been severe, so I had anticipated that the prescription strength steroid cream I had given him would have addressed his symptoms faster than I had promised.  His chief complaint had been itch—a symptom—something that he was experiencing.  He hadn’t even noticed the rash.  It was what one would call “bread and …

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Your medical career won’t last forever

Physician
December 25, 2019

“Slowly comes the hour, it’s passing speed how great.”
– Samuel Cowper

Our careers will end someday.

Of course, we know this deep down, but I think we lose sight of it amid our training and the day-to-day grind of our jobs.

But just this past week, I was given a little reminder.

At our Christmas party, we took some time to honor one of our colleagues on his journey to retirement. He had spent …

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When physicians are so emotionally drained, they have nothing left for their families

Physician
December 25, 2019

The other night, while I was getting out of my car, my oldest son, standing on the porch, excitedly yelled out, “Mom, look at this lego structure I made!”

I couldn’t see it, but I could tell how happy he was to show it to me. “It looks neat from here. Let me get closer.”

My husband appeared, knowing how tired I was, “Mom worked a long day. Why don’t you let …

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A roadmap for physician career transition planning

Physician
December 15, 2019

Many physicians will decide they want or need to make a transition from the practice of clinical medicine to “something else” at some point during their career. Whatever the motivation for their job transition, most doctors appreciate a rational, structured process that enables then to get from where they are to where they want to be. Fortunately, there are some easily accessible resources that can add value to your work/career …

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A physician’s favorite money quotes for the holiday season

Finance
December 12, 2019

This is one of my favorite times of the year. Thanksgiving dinner with my family, cool air that calls for cute winter clothes, and holiday festivities that invoke the spirit of love and positivity. As we embark on this season, inevitable holiday sales may tempt us more than we can imagine. In order to deal with this temptation and stay within our budgets, we may need a little motivation to …

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How physicians can become self-actualized

Physician
December 7, 2019

What really makes a person complete?

What do we want in our lives, and what is it like to become our best, most fulfilled selves?

In the 1960s, psychologist Abraham Maslow tried to answer this question. This eventually led to his well-known hierarchy of needs. You might be familiar with the pyramid.

The premise of the theory is that once we fulfill our basic needs …

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3 lessons physicians can learn from adversity

Physician
December 3, 2019

This time last year, I took the podium at conferences as far away as Dubai to deliver my keynote speech entitled, “On The Cusp Of Life And Death, Choose Life.” My talk highlighted the professional and personal development opportunities that show up as doctors, nurses, and parents navigate the challenges in the neonatal intensive care unit (NICU) caring for preterm and term newborns on the cusp of viability due to …

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The unintended consequences of #MeToo in medical education

Physician
December 3, 2019

Harvard Medical School student Chloe Li typically dressed in scrubs or an efficient, professional outfit as she went about learning to care for patients in the intense, year-long clerkship program where I teach.

For her capstone presentation on graduation day, though, she wore a cream-colored wrap-around dress of luscious silk, tasteful jewelry, and an up-do hairstyle. She had clearly put a lot of care into these preparations. She …

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Doctor: You were strong. You are still strong today.

Physician
November 29, 2019

You were strong in college

You were strong enough to get through weed-out classes in undergrad.  You were strong enough to balance the extra-curricular activities and clinical shadowing expected of you while crushing a 21-hour semester.  You were strong enough to say, “no, I have to study” when friends wanted to go out because you had a dream of becoming a doctor someday.

You were strong enough to pay for the applications, …

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7 reasons why it’s hard to be kind

Physician
November 28, 2019

Why do so many of us (meaning me) need to be reminded to act with kindness? Why can’t we “just do it”?

Yesterday, a friend asked me why we don’t celebrate World Kindness Day every day. I believe that’s a wonderful idea. But in practice, it’s not so easy. So, I got to thinking about why that is.

If we want to spread the ripple effects of kindness — to our families, …

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Stop telling doctors what to do

Physician
November 22, 2019

I enjoy a fairly small private practice and a manageable telepsychiatry side job with good support staff. But even the small scale of my outpatient clinical practice doesn’t fully insulate me from the pain of unnecessary practices that I wish would become obsolete.

1. Preauthorization. The dance of preauthorization starts with the naivety on my part that I decide what medication my patient should be on. I spend precious time crafting …

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Medicine’s not what it used to be

Physician
November 22, 2019

When I was accepted to medical school, I debated — hard — whether or not to attend.

Out of the physicians I shadowed and interviewed, 19 out of 20 advised me not to become a physician.

Their dissatisfaction was rampant.

Over and over, I was told, “Don’t be a doctor. Medicine’s not what it used to be.”

They spoke of concerns ranging from unreasonable work expectations to inhumane conditions. They described insurmountable pressure, decreasing …

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