Practice Management

Physicians and the risk of a plateauing net worth

Finance
May 28, 2019

Wealth accumulation can follow many trajectories, depending on discipline and external factors like stock market health or economic fluctuations.  With a proper financial plan, doctors can stick to a game plan that should allow them to reach financial milestones rather predictably.  The adage that wealth begets wealth certainly does hold true most of the time, but it doesn’t necessarily guarantee financial victory.  One of the issues with wealth accumulation is …

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The financial disadvantages of being a doctor in California

Finance
May 20, 2019

Geographical arbitrage is a huge component to being able to build wealth in a timely manner.  For doctors, the formula for rapid wealth accumulation calls for geographical arbitrage even more strongly as our salaries do not have wide ranges across the country.  A doctor in Texas will probably command a similar salary in Arizona (maybe slightly less).  A doctor in the midwest might earn more, spend less, and work less …

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How a Minnesota Supreme Court decision could affect curbside consults

Physician
May 16, 2019

“In a case that could have wide-reaching implications for medical practice in Minnesota, the Minnesota Supreme Court issued a ruling on April 17 in the case of Warren v. Dinter holding that the existence of a physician-patient relationship is not a prerequisite for a medical malpractice action. Rather, a person may sue a physician for malpractice – even if that person was not a patient of the physician – if the harm …

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Second victim syndrome: a doctor’s hidden struggle

Physician
May 15, 2019

As physicians, we have embraced a calling where we help others. A commitment many of us fully relish. We are grateful for our patients and the families who put their trust in us as we diagnose and treat their sometimes incredibly complex illnesses. I have been genuinely inspired by the stories I have heard from patients and my colleagues on the work we do.

Yet, in spite of the incredible advancements …

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Physicians: Don’t let administration intimidate you

Physician
May 13, 2019

One of the things I am most grateful for, as a doctor who has worked in at least a dozen different hospitals over the last decade, is the broad range of experiences I’ve had and the variety of physicians I’ve met and gotten to know. I enjoy hearing experienced physicians’ perspectives on how the practice of medicine has changed from what it used to be in the 1970s to 1990s.

I …

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Questions about physician disability insurance answered

Finance
May 12, 2019

As resident physicians with a tight budget, one of the last things on our mind is paying for added insurance. Trust me; I get it. However, as a [future] high-income earners, long-term disability insurance is essential. It may not be at the top of our priority list, but it should be.

What is it and who needs it?

Unless you are already financially independent or were lucky enough to have a trust …

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Should physicians lie when asked these questions?

Physician
May 10, 2019

Dear colleagues, I know you have seen these questions:

Do you currently have any physical or mental impairment that could limit your clinical practice?
Are you currently taking any medication?
Have you ever been hospitalized for any reason?
Have you ever been hospitalized for, or diagnosed with, a psychiatric disorder to include substance abuse?

Ugh! I hate, hate, HATE these questions! “It is none of their business,” or at least that is what I told …

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Avoid the stigma: money advice for young doctors

Finance
May 9, 2019

Whenever I discuss matters of money and business with medical students and residents, I‘m surprised by the responses: “Zilch, nothing,” or “Are you kidding?”  Sadly, our doctors-in-training still receive little to no education in this arena.

There’s a stigma surrounding physicians and money, based largely on fact, which has become a beacon for all sorts of disingenuous, exploitive people who view doctors as over-stuffed pinatas, belly-full of money, ready to be …

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How to manage narcissistic doctors

Physician
May 8, 2019

Anyone can exhibit narcissism or narcissistic personality traits or types from time to time in different forms from mild to severe. When doctors are under stress, they can “act out,” or their behavior can worsen. Greater awareness of damaging behaviors is therefore important. The more we recognize the traits in ourselves and others, the less likely they become a problem. However, unfairly labeling or stereotyping doctors as narcissists is to …

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The journey of being a parent in medical school

Education
May 7, 2019

One big life event for me was having my son Matthew during medical school. It has been a fulfilling and interesting journey.

I met my husband Andrew during college, and we were lucky to matriculate together at the University of Minnesota Medical School. I decided to do a dermatology research year between the third and fourth years of medical school, and Andrew did a neurology research year at the same time. …

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Where is the nurses’ lounge?

Policy
May 7, 2019

If you have worked in the hospital setting for any length of time, you likely are aware of the physicians’ lounge. It’s the protected space where the hard-working medical staff can escape to catch a break or grab a hot beverage. The physicians’ lounge is absolutely necessary. Medical staff members need a space where they can refuel and exhale the stresses that caring for the sick and dying will often …

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Stop the anti-doctor media bias

Physician
May 2, 2019

The April 18, 2019 CNN headline was a prime example of clickbait: “Feds charge doctors in 8 states in opioid bust, including ‘Rock Doc’ accused of trading pills for sex.”

The only problem with this headline? Of the 60 individuals charged, half were not physicians. More importantly, Jeffrey Young, the so-called “Rock Doc” who prescribed nearly 1.5 million pills of opioids and benzos often in exchange for …

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We need a Hippocratic Oath for administrators

Policy
May 2, 2019

The biggest change in medical practice that has occurred during my 25 years as a physician is the open acceptance of physician employment. Compared to this change, the ACA, EMRs, “Gorillacillins,” and the latest sepsis protocol, combined, aren’t even worth mentioning.

Physician employment was, and is, obviously an intrinsically flawed structure that was considered absolutely unacceptable for obvious reasons for the entire history of medical practice! Now, suddenly physician employment is …

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When physicians are cyberbullied: an interview with ZDoggMD

Social media
May 2, 2019

Pseudoscience hate groups of all kinds are targeting physicians who openly advocate for public health issues. This is a favorite intimidation tactic used by anti-vaccine activists: When pediatrician colleague Jen Trachtenberg posted a video for National Immunization Awareness Month 2018, she was blasted with thousands of horrible comments and fake online reviews. I wrote a blog post in her defense, and immediately, I was similarly targeted, …

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“I earned it. I’m proud of it. I am a doctor.”

Physician
May 2, 2019

I follow a Facebook group of physician moms.  We share and offer feedback on everything from a clinical puzzle to a frustrating patient encounter, and we offer our tricks for how to find balance in a crazy medical life.  I’ve seen several recent posts about women being called Mrs. even when it is known they are a physician.  Most recently there was a long post where a female physician at …

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How often did doctors treat you with courtesy and respect? 

Physician
April 29, 2019

During this hospital stay, how often did doctors treat you with courtesy and respect?   Seriously?  Why is this question even necessary?  Obviously, because it doesn’t always happen.  Well, that’s interesting.  Maybe interesting isn’t the word.  Maybe the word is, “shocking.”  I can’t fathom treating any patient with anything less than courtesy and respect.   I just don’t get it.

I’m not accusing anyone of being rude to patients.

Remember, HCAHPS are not necessarily …

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Pause before writing your personal statement

Education
April 28, 2019

Trust me: The time you spend thinking about your personal statement before you start writing will make the actual writing process much, much easier.

Before you even start writing a word, spend some time reading personal statement examples. Read good ones, read bad ones, read strange ones. The reason for this is to give you an intrinsic idea of what you personally liked and didn’t like. Moreover, you will begin to …

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What physicians should know about investing in real estate

Finance
April 19, 2019

As someone who can’t stop talking about passive income investments, I inevitably end up having a lot of conversations about investing in real estate.

I’ve heard countless stories of how real estate investing has helped people achieve their goals, but from those who don’t invest, I often hear this objection commonly voiced, “I don’t want to be called in the middle of the night to unclog a toilet.”

What I …

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How physicians and administrators can get to a place of greater trust

Policy
April 16, 2019

Recently, I wrote about some key findings from a 2018 survey of U.S. physicians by The Physicians Foundation. It’s no surprise to anyone working in health care today that the survey found alarming levels of professional dissatisfaction, burnout, and pessimism about the future of medicine among respondent physicians. Sadly, it appears that much of that pessimism is directed toward hospitals and their leaders: 46 percent of survey respondents viewed …

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