Practice Management

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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Medicine’s not what it used to be

Choosing family over medicine: Why I decided to leave clinical medicine

Kelli Randell, MD

Physician

November 19, 2019

When my obstetrician told me I was not going back to my clinic that afternoon due to severe preeclampsia, I was so indoctrinated that my first thought was of the inconvenience to my patients who would need to be rescheduled. Only a few minutes later did it register that I would be giving birth sooner than I had anticipated, and my new life as “working mother” would begin.

I was due …

The problem with reducing physician salaries

Smart Money, MD

Finance

November 18, 2019

Health care is big business, with medical practices vying for contracts, hospitals undergoing facelifts in order to cater to patient experiences, and insurance companies making deals with pharmacies. Some of these arrangements are negotiated in the name of reducing health care spending, but there has to be some skepticism when for-profit entities are implicated. Physician salaries aren’t exactly growing with inflation—some fields have had massive cuts in spending over the …

3 things every hospital should invest in

Christine Lau, MD

Physician

November 18, 2019

In the current health care system, patient outcomes, and patient satisfaction are increasingly important. With the hospital value-based purchasing program, Medicare adjusts payments to hospitals based on the quality of patient care they provide. Hospital consumer assessment of health care providers and systems scores are tied to Medicare reimbursements. Under the hospital-acquired condition reduction program, hospitals in the highest quartile of hospital-acquired conditions are subject to a 1 percent payment …

Lawyers have figured out what doctors haven’t

Allison Edwards, MD

Physician

November 15, 2019

Dear lawyers:

You got it right. Your operations make sense. I know this is wrong for me to say — doctors and lawyers are often at odds with one another — but I have to tip my cap here. I have this unsettling feeling that — from a professional standpoint — your billing practices make sense. And the way you do your documentation also makes sense. Your delegation and hierarchy make …

A physician’s guide to frequent flyer rewards

Cory Fawcett, MD

Finance

November 13, 2019

I recently read an article called “Inefficiency and luxury” in which the author stated that he has never tried to get any frequent flyer rewards, and in fact doesn’t even have a frequent flyer number. This statement left me a bit confused when I first read it. I’m not one who likes to leave money lying on the table. Then he …

Physicians must first establish their life priorities

Meagan W. Vermeulen, MD and Todd Skertich

Education

November 8, 2019

An excerpt from Career & Life Planning Guidebook for Medical Residents: The Best Part of Your Journey Is about to Begin.

Life is a journey. Where is this journey of life taking you? Do you know? If I asked you where you will be in seven years, could you tell …

How illusions impact how we practice medicine

Navpreet Sahsi, MD

Physician

November 7, 2019

We can learn a lot about ourselves by looking at, and thinking about, perceptual illusions and our biases.

Look at the image above. The classic, Muller-Lyer illusion.

We know that the two lines are the same size. But no matter how much we intuitively “know” this to be true, we see the top line as bigger. We can’t unsee it — even if we …

How compensation can affect physician burnout

Sneha Mantri, MD, Andrew Spector, MD, and Nada El Husseini, MD

Finance

November 7, 2019

Burnout in medicine has reached epidemic proportions. A recent systematic analysis found that the prevalence of burnout was as high as 80.5%. All medical specialties are affected, although prevalence rates of burnout vary widely between specialties.

Classically, burnout is defined as a triad of emotional exhaustion, depersonalization, and inefficacy. Recently, moral distress or moral injury has also been recognized as a potential component of Read more…

How compensation can affect physician burnout

How the administrative burden contributes to physician burnout

Philip A. Masters, MD

Physician

November 4, 2019

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

The administrative burden associated with caring for patients in today’s health care system has emerged as a primary driver of the loss of joy in the practice of medicine and the epidemic of burnout among physicians.

No medical specialty is immune from the upward …

How best to support, honor, and show gratitude for your mentors

Johanna Vidal Phelan, MD, MBA

Physician

October 26, 2019

I recently had the amazing opportunity to both witness and participate in an event where my Children’s Hospital of Philadelphia (CHOP) pediatric mentor received a lifetime achievement award for her many years of exemplary service to the pediatric community of Southern New Jersey.

My mentor’s leadership, compassion, and dedication to serving the Latino community have set an example — not only for patients and their families but for generations of pediatricians …

The gold standard of evaluating real estate investments

Cory Fawcett, MD

Finance

October 24, 2019

An excerpt from The Doctors Guide to Real Estate Investing for Busy Professionals.

Cash flow is the only method I use to determine the value of the property to me and is my decision-making tool.

This is how I determine the price I’m willing to pay. This is the only way …

Changing the habit of physician drinking

Kristi H. Angevine, MD

Physician

October 17, 2019

Tuesday, getting ready for work. Standing in the shower, it hit me. I couldn’t remember the last time I wanted a drink.

I almost got a blob of conditioner in my mouth as I snorted out loud.

“Mom, you OK?”

“Yeah, baby, I’m great.”

Incredible, actually.

Like so many, my habit of using external things to feel better was well ingrained. As a kid, I’d sneak ziplock bags of homemade cookies. In residency, stress eating …

5 hidden symptoms of physician burnout

Mitchel Schwindt, MD

Physician

October 16, 2019

As I lay there awaiting my shock, the doctors milled in and out of my room over the course of several hours. It was a normal but hectic morning in the emergency department with ambulances and code blues pulling my doctor away.

Before pushing the Propofol and completing my cardioversion, the doctor flatly stated something I’d heard many times before. With a certain look in her eyes, she shared a personal …

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5 hidden symptoms of physician burnout

Being oversensitive to others’ opinions can be harmful

Ariela L. Marshall, MD

Physician

October 9, 2019

We all want to get home as quickly and safely as possible at the end of the day. The other day — as I braked for a red light and turned my right blinker on — I not only looked to see if cars were coming from the left but also checked my rearview mirror.

In a moment of introspection, I suddenly wondered: “Why am I doing that?” What difference would …

Burnout in fashion and medicine: A fashion designer turned physician compares notes

Hisla Bates, MD

Physician

October 8, 2019

“Fashion Is Moving Too Fast, and It’s Killing Creativity,” by Veronique Hyland, talks about burnout in the fashion industry. As a former Fashion Designer turn physician, my curiosity was piqued. If you substituted the word “medicine” for “fashion,” the title would be just as relevant to the medical industry, as it is to the fashion industry. Yes, medicine is moving too fast, and it’s killing creativity and our doctors. Burnout in the fashion industry stems from the need to …

20 minutes isn’t long enough for an office visit

Fred N. Pelzman, MD

Physician

October 3, 2019

As many of you know, if you’ve read my columns regularly, once a year the whole family escapes from the city, and we travel up to New Hampshire to stay at the lake house that’s been in my wife’s family for over 100 years.

A modest wooden house perched out over the water, situated just right for sunset viewing, for a few …

This doctor defines himself as a Christian, not a physician

Jeffrey McWilliams, MD

Physician

September 29, 2019

What is life? It’s the cumulation of the daily processes all wrapped up into one, filling the void of each day. These processes coalesce hour by hour, filled with demands, expectations, current crisis, and bills to pay. Life is a full-contact sport, each hour brimming with all-encompassing activities, expectations, and trivial pursuits. We live every second to its fullest, squeezing every ounce of information and productivity only to repeat it …

4 reasons why physicians should hire a financial advisor

Wall Street Physician, MD

Finance

September 27, 2019

I’m a big proponent of do-it-yourself investing. In the age of index funds, many investors can manage their own investments at very low cost.

And fees you pay to a financial advisor could be used to invest and grow your nest egg.

But that’s not to say that I believe that no one should have a financial advisor. There are many situations where it can be beneficial to hire a financial …

To extinguish burnout, bring back physician autonomy

Christina Dewey, MD

Physician

September 24, 2019

In his article, “Medical education needs to stop burning out students — now,” Augustine Choi suggests the culture of medical education is responsible for increasing numbers of depression and burnout among medical students, and suggests that more programs are needed to address self-care and wellness in order to build resilience.

While I agree that mental health treatment should be readily available and easily accessible to those in …