Practice Management

What physicians need to know about living trusts

Finance

August 22, 2018

One common question that doctors face in estate planning is whether to establish a trust. This topic gets brought up in the doctors’ lounges, especially after someone gets a pitch from their financial planner. Most doctors who bring up the topic are quite enthusiastic, and cite that doctors need a trust because “we make a lot of money.”

Fair enough.

Medical students and residents probably do not need a trust

I’ll get this …

What do the Fidelity ZERO mutual funds mean for physician investors?

Wall Street Physician, MD

Finance

August 20, 2018

Vanguard, Fidelity, and Schwab have been engaging in a fierce competition to claim the mantle as the leading provider of low-cost index funds. As a result, each has aggressively lowered their fees for their index fund offerings over the past few years and advertised their low-cost offerings to investors.

After the latest round of fee reductions in mid-2017, I wrote a post speculating whether it was inevitable that Vanguard, Fidelity, …

Why doctors don’t like to retire

David Mokotoff, MD

Physician

August 19, 2018

The past decade has seen an enormous upheaval in the practice of medicine. The private independent medical practice is in danger of extinction. Management overhead and red tape has skyrocketed due to government regulations and private insurance and pharmaceutical benefit rules. Added to that are multiple electronic medical records that need to be implemented, vary from one hospital to another, and often do not “talk” to one another. Thus, it …

Read more…

Why doctors don’t like to retire

Live like a medical student, invest like a professional

Tyson Schwab, MD

Finance

August 19, 2018

If money is the root of all evil, what does that make debt? Evil’s ugly big brother.

A report by the Association of American Medical Colleges (AAMC) revealed that over 86 percent of medical graduates carry an educational debt principal of over $160,000, with a significant number of graduates reporting debt totaling over $350,000. In addition to massive student debt, personal financial challenges include the loss of nearly a decade of …

A private equity primer for physicians

Nisha Mehta, MD

Finance

August 12, 2018

“My group has been approached by a private equity company. It sounds like a great deal! Any questions I should ask?”

Whether it be through one on one discussions or through the Physician Side gigs group, I’ve found myself having this conversation with increasing frequency. Part of the reason for that is because I find it fascinating, albeit also sometimes terrifying. As the trend towards consolidation …

Read more…

A private equity primer for physicians

5 reasons you should put physicians in charge of hospitals

Edward R. Mariano, MD

Physician

August 10, 2018

Putting physicians in charge of hospitals seems like a no-brainer, but it isn’t what usually happens. A study published in Academic Medicine states that only about four percent of hospitals in the United States are run by physician leaders, which represents a steep decline from 35 percent in 1935. In the most recent 2018 Becker’s Hospital Review “100 Great Leaders …

How perception can affect your financial situation

Cory Fawcett, MD

Finance

August 10, 2018

An interesting phenomena recurs when I work with physicians to makeover their finances. They almost never believe that overspending is the problem. They believe the reason their credit card balance is growing, and their large monthly income isn’t enough to pay their expenses can’t be due to their own choice to overspend. They always have a reason for the lack money:

They have huge student loans.

They have eight kids.

They are in …

Converting your 401(k) to a Roth IRA after residency or fellowship

Wall Street Physician, MD

Finance

August 8, 2018

Many residents and fellows will contribute to a 401(k) or 403(b) over the course of their medical training. They should be commended for saving for retirement on just a resident’s income.

Often, newly-minted attendings wonder what to do with these 401(k)s or 403(b)s from their training hospitals. In particular, they wonder whether they should convert their 401(k) to a Roth IRA.

4 options: some better than others

In general, there are four things …

Working in the ER on holidays

Maria Perez-Johnson, DO

Physician

August 7, 2018

As I prepare to go into work for another string of night shifts, I become aware that this is just another holiday that I will be working. It’s the Fourth of July, not a major holiday as is designated by any scheduler, so no credit will be given to those of us who work today. Some previous employers have given extra pay for said days, as little as $200 to …

Read more…

Working in the ER on holidays

Gender bias and the word, “doctor”

Roozehra Khan, DO

Physician

August 7, 2018

When I first began writing about the “doctor” title, I led with my personal beliefs. But as my research expanded, I realized there were so many variables and so many experiences that have shaped other women’s views on being called “doctor.”

Call me “doctor,” please

A few years ago, I was at a charity event for underprivileged kids in Detroit. One of the board members was a well-spoken nurse with a PhD. …

Read more…

Gender bias and the word, “doctor”

9 non-medical careers for doctors

Maiysha Clairborne, MD

Physician

August 6, 2018

With burnout on the rise, many physicians are choosing to leave clinical medicine for alternative careers. Other physicians are wondering if it’s worth it to stay in a workforce that does not pull for the well being of their frontline workers.

Gone are the days where physicians stay stuck suffering in a practice or career that is no longer fulfilling or worse, causing burnout. Those physicians are considered old-school and are …

Read more…

9 non-medical careers for doctors

Don’t let physician identity define you

Diane W. Shannon, MD, MPH

Physician

August 3, 2018

When I left clinical practice, I thought I was prepared for the change in my identity.

Wrong.

I was shocked by the degree to which my sense of myself and my value in the world were rocked by leaving the profession. After all, I left practice less than seven years after I could legally write MD after my name. In residency and when practicing (and even to some extent as a medical …

Read more…

Don’t let physician identity define you

Is debt-free medical school a financial blunder for doctors?

Smart Money, MD

Finance

August 3, 2018

Education can be expensive. Higher education can be even more costly. Even partial scholarships can be deceptive as one might opt for a more expensive school for the sake of redeeming “free money.”

As a student, I had no financial understanding of return on investment when I was considering higher education. All in, I plowed through more than a quarter million dollars in my college and medical school after substantial scholarships …

Is going to medical school a wise financial decision?

Wall Street Physician, MD

Finance

July 30, 2018

It is no secret that medical school is getting very expensive. Over the past 20 years, the cost of medical school has greatly outpaced the rate of inflation, and medical school debt is rapidly rising.

The average medical student now graduates with over $192,000 in student loans, but with the cost of attendance for the most expensive private medical schools approaching $100,000, there are some physicians who are finishing residency with $300,000 or …

NP/PA vs. physician: Why is there a productivity gap?

Tracy Cardin, ACNP

Physician

July 25, 2018

So out in the varied land of hospital medicine, I have noticed something that I have no clear explanation for. It turns out there is often a gap in productivity between that of NP/PA providers and physicians. The range of the gap varies wildly – I just got off the phone with a group leader who has observed a 50 percent difference to a smaller gap of perhaps 10 percent. …

After you die, what will your legacy be?

James Turner, MD

Finance

July 24, 2018

As part of my job as an anesthesiologist, I get called to truly horrific airway events. Sometimes they are down in the emergency department after a bad car accident, drowning, or burn. Others are in ICU’s. Sometimes they are even in hallways or bathrooms where people have stopped breathing or collapsed from cardiac arrest. It’s part of the job.

Recently, I was called to an airway in an ICU in what …

What is proper work attire in medicine?

Michael Edmond, MD, MPH

Physician

July 22, 2018

I’m a creature of habit. My first activity every day is to read the New York Times. Depending on my schedule, some days I read more articles than others. This week I was away at a conference and found myself with some early morning extra time before the first meeting session, so I delved into the Arts section. I began to read the first article: “Women …

Read more…

What is proper work attire in medicine?

6 pieces of advice for graduating medical students and residents

Nisha Mehta, MD

Physician

July 13, 2018

My (sometimes solicited, but often unsolicited) advice for graduating medical students, residents, and fellows:

June is one of my favorite times of the year. One, because it’s summer, but also because it’s graduation season. I love seeing and hearing about everyone’s accomplishments, and seeing years of hard work come to fruition – although if I’m being honest, it’s bittersweet, because it’s also a reminder of how I’m getting older.

This year, I’ve …

8 steps to have those difficult conversations

Marlene Chism

Physician

July 12, 2018

An excerpt from 7 Ways to Stop Drama in Your Healthcare Practice.

Although the ability to initiate difficult conversations is part of good leadership, I’ve never met a leader who enjoys it. Whether your conversation is about body odor, rude behavior, dress code, personal conduct or performance issues, difficult conversations are …

10 ways to stay out of the DEA’s crosshairs

Dennis Wichern

Physician

July 12, 2018

No news attracts attention like a physician who’s in trouble with DEA or their state medical board. So, how does it happen, what are the common issues and what can a physician do to safeguard themselves?

First, let’s look at what the numbers and the research tell us.

The Federation of State Medical Boards (FSMB) tells us that 4,091 physicians were disciplined during …