Practice Management

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

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 …

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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. …

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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 …

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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 …

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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 …

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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 …

A conversation with a doctor who was tired of feeling burned out

Nii-Daako Darko, MD, MBA

Physician

July 11, 2018

An excerpt from the Docs Outside the Box podcast, episode 1: When the going gets tough… MOVE!

Dr. Nii: All right, well thank you very much for joining us on the Doc’s Outside-the-Box podcast. You are our first guest — first victim, I guess. It’s the inaugural episode, so I just wanted to thank you for joining us. I know you are in New Zealand, which is roughly 18 hours away.

Dr. Brown: It’s …

3 steps for doctors to move into the next level of career growth

Stephanie Wellington, MD

Physician

July 10, 2018

In medicine, this is the time when one season ends and another begins. New doctors graduate from medical school. They are excited and, at the same time, scared as they enter into residency training. Interns become residents. Senior residents celebrate moving into attending positions or look forward to subspecialty training in fellowship programs. It’s the excitement of completion combined with the uncertainty of charting a new course in medicine. Each …

3 things patients really want from their doctors

Suneel Dhand, MD

Physician

July 5, 2018

The doctor-patient interaction is the absolute core of clinical medicine. Maybe I’ll go much further: it’s the core of health care in general. I always try to remember, whenever I’m ever feeling frustrated with the system, the crazy bureaucracy — and of course, the debacle of our clunky electronic medical records and their data entry requirements — to separate myself from all of that when I’m face-to-face with my patient …

Job security in medicine is a myth

Passive Income, MD

Finance

July 5, 2018

Imagine, if you will, that you’re an anesthesiologist. You’ve been part of a successful practice for over 10 years. You can walk down your neighborhood street and run into mothers whose epidurals you’ve helped place. You’ve established a home, a community, and your children are in a great school system.

One uneventful day, say Wednesday, you get an email from the hospital administrators announcing that there’s going to be a meeting …

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Job security in medicine is a myth

A doctor’s apology can go a long way

Randall S. Fong, MD

Physician

July 3, 2018

I came across a letter I wrote to a patient while rummaging through some old files on my computer. I flashbacked to what triggered this: a response to a letter she had sent me, one that was, shall we say, extremely unflattering and quite scathing in the way she described me and our last encounter. From the letter’s tone, I sensed she held back on using more profane language to …

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A doctor’s apology can go a long way

The difference between care and service is significant

Michelle M. Kittleson, MD

Physician

July 2, 2018

My father, recently retired, spent over 40 years in private practice. After dinner, he would sift through piles of paper charts and call patients with their lab results. As a grade schooler, what impressed me the most was that he knew many of his patient’s phone numbers by heart. Of course, this was in the days before HIPAA and caller ID, so scattered charts on the dining table and calling …

Attending time: That’s just a myth

Time for Money, MD

Finance

July 1, 2018

One of the great myths amongst residents is that once they become attendings, they’ll have so much more free time. I’ll never work this much again, they think. This is the most time-intensive phase of life, and everything after residency is easy in comparison.

Unfortunately, they are usually wrong.

Statistically, working about the same number of hours in residency and as an attending is the norm. In one study, attendings work 59.2 …

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Attending time: That’s just a myth