Practice Management

Physicians writing on KevinMD about running a practice: staffing and overhead, the payer paperwork that arrives with every patient, ownership and consolidation, the administrators and executives who now employ most physicians, and the models physicians have built to get out from under all of it. Four maintained records draw on this archive: Primary care: what physicians say, in their own words, Direct primary care: what physicians say, in their own words, Physicians and administrators: what physicians say about who runs medicine, in their own words, and Private equity and corporate medicine: what physicians say, in their own words.

5 tax moves physicians should make before December 31st

Cory Fawcett, MD

Physician Finance

December 6, 2019

As physicians, we find ourselves in higher tax brackets than the majority of Americans. With the graduated tax system here in the U.S., the more we make, the higher the percentage of taxes we owe. That is not just because of the tax brackets, but also because many tax write-offs are phased out as income climbs, creating a compounding effect.

There are things we can do to decrease our tax burden. …

Misogyny in this physician’s medical career

Cristina Carballo-Perelman, MD

Physician

December 6, 2019

As a woman physician, practicing for over 31 years, I have faced many misogynistic occurrences as well as misperceptions about my career choice. This blatant devaluation of women within medicine may be similar to what other women have had or continue to face daily. At large, these experiences resulted in a journey not always easy, nor welcomed, but in the end, accepted for the maturity obtained.

My hope is that by …

4 strategies for success as an aspiring physician

Charles Wesley and Eric George, MD

Physician

December 6, 2019

Becoming a physician in 2019 presents its share of challenges.

Providers must deal with reimbursement rates that remain a fraction of their previous levels, adapt to a fee-for-value model, adopt ever-advancing technology as an integral part of care delivery and accommodate a patient-provider dynamic that favors patients — who now demand choice, autonomy, affordability, and transparency.

These developments starkly contrast conditions at the turn of the century. Still, they don’t seem to …

Female voices: Achieving the lovely therapeutic range

Lauren M. Kuwik, MD and Shreya P. Trivedi, MD

Physician

December 5, 2019

“She is too direct.”

“She sounds overprepared.”

“She is just not that lovely to hear.”

These are just a few pieces of “feedback” that podcast producer Dr. Shreya P. Trivedi has heard about women’s voices over the years. And then suddenly it occurred to her, she had never heard any comments on a man’s voice or the way he speaks.

Though women have come a long way from …

3 lessons physicians can learn from adversity

Stephanie Wellington, MD

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 …

The unintended consequences of #MeToo in medical education

Elizabeth Gaufberg, MD

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 …

How to overcome the gaps in behavioral health

Michael Consuelos, MD, MBA

Conditions and Diseases

December 2, 2019

National attitudes have greatly shifted over the last 25 years towards the idea that mental and emotional well-being are vital to a person’s overall health. Today, nearly six in ten Americans have sought or want to seek mental health care for themselves or someone they love. While stigma and costs persist as primary barriers to progress for solving the mental health crisis, the key issue—as we have increasingly come to …

What car racing taught me about physician burnout

Jane M. Bridges, MD

Physician

December 1, 2019

Back in 2016, my hospital, also my employer, changed the EMR. I was fully integrated into another EMR, so changing was not on my to-do list in the later part of my career as a diabetologist.

As you would expect, the transition was a nightmare and took me to a new low in my life. Crying in my wine became my new norm. I became distraught, felt imprisoned, and felt that …

9 hacks that will increase your clinical efficiency immediately

Brent Lacey, MD

Health Technology

December 1, 2019

I recently spoke with a colleague who transitioned out of the military in the last year. He was previously excited about his new job opportunity, but now a year later, he tells me, “I hate civilian medicine.”

I was surprised because he had been excited about the opportunity to teach in a residency program again. He said, “I love teaching, and I love the residents. …

Health care needs new presentation techniques

Stephen P. Wood, ACNP-BC

Health Technology

December 1, 2019

“So, if you look at this table, you can see that group X had a small but statistically significant increase in mortality over group Y. What does that tell us? It suggests that maybe there is some signal that intervention A is better than intervention B.”

The slide has some table from some journal, and the speaker will then often circle some p-value and talk about the strengths and weaknesses of …

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

James Turner, MD

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, …

Physicians are usually adulting in every other aspect of their life except money

Cory Fawcett, MD

Physician Finance

November 28, 2019

This week my wife and I celebrated our 31st wedding anniversary. It made me think about how my life has changed from when I was a single freshman in college. A time when I didn’t always do the right thing. I knew it was against both the law and school policy to drink alcohol at my age during a frat party, but I sometimes did it anyway.

We know we have moved …

3 reasons every physician investor should consider self-storage as part of their alternative investment portfolio

Kris Benson

Physician Finance

November 28, 2019

We talk with a lot of physicians every day who ask us a simple question. “Why should I invest in self-storage?” Obviously, as a self-storage operator, we are biased, but there are three data points that we believe make this a fantastic asset class for physicians to evaluate for their own portfolios.

Wait a minute, self-storage is a legitimate asset class? Some statistics on the self-storage industry that may surprise you. …

7 reasons why it’s hard to be kind

Jonathan Fisher, MD

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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7 reasons why it’s hard to be kind

The myth of resilience in preventing burnout

Daniel Berger

Conditions and Diseases

November 26, 2019

With 44% of physicians self-reporting burnout in the 2019 Medscape National Physician Burnout, Depression & Suicide Report, most will agree the profession is in crisis. Of the 29 specialties included, all had at least 1 in 4 members reporting burnout, many with more physicians suffering from burnout than not. Hardly a U.S. problem, burnout affects physicians around the world as well as medical students, and I …

How cartoons can alleviate medical stress

Dan Rosandich

Patient

November 25, 2019

Comical cartoons about medicine and doctors help to alleviate patient fears, make doctors laugh, nurses think, and everyone else involved in the medical field ponder the value of comics. I have been involved in creating medical cartoons for 40+ years and have created custom cartoons for doctors and hospitals. Have you ever looked at a poster in a doctor’s office and felt …

Late-career physician? Change your life by being social.

Richard Plotzker, MD

Physician

November 23, 2019

Sixteen months into retirement, the absence of any externally imposed schedule still leaves me partly edgy. Medicare, COBRA, and cell phone bills come due at expected dates. The check goes out the next day, but it could wait another day or a week. Shabbos commences and concludes as the cycles of nature require. If I miss a meeting or an Osher Lifelong Learning Institute class, there are no demerits. In …

Stop telling doctors what to do

Najma Hamdani, MD

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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Stop telling doctors what to do

Shake up health care leadership. Now.

Jattu Senesie, MD

Physician

November 22, 2019

We are going to need new types of physician leaders to get the change in health care clinicians want.

When I observe current physician leaders, I notice the bulk often fall into two distinct groups. On one side, there are the out-of-touch and on the other the overwhelmed. Both types have positive and negative attributes. In my opinion, the successful health care leader of the future will draw from what works …

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Shake up health care leadership. Now.