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.
Recently I had the wonderful, yet solemn opportunity of attending my ninety-three-year-old paternal uncle’s funeral. I purposely choose the word “wonderful” to describe this experience because honoring the life of such a remarkable man, surrounded by my family who will continue to love him dearly, was such a special gift. Amid today’s increasingly complex world of business and “social” media, it is often a challenge to pause, to reflect, to …
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Compassion is never a sign of weakness. It’s a sign of greatness.
The future of our profession lies in our ability to come together with a unified voice. We must also recognize that the practice of osteopathic medicine, and the training of osteopathic physicians, has evolved significantly since A.T. Still, MD, DO, created osteopathy.
The AOA recognized this when its Board of Trustees announced that the AOA will start providing two pathways for board certification. DOs will be able to …
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It’s time to rethink what it means to be a DO
Financial planning is comprised of the six decisions people make with their money. Physicians need to make decisions as to how you earn, spend, save, borrow, give, and protect yours. Home buying typically touches on all of the six money decisions.
Home buying often begins with a mortgage, so you will have to make decisions about borrowing money. You also must earn money or at least have the potential to earn …
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Home buying tips for physicians
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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Physicians and the risk of a plateauing net worth
I was recently asked to give a speech to the graduating residents in my department, and while preparing my talk, I reflected upon what I wish I had known when I had first embarked on a career in academic medicine — and what nobody was willing to tell me. So what follows are a few thoughts that I learned on the job, often without warning, sometimes too late. I should …
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What they don’t tell you at medical graduation
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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The financial disadvantages of being a doctor in California
When you think about the future of health care, what word comes to mind? How about the word, “female”? If it didn’t come to mind, it should because the landscape of the medical field is changing. As a result of that change, it is more essential than ever for women physicians to take control of their finances.
Whether you’re just entering the field or you’ve been practicing medicine for years as …
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Why women physicians should take control of their finances
Apart from a minority number of academic physicians, nearly all of the physicians openly discussing finance matters online are either retired or in private practice. The data might be skewed since most practicing physicians don’t work in academia anyway. What might be interesting is to compare the percentage of financially literate academic physicians to that of those outside of academia. I would venture to surmise that academic physicians might be more financially …
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Why academic doctors might be less informed about finances
We have all received many gifts throughout our lifetime. Most are long gone and forgotten, but a few gifts stand out as favorites. As kids, we are given so many toys that we don’t even remember most of them. As we get older, practical gifts like ties and socks are given. Sometimes people don’t know what to give us, so we get gifts we don’t even want or need. There …
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How music changed this physician’s life
“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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How a Minnesota Supreme Court decision could affect curbside consults
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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Second victim syndrome: a doctor’s hidden struggle
“Thanks baby, I mean doctor … Doctor baby …” he finished uncertainly.
I washed my hands, gave him a quick nod, and walked out of the emergency department exam room with my smirking attending following behind me.
Speaking to a group of my female colleagues, it seems everyone has a story or two like this. Starting as medical students and continuing through our practice today, for female physicians there seems to be …
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Sexually discriminatory language used against our trainees: There is no grey area
Some people think that the solution to better-supported primary care is in direct primary care/salaried physician payment models. I don’t think it is the best answer. I realize money is not the only motivator explaining why people perform work. Meaningful work matters too. But meaningful work that is not respected and paid for will not sustain or be the source of burnout and resignation, not only for physicians. I think …
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Fee for service is not the root of all evil
”You are the average of the five people you spend the most time with.”
You may have heard this quote, from famous motivational speaker Jim Rohn, many times before. Taken at face value, the quote relates to how we are influenced. But it’s also a sentiment that really sums up how we live and interact with our closest friends and family.
Tony Robbins takes it a step further, saying that “the quality of …
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You are the average of the 5 physicians you spend the most time with
Yes, we think it does. And the time to act has come. The time is now.
We — physicians and nurses — work side-by-side caring for patients, every single hour of every single day. But we don’t often talk to each other about the (seemingly insurmountable) deep and serious issues and challenges we as clinicians face, practicing in today’s broken health care system. That has to end. We must unite.
We are …
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Burnout vs. moral injury: Does it matter what we call it?
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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Physicians: Don’t let administration intimidate you
Owning a medical business is like being a CEO, patient advocate, accountant, human resources manager, medical healer, and office manager all rolled into one. One job title that most physicians put last in their ever-growing list of roles is that of retirement planner. Ensuring that you have your long term financial house in order is often neglected in favor of dealing with all the short term problems that a medical …
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3 ways physicians can ensure an early retirement
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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Questions about physician disability insurance answered
As a medical student, I’m no stranger to being stressed out. From passing board exams, to impressing my attendings on the wards, to matching into the best residency, there are plenty of things for me to worry about. But although these concerns are the ones that take up most of my time, there is one worry which hangs over all of them like a cloud, sure to cast its shadow …
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A new approach to medical student debt
