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.

6 money decisions for physicians

John Dameron

Physician Finance

August 6, 2018

Financial planning may not be what you think

Financial planning means different things to different people. To some, it may simply mean investments; to others, insurance; to others, a Swiss bank account, and a private jet. We believe that, at its roots, financial planning is simply making smart decisions about your money with your goals in mind. We’ve broken it down into six decisions you need to make about your finances that apply …

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6 money decisions for physicians

Physicians don’t just suffer burnout. They suffer moral injuries.

Wendy Dean, MD and Simon G. Talbot, MD

Conditions and Diseases

August 4, 2018

Physicians on the front lines of health care today are sometimes described as going to battle. It’s an apt metaphor. Physicians, like combat soldiers, often face a profound and unrecognized threat to their well-being: moral injury.

Moral injury is frequently mischaracterized. In combat veterans it is diagnosed as post-traumatic stress; among physicians it’s portrayed as burnout. But without …

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

Physician 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 …

Persistence is the secret sauce of success

DocG, MD

Physician Finance

August 2, 2018

My daughter had her first track meet this weekend. We showed up to a field house at the local high school and watched as dozens of kids and hundreds of parents took their places. The competitions spanned from high jump to mile run. Fifty-yard dash to shot put. Watching these fourth and fifth graders compete was pure joy. We marveled at the speed and agility as the winners sprinted towards …

How this physician parent teaches his kids about money

Rogue Dad, MD

Physician Finance

August 1, 2018

Let’s be honest — what I don’t know about parenting is astounding. I’m a pediatrician and have three kids, and it’s amazing what I still don’t know.

Every so often I hear a parenting idea (or come up with one) that seems perfect. Easy to implement and imparts both clear short and long-term lessons.

Implementing new-age parenting techniques makes me feel good, even if in reality I spend most of my parenting …

Side hustles are the best kind of asset protection

James Turner, MD

Physician Finance

August 1, 2018

My oldest girl and I love watching birds. We usually watch the birds right outside our backdoor while they eat from our bird feeder. As we were watching one day, it amazed me how comfortable the birds were jumping from post to post on the feeder or from branch to branch on the trees. Often times at a distance taller than the bird itself. Why would they take this risk and …

Clinician burnout: Be part of the solution

Sasha K. Shillcutt, MD

Physician

July 31, 2018

I was recently interviewed by someone on the topic of clinician burnout. The interviewee asked me how I respond to those who say that burnout does not exist, is being overstated, or is the result of a weaker generation of practicing physicians.

I find this difference in opinion interesting. Most of the time, when a physician complains to me about the focus on clinical burnout, they are 1) of an older …

Is going to medical school a wise financial decision?

Wall Street Physician, MD

Physician 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 …

A good physician will never be out of a job

Ali Chaudhary, MD

Physician

July 26, 2018

“After this, there is no turning back. You take the blue pill — the story ends, you wake up in your bed and believe whatever you want to believe. You take the red pill — you stay in Wonderland, and I show you how deep the rabbit hole goes. Remember: All I’m offering is the truth.”
– Morpheus from The Matrix

Many physicians submit to a life of sterility and dullness — …

The pathologic manifestations of professionalism

Michael Edmond, MD, MPH

Physician

July 25, 2018

Four years ago after moving back to Iowa City, I needed to find a new primary care doctor. I went to the University’s website and scanned the list of general internists. There I noted a physician that I had known when she was a medical student during my prior stint at the University of Iowa 20 years prior. She had been an amazing medical student, very bright, hardworking, conscientious, and …

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. …

Health care needs more physician CEOs

Alexi Nazem, MD

Health Policy

July 25, 2018

If Atul Gawande’s first week as CEO of a health care startup was anything like mine, I hope he is able to get away from it all and enjoy a completely relaxing weekend. He will have earned it.

After Gawande was named to head the joint venture between Amazon, Berkshire Hathaway, and JPMorgan, some critics said that choosing …

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Health care needs more physician CEOs

After you die, what will your legacy be?

James Turner, MD

Physician 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 …

Love smart functions in your EMR? This doctor doesn’t.

Fred N. Pelzman, MD

Health Technology

July 24, 2018

How smart do we want our electronic health record to be?

Somewhere between as dumb as a piece of paper and a pen, and too smart for our own good.

Many, many years ago, before we spent the majority of our office visit staring at a flatscreen LED and typing away, our charts were simple manila folders with those bendy metal bars that allowed you to insert new pages, separated into multiple …

A case for paying doctors more

Ayden Jacob

Health Policy

July 23, 2018

Engaging in an economic conversation about the conventional compensation of a physician leads one to believe that doctors are well-to-do. In the minds of most citizens, school-tuition board members and even local neighbors, if you’re a physician the presumption is that you are economically prosperous, maybe even rich. This sociological assumption probably sounds false to most whom honorably don the white coat. Perhaps a decade or two ago, when medical …

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A case for paying doctors more

A physician’s group disability nightmare

Christopher Yerington, MD

Physician Finance

July 23, 2018

My last operative day was October 15, 2009. My last attempt at getting to understand my group disability policy was on May 10, 2018. I’m a disabled anesthesiologist who lost his career when my left median nerve stopped functioning properly. I had two disability policies, a private and a group. My dealings with these two companies have been day and night.

My group insurance carrier hammered my dignity for years. In …

What type of returns should you expect from the stock market in the future?

Wall Street Physician, MD

Physician Finance

July 23, 2018

No one can predict the future, but when making projections for things like retirement planning, what investment return should you expect?

What do we mean by “investment return?”

Before we get into the numbers, we need to go through a few definitions.

Nominal returns vs. real returns

These are just fancy words for before-inflation and after-inflation returns. Real returns (after-inflation) returns are equal to the nominal returns (before-inflation) minus the inflation rate. Real returns …

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?