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.

These are the 3 financial enemies of physicians

James M. Dahle, MD

Physician Finance

July 6, 2018

Physicians are notorious for being bad with money. Today we’re going to assign some blame for that phenomenon. Physician finances have three enemies, and we’re going to expose them today.

1. Financial professionals

Enemy number one consists of many members of the financial industry. These “helpers” are often part of the problem. One of the biggest problems is commissioned salesmen masquerading as financial advisors. Although some of the these “advisors” …

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

Physician 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

Physician 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

Why more physicians should enter industry

Ayden Jacob

Health Technology

June 30, 2018

Attend any biotech or health informatics conference and one thing becomes clear: the scarcity of physicians. Entrepreneurs, businessmen, angel investors, and software engineers swarm these conferences — and their encompassing companies — all the while the imperative persona in this realm remains tied up behind a dysfunctional EHR or in an overbooked operating room. Why?

Certainly, inculcating these dynamic players in the health care space is integral to the successful evolvement …

The choice between medicine and nursing

Shirie Leng, MD

Physician

June 30, 2018

An excerpt from The Choice: Medicine vs. Nursing.

An extensive amount of data now exists in the science of choice. Social researchers such as David Kahneman and Dan Ariely have conducted numerous experiments which suggest a number of ways in which humans are led …

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The choice between medicine and nursing

10 tips every young physician should read

Sasha K. Shillcutt, MD

Physician

June 29, 2018

How do I balance my home life with physician life?

I really want to do a research study. How do I start?

How do I get involved in my specialties society?

I am overwhelmed with clinical duties. How do I negotiate for nonclinical time?

My manuscript was rejected. What should I do next?

I had a bad clinical outcome, and I can’t seem to recover. How do I move forward?

Joining this committee will be a …

A physician on timeshares: Who are they right for?

Cory Fawcett, MD

Physician Finance

June 29, 2018

Timeshares, for those who might not know, are a way to own the right to use a vacation resort. It comes in two forms, owning points or owning a specific room in a complex for a specific week. It’s like a partial ownership of a condo at a resort. These units can be traded for other timeshares all over the world. If you own a week, it can be traded …

Financial independence requires sacrifice

DocG, MD

Physician Finance

June 28, 2018

It is easy to look at someone’s net worth and ooh and ahh. The response from my monthly income reports is fairly telling. People see the numbers and wonder how I accumulated so much. They peruse the Rockstar Finance’s Net Worth Tracker and daydream. To capture these dreams, there are countless blog posts about how to become a millionaire. If you just follow these three simple steps! The headlines are alluring and the answers are …

How medical training can affect the physician psyche

Ami B. Bhatt, MD

Physician

June 25, 2018

Since the two very sudden public suicide deaths of Kate Spade and Anthony Bourdain, society has again recognized that we never know what is under the surface of another’s façade. As physicians, these tragic occurrences emphasize that our caregiving requires seeing the entirety of an individual’s many parts.

While we acknowledge that the façade is not fake — it is but one true representation of an individual, well-curated, like pages on …

Confronting sexism in medicine

Christopher Johnson, MD

Physician

June 25, 2018

The recent prominence of the #MeToo movement has shined a light at many places in our society where insidious or even obvious sexism against women has long gone unremarked. Even when noticed it’s just shrugged off as the way things are. In honor of this, #MeToo was named Person of the Year for 2017 by Time Magazine. Medicine is no exception to this pervasive problem. A very interesting recent essay in the New …

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Confronting sexism in medicine

Bilateral empathy lowers patient expectations

Kevin R.R. Williams

Patient

June 24, 2018

Generally speaking, patients and physicians are working towards good health. While many patient expectations can be unreasonable, others are practical; this article amalgamates them. Can you identify the absurd demands?

But multiply half of the listed expectations by hundreds or thousands of patients, and we begin to understand why there is such a high rate of physician burnout. Bilateral empathy lowers expectations.

Bedside manner. Don’t accept a walk-in patient and leave us waiting …

How to create an app as a physician

Passive Income, MD

Health Technology

June 24, 2018

“There’s an app for that.”

The phrase became so popular with the advent of smartphones that Apple even trademarked it. There are currently 3.8 million apps available on Android devices and over 2 million available to Apple iPhone users.

Does that mean that we’ve reached a limit on new and useful apps that can be created? Absolutely not. Especially in the medical world, it seems as if there’s so much room to …

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How to create an app as a physician

How to fix bullying in health care

Andrew C. Bland, MD

Health Policy

June 23, 2018

When we think of bullying, we’re usually worrying about our school-age kids or remembering bad experiences from high school.

We learn quickly in the health care field that bullies don’t change once they enter the clinical world. Health care, with its incredible differential in knowledge, authority and pay creates large power differentials and easily generates subordinate/superior relationship dynamics.

Bullying occurs within professions between trainees and trainers and faculty, and across clinical areas …

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How to fix bullying in health care

Health care is making the classic mistake that many startups make

Praveen Suthrum

Health Policy

June 23, 2018

Before managed care became the dominant force that it is, patients and doctors had the opportunity to get to know each other well. Doctors treated multiple generations within families. This helped establish a strong bond among patients and their doctors.

While it might have intended to mean preventing expensive care, managed care began to mean organized care. Run by institutions such as health maintenance organizations.

Insurances began to decide which doctors you …

How every female physician can be a somebody

Amy Faith Ho, MD

Physician

June 23, 2018

We live in incredible times.

A time when a millennial with a YouTube account clears six-figures a year (sometimes, seven figures!) with just a computer and a webcam.

A time when a small-town girl with a love of fashion and an Instagram account can go from Nowheresville, America to front row at New York Fashion Week.

A time when the shy girl in the back of the classroom amasses a following of hundreds …

Your greatest financial asset? Your spouse.

Cory Fawcett, MD

Physician Finance

June 22, 2018

Often a stay at home mom, like we have in our house, is not thought of as a contributor to wealth. Too often, only the person who “really” works and brings home an income is considered to be generating wealth. This is a case of incorrect thinking.

The non-working spouse is a very big factor in attaining wealth. In the book, The Millionaire Next Door, the spouse is considered one …

Am I a doctor or a mother first?

Kelly G. Elterman, MD

Physician

June 21, 2018

It is a little after 9 a.m. I am about to start the second of a long list of endoscopy cases when my phone rings. I glance briefly at the caller ID to confirm it isn’t my office or the hospital calling about another patient, and am quickly overcome with dread as I see the screen reads, “daycare.”

Intuitively, I know why they are calling. My four-month-old must have a fever. …

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Am I a doctor or a mother first?