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Posts tagged physician

If you’re finishing up residency or fellowship, you’ve spent the last 4, 5, 6, 7, maybe even 8 years being paid about 18 cents per hour. Now you’re out there looking for your first “real” job. So when someone comes along and offers you a 6-figure salary, it’s tempting to accept it, no matter how unfair the offer actually is. Unfortunately, some employers are anxious to take advantage of young physicians who are desperate to take any job that will help them begin to pay off their enormous student loans. So many times young physicians wind up accepting compensation under their physician employment agreement that is not up to par with market standards. After all, it’s hard to know what the market standard is when you don’t have access to national physician compensation benchmark data.  Before you accept a physician employment contract offer, be sure someone is looking out for your financial and legal interests.

Many physicians, especially those fresh out of training, are hasty about accepting the first job offer that comes their way because they have enormous student loans to pay off, and they haven’t yet endured a horrific employment experience that has taught them to tread carefully into any given employment arrangement.  After all, when you’re out there looking for your first job, the potential employers are great salespeople- reassuring you that your wants and needs will be met.

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If you had to write a prescription for balance for your patients, what would you include?

Greater effectiveness at work? More time to play? Better relationships with others, as well as his/her self? Or all of the above? Like other prescriptions, a prescription for balance is not “one size fits all” but a customized approach that is based on ambitions, goals, circumstances, and preferences.

As the term “work-life balance” is used more frequently in healthcare these days, what does it really mean for you?

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This is the age of intellectual democracy. In a frightening departure from millennia of human tradition, everyone is now an expert in everything. Turn on the television or surf the Internet. We somehow believe that polls of individuals are useful for guiding policy, in everything from international politics to morals and religion. Legislators and marketing experts trust this information, as if masses of humans had extensive experience in diplomacy and warfare, in economics and federal tax structures, rather than what so many do have expertise in; video games and the accumulated out-takes from American Idol.

It’s especially odious in the world of medicine. How many times do we argue with patients that they don’t need an antibiotic or x-ray, admission or laboratory test? A family once skeptically asked me to show them the x-ray I had taken of their child, who swallowed a coin. Once they saw it, they were satisfied that I hadn’t missed anything. They weren’t radiologists, but they were experts. Because any idiot can be a physician, right?

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It almost sounds like a late night infomercial or a small non-descript ad in the newspaper. The thought and idea of becoming a doctor without a monetary investment is almost unthinkable at this point, but has recently been a topic of discussion. The New York Times published an article, “Why Medical School Should Be Free,” outlining a plan for a freebie degree.

The plan would open doors for more students to become physicians without the overwhelming debt that so many incur. The authors push the idea to promote more doctors-to-be to pursue primary care specialties that tend to pay significantly less than individual specialties. Many students feel specialties are the only way to go if they ever plan to be debt free. This leaves primary care by the wayside. It is postulated that a move to eliminate medical school costs would actually intensify the competition among potential students. Without tuition expenses, schools could be more selective as more applicants would be in the running.

Of course there is a catch, however. Those students who choose to pursue specialties would be required to pay the extra expenses for such training. It would be a small price to pay considering the remuneration to be expected once in practice. This caveat would also encourage more students to choose positions in primary care, thus filling the shortage that is expected to reach 40,000 by the year 2020. It is a plausible plan and one that could potentially solve a number of problems in the healthcare sector, both for students and patients alike.

Although somewhat biased because of my current debt status, I like the idea for another reason. Physicians are expected to provide care whether a patient can pay or not. Insured patients are preferred and those who are uninsured seem to be a nuisance to the system yet they both get care. There is a significant amount of uncompensated healthcare that hospitals and physicians provide as shown in this article by the Kaiser Commission discussing “The Cost of Care for the Uninsured.” Perhaps by paying forward with free education, students would be more willing to provide free care as a way of paying back later in their careers.

The idea is definitely thought provoking and could have a significant impact on medical care. What are your thoughts about a free medical education?

Health professionals can sometimes be under-appreciated, but today seeks to combat that. March 30 marks National Doctors’ Day and it’s the perfect opportunity to thank your own doctor or physician for their service.

The annual event was first celebrated March 30, 1933, when Eudora Brown Almond, wife of Dr. Charles B. Almond, set a day aside to honor physicians. From those beginnings in Winder, Georgia, the celebration spread, and the House and Senate officially declared March 30 “National Doctors’ Day” in 1990.

There are many ways you can participate in Doctors’ Day: thank your personal doctor, reach out to one you don’t know, email a message of gratitude, deliver a card or send flowers. You might also leave something on a deceased doctors grave, such as a red carnation, commonly associated with National Doctors’ Day.

If you want to get creative, there are websites that offer special doctors’ gifts, like a doctors stress ball or prescription chocolate bar found here.

Calls for participation can be found across the Web today, such as this one from Greater Hazleton Health Alliance CEO Jim Edwards:

Each one of us, either by choice or by chance, has been profoundly touched and our lives improved by a physician’s compassionate and professional care. Physicians are responsible for a wide range of our short and long-term healthcare needs such as sickness and health, screenings and immunizations, as well as the safe delivery of our precious newborns. They are committed to our good health and well-being, and for this we should be grateful.

Find more about the annual event here and let us know in the comments what you think of National Doctors’ Day. By the way — I am ALWAYS welcome to receiving gifts..

Every physician I have spoken with recently has smiled and nodded in understanding when we talk about our wonderful patients and their adventures with the Internet. There is an emerging phenomenon where folks are showing up in medical offices across the country locked and loaded with endless streams of data they’ve managed to retrieve from the Internet in their pursuit of answers — where did these red spots on my tummy come from; what does this persistent cough mean; what do you mean oatmeal doesn’t lower cholesterol? These Internet interludes result in what I refer to as the “Internet Printout Under the Arm” sign. As soon as we enter the consultation room, the patient will whip that wad of wisdom out from their armpit, and then there are three of us in the room — the patient, the physician and the Internet.

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With knowledge comes responsibility, and while physicians have insight into the inner workings of the human body and how it responds to disease (more than just a neat party trick), they’re also charged with using that information to make sure they don’t miss the cardinal signs of problems that can lead to the rapid deterioration of a patient.

In our classes we learn about a number of problems that are slow to progress - important to catch but not immediately threatening to life or limb. But as we go through our training, once in awhile we’ll learn about the classic presentation for a problem which, if missed, will result in the patient dying or being seriously disabled within a relatively short period of time, and the physician being in serious trouble if they had the opportunity to catch the problem early but didn’t.

Whenever these come up I try and make a mental note of them, mostly because I don’t want my patients to suffer because of a preventable error on my part.

I’ve racked my brain for what appear to be some of the common ones, most of which I had never heard of before starting medical school. Coming in, most of us already knew that chest pain that radiates down the left arm and up to the chin could be a myocardial infarction (medical speak for heart attack), which usually comes up in first aid classes. On the other hand, I never realized that green vomit could be the sign of something quite ominous, or that what might seem like a minor bump on the head needs swift medical attention.

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The debate over whether there really is a physician shortage is starting to heat up.

A commentary in CNN makes the argument that we don’t need more doctors, instead primary care should be shifted more to nurse practitioners:

However, we submit that these actions lead us in the wrong direction, and there is, in fact, no doctor shortage — as long as we accept the fact that health care can work differently, and better than, the current system.

What’s your take on this issue?

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A typical physicians day consists of seeing 18.1 patients, making 23.7 phone calls, refilling 12.1 prescriptions, writing 16.8 e-mails, reviewing 19.5 lab reports, looking at 11.1 imaging reports, and reading 13.9 consultation reports daily.

Read more at: http://www.ama-assn.org/amednews/2010/05/17/bise0521.htm