Category: Physician Blog

Why Most Medical Students and Doctors are Hypocrites (And How We Can Change)

Why Most Medical Students and Doctors are Hypocrites (And How We Can Change)

Social Histories

If you were to sit in on any routine doctor’s visit, you are bound to hear a few common questions. “Do you smoke? How much alcohol do you drink, if any? What is your diet like? How much exercise do you get weekly?” These are questions we are trained to ask as early as the first week of medical school. We are taught to treat not just the conditions a patient presents with, but also inquire about their overall health and instruct them on ways to improve it.

Addressing negative social habits that can impact patient’s health is a recurring theme throughout medical school.

My classmates and I have learned how to recognize drug addiction and drug-seeking behavior, how to determine if our patients were alcoholics, and effective ways to counsel people on healthier diets. As much as we future doctors know what qualifies as “good” health, and how to attain it, I wonder how closely we follow our own advice.

Medical students work incredibly hard, studying for hours on end for very difficult exams, as well as spending long days in the hospital without pay. With this amount of dedication, certain things are almost automatically erased from our lives. Sleep deprivation is the first thing that comes to mind, and I am constantly aware that this will only get worse when I start residency. Though the field of medicine has made great strides in ensuring that residents have work hour limitations, and the days of sleeping in the hospital all weekend are largely behind us, the amount of work still leaves many constantly fatigued. We counsel our patients to have good sleep hygiene, and often attribute lack of sleep to problems with mood, concentration, and general quality of life. But what about us? We set ourselves up for failure in these areas when six hours of sleep is a good night’s rest.

Doctor Non-Compliance

This lack of good sleep directly leads to an increase in the amount of stress we put on our bodies and minds as students and physicians. Let’s face it: medical school is stressful. This is a point that needs no clarification. Passing exams, getting honors on clerkships, and resting all of our hopes on a few board exams is pressure nobody enjoys. The stresses that come along with a career in medicine are certainly matched in other fields, but most other professionals do not spend their days advising their clients to avoid stress. How ironic is that? I have seen the effects stress can have on people, including my classmates: dissolution of relationships, family strife, and depression, to name a few. While we tell our patients to go easy on themselves when they are having trouble in their personal life or at work, we do not afford ourselves the same luxury.

The last, and possibly most important, area that I notice physicians and other healthcare professionals not taking their own advice is in our indulgences.

Long hours, high student debt, and a relatively low salary can restrict medical students and residents from having the healthiest habits in terms of diet and exercise. When you have to round quickly on patients and get to the OR by 7 am, it is not uncommon that all you have the chance to eat is a light snack or coffee. Throughout the day the demands of the patient wards may prevent you from having a real meal, and the vending machine seems like it may as well be a Michelin star restaurant. In spite of this, I am constantly impressed by a small subset of my peers who manage to make exercise a focal point of their day, whether it be at 5 in the morning or 10 at night. Many of us—and our patients—do not have this will power or motivation, and will collapse into our beds the second we have a minute to do so.

Other indulgences include drugs and alcohol, the unspoken hidden addictions many doctors struggle to control. The House of God provides anecdotal evidence:

“the classic novel where residents take swigs out of a flask at work and aim to be inebriated as often as possible when off the clock. This is a work of fiction, but it is based in reality.”

Physicians are often incredibly vulnerable to addiction when it comes to alcohol and drugs. It may be because we self-medicate, thinking we can recognize a problem more easily since that is what we were trained to do. Hence, we quickly and easily enter the world of self-denial. It is not uncommon to hear stories of physicians overdosing on prescription drugs or attending AA meetings. This is nothing to be ashamed of, and it is always good to get help when it is needed. However, the pressure placed on us not to have such problems—and to hide them if we do—makes it harder to identify and treat addictions when they do exist.

Some Of Our Own Medicine

We should strive to be the best versions of ourselves always, but also recognize that we are not above the maladies that may afflict our patients. If a patient states they are struggling with work and feel they need to drink more lately, it is okay to recognize that you as a doctor have experienced that problem too. When you advise your patient to cut back on the booze, take a day off work, and get better, remember that can be an option for you as well. The next time you ask your patient if they are downplaying a problem, ask yourself the same question. It is just as important to care for yourself as it is to care for others. Remember, just because there’s no lecture on it in med school, doesn’t make the problem any less real.

 

Jessica Celine Morgan
MD Candidate  |  Class of 2017
New York University School of Medicine
Medical School Side Hustles: Are You Up for the Challenge?

Medical School Side Hustles: Are You Up for the Challenge?

Medical School Side Hustles: Are You Up for the Challenge?

Medical school is crazy expensive. Obviously, your first priority should be doing well in school school and building your resume. This should be combined with a healthy balance of quality time spent with family, friends, not to mention focusing on your own personal well-being. If, and only if, all of that is in order, then perhaps you may be interested in one of the following medical school side hustles. However, working during medical school doesn’t have to be a giant commitment either – here are some of the ideas that fellow med students have tried to make some extra money…

Leverage a Talent

You will have to define your talent, but it could be something along the lines of an athletic or musical aptitude. At the very least, your status as a medical student should earn you tutoring gigs, if not for your medical school itself. Basically, if you are a master at something, or at least well beyond average, then you can likely charge for your services. For instance, I teach tennis part time and garner $20+/hour after the facilities cut. I have also tutored intermittently, landing $20/hour there as well. Now it is your turn, dig deep and find your inner medical school side hustles!

Earn $20+/hour Working for Motivate MD

This flexible opportunity fits perfectly with a med student’s busy schedule!  Motivate MD is currently seeking talented medical students for:

  • MCAT Tutor 
  • Pre-Med Online Mentoring 
  • Blog Content Writing
  • Sharing Motivate MD’s Pre-Med App and Services

If you’re interested in using your talents and past experiences to help pre-meds achieve their dreams, and desire the flexibility to fit into your busy med school schedule, this might be the job for you!  Take 5-10 min to fill out our simple job application here.

Donate Plasma

This one is not for the faint of heart, aka those with a crippling fear of needles. You are going into medicine though, so I will assume this applies to the minority. I have donated at BioLife Plasma, which pays $20 for your first visit each week, with another $50 if you come a second time that week. You can only donate twice in a calendar week and each donation must be at least a day apart. The sessions generally last only an hour. The best part is that BioLife has free Wifi, so studying is an easy possibility. I usually crush Anki decks while donating!

Uber or Lyft

I read online that you could net $25/hour and was obviously skeptical. “Why not try it out,” I said to myself. I was pleasantly surprised and did in fact net $25/hour. Surge definitely helps (elevated fairs based on consumer demand), but even without it I would have done well. Moreover, the passengers were all kind and chatty (one simply handed me a $20 for the tip), instead of drunken and belligerent, as I had imagined. The one downside is that your car can take on a lot of extra miles with this, so I would recommend doing it sparingly, but if you have got some time and a ride, give it a shot as one of your medical school side hustles! You can apply to Uber or  Lyft here.

Overnight Sleeping Shifts

These are absolute hidden gems. What is better than getting paid to sleep? Again, I figured this was too good to be true, but am thrilled with the results. Forty hours a week I sleep at a group home. I am actually only awake and doing things, like making breakfast or packing lunches, for 4 hours each week. The remaining time I truly sleep, or study. Facilities like this need round the clock supervision and odds are there will be one and demand near you if you reside in a big city. You will need to feel out the group home residents though. If they are runners, good luck getting sleep. Simply explain the situation to the interviewer and say that you are paying your way through school and actually need to sleep during the shift. They are understanding, as everyone else picks the job to sleep!

Landlording

I wish I could have made this one happen, but it wasn’t meant to be. If you think you have the chops to find an ideal property, location being key, then perhaps you should pursue this. The idea is that you have your tenants, hopefully other medical students, pay your mortgage. Then, long-term you can continue renting to medical students and have created your first rental property, voila! Make sure you have the nerve to handle any hiccups and headaches that may come along though.

Thank you for reading, and best of luck throughout your journey to becoming a doctor!

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7 Key Factors for Choosing the RIGHT Location for Your Medical Practice

7 Key Factors for Choosing the RIGHT Location for Your Medical Practice

 

Becoming a physician is a long, arduous journey. After many years of hard work, you finally reach the point of completion and begin your career as a physician. As you embark on the next steps of your vocation, one important factor must be determined… Where to locate your practice?

Choosing your location is an important decision and one that should not be made solely based on the clinical nature of the job. Due to my years of experience, both working directly for hospitals and as a third-party physician recruiter, I would suggest the following factors to consider:

1) Geographic Location

When choosing to relocate, there are many geographical factors that can sway your decision such as optimal climate and desirable neighbourhoods. It’s important to keep in mind that although these factors can be very tempting, there are future life changes that may also be important to consider such as career opportunities for your spouse, proximity to desirable schools and the growing needs of a family that may come your way.

2) Clinical

When considering the clinical aspect of the role, you need to take into account the following:
Are there enough patients to ensure both clinical competency as well as financial goals?

Is the patient population a group that would consistently need the clinical services you provide? Has the hospital invested in the needed equipment and budget for continued investments over time?

Have they completed a resources plan for the department in order to forecast future hiring and investment?

3) Relationship with Administration

What is the relationship like with the hospital or clinic administration? Given the interdependency with other healthcare providers and administration, these relationships will have a great impact on the environment you work in. The better the relationship the better the environment.

4) Market Share

The hospital or clinics reputation in the region and their market share is important and can potentially impact the clinical volumes and access to resources in the area.

5) Academic

Depending on personal preference, you will want to explore what opportunities exist for continued training as well as leadership development. Look into what affiliations they have with external academic organizations and teaching prospects.

6) Compensation

Compensation can be a key factor, however if you don’t have favourable responses to items 1 to 5, no amount of money will make it a great place to work. Keep in mind that a relocation allowance is not an incentive or bonus, but rather a resource that will make the process of relocation less daunting to tackle.

7) Recruiting Process

Lastly, I believe that the relationship you build during the recruitment process will be a good indication of the brand and culture of the organization and how helpful they will be as you go through the licensing and credentialing process.

Thankfully the process usually transpires over several months and thus allows the time to ask these questions and examine the fit. Physicians don’t move frequently so ensuring a thorough decision process at the start gives the best chance of a long-standing mutually beneficial environment.

Guest Post by:  Kevin Kirkpatrick, Managing Director of TMA Executive Search has worked recruiting physicians and planning for physician staffing for the last 12 years in Canada and the United States. He has worked with academic, urban and rural communities to recruit physicians.
Debunking the ‘Doctor Type’

Debunking the ‘Doctor Type’

 

Sometimes, your greatest obstacles can be in your own head.

Take resident physician Kyle Evers, MD. Throughout high school, he had a strong interest in the sciences and a natural desire to help people. Yet when thinking about his future career, medicine barely crossed his mind as a possibility.

Why? He didn’t fit his own notion of “the doctor type.”

“In my mind, doctors were people who never had to study—those kids who got straight A’s without even trying,” Dr. Evers explains. “That wasn’t me. So I didn’t really consider myself a future doctor.”

Today, Dr. Evers is a third-year resident in internal medicine at Memorial University Medical Center in Savannah, Georgia. It’s safe to say his views on who can be a doctor have expanded—along with his confidence in himself.

Discovering His Passion

When I ask Dr. Evers why he chose internal medicine, he says he loves the diversity of it—and begins ticking off all the different specialties he enjoys. Rheumatology. Nephrology. Gastroenterology. Cardiology. Endocrinology.

“My intern friends would joke that I wanted to specialize in everything, because when starting each new rotation, I would change my mind and decide that one was my favorite,” Dr. Evers says with a laugh. “I just wanted to do everything.”

It might seem hard to believe that someone with such an obvious affinity for medicine could have ever doubted his potential in the field. But Dr. Evers had discounted medicine since his teenage years, and it wouldn’t resurface until he was majoring in biology at LaGrange College. Recognizing his talent, a few of his professors encouraged him to reconsider the career he had long since dismissed.

“I kind of laughed it off at first, but then it became this recurring idea,” says Dr. Evers.

So he did an internship with a general surgeon in his college town. Then, he got a job as an orderly in the operating room, where he worked during his last year and a half at college. “That sealed it,” says Dr. Evers. “I knew I wanted to be a doctor.”

A Diverse Perspective

Dr. Evers decided to attend Ross University School of Medicine in the West Indies for a few reasons, including residency placement rates and overall reputation. In addition, he was intrigued by the option to choose either a single location for his clinical clerkships or experience multiple hospitals throughout the country.

“I love to travel and being able to experience new cultures, so being able to do that while getting a medical degree was a no-brainer,” says Dr. Evers.

Sure enough, during his clinical year, Dr. Evers took advantage of the option—getting a taste for medicine in Miami, New York, Cape Cod, Connecticut and Michigan.

His favorite? Miami. (“I love the culture and the bilingual nature of everything—and there’s amazing food.”)

“You can learn medicine anywhere if you’re willing to study. The real difference is the environment and the experiences,” says Dr. Evers. “That was the key benefit for me. If you work at only one place, you may think every hospital operates like that, but if you move around, you quickly realize how different hospital systems are. And each system has its strengths.”

Making a Home

His rich background across many hospitals helps him appreciate his residency hospital, Memorial Health, that much more.

In particular, Dr. Evers was struck by the “family atmosphere” he sensed at Memorial. During his interview, he was impressed by the interaction between residents and attending physicians. Not only did they stay after meetings to chat, they clearly made an effort to get together outside of work as well.

“It was very comfortable, very warm,” he says. “It’s a very personal environment.”

That environment is good not only for having friends outside of work—it’s also a key factor in helping the hospital run smoothly. Dr. Evers credits the friendly atmosphere with fostering open communication that’s led to great relationships across residency lines.

“Here, the staff is dedicated to patient care and diligent in their jobs,” says Dr. Evers. “It takes a lot of pressure off residents.”

And it’s clear that the feeling goes both ways.

“Dr. Evers is one of our most exceptional residents,” says Dr. Timothy Connelly, associate residency program director at Memorial Health. “I’m grateful for his awesome contributions to our program.”

The Real Doctor Type

Today, that high school student who thought he wasn’t the “doctor type” seems a world away from this dedicated physician who’s enamored with his work and singularly focused on patients.

Dr. Evers says he can’t imagine himself doing anything else.

“Even if I had a billion dollars and didn’t have to work, I’d still want to do this job. I can’t think of anything more perfect for me,” he says.

In fact, while some of his medical school classmates are earning their MBAs or have an eye towards management in the future, Dr. Evers couldn’t be happier exactly where he is.

“I don’t have administrative aspirations,” he says. “I just like taking care of people.”

Guest Post By Kristin Baresich – [email protected]

 

 

Better to Burnout than Fade Away?

Better to Burnout than Fade Away?

Physician burnout is a hot topic lately.  The trade magazines, e-mails, and even popular media have been featuring stories on physician burnout.
In case you haven’t been paying attention, here are 10 links from a quick google search:

§  New York Times
§  Physicians Weekly
§  Medscape
§  Consumer Affairs
§  Americain Medical Association
§  Huffington Post
§  Washington Post
§  Chicago Tribune
§  Hospitals & Health Networks

What is burnout?

How is burnout defined?  In this context, it is described as a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment.  In another context, it might be the guy who started smoking weed in 7th grade and now hands you the stub from your movie ticket, keeping the other half for his employer.
Of course, in this post, we’re talking about physician burnout brought on by increasing bureaucracy, increasing hours and expectations, decreasing time with patients, pay for performance, unfair ratings systems, etc…  It wouldn’t be tough to come up with a list of 101 ways a physician’s life can be made more stressful.

Why Does Burnout Matter?

Why should we care?  On a personal level, burnout is not a good feeling.  A burned out physician may not be able to give every patient the level of care they’re expecting.  A burned out physician may be more likely to make a mistake.  A burned out physician may not be at his or her best at home, leading to marital conflict, decreased life satisfaction, making work even more difficult to stomach every day.  It’s easy to envision a cycle that repeats itself, becoming a downward spiral that can’t possibly end well.
The repercussions are not good for patients.  Would you want to be seen by a physician who dreads coming to work each day?  A physician who is more likely to abuse alcohol or other substances?  One who is more likely to contemplate suicide?  The stakes are that high.

The Prevalence of Burnout

How common is burnout?  Quite common and increasing.  A recent article published in the Mayo Clinic Proceedings showed at least 1 symptom of burnout in 54.4% of physicians in 2014, up from 45.5% 3 years earlier.  Satisfaction with work-life balance decreased from 48.5% to 40.9% over that time.  A 2012 articlepublished in JAMA showed 45.8% of physicians exhibiting at least 1 sign of burnout, and physicians having an overall burnout rate about 10% higher than the non-physician worker.  Dissatisfaction with work-life balance was about double when compared to the non-physician.
What can be done?  There are big, system-wide answers and there are tiny, change-your-routine answers.  I won’t pretend to have them all, but I can at least tell you what others have done or suggested.  Stanford is rewarding emergency physicians with its time banking program, offering “meals, housecleaning and a host of other services — babysitting, elder care, movie tickets, grant writing help, handyman services, dry cleaning pickup, speech training, Web support and more.”
A recent newspaper editorial suggests the public needs to rally around its doctors like it has its teachers, who have been subject to the myriad of metrics in the recent past.  The AMA has released its STEPS Forwardprogram to help physicians gain control of their professional lives.
Common recommendations to relieve burnout are the usual suggestions to relieve stress:  eat better, take time for yourself, exercise… I’m just not sure how many of us can yoga our way out of professional misery.

My answer to physician burnout

What do you suppose I would suggest to help prevent or alleviate symptoms of burnout? Can you read the words at the top of the page, you know, that whole FIRE acronym?  I believe working toward a goal of Financial Independence, and seeing real progress toward that goal, can do wonders for the psyche.  If you are experiencing burnout, but can see a sliver of light at the end of that career tunnel, and you can watch that sliver expand and shine brighter, your outlook on your career and life might start to glow brighter as well.
When you are saving like Dr. Anderson, you know that you won’t be stuck in this position forever.  Starting from scratch, you could achieve Financial Independence within about 10 years.  That may seem like a long time depending on the stage of your career, but it’s less than the combined years you put in to college, medical school, and residency.
Once you have achieved FI, you’ll have options to lighten the load you’re carrying.  You can work fewer days or hours if your position allows.  You may be able to drop the worst part of your job, while maintaining the part you enjoy.  For example, The White Coat Investor is dropping his overnight E.D. shifts now that he’s got a sizeable nest egg.
You will be empowered to enact the changes you need.  If the only appealing option is to be done entirely and stop working, you can do that too.  And let every day be a Saturday.
Personally, I would rather remain gainfully employed than walk away at the age of 40.  I haven’t taken a formal survey or questionnaire, but I would guess my burnout score would be pretty low.  Some workdays are tougher than others, but I don’t dread them or end them feeling overwhelmed and exhausted.

Burnout varies by specialty

I may be in a specialty that is somewhat shielded from the bureacratic nightmares that plague primary care. The term “prior authorization” does not factor into my workday; I don’t have to worry about dotting enough i’s and crossing enough t’s to magically transform a clinic visit into a Level 3.
The 2015 Medscape Lifestyle Report show anesthesiology having a burnout rate of 43%.  That’s not as low as the dermatologists, reporting a survey-low 37% burnout rate, but quite a bit better than the 50% to 53% seen in emergency, internal, and family medicine, general surgery, and infectious disease.
In My My, Hey Hey, Neil Young tells us that it’s better to burnout than fade away (a worldview repeated by Def Leppard in Rock Of Ages).  I think I’ll ignore their collective wisdom, and do my best to fade away when I’m ready for my career to wind down.  From what I’ve read, burnout can be downright ugly.
What do you think?  Feeling burned out?  Why or why not?  Would progress towards or achievement of Financial Independence change anything for you?  Sound off in the comments below.

By Physician on Fire