December 2017

Social media: The ultimate tool for women in medicine

This post was originally published on this website

There is a movement afoot. I can feel it. I can see it. Women in medicine are no longer going to tolerate the subtle and not so subtle discrimination that has stymied their career growth. They are not going to be complacent while their male colleagues are paid higher salaries, offered speaking engagements and research opportunities and promoted at a greater rate. Women in medicine are pulling together in an incredibly organic way — fostered by social media. Their goal is to help each other achieve their professional goals.

It has been two years since Heather Logghe, a surgical intern first tweeted #Ilooklikeasurgeon. Since that time, this hashtag has received over 2.8 million impressions on Twitter. Women surgeons around the world have been encouraged to post pictures of themselves at work. Women now use it to identify their tweets and build a community.

Last spring, the cover of the New Yorker magazine spurred another social media phenomenon. The #NYerORcoverchallenge was started by surgeon Susan Pitt, also encouraged women surgeons to recreate the now iconic image that challenged the archetypical surgeon. Women continue to post their pictures, and they are retweeted and liked by others, again from around the world.

Continue reading …

Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.


Doctors should start watching more science fiction. Here’s why.

This post was originally published on this website

I often say that electronic health records (EHRs) is like Skynet in the Terminator. I expect to turn around from my screen someday, and Arnold will lift me by my throat saying, “You haff not been doing yuh meaningful use.”

We practice in a time when EHR confounds us by freezing, crashing and chaining us continuously to our work, as we spend evenings and weekends on documentation. For reimbursement purposes, we are instructed to include more and more useless details. As we pay more attention to the “iPatient” than to the real patient, we have confused the map for the territory. Is there a Dr. John Connor out there who will lead the resistance against Skynet EHR?

Perhaps instead it will be a hacker anti-hero that brings the whole system crashing down — an Elliott Alderson from Mr. Robot. Or perhaps a robot will herself take out the abusive, misogynistic corporate head, as Ava does in Ex Machina.

Continue reading …

Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.


Think the world is in chaos? Focus on mental health.

This post was originally published on this website

About a year ago, I did away with TV. It was an overwhelming expense with little personal utilization. I thought to myself while struggling with the decision to cut the cable, “What will I be missing?” I may no longer be “Keeping up with the Kardashians,” but I do keep a regular eye on my iPhone news feed. It is an addiction many people share. That itch to grab our phones with every buzz and ding. That phantom sensation you feel as if your phone vibrated in your pocket only to find out there is nothing new waiting for you.

Lately, the news feed is plagued with political updates. Then there are the protests for and against white supremacist ideology. Finally, the three major mass casualty events in the last few months. I am taken aback by the building amount of discord in our beloved America.

I have been on a quest to redefine my view of our health care system. I had always had a passion for mental health topics but came to the realization that our mental health as a population is central to a lot of our societal issues as well as chronic health problems. As long as we continue to marginalize and stigmatize the importance of our mental health, we will be a society drifting towards further chaos.

Continue reading …

Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.


Is there a future for robot-assisted surgery?

This post was originally published on this website

Recently, there was a fascinating article in the Wall Street Journal regarding robot-assisted surgery. It reported the results of two articles published in JAMA that demonstrated that robotic-assisted surgery cost more and took longer without achieving superior results to laparoscopic surgery on average.

With this, my LinkedIn account lit up. Here are several of the comments that came through:

“I’ve come to assume that robotic surgery is better for GYN and colon surgeries simply because of their increased precision and accessibility to small spaces.”

“Robots are sexy, the media covers it like it’s the next best thing since sliced bread, and advantages may or may not be earth-shattering. Since when has that ever stopped a sale?”

“If you’re a surgeon: would you rather stand uncomfortably over a patient for 2-3 hours, trying to manage laparoscopic instruments? Or would you rather sit comfortably at a console and feel like you’re playing a surgery video game? It isn’t about outcomes. Plus, robots are cool to patients.”

Continue reading …

Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.


This physician is burned out. But not for the reason you think.

This post was originally published on this website

I am an Olympian. I am a retired All-American student-athlete.  I am a resident.  I am burned out.

Let me be clear: I love medicine and the opportunity to have privileged relationships with patients and their families.  I thrive on the fast-paced environment, growing to-do lists, and the chance to work in a field with endless learning.  I love working in team environments to provide optimal care for patients and their families.  The most rewarding point in residency training has been the transition to a senior resident where I can create positive learning environments for other learners.  Practicing medicine is an extremely fulfilling career that I am very fortunate to have pursued, and I will never regret that choice.

The demands of patient care and the number of hours residents work is not the primary reason for my burnout.

Continue reading …

Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.


5 expenses that go down after you retire

This post was originally published on this website

In order to safely plan for a successful retirement, it’s imperative to have a general idea of what your spending needs will be when retired. We cannot calculate whether or not our anticipated withdrawal rate would be considered safe (in the range of 3% to 4%) without knowing the size of the annual withdrawal.

That number can be difficult to pin down, as there are many variables. It can be informative to budget (we don’t) or track spending (we do), but this year’s spending might not look like last year’s, and could be entirely different than what we will end up spending in retirement.

Fortunately, there are a number of categories in which your annual expenses can be expected to drop when you give up the day (and sometimes night) job.

Continue reading …

Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.


Medical workers: Vaccinate yourselves first

This post was originally published on this website

Just under half of health care workers do not get their annual flu vaccine. Some of these workers contract the flu and unknowingly transfer it to their sick hospitalized patients, and in some cases, because of them passing the flu along, those patients die.   We know the most important reason for health care workers to get vaccinated against influenza is that it is the most effective way of preventing influenza among their patients. And yet, unfortunately, many health care workers are putting patients at unnecessary risk.

If medical professionals know this, then why aren’t they complying?  As physicians, one of the most challenging things we do is to encourage our patients to comply with our treatments.  Why, then, do we not comply with a preventive treatment we know we protect our patients and ourselves?  I asked colleagues about this over the years and they have usually told me that they are either afraid of side effects or they don’t believe that the vaccine works.

There is more than enough data to prove them wrong.

Continue reading …

Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.


Insurance and the destruction of our health care system

This post was originally published on this website

When interviewing for my book, I asked about insurance, but the topic came up even when I didn’t specifically ask about it. It was never positive in relation to practice.

A doctor said, “I expected to be around tough and hard cases. I expected it to be hard. I did not expect to have to think if the insurance company will not pay for it.”Another one said, “This completely changes the role we play as physicians The insurance companies are taking the ability to practice medicine the way we want to away from us.” Another doctor agreed, “It used to be in the days of yore you provide the services you thought were appropriate. Now there are restraints via insurance companies willing to pay what they are entitled to and what we can offer.” Another one agreed, “You have to watch the bottom line, or you get kicked off of the insurance panels and the hospitals and cannot earn a living. It is not most important to take care of people.” Overall, said one, “The insurance companies did not have as much power dictating things to me in the past as they do now.” One doctor said, “Insurance companies weren’t allowed to deem a recommended procedure as unnecessary not indicated and not reimbursable.”

The patients get hurt. “Patients don’t get adequate care sometimes.” and “They get inferior care,” said two interviewees. “Now almost anything we do we have to really think about the cost-benefit ratio to the patients. Will the insurance company pay? If not, can the patient afford it? Will the patient be physically harmed if they don’t get it? How can I help this patient?”   Another said, “We see more patients skipping their appointments and meds.” Shockingly, “There are delays in diagnosis. Delays in treatment. And in some cases, I had to cancel surgery because of insurance reasons.” In summary, “We are not delivering as good a product as we think we are. It comes down to insurance companies having too much power over the processes.”

Continue reading …

Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.


The hidden work of primary care

This post was originally published on this website

It was nearing the end of my day at the mobile health clinic where I work as a nurse practitioner, providing free, comprehensive primary care to uninsured patients in central Florida. Clinic was officially over, and we were no longer taking patients; I was signing notes and finishing up some teaching points with a PA student when a woman walked up and asked me if she could “talk to me for a minute, just to ask a quick question.” After many years working in community health, I know these types of requests are rarely “quick,” but, understanding our patients’ limited opportunities access to care, I obliged.

As soon as we walked into a private space, the woman, whom I’ll call Alice, began to unload.

“I’m having all this belly pain. I think it’s from my cervical cancer which has spread to my ovaries. I went to the ER, and the doctors didn’t do anything. They did a pap smear, and I think they’re hiding my cancer from me.” This stream-of-consciousness deluge went on for several minutes while I listened and nodded despite my growing anxiety at having gotten myself in over my head with this unplanned clinical visit.

Continue reading …

Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.


The demand for preparation: from the playing field to the OR

This post was originally published on this website

We often pull comparisons between unexpected resources in any given profession, especially when it comes to adopting tried and true best practices. For example, I always encourage hospital systems and training institutions to look to the hospitality industry for the treatment of patients and guests, among other areas. Last year, as I settled into my seat on a cross-country flight, I witnessed a textbook example of looking outside the box for surgical training inspiration.

One aisle over from me, an NFL coach taped pages upon pages of plays across the seat in front of him, studying for an upcoming game. As a practicing head and neck surgeon and an advocate for constant education, I imagined how great our healthcare system would be if we all prepared for surgery with the matched fervor of this coach.

Before diving into the details of what surgeons can learn from football, there’s one other important story to tell. Recently, I was in the backseat of an Uber when the driver asked how long it took me to become a doctor. Anyone who is currently practicing knows this is not an easy question to address. My answer was two-fold.  First, it took me eight years of schooling, but truly 14 years before I was able to become a surgeon. It takes several years to be fully prepared to take care of patients. Physicians go through a tremendous amount of training, so we certainly can’t say that any one person (football coach vs. surgeon) is more prepared than the other. However, it’s possible for a mindset to creep in once you’ve been practicing for a significant amount of time — the mindset that it’s acceptable to continue what you’ve been doing since day one. So, how do we remedy this? We use the coach on the plane as an example.

Continue reading …

Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.