Category: Physician Stakeholders

A Time for Doctors to Shine???

Check this out. What you will see is a physician author describing physicians as going through Kubler-Ross’s five stages of grief in terms of their professional autonomy and compensation. Over the last couple of decades, doctors have increasingly been forced to cede their power, and much of their incomes, to stronger forces. Insurance companies, medical systems, etc. Early on, we saw doctors in the first stage of grief. Denial. Doctors denied that their lives were being tampered with, and they stayed silent. Mentions of physician “unions” were rebuffed. 

Over subsequent years, the doctors predictably marched through the other stages of grief. So now they are where they are. Interestingly, as COVID-19 looked like it was passing off into history, doctors believed that this would be an ideal time for them to recapture their pre-grief former lives. Not so fast! Many of our citizens are facing difficult financial times as a result of the pandemic. Small businesses are struggling to stay open. AND. Many Americans are mindful that among developed countries, the US has the least cost-effective healthcare system on earth. Not a great time for doctors to be asking for more money and more autonomy.

Bottom Line. SO. Dr. Pearl is suggesting that American physicians move on to the last stage of grief. Acceptance.  No, not acceptance of the fact that our healthcare, and doctors’ lives, will continue to get worse and that there is nothing to be done about that.  Nope. Acceptance of the realization of what is broken, e.g., an uncoordinated fee for service system. And making the commitment to fix the problems. 

Then, and only then, will physicians and patients be able to stop grieving!

Gut Girl, M.D.

Check this out. What you will see is a video by Dr. Dawn Sears. She’s known as “Gut Girl” because she is a Gastroenterologist, but for another reason as well. Besides her successful practice, she’s had the guts to establish a consulting business that, among other things, helps medical institutions achieve more engagement from their female physicians by setting up programs that avoid burnout, clean up toxic environments, reduce sexual harassment, etc.  

Bottom Line. It’s interesting. Most of the physicians with consulting “side gigs” like this that I have sent you to have been female. When male physicians do side gigs, they focus more on successful financial planning for doctors.  

Gender stereotyping strikes again?

It Is Wrong For Doctors To Retire “Early?”

The gentleman pictured above is Dr. Jimmy Turner, the self-proclaimed “Physician Philosopher”. In this post, he sets out to debunk the title shown above. In doing so, he argues that a physician’s early retirement does not render the slot he occupied in medical school a waste. How many years should a doctor be required to practice in order to make his education worthwhile? 10? 20? Until he dies? Good question!

He also defuses the concept of early retirement contributing to the physician shortage. Here, he argues that too few doctors entering the field, rather than too many doctors leaving medicine, is the actual cause of the doctor shortage. He’s probably right again!

Of course, Dr. Turner has an axe to grind here. He coaches physicians on the principles of FIRE, Financial Independence and Retiring Early. 

As I pondered this piece, I thought of the work I do as a Board member at Volunteers In Medicine on Hilton Head Island, SC. We have 10,000 patients who would otherwise be medically underserved. And what lets us care for all of these patients with only a minimal budget? Volunteers. RETIRED volunteer physicians, nurses, dentists, pharmacists, etc., all anxious to continue to put their clinical skills to good use, especially now that they don’t have to worry about running a practice as a business. Many in their 70’s, retired for years, but still going strong.  

Bottom Line. So, is it really wrong for a doctor not to work full time practicing medicine until she dies, worried the whole time about finances and burning out? 

I am going with a big “No” on that one! How about you???

Should Doctors Give Patients Their Cell Phone Numbers???

Check this out. What you will see is a well-reasoned discussion of the above thought question. The result? The recommendation that doctors’ cell phone numbers should not be distributed under most circumstances. Why? Optimal medical care cannot be delivered spontaneously. You call the doc after he has had two glasses of wine. What happens then? You call a doctor who has 2,500 patients of which you are one, and you have not seen her in over a year. Not surprisingly, her first thought is “Who the heck are you?” Etc.  

Bottom Line. In the age of social media, we have learned to expect instant two way communications. Likely, a doctor’s cell phone should not be a part of this networking. OR. Maybe we need to rethink the overall premise that spontaneous communication is good communication!

The Pandemic And Medical Malpractice

Want to know what one of the longest-term side effects of the COVID-19 pandemic will be? Easy one! Growing numbers of malpractice cases against physicians and hospitals.  

Check this out. What you will see is a primer on the changing face of healthcare litigation resulting from the coronavirus. Example. Oncologists in my On Doctors’ MindsSM study are telling me that they are seeing “stage shifting,” i.e., patients presenting with later and less treatable forms of cancer due to delayed/missed colonoscopies, mammograms, etc. What if these delays were caused by a hospital shutting down “non-emergency procedures?” Liability???

AND. If a case is filed, what impact on outcomes results from the trial being conducted via Zoom???  

Bottom Line. Explore any of the topics included in this article’s pull downs. And remember. The healthcare institutions and practitioners being discussed here are our customers. What impact do we think this all will have on them…and on your business???

New Causes Of Malpractice Concerns For Physicians

I just got off the phone with a Family Physician discussant who was participating in one of my On Doctors’ MindsSM conversations. He had a lot of interesting things to say, but one really stood out in my mind. More specifically, he told me in no uncertain terms that he had NO interest in participating in medical care delivered via telemedicine. None! He feels that he cannot deliver proper care without “putting a stethoscope on the patient,” and that the malpractice concerns attendant to telemedicine are consequential. 

Then I read this. An actual case study involving a “wearable,” i.e., a medical device that permits remote monitoring of patients. In this case, a device that was supposed to keep track of a patient’s heart function. Only thing is, the patient didn’t put the darn thing on for several weeks after receiving it, and never got it to function. Punchline? The patient’s doctor got a report from the wearable’s manufacturer, that he shared with the patient, that the gadget had determined that the heart function was “normal” during this time frame. Whoops!!!

Bottom Line. New technologies are opening up new “roads to risk” for physicians relying on them. Medicus Emptor (Let the doctor beware)!!!

Physician Stress “Thanks To” Covid-19

Check out this 4 minute video clip. What you will see is two female Cardiologists, discussants in my On Doctors’ MindsSM  project, talking about the reasons that the pandemic is causing them both major stress. Covering for sick colleagues, concern about lack of PPE, worry about bringing the disease home to their families, being forced to treat hospitalized COVID-19 patients even though they are not trained as Intensivists, etc. are all contributory factors here. 

Bottom Line. As I talk with these physicians every month, I wonder… I wonder what impact this stress is having on their current treatment of patients. I wonder whether this stress will cause them to burnout, retire, develop mental health problems, commit suicide. 

Again, Wolf Blitzer and Lester Holt have done a wonderful job taking us inside the “nation’s busiest ICU’s” and showing us the living hell that the pandemic has made of the lives of Intensivists. BUT. Office-based Primary Care Physicians and other specialties will also likely be suffering the psychological sequelae of the pandemic for years to come!

Loneliness Hurts The Most

What is the worst thing that the pandemic has done to us? Killing 500,000 Americans? Not good!  Screwing up major pieces of the U.S .economy? Also, not good!

BUT. Perhaps the worst thing that COVID has done to us is to increase loneliness, and even more pervasively, the fear of being alone.

Check this out. What you will see is the story of a doctor who learns that even though he has asked all of the right medical questions, he has not fully done his job if he has not made sure that he has done as much as possible to treat the patient’s loneliness. To find her missing cell phone and get it to her. To reconnect her with her family.

Bottom Line. Isolation. Quarantining. I talked to a 60-something “bag boy” at my Country Club today. I knew he had had Covid, and I asked him how he had made out with the disease. By way of response, he without hesitation told me that the worst part was being separated from his wife. At home. Quarantining in the bedroom. NOT in an ICU bed. Not on a ventilator. But still being alone.

Hopefully this will be a positive learning experience that comes out of the pandemic. The realization of just how important our connectivity with other people actually is, and how distressing it can be when that connectivity is taken from us!

A Physician Dilemma During A Pandemic

Check this out. What you will see is a blogging physician asking whether we really mean it when we say we support our “healthcare heroes.”

Here’s the deal. A public health physician ended his day with 10 doses of COVID vaccine left over. What to do? There was at the time no protocol for how to handle left-over doses. There was no known waiting list for him to contact. So, he decided to spend his own time to go search for patients who might benefit from the vaccine before it spoiled. Which he did after getting permission from his boss.  

Like the old proverb says, “No good deed goes unpunished.” He was promptly fired from his job for going “above and beyond,” and the District Attorney launched an investigation into whether he should actually be charged with stealing the vaccine. Oh, and the Texas Medical Board weighed in as well.  

Bottom Line. Good grief! How many thousands of situations like this have dotted the landscape in the last 4 months since the vaccine became available? Remember the guys who got trapped in a blizzard, and wandered up and down the highway administering vaccine to other trapped drivers before the juice went bad? Did they commit a crime?

Sure, Dr. Gokal got his job back, the Texas Medical Board backed off and the initial criminal charge against him was dismissed. BUT. The DA continues the witch hunt, and the aggravation for the doctor along the way must have been significant to say the least.  

SO. Besides the lip service of praising our “front line health care workers,” how about if we actually show them some respect in ways that really matter???

Doctors As Dog Groomers

Check this out. What you will see is an exploration of the various jobs that the 21% of physicians for whom the pandemic brought furloughs or other reduction in hours/income have pursued in an effort to keep financially afloat. Dog groomer, warehouse worker, doll house decorator, etc. 

Keep in mind that this is the first time in memory that physicians in the U.S. have faced any widespread version of unemployment. Little wonder that 2020 has, as this article reports, led many doctors to consider leaving medicine altogether.

Bottom Line. As we have discussed in previous posts, this is a really strange time to be a physician. While doctors are increasingly valued and some specialties are working unconscionably long hours, others are out of work in whole or in part.  

How long will it take the medical community to restabilize itself after this multi-faceted onslaught? I am thinking “Years!”