In an era of increasing transparency in medicine, the Centers for Medicare & Medicaid Services (CMS) has been publishing data annually on payments to individual physicians since 2014. The database, officially called the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File, has been a window (albeit a cracked and opaque window) into the practice patterns and reimbursement of individual physicians. It includes most payments for services ...

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There is a lot of talk on the web about having an emergency fund. Typically this is three to six months of expenses. Some would argue to keep three to six times bare bones expenses, and others would argue to keep three to six times the average amount you spend on expenses. Having an emergency fund makes sense to cover life’s unexpected occurrences. What could these be? Well, the biggest ...

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This is a tough post to write. I struggle with this issue daily. Is it OK for a physician to retire early? The obvious answer is: yes. Each individual should live their life as they see fit. But with a continued shortage of physicians (granted this is more in rural areas and not big metropolitan cities), and the time, money and resources required for training physicians, is it selfish to ...

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I get on the phone with a physician. She is stressed. Her tone is exasperated. Her frustration has been building and building. I hear the stress in her words. She feels like she has been juggling ball after ball after ball. Living her circus of a life. Taking care of her patients. Pulling extra shifts and doing locums. Somehow, fitting in a little bit of time when she can for her caring ...

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I feel privileged to be practicing medicine. Many people consider doctor careers and imagine how great it may be. Is it the right thing for you? Yes there are days of frustration, exhaustion, and utter defeat, but at the end of the day I home and know that I helped at least one person if not two from the 16 I meet. The fact that I alleviated one individual’s anxiety or ...

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Recently, I had the privilege of presenting the Clinical Specialty Award for General Surgery at the 2017 Graduate Awards Celebration at Western University of Health Sciences College of Osteopathic Medicine of the Pacific (COMP-NW). It was amazing to hear all the accomplishments and meet so many wonderful new doctors in this year’s class. I also got the opportunity to meet a few proud parents and professors. The list of accomplishments of ...

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In honor of everyone graduating and moving on to the next step, let's talk about money. And by money — I mean debt because new doctors don't have any money! All we have are bills to pay! I am the one who does the finances in our household. It really happened by accident. My husband was deployed shortly after we got married, so all daily responsibilities were de facto handed off ...

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My cousin visited me in sunny Cali this past weekend. She lives a life that many in the medical community can appreciate: a stable and successful job for many years, but burnt out. She then decided to take six months to work on her writing and try establishing herself through various pursuits. While successful in some ways, she decided she needed a more stable position. So she found a job, ...

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There has been much talk over the years about resident work hours. How long is a safe shift? With safety being considered for both the patient and the resident. But no one ever discusses attending work hours. If putting in a 24-hour shift is bad for a resident, isn’t it bad for an attending as well? When I was working in critical access hospitals, I usually was on call for ...

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D.J. is a 55 year-old woman with recently diagnosed early-stage left-sided breast cancer. She just had a lumpectomy to remove the tumor, and now has to decide whether to undergo chemotherapy after surgery. Her oncologist carefully discusses the clinical and pathologic data about her tumor, in terms D.J. can understand. She discusses the risks, benefits, and side effects of chemotherapy, and recommends treatment. D.J., having learned about the risks and ...

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