This is one of my favorite times of the year. Thanksgiving dinner with my family, cool air that calls for cute winter clothes, and holiday festivities that invoke the spirit of love and positivity. As we embark on this season, inevitable holiday sales may tempt us more than we can imagine. In order to deal with this temptation and stay within our budgets, we may need a little motivation to ...

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Your medical training has failed you. When it comes to leadership, acting as the supreme commander — large and in charge — is not solving your problem. You are racing from patient to patient, running as fast as you can to keep up. You see your income falling while your workload increases and the joy you used to derive in helping people to live healthier lives evaporating. How much longer can ...

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My 20-year medical school reunion was a time to reflect: Have we aged more gracefully than medicine? The Class of 1999 carried books and wore pagers while scrambling to gather paper charts for rounds. Residency did not prepare us for the explosion of managed care, EHRs, health systems, and allied health providers. What do I wish I knew then? The hardest part of medicine isn’t becoming ...

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What really makes a person complete? What do we want in our lives, and what is it like to become our best, most fulfilled selves? In the 1960s, psychologist Abraham Maslow tried to answer this question. This eventually led to his well-known hierarchy of needs. You might be familiar with the pyramid. The premise of the theory is that once we fulfill our basic needs ...

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How would you make sense of the following vignette:

  • Over a 40-plus-year period, a disease ("X") is diagnosed, its causes are defined, and effective treatments are prescribed
  • 30-50+ percent of people working in your organization are currently suffering from X and cry out for relief
  • The stakeholders in your organization not only fail to apply best practices for preventing/curing X; they actually enable the drivers/vectors of the epidemic to intensify
As ...

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As physicians, we find ourselves in higher tax brackets than the majority of Americans. With the graduated tax system here in the U.S., the more we make, the higher the percentage of taxes we owe. That is not just because of the tax brackets, but also because many tax write-offs are phased out as income climbs, creating a compounding effect. There are things we can do to decrease our tax burden. ...

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As a woman physician, practicing for over 31 years, I have faced many misogynistic occurrences as well as misperceptions about my career choice. This blatant devaluation of women within medicine may be similar to what other women have had or continue to face daily. At large, these experiences resulted in a journey not always easy, nor welcomed, but in the end, accepted for the maturity obtained. My hope is that by ...

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Becoming a physician in 2019 presents its share of challenges. Providers must deal with reimbursement rates that remain a fraction of their previous levels, adapt to a fee-for-value model, adopt ever-advancing technology as an integral part of care delivery and accommodate a patient-provider dynamic that favors patients — who now demand choice, autonomy, affordability, and transparency. These developments starkly contrast conditions at the turn of the century. Still, they don’t seem to ...

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"She is too direct." “She sounds overprepared.” "She is just not that lovely to hear."   These are just a few pieces of “feedback” that podcast producer Dr. Shreya P. Trivedi has heard about women’s voices over the years. And then suddenly it occurred to her, she had never heard any comments on a man’s voice or the way he speaks.  Though women have come a long way from ...

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This time last year, I took the podium at conferences as far away as Dubai to deliver my keynote speech entitled, "On The Cusp Of Life And Death, Choose Life." My talk highlighted the professional and personal development opportunities that show up as doctors, nurses, and parents navigate the challenges in the neonatal intensive care unit (NICU) caring for preterm and term newborns on the cusp of viability due to ...

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Harvard Medical School student Chloe Li typically dressed in scrubs or an efficient, professional outfit as she went about learning to care for patients in the intense, year-long clerkship program where I teach.

For her capstone presentation on graduation day, though, she wore a cream-colored wrap-around dress of luscious silk, tasteful jewelry, and an up-do hairstyle. She had clearly put a lot of care into these preparations. She ...

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National attitudes have greatly shifted over the last 25 years towards the idea that mental and emotional well-being are vital to a person’s overall health. Today, nearly six in ten Americans have sought or want to seek mental health care for themselves or someone they love. While stigma and costs persist as primary barriers to progress for solving the mental health crisis, the key issue—as we have ...

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Back in 2016, my hospital, also my employer, changed the EMR. I was fully integrated into another EMR, so changing was not on my to-do list in the later part of my career as a diabetologist. As you would expect, the transition was a nightmare and took me to a new low in my life. Crying in my wine became my new norm. I became distraught, felt imprisoned, and felt that ...

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I recently spoke with a colleague who transitioned out of the military in the last year. He was previously excited about his new job opportunity, but now a year later, he tells me, "I hate civilian medicine." I was surprised because he had been excited about the opportunity to teach in a residency program again. He said, “I love teaching, and I love the residents. ...

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“So, if you look at this table, you can see that group X had a small but statistically significant increase in mortality over group Y. What does that tell us? It suggests that maybe there is some signal that intervention A is better than intervention B.” The slide has some table from some journal, and the speaker will then often circle some p-value and talk about the strengths and weaknesses of ...

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You were strong in college You were strong enough to get through weed-out classes in undergrad.  You were strong enough to balance the extra-curricular activities and clinical shadowing expected of you while crushing a 21-hour semester.  You were strong enough to say, “no, I have to study” when friends wanted to go out because you had a dream of becoming a doctor someday. You were strong enough to pay for the applications, ...

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This week my wife and I celebrated our 31st wedding anniversary. It made me think about how my life has changed from when I was a single freshman in college. A time when I didn’t always do the right thing. I knew it was against both the law and school policy to drink alcohol at my age during a frat party, but I sometimes did it anyway. We know we have moved ...

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We talk with a lot of physicians every day who ask us a simple question.  “Why should I invest in self-storage?”  Obviously, as a self-storage operator, we are biased, but there are three data points that we believe make this a fantastic asset class for physicians to evaluate for their own portfolios. Wait a minute, self-storage is a legitimate asset class?  Some statistics on the self-storage industry that may surprise you.  ...

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Why do so many of us (meaning me) need to be reminded to act with kindness? Why can't we "just do it"? Yesterday, a friend asked me why we don't celebrate World Kindness Day every day. I believe that's a wonderful idea. But in practice, it's not so easy. So, I got to thinking about why that is. If we want to spread the ripple effects of kindness — to our families, ...

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With 44% of physicians self-reporting burnout in the 2019 Medscape National Physician Burnout, Depression & Suicide Report, most will agree the profession is in crisis. Of the 29 specialties included, all had at least 1 in 4 members reporting burnout, many with more physicians suffering from burnout than not. Hardly a U.S. problem, burnout affects physicians around the world as well as medical students, and I would ...

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