When I read The Broke Diaries, it was like reading my financial autobiography in medical school. I remember negotiating with the dry-cleaner to split my bill so that I could only pay for one dress and pick the rest up later.  Looking forward to making some furniture craft for my apartment on Spring break while the rest of my classmates were going to some exotic Island ...

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Just as providers have reimagined their clinical and business models in light of the pandemic, there is an opportunity to reimagine their relationship with health plans. Particularly in the context of evolving value-based contracts, there are a variety of “asks” that are likely to find receptive health plans. Three issues that are particularly important to health plans are administrative efficiency, quality measures, and overall cost of care. Each one creates ...

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"When it comes to using telehealth to treat patients out of state, most physicians are mindful about licensure issues. But some are not aware that if you don’t have a license to practice medicine in a given state, it isn’t just malpractice: It’s a criminal offense. Licensing restrictions have been eased to facilitate ...

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"Something had to give, and it would either be clinical medicine, or my business. I finally had to admit I was no longer fulfilled to the same level doing hospitalist work. So I made the decision to leave my clinical job. It was so terrifying that I put off making a decision for ...

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Every physician has had the experience.  The moment you ask yourself, “Why am I doing this?” It could be when you look into the waiting room where there are more patients to be seen and know if you take a break, it will set you back even further. It could be on the final stretch of the 24-hour shift that redefined the meaning of the word "nonstop." It could be the third time ...

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"It is still extremely early in the Bitcoin story. This is due to the same network effect that Facebook, Amazon, and Apple have had as adoption of new technologies rapidly expand and are adopted by society. Bitcoin has passed its 'tipping point.' Converting some of your money to Bitcoin now is ...

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Changing direction once established is not easy, but it can be rewarding. I recently read the essay on KevinMD ("How this physician escaped the system") from a physician who shifted gears to her own business after some discouraging experiences in “the system.” During her residency, her attending physician asked her what her purpose was in becoming a physician. To her credit, she said that her goals ...

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I am a Gen X'er. We are a generation that I think is most aptly described as hardworking, rule-following, law-abiding, good, and productive citizens. That's a good thing, right? Most of the time, sure. Where we go wrong is we work hard, follow the rules, and do what we are told even when our hearts are not in it. I have too many times overheard, and if I am being ...

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Creating the ideal life is hard, but it can be especially difficult in medicine, where the pressures and daily stresses are significant. What simple steps can you take to live your best physician life? Here are some action items to consider: Follow your values. Most of us pursued medicine to help others, but were there other reasons that inspired you to dedicate a decade of your life to become a doctor? ...

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When I think about boundaries, I am struck by how individual, varied, and unique each of our own personal definitions of boundaries can be. For one person, it is the physical boundary between the external world and our property. For another, the emotional and relational boundary between physician and patient. For many, the physical, emotional, and energy boundary between work and home. And often the most difficult, the boundary between ...

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"The first thing my husband said when I told him about MBA school was, 'the NBA has a school?'  It didn’t help that we first had our conversation about MBA school during the NBA playoffs but really – NBA school?  I quickly overcame this moronic start to the conversation by saying 'M' ...

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"Oh, Canada! Every presidential election cycle, my colleagues joke that if the election result is not to their liking, they will move to Canada. On election night 2016, 'move to Canada' trended on Google, and the Canadian immigration website crashed. This election cycle America is having an existential crisis. What does ...

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Do you routinely make deadlines for meeting registrations? Paper revisions? Promotion and submissions? Most physicians easily make professional deadlines, but how often do you honor commitments to yourself? Similarly, do you have a friend who plans to go with you to the gym and then is always a no-show? Do you have a hypercritical friend who routinely tells you, "you are a terrible mom!"? Do you have a weirdo roommate who ...

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Physicians are overwhelmed and burned out. We have an epidemic of “too busy.” Many of us think we could get so much more accomplished if we had more time. Why aren’t we taking the time? Doctors need to start taking growth days. These aren’t sick days, mental health days or vacation days. Growth days are days strategically taken during the month that are specifically meant for personal growth. This could ...

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I knew this day would come, when my survival would depend on my ability to reframe a covenant once made. Medicine, the knight in shining armor that has given me livelihood and legacy has taken so much. I willingly surrendered for the title of physician and the responsibility and privilege of being a healer. But relentlessly, Western medicine has tried to strip me of me so I would robotically serve ...

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I love metaphors. I think they can be so powerful and can convey so much, sometimes with just a few words.

One metaphor we use in coaching to describe the coach’s role in a session with their client is that of a swimming pool. The client is in the swimming pool, and as the coach we have the job of not jumping in the pool with them.

Imagine you ...

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“Wrong! The most important part of your job is to make money.” I will never forget those words from an attending in residency – though I did not know it at the time, it was a pivotal moment in my decision to pursue a nontraditional route in medicine. I loved my patients; I loved the critical thinking required for taking care of them, I loved the scientific knowledge underlying the ...

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A mid-life crisis, re-assessment, re-envision. Hollywood’s cliché version epitomized by Chevy Chase driving the “family truckster” while flirting with Christie Brinkley and later trying to skinny-dip with her. Of course, it is more than that. Researcher, Brene Brown, calls it the unraveling. It is a pause. Turning off auto-pilot. A re-evaluation of goals. Clinically, it is called a mid-life transition or stage of adult development. It can be midlife or mid-career ...

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A backlog is a terrible thing, isn’t it? It’s certainly something that we often choose to hide as physicians. We use it as a source of shame, guilt, frustration, and overwhelm. Many physicians have had their jobs threatened, or even lost their jobs, due to mountains of unfinished charts or inboxes. When you understand this, you can see why you would keep that sort of thing to yourself. Every day the ...

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"At first, it may seem strange that 'physician' and 'side gig' are even used in the same sentence. After all, the average physician in the United States is already working more than a 40 hour work week and struggling with issues related to work-life balance. As someone who talks about physician ...

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