Residency

Family comes first for some who have finished residency

by Dr. Whoo, MD

I have met several women who have completed residency and maybe even practiced beyond that, but decide to quit and stay at home with kids. I wonder – why would a woman who has gone through all of that training just quit? It would seem like the hard part is behind them and I am perplexed by their decision but, of course, I …

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Medicine residency survival tips during pregnancy

by Dr. Whoo, MD

Q. I just found out last week that I’ll be a new mom in November, making me an official mother in medicine! I’ve been reading the blog for a while, because I love hearing what all of you have to say about your lives. Here’s my question: What tips would you give for surviving residency while pregnant, especially 30-hour calls (without caffeine)?

— From a future mom and …

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How much time do doctors spend on paperwork?

A common complaint is that doctors these days are spending more time doing clerical tasks.

Examples include filling out pre-authorization forms, talking to health plans for pre-certifications on imaging studies, and spending time jumping through bureaucratic hoops. Generally, you do not need a medical degree to do these tasks.

Bob Doherty points to a study that gives some numbers to back up the claims. Primary care doctors spend about 3.5 …

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Did the Canadian health system fail Natasha Richardson?

Would Natasha Richardson be alive today if she had gone skiing in the United States instead?

I don’t think it would have made a difference.

To recap the tragedy, Ms. Richardson died from an epidural bleed, after she fell while skiing. Her presentation was somewhat classic, with the well-described “lucid” period before she deteriorated.

According to Canada’s Globe and Mail, “ambulance workers were not …

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Relative value units, and how the RVU payment system doesn’t allow doctors to practice good medicine

For those who don’t know, every piece of work that a doctor performs is quantified and measured.

The base unit of physician work is known as the relative value unit (RVU). Most physician salaries are determined by the amount of RVUs a doctor produces in a given year, and in most cases, can range between$35 and $45 per RVU in primary care, depending on geographic location and …

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Is there a place for a part-time medical residency?

Doctors in training often do so in their prime family-rearing years.

A few pediatric residencies are offering part-time residency options, designed for those who also want to raise their own families. Proponents argue that residents can not only get more rest, but also avoid depression, which affected almost a quarter of pediatrics residents.

Combined with the talk of further limiting work hours down to 56 …

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The fourth year of medical school

It’s often seen as the light at the end of a rigorous tunnel of training. Filled with residency interviews, sub-internships, and elective rotations, this year is often the most enjoyable. Here’s what to expect.

topics: medical school, residency

The shift worker mentality

retired doc laments the declining sense of duty in today’s physicians, fostered by work-hour restrictions during residency.

Shift work medicine is here to stay, as hospitalists, part-time physicians and mid-levels make up an increasing amount of the clinician force.

It’s just another sign of how today’s physicians value lifestyle more than their predecessors. And there’s nothing wrong in desiring that kind of work-life balance.

Night float

Frequent NY Times contributer Sandeep Jauhar has a piece in Slate talking about night float, where interns take a 12 to 14 hour shift overnight to cross-cover the entire hospital.

Sometimes the problem of caring for another doctor’s patients can lead to medical errors:

The nightmare of night float raises a central question about work limits for interns: Is it better to be cared for by a tired resident …

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Business and medicine

I have long contended that some sort of business education or degree should be mandatory for every practicing physician.

Skills like running a business and the art of negotiation are just as important as clinical aptitude. The medical profession’s lack of business skills is a major reason why physicians have lost control of their profession, and why doctors have so little influence in the health care debate.

Those …

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Is general surgery the primary care of specialties?

WSJ Health Blog: “One key driver of this trend is a move toward specialization by young docs. In 1992, 55% of surgeons did a subspecialty fellowship after finishing surgical residency; now that figure is over 70%, the authors report.

This sounds a lot like what’s happening on the medical side of the profession, as younger docs increasingly head for medical subspecialties that often pay more and give doctors …

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Opting out of Medicare

DrRich looks at how feasible that would be.

The fact that many physicians are piss-poor at business and have learned to bend over and keep taking it during medical school and residency places doctors at a disadvantage during any difficult negotiation. We need to toughen up as a profession.

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