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"I wouldn't do it twice, but I would not 'not' do it once."

- ZDoggMD

Thursday
May242012

Why Your Stitches Cost $1500

The Unites States is one of the richest countries in the world. I guess that means we have to pay more for healthcare.

 

Why Your Stitches Cost $1,500 - Part One

Created by Medical Billing And Coding

Wednesday
May022012

Harvard & MIT Launch edX Worldwide Education Platform

Harvard & MIT are launching edX, free education online for anyone in the world.

Watch the launch video below. Go to edX

edX joins Coursera.org, a similar venture involving Stanford, University of Pennsylvania, University of Michigan and Princeton University.

The goal according to edX is to educate a billion people online.

Monday
Apr302012

A CEO & Entrepreneur Who Also Happens To Be A Surgeon; An Interview With Dr. Arlen Meyers

"Taking Care of Business Is Taking Care Of Patients." -Dr. Arlen Meyers MD MBA

When you ask most physicians what they do, the answer is expected to include their specialty and maybe a bit about a fellowship or possibly some research. With Dr. Arlen Meyers, it's not quite that simple. A professor of otolaryngology, dentistry, and engineering at the University of Colorado Denver, he is also cofounder, President and Chief Medical Officer of medvoy.com, a globally integrated, doctor to doctor referral platform. He has been named one of the 50 Most Influential Physician Executives of 2011 by Modern Healthcare and is currently serving as the founding CEO and President of the Society of Physician Entrepreneurs and Director of the Certificate Program in Bioinnovation and Entrepreneurship at the University of Colorado. This is just the tip of the iceberg; Dr. Meyers is working to radically change the way doctors do business. I was able to catch him for a quick chat.

Enter Dr. Arlen Meyers

What Does Your Job Entail

Basically, I have two lives. The first as an academic head and neck surgeon which involves teaching medical students, residents, staffing clinics, and all the other medical stuff. The other side of my life is all about bioentrepreneurship. My second world is about the research, education, and practice of bioentrepreneurship in medicine; specifically ENT surgery, and that’s how I spend my time.

What’s the secret to becoming an entrepreneur and a surgeon?

I don't think it's a secret, but I'd say you need to get up early and work your ass off (said with a grin). I don’t know what else to tell you. We only have 24 hours in a day, and we just choose to use them in a certain way.

When did you first develop an interest in entrepreneurship?

Well in retrospect, probably when I was 8 or 10, but I think I was too stupid to know that at the time. Fundamentally, my view on this is that becoming an entrepreneur is about 15% being hard wired to do it, and it’s about 85% getting the knowledge, skills, abilities, and work experience to make it happen.

What is your advice to physicians or medical students who are considering getting an MBA?

It's really quite simple. Basically you are going to get your ticket punched, and everyone’s going to say, “Hmmm, this doc is an MD MBA.” You’re going to meet a whole bunch of business minded people, and you’re going to learn some stuff. Those are the three reasons that you go to business school. Now, what opportunities will you have if you get an MBA? That’s always the real question.

Doctors who get an MBA basically are doing it for 3 main reasons:

1.They’re interested in furthering their education and getting credentials so they can be in a health service leadership position—VP for medical affairs, medical officer, president of the hospital, whatever.

2. They want to do it because they’re interested in health service research or strategy, so they want to run a public health office in their state or something like that.

3. They want to start a company or they want to be an entrepreneur.

My advice would be that an MBA makes the most sense if you’re in category 1. If you’re in category 2, you probably shouldn’t be pursuing an MBA. You should probably be doing a Masters in Public Health or Public Administration. And if you find yourself in category 3, you shouldn’t waste your time with an MBA; just go out and start a company.

Why did you decide to start the Society of Physician Entrepreneurs (SOPE) and what kinds of things does it do for physicians who are interested in entrepreneurship?

I started it because it needed to be done and no one else was doing it. The Society of Physician Entrepreneurs is a lesson in entrepreneurship and that is something that doctors are not trained to do. Basically, in order for you to start something to be successful, it has to satisfy three objectives: One, it has to be a big unmet market need. Two, you have to create something that satisfies that need in such a way that people are willing to pay for it. Three, you have create a business model so it sustains itself. We do not get trained about this stuff in medical school or residency.

To me, the biggest opportunity in US Health care reform is innovation. However the sad truth is that most doctors don’t get it. Remember the typical line, "doctors are terrible business people." Actually, I don’t think they are but that’s a whole another conversation. I want to fundamentally change that stereotype and SOPE is one way to make that happen. Our focus is not on practice management in the traditional sense, our focus is on innovation and on bioentrepreneurship. We want to show how to get a life science idea to market and change health care with your idea. It’s not how to squeeze another nickel out of your accounts receivable.

Do you have a book recommendation for our readers?

The one that I’m writing called The Life Science Innovation Road Map. You will hear more about when it is relased, I hope it will help doctors learn how to make there ideas a reality.

 

Friday
Apr272012

Inception Into First Year: A Bohemian Rhapsody Parody about Med School

5 Texas A&M Health Science Center College of Medicine second year students embark on a nostalgic journey, reliving their first year of medical school in a dream world where Queen's Bohemian Rhapsody becomes...
Thursday
Apr262012

The Book Of Things To Know

Monday
Apr092012

The Battlefield Mentality Of Medicine

 

 The Physician Casualties of Medical Tragedies

 

A Guest Post by Dike Drummond, a family doctor who specializes in physician burnout prevention and treatment at his website, The Happy MD.

 

The mother of the dead baby sat in her husband's arms and simply asked "why?" over and over through the Vietnamese interpreter. I had no way to answer the question. I didn't know why. There was nothing to point to. No defect in the child or mother or the actions taken in L&D.

All I could do was say "I am so sorry" ... for your baby, for you ... for everyone involved.

It was a nightmare, losing a baby during childbirth in my family practice residency. It was THE thing each of us dreaded the most. What happened afterwards was even more devastating in the long run. What happened was ... nothing.

It had been a normal evening on call. The family practice residents ran our community hospital. I would end up delivering over 250 babies in my two years here. It was just before midnight, three women in labor, I had just changed out of my clothes into green scrubs and the typical long white jacket.

As I walked past the first labor room on the left I heard an obvious deceleration on the external monitor. HR dropped from 140 to less than 60 for almost a full minute with what looked like a late pattern. The mother was a Hmong woman who did not speak English. This was her third child. No previous problems in childbirth.

She was doing just fine. Dad was standing by the bed in the half light of the labor room. Everything was quiet - that’s how I had heard the deceleration. The night shift had just come on. A calm scene really, except for the yellow light of my nerves jangling from the deceleration.

Exam showed her to be 7 cm dilated, head well applied, normal contraction pattern. The decelerations continued. Protocol called me to rupture the membranes and apply a scalp electrode. I opened the amnion hook, had the nurse stabilize the external monitor puck and apply some fundal pressure. The father held the mother’s hand as they spoke quietly to each other in a language I couldn’t understand.

I ruptured the membranes but only a small amount of clear fluid came out. The heart rate dropped immediately to zero as if it had tipped off the edge of a table and fallen to the floor. 140 - 60 - 20 - nothing. Vaginal exam showed no prolapsed cord, no bleeding or any other abnormality. I was the only doctor in the hospital. The OB attending was 15 minutes away. This baby needed to be out right now.

With much shouting to push, my fingers completing the dilation of the cervix and good cooperation from the mom ... we had the baby out within three contractions.

No nuchal cord, no abruption, no blood anywhere ... the child was normal ... except it had been without a heartbeat for almost 5 minutes at this point. Full resuscitation. Epi down the tube. Chest compressions. Nothing. [Heart breaking. Are we getting anywhere? I do not want to call the code and give up.] Suddenly, five minutes of chest compressions and two doses of Epi in ... we have a heartbeat at 160. [Hallelujah] Stop the chest compressions. Let's tape the tube and call the NICU in the big city down south.

As the nurse and I begin to breathe again ... I feel a gentle tap on my shoulder. The father is standing next to me and points at my left hand. I notice that this whole time - as I stabilize the ET tube and the child’s head - the tip of my left pinky has been touching the baby's open eye. I thank the father, change my grip and close the upper lid. I begin to realize this heartbreak of the last 20 minutes is only the beginning.

We got the call three days later. The child showed no signs of brain activity and the ventilator had been turned off. I released the breath I had been holding since that night in this moment of final recognition. The baby was dead. That is NOT supposed to happen to anyone ... ever. Not to the baby, not to the family and not to any Resident.

The director of the residency program and the OB staff held a case review. No "fault" was found. Procedure had been followed. The baby's post mortem was normal. All actions were deemed "appropriate". I was not to blame. That was very little consolation. The baby was dead. My mind ran over and over the events like a gerbil on a wheel.

A little piece of me died that day. Deliveries were never the same joyful wonder they had been before ... they were bullets to be dodged. For years and another 300 deliveries I would occasionally be jolted awake at night by a vision of an amnion hook with a trigger on it.

In the days and weeks afterwards ... it gradually dawned on me that something I had always taken for granted ... was NOT happening. We were a small residency ... only 8 of us running our community hospital. It felt like a family. I had always assumed any tragedy would be met by a rallying around the unfortunate resident.

Here was our collective worst nightmare ... and ... nothing happened. Nothing except the case review and my meeting with the family - both agonizing experiences where I was by myself. I felt tainted, like a failure, an outcast in the wilderness.

I don't blame anyone. I am certain the first reaction among my colleagues was ... "OMG it happened". Followed by, "thank GOD it didn't happen to ME."

It’s the same thought process as a soldier in battle when his best friend goes down as they storm the beach. I don’t know if I would have thought the same things if it had happened to another resident. I don’t know if that fear would have stopped me from reaching out to them. Here’s what I do know...

Most of the physicians I have worked with have their own version of this story; something bad that happened followed by complete isolation. It has hurt us all. Let’s vow to end this compounding of the natural tragedies that occur in our profession. Losing a baby is bad enough. Coming away from the experience feeling that no one really cares and we are all on our own in the end ... is a wound on a wound. This does not have to continue. We do not have to let our own fear stop us from supporting our colleagues in their hour of greatest need.

If you are still reading this article, I want you to know something with crystal clarity. Your Physician Colleague who suffers a bad outcome wants you to come and talk with them. Sit and have coffee, put a hand on their shoulder. Make them a “hot dish” so they don’t have to cook for a couple days. (I am from the upper Midwest ... that’s just what we do) Do it again and again until they say, "enough already".

There are some stories even our significant other and parents can never understand ... only another doctor can fathom the feelings. The next time tragedy strikes in your medical community, reach out to your sisters and brothers. PLEASE don't run from them because of your own discomfort. They are not contagious, nothing is going to rub off on you.

Don't let the natural "battlefield mentality" win out. Notice it and act in spite of it. It will make a huge difference to your friend. I promise.

This is the time when you can step up and pay it forward. Just be there ... when it counts the most. You never know when you will desperately want them to do the same.

-Dike Drummon M.D. The Happy MD

Saturday
Apr072012

Managing Student Loan Debt

A Government Program You Need to Know About

As graduation approaches, medical students are concerned with two things: having as much fun as possible before internship starts, and what to do when we have to start repaying the massive amount of debt accrued during school. I can't help you with internship, but I do want to point you to a relatively new (2007) government program which graduating students should seriously consider. The video below explains the value of combining Income Based Repayment (IBR) with Public Service Loan Forgiveness (PSLF) instead of entering forbearance as a resident. These two programs combined could save you $200,000 or more in the long run. The best part? To qualify you only have to work for a non-profit, and 80% of hospitals qualify.

Finally, make sure to file a tax return during your graduating year even if you didn't make any money as a student, as the next year's IBR will be based off that income. Check it out and let us know what you think!

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