High School Sports Physician

Volunteer with your local high school teams to provide care on the field and goodwill to the community.

By Marcia Travelstead | Career Move | Fall 2013


Jeff McDaniel, M.D., volunteers as a team physician for several high school sports teams. His involvement is voluntary but has the added benefit of driving young athletes to his practice, too.

NAME:  Jeff McDaniel, M.D.

SPECIALTY:  Family Medicine, Sports Medicine at Methodist Family Health Center.

LOCATION:  Midlothian, Texas

RESIDENCY:  Palmetto Health Family Medicine, Columbia, S.C.

FELLOWSHIP:  Primary Care Sports Medicine Specialty; Graduated 2010

During his fellowship year, McDaniel served as a team physician for the University of South Carolina Gamecocks, Benedict College Tigers and Airport High School. He currently is a team physician for the Midlothian High School football team and several Mansfield area high schools. Although he works with five high schools in Mansfield, he primarily works with Lake Ridge High School and Mansfield High School.

What do you like best about being a high school sports team physician?

It combines my two loves: medicine and sports. It’s a patient population that is young, active and fun to work with. I grew up in Texas and played football, so I think I can relate and understand to some degree what the athletes are going through and help them recover from their injury and get back on the field.

What kind of commitment is expected?

Usually it’s a Friday night once a week or occasionally a Saturday for the whole season. I do their sports physicals prior to the practice season as well. Generally, the season runs from the end of August through the first part of November unless they go into the playoffs, where that could run into an extra few games. It generally involves four to five hours on a Friday night.

Is there anything that surprised you about being a high school sports physician?

The coaching staff may have one agenda, the physician may have another and the parents may have their own as well. I’ve often run across parents who really want their child to excel. For the physician, that can mean walking the fine line to getting the athlete better yet making mom and dad happy. A lot of it is educating and reassuring the parents. Their child wants to be out on the field but the physician has to make sure the athlete has recovered enough to be on the field as soon as possible but not risking permanent injury.

Have you found being a high school sports physician has benefited your practice?

I feel it has. I’m not paid to be on the sidelines and it’s completely volunteer on my part, but I’m being an active role model. It has given me exposure to this particular patient population as well as to the community. It opens up conversations with regards to being seen on the field. People find out who I am, and that’s the best way to build a practice—word of mouth. I’ve also acquired a number of patients from athletic trainers who know I specialize in concussions.

Are you a team physician for other high school sports besides football?

I do provide care to athletes competing in all sports with the high schools in this area. I don’t get the chance to make it to all the games and be on the sidelines due to scheduling conflicts. For example, the soccer games are often held during the week or over a time when I am working in the office.

What advice do you have for physicians interested in being involved in high school sports?

A fellowship in sports medicine would be one way to start because you get exposure to several levels of competition. Apart from that, one of the best ways for a physician to get involved is to locate and meet with the athletic trainers of a particular program. Really make yourself available to them. If you make it difficult for them to contact you then they are not going to want to work with you. I take the team approach and make myself available to them during practice, weekends or whenever they have a question. I don’t think they have ever abused that and have always been very respectful.


NAME:  Jerry Bornstein, M.D.

TITLE:  Semiretired Orthopedic Surgeon; Medical Director for Los Angeles Unified School District Department Of Athletics.

RESIDENCY:  Los Angeles County General Hospital

Bornstein has been a physician and consultant for high school, college and professional sports teams for more than 50 years.

What do you like best about being a high school sports team physician?

The satisfaction of seeing athletes return to the high functioning ability that may have not been possible without adequate medical care. They may have been unable to continue, resulting in lost scholarship opportunities. In addition, they may have had permanent residuals from the injuries. It is gratifying to see them return to play (RTP) and continue to advance further in their athletic career.

In addition, there is gratification in the contribution of community service in areas where family or other funding for medical care is not easily available.

Is there anything you don’t like about it?

The difficulty in obtaining necessary care for those unable to afford private services. Also, parental interferences both on and off the field, which can affect proper evaluation and care. The medic needs to be able to do his or her job. I have also witnessed an increasing feeling of entitlement some athletes are developing, even at the high school level, in addition to disrespect for upper authorities.

What is your role as Medical Director of Los Angeles Unified School District Department of Athletics?

Training health care professionals such as resident physicians, EMTs, ATCs, RNs, etc. in on-field protocol and the initial evaluation/care of injuries. This is done via seminars and on-field supervision. They evaluate injuries and determine whether the athlete is able to return to play and to initiate treatment as indicated.

I deal with assigning medics’ schedules, intra-week schedule changes and other emergencies as they arise. I am on-field game day either covering a game or at a game with one of the medics, supervising and teaching. In addition, I am always available by phone to medics, athletic directors and coaches to answer any questions they might have.

Is there a problem getting physicians to volunteer?

There can be difficulty getting medical coverage for games in many areas. For physicians, there could be insurance concerns, time constraints and/or the feeling of incomplete knowledge/training for on-field tasks. Therefore, the use of other health care professionals becomes necessary.

Is there anything that surprises you after all these years of being involved as a high school team physician?

The lack of commitment and involvement on the part of some athletic directors and administrators in an important segment of a high school student’s educational life.

What’s your advice for physicians who are interested in getting involved in high school sports?

Gain training, which is readily accessible in a number of ways. First, become involved by shadowing or following a team physician who has experience. Secondly, read books or access the internet. There are a number of publications on team physician protocol. Thirdly, take a course. The American Association of Sports Medicine offers courses every year on team physician care. By doing all of these things, the physician will feel more comfortable on the field.

—By Marcia Travelstead



Career Move Featured Physician on Dr. Oz!

Blog | Career Move


Infectious Disease specialist Tracy Zivin-Tutela, M.D., who was profiled in our summer 2013 Career Move article, will be featured on the Dr. Oz Show this Thursday, Dec. 5.

Zivin-Tutela frequently provides medical context for various media outlets. In our summer article, she gives tips for other physicians looking to do the same. Check out our interview with her here, and visit Dr. Oz’s site to find out when the show is playing in your area. (You can find local times by changing the zip code in the top righthand corner below the search bar.)





Physicians in the media

Share your knowledge with the general public by being willing and available for media interviews.

By Marcia Travelstead | Career Move | Summer 2013


Tracy Zivin-Tutela, M.D., provides medical context for various media outlets. If you’re interested in doing the same, Zivin-Tutela advises approaching your local newspapers, online health forums, local TV stations and the public relations department at your local hospital.

NAME:  Tracy Zivin-Tutela, M.D.

TITLE:  Physician at Westside Infectious Diseases; St. Luke’s-Roosevelt Hospital Center, Division of Infectious Diseases

RESIDENCY:  UMDNJ – Morristown Memorial Hospital

FELLOWSHIP:  St. Luke’s-Roosevelt Hospital Center-Columbia University, New York City

Zivin-Tutela has been featured on The Dr. Oz Show, local news stations in the New York City area, NBC National Affiliates, and numerous online articles.

What do you like best about doing media interviews?
I like to educate the broad population. As physicians, we are born educators. I especially like the opportunity to dispel myths among the community regarding the latest health issues and how people can protect themselves, as my specialty is Infectious Diseases.

What are the challenges?
The nature of the media business is time constricting, and so the thing I like the least is that I don’t always have the ability to leave my own patients to give advice to the larger audience of patients. The TV stations will call and ask if I can speak on a topic and will either arrange for a camera crew to come to me or will pick me up to take me to the studio. It’s usually their decision, not mine, and it’s usually within two hours. That’s really the biggest thing that I don’t like about it.

How do you prepare for an interview?
Being an expert is only as good as staying on top of things. Sometimes the TV station will give me a topic and I don’t even know the story that’s about to break because it’s not in the news. A lot of times, they’ll tell me to talk about a subject and I’ll have to ask what it’s regarding. Sometimes I don’t know the whole story and that’s a little frustrating.

Do you ever know in advance what your questions are going to be?
The Dr. Oz Show did go through questions in advance, but most of the others did not. I was literally asked the questions on camera at that moment, which is stressful. It’s not enough just to know the information. It’s my obligation to give honest, accurate and up-to-date information.

I also have to translate the information from doctor language into language everyone watching can understand. Sometimes when a physician takes some time to answer a question, it is not because they don’t know the answer. It’s because they are trying to word it in a way that basically a child can understand.

You mentioned doing an appearance on Dr. Oz. What other appearances have you made?
The local news channels in the New York tri-state area. I had an appearance on the NBC Nightly News with Brian Williams. I have probably done about 30 over the last five years in addition to phone and online interviews.

If a physician would like to appear on television, what recommendations would you give?
Don’t be afraid to approach your local newspapers, your online health forums, your local TV stations and the public relations department at your local hospital.

I’m not employed by the hospital, but the public relations department is thrilled when I do something that represents them. I think it’s very easy to go to your local newspaper and tell them about a topic that is interesting. It could be a new heart medicine for older people, for example. You could offer to do a series every once in a while on a medical brief. Having done that, it that could turn into an appearance on a local TV channel and can snowball after that.

For example, ABC, NBC and CBS take interviews and put them into a type of database that all of their affiliates all over the country have access to. That is another way that TV stations all over the country look for you because they have seen you on a local TV channel.

I don’t think it’s necessary to hire a public relations person, just reach out. Then, my main advice is to make sure you are responsible and honest with your information that you disseminate into the mass population, and to stay current. Even though I only get one to two hours from notification, I still go online to see what is going on. Something must have happened that’s going to be in the news today.

Medicine is ever changing. Things I learned in medical school are not necessarily fact today. I really need to stay on top of things. In addition, I’m obviously comfortable with the subject they’re asking about or I wouldn’t be doing the interview.

Is there anything about doing media interviews that surprised you?
What surprised me were the reactions of my patients, my parents and their friends. There were 70- and 80-year-olds that said they saw me on TV and remembered me when I was small. My patients send me emails, and they are proud and it makes me proud. That is something I was totally unprepared for.

Do you have future plans regarding TV appearances? Maybe have your own show?
I have a lot of people who ask me why I don’t do this full time. First of all, no one has approached me. And secondly, I really love practicing medicine and taking care of patients. I like doing TV interviews on the side. I don’t know if I’d like it as well if I wasn’t still practicing full time. I don’t know if I’d get skewed by the media or if I’d be out of touch with what’s current if I wasn’t still practicing. So, it’s a nice hybrid to do both.



Airline Medicine

Emergency medicine with a twist provides care to those in the air.

By Marcia Travelstead | Career Move | Spring 2013


NAME:  David Streitwieser, M.D.

TITLE:  Emergency medicine physician; Medical director for MedAire, Inc. at Banner Good Samaritan Medical Center, Phoenix

Medical school: University of California, San Diego
Residency: Valley Medical Center of Fresno

What happens if someone has a medical emergency while on a flight? It used to be that this call was made throughout the cabin: “Is there a doctor on board?” Now, that call is likely to be made to a company like MedAire, who through their MedLink service provides in-flight telemedicine services to airline personnel through emergency medicine physicians and support staff.
David Streitwieser, M.D., started with MedAire 25 years ago. “We have a lot of experience, we’ve seen a lot of situations, and we’re comfortable at handling anything from a telemedicine standpoint,” he says.

What is your typical day like?
There are two ways we staff the call center. Monday through Friday for eight hours a day, we have a doctor who is dedicated to that call center. He or she basically stays in that call center taking as many calls as possible while on duty. After those hours, the calls are taken by the doctors who are on duty in the emergency department. The doctor may be seeing patients when a call comes in, or may be able to break away from charting or whatever else and take the call.

Are all of your calls from airlines?
The majority are commercial airlines but there are other clients, including some companies with their own aviation departments. We handle their needs whether they are in the air or on the ground when they are traveling. We also handle some private yachts that could be anywhere in the world who may have a medical event. There are also some commercial vessel tankers for which we handle medical emergencies.

What do you like best about your job?
It’s interesting because you get to apply your medical knowledge, especially your knowledge of emergency medicine, to situations outside of the emergency department.
For instance, somebody in an aircraft could be having chest pain. We know how to handle that in the emergency department. We know what things we are worried about and we know what things are available to treat chest pain. On the aircraft, we find out what symptoms the patient is having, what diagnostic capabilities and what treatment modalities are available and tailor it to fit the individual interaction. It’s a unique type of practice and the more you do it, the better you get at it.

Does it take a lot of experience to become a physician with your group?
We hire new doctors every year for our practice and we have to train them how to take the calls. They are monitored for their first year or so with me reviewing their patches or calls. There is always another doctor around to help them if they run into trouble. They are never alone. That seems to work fairly well.

How does the schedule work?
The shift where the doctor is dedicated to the MedLink calls—those are fixed hours. That schedule is run separately from the work schedule of the emergency department. So the days the physician is not scheduled to work in the emergency department, he or she can sign up to work those MedLink shifts. It’s only the experienced doctors that get to work the MedLink shifts.
When a physician works in the emergency department, he or she is expected to take calls while on duty. That’s part of the job. The physician who is the dedicated MedLink physician is in a voluntary extra work situation.

What are the challenges?
There are times when I get really busy in the emergency department and MedLink gets extremely busy. That’s extra stress, another responsibility. If you know emergency medicine, then you know physicians are frequently interrupted by any number of distractions. This is another distraction from the flow of care. However, we are actually working on other ways of handling the calls during those peak times.
Regarding the calls, we have many full-time communication specialists who do a lot of the documentation. There are a surprising amount of phone calls involved with handling an airline medical event. The airport where the flight is going to land needs to be contacted to arrange for emergency medical services. The airline itself may need to be notified regarding that particular flight. We have those calls delegated to the communication specialists. We maximize the efficiency of the physicians by getting the information and making decisions and leaving the rest of the work to the non-physicians. That works out well for our practice regarding patient flow and other responsibilities.

Approximately 45 emergency medicine physicians provide telemedicine care for in-flight emergencies from the ground through MedAire’s MedLink service. Full-time communication specialists help document the calls and maximize physician efficiency.

What advice would you give a physician who would like to do what you’re doing?
The physician will want to do emergency medicine and if he or she has an interest in this type of telemedicine, then he or she will need to work for a group that has this type of capability. There aren’t going to be many of them out there.

There is a website for MedAire and International SOS. The physician could get linked to our group. There is also a chapter in the American College of Emergency Physicians (ACEP). They have a section on airline medicine.

Is there anything that surprised you about working as a MedLink physician?
When I started with MedAire, we didn’t know if the model (MedLink) we chose was even going to work.

There were emergency physicians who were used to directing paramedics or nurses on air ambulances who needed medical advice. However, would this type of model allow the physician to give meaningful advice to airline personnel calling with needs for airline passengers? (By the way, the woman who started MedAire had been a flight nurse.)

Initially, this was a very small operation. We found it was effective. We could give good advice and make reasonable decisions and really help people. The only other alternative for the airline prior to MedLink was if there was a doctor onboard the flight. Some of the airlines had a doctor employed by them who was basically an occupational medical doctor. He or she would do employee physicals and might be on call for emergencies but did not practice emergency medicine and may not be available around the clock. There was nothing like MedLink.

I also think it was a surprise to me how much of a need there was in the airline industry for this kind of service. Having done it, I can see that it is a win-win situation. It’s great for the airlines, their passengers and the physicians taking the calls.



Wilderness Medicine

International travel awaits physicians with a thirst for adventure— who don’t mind paying their own way

By Marcia Travelstead | Career Move | Winter 2013


NAME: Gregory H. Bledsoe, M.D., MPH

TITLE: Board certified emergency medicine physician; Founder and CEO of ExpedMed Expedition and Wilderness CME


Medical school: University of Arkansas for Medical Sciences

Residency: University of Arkansas for Medical Sciences; Two years in International Emergency Medicine

Masters of Public Health: Johns Hopkins Bloomberg School of Public Health

“There are some really remote places that, even with our technology, it’s difficult to reach people.” —Gregory Bledsoe, M.D.

Bledsoe has been an instructor and medical consultant for the United States Secret Service. He was the personal physician to former President Bill Clinton during Clinton’s tour of Africa in September of 2002 and served in Uganda and Senegal on the advance team of President George W. Bush when the President visited the African continent in July 2003.

His international medical experience includes travel to 40 countries, serving as a field physician in Honduras, teaching disaster preparedness in Tanzania, leading a nutritional survey among the Beja tribe in northeast Sudan, working as a medical consultant in Beijing, and acting as the medical officer for ships in both Antarctica and the Arctic.

What do you like best about wilderness medicine?

I was able to go on medical trips overseas with my dad, who is a surgeon. In high school, I went to Haiti and when I was a resident and medical student, I went to Honduras. I finished residency in 2002 and had a two-year fellowship in international health from 2002 to 2004. I did a lot of international work and remote medical work from 2002 to 2009.

When I was in medical school, I was taught how to handle patients who were in the hospital. There was a certain amount of control. In the field, however, a wilderness physician can’t control the weather or patient type. There isn’t the technology or stability. That really fascinates me.

How do you get the time off from your current practice?

That’s one of the reasons I practice emergency medicine. I choose my shifts and when I work. It gives me more flexibility than if I had an office-based practice such as a family practitioner or surgeon. It’s one of the benefits of working in emergency medicine.

Is there anything you don’t like about wilderness medicine?

For most of the trips, the difficulty is from the funding aspect. Even for the big trips that you see on the news, the expeditions to various places, often the physician on those trips has to pay for his or her own way. Finding someone to fund your trip, even if you are the physician, can be very difficult. So I think that’s a downside and why more physicians are not involved in wilderness medicine. It’s not because physicians aren’t interested. It’s a fascinating way to practice medicine.

What’s your advice to someone who wants to practice wilderness medicine?

Even if you are an excellent physician in your area of expertise, working in the field is different. I always advise physicians to get some training. ExpedMed runs conferences so whether it’s our conference or another conference, make sure you know of the risks. It’s unfortunate but there are malpractice risks even out in the field.

Knowing the body of information depending on the trip or project you are working on is a must. You need to be educated and have significant field experience.

The way you get yourself known is like anything else. It’s by being there, participating in trips and projects. The fastest way to start is volunteer work. Then, if it’s something you enjoy, there are volunteer agencies, nonprofits, etc. that won’t pay you a salary but will cover your expenses. There are a few jobs available for those who want to do it full time, but those jobs usually go to physicians who are fairly well-known and have significant field experience.

Was there anything that surprised you about practicing wilderness medicine?

What I’ve found in every community I’ve been to is that there are some good practitioners of medicine, maybe nurses or local physicians. They are very knowledgeable, however they don’t have the facilities, medicines and equipment necessary to diagnose and treat patients. I’ve been impressed with the medical knowledge among the local physicians, but often the infrastructure is so poor that they can’t get the patients the medicines and treatments they need.

The other thing that surprises me is that it’s amazing how many Western travelers go to remote places without any thought as to what will happen if they get sick or injured. So many people have rose-colored glasses. They think somebody is going to come and get them off a mountain. You need to have a plan. Many veteran travelers get into a lot of trouble because they think a cell phone or radio call will result in a rescue. It’s not that easy. There are some really remote places that, even with our technology, it’s difficult to reach people.

What’s your schedule like on one of these trips?

It depends on the circumstance. If you work as a ship physician, sometimes you’ll have another physician on the ship and you’ll be able to rotate call. However, if you’re the only physician on a trip, you are definitely on call for 24 hours. You just have to deal with whatever comes along. It depends on the project and your resources.

—By Marcia Travelstead



Workplace Clinics

With a focus on prevention, this physician found his balance

By Marcia Travelstead | Career Move | Fall 2012


NAME: William Bray, M.D.
TITLE: Family practice physician for WeCare TLC
Medical school: Indiana University
Residency: Ball Memorial Hospital in Muncie, Ind.
As a workplace clinic physician, who specifically do you work for?
My employer is WeCare. They are a Florida-based company that specializes in employee-based clinics. There are others out there that do similar things. WeCare manages the on-site clinic for Subaru, which has a very large automobile production facility in Lafayette, Ind. Subaru employees and dependents are eligible to use the clinic.

What do you like best about being a workplace clinic physician?
I like the focus on prevention. I also like that it’s not necessarily a production-based environment. I like that I can spend more time with patients and I can focus on keeping them well. I have the resources and support to do that effectively.

Is there anything you don’t like about being at a workplace clinic?
So far, no. It’s a really nice blend of disease management and preventative care. Personally, it’s not as demanding on my time because it is more productive. I’m not dealing with insurance companies and collections. It’s an employer-funded operation, so instead of spending time with insurance companies, I’m spending the time with the patients.

Why did you choose to join a workplace clinic?
There are a number of reasons… such as a chance to get back into family medicine. I previously was in a practice that was occupational medicine and family practice. It soon became full-time occupational medicine. This was really a chance to be part of something where I see health care needs to go. That is, with the focus on prevention versus a system that’s motivated by illness, if you will.

Have you always been located in Indiana?
Yes, I have, except for the five years I was a flight surgeon for the United States Air Force. That was the only time I was out of Indiana. I was stationed in Florida and Germany at that time. I continue to serve as an Air Force Reservist. My employer has been supportive of that.

What’s your advice for physicians who are interested in joining a workplace clinic?
Stick with the things that make you happy in life and you enjoy doing. I’d take a long look, especially for younger physicians, at where health care is headed in our country and weigh that into the decision. There’s something to be said for being in a private practice, going into that model. Maybe the rewards are there for some people. I think this is a neat change and I’m looking forward to a future with it.

Was there anything that surprised you about your career choice?
I was surprised I finally accepted this model. It’s a unique and different way of delivering health care. I was a little surprised at myself after years of doing things a certain way that I came to accept that this could work.

How would a physician get started on the path to becoming a workplace clinic physician?
Do your research. Not only on the company that you are providing a service to but the company you will be actually working for. Be prepared to accept the different model and delivery of this health care. Think outside of the box.

Would a workplace clinic physician be a model a new physician could go into immediately out of residency?
Yes, in fact in a way, it is almost ideal because in residency, you get some training about the business of medicine but many times, it is limited. In this particular model, you can focus on patient care fresh out of the program, which is primarily what you did the whole time in residency. I think it would be an easy transition for a young resident coming out of the state residency programs to embrace. It’s a model that requires very little business savvy or business sense because you are not dealing with insurance companies, collections or worried over bad debts. It’s a completely patient-centered medical environment.

Anything else you’d like to share?
I’m very happy and pleasantly surprised with the opportunity and I think as with anything, this is a novel concept to a lot of people. Time will tell if this is the direction health care will go. I don’t know if the government will be able to solve our health care dilemmas and I don’t know if physicians as a whole are motivated to change. It might be the employers in the country that force the reform. I think when the employers push, that’s when things will happen because ultimately employers pick up a lot of the health care tab.

– By Marcia Travelstead



Veterans Affairs physician

By Marcia Travelstead | Career Move | Summer 2012


NAME: Uzma Samadani, M.D., Ph.D.

TITLE: Chief neurosurgeon, Manhattan VA Assistant professor, New York University Neurosurgery

Medical school: University of Illinois in Chicago
Residency: University of Pennsylvania

What do you like best about being a Veterans Affairs Physician?

The patients…they are wonderful. They are grateful for their care, have patience, are stoic, polite, brave, courageous. Overall, they are just good people.

I think the amount of courage and stoicism that you see in your VA patients is more than you see in your typical patient population.

Is there anything you don’t like about it?
It can be difficult when you have patients you can’t help. That’s the hardest part of this job for all of us.

Why did you choose to practice neurosurgery?

I always knew I wanted to be a doctor. I loved the idea of helping people with medical problems. When I was in college, I worked in an ophthalmology lab. I was doing microsurgery-cornea transplants on mice. It was phenomenally fun. I liked working with my hands and I liked working under the microscope. That was really the first time I realized I wanted to be a surgeon.

The next year, I worked in a transplant lab and loved it. At that time, I thought I’d never be a surgeon because the lifestyle is terrible and I saw how hard the surgeons worked. Then I went through medical school and I approached each specialty like that was what I was going to do for the rest of my career.

When I went through my internal medicine rotation, I pretended I was going to be an internist. When I went through my psychiatry rotation, I pretended I was going to be a psychiatrist. However, there was really nothing that made me as happy as neurosurgery. From my very first neurosurgery rotation at Cook County Hospital in Chicago, I knew there was nothing else I could do. This is what made me the happiest because I love the surgery part and I love the fact that intervention can completely and dramatically make someone’s life much better. We can cure people…it’s amazing what we can do.

The VA enables me to practice surgery in its purest form without having to deal with all the headaches and hassles that are generally associated with the practice of medicine.
— Uzma Samadani, M.D., Chief neurosurgeon, Manhattan VA

Why did you choose the VA?

The VA enables me to practice surgery in its purest form without having to deal with all the headaches and hassles that are generally associated with the practice of medicine. So, for example, I don’t have to deal with billing and insurance and fighting to do a particular procedure on a patient because I think it’s the best procedure for them. I can go ahead and do it.

I don’t have to justify to the insurance company why I used instrumentation X rather than instrumentation Y. Also, I get paid the same whether I operate or not, so there’s no pressure on me to do extra surgeries. If I see a patient in a clinic and I don’t think they need surgery, I can tell them, “Look,I don’t think you’ll need surgery. I don’t think it will help you.”

Physicians in private practice may also be under pressure to reduce length of stay and procedure cost. I don’t have to worry about that as much. The other advantage of the VA for me is doing research. I spend half my time doing research. The VA makes that possible for me. The database here is the best in any medical system. I have access to a phenomenal amount of data for research purposes.

And you’re also an assistant professor?

Yes, at New York University School of Medicine. I work with a lot of different residents and medical students at NYU SOM. I give lectures in the medical school on brain injury. This summer, I’m mentoring five students with research projects and last summer I mentored three. We are conducting two prospective studies including a clinical trial, and cohort study as well as several smaller retrospective projects all related to brain injury and hemorrhage.

I’ve mentored students every year since I first started, and every summer I’ve had at least one student win a research award or fellowship. All of my students have published papers in the scientific literature. It’s been fantastic working with medical students because they are really motivated. They ask a lot of questions, are incredibly creative and very hard working. It’s been a great experience.

What’s your advice for physicians who are interested in becoming a VA Physician?

I think the biggest advantage of the VA is that it allows you to practice medicine without the extra baggage that comes with it. Also, it allows you to do research, if that interests you. You can practice in the VA system without performing research, however I think the ability to do research is one of the biggest perks of the job and it would be a shame not to take advantage of it.

Was there anything that surprised you about the VA or becoming a neurosurgeon?

Becoming a neurosurgeon is a huge responsibility and a privilege. People literally put their life into your hands. It can be stressful and I knew that when I chose to go into the field. I still have some sleepless nights thinking about how I am going to do a complex case. I am surprised how happy I am and how much job satisfaction I have.

Anything else you’d like to share?

Statistically, I was tied for being the 200th board certified female neurosurgeon in the country. I’m also the first female neurosurgeon to be on the staff at NYU School of Medicine. I would encourage women who are thinking about neurosurgery to find mentors and look at the WINS (Women in Neurosurgery) website for advice.



Correctional medicine

Practicing in correctional facilities can offer a predictable schedule and the ability to care for patients long-term.

By Marcia Travelstead | Career Move | Spring 2012


NAME: Patrick Arnold, M.D.
TITLE: Regional Medical Director
EMPLOYER: Corizon, Albuquerque, N.M.
EDUCATION: Attended medical school at Alabama School of Medicine; post-graduate education at Oklahoma University Health Sciences Center in Internal Medicine.

What do you like best about being a correctional medicine physician?
I’ve been able to address common and uncommon medical conditions in a captive population. That affords me the opportunity to follow patients long-term. I like the support that I get from my colleagues and superiors…the opportunity to practice in what I think is an interesting field.

Is there anything you don’t like about it?
No, but I think for an individual on the outside looking in, the possible experience of practicing within a correctional environment could be somewhat daunting. For me, when I initially entered correctional medicine in 2004, I was somewhat apprehensive. I entered a correctional facility, and the doors were securely closed behind me. I was oriented to the clinical area; it was just like practicing ambulatory medicine in any routine outpatient clinic.

Why did you choose to practice correctional medicine?
I worked in a community-based clinic in rural Mississippi and was looking for a change from that environment. A recruiter contacted me about working in one of the correctional centers. I interviewed as a temporary replacement to earn extra income and ended up working in that facility from 2004 to 2006.

Today, I’m the regional medical director at a New Mexico contract for Corizon, but I do have some clinical duties to perform patient care.

I think correctional medicine is an excellent opportunity for practitioners to practice autonomously and to take care of patients. They have excellent support from the company to practice evidence-based medicine and to develop experience in a managed care setting. more »



Career Move: Locum tenens physician

Travel, extra income and flexible scheduling can attract physicians to locum tenens opportunities.

By Marcia Travelstead | Career Move | Winter 2012


Avishai Meyer, M.D.
Title: General surgeon
Employer: LocumTenens.com
Education: Sackler School of Medicine, Tel Aviv, Israel. Residency at University of Colorado, Denver and University of Nebraska, Omaha. Fellowship at University of Nebraska Medical Center, Omaha.

What do you like best about being a locum tenens physician?
I’m a locum tenens physician on weekends currently in Pierre, S.D. I like the ability to interact with and provide medical care to a rural population in need. Also, it enables me to see what it’s like in the real world of a surgeon. As a fellow at the University of Nebraska Medical Center, I am sheltered from the burden of blame, if you will. Working as a locum tenens physician gives me a taste for what it’s really like to be a doctor and incurring the entire responsibility of the care I am giving. That’s scary but welcome. It’s not just being carried by the attending. I’m doing it myself.

Is there anything you don’t like about it?
It’s sad to be away from my family. I happen to have a 6-week-old child, so not being around is a little upsetting. We also have a 2-and-a-half-year-old, so it’s difficult for my wife. I’m not there to help out. That would be the only complaint I have about it, but that’s my choice.

Why did you choose to practice locum tenens?
I’m making extra money, so I’ll be able to facilitate good things in the near future. Weighing the pros and cons, I thought it was definitely a pro. At this stage of the game, I can only give them weekends. I plan to do this weekend work for a long time.

It’s hard when you’re still in training. You don’t make much money, and you still have student loan debt and those kinds of things. One thing I do have is motivation and the ability to work.

Does the locum tenens company pay for your airfare and lodging while you are away from home?
Yes. My only out-of-pocket is for food and entertainment.

more »


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Career Move: Concierge physician

Love the idea of greater accessability, stronger relationships and more time with patients?

By Marcia Travelstead | Career Move | Fall 2011


Dirk Frater, M.D., practices concierge medicine in Dallas and Jordan Shlain, M.D., San Francisco.



TITLE: Physician
EMPLOYER: E. Barrow Medical Group, Dallas
EDUCATION: Graduate of Yale University. Attended medical school at Albert Einstein College of Medicine in the Bronx. Residency at Parkland Memorial, Dallas.
BACKGROUND: Practiced internal and emergency medicine prior to becoming a concierge physician in 2008.

What do you like best about being a concierge physician?
The main thing is that I get to practice medicine the way it used to be and how I envisioned it when I went into medicine. Just having enough time to communicate with folks and take care of problems in an in-depth way. To really be a patient’s quarterback.

Is there anything you don’t like about it?
No. You have to be willing to be available all the time. That shouldn’t be something that throws you off or makes you regret you’re doing it.

Why did you choose to become a concierge physician?
My day-to-day practice required I spend less time with each patient so I could see more patients each day to maintain my income. I finally drew the line in the sand and said I wasn’t going to see any additional patients. It was a combination of having to do what was required to keep up with costs and how that was affecting how I was able to practice medicine.

Do you have any advice for physicians who are interested in the concierge model?
They should be encouraged. There’s more and more opportunity that’s going to be created for smart young doctors who want to work hard and want to really be involved in their patients’ care.

In your experience, do you think a physician new to the profession could begin as a concierge physician?
You have to build up a practice—have a track record, if you will—for patients to be willing to make that kind of move to a concierge practice.

Do you have a hybrid concierge practice?
I’m strictly on a retainer model. My concern with the hybrid model is treating patients differently than others. I want to treat everyone the same.

Was there anything that surprised you?
Mostly just how respectful patients were of my time. There’s still some folks who had a problem and then didn’t call. Part of the reason for me doing this was for them to be able to get ahold of me whenever they need me.

How would a physician get started on the path to becoming a concierge physician?
Speak to physicians who are doing it. There is a course offered by NPI, National Procedures Institute, which is an effective introduction to the topic. I think the key for most concierge physicians is that they really want to practice medicine the old-fashioned way where you are the patient’s main source of information, advice, referral and recommendation for problems large and small. If a physician really wants that kind of involvement, then they should aspire toward this type of practice because that’s what they’ll be able to do.




TITLE: Physician
EMPLOYER: Current Health, San Francisco
Education: Graduate of University of California, Berkeley. Attended medical school at Georgetown University.
BACKGROUND: President, American Academy of Private Physicians (AAPP); Northern California medical director for Lufthansa Airlines.

What do you like best about being a concierge physician?
I have the time and ability to think through a lot of the nuances that is medicine. For example, two people can have diabetes, but their circumstances can be wildly different. I have the time and ability to really get involved. It’s not that I think I’m a better doctor, I just have the luxury of more time. Furthermore, I have the lifestyle that gives me more time off for myself. I get to enjoy my life.

Is there anything you don’t like about it?
No, nothing.

What if a patient needs you on a holiday? Would that be a downside?
Not really. The beautiful thing is the Internet, text messages and the phone—there’s a lot of methods of communication. Part of the promise I make to my patients is that they can always get in touch with me, 365 days of the year. I have partners. If I’m not working that day, my partners are. They still have the ability to contact me if they want. Like any doctor, there are no holidays. You’re always on call, so it’s no big deal.

You became a concierge physician early in your career. Is that unusual?
Totally unusual. As president of the association (AAPP), we give conferences. There’s usually 50 to 100 physicians in their 50’s wondering if they should switch models and go into this. I tell them that as soon as patients buy into a practice, they have the loyalty to the doctor. That’s an asset you can sell someday when you decide to retire or you decide to sell your practice.

So, you don’t have to be an older, established physician to go into concierge medicine?
No, but you have to have the ability to ride it out for a few years. You might only make half of what you’d make in routine primary care initially, but you might triple that amount once you get established. Never take your eyes off the prize. Always deliver on your promise, which is that you’ll be good, available and incredibly helpful. People will pay for value all day long. Health care is no different. Doctors are just small businesses.

What about new physicians who would like to do this?
It’s really hard. You need to have some patients. You need to find a private doctor who’s growing, and join that guy. Make sure you have a good contract and you’re part owner. That could take awhile because you have to build a practice. Once you become established, then you start talking to your patients and put out a survey to see if they would join at $1,000 a year, for example.

Was there anything that surprised you about your practice?
How appreciative my patients were. How much they loved it, and how much they disliked the other model.

What advice would you give physicians who would like to become a concierge physician?
It’s your future. You should invest in yourself. No one is going to look out for you like you are going to look out for you. If you want to be independent and want to have some control of your destiny, this is how you do it. If you want to learn more about it, American Academy of Private Physicians (aapp.org) is a great resource.
Also, don’t skimp on your website. Aesthetics are important.
…Once you do this, it’s so liberating. You can’t believe you ever did it another way.


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