Do a Site Visit Right

Make the most of this chance to visit a new community by knowing ahead of time what you want to learn about the practice, the key players in the medical community, and what the area has to offer. It can be a fun few days, but remember, it's still and interview.

By Karen Childress | Feature Articles | January/February 2009

 

Afshin Malaki, MD, right, and his wife, Lis Annette, chose to move from Brooklyn, New York, where he completed his OB/GYN residency, to Ames, Iowa. Afshin now practices at the McFarland Clinic, while Lis Annette plans to resume her career as an anesthesiologist now their children are in school.

Afshin Malaki, MD, right, and his wife, Lis Annette, chose to move from Brooklyn, New York, where he completed his OB/GYN residency, to Ames, Iowa. Afshin now practices at the McFarland Clinic, while Lis Annette plans to resume her career as an anesthesiologist now their children are in school.

You’re doing well on your job search. You’ve narrowed your focus and have gotten past preliminary interviews to the point where it’s clear that there is a likely match between what you are seeking in a new job and what a hospital or practice has to offer. It’s time to go take a look.

A site visit, which may be as short as one day or as long as three, is your opportunity to size up both the practice and the community. On a typical site visit, you might fly in on a Thursday, have meetings, tours, and interviews on Friday, enjoy dinner with key physicians or administrators that evening, and then tour the community with a real estate agent on Saturday. You may choose to stay through Sunday in order to further explore the community.

Jolene Yates is a physician recruiting consultant with Banner Health in Greeley, Colorado. She says that a site visit is critical for any physician considering a job offer.“Through phone conversations they can get the essence of the job, but they really need to experience it firsthand,” says Yates. more »

 

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The Whole Truth

It can be lucrative and exciting, but being an expert witness isn't always easy.

By Julie Sturgeon | Feature Articles | November/December 2008

 

Taking the Stand — Is expert witness work for you?

Taking the Stand — Is expert witness work for you?

It looks glamorous on our television screens each week: Physicians in a seat of authority in the courtroom, pointing the finger at the bad guy in a calm, cool style. They are Matlock’s right-hand men and women, Arthur Branch’s buddies. But in real-life courtrooms from New York City to Atlanta, Las Vegas to Miami, the drama surrounding expert witness services is tame—until the physician exits the courthouse doors.

When it comes to taking the stand, the American Medical Association is in favor of it, and actually encourages members to serve as impartial expert witnesses. The AMA is, however, on the record in favor of medical associations punishing those physicians who violate pre-set ethical standards. In a nutshell, it considers expert witness activities to be the same as practicing medicine, so what you say on the stand is subject to peer review. Individual medical societies put out statements using different words, but they boil down to similar sentiments. more »

 

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Endangered No More

Whether it's a convenient service for travelers or wealthy clients or a replacement for office visits for the elderly or homebound, house calls are making a comeback.

By Marcia Travelstead | Feature Articles | November/December 2008

 

 John Horning, MD, has filled a niche treating travelers and less-mobile locals in the San Francisco Bay area through his business, Urgent Med Housecalls.

John Horning, MD, has filled a niche treating travelers and less-mobile locals in the San Francisco Bay area through his business, Urgent Med Housecalls.

Do you ever feel overwhelmed struggling with your workload in an office-based practice? Do you wish you had the time to build better and deeper client relationships versus seeing a steady string of patients in a normal workday? Changing from an office-based practice to home care practice by making house calls may be the answer.

Aren’t house calls more or less a thing of the past? Actually, that’s far from the truth. House calls used to be common a generation ago, but traveling made them impractical. However, in the last several years, doctors are finding creative ways to make them viable again.

The American Academy of Home Care Physicians (AAHCP), located in Edgewood, Maryland, has served the needs of thousands of physicians and related professionals and agencies interested in improving patients’ health in the home for more than 20 years. According to AAHCP statistics, for every elderly person in a nursing home, there are three equally infirm seniors living at home. Home health has become the fastest growing segment of Medicare’s budget. According to the Center for Medicare Services (CMS) Medicare National Procedure Summary Data File, the number of house calls paid by Medicare has increased by 100,000 per year since 2001. Although it leveled off in 2004 and 2005, it began to rise again in 2006.
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Green Goes Mainstream

Sustainable medicine, once the passion of fringe physicians, has become a popular, responsible way to practice. Proponents are finding it's not only good for the environment, it's good for business.

By David Goodman | Feature Articles | September/October 2008

 

Sustainable Medicine: Going green—good for you, business, and the environment

Sustainable Medicine: Going green—good for you, business, and the environment

Lawrence Rosen, MD, was “a fairly conventional pediatrician” when he finished his residency and began practicing medicine in New Jersey about a decade ago. But his years of training at Mt. Sinai Medical School did not quite prepare him for what he encountered in his new practice. “I started to realize pretty quickly that there were many children with chronic health care illnesses who were not being served well by conventional medicine. I was seeing an increase in developmental disorders like ADHD and autism, rising rates of asthma and allergies. I felt inadequate to care for these kids with the conventional tools I had.”

Rosen’s search for solutions that would help his patients and their families led him to look at how the environment was affecting children’s health. He quickly came to an unsettling realization: he was part of the problem. The health-care system itself often has a negative impact on the environment. How to deal with all this? That’s when Rosen discovered the world of sustainable, or green, medicine. more »

 

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Hail to the Chief

Young physicians who lead their medical staffs sometimes fall into the role and others seek it. Regardless, they juggle clinical and administrative tasks and grow as they serve their colleagues and hospitals.

By Anayat Durrani | Feature Articles | September/October 2008

 

Ramsey Hasan, MD, at 37, is the youngest chief of staff in the history of Hawaii-based Castle Medical Center. "For younger physicians it's a very challenging role," he says. "As chief of staff you are expected to be the glue between the different departments and to become a great communicator."

Ramsey Hasan, MD, at 37, is the youngest chief of staff in the history of Hawaii-based Castle Medical Center. "For younger physicians it's a very challenging role," he says. "As chief of staff you are expected to be the glue between the different departments and to become a great communicator."

Throughout his career Ramsey Hasan, MD, has often been told he looked too young to be a physician. While he’s no Doogie Howser, Hasan holds an early accomplishment that would probably get a professional nod from the child prodigy doctor. Lining the halls of Hawaii-based Castle Medical Center are photographs of all the chiefs of staff who have served the hospital. Standing out among the gray-haired former chiefs is a boyish Hasan, the current—and youngest—chief of staff in the history of the hospital.

The role of chief of staff is one many doctors aspire to later in their professional careers, but anecdotally it seems doctors are stepping into it before they reach the age of 40. For Hasan, who specializes in emergency medicine, becoming chief at the age of 37 was never really on the agenda. He sort of fell into it.

“No. Never thought about it,” says Hasan. “Somebody recommended me as a nominee, and I said yes. I had no plans to run.”

There were multiple people in the running for chief at Castle in 2004, and along the way some people dropped out. In the end it was down to Hasan and a surgeon in his 50s. Once elected, Hasan served the customary two years as vice chief of staff, during which time he “learned the ropes” and then began his two-year term as chief of staff in January 2007.

“It’s at times a popularity contest, but it’s also ability and experience,” says Hasan of the election process. more »

 

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Employment – The Sequel

Everything old becomes new again, so goes the adage. It seems it could be true for the health-care market now as physician practices and hospitals integrate in ways eerily familiar to - and yet decidedly different from - the 1990's

By Karen Edwards | Feature Articles | July/August 2008

 

Everything old becomes new again, so goes the adage. It seems it could be true for the health-care market now as physician practices and hospitals integrate in ways eerily familiar to—and yet decidedly different from—the 1990s.

Everything old becomes new again, so goes the adage. It seems it could be true for the health-care market now as physician practices and hospitals integrate in ways eerily familiar to—and yet decidedly different from—the 1990s.

Ratna Palakodeti, MD, had a decision to make and it had to be made quickly. In 1991, he had joined a small family practice in Beavercreek, Ohio, just outside Dayton. Four years later, all four of his partners left the practice, leaving him a solo practitioner—an increasingly untenable position in the health-care climate of the ‘90s.

“I had to find four partners fast,” he says. But before he could start recruiting, the local hospital came courting. Let us buy your practice, the hospital recruiters told him. We’ll take care of all the administrative work. All you’ll need to do is take care of patients. Palakodeti sold his practice.

He wasn’t the only one.
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Single Doc Seeks Efficient Practice

Office automation is spawning a growing number of solo practitioners, and those pioneers are helping to break the trail for newcomers.

By Eileen Lockwood | Feature Articles | July/August 2008

 

The old days:  You walked with your mother to a pleasant clapboard house where, in a sunny side room, your friendly family doctor would make you say “ah,” diagnose a respiratory infection and send you on your way with a timely prescription. Or worse, wave a frightening needle in your face and then stick it in your arm.

The NEW days, as described by a growing number of 21st-century physicians:  Patients make same-day appointments on the internet, type in health information online, and drive to a small office building where they know that friendly Dr. Jones will see them immediately. During the exam, which includes a couple of clicks on the physician’s laptop and to bring up the patient’s electronic medical record (EMR, or EHR for electronic health record), Dr. Jones may spend a good half hour with the patient, perhaps typing a prescription order on the computer, zipping it off to the patient’s pharmacy. After the visit he enters new information—online—into the health record, prepares his bill, and zips that off to the appropriate medical insurer.

Exhibit A: Scott Clemensen, MD, who can’t resist a little preening. “By the end of the day, I’ve completed all documentation, my billing has been sent electronically to the clearing house, all of my correspondence is done, and all my patients have been followed up with on the daily work,” he says. In today’s technological terms, “The inbox is empty at the end of the day.” more »

 

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Right-Those Wrong First Impressions

When you've gotten off on the wrong foot - whether with a supervisor, a co-worker, or a patient, it's both important and possible to get the relationship back on track. Simple steps to patching things up and moving forward.

By Marilyn Haddrill | Feature Articles | July/August 2008

 

Early in his medical career, pathologist Ronnie Garner, MD, was working at a medical facility where he observed blood bank procedures that he was convinced needed to be changed immediately.

 

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Practicing in the Public Eye

It's not the glamour job you may think, and you probably won't get rich, but physicians who work in the media agree that if you have the passion, it's a great career.

By Jon Van Zile | Feature Articles

 

Pamela Peeke, the chief medical correspondent for nutrition and fitness for the Discovery Health cable network, made an unusual career choice a few years ago: She moved into a full-time media position.

When she did this, Peeke, MD, MPH joined a small group of high-profile physicians who serve as trusted advisers, teachers, and frequently authors, and who live in a rarified world of high public exposure.

“We are a self-selected group,” Peeke says. “People who get jobs in media are inquisitive, are always learning, and are willing to be very flexible with a crazy schedule.”

Peeke and other “media docs” have been—and in many cases, still are—practicing clinical physicians and scientists. But somewhere their career paths took a turn and they ended up in front of a camera or behind a word processor. In fact, media exposure and even working for a news outlet may be good for a doctor’s career. It can raise your profile and give you additional streams of income. In some rare cases, a media job can be lucrative enough that you can transition completely out of clinical medicine if that’s what you want. more »

 

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Banishing the Aura

Separating your professional and private life can be as easy as a stock response to requests. Making your friends and family heed that, however, presents a whole new wrinkle.

By Julie Sturgeon | Feature Articles

 

He knows the drill well: He’s dining in a restaurant with his family, catching up on the day when suddenly someone appears at his elbow. “Why, hello, doctor! Imagine running into you here,” the person greets him.

Maurice Ramirez, DO could put money on what the rest of the conversation will center around. The visitor swears she called the office/meant to call the office/should call the office but—could he call in a refill prescription for her? It will just take a minute and she’s down to her last one.

It’s a scenario he inherited the minute he started picking up board certifications in emergency medicine, family practice, and sports medicine to name a few of the specialties he covers in his boutique practice in Kissimmee, Florida. No matter where he goes, Ramirez—along with the other 700,000-plus physicians in this country—are sitting ducks. Blame it on the media, folklore, or gossip, but the American society isn’t set up to allow physicians to be regular people. The pressure, says John-Henry Pfifferling, PhD, the director of the Center for Professional Well-Being in Durham, North Carolina, is always to be on, always knowledgeable, clear and present, never tired or irritable, and an exceptional human being.

“A lot of people look to doctors as surrogate fathers who know everything from stock tips to housing advice, to how to deal with a cold,” says Thomas Demaria, PhD, the assistant vice president of behavioral health sciences at the South Nassau Communities Hospital in Oceanside, New York. “The assumption is that they are all powerful.”

Physicians feed the image, of course: They answer the telephone as “Doctor Smith.” They order family address labels announcing the card sitting in a friend’s mailbox is from Doctor and Mr. Smith. One of Demaria’s friends had the bureau of motor vehicles in his state put the letters MD on his license plate. “I said, ‘Why did you do that?’ and he said quite earnestly, ‘I want to be available in case people need me,'” says Demaria.

Ego is the other unspoken reason. Counselors to physicians readily admit the requirements for entry into this profession weed out the weak personalities and sharpen competitiveness and perfectionism. Doctors commonly fall into the trap of defining themselves as people by their occupation. more »

 

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