Cristiana Angelelli, M.D.

Snapshot | Winter 2016

 

Specialty: Family Medicine

Employer: Baylor Scott & White Health

Residency: UT Houston Family Medicine, 2014

In practice since: October, 2015

Angelelli enjoys swimming, SUP, live music and traveling.

Christiana Angelelli

Cristiana Angelelli found a job in the location she wanted—near her family—by using PracticeLink.

What surprised you about your first post-residency job search?

It was not as easy as I had pictured during residency to find that ideal job I was searching for, my best fit.

What’s your advice for residents beginning their job searches?

Depending on if they are a U.S. citizen or foreign medical graduate, their medical license status, etc., some people may need to start the process earlier than others. Be proactive, always keep your options open, and search for the type of work that would truly make you the most happy.

What was the most important factor in your search for a new job?

Location. I wanted to be in my city and close to my family. I also wanted a healthy work/life balance.

How did you find your job?

Shortly after signing up on PracticeLink, I received a call from an in-house recruiter who found my profile on the site.

Anything particularly unique about your job search?

You have to be prepared for a sometimes overwhelming amount of emails, calls, letters, etc. from recruiters from all over the country. It is ideal to already have an idea of the basics you are looking for and be able to narrow your search (and also, therefore, the amount of people contacting you).

How did PracticeLink help you in your job search?

PracticeLink has been greatly helpful in my job search. Once I uploaded my profile on PracticeLink, the job offers started taking off. I very quickly received a job offer from a recognized institution in the city I was looking for and have now signed the job! Thank you, PracticeLink! It got me the job I wanted.

 

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Richmond, Virginia

The James River divides this historic city in two. Both sides offer career opportunities for physicians and entertaining activities for their families.

By Liz Funk | Live & Practice | Winter 2016

 

“I was originally on a path to be a surgeon, but my wife was on a similar path,” says Sidney Jones, M.D. “We realized that our lifestyles would not be conducive to spending much time together.” Jones is now an internist and primary care medical director at Bon Secours Medical Group, and his wife is a child psychiatrist. They’re practicing happily ever after in Richmond, Virginia.

Sidney Jones

“It’s a very family-friendly city,” says Sidney Jones, M.D., of Richmond. “You can walk to restaurants, and it has a great proximity to the beach and to Washington, D.C.”

Jones grew up in rural southern Virginia. He attended Davidson College just outside of Charlotte, North Carolina, but returned to his home state for medical school.

Jones found Richmond’s school system to be excellent. His two children, now 23 and 19, both went through Richmond public schools and had very positive experiences.

“Richmond is rich in academics,” says Karin Guye, a recruiter for JenCare Neighborhood Medical Centers. She adds: “I think from a professional perspective, there is a lot of opportunity for continued growth and learning.”

Richmond neighborhood

Richmond features both historic architecture and tall buildings.

The city itself is also growing, says Chelsea Miller, director of physician integration for Bon Secours Richmond Health System. She says, “Compared to when I grew up out in the suburbs of Richmond, Richmond has grown exponentially and has become increasingly culturally diverse.”

Bon Secours is one of the major health systems in Richmond and is growing fast, Miller says. “Bon Secours Health System is in six different states. Virginia is our largest market. We have been growing exponentially.” Bon Secours Richmond Health System has five area hospitals: St. Mary’s Hospital, St. Francis Medical Center, Memorial Regional Medical Center, Richmond Community Hospital and Rappahannock General Hospital.

“It’s a Catholic health care system, and the major tenet is our willingness to see all patients regardless of race, ethnicity, sexual orientation, whether you’re here legally or illegally, insured or uninsured,” Miller says. “We really care for the people who are on the margins of society who might not have access to health care.”

“In 2011, St. Francis was voted one of America’s most beautiful hospitals,” says Miller. “It feels like a five-star hotel. It’s very soothing and calming. And St. Mary’s has repeatedly been voted the favorite place in Richmond to have a baby.”

Virginia Commonwealth University has also helped drive area growth, such as through its adaptive reuse approach to creating medical and office space in Richmond. “They have done a lot in terms of buying up old buildings and turning them into academic buildings or office buildings and dormitory space,” says Erin Bagnell, public relations manager at the Richmond Metropolitan Convention and Visitors Bureau.

VCU Medical Center, a 1,125-bed Level I Trauma Center, is in the middle of a large renovation and expansion of its operating room, and physician input plays an integral part. Aisha DeBerry, manager of physician recruitment for VCU Health, says that the physician leader in charge of the project often tells her, “When you are recruiting physicians, please tell them that I want them to be part of this revamp of the OR. Let them know that I would like to meet with them to hear their voice, to hear how we can make the OR more conducive in a perioperative space.”

VCU Medical Center also serves as the only NCI-designated cancer center in the area. It also has the area’s only full-service children’s hospital.

Virginia Community Healthcare Association is also based in Richmond, with member health centers both in the area and throughout the state. Suzanne Speer, a clinical recruitment services specialist for the organization, explains the association’s distinct mission: “Our health centers serve people of all ages, all incomes, whether or not you have private insurance, Medicare or Medicaid. We also serve those who fall into that insurance gap and don’t qualify for any public health insurance, and they can’t afford private insurance on the exchange, even with the Affordable Care Act.”

To do this, Virginia Community Healthcare Association’s member health centers provide services on a sliding fee scale. “We are able to see everybody in the communities we serve,” Speer says.

In Richmond, there are scores of family activities. Bagnell recommends the Science Museum of Virginia, the Children’s Museum of Richmond and the Lewis Ginter Botanic Gardens, which has a children’s garden with a splash pond.

Another major local family attraction is Maymont. “It’s a 100-acre estate within city limits, focused on nature programming for children,” Bagnell says. “There’s an Italian garden, a Japanese garden, and a bamboo maze.”

Jones agrees that Richmond is great for raising children. “It’s a very family-friendly city,” he says. “You can walk to restaurants, and it has a great proximity to the beach and to Washington, D.C. It’s a great place to live. It’s great to be here, and it’s great to enjoy the broader area.”

That broader area has plenty of places to eat. “We’re one of the best foodie towns in the region,” DeBerry says. “There is a corridor in downtown Richmond where there are no chain restaurants allowed.”

Even though Richmond is an attractive place to live, housing costs aren’t sky-high. “Richmond is a little more moderate in terms of the housing market,” says Guye. “It’s probably more consistent with what the national median or norm is. Certainly it’s way cheaper than D.C. or New York.”

One unique feature of Richmond is the James River, which divides the city—and offers rafting on class-four rapids right downtown.

On both sides of the river, homebuyers and renters can choose from distinct neighborhoods. Jones, a historic architecture buff, says, “The city has rich history with preserved architecture. It has become vibrant, eclectic.” Bagnell concurs: “We’re a historic city—over 400 years old. There is beautiful historic architecture, and there are lots of new properties being built.”

 

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Colorado Springs, Colorado

Colorado Springs may be a winter wonderland with skiing and snowboarding, but it still has year-round sunshine.

By Liz Funk | Live & Practice | Winter 2016

 

As he planned for his future, Gregory Carlson, M.D., knew two things for certain: He wanted to be a surgeon, and he wanted to raise kids in an athletic, outdoorsy environment. He got his wish. Carlson is now a vascular surgeon at Memorial Hospital in Colorado Springs.

Vascular surgery was in Carlson’s blood (no pun intended). His father had also been a vascular surgeon, so Carlson knew the job’s variety and challenge would suit him. “I always wanted to go into surgery because of the variety in your day,” he says. “I was attracted to vascular surgery because it was challenging and evolving.”

Carlson grew up in Denver and attended Jefferson Medical College in Philadelphia. After residency in Massachusetts, he returned to his home state, this time to Colorado Springs. “There were not a lot of barriers to starting my career here,” he says. “I got in with a group of good doctors and joined a private practice.”

After that, Carlson joined Memorial Hospital as a vascular surgeon. When he started there, Memorial Hospital was a large, private, for-profit hospital. Over the past few years, University of Colorado Health acquired Memorial along with four other community hospitals.

Colorado Springs

Colorado Springs

Carlson says this change benefited patient care. He explains, “When the hospital transitioned, it brought an opportunity to physicians to step up and meet the community’s needs.”

University of Colorado Health is one of the city’s two major health care employers.

“We are proud to have Memorial Hospital as part of our health system,” says Kelley Hekowczyk, physician recruitment manager for University of Colorado Health. “The hospital is a 500-plus-bed facility, and over 100 beds are dedicated to the Children’s Hospital of Colorado.” According to Hekowczyk, Memorial Hospital Central manages 320 open heart surgeries and over 100,000 ER visits each year, making it the busiest ER in Colorado.

“We have three CAT scanners, a PET scanner and an intraoperative CT scanner in the OR. We have 12 da Vinci robots, which perform robotic surgery primarily for gynecology and urology patients, as well as an O-arm [a surgical imaging system] that we use for spinal work for neurosurgeons. We have a 37-bed stroke unit.”

Memorial Hospital Central also has 11 operating rooms, 36 ICU beds and five isolation rooms. These certainly keep the 800 physicians on staff busy.

In northern Colorado Springs sits Memorial Hospital North, also a part of University of Colorado Health. “Memorial Hospital North operates more like a community hospital,” Hekowczyk says. “Patients needing more acute care will go to Memorial Hospital Central.”

Hekowczyk is hard at work bringing newcomers to Colorado Springs. She is actively recruiting for primary care, as well as a full range of positions, such as trauma surgeons interested in the growing trauma center. According to Hekowczyk, administrators are focused on strengthening this program. “We are currently a Level II facility. We are actively working to become a Level I Trauma Center.”

Another big player in Colorado Springs is Penrose-St. Francis, a part of Centura Health that includes Penrose Hospital and St. Francis Medical Center, which together offer 522 beds.

“St. Francis Medical Center houses our women’s services: women’s, OB/GYN, and also orthopedics, pediatrics and general surgery. We’re also a Level III trauma center,” says physician recruiter Susan Jenkins. “Penrose focuses on cardiothoracics, vascular, and also some orthopedic. We’re a Level II trauma center.” Penrose-St. Francis has also been named one of America’s 50 Best Hospitals by Healthgrades for the past eight years, and is southern Colorado’s only Magnet Recognized hospital. Penrose’s hybrid OR is attractive to their surgical specialists. Their clinics are all based on the patient-centered medical home model—and are either accredited or on their way to becoming accredited.

“We are recruiting for everything,” Jenkins says. “We have a huge need for primary care, but we are also growing our orthopedics service line. We have embedded behavioral health in our primary care clinics.”

Colorado mountains

There are plenty of activities for outdoorsy families in Colorado Springs.

Medical opportunities aren’t the only things that draw physicians to Colorado Springs. Hekowczyk says the call of the great outdoors also plays a role. “We attract outdoorsy people,” she says. “We have four seasons of outdoor activities.”

Carlson certainly takes advantage of this in his free time. When he’s not treating patients, he hikes, bikes and skis. “This is a great place if you like outdoor sports,” he says. “There is sunshine almost every day. It’s also a fantastic place to raise kids. There are safe streets and bike paths. It’s the right size small city with lots of culture.”

“It’s a great place to live and practice,” Jenkins concurs. “Colorado Springs is very livable. It has lots to offer, including a thriving cultural arts scene and lots of college level sports. We have three colleges in town: Colorado College, the U.S. Air Force Academy, and the University of Colorado Colorado Springs. Professional sports are just up the road in Denver.”

Colorado Springs native Chelsy Offutt is director of communications for the Colorado Springs Convention and Visitors Bureau. “Waking up to the gorgeous Colorado Rockies and Pikes Peak is pretty hard to compete with,” Offutt says. “The panorama is a draw. The mountains are visible from anywhere in town. We are well-known for the easy access to outdoors. We’ve been on lots of magazines’ top lists for everything from safest community to most active community to how to raise an outdoorsy kid.”According to Offutt, Colorado Springs’ most popular place to hike is Pikes Peak, also know as America’s Mountain because it inspired “America the Beautiful.” People also hike the Barr Trail, and the mountains offer other attractions for those who don’t hike. “Cheyenne Mountain Zoo is America’s only mountain zoo,” Offutt says, explaining that this makes it very different from the typical zoo. “It’s built into the mountainside, and they spend a lot of energy on conservation and making sure the animals have really beautiful, realistic habitats.”Offutt also recommends the kid-friendly Colorado Springs Science Center and the Colorado Springs Pioneers Museum.

In Carlson’s neighborhood, he reports, “We counted that there are 31 kids between the ages of 2 and 16. We have block parties, and we have a yearly back-to-school campout for all the kids who live on the cul-de-sac. There are always kids running around the neighborhood, and it’s nice to see parents around, too. You get to know everyone. It’s a fantastic place to live.”

 

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Helena, Montana

With just one hospital, physicians who live and work in Helena get to spend lots of quality time with their families.

By Liz Funk | Live & Practice | Winter 2016

 

Helena Missouri River

Helena sits halfway between Yellowstone and Glacier National Parks, close to the Missouri River.

Don Skillman, M.D., has seen the world. During his 28 years as a U.S. Army internist and infectious disease specialist, he lived in Brazil, Kenya, Egypt, Thailand and Belgium. But for this native Montanan, nothing tops his home soil.

“I love to visit all those beautiful places, but Montana is just spectacular,” he says. He now lives in Helena, and says it tops all the places he has traveled.

Skillman was born in Livingston. He attended high school and college in Missoula. He went to Bethesda, Maryland, for medical school at the Uniformed Services University of the Health Sciences.

When Skillman left the armed forces in 2006, he, his wife and their three sons moved to Helena. His youngest son, now 18, was raised in Helena, and Skillman says the town offers great educational options.

“This is a tremendous place,” he says. “The public schools are outstanding, and there’s a wonderful small college called Carroll College that is ranked sky high by U.S. News & World Report. It gives us a college town atmosphere. We’re the state capital, but it’s still fairly small.”

In Helena, St. Peter’s Hospital—where Skillman works as an infectious disease specialist—is the only hospital. (Fort Harrison VA Medical Center is just outside downtown.) Kendra Lenhardt, director of clinic business operations and physician recruitment at St. Peter’s, says this makes things easier on physicians. “A lot of doctors like it because they don’t have to cover more than one facility,” she explains. “There’s only one facility they need to be on call for.”

“We are a standalone hospital. We’re not part of a huge system, but we are state-of-the-art,” Lenhardt says. “We have 123 beds. Our floors are set up so we have surgical and oncology on one floor. Medical has its own floor, and then the next floor is set up for OB and pediatrics. We have an inpatient behavioral health unit, and we are the only place in the state that has inpatient geriatric psychiatry.”

The hospital had a $55 million expansion project four years ago, which included a new four-story patient wing. Lenhardt raves about the new addition, saying, “Every single room we have is single occupancy, so there’s no double-upping on anyone. We just updated all of our ORs. Our OB rooms for our moms are LDRP rooms. We have an OR on that floor as well, so we can do C-sections there. Moms don’t have to go downstairs. They can stay on that floor.”

Lenhardt says there are many advantages to working for a smaller hospital. “We’re a not-for-profit community hospital that doesn’t report to anybody, which is really nice because if you want to change something or something’s not working out, you can do it that day—make a change. It’s really nice.”

Skillman also enjoys the collaboration that comes with being in a small hospital. “I like the collegiality. There’s never any sense of competition between groups,” he says. “We all know each other very well because it’s a small number of orthopedists and surgeons and medical subspecialists. We have three cardiologists, one rheumatologist and two GI docs, so we’re like a small family. …I don’t think the family practice doctors would hesitate one bit to ask specialists about a patient. They certainly call me all the time.”

Staff members at St. Peter’s support each other, and the administration supports them. Skillman says employees are able to achieve work/life balance. “The administration of the hospital is very fair,” he explains. “They are totally dedicated to finding out what makes each one of us happy and then optimizing that. They are certainly very happy to help with a balance of lifestyle and work. …The key feature is doctors can make just as much as they could in Cleveland or Dallas or LA. But the homes here are not expensive, and the lifestyle here is superior in its own way.”

Heidi O’Brien, executive director of the Helena Tourism Alliance, has lived in Helena for 15 years. “It’s definitely an outdoor-oriented culture, and it’s definitely a family-oriented place,” she says. “There are kids’ fun runs and kids’ festivals in the fall and summer.”

According to O’Brien, the town also has well-developed sports programs and other activities. “There’s really no shortage of things for kids to do,” she says. The public pool at Memorial Park is popular for kids, and Centennial Park—which has mountain biking and a rock climbing wall—is also a favorite.

Families in Helena also have the luxury of being a short car ride away from national vacation destinations. “We’re right between the national parks—four hours from Glacier and four hours from Yellowstone,” says O’Brien.

O’Brien finds that people who don’t know the area well have misperceptions. “With Montana, sometimes people look at it like it’s the end of the earth. They wonder, ‘Will I be able to buy shampoo when I’m there?’ But it’s a happening place. We have a lot of things going on here. I equate it with cities like Portland and Seattle but on a much smaller scale.”

 

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Savannah, Georgia

By Liz Funk | Live & Practice | Winter 2016

 

Savannah combines historic Southern charm with an eclectic arts scene, plus everything from fishing to dolphin watching.

Dwayne Gard, M.D., D.C., was familiar with Savannah before he moved there. “This is where my wife’s parents are from,” he explains. “Even while I was going through medical school in Augusta and my residency in Charlotte, we were frequently coming down to Savannah to spend holidays and long weekends with her family.”

So when Gard and his wife looked for a place to raise two children of their own, Savannah was an easy choice. “I find Savannah to be an ideal-sized city for raising a family. It’s a place where you have extracurricular activities right at your fingertips, and it’s a very friendly town that’s easy to get around.”

Dwayne Gard

Dwayne Gard, M.D., D.C., was familiar with Savannah before he moved there—it’s where his in-laws are from. “I find Savannah to be an ideal-sized city for raising a family,” he says.

Gard began his career as a chiropractor in Georgia. After a few years of practice, he decided to go to medical school at the Medical College of Georgia in Augusta. He completed his residency at Carolinas Medical Center in Charlotte, North Carolina, and moved to Savannah in 2008 to become a hospitalist at Memorial Health.

A rapidly growing hospital, Memorial Health offers a wide range of specialties. “We don’t find ourselves referring out very often,” Gard says. “We have subspecialists all the way from neurosurgeons to interventional radiologists to interventional vascular surgeons. We have all the medical subspecialties that I call on.”

“You have to have a fantastic ER in order to take care of a Level I Trauma Center,” says Mark Kolbush, a physician recruitment and retention executive at Memorial Health. “We see all kinds of traumas here, and people get flown in by helicopter every day. We take care of the sickest of the sick. On top of that, the quality of our care is exceptional.”

The Leapfrog Group, which independently evaluates health care quality, gave Memorial Health a Grade A safety score.

“Our actual mortality is better than our expected mortality,” Kolbush says. “We have it graphed out so we can see the lives we save every year. It’s a great place to work.”

Erica Backus, director of public relations for Visit Savannah, says Savannah is economically healthy and that health care is the region’s second largest industry. “We have two major health systems: Memorial Health and St. Joseph’s/Candler,” she says. Memorial University Medical Center is an academic hospital with 604 beds. St. Joseph’s Hospital is an acute care facility with 330 beds. And Candler Hospital, which has 384 beds, is the oldest hospital in Georgia. It was founded in 1804.

Savannah’s natural beauty draws physicians to the area. “Savannah sells itself,” Kolbush says. “It’s a beautiful historic city, and it’s very charming with lots of squares filled with live oak trees. And the cost of living in Savannah is 6.5 percent lower than the average American city.”

He adds: “Savannah is a growing population. It’s a mixture of people who have been here generation after generation, as well as people new to the area. Savannah is home to Savannah College of Arts and Design [SCAD]. It’s a very good school, and that school has grown over the years and is a destination for students from all over the country.”

Savannah

At more than 20 city squares, Savannah has the nation’s largest National Historic Landmark District.

Another major draw to Savannah is Gulfstream Aerospace, a major area employer that designs and manufactures small aircraft. “They’ve done fantastic, and they are continuing to grow. So between SCAD, Gulfstream and tourism, we have a stable economic base, which makes it easier to grow the [Memorial Health] facility and add more jobs,” says Kolbush.

Backus agrees that SCAD has had a major influence on life and culture in Savannah. “We were once a sleepy Southern town that hung its hat on its terrific historic architecture. Now, it’s really been infused with a new vibrancy. We have four colleges, and we’re aptly described as a young, hip town,” says Backus.

Savannah’s coastal location influences its economy and culture. “We have 100 miles of coastline,” says Backus. “It’s great for boaters, kayakers and fishermen. People here tend to be pretty outdoorsy.”

The location has even affected the area’s cuisine. “It influences the way we eat—lots of seafood, especially shrimp,” Backus says. “We have a year-round growing season, so we cook with abundant in-season produce.” The coastline also makes for good family fun. Backus recommends day trips to nearby Tybee Island, where families can take dolphin-watching excursions.

Gard and his family like to take advantage of Savannah’s arts offerings as well as the entertainment provided by proximity to the water. “There are enough activities here that I felt like I didn’t miss the big cities. There are multiple restaurants in the historic part of Savannah and a real nice environment by River Street. We’re right here on the ocean with plenty of water sports and fishing. Savannah is definitely influenced by being a coastal town. We have a lot of good seafood. I grew up doing more freshwater fishing on lakes, so it took me a little while to adapt to saltwater life.”

With its seafood, dolphin watching and job opportunities, Savannah seems to be well worth the adjustment.

 

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Flexible Medicine

By Marcia Layton Turner | Feature Articles | Winter 2016

 

Shifting attitudes among physicians means work/life balance is becoming an even bigger career concern than income among new physicians. “There is a big emphasis on quality of life now,” says Lisa Freda, director of physician recruitment for Chen Medical and JenCare Neighborhood Medical Centers. “The whole climate is changing.”

Freda says location and scheduling flexibility trump all other considerations as health care employers compete for physician candidates.

“Organizations that can be flexible have an advantage,” she says.

Across the board, physicians are asking for flexibility. How they achieve it is unique to each situation and ranges from working with a potential employer to striking out on their own.

The options illustrate the wide variety of today’s practice choices. We spoke with a few physicians about how they approached their desire for flexibility, and to in-house recruiters about if and how to incorporate it into your next practice search.

Stepping out of insurance

Years ago, Doug Nunamaker, M.D., chief medical officer at AtlasMD in Wichita, saw that physicians were burning out because they spent too much time on insurance paperwork. He asked what he could change and came to the conclusion that patients needed to be responsible for their financial decisions.

Nunamaker

Doug Nunamaker, M.D., was motivated to improve both patient care and the time he spent with family.

“We don’t purchase anything else the way we purchase health care,” says Nunamaker. He cites car insurance as an example: The owner pays for gas and vehicle upkeep, and insurance only comes into play when an accident or other event necessitates repairs. Nunamaker envisioned a similar system for medicine. He thought routine care should be cheap, and insurance should only cover catastrophic injuries or illness.

So Nunamaker introduced a membership-based system at his practice, where patients pay a monthly fee for unlimited access to the physician. There are no co-pays for appointments, and patients pay wholesale fees for lab work. The practice does not accept insurance, but Nunamaker sometimes works with insurance companies to help patients lower their premiums.

Whereas other practices often have 2,500 to 4,000 patients, the four physicians at Nunamaker’s practice take on no more than 600 patients. He usually works about 45 hours a week, instead of the typical 50 to 60, and sees five to six patients a day. As a result, he gets more time with his family.

But for Nunamaker, the new model isn’t just about reducing his workload. “It’s what you do in those hours that really matters,” he says. Because he has fewer patients, he can spend more time researching solutions. He finds that “patients don’t have to come back as often.” And when they do, he has time to spend 30 to 90 minutes with each.

“It’s not the money that’s a priority, but being both personally and professionally satisfied,” he says of his practice choice. “Improving patient care while improving my personal family time is a key motivator for this kind of medical practice.”

Building a concierge practice

Sarah Davis, M.D., of Park Cities Personal Physicians in Dallas, based her career decisions partly around spending time with her young children. After completing her residency in family practice at the University of Florida at Gainesville, Davis started working at a private practice. However, she felt unfulfilled because she didn’t get to spend enough quality time with patients.

Davis heard about concierge practices that limited their patient rosters and charged an annual fee for 24/7 physician access. That model appealed to her, so she set up her own concierge office.

Instead of seeing 40 patients a day, her practice serves only 100 in all. Some weeks, she has few patient appointments and can be out of the office as long as she can be available if needed.

Although patients have her cell phone number and email address, they try not to bother her during evenings and weekends unless there’s an urgent issue. “The nice thing is that I don’t have patients stacked up in the office,” says Davis. “The downside is that when a patient needs you, you drop everything to see them.”

The concierge model also appealed to Joseph T. Barry, M.D. In January 2015, Barry started offering concierge services at his practice in Camillus, New York. “I was looking for quality of life,” he says. His business partner continued to manage traditional operations, and this two-tiered model allowed clients to choose between traditional and concierge services.

Then the concierge network SignatureMD approached Barry about joining their network, and he opened his own concierge practice. He now benefits from their operational support.

Barry now works in the office from 8 a.m. to 5 p.m. four days a week and uses Wednesdays to see patients in nursing homes, hospitals or their own homes. Concierge patients pay $1,800 per month for access to Barry, who says that the nationwide average for monthly concierge payments is $1,500 to $5,000. Insurance does not cover any of that fee, although funds from a flexible spending account or Social Security can be applied.

By limiting his patients to 300, Barry can devote more energy to each. “I have time to think about patient problems,” he says. Those 300 patients get nearly unlimited access to him. Often, he can give them a same-day or next-day office visit and an immediate phone call. He finds this easy access appeals to professionals, who don’t have time to sit in a waiting room, and older patients, who want same-day appointments. At the practice, a secretary greets each of Barry’s patients by name and offers them fresh fruit.

He also makes himself available outside the office. Every other Tuesday, he walks with patients on the Erie Canal. He meets them at the local farmers’ market to talk about healthy eating and offers cooking classes to demonstrate vegetarian or Mediterranean cuisine. In addition, he keeps in touch with a monthly newsletter.

The change has also helped him balance his life. “When I’m done with work, I’m done,” he says. “It gives me a more regular schedule so that I can make time for jujitsu, racquetball and saxophone lessons.” Perhaps most importantly, he says, “I feel better about being a doctor.”

Piecing together a satisfying career

The search for schedule flexibility leads some physicians to trade a standard arrangement for a more creative one. After completing her residency at St. Christopher’s Hospital for Children in Philadelphia, Cheryl Wu, M.D., opted to work a few part-time roles for maximum control of her time.

Cheryl Wu

Cheryl Wu, M.D., chose to piece together shifts to give her maximum control over her schedule.

Wu started as a locum tenens pediatrician in a federally funded clinic while moonlighting in a pediatric emergency room for a couple of years. When she became pregnant, she needed more stability, so she interviewed for hospitalist shift positions and took a locum tenens spot in Pennsylvania. She worked a 40-hour shift from Friday night to Sunday morning once a month during her pregnancy and her son’s infancy. “In terms of lifestyle, it worked,” she says.

As her son grew, Wu’s needs changed, too. She wanted a 9-to-5 job with a predictable schedule that would help her arrange childcare more easily. She joined a private practice for a few years, but still didn’t feel she had the control she needed over her schedule.

“I realized the most important thing for me was being able to work and take off when I wanted to,” she says. She also felt restricted because she could only take one of her four vacation weeks at a time. “I wanted to be able to travel, to see my family in Asia, which I couldn’t do in just one week of vacation.”

So Wu decided to leave the practice—and found a job that had everything she was looking for at 139 Medical PC, a thriving practice in Chinatown.

The practice offered per diem pay and malpractice insurance, and Wu only has to commit to two days a week and one Saturday a month. Best of all for her, she doesn’t have to work weekends or be on call.

Wu continues to moonlight in an emergency room two or three times a month in the evenings and on weekends. She can work more days when she wants to, but says there’s no pressure to do so. She earns nearly the equivalent of a full-time salary by piecing together shifts that are convenient for her.

Looking back, Wu remembers she and her medical school and residency colleagues talked more about careers than work/life balance. Occasionally, they discussed how certain medical specialties like anesthesiology and radiology offered more desirable lifestyles, but it wasn’t a top focus until she finished her residency. She says: “Lifestyle becomes a much bigger deal once you’re done.”

 

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Physicians and their passions

Hobbies provide a valuable work/life balance no matter your level of expertise. But these physicians take it to a new level, balancing clinical careers with high performance in the activities they love.

By Marcia Travelstead | Feature Articles | Winter 2016

 

Making time for extracurricular pursuits can be difficult for any adult—and given their demanding schedules, physicians find it especially hard. But balancing a successful medical career with other activities isn’t impossible. In fact, many physicians devote their off hours to hobbies and side businesses. We spoke with four of them to learn their secrets of maintaining a healthy work/life balance.

Myles Stone, M.D., MPH: Craft beer brewer · borderlandsbrewing.com
Myles Stone

After trying out some brewing equipment, Myles Stone, M.D., MPH, and a friend decided to take their hobby to a new level—and opened Borderlands Brewing Co. in Tucson.

Myles Stone, M.D., MPH, got his start in craft beer thanks to a professor who gave him more than medical expertise. The professor and his wife owned brewing equipment they weren’t using, so they gave it to Stone, a family medicine physician at The University of Arizona College of Medicine in Tucson.

Stone tested the equipment with a close friend, a University of Arizona researcher who has a Ph.D. in microbiology. The project wasn’t completely foreign—Stone’s friend once worked for Anheuser-Busch, and as a child, Stone learned about business and accounting at his family’s bicycle shop.

After a few trial batches, they combined their brewery and business experience, gathered their funds and opened Borderlands Brewing Co. in an early-1900s building in the Tucson Warehouse Arts District. Together, Stone and his business partner balance their professional careers with running the brewery.

Julia Nordgren, M.D.: Chef · drjuliacooks.com

Julia Nordgren, M.D., a pediatrician at Palo Alto Medical Foundation in Palo Alto, California, has always loved food. So when she saw how her patients’ food choices affected their diseases, she recognized an opportunity to combine her passion with her profession. Nordgren, who graduated from Dartmouth Medical School and completed her pediatrics residency at Dartmouth-Hitchcock Medical Center, also attended the prestigious Culinary Institute of America in Napa Valley, California, and graduated in 2013 with honors.

Julia Nordgren

Julia Nordgren, M.D., combined her passion and her profession—and now uses her skills to educate patients about the intersection between food and health.

At the Institute, Nordgren not only mastered the art of fixing a perfect roast, but also learned how to teach cooking. As a pediatrician, she uses that training to educate patients about food. She offers personal health and culinary consultations, lectures, wellness seminars, cooking demonstrations and individual counseling sessions.

Nordgren is writing a cookbook, and she worked behind the scenes as a sous chef for WGBH’s (Boston) cooking show, “Moveable Feast with Fine Cooking.”

Paul Paulman, M.D.: Model rocketeer

Family medicine physician Paul Paulman, M.D., flew Estes model rockets when he was growing up. Now the assistant dean for clinical skills and quality at the University of Nebraska Medical Center in Omaha, he still flies rockets in his spare time and sees science as the common thread between medicine and rocketry.

But rockets are no longer child’s play for him. Paulman completed a three-level certification to fly high-powered rockets. He uses the same explosives as space shuttles do, and he’s certified to launch them as high as 20,000 feet!

For more information on rocketry, visit The Heartland Organization of Rocketry and the Tripoli Rocketry Association.

Christopher Shih, M.D., FACG: Concert pianist

Christopher Shih, M.D., graduated cum laude from Harvard University and earned his medical degree at the Johns Hopkins University School of Medicine. He completed his internal medicine residency training at the University of Pennsylvania and his gastroenterology fellowship at Johns Hopkins.

After Shih performed with the National Symphony on the Capitol Lawn, a Washington Post writer declared, “If Shih is as gifted in medicine as he is in music, he has some serious career decisions to make.”

But Shih didn’t have to choose between the two. Even as a gastroenterologist at Regional Gastroenterology Associates of Lancaster in Pennsylvania, Shih continues to perform in major venues in the U.S. and abroad. He has played in over a dozen countries and on television and radio programs, including NPR’s All Things Considered, Radio France, Canada CBC, Taiwan CTV and more.

Achieving a work/life balance

Having a hobby about which to be passionate is important for most people. However, many of us simply don’t have the time it takes to perfect a passion. With a family, friends and everyday life—not to mention a rigorous schedule—it becomes a challenge.

So how do they do it? There’s no one-size-fits-all solution, but these physicians say a few things help: finding supporters, being flexible with your schedule, and truly enjoying your additional pursuits.

Supportive family and community

All four physicians say having supportive family and friends is essential. “It’s important to get your spouse on your side so they support your hobby,” Paulman advises—then jokingly adds, “Or at least tolerate it.”

Nordgren agrees that support at home is key. “I have a supportive partner, or I couldn’t have been separated from my family for nine months to attend culinary school on the other side of the country.”

Her husband is also a physician, and Nordgren says it’s helpful that he understands the pressures of a medical career. “That’s what I think is nice about having a duo-physician family,” she says. “We truly understand each other’s careers are important to us and what we do is meaningful.”

Shih also has a family that shares his passion. His wife is a professional violinist, and all of his children play musical instruments. “For my family, music is always in our lives in a variety of ways,” he says. “It’s who we are.”

But Shih stresses that physicians who pursue personal passions need to prioritize their families as well as their other pursuits. He limits the time he spends on his hobby so that he also has time for his family.

“I only perform in three or four concerts a year and only accept the concerts that I would only need no more than one or two hours a day of practice,” Shih says. “When I get home from work, I spend time with the family, have dinner, do chores, do homework with the kids and then spend time with my wife.”

Physicians also need supportive friends. Stone says finding trustworthy partners is essential. “Work with good people. I just can’t stress that enough,” he says, adding, “It simply would not work in any other format. I have an absolutely perfect business partner. We employed a staff that we can trust our business with every day of the week when we can’t be there.”

Similarly, Paulman suggests finding a good community. “Connect with people who have similar mindsets,” he advises. “Reach out and get the support going that you need. For example, if you are interested in rockets, there are rocket clubs in every part of the country. …You can connect with one of the members of a club and give it a try.”

Flexible schedule

Several of the physicians we interviewed said freedom in their work schedules also helps them pursue their passions. For example, Paulman likes to schedule work around his launches. “I try to avoid clinical responsibility when doing a launch,” he says. “It’s only one day a month on a Saturday.”

Nordgren says it’s easier to make time for cooking at this point in her career. “I have a lot more control over my career, so I can schedule my workshops to be away from home for a few days. However, the following three days, I can arrange to be home with my family.”

A flexible schedule helps, but it’s possible to work around a rigid one. Last year as an intern, Stone worked 16-hour days with four days off a month. He had to spend almost all of his free time at the brewery.

“Last year, I thought I bit off more than I could chew!” he says. “Now, coming into the second year, it’s a lot calmer, and the brewery can grow, and we can hire more staff.”

Shih, who also maintains a fairly strict schedule, says making time for his hobby is a matter of setting priorities. “I hear people say they don’t have time for things. It’s not that they don’t have time. They aren’t making it a priority.” He says: “I think you can do about anything you want to do as long as you have the passion and desire.”

Having fun

To turn a humble hobby into something more, these physicians say it’s essential to love your passion deeply.

“If it wasn’t fun, it wouldn’t work,” Stone says. “The fact that I worked 16 hours at the hospital and headed over to the brewery to do something I wanted to do was absolutely critical.”

While growing up, Shih never thought he would make a career out of music. In fact, he quit playing early in his medical career. His love for music drove him back to it. “If it’s something you are passionate about, it certainly can be done,” he says.

Paulman says building and launching rockets has improved his quality of life. “It gives me something to look forward to, something to enjoy,” he says. “There’s always a problem to solve or a situation to explore. There are aspects of the hobby that are fun to look at. There’s always a next level. It’s similar to golf in that you hit a good shot, and it keeps you coming back!”

Nordgren is adamant about her passion for cooking. “It lights me up!” she says. “I love to go to food conferences and get to speak with people who love it as much as I do. …Whatever your passion—food, music, writing, etc.—having these shared experiences about things you love and are passionate about, that’s what makes life great.”

Fringe benefits

If you can find time for them, extracurricular pursuits are incredibly rewarding. They can enrich not only your life but also your career.

What do you like to do

What do you like to do?

What physicians do in their free time varies by all the typical limiting factors: career stage, life stage, demands from family and career. Travel, exercise and reading top the list though of favorite pastimes—though number one is spending time with family. Family time, though, is not a given for all—the percent of physicians who chose it as their favorite activity dropped 8 percentage points from 2013.

Source: Peckham, C. Medscape Physician Lifestyle Report 2015. Medscape. Published Jan 26, 2015. Available here.

For example, Stone credits the brewery with making him a better physician. “There is no doubt that these skills have enhanced my quality of life,” he says. “The brewery has provided me with an incredible amount of opportunities to develop a different skill set than what I learned in medical school. Problem solving, interpersonal relationships and financial analysis are important. There is no doubt that these skills have enhanced my quality of life. If nothing else, it has given me a far deeper appreciation for the intricacies and economics of running a health care organization. Of course, there are plenty nights when I came home from the hospital and analyzing spreadsheets didn’t sound anywhere as appealing as going to bed. However, I wouldn’t trade it for anything. I have learned so much and have had a wealth of experiences over the last few years.”

Nordgren has also found that her hobby makes her a better physician. She’s able to provide her patients with better care and suggest diet changes, but she says her hobby would still strengthen her even if it didn’t have such a direct benefit.

“For me, there’s a very specific connection between my hobby and what I do as a professional,” she says. “That’s not always the case. However, I would say don’t ignore your hobby. It makes you a better person in everything you do.”

Making time for extra pursuits is a lot of work. But all the physicians we interviewed agree: It’s worth the effort.

Marcia Travelstead is a frequent contributor to PracticeLink Magazine.

 

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Secrets of the happiest specialties

A recipe for contentment from physicians in the field.

By Chris Hinz | Feature Articles | Winter 2016

 

Orthopedic surgeon Chad Krueger, M.D., loves the technical challenge of fixing broken bones. Restoring someone’s function and motion is very hands-on and concrete.

His greatest satisfaction, though, comes from his patient population at the Fort Bragg (North Carolina) Womack Army Medical Center—men and women who’ve suffered mangled extremities and other devastating injuries from military conflict. Even though they require extensive services to optimize their potential and rebuild their lives, Krueger revels in their progress. He sees inspiration in every soldier who once only hoped to walk his daughter down the aisle but can now share picture proof that he finally did. Ditto for the patient who’s strolling with her spouse or holding her child for the first time in a long a time.

“Knowing that you’ve impacted someone’s life so positively is pretty powerful,” says Krueger. “It’s hard to put into words the happiness you experience when someone tells you, ‘I was able to do this because of everything you did for me—thank you!’”

Chad Krueger MD

 

“…You’re working with many other people to get the best outcomes for these patients. When things align, I feel very good,” says orthopedic surgeon Chad Krueger, M.D.

 

 

In the pecking order of professions, you can’t get much better than medicine for feel-good moments. In fact, even if you’re fairly new to your job, you’ve likely had a few gratified patients make your day. But are ringing endorsements enough to ensure happiness as a physician? Chances are no, as other factors can toy with your emotions and impact your work and life styles.

Even your specialty can make a difference, at least according to one survey. When Medscape asked users about happiness in Physician Lifestyle Report 2014: Do Physicians Lead Healthy Lives? certain specialties rose to the top five.

In terms of work, dermatologists, allergists/immunologists, ophthalmologists, pathologists and psychiatrists scored the highest happiness responses. The deck was shuffled a bit for home life with ophthalmologists and dermatologists still rising on the contentment scale, but accompanied closely by urologists, orthopedic surgeons and emergency medicine physicians.

So what are the secrets to these so-called happiest specialties? A PracticeLink follow-up with physicians in several of the disciplines reveal a spate of common denominators enriching their experience: a sense of fulfillment, great workplace dynamics, good opportunities for growth and room for an active life outside the office. As a job-seeking physician, you may be targeting the perfect match for your skills and ambitions. Yet focusing on factors that have impacted others—whether or not they share your specialty—could be significant to your long-term success. Chief among them is a seemingly basic key in keeping spirits aloft in any field: “I think happiness really boils down to the core matters of being optimistic and doing what you love,” says Maryann Mercer, Ph.D., co-author of the book Spontaneous Optimism: Proven Strategies for Health, Prosperity and Happiness. “It’s not so much about the profession you’re in as it is about the choices you make. If you’re following your heart or the vision you have for your life, you’re likely going to be happy.”

Identifying meaning

The idea that following one’s heart leads to happiness is more than a philosophical ideal. Scientists have produced a bevy of studies quantifying why some people are working and living fulfilled while others don’t have the same internal GPS. They’re bringing into focus a once-fuzzy picture as to how individuals internalize and respond to the world.

Experts like Mercer, for instance, look to optimism as the force that drives an upbeat attitude. Because perennially cheerful individuals tend to have more positive thoughts and emotions than those unhappy blokes who like wallowing in the negative attitudes that make them persistently pessimistic, they’re also able to form a meaningful vision for their lives along with a can-do attitude about meeting its challenges.

Mercer is not alone in noting the role of purpose. Scientists exploring positive psychology, a branch of the mental health field that’s shining a rigorous research light on well-being or the virtues and strengths of living more fulfilling lives, say the roots of happiness are indeed multidimensional. They include three basic components: meaning or serving a cause bigger than yourself; engagement or being so absorbed by the daily activities that you enjoy that you lose track of time and yourself; and pleasure or relishing the everyday plusses of life.

Although people with high levels of all three seem to be most satisfied, according to positive psychology’s leading gurus, some components have more staying power than others. For instance, good times can definitely add balance to an otherwise hectic life, but the afterglow is typically short-lived. That leaves meaning and engagement working in tandem to provide the linchpin for an abundantly gratifying life. Whether you identify strongest with faith, family or your professional mission, you’re bringing to bear your highest potential and best self. Whether you’re performing a challenging procedure or playing a riveting musical piece, you’re so fixated that you get lost in the “flow” of the experience. A life woven with many “flow” activities is a life of great satisfaction.

In terms of his own happiness, Landon Trost, M.D., a urology subspecialist in male infertility and andrology at Rochester, Minnesota-based Mayo Clinic, puts stock in the deep pillars of his life. He ranks religious beliefs and family as the top two items that give his days meaning, with job satisfaction a not-too-distant third and an active lifestyle a distant fourth. As someone who experienced his own medical scare several years ago and chronicled the journey, Trost says his enthusiasm for life never diminished. That’s in large part because he views happiness as reaching for and achieving the aspirations and guiding principles one sets for oneself. “Happiness is living your life in a manner consistent with your ideal expectations and goals,” he says. “If you fall short of them, you’re going to be unhappy. But if you achieve them, you’ll have a renewed sense of choice and control about your life.”

Physicians who’ve managed to forge such a life are indeed finding meaning and engagement in the roles they’ve pursued. They love what they do because they’re well matched to the interactions and tasks making up their day. Whether that means taking care of patients over the long term or intervening for an acute health event, it’s how they envisioned practicing medicine. What’s more, they’re still jazzed about making a difference.

Jonathan Jones M.D., for instance, loves the fact that as program director and associate professor of emergency medicine at The University of Mississippi Medical Center in Jackson, he sees patients in their time of need. Whatever the outcome, he delights in the hands-on part of his job—relying on his stethoscope, a patient’s history and physical exam to discover what’s really going on, particularly in someone whose chief complaint is “I just don’t feel good.”

“People often make fun of our specialty, saying that we don’t actually fix a lot, we just diagnose someone and then call in a specialist.” Jones says. “Sometimes that’s absolutely true. But diagnosing is what medicine is all about. Whether I eventually fix the patient or refer to a colleague, solving the enigma is what really gets my brain going.”

By splitting time between Columbus-based The Ohio State University’s James Cancer Hospital and Solove Research Institute, where she’s director of the Pigmented Lesion Clinic, and her nearby general dermatology practice, Shannon C. Trotter, D.O., says she has the best of both professional worlds. By merging academic medicine and patient care, she’s able to tap many aspects of her personality, including her ability to roll with the punches or lead the charge. In either case, Trotter relishes the direct, sometimes dramatic, impact she can have on patients. “I think patients truly appreciate what we do for them because the skin has such an impact on one’s outward appearance and self-esteem,” she says. “I often kid my primary care friends that if they lower someone’s blood pressure, that patient doesn’t necessarily care. If I clear up someone’s acne or psoriasis, I’m their new best friend.”

And even though she doesn’t always work directly with them, Heather Signorelli, D.O., clinical pathologist for UniPath in Denver, gets the same joy from helping her patients. Whether it’s through a consultation or multidisciplinary conference, she’s helping colleagues make effective choices for people she’s never even met. “One of my favorite things about pathology is that we’re heavily involved in how clinicians work up and treat patients,” she says. “We have a great opportunity to help them select and interpret the right tests so that we deliver the best patient care as early as possible.”

Navigating the workplace

A workplace culture that mirrors your philosophy of medicine and arms you with the tools to do what you want to do can be critical in putting a purpose-driven life into action. True happiness may have little to do with the ebbs and flows of the workplace or workday—and more to do with one’s general state of mind—but joining a supportive, collegial organization certainly can make a perceptible difference.

That’s not to say that health care’s growing bureaucracy doesn’t ever intrude on one’s ability to make prudent choices, call the right shots or even relate like they want to relate. But physicians content with their situations don’t allow such changes to spoil their excitement for medicine or their specialty. In fact, they’ve learned that the key to being happily successful is not to internalize every obstacle they encounter. Instead, they stay focused on the needs of their patients, even as they navigate interferences. More importantly, they work with administrators who have lessened the barriers to delivering quality care and encouraged them to be decision-makers.

“One of the critical things for physicians is to find that spot, whether it’s in private practice, a hospital or another setting, where their voices will be heard and their input sought in making decisions for the community they serve,” says Christopher R. Scott, FASPR, assistant administrator-orthopedics for Durango, Colorado-based Mercy Orthopedic Associates.

Jones is able to do what he’s trained to do because other factors make it relatively easy. He has the wherewithal to make an accurate diagnosis, order a treatment or even call in additional help because of the complement of specialists and technological bells and whistles available throughout his institution. He also doesn’t worry about insurance or other administrative tasks tying his hands because other people take that on. “I’m not naïve,” he says. “I know that people have to pay their bills and hospitals have to collect money. But it doesn’t matter if someone is rich or poor. I’m there to take care of them in their time of need. I’m there to ask, ‘Where do you hurt?’”

Krueger has learned not to focus on what he can’t control and instead prioritize those things that he can. Because his patients often have multiple health issues, that means finding meaningful ways to collaborate with other departments. “It’s very easy to become myopic in the sense that you only focus on what would be perfect for you,” he says. “But you have to understand that you’re working with many other people to get the best outcomes for these patients. When things align, I feel very good.”

Growing in the job

Although there are many ways to be fulfilled as a physician, advancing your training and other passions not only can round out your career, but also contribute to a great workplace experience. Opportunities to grow in the job are especially relevant in medicine, given studies repeatedly demonstrating that highly skilled individuals who are highly challenged are much happier and energized in their jobs than highly skilled individuals who aren’t performing at maximum capacity.

Whether you pursue research, write journal articles, train residents and fellows, participate in specialty societies or advance your training, you’re doing what researchers believe is important for staying upbeat: performing at peak potential.

At Bennington’s Southwestern Vermont Medical Center, administrators offer an annual medical leadership course to give doctors a jumpstart if they’re interested in being at the helm of a physician-run practice. With health care moving increasingly toward a physician-in-charge model, they want their Dartmouth-Hitchcock Putman Medical Group providers to be ready when the opportunities are ripe. “The preparation not only is making our doctors better leaders,” says Nicole Goswami, physician liaison and recruiter, “but I think we’re also helping them realize how they can make a difference within the organization.”

As health care changes in both exciting and onerous ways, Signorelli sees a great opening for physicians to stretch and grow, no matter their specialty. Whether it’s making sense of regulatory changes or adding administrative tasks, the experience can be gratifying, particularly if the outcome positively impacts an entire health care system. For instance, the information technology explosion has affected all of medicine, but it’s been particularly beneficial in pathology where better algorithms—in addition to other technologies—are enabling more sensitive laboratory tests. Because pathologists can now identify certain tumor mutations, for instance, they’re able to assist clinicians in personalizing therapy. Such advances are not only helping physicians help their patients, but are also stimulating pathologists by the evolution of their field. “One of the most exciting things about pathology,” says Signorelli, “is that it’s developing at such a rapid pace. We’re constantly learning. It’s exhilarating.”

Making room for life

Integrating your professional and personal time so that the former doesn’t overshadow the latter is indeed a key element in staying emotionally healthy. But it’s no small achievement for physicians, given that no matter where they are or what they’re doing, they’re always physicians, with everything that entails.

Not surprisingly, it can be difficult to separate the physician from the person enough to enjoy the other parts of the day. But establishing a life outside your practice is critical for long-term sustainability.

“Balance is extremely important to one’s happiness,” says Whitney Paige Barnett, physician recruiter for Mon Health System in Morgantown, West Virginia. “The job and organization should hold value and a prominent place in a physician’s life, but they shouldn’t be the physician’s life.”

So how do you create a comfortable merger? “I think happiness starts by being honest with what you want in both your personal and professional lives,” Scott says. “If you want to be the busiest physician you can be, then you need to go somewhere where that can happen. But if it’s about having balance, you need to take that into consideration. You do yourself a great disservice if you don’t have that honest conversation.”

Beyond that initial talk, there’s no one-size-fits-all solution for taking care of yourself since what you do is based on preferences and priorities. But physicians who believe they’ve achieved a rich balance are persistent in pursuing the things that give their lives dimension. Faith, family, friends and interests have helped them remain healthy, energized and happily centered.

Moreover, they’ve found ways to deal with the day-to-day reality that a case might not go perfectly for all of their hard work and commitment. They don’t fool themselves into thinking that everything will be right all of the time. Instead, they’re prepared for inevitable ups and downs so those intrusions don’t necessarily interfere with home life.

“You’re going to have good days and bad days,” says Jones. “But you can still have a positive experience if you say, ‘How can I approach this situation to make something good out of it?’” Jones says it has taken time to fully realize that he can have a very positive impact even in the absence of a good medical outcome. Yet switching gears to help those he can still help also improves his outlook immeasurably. “I think sometimes you have to redefine how you can make a difference,” Jones says. “Maybe I can’t save the patient, but that doesn’t mean I can’t make a difference for the patient’s family.”

The fact that Signorelli’s husband isn’t in medicine definitely provides a buffer between her professional and personal time. When she comes home, they focus on their children and other compelling non-medical topics. That doesn’t mean that there aren’t intrusions, however. She still gets messages after office hours and sometimes finds it hard to stop thinking about a difficult case or what didn’t go well that day. For the most part, however, Signorelli makes a conscientious effort to block off time for herself, her family and friends. “It’s so easy to get wrapped up in work because it’s never-ending,” she says. “But you have to remember that you’re only human. It’s really important to have time when you’re not thinking about your practice, when you’ve shut off that connection. There’s great satisfaction in being able to say, ‘I did a great job today. I’m happy with the way things went. Now I can go home and focus on my family.”

Heather Signorelli, D.O.

 

Being able to focus at home or work—wherever you happen to be—is an important part of the quality of life for pathologist Heather Signorelli, D.O. “There’s great satisfaction in being able to say, ‘I did a great job today. I’m happy with the way things went. Now I can go home and focus on my family.”

 

 

If there are secrets to the happiest specialists, it’s that the factors keeping them happy aren’t so secret after all. Physicians who navigate the everyday challenges of work and life with a positive spirit are performing meaningful work that engages them both intellectually and emotionally, regardless of their medical niche. They’ve found supportive environments where they can work to their maximum potential and grow. At the same time, they try to have balance in their lives.

That’s not to say that other factors aren’t at play; scientists have made serious inroads concerning the nuances of happiness with more findings likely in the works. Yet for many physicians, feeling good still comes down to knowing at the end of the day that they’ve contributed when someone needed them the most. Krueger, for instance, is excited to get to work because he simply loves performing surgery. But the bigger joy comes in seeing those men and women who’ve transitioned successfully through surgery and months of rehab. “When they come into the clinic and smile,” he says, “it’s pretty powerful stuff.”

 

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CV vs. Resume: Do you know the difference?

It’s up to you to connect the dots for employers and show how you’re a fit for the opportunity.

By Anish Majumdar, CPRW | Job Doctor | Winter 2016

 

The question I’m most frequently asked by physicians who are about to embark on a job search is, “Do I need a CV or a resume?” It’s usually followed up a moment later by, “What’s the difference, anyway?”

The confusion is understandable. After all, if you’re hunting for a position in Europe or other parts of the world, resumes and CVs alike are all referred to as CVs. Even here in the United States, where significant differences have emerged between the two documents, it is by no means uncommon to hear the two terms used interchangeably. Let’s talk about the major differences between CVs and resumes, and how to develop either in a manner that gets noticed by employers.

Layout: Comprehensive vs. Strategic

Lay a curriculum vitae and a resume side-by-side and the first big difference becomes apparent: length.

While most resumes stop around the two-page mark, a CV can easily stretch to three, four, even five pages. Ever wonder why? Inspecting the layout of each document reveals some important clues. Here are the general headings for each:

CV

  • Opening section
  • Education
  • Licensure & certifications
  • Postdoctoral training
  • Professional experience
  • Teaching experience
  • Research experience
  • Publications & presentations
  • Community involvement
  • Professional affiliations

Resume

  • Opening section
  • Professional experience (with teaching and research experience usually integrated)
  • Education
  • Community involvement
  • Professional affiliations
  • Special interests (optional)

CVs are sticklers for detail and leave very little wiggle room for interpretation. It’s what you’ll need to pursue clinical and academic positions, and because of the life-and-death stakes, it’s how you’ll communicate that you have the specific knowledge base and experience required for success. Use the following question to guide your CV writing efforts: Have I made it crystal clear that I can handle every one of the major responsibilities required by this position?

A resume is what you’ll need for non-clinical positions, everything from hospital administration to technology/informatics (serving as chief medical information officer, for example), pharma/biotech R&D and management consulting.

Due to the significant career pivot necessary for jobs like this, emphasizing the right details is far more important than being comprehensive. Ask yourself the following question when crafting a resume: Have I elaborated upon those aspects of my experience and training that support a move to the targeted position?

Branding: Expert vs. Visionary

In a hiring environment that is growing ever more complex and data-driven, it is essential to do the heavy lifting when it comes to branding yourself. Never rely on someone else to connect the dots between what’s on the page and why you’re a great candidate. Take control of the message to get a significant leg up on the competition.

I usually begin CVs with an opening paragraph designed to establish credibility and professional stature. This is where you’ll want to include details such as being board certified and fellowship trained, the Level I Trauma Center you’re working at, and the strong EMR experience you’ve gained. Everything needs to be tied down to specifics. Show an unbroken timeline of your work history. Avoid fluff.

For the resume, think in terms of an “elevator pitch.” If you only had the time it takes for an elevator to go between floors to convince an employer to hire you, what would you say? Wouldn’t it behoove you to communicate your passion, and perhaps back it up with one or two career accomplishments that demonstrate transferable skills? Remember: It’s only considered bragging if done badly!

Keywords: Hard vs. Soft Skills

The use of Applicant Tracking Systems (ATS), software designed to serve as the first pair of “eyes” when it comes to evaluating candidates for a job, is a hiring practice that is ubiquitous outside the health care industry. Up until recently, physicians could rest easy knowing that their CVs would be evaluated by an actual person, not rejected by an ATS system for insufficient keywords. Times have changed, and it may surprise you to know that physician Applicant Tracking Systems are being increasingly used to identify high-quality professionals. Here are the strategies I use to address ATS systems and get documents seen by those who matter.

CV keywords are all about hard (read: quantifiable) skills. Think about including a boldfaced section near the start of the document that calls out procedures and emerging/established areas of expertise. Here’s a keyword section I developed for a nephrologist who had recently completed his training and was on the hunt for a clinical-heavy role:

Procedures: Peritoneal Dialysis (PD), Central Line and Arterial Line Placement, Lumbar Punctures, Paracentesis, Conventional Hemodialysis, CVVH/CVVHD/SLED, Home Hemodialysis, Thoracentesis, Arthrocentesis, ICU Care and Ventilator Care

Resume keywords can focus more on soft (read: big picture) capabilities. The goal is to move beyond current skills and into the realm of potential. Here’s a keyword section I developed for a board-certified pediatrician in search of a program development/consulting role:

Core Competencies: Health Care Management, Program Development, Community Outreach, Health Care Information Technology, Quality Improvement, Patient-Centered Medical Home, Public Health, Critical Care, Health Care Reform

Expert tip: Searching on LinkedIn for professionals who currently have the job you’re after is a fantastic way to get keyword ideas. Insert the exact job title into the search bar, click on the first few member profiles that come up, and scroll down to the “Skills” section for a rundown of keyword ideas. Of course, be sure they’re based in your reality. Be prepared to defend the keywords included within your resume or CV in an interview.

Anish Majumdar is a Certified Professional Resume Writer (CPRW) and founder of ResumeOrbit.com. He works one-on-one with physicians and health care leaders in developing optimized CVs and resumes, LinkedIn presences, and other tools for rapid job placement. He can be reached at anish@resumeorbit.com.

 

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Achieving automation through apps

These medical apps support surgeries, reschedule no-shows and ping physician networks for referrals and consultations.

By David Geer | Tech Notes | Winter 2016

 

As with any other busy professional, physicians are always searching for ways to offload and automate tasks that are not their core business—caring for people.

This issue’s apps, together with input from end-user physicians, merit your consideration.

Product in Action Dashboard

The Luma Health web-based app and service is available at lumahealth.io. Cost is $250 per provider, per month. A free two-month trial available.

Luma Health fills canceled appointments through patient texts

The Luma Health solution is about as significant as the challenges that it solves. Appointment cancellations and no-shows lead to make-shift approaches to scheduling and rescheduling patients: paper lists, Post-It Notes and Word documents. Not to mention the hours staff members spend calling patients to finalize appointments. This process scales poorly at best. And the larger the practice, the more the chaos.

“Luma Health enables practices to automate appointment workflows and reduce appointment cancellations. It automatically identifies appointment cancellations—filling those slots from a wait list, no phone calls required. The app reschedules canceling patients as well,” says Tashfeen Ekram, M.D., cofounder of Luma Health.

The Luma Health app and service uses secure SMS messages that meet HIPAA requirements. “Our first point of contact reminds patients about their appointment, providing additional pertinent information such as co-pays and pre-appointment instructions,” says Ekram. The SMS message prompts the patient to confirm or cancel. The app pulls the real-time message data from the patient and records it for medical staff to access in a centralized dashboard.

Shahriar Heidary, M.D., is a non-invasive cardiologist in San Jose, California, whose practice is part of the South Bay Cardiovascular Medical Group. Heidary was looking for an easier way to fill canceled appointments for office visits and tests when he found Luma Health.

Ortraxe

The web-based OR TRAX platform is accessible from any Internet-capable devide. Apps are also available through the Apple App Store and Google Play. Free to physicians whose facility uses the OR TRAX service.

“I enjoy the fact that it is automated, saving time,” he says. “Multiple users can use it. Patients like the app’s streamlined approach. Receiving a text is easier, and the app can send texts in multiple languages.”

It’s also mobile-enabled. “I am able to use it from my iPhone and my Windows PC,” says Heidary.

For future versions of Luma Health, Heidary would like to see expanded text-based communications that include reminders about a patient’s required exercise time, medication regimens and billing payments.

OR TRAX sends surgical schedules to support the operating room

OR TRAX is an electronic medical standard database that enables providers to send surgical schedules to surgeons and medical device vendor representatives who supply products such as implants, instrumentation and support to the operating room.

“The app is free of any PHI (Protected Health Information) and is only accessible to vendors who are credentialed at the given facility,” says Abram Liverio, COO of OR TRAX.

OR TRAX’s database returns time to health care professionals, strengthens HIPAA compliance, and reduces OR expenses that would result from vendor tardiness. It’s unique in that it transmits this information in real time, notifying surgeons and vendors automatically of case time changes, cancellations and reschedules.

Ira Guttentag, M.D., FACS, is the head team physician and medical director for the Tampa Bay Lightning hockey team. He was looking for a technical solution to keep him abreast of what surgeries he is performing, when and where they will take place and any changes to the cases.

“Prior to adopting OR TRAX, my office staff or PA would coordinate between the surgery centers, the vendor representatives and the hospital staff to set up and change appointments and case times. Then they would relay the information to me,” says Guttentag. OR TRAX automatically notifies Guttentag of changes to procedures and guarantees that the proper vendor representatives, trays and implants will be available at each case time. “I just wait for the notifiers to come in on my updated cases screen,” he says.

Guttentag’s favorite features on the app include the ability to check case times, locations and particulars anytime, with live updates.

OR TRAX

PingMD for the web, Android, and iOS comes in four versions, from basic for secure messages to a version with eVisit, concierge and virtual care abilities and services.

Pingmd builds professional networks for referrals and consults

Kenneth E. Grant, M.D., head of gastroenterology at CHOC Hospital in Orange, California, was used to texting, paging and calling his fellow physicians to make referrals, and was interested in a tool to ease the process.

Then he found pingmd, which secures transmissions of unstructured data—such as messaging content, still images, videos, PDFs and synchronous video chat—in a HIPAA-compliant manner.

“The app enables practitioners and health care providers to build their professional networks to manage care transitions, referrals and consults efficiently,” says pingmd CEO and cofounder Gopal Chopra, M.D. “It enables patient engagement to manage patient queries, surveys and care management for primary, specialty and chronic care.”

Grant uses the app every day in support of consults and reports enhanced productivity when working on complex decisions that require group interactions in real time.

“Now I benefit from efficient referrals from my external primary care network and the availability of better and more secure communications with my colleagues and care teams,” he says.

His favorite features of the app include the video chats, VoIP, networking, referrals and its ease-of-use when compared with other solutions.

 

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