Physician relocation involves all the usual considerations plus a particular concern. “What are the three key success factors for a restaurant?” The answer applies with even greater force to a doctor who is moving: location, location, and location.
Physician relocation requires consideration of real estate values, schools for your children, back yard to play or entertainment, a community where your family fits in, religious involvement, property taxes, even parking (viz., New York city), etc.
But a doctor has a special problem—not unique in type, but certainly unique in scope. Persons with commercial or political authority often have more demands on their time than there are hours in the workday. Thus, by that logic, a doctor has more time demands in a day than their alotted twenty-four hours.
Physician relocation forces you to ask: Will I be there for my husband or wife? Can I get to my child’s soccer game? How can I make myself available for my patients when they need me? How many dinner dates will I miss or cut short because of a patient emergency? How will I find time to exercise? Is there such a thing as time for me?!
Reality is this. You cannot expect to see your child play soccer in between patients. Your marriage will suffer if your spouse always comes last. You will become overweight and unhealthy if you don’t exercise. And of course, you cannot say, “Call me in the morning,” to a patient with chest pain.
If you carry a beeper, your time is not your own.
What does this have to do with physician relocation? Answer: the one factor over which you have control is wasted time, especially travel.
Physician relocation requires you to find a place to live that minimizes the various (wasted) travel times, not only from home to work but from home to exercise or from work to child’s school or other activity. This may require negotiation with your spouse. The key is explaining how your location choice can benefit him or her.
Which lifestyle do you want? That’s the real question.
Elliot Health System is located in beautiful New Hampshire where the recreational opportunities are incredible. Would you like to learn more about them? If so, please download our free guide.
Who cares for the caregivers?
That’s the question many in the healthcare industry are asking in response to a recent study conducted by the Commonwealth Fund and the Kaiser Family Foundation that shows that 47 percent of physicians have considered retiring early. This might not be so alarming if the reasons for early retirement included fulfilled goals and financial health. Sadly, those aren’t the reasons nearly half of all doctors have at least contemplated getting out of the profession.
Instead, the reason most commonly cited is dissatisfaction with the current state of the modern healthcare industry. Slow Medicaid and Medicare payments, bureaucratic red tape, unyielding reliance on quality metrics to assess performance and seemingly arbitrary financial penalties for missing metrics have physicians feeling less engaged. This is a scary prospect for physicians, healthcare organizations and patients alike. Keeping physicians engaged is critically important to patient outcomes, an organization’s culture and overall financial performance, and the doctor’s own health.
Here is a look at how some healthcare companies are keeping physicians engaged:
In most physicians’ minds, volume should not equal value. While financial incentives are important and effective ways to remove barriers to physician engagement, they need to be clear, concise and easily understood. However, they cannot be tied to productivity, which conflicts with value-based health care. Instead, financial incentives and compensation models should be designed to promote patient satisfaction and the best possible outcomes. When physicians feel they will be rewarded for taking time to connect with patients and deliver improved outcomes–which is why many become doctors in the first place–they are likely to be much more engaged.
It is difficult to disengage when you are part of an organization’s leadership team. Keeping physicians engaged and developing leaders go hand in hand. Everyone wants to be considered an important part of their employer’s future. It’s when they don’t feel valued or that they play a role in helping the organization move forward that they disengage.
Keeping physicians engaged through leadership development can be as easy as developing a model for joint decision making among physicians and administrators, providing governance roles for physicians and offering formal leadership development opportunities for physicians.
Another way to keep physicians engaged? Give them ownership opportunities.
By their very nature, physicians have difficulty when it comes to delegating. Often, they are expected to–and expect to–dictate every aspect of their offices. However, smart doctors and organizations hire smart staff members–and those employees should be trained and trusted to do the jobs for which they were hired. Of course, this only works if staffing levels are at appropriate levels, so proper staffing is critical to keeping physicians engaged and allowing them to delegate. When doctors effectively delegate administrative tasks, they have more time to focus on patient care, staying current with the latest research and even taking time off to recharge and refocus.
There are many barriers to keeping physicians engaged–from red tape to traditional tension between doctors and administration. Ultimately, no healthcare organization can achieve its patient outcome and financial goals if it can’t figure out a way keep its physicians focused on building a brighter future–for their patients, their employers and themselves.
Elliot Health System believes that a positive work-life balance helps to boost overall career satisfaction. Consider a career with a healthcare system that cares about their physicians on a personal level.
Substance abuse is an insidious public health problem in the United States. It’s costs to society are measured in both billions of dollars and thousands of lives lost.
It also directly affects physicians, who frequently find themselves on the front lines of the battle against drug and alcohol abuse.
According to the National Institute on Drug Abuse, the health care costs of alcohol and illicit drugs totals more than $35 billion annually. The Centers for Medicare & Medicaid Services reports that more than 45,000 people die from drug overdoses each year and another 29,000 deaths are alcohol induced.
Many of these people present to emergency departments and appointments while they are under the influence.
Patients with substance abuse problems and are under the influence are particularly vexing for physicians. They raise questions related to informed consent, standards of care, and the safety and security of hospital staff as well as other patients.
Here is a look at how to effectively manage patients that are under the influence:
Address Safety Issues
Patients who are under the influence have been known to spit, punch and kick physicians, nurses, staff and even other patients. They can be belligerent, noisy and difficult to assess. Their mere presence can elevate the stress level of everyone in the hospital or clinic.
The first thing you should do when a patient appears to be under the influence is take steps to keep yourself, your staff and other patients safe.
Because most healthcare professionals will rightfully feel obligated to try to at least assess the patient’s condition, steps should be taken to do this as safely as possible. Separating the patient may be an option. However, it may be necessary to call security or local law enforcement if the patient refuses to cooperate and continues to be disruptive.
In cases where treating the patient is absolutely necessary, it may be appropriate to restrain the patient physically or with medication.
Reschedule, if Possible
Generally speaking, patients who are under the influence of drugs or alcohol should have their appointments rescheduled if their condition is stable. Rescheduling is not always an option, and should be the course of action only after an appropriate assessment has been completed.
Rescheduling reduces your liability, helps protect your staff and ensures that any treatments are properly prescribed. It also provides an opportunity for you to educate the patient about the impact substance abuse has on their health–as well as your ability to provide care.
Of course, if the patient is in the throes of an acute medical situation, you should follow the practices outlined in your organization’s standard of care policy.
Discuss and Document
To determine whether or not an appointment can be rescheduled, it will be necessary to discuss the situation with your patient. Document the current situation and any history of substance abuse. Make sure to take into consideration the patient’s ability to provide accurate information.
Discussing the situation with your patient and documenting the interaction will both help you determine the best course of action and protect yourself from future lawsuits or claims of malpractice. Be sure to include patient comments–even quotes–in your notes as well as advice, instructions and any non-compliance.
Advise and Instruct
Physicians have a duty to provide appropriate discharge instructions. In a case of a patient who is under the influence, these instructions should include addressing transportation needs. If you feel the patient should not drive home, it’s critically important to make this clear–and arrange an alternative form of transportation for the patient.
Dealing with patients of all kinds can be very stressful, and that’s why Elliot Health System promotes a healthy work-life balance. Consider some of the options in this guide if you need to take some time for yourself.
Success! You’ve completed medical school. With luck, you’re doing exactly what you want to be doing and life is good. Now, if you could only get rid of those medical school loans…
If you borrowed money to attend medical school, you know how onerous that debt load can be. In fact, median student loan debt for those who graduated in 2013 was $175,000 (including undergraduate studies but excluding interest). Compare that sum with the median debt of $13,469 in 1978 and you realize that your debt load seems like a heavy burden because it is a heavy burden.
A manageable monthly payment may be small comfort knowing that you’ll be making those payments for years to come. Fortunately, things might not be as grim as they appear. There are ways to get out from under the debt of your medical school loans faster than you might think if you’re committed to doing so.
Possessing the proper perspective is critical to carrying out the steps necessary to pay off your medical school loans as quickly as possible. Feeling guilty because you’ve incurred so much debt will not serve you. You are not alone. According to the Association of American Medical Colleges (October 2014):
Knowing that there’s nothing to be ashamed of, if ridding yourself of your education loan debt as fast as possible appeals to you, here are some steps that can help you do so:
Know your debt.
Take inventory of whether your loans are government issued, from private lender(s), or a combination of both. The nature of the lender may impact which debt management strategies are available to you.
Seems obvious, but if you fail to follow basic debt reduction steps such as calculating what money you can make available to pay off your medical school loans, you’ll simply make the minimum monthly payment, precluding you from satisfying the debt sooner.
Pay more than the monthly minimum.
Most student loans agreements contain no prepayment penalty provisions. If yours does not, paying more than the minimum amount required will save you money and shorten the repayment period.
Even a little bit helps.
That $5.00 you spend every morning on your favorite double whip, low fat, extra jolt coffee can make a difference over the months and years ahead.
FinAid.org offers an incredibly useful calculator that will help you “estimate the size of your monthly loan payments and the annual salary required to manage them.” Your lender may also help you calculate your options.
Consolidate your federal medical school loans. Making a single monthly payment at a fixed interest rate can help you strategize your payments and eliminate the vagaries of variable interest rates. This suggestion does not apply to loans with low fixed-interest rates. Further information is also available at studentaid.ed.gov.
Medical school loans are an example of “easy come, easy owe” – money easily borrowed at seemingly low interest rates. While it certainly adds up, you may be able to pay less and over a shorter period of time.
One other way to pay off your medical school loans is to find a job you love! If you are still searching for the perfect position consider Elliot Health System!
The stress involved with being a physician can take a toll on physical and emotional health. When your workday involves keeping people alive, multi-tasking and being available for emergencies, the potential for physician burnout is high. And, of course there are also the added demands that family and friends place on you. You want to spend quality time with your family and form meaningful bonds within your community, but these things take time, which is in limited supply in a physician’s schedule.
Achieving a better work-life balance and avoiding physician burnout is possible if you work in a supportive work environment like the Elliot Health System. Here are some ways to avoid physician burnout with a better work-life balance.
Caring physicians spend much of their time meeting the needs of patients’ and staff needs. It’s easy to forget that you need to take care of yourself first when you spend most of your day caring for other people. Within the Elliot Health System, physicians are encouraged to take care of themselves so that they can perform their jobs at optimal levels.
It’s very important that you arrange time to tend to your personal needs. Avoid skipping lunches and other meals, and instead plan to step away from the sometimes high-intensity environment of the hospital or medical facility during breaks. On such breaks, consider taking a brisk walk outside and enjoy the beautiful changing seasons of New England weather, eating your lunch on a park bench instead of inside or even participating in a bit of midday exercise at the TaeKwonDo Center (where Elliot Health System physicians enjoy complimentary access). It is also very important to keep up with your personal health needs, including regular checkups and dental visits.
One of the most common ways that physicians feel stress is when they are made to feel that they should be doing something other than what they are doing, or to be someplace else. When you are engaged in an activity, whether it’s examining a patient, filling out a chart, or splashing with your kids at Six Flags New England, be present. Know that you are where you are supposed to be, doing what you are supposed to be doing.
The way to achieve this presence is to set boundaries. Although you need to be available during on-call hours, you shouldn’t feel you can’t be fully present with your family when you’re not officially on-call. Instruct staff as to your off-duty hours so they understand your boundaries. The same thing must be done with your family. Of course, you want to be informed of family emergencies or urgent situations, but you also want to be able to concentrate on work while you’re on duty. Setting boundaries with those you work and interact with will help you to avoid being pulled in opposite directions at inappropriate times.
No one can maintain the busy lifestyle of a physician and have a healthy work-life balance without proper nutrition. At the Elliot Heath System, physicians have access to a cafeteria with a full menu at discounted prices. In addition, nutrition counseling is available for physicians who may want guidance for optimal nutrition and health.
It can be far too easy to eat out of vending machines, skip meals or constantly eat on the run. But nourishment is the cornerstone to avoiding physician burnout. When your body feels nourished, your mental capacity will be at its peak, and you’ll be able to conquer the challenges that work and family bring.
These tips for avoiding physician burnout and achieving a better work-life balance will help you to enjoy a long and fruitful physician career.
Is your physician career lacking balance? Consider joining Elliot Health System!
First impressions matter. Onboarding new physicians is an opportunity to make them feel welcome, but it’s also a chance to provide orientation materials, communicate company culture and ensure a healthy transition into the new workplace.
The most successful healthcare facilities understand how to roll out the red carpet. The following physician onboarding ideas can help achieve multiple goals, including integration into the local medical community, understanding of policies and procedures and transfer of information so the physician has the best chance of successfully fulfilling job responsibilities.
Written orientation materials assist newcomers with information they can refer to repeatedly during their tenure at the medical facility. At Elliot Health System, orientation materials include general resource information regarding names and contact information of various staff members and departmental heads. They also include general policies and FAQs about handling hazards and other situations as they may arise.
These materials help to answer many of the questions that newly hired physicians may have on basic topics specific to that medical facility, as well as provide written information that will be a go-to resource over time.
Being able to enter a community of fellow physicians and medical practitioners with an introduction is key to forming deep bonds that ensure mutual respect and easy working relations.
One physician onboarding idea that many hospitals implement is providing medical community introductions on an informal level. Planned intimate social gatherings can be the ground for introducing new members of staff where they can casually engage with future colleagues and supervisors.
These interactions lead to open communication and understanding. When potential problems arise, its more likely that a new or seasoned physician will feel comfortable approaching a colleague or department head early, and bringing them in on the decision-making process.
The best medical facilities understand that their physicians are also part of a personal family. They don’t look at or treat their new physicians as independent units, but as part of a family unit. As such, new Elliot Health System physicians are provided with a variety of benefits not only for themselves, but for their families as well. These include discounts at local shopping clubs like Sam’s Club and BJ’s, discounts at family parks like Water Country and Six Flags New England, childbirth classes, bus passes and discounted movie tickets. Elliot Health System welcomes new physicians by rolling out the red carpet for the entire family.
Physician onboarding ideas like these help to make every new physician feel welcome and capable as they begin their new life. Are you interested in joining the Elliot Health System community? Consider our open positions.
As a physician looking for your next job, you are likely taking into account many different criteria. You may be considering how well the job pays, how the experience will affect your career trajectory, and how well respected the institution is in the medical field.
But, arguably one of the most important things you need to consider is how the new job will affect your spouse. A physician’s spouse makes many sacrifices—albeit, willingly—during the course of physician careers. The spouse goes where the physician’s job take him or her; moving house and setting up the family life in a new location, perhaps over and over again over the span of a lifetime. These challenges that a physician’s spouse must accept and overcome can be made a little easier when the physician factors the spouse’s interests into the equation. Here’s how to include the spouse’s needs and wishes in your physician careers decision.
Encourage Independent Activity
As a physician, much of your time will be consumed at the medical facility where you work. Long and unpredictable hours are the hallmark of physician careers, no matter which position you decide to take. This leaves your spouse alone for several, if not most of their waking hours. Because of this, a physician’s spouse can feel lonely and isolated. In worst cases, this can lead to feelings of abandonment or depression.
When you encourage your spouse to enjoy independent activity, you are helping them find fulfilling ways to spend their time alone. As your spouse finds new ways to enjoy their own free time, you will naturally feel less pressured in your job as a physician, knowing that your spouse is not sitting at home counting the hours until your return.
When considering places for your next job, look for areas where your spouse can pursue and engage with their chosen independent activities. For instance, if they have taken up bicycling, look for towns with plenty of bicycle paths. Taking your spouse’s interests into consideration will help both of you to find happiness in your new job.
Include Your Spouse in Social Occasions
Being the spouse of a physician is dissimilar to being the spouse of other career men and women. Often, the unique issues and problems of a physician’s spouse are not able to be understood by those who are not married to a physician. As such, it’s very important for your spouse to be able to develop friendly bonds with other physicians’ spouses in your new job location. In that way, your spouse will be able to find emotional support in times when no one else seems able to understand their feelings.
When you are meeting with potential new employers at cocktail or dinner parties, be sure to bring along your spouse if possible. These social occasions and informal interviews are excellent opportunities to ensure that your spouse and the other physicians’ spouses will be a good match. Your spouse should be able to find at least one other person who might be a potential friend. These friendly relationships between physicians’ spouses will form the foundation of a community of friends and colleagues upon which you and your spouse can build a rewarding life in your new job location.
Remember that you and your spouse are, at the heart of all matters, a team. When you take your spouse’s needs and wishes into consideration, they will be emotionally and mentally able to support you in your career goals. Physician careers require an extraordinary amount of time, commitment and focus. When you and your spouse operate as a cohesive partnership, both of you will flourish.
Are you wondering what sort of options exist for recreation around Elliot Health System? If so, make sure to check out our free Outdoor Adventure Guide.
Earlier this year, the online news outlet for the American Medical Association published some startling, but not surprising, information: Work-related burnout among physicians is pervasive–and getting worse.
According to a survey of nearly 7,000 physicians conducted by the AMA and the Mayo Clinic showed that an alarming 45 percent of physicians met the criteria for burnout in 2011. When a follow-up study was conducted last year, 54 percent of the physicians who responded showed at least one sign of burnout, which includes feeling exhausted, detached from patients, or cynical and stressed.
What’s so startling about the study is that burnout among the “normal population” is only about 25 percent. This means physicians are nearly two times more likely to suffer from burnout than the people for whom they care.
The study made headlines and grabbed the attention of medical professionals and ultimately raised two questions:
• Who cares for the caregivers?
• What can be done to prevent physician burnout?
The answers to the questions are intertwined. Physicians need both personal and professional strategies to prevent physician burnout. Here’s a few strategies you can use to avoid this issue:
Take time for yourself
Sometimes it can be difficult to escape the pressures of your practice, but making time for outside endeavors is incredibly important to preventing physician burnout. Your hobbies allow you to decompress and think about something other than patient care. If you don’t take time for yourself, the cumulative effect of increased work hours could lead to mental and even physical problems–and burnout. Sometimes it is necessary to put your own needs before those of the patient. So read, exercise, go fishing and reconnect with your hobbies.
Develop a support system
Physicians are trained to help people during their worst moments. Physicians must, on some level, remain detached in order to help patients achieve the best possible outcomes. However, physicians are also human. You’re not immune to the emotional challenges associated with difficult and complex cases. That’s why it’s important for you to develop a support system comprised of people you respect, people with whom you can debrief cases, discuss emotional experiences and decompress.
Having people in your life with whom you can discuss the emotional aspects of the profession is an effective way to manage stress and identify the signs of physician burnout before they become acute.
Be smart about your schedule
Today’s physicians are incredibly overworked. Waiting rooms are typically full and insurance companies seem to increasingly value quantity over quality when it comes to patient contacts. However, most practices have times of the year when there are lulls. Take time off during these periods. Getting out of the office when possible–rather than being “trapped” with a light schedule–provides opportunities to re-charge your batteries.
It’s likely that you have talked to your patients about the importance of exercise. Now it’s time to listen to your own advice–and do it for all the reasons you share with patients. Do it for the endorphins! Do it for the improved sleep! Do it for the reduced stress and anxiety! But most importantly, do it for yourself and to prevent physician burnout.
Sometimes solving the burnout issue can be as easy as finding the right tools to make your day run smoothly. If that sounds like something that would help make your day more productive, consider downloading our free Physician Resources Sheet below.
It isn’t just for entrepreneurs and business executives. Over a million doctors and other medical professionals use the site. There are specialized forums on medical topics. In short, LinkedIn is a low-energy, high-impact tool that could be the springboard to launch your online presence. Here are just some of the reasons why doctors should use LinkedIn.
Control your digital C.V.
You can expect most patients, doctors, hospitals and other professionals to Google you. Google search results are slowly replacing the traditional curriculum vitae.
LinkedIn is highly-rated by all search engines therefore it offers you the opportunity to control and curate your “digital C.V.” The more sections you complete, the more you will appear at the top of the search listings. Fill out your interests, professional history, awards, speaking engagements, publications and professional memberships. A comprehensive LinkedIn account allows you to partially control your online presence and push down unfavorable reviews, an inevitability in the modern economy.
As your LinkedIn becomes more robust, it will complement your marketability and professional profile. The more curated and organized your LinkedIn, the more it can connect you with professional opportunities like grants, jobs and speaking opportunities.
The economy is evolving. Every smart marketing professional will tell you that branding is the key to success and standing out from the din. LinkedIn is the springboard to your brand. A brand is two things: your professional accomplishments / specialty and your approach to medicine.
Connect your blog to your LinkedIn, write content and share it with your network. Share and comment on interesting articles or journals. Report your latest publications and speaking engagements. The more you share on your LinkedIn, the more you become an authority and by extension a brand.
Create a running theme through your LinkedIn. Humanize it and connect it with how and why you practice medicine. This allows your network to know your brand both professionally and personally.
As your brand grows, so does your access to professional opportunities.It isn’t enough to be a decent surgeon, you must create a persona with which people will relate and remember you. LinkedIn is a low-risk, high-yield tool to build your brand and online presence.
Build and utilize a network
Unfortunately, modern professional life is still about who you know rather than what you know. As some say your network is your net-worth. The more you effectively brand yourself, the more you can leverage your network. A good network can expand your practice, connect you with other doctors and perhaps even lead to job opportunities.
As your network grows, so will you access to the collective knowledge of all those doctors. Concerned about joining a research group? Ask your connections. Joining a new hospital? Someone in your network may have the inside scoop.
Moreover you aren’t limited to your connections, join practice groups. These groups often have members from all over the world. These groups share the newest medical knowledge, job openings, speaking opportunities and more. If used properly, your network can become one of your most effective tools to grow and safeguard your practice and professional life.
LinkedIn expands your professional network to all over the world. A larger your network means more professional opportunities.
It will take a lot of initial legwork but LinkedIn can become one of the best tools to enhance your professional life. LinkedIn is a low-risk and high-impact tool that can serve as the springboard to launch and control your digital footprint.
Are you interested in connecting with Elliot Health System socially? If so, then click the buttons below:
In March of 2016 the gastroenterology certification requirements changed. There are new requirements that you must meet to successfully complete your certification. This article will provide you with what you as a physician need to know in order to successfully complete the gastroenterology certification process.
The subspecialty of gastroenterology requires that you have already obtained your internal medicine certification through the ABIM and hold a valid license to practice. According to the ABIM, “To become certified in a subspecialty, a physician must satisfactorily complete the requisite graduate medical education fellowship training, demonstrate clinical competence, and procedural skills.” The internal medicine training must have been completing in an accredited U.S. or Canadian program. Any training prior to completing your internal medicine training will not count toward the subspecialty training. The training must be completed by the end of October of the year of the examination. 36 months of training with 18 months of clinical training is required prior to the exam. Specific procedures must have been learned during your training and these include diagnostic and therapeutic upper and lower endoscopy. This is a specific feature of the gastroenterology certification requirements. If you are also seeking to be certified in transplant hepatology it is necessary to be previously certified by ABIM in gastroenterology. This certification will not be further explored here.
For any certification it is required that you have documentation of clinical competence in patient care and procedural skills, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism and systems-based practice. Your training program director will determine your competence across these areas as they have been dictated by ACGME/ABMS expectations.
Once all of these requirements have been satisfied you are then prepared to sit for the gastroenterology certification examination. An application and fee must be submitted and then the exam itself be scheduled at a Pearson VUE testing center.
This exam will test your ability to use clinical judgement, diagnostic reasoning and evaluate your knowledge across different areas as a certified gastroenterologist. This exam requires knowledge of common and rare problems a gastroenterologist would be expected to consult on. The exam content includes several different medical areas each with a different percentage of expected content in the exam. These include:
• Stomach and Duodenum
• Biliary tract
• Small Intestine
In addition to these content areas, other topics that are covered can include endoscopy, genetic conditions, medical management and risks, nutritional support and quality benchmarking.
The exam itself is up to 240 multiple-choice questions with a single best answer focusing on patient scenarios. These questions are set up with a brief statement, case history, graph or picture and a list of possible options. You must decipher the most correct answer of those provided. The exam can take up to 10 hours to complete with several breaks. The current examination process is 4 sessions of 60 questions each for which you have 2 hours to complete. You are provided with a total of 100 minutes break to be divided between 3 break sessions.
The results of your exam will be transmitted to you electronically in a pass fail format. You can expect to learn of these results within 3 months of the date of the last scheduled exam in your speciality area. So long as you train, practice, and meet the gastroenterology certification requirements you are prepared for this process. According to the ABIM in 2015 94% of those who took the exam passed the first time.
Did you just pass your exam? Consider adding Elliot Health System to your list of places you’d like to work.