Pearl for new grads on safe, efficient, and effective practice

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stsa84 said:
I've received a few beautiful cakes, dumped in the trash after the patient leaves. Or left on a break room table, where the vultures devour it...
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there is no amount of food that you can leave out for the nurses where it isnt gobbled up in minutes.

"but doctor, i can eat all those sweets". sure......
 
The most questionable thing I ate was a creamy mushroom pasta dish with mushrooms they handpicked on a recent Europe trip
 
A lot of good advice here. If you have not already I would strongly encourage getting your personal finance in order and the plan for this going forward. I found the white coat investor invaluable but there are numerous other resources out there. If you have your financial situation in order it is much easier to practice because you do not feel like you have to work, eventually being able to walk away from anything you do not want to do. Similarly, think about what causes burn out for you. You put a lot of time and resources into getting your degree, and it should be fulfilling for many years, there are ways to mitigate burn out, I found the most helpful for me was cutting back to 4 days a week and having saved enough money that I can walk away and do something different if I really had to. You may find other things that allow you to have a fulfilling practice, but pay attention to what bothers you and what brings you joy in your practice.

If you have a family and kids I highly recommend scheduling date night with your spouse/partner regularly, and similarly 1 on 1 time with your kids if at appropriate age for that. One of the best things was scheduling time with my daughters 1 on 1. They pick the activity and the main focus of it is to have fun, any family issues, school issues, etc. stay out of this time unless they bring it up. Once they got to being teenagers and this was an established activity it was really great because I hardly see them now as they transition onto being young adults, and this provides us a chance to connect. Finally, pay attention to stages of life you are in. Again not knowing your family situation this may not apply but when your kids are in competitive sports or similar activities your life will be providing transportation, money, and most of your free time to these activities. You can either accept the stage of life you are at, and enjoy what it has to offer or bang your head against it. Having banged my head against it in the past I can tell you what I think is more productive 😎. There will be a stage in your life when you will transition to taking care of your parents, there will be a stage in life where your body starts to fail you. If you have your practice set up in a way that also allows you to also manage these things in your life you will find your life much more satisfying. If your practice is set up in a way that conflicts with your life outside of your practice you will have a lot of stress, and likely less happiness.
 
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kstarm said:
A lot of good advice here. If you have not already I would strongly encourage getting your personal finance in order and the plan for this going forward. I found the white coat investor invaluable but there are numerous other resources out there. If you have your financial situation in order it is much easier to practice because you do not feel like you have to work, eventually being able to walk away from anything you do not want to do because you do not need the money. Similarly, think about what causes burn out for you. You put a lot of time and resources into getting your degree, and it should be fulfilling for many years, there are ways to mitigate burn out, I found the most helpful for me was cutting back to 4 days a week and having saved enough money that I can walk away and do something different if I really had to. You may find other things that allow you to have a fulfilling practice, but pay attention to what bothers you and what brings you joy in your practice.

If you have a family and kids I highly recommend scheduling date night with your spouse/partner regularly, and similarly 1 on 1 time with your kids if at appropriate age for that. One of the best things was scheduling time with my daughters 1 on 1. They pick the activity and the main focus of it is to have fun, any family issues, school issues, etc. stay out of this time unless they bring it up. Once they got to being teenagers and this was an established activity it was really great because I hardly see them now as they transition onto being young adults, and this provides us a chance to connect. Finally, pay attention to stages of life you are in. Again not knowing your family situation this may not apply but when your kids are in competitive sports or similar activities your life will be providing transportation, money, and most of your free time to these activities. You can either except the stage of life you are at, and enjoy what it has to offer or bang your head against it. Having banged my head against it in the past I can tell you what I think is more productive 😎. There will be a stage in your life when you will transitioned to taking care of your parents, there will be a stage in life where your body starts to fail you. If you have your practice set up in a way that also allows you to also manage these things in your life you will find your life much more satisfying. If your practice is set up in a way that conflicts with your life outside of your practice you will have a lot of stress, and likely less happiness.
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Love this!

If you have kids please read this book, you can probably find a pdf version online to download free.

The Family Board Meeting

Our Book | The Family Board Meeting — 18 Summers

www.18summers.com www.18summers.com

Get past the title, it’s more surf board than board room.
 
GoBeers said:
nice. PCPs had a huge hand in starting the opioid train. Now they've jumped off just to let the train crash into the Pain station. You can't convince me why a non-pain doctor cant prescribe pain meds within guidelines and MED <20. It's not rocket science.
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Exactly, it’s not rocket science. You don’t need a pain specialist to write them.

Make recommendations, end it there. The overhead required to run a medication management arm of the practice is not worth it.
 
Agast said:
I gave a lot of people their copay back and canceled their first consult when it became clear to me I would not want that person to darken my doorstep again. You have to protect your future self. There was a self-pay guy who showed up, opened his wallet to fat wads of cash and asked if I prescribed norco. His appointment was canceled at the front desk.
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DEA mole?
 
Baron Samedi said:
Ah yes when I was getting started last year I took on a patient (now known in clinic as "butthole lady") who I still dread seeing.
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....andddddd I just found out today that her insurance coverage was invalid and I essentially did every office visit/procedure for free over the last year. Oh well, at least it's a golden parachute to get out of the relationship.
 
Baron Samedi said:
....andddddd I just found out today that her insurance coverage was invalid and I essentially did every office visit/procedure for free over the last year. Oh well, at least it's a golden parachute to get out of the relationship.
Click to expand...
I had a patient owe me $600+ and I told her she would have to transfer care if she didn’t wasn’t able to settle her account.

Every few years she tries to come back, maybe hoping my memory isn’t that good
 
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