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Category: lifestyle

If you Want to Succeed, hustle like Taylor Swift

Posted on November 28, 2015November 27, 2015 by SmartMoneyMD

Those who are successful in their careers often are not only talented but also willing to outperform their peers. I’ve written previously that it is hunger that drives our will to succeed. We see that the willingness to sleep less and work harder often translates to more wealth and success.

These exact traits can be seen in politicians, celebrities, and innovators. One celebrity whose image reflects this hunger is Taylor Swift. I am by no means a fangirl/fanboy, but am absolutely an admirer of her drive. I state this as an older professional whose career trajectory was completely opposite of the stardom and fortunate that Taylor has generated in her career. If anything, understanding the progression of her career gives us a model to follow, no matter what profession we are in.

Talent.

To say that Taylor Swift is talented would be an understatement. She is a musical prodigy whose range of skills include songwriting, production, performance, and entertainment on the big stage. Ability to this degree is rare. Geniuses like her only present once every decade, but doctors and medical professionals are a dime a dozen. Think of how many classmates in your medical class went into your specialty, and think about how many medical schools there are that place students in your specialty—a lot.

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If you are fortunate enough to have talent in your profession, consider yourself lucky. You can potentially get very far in life. If you are only blessed with average talent in your profession, you can still succeed. No one is ever condemned for mediocrity, but skill can really get you far.

Drive.

As Malcolm Gladwell describes in his book, “Outliers”, many leaders of their profession not only possessed talent but also lived in the right place at the right time. Bill Gates was skilled in computing, but he also had access to mainframes that allowed him to nurture his talent.

Taylor Swift definitely had the hunger to become a star long before she was known. In her early teens (age 12), she convinced her parents to drive down to Nashville from Pennsylvania so that she could find someone who realized her gift. She would knock on doors of producing studios to find someone who would listen to her mix tapes. Rejections certainly came by the hundreds before her talent was realized. Taylor eventually convinced her parents to move to Nashville to immerse herself with the music scene.

She perfected songwriting from absorbing the experience that others offered her. She spent her early teens writing hundreds of songs in her bedroom. Taylor Swift nurtured her talent by positioning herself among the musicians that she wanted to become.

Appeal.

In order to sustain your success, the service that you are providing has to be what people want. For Taylor Swift, her music delivered a message of common struggle that most teenagers experience. She has kept her public image clean from scandal, which reassures parents to allow their kids to listen to her music and attend her concerts.

As a physician, your delivery of care needs to target your intended audience: patients. You must treat them with care and compassion that you would care for your own family. Specialists need to treat their referrers equally well—the last thing your primary care physician referrer wants is for a specialist to work on their patient without any feedback or updates. Keep them in the loop, and they will continue to treat you well.

Hustle.

The final point to understand is that your success depends on what your goals are, and how long and hard you plan to stick to your game plan, and even a bit a good fortune. Talent, drive, appeal, and hard work—take the wisdom of Taylor Swift into consideration, even if she may be half your age.

(Photo courtesy of Jana Beamer)

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The Fundamental Art of Getting Stuff Done

Posted on November 25, 2015November 24, 2015 by SmartMoneyMD

We are busy. Patients, charting, meetings, business plans, e-mails, and texts flood our daily life whether we are in the office, operating room, or at home on the weekends. By profession, I think doctors are more efficient than the average person. We could still do better. Remember, the sooner and more efficiently you can finish your tasks, the higher your hourly rate becomes.

We all have our methods to get stuff done. No single strategy is going to be better than any other, but I have a few pointers that have gotten me through 50 e-mail days. Below is the Smart Money MD rules for getting stuff done.

Don’t Panic.

One of the administrators at my practice receives over 100 e-mails a day in addition to phone calls. I’ve had several days where my inbox had over 50 e-mails! Sometimes you run late in clinic, have meetings to attend, and then have dozens of tasks to complete or phone calls to return. Realize that our work lives have become so much more complex than it used to be, and so has medical practice. The world will not end if you don’t finish every task.

Prioritize using Buckets.

I am not a fan of “To Do” lists. It works great for groceries and a handful of household tasks/errands that I need to run. But in the workplace, many tasks fall into grey zones and these tasks end up staying on the list for an indefinite amount of time without being dealt with.

The goal of having buckets is to have a means to store your pending tasks without having to think about them while you’re doing something else. We have limited cognitive processing power, and the more we keep in our minds, the more likely we become distracted from the task at hand. Remember, the sooner you finish the task you are working on, the sooner you can move on to the next.

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I recommend keeping two mental “buckets”: one for getting stuff done right away and one for everything else. Every end of the week, the goal is to clear out the everything else bucket and start with a clean slate. Prioritization is key. The right away bucket should have patient tasks, lab follow-ups, and other needs that must be taken care of by the end of the day.

Prioritize the items within the bucket.

Every morning I quickly review the tasks for the day, and reprioritize them during the day as new issues arise. The items that must be performed during business hours take precedence, and tasks that can be taken care of via e-mail are taken care of immediately. Once the e-mails have been sent, the task is done. Get rid of it from your memory.

When your right away bucket has been emptied, review the everything else bucket and move accordingly.

You may never finish.

Remember that even though you are hypomanic, you are still human. Society has forced us to work efficiently whether or not getting tasks done actually create positive value to society. Be aware that you may never finish everything that is thrown at you. Take care of your patients, finish your charts, and work hard. The rest will fall into place.

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You must have a financial goal in mind in order to achieve it

Posted on November 23, 2015November 22, 2015 by SmartMoneyMD

Doctors undergo a regimented course throughout their training. We are used to having clear milestones during the journey to achieve our goals. What do I have to do to get into a residency? Get good grades, crush the USMLE Step 1, and get recommendation letters. Each single step can be broken down into a series of tasks and checklists. If you can sustain it for your entire medical school, residency, and fellowship, you reach your goal of becoming a doctor!

Unfortunately when it comes to securing our financial future, the goals are less defined. We all want to have a good lifestyle, enjoy our hard work, and have enough left over for retirement. That magic number is different for everyone. If you like to vacation every year in the Seychelles and want to continue doing so when you’re not practicing medicine, you might want to beef up your bank account. If you plan to live off the grid, grow your own vegetables, and farm your animals, your stash probably doesn’t need to be as substantial.

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Work with a goal in mind.

The first step in establishing a financial plan is to have a goal in place. The more concrete you can define your goal, the easier you can figure out how to achieve it. From your goal, you then build a financial map. For most people, the answer may not be clear. We all start with a vague notion of what we want. Whittle down the details as we progress in our careers. Our goals may change depending on life changes. You don’t have to figure it out right away, and that is okay. It’s taken me several years to figure out exactly what I want, and my goals are still evolving.

In the meantime, build up your nest egg.

Refine that goal.

Once you have a goal, you can start building your financial map. Is there a certain age that you want to retire from your medical career? Do you love medicine enough to practice until you die? How much are you earning now, and how much do you anticipate earning a decade from now? Map these concepts out in writing. Some people build lists, others have flowcharts. Whatever you do, put it in writing.

New questions will always arise in the process, but the first step is to estimate how much your living expenses are even if you don’t track every single penny that you spend. You have to know how much you spend in order to know how much you should save. Each decision point in your financial map should trigger new ideas, unknowns, and more immediate goals. At each step, you should ask yourself what you can do now to help you reach that step in the future.

Then act upon these mini-goals and tasks.

It is okay to change your mind.

The decision tree in creating our financial map sort of correlates with a working diagnosis in medicine. When a sick patient rolls into the emergency room, we form a series of possible causes based on signs, symptoms, and lab work. The list of possible diseases becomes refined as we establish more data. The same applies to our financial goals. If your daughter wins a full scholarship to Harvard, you can mark off tuition payments on your list and recalculate your financial needs.

Don’t be afraid to learn.

When you first encountered an unknown condition in medicine, you sought out the textbooks, research articles, and papers. In creating your financial map, you will encounter many subjects that you are unfamiliar with. Be resourceful and learn. Figure out how much you spend per year, how many years you will likely need, and calculate how much total wealth you would need to build up by the time you stop bringing in a full working income. Keep evolving as you build your knowledge and understand your financial situation more. You will make mistakes. That is okay.

Just remember, you have a lifetime to get the details right.

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How to become good at everything without knowing everything

Posted on November 9, 2015November 8, 2015 by SmartMoneyMD

There is a reason why interventional cardiologists require 7 years of training—the specialty is complex enough that we not only need the time to learn the nuances of the skill set required in the field but also to encounter enough situations to apply those skills. Despite such long training to become an interventional cardiologist, you (unfortunately) still have limited knowledge of other fields like general surgery.

That is okay, since you can get by in your career without knowing a whole lot outside of it. The truth is that it would be nice to be an expert at everything, but most of us don’t have the time, energy, or interest to master everything. Most people I know who know more than the average person are incredibly intelligent and likely hypomanic.

The Key To Knowing Everything is to Knowing When to Outsource Your Knowledge.

For everyone else, the key to knowing everything is learning to direct your time and energy to high-yield tasks to help you outsource your tasks. There is no universal template to follow—each one of us has different strengths, different time constraints, and different interests. For instance, you may choose replace your own car headlights to save yourself the time and money from outsourcing it to a mechanic. However, perhaps you have a screaming 3 year-old at home that you need to tend to instead. In this case, you might consider going to the mechanic anyway since your time with your kid is more valuable. In order to follow through this decision tree with the most information, you’d have to consider the following:

Changing the headlight bulb on your car is easy for you, and low risk.
Cost savings for doing this by yourself is huge; for minimal risk a 10 minute job for yourself can potentially save you $50 of post-tax income.
You actually have some interest in tinkering with the car.
You do not have more pressing matters to attend to if you were to embark on this task.

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If any of the criteria above is not applicable to you, you might be better off outsourcing the task. Furthermore, if it takes you an unreasonable amount of time to obtain enough information to make that decision, you’d be better off outsourcing it.

You Are Better Off Learning Some Tasks.

Finance is a key topic where you are likely better off investing some time to acquire a baseline knowledge first. No one cares more about your money and future than you. This includes taxes, asset protection, and investing. If you decided to outsource your finances to an advisor, your spare time would be still be well-spent to educate yourself on the basics.

Other fundamental tasks that you could manage yourself and delegate as your time becomes more valuable include cooking, cleaning, home repairs, or vehicle maintenance. I know doctors who enjoy working in the kitchen, and treat their time cooking meals as a therapeutic escape. Likewise, I know some people who would rather exercise on the treadmill instead of mowing their lawns for exercise. To each his own right?

Your Skills Will Build Over Time.

You have a lifetime to acquire your skills and knowledge. That is the excitement of life. Chip away at the needed skills one at a time. Sooner or later, you will have either mastered that skill set or at least acquired enough knowledge to delegate.

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Your Attitude Towards Your Job Makes You Successful

Posted on November 2, 2015October 31, 2015 by SmartMoneyMD

The three A’s of medicine determine your success as a doctor. It’s not rocket science (or brain surgery) that the three A’s also translate into success of any service profession. Case in point: attitude can destroy your career even as a hair stylist.

I came across a hair stylist training school today and decided to see what my experience could be like having a trainee cut/style my hair. As a customer, I get a discounted rate by having someone less experienced work on my hair. As the trainee, the stylist in training gets pointers and on the job experience. Sounds like a win-win for both parties…in theory.

The Trainee Model Is Still How We Learn Medicine.

The apprenticeship model has applied to medicine for centuries. When I was a medical student and was offered the opportunity to practice phlebotomy, lumbar punctures, or chest tubes, I took pride in mastering all of the theory, procedure steps, and complications that come from a procedure. This enthusiasm came on top of having had to vie for spot in my medical school class AND pay a $50,000+ annual tuition! All in the name of delayed financial gratification and prestige.

In internship, being selected to assist in cholecystectomies (or even perform one) or allowed to “close up the skin during surgeries” after the attending left the room was an honor. I toiled for hours learning the steps of the incisions, techniques, and closures to show my superiors that it wasn’t a mistake that I was in their training program. I remember that one of the general surgeons was furious that a non-surgical intern (me) was the only person available to assist him on an emergent appendectomy in the middle of the night. It was only after I saved his ass by alerting him that he didn’t fully cauterize the appendicular artery anastomoses before tying off the appendix that he realized that I was not a joke. Mind you, I was commanding a solid $45,000 annual salary while consistently reaching and exceeding the theoretical work hour limits. What a bargain to get such help in the hospital.

Unfortunately, Not Everyone Values The Opportunity of Apprenticeship.

It is unfortunate that not everyone carries a positive attitude in his profession.

My hair stylist was a girl in her 20’s who clearly had no idea what she was doing. She was 10 months into a year-long hair styling program. It was clear that she had neither the coordination nor the knowledge to use a trimmer, scissors, or comb on any client without contorting their neck. After taking 45 minutes to perform what would have otherwise taken 5 minutes, she asked an instructor for help. I wasn’t sure if she was even listening to the instructor. She kept glancing away. She had the wrong attitude.

In the end, I felt bad for my hair stylist in training. She wanted to become a consultant stylist who travels to clients’ locations. Unless her attitude changes she will not get any clients. Perhaps her attitude towards people will change after she opens her business and her livelihood is on the line.

There is a silver lining in this experience.

After my experience with the apathetic hair stylist, I was reminded that as doctors, we are also held to a particular standard for attitude. If we don’t convey a positive outlook towards our patients, we will never succeed not matter how competent we are medically. We are held to an even higher standard than other service professions because many of our clients [read: patients] see us during vulnerable times in their life. We not only have to make them better but also have to provide them a positive experience.

After all, isn’t that why we get paid handsomely? (j/k)

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Be Careful What You Wish For In Your Job

Posted on October 15, 2015October 10, 2015 by SmartMoneyMD

I previously wrote about compromising career options for family reasons. There are often scenarios where you do find your so-called “dream job” only to realize that it’s really not what you expect it to be. If you are looking to start your first job or simply to find greener pastures, buyer beware.

Private Practice Dream Jobs

For instance, the buzzwords in private practice include “high income potential”, “real estate opportunities”, “busy on day one”, and other phrases along the lines that suggest that the new physician will be wildly successful financially and have a great lifestyle. Can that be possible? Sure, but those opportunities may be more uncommon than you realize. As doctors, we are paid on productivity. We’ve discussed how doctors are paid, and how they can earn more money. An opportunity that has “high income potential” can mean a handful of things: (1) You will work your tail off seeing tons of patients a day or doing a ton of surgeries (2) You do that while building ancillary income opportunities through real estate or hospital contracts or (3) something that the practice is doing is either unethical or illegal. We all hope that we never end up in the third scenario, but these instances exist. You sometimes hear about docs who have homes abroad, private airplanes, and an 10-car garage. Some of them are even being investigated for insurance fraud. If a potential employer tells you that’s their lifestyle, beware. Most doctors under our healthcare system can become rich, but not likely real estate mogul rich. Grand riches in medicine always come with a catch.

University Based Dream Jobs

The appeal of working at a university include working with like-minded peers in your field in a cutting edge setting. You have the potential to run clinical or laboratory research to mold the way we practice medicine. You also have the opportunity to educate the future of medicine. Monetarily, you will still do fine, but you will likely have additional income through speaker or consulting fees. Beware, even the best university-based medical jobs will NOT be perfect. One lesson that I’ve learned is that you must love your career in order to succeed at the university, because you will likely be BUSY. While you may only have one to two days of clinical work, you will likely spend a lot of time working on lectures, presentations, teaching, and paper writing. This time can extend into your personal life at home. There were plenty of nights I spent during my training preparing abstract and paper submissions into the early morning hours and still received prompt e-mail responses from my attending mentors. If you wish to succeed in an academic environment, you will have to spend more time in your career than you would otherwise. This isn’t necessarily negative, but a dream job at a university is really one that allows you to focus your energy toward your career.

Your Dream Job May Be One That Affords Your Time Away From Work

Ironically, an ideal medical career for you may be one that allows you to have time off from the daily routine. I have seen job offerings in remote areas of the country (or the world) that allow up to 3 months of time off! For unmarried doctors with the travel bug or an interest in adventure, three months of time off would be a dream job. Even at a lower base pay, you can sustain a healthy life outside of medicine. Being a doctor will hopefully provide you with career stability, but time is a precious resource that we gave up during our training. It would be nice to have control of our time to enjoy our hard earned dollars.

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The Daily Life of A Dermatologist

Posted on October 9, 2015February 2, 2021 by SmartMoneyMD

The television perception of doctors is often skewed toward drama, sex, and a rockstar lifestyle. Take Grey’s Anatomy, Mistresses (plastic surgeon character), Scrubs, or Dr. 90201. Even reality medicine shows like NY Med or Boston Med portray a more sensational view of a doctor’s life. Our lives are both exciting and boring at the same time. Exciting in that most specialties involve troubleshooting symptoms and boring in that there is quite a bit of repetition.

To help the general layperson get a broad sense of an average doctor’s routine, I will detail the daily life of a dermatologist. Note: I am not a Dermatologist, but have spent considerable time working with them and have colleagues in the field.

Clinical Lifesyle

The average workday of a Dermatologist is not easy by any stretch of the imagination, but it is also a very manageable day. A typical day runs about 8-10 hours including some amount of time to use the restroom and eat lunch (10 minutes – 1 hour). Most of the workday for a clinician dermatologist involves patient care. An average Dermatology office will have its doctor see about 40-50 patients a day, although I have seen numbers up to 100 a day! What this means is that you haul ass, as a Dermatologist! Minimal chit-chatting, and a lot of spot diagnoses and treatments. Our reimbursements have dwindled over the years, and many offices are often forces to pile on our patients. Nonetheless, the brief time the Dermatologist spends with her patients is quite sufficient for accurate diagnosis.

Rinse and repeat for each of the days the doctor is in clinic. Some Dermatologists may have certain half days dedicated to biopsies or particular skin treatments in order to operate more efficiently. Most doctors will also have administrative duties like business meetings that often add on 5-10 hours a month to the work schedule.

There’s no loitering around. On an average 20-day month, a Dermatologist seeing 50 patients per day will see 1000 people!

Academic Lifestyle

An academic Dermatologist will have more dedicated time to research, teaching, administration, or writing. Many university-based doctors will have perhaps two half-day clinics of patient care with perhaps two days a week of research time. One day of the week may even be dedicated to administrative duties. Revenue generated by the academic Dermatologist is minimal and likely insufficient to even cover the doctor’s salary. Income thus comes from donations (appointed chairs), state/governmental funding, and grants to perform research. The perks of academic medicine include the fact that you can be removed from the financial considerations of medical practice. You involve yourself with interesting technology and are given the opportunity to work with thought leaders (and become one) of your field. You can’t really put a price on fame. And what you do daily really shouldn’t be boring. You can immerse yourself in the cutting edge of medicine. Most academic physicians I know bring their paper-writing home and spend a lot of their free time on their careers. Not necessarily a bad thing to do, but it really shows that you love your career.

One of the downsides of the academic lifestyle is that you are removed from many of the practical matters of medical practice (read: finances). Most doctors I know in academia are quite ignorant of finances and actually think that their one-day a week clinic actually covers their salary. There is no free lunch. You really aren’t generating your worth in cold, hard, cash but rather intrinsically through your research, teaching, and innovations to the field.

Dermatologists Are Busy

You can basically substitute in any medical specialty in the sentence above (except for maybe rehab medicine—j/k). Dermatologists are no different. The clinician routine is quite repetitive. Imagine spending your entire 20’s training to see thousands of patients a month for your entire career! It is not an easy task. Maybe that’s why we often seen doctors with those fancy cars, homes, and yachts….

Do you have any comments to add regarding the lifestyle of a Dermatologist? Sound out below!

Those of you who are interested about the life of a Moh’s surgeon, see our post on this specialty.

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