Hey there, and Happy Holidays! If you are looking for the perfect gift for the doctor in your life, whether that’s YOU or someone else… read on! I’m excited to announce I’ll be speaking at the annual White Coat Investor’s Physician Wellness & Financial Literacy Conference on March 4th-6th. Network and learn from the comfort […]
The TiredSuperheroine blog is all about building your career capital and thriving in a male-dominated field.
This week’s is a guest post from Dr. Sandra Weitz, an anesthesiologist specializing in pain intervention. She shares her path from budding physician, through varied challenges, and into the life of a practice owner. It’s a fascinating ride. Here’s a look back at the career of a real-life superheroine who claims you really can have it all.
I can’t help but smile when I think of the Enjoli commercial from the late 1970’s. It was an advertisement for cheap perfume, but to me, it was a feminist call to action. The message was: if she wore this perfume, a woman could have it all. This commercial illustrated the possibilities for me as a woman early on.
When I was six years old, my father, a two pack/day smoker, died of lung cancer. Somehow I thought it was my fault. My solution was to become a doctor and save the world. So, with tunnel vision, I plunged ahead. It never dawned on me that there was any other alternative. I went to college at 16, majored in Biochemistry, and graduated at the age of 20.
The only thing that (temporarily) slowed me down was lack of money. My father, a cutter of women’s coats in the garment district of New York City, left us with no money. My mother worked as a high school teacher. Scholarships, financial aid and work study got me through college, but I didn’t have enough money to apply to medical school. I took a year off to work as a lab technician at New York University and apply to medical school.
Four years later, I decided to apply for surgery residency. I totally bought into the idea that being a surgeon was my route to saving the world. I moved cross country and got married in the 4 weeks between medical school and internship. My husband and I simultaneously started our surgery internships at UCSF, at a time when call was every other night. We were both off call one weekend a month. It didn’t take long to figure out that we had different goals for that weekend—he wanted to have fun, and I wanted to have a clean apartment. We had 300K in student debt and little expendable income, but hiring a cleaning lady was clearly a worthwhile investment.
I actually wanted to be a neurosurgeon. But, somewhere in the middle of my internship, I had the epiphany that surgeons (and doctors in general) don’t really “save” people. Then, one of the Neurosurgery attendings talked to me about pain management—a new multi-disciplinary field that included minimally invasive procedures. After learning more about it, I made my first pivot, switching into an anesthesia program. After that, I did a pain management fellowship. I figured out that by treating chronic pain, I could significantly and meaningfully impact people’s lives in the way I had envisioned, while enjoying reasonable work hours.
After finishing all of my training, I stayed on as faculty at UCSF. As the Director of the Pain Management Service, I thought I had hit the jackpot. I loved the academic environment and had visions of grandeur, including becoming a department chair. I was appointed, as the only woman and the youngest member, to the Department’s Finance Committee. In retrospect, this was probably a diversity move, but it turned out to be a fantastic gift. This is where I learned the “business” of medicine.
Meanwhile, my husband finished his Urology residency and got a job at Kaiser Permanente in San Jose. After a while, reality set in—we were a two-physician family living in the Bay Area during the height of the Silicon Valley boom. The cost of living was outrageous. We had long commutes, were house poor, and our salaries were stagnant. And did I mention all of our student loans?
We mutually agreed that life is all about choices, and after some soul-searching, we decided to look for jobs elsewhere. When we told our nanny that we were moving, she said, “Great, because I was going to quit. You are under-paying me.” That was at a pay rate of $45,000 in 1997. By the time I paid taxes, the nanny, gas and car insurance, I was essentially working for free.
That job search landed us in Baton Rouge, Louisiana. You might wonder how a New Yorker who went to school in Boston, lived in San Francisco for a decade, and married a guy from California ended up Louisiana. We came to interview in mid-May when the weather was perfect. The cost of living was low, the commute was short, and the opportunity seemed to address most of our criteria.
My move involved joining an anesthesia group that claimed they wanted a pain specialist. Despite our conversations regarding my approach to pain management leading up to my accepting the position, once I started, it became apparent our expectations were not aligned.
The anesthesia group thought that I would do “blocks” in the back of a PACU. I explained to them repeatedly that I believed in the multi-disciplinary approach to pain management, and that I needed a true clinic with access to multiple modalities. They laughed. I explained that the clinic and I could generate a lot more revenue than their model. They laughed. I laughed too when I told them I was leaving.
I started my own practice in a rented space within a regional 1000-bed medical center. Within a year, my practice had grown exponentially, and I needed to bring in additional providers to handle the volume. We all know that there are only so many hours in the day, and only so many patients that you can see.
By adding additional providers, I was able to have greater flexibility. If I had to leave to pick up a sick child, clinic did not come to a screeching halt. My clinic hours became more manageable. I made it to every soccer and volleyball practice, every school event, any and every activity that was important to my family. I controlled my own schedule.
As a pain management specialist, I obviously did interventional pain procedures. I went to the hospital’s administration and proposed a joint venture for an ambulatory surgery center (ASC). Why? Because I recognized that they were collecting the facility fee for every procedure I did. Did you know professional fees make up just one-third of total charges, and the facility makes the other two-thirds? I understood that the facility had to cover expenses, but still felt like I was giving up a large piece of the pie. After the hospital declined to form a joint venture, I decided to control my own destiny. At that time, my kids were 3, 5 and 7.
We bought a lot and built a 25,000 sq ft medical office building. Having my own ASC would allow me to capture the revenue from the facility fee. We decided to have my clinic and an ASC on the first floor and lease out the second floor. By the time the building was completed, I hired an additional physician and two mid-levels. Within six months, we had outgrown the clinic space. Shifting gears, we finished the upstairs as a new clinic space with 23 exam rooms, and expanded the ASC to occupy the entire first floor.
Ever since my fellowship, I have utilized a multi-modality approach to treating chronic pain. As a result, I was referring patients to psychological services, weight loss programs, physical therapy, chiropractic care, massage therapy and more. I ordered imaging studies and laboratory tests as part of the evaluation process. I recognized that my practice controlled the outflow of these referrals. By bringing all of these services in-house, I was able to provide a comprehensive approach, improve patient care, and capture the extra revenue.
Over time, I added additional specialties to the ASC and sold shares to other physicians. I invested in an imaging center and a physical therapy service. I started an anesthesia company to provide services to the ASC. Then, I added psychological services, weight-loss services, massage, chiropractic care, and lab services to the practice. The practice and ASC paid rent to my real estate company. All of these businesses were horizontally and vertically integrated with my medical practice to maximize both my patients’ care and the revenue produced.
What did I figure out through this journey? I could indeed have it all.
In order to to that, I took on risk. And at times, that was scary. Especially at the beginning, when I started my practice with three little kids. But I recognized that I could let fear paralyze me, or use it to empower me. Developing an action plan supported by real data allowed me to mitigate the risks I faced. And with each small win, I got braver.
It didn’t take long for large amounts of money to come rolling in without my having to see each patient. The more each business grew, the more it fueled the other businesses, and the more I made. Whether I went on a long vacation, took six weeks off to take care of a sick child, or simply wanted to work fewer hours, I made money. I controlled my own destiny and achieved financial freedom. I sold my businesses on my terms and retired at 53.
Looking back, I feel that I lived a feminist’s ultimate dream. I’m proof that you really can have it all. While I’ve had a successful professional career and owned several profitable businesses, I’ve had a loving, supportive husband and raised 3 children, who each became successful in their own right.
If I can do it, so can you!
Dr. Sandra Weitz is a retired anesthesiologist specializing in pain management. She now splits time between her family and mentoring other physicians in their business pursuits.
I’ve been so busy promoting my book, my head is spinning! In the midst of planning the launch of Save Lives, Enjoy Your Own, I was asked to join the 5th Annual Northeast Vascular & Interventional Radiology (VIR) Symposium at my home institution of Brown. So despite the book launch, I was excited to take part in the symposium. It was an honor to join other outstanding women in my field at the event, which happened on September 27th. The questions from the Northeast VIR Symposium were so good, I thought I’d share them here on the blog.
Those were some highlights from the Northeast VIR Symposium, which normally takes place in person. The virtual version was the next best thing!
What questions do YOU have about being a woman in VIR or in a male-dominated field of medicine? Leave a comment below!
And if you have a chance to attend the Annual Northeast VIR symposium in the future, I highly recommend it.
I also wanted to let you know about a new podcast called Marriage, Money & Medicine, started by my friend and fellow radiologist Dr. Kate Louise Mangona. I’m one of her inaugural guests! In our episode, we chat about how we came to form our families, and the finances of physician families, specifically as it relates to being a female bread-winner! You can check out that podcast anywhere you listen to podcasts. I’ve been enjoying Overcast, if you’re not totally happy with the medium you’re using. Link to the podcast page and show notes by clicking here.
This is a guest post from a blogger who is doing some good in the world. Catherine Burke helps those who’ve been suckered into payday loan schemes to find their way out. When she asked the kind of content she might write for you, I liked the idea of covering the emergency fund. It’s a bit of a loaded topic for residents, who are often saddled with educational debt. Does a resident actually need an emergency fund? Here’s a breakdown from Catherine.
-Barbara Hamilton, MD
You could call an emergency fund the backbone of your personal finance strategy. If an emergency arises suddenly, you will have the emergency fund to support you. That is why personal financial specialists have always endorsed having one.
In this article, the focus is on demonstrating how such a fund will work for medical residents who are getting an annual salary of $45,000 to $60,000.
“Keep the emergency fund intact in case you lose your job or income.”Michelle Singletary
For a medical trainee, directing an amount of money towards an emergency fund may not seem a practical option, but it is really important.
You don’t know what is going to happen with you tomorrow. Maybe you need money suddenly, like in the case of a sudden accident. Then the money you’ve saved in an emergency fund will come in handy.
That is why you need to save at least 3 months to 6 months’ salary in your emergency fund. Suppose, as a medical resident, your income is $60,000 per year. Then you should aim to save $15,000 to $30,000 for an emergency.
Believe me! Creating an emergency fund and saving at least 3 to 6 months’ savings is necessary for a medical trainee.
The Student Loan Hero website states that on a standard medical student loan repayment plan where the payment duration is 10 years, you have to pay a regular monthly payment of $2,300 per month on a $196,250 loan amount and 7% interest rate.
In addition, you have to pay for your food, utilities, rent, etc. You may feel like you don’t have enough money left over to save.
So, try to save some dollars in the emergency fund slowly but steadily. The amount of money is not important here. The important matter is to maintain the Emergency Fund and continue to save dollars in the Emergency Fund regularly every month.
You can say that online banks are currently a good way to store your savings. Online banks currently offer higher interest rates compared to brick and mortar banks.
So, the ideal account for keeping the money for Emergency Fund purposes is an online account.
According to the Bankrate.com report and our estimation, if you want to open an online bank account for emergency savings purposes, you can rely on 2 online banks.
These are Citibank and Vio Bank. Citibank is offering 0.90% APY (Annual Percentage Yield). You don’t need any minimum balance to open a savings account in Citibank. You’ll get access to the ATM with Citibank.
Vio Bank is offering 0.83% APY and you need a minimum of $100 to open a savings account in the Vio Bank. (Editor’s note: Ally, CapitalOne360, *Etrade, and many others offer high interest rate savings accounts. Mine is at *Etrade.)
Financial experts always suggest that you should create a separate account for emergency purposes if you already have a savings account.
The thought may arise in your mind that if you already have a savings account then where is the need to open a second bank account?
Well, the 2 accounts have different purposes. In the savings account, the money you’re going to save is for your future. The savings account will provide you financial security.
The bank account you’ll open for emergency purposes will serve your emergency purpose needs. In case, you need some money suddenly, you can instantly withdraw the cash from your emergency account.
That is why you need to strictly follow the rule that you’ll only withdraw money from the emergency fund just for emergencies that arise.
With the emergency fund, you should take care of your debts too. As a medical resident, maybe you have unsecured debts like credit card debts or a payday loan, in addition to your medical student loans. In an emergency, it is easy to depend on credit cards and payday loans to control the situation instantly. But in the long term, you’ll face problems while paying off the credit card and payday loan balance with a high-interest rate.
If you end up in this situation, you might consider consulting an expert on the repayment of credit card and the payday loan debt. You can use options like debt consolidation, card balance transfer, or payday loan consolidation to solve your problem.
Personal finance experts like Suze Orman and Dave Ramsey are quite vocal about the emergency fund.
Dave Ramsey has advised that all Americans should start by saving $1000 in an emergency fund. Once you have saved $1000, then you can aim for the larger goal of saving 3 to 6 months of your annual salary.
Suze Orman states you will be in a better position if you save 8 to 12 months of your annual salary.
So, the personal finance experts have supported the emergency fund quite vocally.
Your emergency fund is the test regarding how much you’re prepared to face an unexpected scenario. If you are generally living a paycheck-to-paycheck life, start by saving $100 each month. The best option is to use a high-yielding savings account, as previously described. You’ll be glad you have it in case of an emergency.
As Greg McBride, Chief Financial Analyst for Bankrate.com has said, “Nothing helps you more than knowing you have money tucked away for an emergency.”
What is your experience with the e-fund: do you have one? Where do you keep it? Does it help you feel financially secure?
Catherine Burke is a financial writer for Online Payday Loan Consolidation. She provides resources to help people get out of predatory debt. She lives in Kansas and has hard-won knowledge when it comes to payday loans.
I don’t actually talk about personal finance in my book, Save Lives, Enjoy Your Own. I allude to the fact that as a physician, you will be able to make a living that allows you to make choices that suit you and your family (if you choose to have one). You’ll have the resources to get help as your career makes demands on your time. I left personal finance out of the book because it’s a huge topic, and will likely be the subject of its own book. So as we prepare for book launch, and the important task of finding your place in medicine, here are some financial considerations for you, the budding physician. And read through to the end to find out how you can learn more about setting up your finances with my friend, Dr. Bonnie Koo, a.k.a. WealthyMomMD.
Most of us incur educational debt on the path to medicine. But it should be kept low/ manageable enough so as to NOT affect your career choice. I know, six figure debt a huge amount, but you can do it. Even if you choose a lower paying specialty with a high debt burden, you can always go for a student loan forgiveness program. If you want to read about the different kinds of student loan forgiveness programs available, The Physician Philosopher’s Guide is a great resource. TPP delves into these programs in detail, in an understandable way.
So what should career choice be based upon? Well, I did a deep dive into that topic in my new book. My approach is tailored to those who think they might want to work with their hands, in a procedural or surgically-oriented field of medicine. Check it out!
As you accumulate student debt, it can be really anxiety provoking. I know this first hand. As you work and study so hard, and push yourself to exhaustion at times, you just can’t afford to lose sleep thinking about your loan balances. It’s not good for your well-being. As a defense mechanism, professionals in education debt become numb to it. As you do the best with what you have, know that you’ll have more resources to deal with your debt when the time comes.
Basically, you have a mortgage on your mind. It is a valuable investment, even if there isn’t a lot of tangible evidence of its value just yet. Hang in there. One day you will have a paycheck large enough to make real decisions about where the money should go. Whether you decide to tackle your debt head-on, or refinance and let it simmer for decades, that’ll be up to you!
As you make your first moonlighting paycheck, or that first sign-on bonus, you might be wondering when you’re ready for a lifestyle upgrade. This can be an incremental process. It’s enjoyable to increase your lifestyle, after all. It’s part of why we work so hard!
One mistake I see is people making a lifestyle leap. They get their first job and lease a luxury car. They make decisions based on a lack of financial goals.
Speaking of financial goals: Do you know how to setup your finances? You might even feel the pressure of being the breadwinner of the family. That’s what prompted me to start learning all about personal finance.
Let me know what personal finance questions are on your mind.
To your health, wealth, and happiness!
Did you know publishing a book– and then promoting it– are a lot of work behind the scenes? That’s what I’m up to lately, and for the foreseeable future. I’m a one-woman PR firm, help me!
First off, I want to explain the point of a book launch. My book is currently live on Amazon, but it’s really, really hard to find, because it doesn’t have any reviews or sales yet. Right now, I’m pre-selling copies that I will personally sign and send you. It’s a celebratory special edition. For more details on how to get YOUR copy, see this post.
A book launch is usually accompanied by some PARTIES. But because of COVID, I will hold live virtual events instead. I’ve set aside Saturday 10/3, Sunday 10/4, and the evening of Wednesday, 10/7 to host these events. They’ll be like a group hangout mixed with a group coaching session. We can all share and laugh and cry together. If you’re into that.
During these events, you’ll listen to readings from the book– stuff you haven’t had a chance to hear yet. And I’ll be hosting some special guests. One of them, Stephanie Pearson, for example, is an OB/GYN turned disability insurance broker, who advocates for physicians. She can answer your questions about protecting your future income. If you want a primer on what she does, check out the post I wrote about buying my own policy.
Another possible guest who’s yet to be confirmed is a financial blogger who has supported this launch, by sponsoring hundreds of free copies for students and trainees, so YOU don’t have to spend your own $20! He’s amazing.
As my book coach says, these launch parties are sort of like a baby shower: we are celebrating, even though we won’t have “met the baby” yet.
When you sign up for the launch, you will enter your mailing address so I can send you a signed copy of the book. Yes, I’m for real! (Edited to add: the book giveaway period has ended as of late October 2020).
Sponsors I want to thank include my colleagues at work, my friends in interventional radiology, and some small (and not so small) businesses who’ve purchased copies of this book for you. I’ll announce them all at the launch, where you’ll get a chance to hear just how many people believe in you, the future of medicine!
So sign up here (period has ended) and I’ll send you a free book. I’m also becoming a one-woman shipping operation in the next few weeks. I’ve just ordered 700 copies which are coming to my home. Believe it or not, my free time is now also spent researching packaging & shipping options. I’m going to sign these babies with gold glittered pen and slap a label to send them off to you!
When you have a chance to read the book, if you like it, drop a review on Amazon. Tell all your friends about the book.
Tell your Deans and Administrators you want to host an event with me so we can hang out some more.
It’ll be awesome.
Hi Friend! This is a short post as I’m out enjoying life somewhere in the woods with my family. It’s a needed change of pace. But planning for the book launch of Save Lives, Enjoy Your Own doesn’t stop. Here’s the update!
As you may know, my book Save Lives, Enjoy Your Own: Finding Your Place in Medicine comes out next month. Here are some announcements on how you can get your hands on a signed special edition copy. I’ll be ordering my first boxes of books in the next week, so I can sign the first batch for YOU! Get a SIGNED special edition when you pre-order the book here.
Whether you need this book to help guide your career decision, or want to purchase a copy for a mentee, you can be among the first to hold this book in its physical form. When you buy this book for an up and coming woman in medicine, you’ll start a ripple effect which could save thousands of lives. I’m serious. Buy a book, save a life!
If you are part of an institution that teaches medical students or residents heading into the procedural or surgical specialties, you can order bulk copies of the book by emailing me at email@example.com. If you order a bundle of books for your school or institution, I’d love to set up a virtual book club or happy hour to discuss all the juicy contents of the text with your group!
If you’re a trainee who wants to join my launch for a chance to win FREE (sponsored) copy of the book, that time has come and gone (as of the end of October of 2020).
For a preview of the book and a list of contributors who shared their perspectives, check out this teaser post.
Have a great weekend, and don’t forget to enjoy your own 😉
Barbara Hamilton, MD
In part two of my series on radiation protection, I thought it would be useful to cover considerations for physicians considering a pregnancy. This is a common question among med students and trainees, and frankly, it seems to be a deterrent for some. Many blame radiation exposure for keeping women from entering fields like interventional radiology (IR) and vascular surgery in greater numbers. A frequently asked question I hear is, “Is it safe to use fluoroscopy when you’re pregnant?”
The short answer is yes. This work can be accomplished safely, and it has for decades. It’s just that all the women who have practiced with fluoroscopy through their pregnancies and have healthy normal kids are still few and far between in a field with just 9% women. So you may not see them at your institution or have access to them as role models!
Pregnancy in and of itself incurs risk. Working with radiation incurs risk. But the risks don’t have to be additive. You just need to take precautions and generally take the best care of yourself that you can.
Some of the best data we have for pregnant workers outcomes relates to flight attendants. This largely female workforce encounters cosmic radiation every time they fly. As you can see in this article, they aren’t at any increased risk of miscarriage compared to teachers, a group that generally receives only background radiation. However, the article notes some potential risk at a certain radiation threshold and related to circadian disruption. It’s an interesting read.
Another concern in certain fields is standing for long periods of time. While prolonged standing as a pregnant IR may be tiring, it’s not necessarily dangerous. The exception comes with certain conditions, like preeclampsia, cervical effacement or incompetence, vaginal bleeding, premature labor, multiple gestation, or a history of premature birth. In these cases, your OB may advise you to limit long periods of standing, or to stay off your feet altogether.
As soon as you know you are pregnant, you can confidentially inform your radiation safety officer (RSO), so they can provide a fetal badge. This will monitor your monthly dose under your lead. Telling your RSO can be completely independent of your announcement of your pregnancy to your program, employer or group. That’s because most women wait until the first trimester is complete, to ensure viability of their pregnancy.
As soon as I was ready to conceive, I wore an extra shield around my waist. I used a square sheet of lead suspended from a waist belt. This kind of lead is often used for shielding for pediatric x-rays. It is a lightweight way to add an extra layer of shielding in front of the pelvis. I put this on under my kilt, and this took just a few extra seconds as I walked into each case. This way, I felt I had a layer of extra protection before I even became pregnant.
Once I got pregnant, I continued to use this extra shielding. Once I announced my pregnancy, the staff around me worked to make sure I had all the protections possible. Although there is already a table-mounted shield hanging from the fluoro table, the staff brought in an additional rolling shield, which I could place between me and the patient. Ceiling mounted shields are another great ally in reducing radiation exposure.
As I spoke about in my previous radiation protection article, whether we are male, female, or non-binary, we all need to adhere to best practices when it comes to protecting ourselves from radiation. Head back to my last article on ALARA to refresh your memory on all the ways to keep your dose “as low as reasonably achievable.”
It may feel different when a pregnant worker is in the room, but the principles remain the same. Everyone should take steps to protect themselves at all times. The nice thing about being a fetus is you have the additional protection of mom’s belly. That means baby benefits from additional layers of radiation-blocking tissue. The amount of radiation reaching a fetus, with appropriate shielding, is therefore often so low as to be undetectable.
Use a RadPad: A challenge in practicing today, in 2020, is that our population is larger than ever. This means the dose of scatter from a patient can be up to eight times that of someone with a normal BMI! This is one of the reasons I depend on RadPad radiation protection pads in most of my body and extremity cases. When I know there will be more than a minimal amount of fluoroscopy, I reach for a RadPad to protect myself, whether I’m pregnant or not.
The beauty of the RadPad is you can place it strategically to block scatter coming from the patient’s body. This is critical when imaging and working on a thick body part like the abdomen. It’s also important when the case is more than a couple minutes of fluoro time. Time and thickness of the body part are key considerations as I reach for a RadPad.
Some people, even physicians, may lack adequate knowledge as to the particulars of women working with fluoroscopy. This can lead to harmful misinformation, causing women to shy away from fields like interventional radiology, vascular surgery, and the like. The truth is, with the proper protection, women can safely work in these fields just like their male counterparts. It is generally safe to use fluoroscopy while you’re pregnant with the usual precautions.
That said, pregnancy demands a lot on the body. It’s sort of like IR training: the hours and physical demands can be grueling at times! But they are both worth it. Every woman has a different pregnancy experience. Some women suffer nausea in the first trimester, while others experience it for the entire pregnancy. Some women may have musculoskeletal issues related to the hormonal effects of pregnancy, while others will have none. A healthy friend of mine unexpectedly suffered cholestasis of pregnancy. No one is truly immune to the possibility of a pregnancy-related complication. So if you take on the challenge of creating a human, it’s part of the deal.
Rest assured, countless pregnant workers have come before you. People are generally understanding if you need to sit down and rest, get a drink, go to the bathroom. A close friend of mine had to un-scrub from an aortic endograft to throw up in the trash!
When embarking on a pregnancy, you won’t always be in charge of what is happening with your body, and that’s OK. It’s part of the process.
Using myself as an example, I had to go on modified bed rest for several months. Luckily, since I work in a practice that does both interventional and diagnostic imaging, I was able to put my feet up and read diagnostic studies for the latter half of my pregnancy. If this is not an option, sometimes short term disability insurance (SDI) is a good idea to keep income coming in while you’re off your feet. There are state short-term disability funds, and private policies you can buy. Just make sure you buy your SDI before you get pregnant!
In general, women take at least 6 weeks to heal after a vaginal delivery, and 8 weeks after a cesarean section. In addition, there is family bonding time you can get either through your company or groups parental leave policy and/ or within your state.
For instance, in California, where I live, many people take 12 weeks off with partial pay, up to a certain cap. As a radiologist, I hit the cap, which was about $1100 per week. This was helpful to pay my mortgage while I was on leave! Rules differ by state, but in some states, you can even take paid weeks off to bond with baby after your initial recovery. So if you group would like you to come back after 8 or 10 weeks, you can use your remaining weeks later in the year, and still receive the SDI benefit. And if you’re in certain states like CA, NY, RI, HI, NJ, or in Puerto Rico, you’ve automatically paid into this state disability fund from your paycheck.
From healing from birth to raising a little one, no one can do it truly alone. The more support you enlist, the better, in my opinion. As physicians, we become used to being hyper-productive and relying solely on ourselves. But if that’s been your ethos, you might consider changing gears as you become a parent.
Even single parents can benefit from taking a team approach. Partnering with other caregivers and helpers can make parenting more doable and enjoyable. I talk about childcare as a busy physician in this article, which is geared toward the baby period, and then in this article, which covers more logistics as baby gets older.
I wrote up my experience and hacks from a year of breastfeeding and pumping as an interventional and diagnostic radiologist. You can find that article with affiliate links to some of my favorite products here.
For more resources, check out all the information and personal accounts shared in the SIR’s Pregnancy Toolkit. Trainees and attendings alike continue to work on this living resource, to help support would-be IRs and fluoroscopy workers who need more information about working with radiation while pregnant, not to mention what happens after pregnancy!
As you can see, there are plenty of considerations in becoming a parent as a busy doctor, but now, at least you don’t need to worry about whether it’s safe to use fluoroscopy when you’re pregnant!
Writing a book is like giving birth again. How did this even happen? Where did I find the time? I thought I’d write a little e-book on finding your place in medicine. Then, I stumbled upon a book coach in a physician Facebook group. My coach is a neonatologist, preventive medicine specialist, and social entrepreneur who is making the world a better place through the cultivation of first-time authors. And as a coach, she delivered. She told me where I needed to add a story here, or clarify something there. That’s when Save Lives, Enjoy Your Own started to look like a real book in the making.
This book is for those in medical school, who are staring down one of the biggest decisions of their life– choosing a medical specialty. That’s why I focused on medical students as I wrote and edited (and edited… and edited) this book. Yet I also wrote the book as a person who found herself at a fork in the road mid-way through residency. I had to decide whether I’d be a diagnostic radiologist, or dive into the ultra-male-dominated, adrenaline-soaked field of interventional radiology. That’s why I understand that some residents may need the book when they’re in the midst of their training. And still others may find the book as a pre-medical student or non-traditional post-baccalaureate student. There is value in the book at each of these stages.
Many women entering medicine will identify with the messages in the text. As they begin to encounter some of the more traditional and even outdated ideas about gender in medicine, I hope this book helps to light the way. Others who want to learn more about what their female colleagues face as they become physicians may read the book as he-for-she advocates. Finally, students and trainees who identify as underrepresented minorities may find guidance and comfort in the pages of Save Lives, Enjoy Your Own. For aspiring and training doctors finding where you belong in the medical field, I’ll show you how it’s not easy, but it’s worth it.
We are a month out from book launch in October. In order to tease some of the contents of the book, here are the foreword and mini-bios of the amazing physicians who contributed.
Sometimes the phone rings just after the first precious hour of sleep. The trauma surgeons need my help. When I rush into the hospital for an actively bleeding patient, I might not return home until dawn, but as I work, I’m in the zone. This work is a part of me. Being able to save a life is worth it every time. And I want you to find the kind of work that engages and fulfills you, too.
But how do you find the right field of medicine, in which you can harness your unique talents and skills? How do you find your calling while drinking from a fire hose? I’ll address these important questions, with the help of some colleagues in various medical specialties.
Unfortunately, the male-dominated atmosphere, outdated ideas about what constitutes women’s work, and concerns about work-life balance can discourage some women from surgically-oriented fields like my own. If your desired field is a boy’s club, how do you figure out if you truly belong there? How do you navigate a sometimes foreign environment and succeed, despite the lack of female representation there?
If you dream of transforming from an uncertain student or trainee into one who confidently pursues her career path, you’re in the right place. From the decision to work with your hands, to finding the right balance and learning to lead, this book will light the way. I’m so excited for you to join me as a physician who saves lives and enjoys her own!
I would like to thank the women who contributed to this book. It’s a privilege to call them my friends and colleagues. They know it’s possible to save lives and still enjoy your own. The following are abridged biographies, which highlight some of their many accomplishments.
is an interventional radiologist who was named a Washingtonian Top Doctor in 2018 during her time at the MedStar Georgetown University Hospital in Washington, D.C. At the time of this writing, she is transitioning to her new roles as an Associate Professor of IR, IR Division Director, and Vice-Chair of Interventional Affairs at the University of Alabama at Birmingham.
is a third-year medical student pursuing an MD/MBA degree at the University of Miami Miller School of Medicine. She aspires to be efficient, autonomous, and joyful throughout her career. Her specialty choice is yet to be determined, and she plans to take a year off to consider her options, which include IR, surgery, family medicine, and OB/GYN.
is a Past President of the Society of Interventional Radiology. She is a Professor of Radiology & Surgery at the Emory University School of Medicine and the Chief of Service for Radiology at Grady Memorial Hospital in Atlanta, Georgia. She’s passionate about leading patient-centered change in healthcare and is an avid cyclist, skier, and snowboarder.
is a board-certified vascular surgeon in private practice in Southern California. She specializes in endovascular & vascular surgery including the treatment of venous disease. In her free time, she enjoys quality time with her son, Bikram yoga classes, and long-distance running.
is an Assistant Professor of Pediatric Interventional Radiology at the Emory University School of Medicine. She is a leader within the Women in IR Section of the Society of Interventional Radiology, in which she works to increase the gender diversity of selected speakers at national meetings.
is a board-certified obstetrician-gynecologist in private practice in Southern California. She’s a world-traveler, outdoor adventurer, burgeoning cook, and trivia geek.
is an interventional radiologist who has spent the majority of her career in private practice. She continues to find her balance with the help of entrepreneurial endeavors since completing her MBA at the Kellogg School of Management. A leader within the Society of Interventional Radiology (SIR), she led the development of the first Women in IR Champion Award.
is an early career IR in private practice. She is a passionate advocate for mentorship, with countless projects completed with the Residents, Fellows, & Students (RFS) Section of the SIR. As a leader within the Women in IR Section and as a SIR delegate for the Young Physicians Section of the American Medical Association (AMA), she continues to lead into early attendinghood.
is a rising PGY-3 IR/DR resident at Stanford Hospitals and Clinics. She aspires to be compassionate, creative, and relentless in the pursuit of leaving her community a better place than how she met it. She likes improv and baking cookies.
is an academic bariatric surgeon. A former Scholar in Residence at the Stanford University School of Medicine, her research focuses on gender equity, well-being, and the challenges women face in the workplace. She is an internationally recognized speaker and an activist against sexual harassment.
is an orthopaedic surgeon in private practice. She is also a mother, half of a dual-physician couple, a writer, a speaker, and a podcaster (The 6% with NancyMD). Through these roles and her online content, she helps open doors for those that wish to be more and do more in their own lives.
is a practicing Vascular & Interventional Radiologist who is board-certified in Internal Medicine (ABIM), Nuclear Medicine (ABNM), and Radiology (ABR). She is a Clinical Assistant Professor at the University of North Dakota. A passionate advocate of women in radiology and informatics, she founded the Facebook community Radiology Chicks.
These women prove it’s possible to save lives and still enjoy your own. I’m inspired by them, and I know you will be too. They’ve found their respective place in medicine. From academics to private practice and beyond, they represent several different subspecialties. They share their experiences and career lessons to help you see that there are many ways to be a woman in medicine.
You can still purchase a signed special edition of the book by clicking right here.
This week’s blog is a guest post from an allied health provider who has transitioned to an alternate career herself. With the ubiquitous concerns around physician burnout and the ramifications for our health systems, I felt this was an interesting share. Are you afraid of burning out early in your career? Let me know what you think in the comments below. -Barbara Hamilton, MD
Working in a healthcare environment is intense and demanding. The epidemic numbers of physicians experiencing burnout has grabbed the attention of third–party payers, legislators and professional organizations.
As the level of technological advancement in medicine rose, healthcare leaders hoped it would improve the levels of physician productivity and satisfaction. Yet digitizing processes had the unintended consequence of producing alienation and disillusionment in even medical students, residents, and early career doctors.
Knowing the factors that contribute to burnout can help keep you from burning out yourself. Just knowing the viability of alternative career options can reduce the risk you’ll feel stuck, should you experience burnout in your career.
The Medscape National Physician Burnout Report for 2020 surveyed over 15,000 doctors. Results showed:
The report also found that reported coping mechanisms ranged from constructive to destructive. The strategy most used was isolation, which can perpetuate burnout. However, the second most used strategy was exercise, which is a constructive method of reducing stress.
Slightly more than 50% of women were willing to take a pay cut to have a better work life balance. But, isn’t there a better option?
According to Dr. Dike Drummond, author, speaker and consultant on physician burnout, “There is an epidemic of physician burnout in the United States, and it has a pervasive negative effect on all aspects of medical care, including career satisfaction.”
Burnout is directly linked to striking number of consequences:
A survey of doctors in 2014 found that 54.3% had symptoms of fatigue. 32.8% reported excessive fatigue, and 10.5% reported a significant medical error in the last three months. It’s no wonder we are afraid of burning out. The price paid by physicians and society is steep.
After completing hours of one-on-one coaching with physicians who experienced burnout, Drummond determined that the five biggest causes are:
Like factors named by Gagné and Deci, who study intrinsic motivation in the workplace, these factors increase a doctor’s risk of burning out. The pillars of intrinsic motivation are autonomy, competence and relatedness. Each has suffered as a result of healthcare restructuring.
Physicians experience a lack of control over their time, contributing to burnout. They are forced to check off boxes to meet billing standards, leaving them less time to develop therapeutic relationships with their patients. These factors are related to the three top contributors to burnout found in the Medscape 2020 report: bureaucratic tasks, hours at work and sensing a lack of respect from administration.
While work-life balance may not have been stressed during medical education, it’s critical to foster a personal balance as a physician. The characteristics that supported great grades during medical school should also be channeled toward personal wellness. Finding balance starts with identifying physical and emotional areas that may have been overlooked in the pursuit of a rewarding yet often demanding career.
Self-care basics: exercise, nutrition and sleep. Under the stress of work, maintaining relationships, and growing a family, basic self-care can fall to the wayside. However, prioritizing physical and emotional health is key to avoiding burnout in the long term. This means adequate exercise, healthy eating and getting 7 to 8 hours of quality sleep each night. These basic strategies improve a physician’s ability to withstand external stressors.
Set boundaries. Doctors who don’t uphold personal boundaries may be at increased risk of burning out. A lack of boundaries between work expectations and down time can create tension and stress, in turn raising the risk of burnout. It is vital to deliberately set boundaries and then protect them as a physician.
Knowing and practicing these simple strategies may help you reduce the potential for burning out in the future.
The skills gained during medical education and practice are remarkably transferable to different career options. Yet a physician’s education is highly specialized. Here are several alternative options that may allow a physician to return to clinical practice later if they are burning out.
Physicians may not consider clinical practice outside their specialty but it is a viable option. Physicians from a variety of specialties find wound care challenging and rewarding. The subspecialty has less stress, a predictable environment, a competitive salary and keeps physicians clinically and procedurally active. Family practice, plastic surgery, internal medicine and vascular and general surgery are just some of the specialties that involve skills that transfer into wound care.
This is a long-standing option that physicians have taken over decades. Physician administrators may be more apt to initiate change based on the challenges and frustrations experienced by clinical staff. Physician administrators often have the respect and goodwill of other doctors in the hospital, which improves their ability to be successful. Hospitals are seeking a balance of clinical and administrative skill to more fully integrate the needs of physicians with the demands of third-party payers. One hurdle some physicians face is a lack of business knowledge needed to run a hospital profitably. Some have completed an MBA to overcome this challenge.
Teaching offers physicians the option of continuing clinical work while engaging with medical students. Most academic positions are seeking physicians who have published in peer reviewed journals and prefer doctors who have specialized. This is an opportunity for physicians who prefer a daily routine and have the background and clinical practice to support an academic career.
Doctors who enjoy writing and translating complex medical concepts into language the general public can digest may consider this alternative career. Pharmaceutical companies, research studies, and editorials all offer venues for physicians to help propagate medical knowledge.
This is an option that allows physicians to continue to interact with patients through clinical practice, while benefiting from predictable hours. Telemedicine is flexible, allowing for a part-time or full-time schedule. In an environment where more people are apt to stay at home, the global market for telemedicine is growing.
Telemedicine and in-home visits are a hot topic and area of study, even in interventional radiology! So if you are afraid of burning out, take comfort in all the options at your fingertips, from preventative strategies to career alternatives in the future.
Author: Gayle Morris is a freelance writer who has written on health and wellness for over ten years. She spent over 20 years as a certified nurse and nurse practitioner before hanging up her stethoscope and picking up the pen.
To hear my personal take on early career burnout and some strategies I used to deal, check out my recorded talk on balance. You can access it by clicking here.
And let me know what you think about this post in the comments below! Share your experience, or your unanswered questions. Are you afraid of burning out?
How can you be endlessly fascinated by your work as a physician? Here are some examples from my life as an interventional radiologist that others in the procedural and surgical fields may relate to.
By looking into someone, a radiologist sees how one has lived their life– from cerebral atrophy to fatty liver and osteoarthritis, many of these processes are a function of a person’s lifestyle. Too much alcohol or multiple strokes can cause brain atrophy. Obesity, poor diet, and alcohol can cause fatty liver…
Osteoarthritis can come from past trauma, or from years of carrying around excess weight.
I think, how does this 90 year old have a brain that looks like someone decades younger? And I look for ways I can improve my own reserve, should I live that long myself. I think about keeping my weight in a healthy range, and moving my body, so I keep my joints strong, but don’t expose them to excess wear and tear. Being familiar with the range of what people’s insides look like is very motivating. I want my own health to last!
It’s a rare privilege to see someone from the inside, in a way many others can’t. It’s really a super power. It takes 4 years of residency to learn these skills– to learn imaging of the body in different modalities from head to toe. Although other specialists learn imaging in their respective areas, they still need our help. Radiologists and interventional radiologists work closely with oncologists, surgeons, emergency docs, hospitalists, and many more. That’s why they call us “the doctor’s doctor.”
Lately, I seem to have seen a lot of superlatives in my practice. It has surprised me that six years into practice, I can still be shocked by what I find when I open a study. For instance, I recently saw the largest pulmonary artery I’ve ever seen, as it took on the appearance of a rounded cardiac chamber more than a typical tubular structure. Just recently, I opened a comparison image to see the largest appendiceal mucocele I have ever seen. Just the other day, there was the most massive liver I’ve seen in the setting of a Riedel lobe and fatty infiltration.
It’s not just the largest things that fascinate me in my daily work, but a cute appendix filled with enteric contrast, which unexpectedly twirles in front of my eyes as a walk through a patient’s images. In the range of normal anatomy, developmental anomalies and acquired pathologies, the work is endlessly fascinating and professionally gratifying.
Beyond diagnosing disease, it’s a privilege to share these images with patients so they can see their own insides! I do this during consultations for fibroids, filter removals, etc. In this way, I can explain for example, why a woman with a fibroid uterus needs to run to the restroom more frequently, or how the position of the fibroid within the uterus affects her monthly cycle. This can deepen a patient’s understanding and appreciation for what’s happening inside. By meeting the patient where they are, I am engaged by my work all over again.
When you apply the skills I describe to procedures, it’s even more stealthy.
That’s why I love sharing my career story and what it looks like behind the scenes as a woman in IR. There are many procedurally-oriented fields and surgical subspecialties that remain male-dominated, so some women may dismiss them, or think they can’t excel there. But the truth is, these careers are challenging and multi-faceted for anyone who’d pursue them.
Unfortunately, even in 2020, some women shy away from these fascinating fields. That’s why I’m still talking about it.
It was my privilege to join Dr. David Draghinas on the Doctors Unbound Podcast to discuss my blog and mission. His podcast is about ALL the things doctors can be- from coaches and business owners to podcasters and beyond! Doctors are an industrious, multi-faceted group. So a couple months ago, I pitched the idea for an episode together: doctors unbound by gender stereotypes.
I had so much fun connecting with the host, Dr. Draghinas. He is an awesome guy, not only for supporting women in male-dominated fields through this episode. Through his podcast, he encourages physicians at large to break out of the sometimes limiting expectations placed on us. He encourages us to find other passions, and get what we really want out of life!
To see the guide to our episode together, click here.
You can listen on this page, or anywhere you get your podcasts. It’s episode number 147 of Doctors Unbound with Dr. David Draghinas.
Let me know what you think of our chat!
And if you want to learn more about learning to take on a leadership position in our cultural milieu, check out my audio recording called “Being Nice… As a Boss Lady.” Even as you’re endlessly fascinated by your work, you can learn to lead your team to greater heights with the mindset I describe.
Now go have a listen! And please share this with a friend who needs it today.
How can you be endlessly fascinated by your work as a physician? Here are some examples from my life as an interventional radiologist that others in the procedural and surgical fields may relate to. By looking into someone, a radiologist sees how one has lived their life– from cerebral atrophy to fatty liver and osteoarthritis, […]
...and perfect is the enemy of good.
These concepts in medicine & parenting are parallel.
As a female physician, are you allowed to be confident? Are you allowing yourself to be confident?
What does self-care, parenting, and life outside the hospital look like for a parent in a high-octane field?