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tired superheroine

what does a momma doc actually do with a week off?
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What does a momma doc do in her spare time?

Balance

As an interventional radiologist at a trauma center, I also happen to be a human and a mom. You might wonder, how do I balance the sometimes demanding, unpredictable schedule of emergency call with the rest of my life? Well, I take a week off nearly every month, for a total of 10 weeks per year. That might sound like a lot, when you’re used to 3 or 4 weeks off per year as a trainee! So what does a momma doc actually do with all this time off? Here the top 10 things you’ll find me doing in my spare time. 

Extended a.m. routine

1. I’ll extend my morning routine. This might involve sleeping an extra few minutes, but I don’t sleep in like I used to pre-child. I get my little man ready and off to pre-school by 8:30. We have some time for coffee, breakfast, and potty. This gives my husband a break, since he does toddler mornings when I’m working. 

Self-care for a momma doc

2. On a week off, I’ll head to some appointments. Whether I need a skin check at the derm, new tires, or a sit-down with my accountant, it’s all part of self-care as a mom who also works outside the home! And every week off is an opportunity to see my therapist, who helps me with relationships and stress management.

3. Eat healthy food. I fast until 11, then fill up on some eggs and avocado toast. If I crave something sweet or feel like a bottomless pit, I might make a protein shake from Body Love

Strategy for the momma doc

4. Whether I’m working or not, I blog. When I’m off, I have more time to brainstorm upcoming topics to share here. I’ll also write drafts, edit, format, and publish posts. I used to plunk down at a coffee shop for a few hours at a time to do this, but I’ve gotten more efficient with practice. 

5. Manage the finances. I look at all our accounts, and make sure the money is going where it’s supposed to. How is my 401k balance doing? Do I need to reinvest some dividends? How’s our progress toward savings goals? Or do I have excess cash lying around, looking for a job?

Family matters

6. Most days, I aim to get outside with my little dude, who is three. Whether we head to the park after school, or visit our equine friends at the local stables, we make it a point to get out for some desert sunshine. 

7. Hang out as a family. This can involve a trip to the local air museum, bubbles in the backyard, or recording the latest musical sensation in our little studio. 

Sharing the message of the empowered doc

8. In the evening, I’ll sign and send some copies of Save Lives, Enjoy Your Own. I love my label printer, which reminds me of my play cash register as a kid. Any chance I can feel like I’m playing is a win!

9. Strategize how to reach more people with my book and its message. This involves researching people of influence like medical school Deans and podcast producers, so I can introduce myself.  

Mind the timeline

10. Though most weeks during the pandemic involve staying home, my list had to include checking off a bucket list item. A recent example: I’d been dreaming of seeing Grand Teton National Park for a decade. So I convinced my husband to get on board, and we piled in for our first socially-distanced RV adventure, traveling from Palm Springs, California to Jackson, Wyoming.

Was it worth the drive? Heck yeah, it was! I relished the change of scenery in a whole new way I don’t think I could have pre-COVID.

Medical training teaches you to put your nose down and work for long-term gains and delayed rewards. But after training comes the rest of your life, and it’s finite. So don’t forget to assemble your own Grand To-Do List, and start checking things off!

What’s on your bucket list? 

What are you most likely to do on a week off, once the laundry is done, and you’ve called your mom?

Tell me in the comments below!

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an ideal week at work
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What’s my ideal week look like?

Career & Leadership

I’m beyond pleased to tell you, I’ve completed my book giveaway as part of the launch of my new book, Save Lives, Enjoy Your Own. I’ve sent over 700 books around the globe, from the US to Switzerland, Nigeria to Saudi Arabia, and Hong Kong to Australia. This process involved a steep learning curve. Sometimes I fought with my email service provider, other times I was running to Staples for a critical roll of label tape. Sometimes I had a surge of energy, personalizing an inscription by first name, wishing them success in their career and beyond! Other times my signature looked like a middle school boy’s boxy scrawl, signaling the fatigue I didn’t realize was creeping in. All of this was actually a part of an ideal week for me. Why? 

Because as I signed and packed each book, I knew it had the potential to change the course of someone’s future career. I knew each little package could contain just the encouragement the recipient needed to become the next superstar in medicine. 

What’s an ideal week for me as an interventional radiologist?

Once, a mentee asked me what an ideal week looked like for me, as an IR. It’s an interesting question, and it varies from week to week. Since I spend most of my work life at a level 2 trauma center in the community, I’ll describe my ideal week there. As to my ideal week off, that looks pretty different, so I’ll write about that next. It definitely deserves its own blog post. 

Rolling out of bed: before 8 am is an emergency

My ideal week as an IR involves coming in each day at 8 am. I’m on call through the night, and the ideal week involves racing in once per week to rescue a bleeding trauma, whether from a pelvic crush injury or a liver laceration. The best weeks for me include a moment where I sweat: I race to fix the bleed as fast as I can. 

Since I thrive on the variety of cases in private practice at my insitution, the ideal week also includes a uterine artery embolization with peri-procedural management and follow up. It involves a few image guided biopsies, where I can stretch my ultrasound skills a bit, and perhaps a thermal ablation of locoregional disease, like a liver metastasis. I love doing peripheral arterial work, and I recently had the pleasure of taking over a case from a colleague, where he thrombolysed, or dissolved clot in the popliteal artery harboring an underlying aneurysm. I was able to exclude the aneurysm with a well-positioned stent-graft.

The ideal work week includes routine cases, too

My ideal week involves bread and butter cases like permcath & port placements, declots, bone biopsies, and abscess drainages. Every case is an opportunity to hone my techniques, with the goal of operating as painlessly and stealthily as possible. Routine cases also allow for time to teach my growing team about peri-procedural management for common procedures. 

A typical week involves going home anywhere between 3 pm and 8 pm when I’m on call. At my hospital, one IR is responsible for all the work that comes in, so we leave when the work is done. There is a typical rhythm to each week: I stay a bit later on Mondays and Fridays, while the mid-week days are (a bit) more predictable. Even on call, I might meet a friend for dinner, as I did the other day. 

The evening routine

When I’m not catching up with a friend, most nights I’m headed home. Thursday nights my husband teaches a music lesson, so sometimes I’m rushing home just in time to be with my little boy as my husband starts his lesson. We eat and play, this week, rolling a rubber ball around the living room. Wes takes a bath while I shower, then he demands a late night snack as I try to brush his teeth.

After our little sprite is down, my husband watches some of a movie, while I listen to a mindset recording. We prepare to get some rest! 

Getting going each morning: my routine

Mornings involve a pot of coffee and a simple routine before I’m out the door. I have a blessedly short commute of less than 10 minutes to our local hospital, and I appreciate that every day. Side note: I highly recommend you take this into account as you choose a job and place to live, when the time comes. A shorter commute= a better quality of life!

At work, I supervise residents who are interested in learning simple procedures like paracentesis, catheter removal, and the like. They pop in and out of my procedures when they can, and they come to me with questions. Though I don’t have radiology or IR residents, I enjoy the teaching and interaction that occurs at my community teaching hospital with trainees of different stripes.

My ideal week has room to breathe

During room turnaround time, or during quiet moments, I might type up a blog post like this one, or edit, or format one. I might call a plumber or make an appointment to see my accountant on my next week off. There’s usually some space in the day to have a phone call with a colleague, answer some emails, or complete a task for my committee work with the Society of Interventional Radiology

In summary, my ideal week at work involves some straightforward cases mixed with a breadth of challenging cases and consults. I truly enjoy my work, and generally don’t feel it encroaches too much on family or personal time. Even during busy weeks, there is plenty of time for sleep and basic self-care.   

Taking care of myself as I care for patients

I always sit down for lunch, but the specific time varies, since I squeeze it in between cases. During my break, I chat with colleagues in the doctors’ lounge about our patients in common, hospital politics, and life. Each day, as long as I eat lunch and have time for tea, I feel like I’m taking care of myself, no matter how hard I’m working. 

An ideal week is one in which I feel I did the best work I could, and no one got hurt. It’s one in which I feel in sync with my colleagues, and we have a chance to talk about the practice and any issues at hand. If I got to save a life or help a patient understand their condition better, that’s icing on the cake. 

What’s your ideal week like right now? Or, what do you think your ideal week SHOULD look like? Build the ideal week for you, and you might just find it out there in the job market!

Share your thoughts by leaving a comment below. 

And a final note for this week: THANK YOU to all the sponsors who bought books for students and trainees around the globe! I couldn’t have accomplished this without them.

Click on their names or business names to learn more about the good they are doing in the world!

The Save Lives book giveaway was accomplished with the help of the following sponsors: 

Physician on FIRE

Guerbet Medical

PearsonRavitz

Argon Medical

The Physician Philosopher

Dr. Agnes Solberg

Dr. Tara Hanjan

Dr. Shervin Rafie

Dr. Monica Uceda

Dr. Arun Thunga

Dr. Damien Dupuy

Dr. Hirschel McGinnis

Dr. Allan Lipkowitz

Dr. Linda Armstrong

Dr. Grace Huang

Dr. Eric Presser

Dr. Carlos Ledezma

Dr. Learned Gonzales

Dr. Mike Obedian

Student Loan Planner

Dr. Linda Street

PassiveIncomeMD

Kelly Schoenfeld 

Dr. Sandra Weitz

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you really can have it all
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This entrepreneurial superheroine claims you really CAN have it all.

Career & Leadership

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.

-Tired Superheroine

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.

The beginning: before having it all

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. 

Figuring out where I belonged in medicine

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. 

Re-evaluating what we’d built thus far

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. 

Misaligned expectations

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.

How I faced new challenges

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.

Deciding to “have it all”

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. 

Investing in patients… and my future

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. 

You really can have it all

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.

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Important Questions from the Northeast VIR Symposium
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Critical Questions from the Northeast VIR Symposium

Career & Leadership

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.

Tell us about yourself & your path to VIR

  • I’m a private practice IR in Southern California
  • Now 6 years out of training
  • I’m Chief of my IR section
  • I’m a wife and a mom to a little cherub
  • In the last couple years I’ve become a blogger and author!
  • My path to IR was via diagnostic radiology. I did residency at Brown and IR fellowship at UCLA. 

What other fields/specialties did you consider going into and why?

  • Family med- because of the breadth of practice, which is similar to radiology. You need to know about a lot of different things, and that keeps it interesting. I envisioned a role in primary care in which I’d do procedures– which is more common in the western part of the country. 

How did you go about seeking mentors during your training? What does mentorship mean to you as a woman in IR?

  • I found the process intimidating. 
  • Ultimately, the process of finding my mentors was somewhat organic. My 1st mentor was a woman in radiology who lectured us in med school. After her talk, I went up to her and made contact.
  • Later: it happened organically. Some people are more supportive than others. But I learned from all! 

What do you think are some of the misconceptions that may deter students from pursuing IR? How can we change that?

  • The idea that it’s not for women
  • That it’s not for women who want to have kids
  • That it’s so competitive that you have to be from an elite physician family
  • The idea that radiation is bad for women
  • How to change it? By being an example of what is possible
  • Showing the positive aspects of the field for women
  • Correcting misinformation regarding radiation and specifically, radiation in pregnancy

How have you been able to balance your career in IR with other interests/non-medical pursuits?

  • I strongly believe everyone has a choice in how they spend their time. Everyone has free time if they care to find or make it. Once you find time, you can harness it with passion and focus. That has allowed me to write my blog between patients, or to apply for a leadership position as I’m waiting for a trauma patient to be prepped. I used to fritter these moments away, but I’ve found satisfaction in using them more intentionally.

Can you speak to your time in leadership roles and give advice on making leadership a part of your career?

  • I like to talk about the messiness of learning to lead, because we all think of leaders as exemplary specimens of perfection. In order to learn to lead, you need to embrace the messy imperfection of leadership in medicine
  • I talk about my own experience and lessons specifically in the context of early career leadership in a private practice environment. 
  • Beyond local leadership, there are countless opportunities to learn to lead in our societies. These can be great places to find leadership opportunities. 

Have you had a particular challenge which you had to overcome on your path to IR that has left you with a lesson you could pass on to students or trainees?

  • Learning to listen to myself as I entered an elite hierarchical world where everyone knew more than me. I needed to learn I still had a valid guiding voice inside. 
  • Learning to nix the naysayers. It’s a skill to parce through advice which may be tinged with baggage or bias. Sometimes you need to discard the advice if it doesn’t suit you or your situation. 

Can you talk about any experiences you have had with imposter syndrome in medicine? What strategies have you used to overcome these experiences?

  • When you enter IR, it’s so foreign. Some students and trainees act like they may understand everything that’s happening, even if they don’t. Sometimes, it takes learning a ton of a field for everything to fall into place. So if it feels that way in IR, that’s OK. It doesn’t mean you can’t do it/ will never get it. 

What words of advice do you have for those interested in VIR and other male-dominated fields?

  • Don’t settle on a career just bc someone tells you it’s “more woman/ family-friendly” 
  • Follow your interest, and your work will always be enjoyable. 
  • Working with your hands in these procedural and trad male-dom fields is some of the coolest most gratifying work in medicine!

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.

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do residents actually need an emergency fund?
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Does a Resident Actually Need an Emergency Fund?

Financial empowerment

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

Does a Resident Really Need an Emergency Fund?

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

What if you’re a resident earning $60,000 per year?

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.

What if you are repaying your student loans?

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.  

Where should a resident keep her emergency fund?

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.)

What’s the difference between a savings account and an e-fund?

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.

What if you have other debt?

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.

What do personal financial experts say about the emergency fund?

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. 

A final word on emergency funds

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. 

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practical financial considerations for the budding doc
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Practical financial considerations for the budding doc

Financial empowerment

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.

1. Your career choice should not be made based on financial factors.

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!

2. You’re learning to tolerate debt right now, but you can regain control of your finances, once you have the tools. 

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!

3. Lifestyle creep is a practical financial consideration!

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!

TiredSuperheroine

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behind the scenes of a book launch
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Exclusive look behind the scenes of a one-woman personal relations firm!

Career & Leadership

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!

What’s a book launch?

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.

Behind the scenes: getting ready to celebrate

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).

It’s all thanks to sponsors who believe in you behind the scenes

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!

It’s inspiring. 

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!

How can you thank me? 

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. 

Xo, 

TiredSuperheroine

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book launch for Save Lives, Enjoy Your Own: Finding Your Place in Medicine
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Get on board the book launch for “Save Lives!”

Career & Leadership

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!

It’s ready for launch!

Secure individual copies of the book

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!

Bulk book orders for groups, schools & hospitals

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 tiredsuperheroine@gmail.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!

Join the launch for guest speakers & giveaways

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

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Is it safe to use fluoroscopy when you're pregnant?
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Is it safe to use fluoroscopy when you’re pregnant?

Balance

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?”  

Is it safe to use fluoro while 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.

What you may do differently while pregnant

 Get a fetal dose badge

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. 

Extra lead & adjunctive shielding methods to use when you’re pregnant

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.

What doesn’t change when you’re pregnant

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. 

Naysayers and complications in pregnancy

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.

Physical demands on the pregnant doctor

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!

Postpartum logistics

Parental leave

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. 

Enlisting support as a new parent

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. 

Breastfeeding as a busy proceduralist or surgeon

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!

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Save Lives, Enjoy Your Own: Finding Your Place in Medicine
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Save Lives, Enjoy Your Own: Finding Your Place in Medicine

Career & Leadership

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.

Who it’s for

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.

Foreword

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.

What’s keeping some women from saving lives?

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!

Contributors for Save Lives, Enjoy Your 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.

Theresa Caridi, MD, FSIR 

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.

Hannah Clode 

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.

Laura Findeiss, MD, FSIR, FAHA

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.

Anna Gasparyan, MD 

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.

Anne “Annie” Gill, MD

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.

Lara Hasan, MD

is a board-certified obstetrician-gynecologist in private practice in Southern California. She’s a world-traveler, outdoor adventurer, burgeoning cook, and trivia geek.

Aneesa Majid, MD, MBA, FSIR

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.

Natosha Monfore, DO

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.

Lola Oladini, MD, MBA

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.

Arghavan Salles, MD, PhD

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.

Nancy Yen Shipley, MD 

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.

Agnieszka Solberg, MD

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.

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Done is better than perfect

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...and perfect is the enemy of good.
These concepts in medicine & parenting are parallel.

career, balance

Save Lives, Enjoy Your Own: Finding Your Place in Medicine
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Save Lives, Enjoy Your Own: Finding Your Place in Medicine

Career & Leadership

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 […]

Grab a hot tea & stay a while!

WElcome to the BLog

The TiredSuperheroine blog is all about building your career capital and thriving in a male-dominated field.

Confidence

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As a female physician, are you allowed to be confident? Are you allowing yourself to be confident?

career

Balance & parenting as a momma doc

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What does self-care, parenting, and life outside the hospital look like for a parent in a high-octane field?

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The path can be riddled with failures, even if you're doing it right. In this recording, I share some of my gaffes with you.

Failing Forward

FREE audio