Careconnectix.com -The New Face Of Medical Travel

Another barrier falls.

Despite the growth of domestic and global medical travel, patients leaving home for care, there are still major blocks to widespread adoption and penetration by patients and doctors. One is the communications firewall that exists. That's why we've created a free, global healthcare social networking site at www.careconnectix.com

By registering on Careconnectix, doctors can now exchange information about their countries , their credentials and specialty interests and other pricing and quality information patients need to make a reasoned healthcare purchasing decision base on value. Patients, on the other hand, can exchange medical travel experiences, rate their providers and share stories about they found quality care at an affordable price around the world.

If you are interested in being part of this growing international conversation, please join us at www.careconnectix.com, the new face of global care.

Physician vs Weatherman

By James Barone MD

Why wouldn't any physician want to be a weatherman?

As I sit here this morning, two inches of snow are on the ground and the snow shows no sign of letting up. The forecast was “Snow showers with no accumulation.” Once again, the forecast was wrong.

Just how accurate are weather forecasts? A New York Times article described in detail a study that was done in Missouri. It showed that television meteorologists were remarkably bad at predicting the weather and the further out the forecast went, the worse they did.

A website called “Forecast Advisor” tracks the accuracy of forecasts for any area of the country. For New York City last year. The first screen shot shows three different forecasts for today. The first was posted yesterday and the other two are revisions. None are correct as it is snowing heavily right now. The second screen shot lists cumulative accuracy statistics for the New York City area. At first glance, the accuracy for last year looks pretty good. But here’s an interesting thought. According to the New York Times article if you predicted it would not rain every day, you were right 86% of the time.

The website Weather Report Card gave “D” grades to all five major weather services that it follows regarding both temperature and precipitation forecasts for yesterday, January 24, 2011.

Now contrast this with my current profession, general surgery. How would you feel about me if I told you I made the correct diagnosis of appendicitis 76% of the time last month? Or say I told you that you needed hernia surgery but my record of actually finding a hernia was 86%? I think I would very soon be out of business.

Not so the weathermen. It seems that they are immune to criticism or accountability. In fact, the Times report stated, “When station managers were asked about this [accountability], one said, ‘There’s not an evaluation of accuracy in hiring meteorologists. Presentation takes precedence over accuracy.’”

This is why I’d like to be reincarnated as a weatherman. You can be wrong as often as you like. And if you are, no one cares. In addition, you get to engage in witty banter with the news anchors and the sports guy. My really special reincarnation wish would be to come back as the guy who stands on the beach during a hurricane and tells you it’s raining hard as my hat blows away and billboards fly past. By the way, what do those guys do when there are no hurricanes? I want that job too.

About: James Barone MD has been a surgeon for almost 40 years and a surgical department chairman for over 23 of those years. He blogs at http://skepticalscalpel.blogspot.com/

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Disability Insurance for Physicians: Essential Features

In a previous post I discussed the single most important feature of disability insurance for physicians—the definition of disability.

But there are multiple other features of disability insurance you need to think about before you buy additional insurance or if you are buying a policy for the first time.

Before I discuss those features, why exactly do you need disability insurance to begin with? Here are some sobering  statistics to think about:

1. Almost 20% of working age people have a disability—half of these are severe
2. There is a 1 in 8 chance of becoming disabled before age 65
3. Only about 25% of working people with a severe disability are employed
4. It is much more likely (nearly ten times more likely) that you will become disabled than die during your working years

Let’s take a look at the key features you need to think about your disability insurance policy:

Benefit Amount.  Next to the occupational definition of disability this is the next most important feature of your policy. Your benefit amount is related to your specific occupation. So higher risk specialists such as emergency medicine physicians will qualify for a lower benefit amount than lower risk physicians such as internists.

The benefit amount also depends on the income you make since the insurance company won’t pay out more benefits than your current income. Typically you won’t be able to buy insurance greater than about 60-70% of your gross income.

But one common mistake I see most financial advisors and physicians make is that your benefit amount should be correlated as close as possible to your current monthly expenses. If you don’t know what you’re spending today, then how do you know what amount of disability insurance to get? So sit down and figure out what you’re spending before you buy a policy. I know physicians who spend $20,000 per month or more and have disability policy benefits of less than $10,000 per month. Will you be able to get by on disability benefits that are significantly lower than what you’re spending right now?

Elimination Period. This is similar to a deductible in the sense that disability benefits typically don’t kick in until several months after you are totally disabled. In effect you are paying for your disability out of pocket until benefits kick in. The most common elimination periods are 90 days and 180 days. So if you become disabled today and you have a 90 day elimination you won’t receive your first check until the 4^th month of being disabled (7^th month for 180 day elimination period). So this again gets back to the issue of what you’re spending. How long can you get by with your current savings before you need income? If you can’t get by very long, your disability policy should have a short elimination period but if you have adequate savings, choose a longer elimination period to save on the premium.

Next time I’ll discuss other features that you need to consider in a disability insurance policy.

2011 Medical Fusion Conference Faculty

Medical Fusion faculty members talk between sessions. From left to right: Dr. Natalie Hodge, founder of Personal Medicine; Dr. John LaPuma, New York Times best-selling author and founder of ChefMD; Dr. Jeffrey Segal, founder of Medical Justice; Dr. Steven Peskin, Executive VP and CMO of MediMedia

The next Medical Fusion Conference will be November 11-13, 2011 at the Aria Resort in the new City Center development on the Strip in Las Vegas.  

For those of you who have never attended one of our Medical Fusion events, the purpose of this conference is to help physicians learn how to apply their medical training in unique ways.  We scour the country to find experts who can help those in clinical medicine develop career niches using their medical expertise, and we have a good time learning from these experts while we hang out at a fabulous Vegas resort.  

Basically, the Medical Fusion Conference is Freelance MD come to life, a place where you can meet and interact face to face with many of the authors and experts here at Freelance MD.

For 2011, I am pleased to announce yet another incredible faculty list.  We have individuals from many niche areas who will be teaching conference participants how to take control of their careers and apply their medical knowledge in many unique ways.

So without further ado, here's our 2011 Medical Fusion Conference faculty:

• Dr. Julie Silver, Chief Editor of Harvard Health Publications
• Dr. Steven Knope, author of Concierge Medicine: A New System to Get the Best Healthcare
• Dr. Barry Silbaugh, president of the American College of Physician Executives
• Dr. Setu Mazumdar, founder of Lotus Wealth Solutions
• Dr. Kenneth Cohn, author and founder of HealthcareCollaboration.com
• Dr. Mike Woo-Ming, internet entrepreneur and founder of IncomeMD.com
• Jeff Barson, founder of MedicalSpaMD.com , co-founder of FreelanceMD.com
• Dr. Alan Neuren, independent disability consultant
• Ms. Ashley Wendel, consultant for physicians pursuing nonclinical careers
• Dr. Gary Taff, serial entrepreneur and real estate investor

Together this faculty represents the best source of information for physicians interested in developing a unique and meaningful career.  

Topics for the 2011 Medical Fusion Conference include concierge medicine, monetizing your blog, cosmetic medicine, product development, writing/publishing, internet entrepreneurship, real estate investment, developing your niche as a consultant, physician career transition, financial management, and much more.

I'll be writing more in the future about this faculty and some of the interesting personalities you'll meet at our event.  

If you're interested in attending the Medical Fusion Conference or just have some questions for us, feel free to contact us here at Freelance MD or call our event offices at 866-924-7929 .  Be sure not to wait around, though, since this event will fill up quickly and we want every one of our Freelance MD readers to have the opportunity to attend.  

If you like Freelance MD, you'll love the Medical Fusion Conference and we'd love to have the opportunity to meet you face to face.

Working For A Small Or Startup Company: The Other Side Of The Coin

If you don't want to get in bed with Big Pharma or Big Device, think small.

Several of my co-authors on this site have described their experiences working for large biopharmaceutical or device companies. While I work with a few as a consultant, most of my experience has been in starting and developing my own companies or consulting to early stage companies. Here are some experiences and lessons learned working with small companies:

You are being hired to provide the 3 C's

Early stage companies hire you because you provide the 3 C's: credibility, content and domain expertise and connections. They want your credentials on their website to raise money and establish credibility with investors. They want you to connect them to other thought leaders, users or participants in future clinical trials. They are looking for bioangels and early stage investors and turn to you for connections. They don't want you just because you have MD after your name.

Startups expect you to work for equity

Early stage companies have little or no money. Their first priority is to save cash and survive to the next step of development and commericalization. If you don't have that kind of risk tolerance or are looking for a big salary supplement, you are barking up the wrong tree.

You will be a co-chief cook and bottle washer

This is the fun part. In the beginning. there will be an organizational chart that includes the CEO, Sales and Marketing, Finance and other functions. In the beginning, maybe two or three people fill the boxes. You will be expected to supplement them and play multiple positions on the team until it gets to the point where the company can afford to hire specialists, like a CFO to help with a private placement memorandum, or a Director of Sales and Marketing to handle the sales force.

You will fail more often than you succeed

Let's face it. Creating a successful biomedical company is a crap shoot. Don't put all of your eggs in one basket and try to work with a portfolio of companies to increase you liklihood of success. The more experience you get, the better you will get at spotting the losers up front.

If you want to work with industry, you don't have to be the Man in the Grey Flannel Suit. I think it's more fun to wear jeans and a black tee shirt.

Non-Clinical Careers: Working For A Large Corporation

Physicians looking for non-clinical careers in industry can learn from the mistakes of others.

In general, physicians are an independent breed—and have traditionally been captains of their own ship. Some may have gone to medical school partly to become their own boss. Private practice allows for such independent-spirited behavior.  

All this seems to be changing, doesn’t it? Rapidly, one way or another, physicians are becoming part of large organizations. Very few graduates of residency programs are starting their own practices—and the number joining a private practice is shrinking. Many are becoming salaried employees of large medical groups or healthcare organizations.  This may say something about the lack of independent business sprit among physicians, or it may say something about their lack of options in this regard.

Some may be coping with the situation reasonably well.  But what about those who are looking for non-clinical roles in industry? If you choose to pursue a career in a leading medical device or pharmaceutical company, you could be adjusting to a new reality—working for a very large corporation, with tens of thousands of employees. One of the pharmaceutical giants now has over 120,000 employees! 

I have worked in both the medical device and pharmaceutical industries for 30 years. My career has involved senior management roles in companies ranging from $100 million in sales and 300 employees to over $15 billion in sales and 20,000 employees. While the overall experience has been very positive, the process was not always smooth for a physician learning about business in real time.

Now, don’t get me wrong. I don’t want to give the impression that the view from the top is not worth the climb in industry. You may very well find the right company with an incredibly rewarding role for the next chapter of your life. But you should go in with your eyes open.  

I want to share some observations and insights I have gained in the process of adjusting to working for a large corporation. Yes, there are many books on how organizations should work. But then, corporations don’t always read these books. So, I will draw from my own experience—and the mistakes I’ve made in my career transitions.  Why should I be the only one to learn from my mistakes?

First mistake: I thought it would be easy. Since medical device and pharmaceutical companies are in the healthcare arena, I thought the organizations would make it quick and easy for a physician to work in industry.  But my experience in medicine did not prepare me for the way a staff member of a large organization has to move at the speed of the whole organization—and in paths the organization had laid out. Large organizations are complex, and their decision-making processes may be convoluted.  Organizations have their own cultures and hierarchies, and each has different channels for information.  And it isn’t just that the decision-making is a slow and complicated process.  Just learning how it works (and how to make it work) requires considerable time and effort.  Get ready to learn a whole new language and set of acronyms for each business. 

Second mistake: I assumed the organization would adjust for me. The culture of an organization is a complex set of behavior patterns, values, and beliefs. Joining a large corporation requires that you become a part of this culture. Thinking that you can change the culture is hopelessly naïve.  Of course, the culture of any organization must evolve, and you may be an important part of this evolution.  But ultimately, you will be expected to adjust to the organization rather than vice versa.    

Large organizations are a great pool or resources, but these resources are not always there to help you. Change or development in one area usually means de-emphasis in another. As a result, some of the organization will always be skeptical or threatened by change—and may act in ways intended to protect their area at the expense of others. Moreover, even with conceptual support for what you do, everyone is very busy keeping his or her own house in order—and may not have much time to assist you. At times, it feels as though you succeed in spite of the organization rather than because of it. 

Third mistake: I assumed I’d have better work-life balance. A clinical practice can be very rewarding.  Unfortunately, this comes at a price—for the demands are high, and the hours are long. When I decided to work in industry, I expected there would be some trade-offs. I thought I would have to give up something financially—but I would have more time for family and other interests.    

What I have learned is that the demands can be just as high, and the hours can be even longer in a senior management role in a large corporation. Performance expectations revolve around delivering results (measured frequently) and creating value for shareholders and staff as well as patients. Senior executives are expected be available virtually 24 hours a day, seven days a week.  And some roles may require a significant amount of travel—and time away from family. While some companies talk about work-life balance, this could prove to be an unrealistic expectation.        

Looking For A New Opportunity?

Build a chain of Surgitels

Jackie G, a 23 y/o investment banker and avid tennis player, has arrived at the Meyers Palo Alto Surgitel following her arthroscopic shoulder surgery in a facility across the street from the hotel. Jackie lives in Denver, but came to Palo Alto because of the reputation of her surgeon, Dr. Meyers, who charged a lot less than her Denver based orthopedist. MedVoy has recommended she spend the first postoperative night at  the Meyers Surgitel Suite because of its reputation for catering to patients needing accommodations following discharge from a medical facility or needing a place to stay while getting outpatient treatment. Jackie is accompanied by her girl-friend, Sara, who will be watching over her.

Fortunately, everything went smoothly with Jackie’s operation and she was discharged from the Palo Alto Surgicenter at about 3Pm that afternoon. A hotel van takes Jackie and Sara from the Surgicenter to the Meyers Surgitel. They arrive via a private entrance with a wheelchair ramp and are met by a hotel greeter who wheels Jackie in her wheelchair to her room. Jackie and Sara have been preregistered. The room is on the ground floor with spectacular, soothing views , just right for a patient who needs rest and relaxation. The room looks like no room she has stayed in before…part hospital, part hotel. All the surfaces are antibacterial and the bedroom and bathroom have guard rails, walk-in tub and antibacterial soap to clean her wounds. The sink in the bathroom has fixtures that allow her to turn on the water with her elbows, an advantage for someone who arm is in a sling. Her friend, Sara, is staying next door and can enter through a common door. There is a small kitchen so Sara can make Jackie a bowl of oatmeal for breakfast.  The room service menu accommodates her special post op needs as does part of the menu in the hotel restaurant. An inconspicuous storage locker has medical supplies and wound dressings for medical professionals who might come to the room to visit her before she leaves for home. Her postoperative pain medicine has been delivered to her room, thanks to an arrangement made with a local pharmacy chain. She attaches her cooling shoulder apparatus.  A computer monitor allows her to communicate with her doctor and the doctor’s staff as well as her children back home. It also asks her to review a video of postop instructions before she leaves and confirms that she has done so.

During the night, Jackie is awakened with pain in her shoulder. She calls the medical concierge who has the contact information for the orthopedist taking call for Dr. Meyers. Within minutes, she gets a call and is reassured that this is a normal event following her surgery. Soothed by the presence of her Shetland sheepdog, Charlotte, sleeping next to her, she has an uneventful night.

After breakfast on the deck of her room, Jackie and Sara check out online, the bellhop takes their bags and they leave through a private exit to a waiting vehicle that will take both Sara and Jackie to her surgeon for a postop check (if she can’t come to her room) and then to a relaxing three day recuperation at a local spa arranged by MedVoy as part of her medical travel experience. They even allow pets. Much to her surprise, a few months after returning home, Jackie receives a check from her health insurance company as a reward for helping them keep down medical costs. Jackie bought a new tennis racket.