Social Media For Non-Clinical Physician Jobs?

I wonder if social media is used by a greater percentage of physicians who are looking for non-traditional or non-clinical jobs than their clinical counterparts?

AMN Healthcare’s "2010 Social Media Survey of Healthcare Professionals," which was released December 14, shows findings suggesting that traditional recruitment methods such as referrals, online job boards and search engines are still more preferred by job seekers than social media; however, social media is now more preferred than methods such as newspaper ads, career fairs and other methods. Additional findings from the survey include:

• Thirty-eight percent of clinicians surveyed are currently seeking employment, and 12 percent of current job seekers have been looking for more than a year.
• Nurses have had a significantly shorter job search than their fellow professionals, averaging three months, compared to just less than seven months for physicians and allied professionals, and nine months for pharmacists.
• Thirty-seven percent of clinicians reported using social media for professional networking; nurses had the highest use among healthcare workers at 41 percent.
• Ten percent of healthcare professionals are using mobile job alerts, but only 3 percent have received an interview, 2 percent have received a job offer and 1 percent secured a new job.
• Physicians are by far the heaviest users of mobile devices for professional reasons among their medical colleagues; 37 percent used healthcare-related applications and 17 percent used mobile devices for healthcare-related content or jobs.
• Sixty-four percent of the clinicians surveyed would choose Facebook, the clear favorite, if they could choose only one social networking site.

To be honest, the survey's decision to categorize online physician job boards — like our own at http://jobs.FreelanceMD.com — as 'traditional' seems inaccurate. I would categorize Freelance MD, and our job boards as 'social media' since it depends upon online interaction between individuals to a great extent.

Locum Tenens As A Physician Career?

By James H. Bledsoe, MD, FACS

Locum Tenens can be a rewarding, if non-traditional career for the right physician.

With all of the  changes that medicine is experiencing, I felt compelled to write about my time spent as a locum tenens general surgeon. My experience is probably similar to many who already are going to places where their services are needed and very much appreciated. Having said that, I must state that there are no two physicians that have the exact same reasons to do locums nor are all of the assignments the same.

After serving two years in the Air Force, assigned to a regional hospital, I started private practice in Arkansas in what was a  small community hospital in 1976. I was there for a year and a half before moving to a larger community hospital. Even though the hospital had only 165 beds, it was a very well run institution with great services. As a general surgeon, I was called on to perform major vascular and thoracic cases. My associates and I were repairing abdominal aortic aneurysms – both elective and ruptured. During that time we performed three distal spleno- renal shunts for bleeding esophageal varices. On two occasions we performed extra-anatomical grafts for infected aortic grafts. Some of the many thoracic procedures included pneumonectomies and esophageal resections. Since I was responsible for the patients’ follow-ups, I can state with certainty that with very few exception these patients did well.

During these years, we had a significant number of major trauma victims and unless they had a bad head injury we took care of them. I will not dwell any more on the types of surgical cases I was involved in, but suffice it to say it was varied and many patients were involved. Early on we had no blood bank or arteriography capabilities. The arteriograms were done in a facility 25 miles away and we obtained blood from the blood bank 75 miles away. No ultrasounds were available much less MRI nor CAT scans which came later. Discussion of the logistics involved under these circumstances is for a later date.

In my own personal practice I was starting to stay more with strictly general surgery which by now included laparoscopy. Vascular and thoracic surgeons were starting to open practices in our area so the decision to limit doing these cases was much easier.

Also, the politics in medicine was becoming a real issue. Physician practices and hospitals were being bought up and this created awkward situations for referring doctors to send patients to a specialist outside their network. Referral lines that had been present for years were disrupted. In short, instead of medicine being in large part a ministry it was becoming business. Physicians were now working for their respective corporations -  not their patients.  I am not necessarily saying that this is altogether a bad thing but it was quite different.

Another factor in my life was that my children were now married. My oldest son is an Emergency Medicine physician working in Alabama, my other son is a surgeon working in Louisiana, and my daughter is on maternity leave as an attorney for a law firm specializing in malpractice defense.

The factors mentioned plus I am trying to slow down all played roles in my decision to look for a change. Locum tenens appeared to be a viable possibility. It certainly seemed better than retirement.

I knew very little about locums so I had a lot of learning to do. Still I was so certain  that I was ready to change courses that I stopped my private practice and began my research. I signed on with two locums companies and within weeks I started assignments with them. My first assignment was in New Hampshire and I was able to start immediately because in this state you can get a temporary license. (Not all states have this provision and in most states it takes as long as six months to receive a license so it is wise to be proactive so that you can keep gaps in your work schedule at a minimum.) Since I am classified as an independent contractor, I must with hold my own taxes. I do this by having a separate bank account and pay my quarterly taxes out of this. Also, I have to have my own personal health insurance. At the onset of my locums career this latter was daunting but it worked out by looking at all of the options.

All of the locums companies I have signed on with have similar pay scales. They all cover your travel expenses and malpractice premiums. Speaking of malpractice coverage, I had to pay for my tail which consisted of one year’s payment coverage that I had with my old company and the locums group covers me while I work for them. I had one lawsuit filed against me in my 29 years of practice before locums and it was dismissed with my insurance company not having to pay anything. However, just the fact that I had a suit filed against me was a red flag in all of my applications. I  had to document everything. What I am saying is that malpractice issues may not preclude a physician from working as a locums provider but it will be a big issue when applying at a hospital.

The other expense is lodging and this is usually provided by the hospital where you are working. In fact, some hospitals allow their on call physicians to eat there with no charge. Basically, your overhead is very low doing locums.

Another aspect I greatly love is that you can decide if you want to work at a particular location and for how long. All of this will be decided before you arrive at a location and I can say that all parties have been very accommodating in this regard.

One thing I must strongly advise physicians in accepting an assignment is to be certain about your skills and what you ask for regarding privileges. For example, one of the small hospitals I was scheduled to work in required general surgeons be able to perform C-sections. Before I agreed to come I made it clear that I would only do C-sections as an absolute emergency. This particular hospital was isolated and in a few instances the only safe thing to do was have the best medical personnel available perform whatever had to be done.

Along the same lines, all operating rooms have some differences. It takes a little while to feel comfortable with the personnel and their capabilities.  Some of the after hours personnel are not as familiar with the laparoscopic equipment, especially the instruments. Some cases have to be converted to an open procedure if for no other reason due to a safety aspect. Also, there is a wide variety in surgical instruments, not just laparoscopic, at each hospital. The larger the hospital where you are assigned, the less chance these issues become a real adventure.

I have doing locums since June 2005 and I am very glad I am doing it. It is not for everyone. If a physician still has children at home, I would not recommend it. My wife accompanies me when she can especially on long assignments. I have worked for as short a period as a weekend and as long a time as two years. I can definitely say that all of my assignments have been good with some better than others. I am licensed in six states and this is all I plan to keep current as there are plenty of opportunities to work.

Regarding the location, time, and frequency of work is pretty much the choice of the individual practitioner once you are established into the system. The more you work, the better will be your compensation. All of the locums companies pay a certain amount on a daily basis guaranteed. After six or eight hours, depending on the company and the work situation, you are paid an amount per hour overtime. Working at a Level II Trauma Hospital will pay more than a less active community hospital and obviously the more overtime accrued the more the compensation. I feel the pay structure is very fair.

In summary, for physicians who are tired of the hassle of private practice but want to stay fairly active, locums should be considered.

James H. Bledsoe,MD,FACS

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Physician Writing: Emotional Responses To Breast Cancer

By S David Nathanson MD

Ordinary Miracles: Learning from Breast Cancer Survivors.

Directing a Multidisciplinary Breast Cancer Clinic gave me the opportunity to interact every Thursday morning with newly diagnosed patients, their families and friends, and with my colleagues in Medical Oncology, Radiation Oncology, Nursing, Radiology, Pathology, Genetics, Plastic Surgery, and Psychiatry. I met and observed six new patients every week for years. I noticed that patients, while grateful for the purely technical and medical information, seemed quite interested in the other patients. Patients struggling with their fears of death and the uncertainty of an impending barrage of treatments want to determine how other newly diagnosed patients feel. I wanted to understand these uncertainties, emotions and feelings in order to better manage my patients and to help them cope with their disease. I asked eight hundred of my patients to write about their experiences. I encouraged them to remember the feelings when they were told there was a suspicious lesion in the breast, when they were given the diagnosis in the surgeon’s office, when they faced surgery, chemotherapy, targeted therapy, radiation and follow-up visits. About ten percent of the patients responded to my request, some with brief paragraphs, others with many pages.

A number of common themes emerged from the patients’ stories. There is an emotional value in knowledge gained from professional explanations. Knowledge enabled an understanding of the choices, helped overcome myths, guided decisions, provided hope and diminished fear. All the patients showed an innate wisdom and determination to survive. In taking control of their own treatment decisions and choices they helped unmask the feeling that the disruption to their lives would eventually be overcome, that ‘time would heal the issues.’ During the disrupting events of each of the treatment modalities they found the strength to immerse themselves in ‘normal activities’ which helped them avoid focusing every moment on the cancer. The support provided by family, friends, health care workers, cancer support networks, one’s boss and co-workers were very valuable. Faith in the health team and in ‘a higher power’ played a big role in emotional support although professional psychological help was sometimes necessary. The biggest fears were: loss of control, loss of dignity, pain, loss of a job, and progressive encroachment on personal freedom.

I learned important lessons that enhanced my own ability to manage patients and I was enchanted by stories of great courage, bravery, inner strength and tenacity. I thought that the stories would help many new breast cancer patients, and also their care givers and perhaps many other patients with life-threatening diseases. Organizing the stories into a book was time consuming and filled with joy and it took some time to come up with the title: ‘Ordinary Miracles: Learning from Breast Cancer Survivors.’ Miracles abound in the modern day management of breast cancer and many are related to the creativity of modern scientific discovery, leading to a twenty percent improvement in the overall cure rate of stage one disease over the past thirty years. But the miracle in my title refers to the triumph of the human spirit. Faced with despair and death, the human soul chooses life and hope. No matter how devastated the patient feels when first confronted with the diagnosis, she displays a miraculous and triumphant change within a few weeks while she goes though the necessary treatments. This is an ‘ordinary’ miracle because it is accomplished by almost everyone, old and young, highly educated and less educated, of all social, economic and ethnic classes, and therefore not ‘extra-ordinary.’

Serendipity accounts for the rapid publication of my book. The day after I completed the last page, while wondering how to get it published, I received an email advertisement about a workshop in Boston that offered to address this exact question. I brought the manuscript with me to the workshop, found an editor who liked the work and offered to take it with her to her company in Connecticut. Six weeks later I signed my first book contract. There followed a whirlwind few months of editing, finding a publicist and obtaining endorsements from prominent oncologists, a patient, a theologian, a psychiatrist and a psychotherapist. Soon after the first printing, and while working full-time in my academic position, I was exposed to a number of media interviews including major newspapers, magazines, television and radio. I found myself signing copies of the book at Borders, cancer survivor luncheons and in my office. The most rewarding part of all the frenetic activity associated with the writing and publication was to hear from patients and from nurses that newly diagnosed breast cancer patients felt quite comforted to recognize that they were not alone in their fears. Knowing that someone else had experienced the same feelings and emotions and had survived the treatments was extremely comforting. The learning experience for me and for my patients continues.

About: S. David Nathanson MD, surgical oncologist and Professor of Surgery at Wayne State University Medical School in Detroit is a breast surgeon at Henry Ford Health System in Michigan. He directs A Multidisciplinary Breast Diagnostic Center at West Bloomfield Hospital and the Multidisciplinary Breast Cancer Clinic at the Detroit Campus of Henry Ford Hospital and can be found at www.facebook.com/henryfordpinkyswear and www.youtube.com/user/HenryFordTV.

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A Physician’s Journey To Social Media & Blogging

By Richard C. Senelick MD

A Physician’s Journey to Social Media and Blogging

A physician’s life often seems to be programmed. We go from college to medical school to internship to residency to fellowship to practice in a seamless path. Twelve to fifteen years go by without too many questions for we are consumed with the educational process and the brass ring at the end of this marathon event. Another straight line seems ahead of us as we pursue our career.

But, are our lives as physician’s really such a straight line or are they influenced by minor events that have major influences on the paths we travel? Life is like a novel where minor or serendipitous events take us in a different direction until another such event pushes us down another path. Most of the major decisions in our lives seem to be made with inadequate information- the decision to marry someone, become a physician, and choose a specialty.  Who really knows what marriage or a particular career will be like?

A Serendipitous Meeting

I had been in practice 35 years, written eight books and produced multiple DVDs. (http://www.richardsenelick.com/books-dvds) I enjoyed lecturing and writing, but again felt that itch to take that little fork in the road that might open new doors and get the creative juices flowing again.  I am a firm believer in reinventing oneself every 5-10 years. I received an email flyer for Dr. Julie Silver’s course at Harvard on “Publishing Books, Memoirs and Other Creative Nonfiction". I can’t tell you exactly why I signed up, but it seemed like a good diversion from the usual meetings on Stroke, Brain Injury and Rehabilitation. I already had a distribution system for my books, wasn’t looking for an agent, but some intangible nagging resonated with that “fork in the road” part of my brain. It was March 2010 and winter had descended on Boston, with winds blowing the snow horizontally. This was perfect weather to settle in for a meeting and avoid the temptation to walk along Newbury Street and sit at a café with my new iPad. I am famous for not being able to sit longer than 2-3 hours at a meeting. So, I took my usual spot in the last row, convenient for the quick escape. What followed were 2 ½ days that became one of those critical forks in the road for me.

Social What?

I was having a great time and getting all kinds of good information on writing, publishing and meeting people, but nothing seemed to be happening that would make a major difference in my career. It is not unusual for me to blow off the last morning of a 2 ½ day meeting, but my curiosity was piqued by a talk on Social Media by Rusty Shelton of Shelton Interactive. I had a “facebook” account I never used, but didn’t have a website, know how to “tweet” and had never commented on a blog, let alone written one. 

I am your typical cynical neurologist, so I sat in the back of the room with my arms folded as Rusty Shelton started his pitch for the new order of social media and publishing. It is not an understatement to say it was a true epiphany and resonated throughout my body. I instantly “got” social media and saw that door that only needed to be opened. It usually took me a year to write a book and then it was only seen by a limited number of people. Even worse that book might be out of date in six months. 
It became clear. My books were meant to educate healthcare professionals, people with disabilities and their families. With a website and a blog I could instantly disseminate information, keep it up to date, communicate with colleagues, people in need and get instant gratification. I also realized that all of my magazines and newspapers were getting thinner and that I was getting 90% of my information from the Internet. I no longer went to the medical school library weekly to sit in the stacks, but the stacks came to me on my computer screen. If I wanted to be part of mainstream society and contribute on an international level the remainder of my life, I had better get on board the social media train or be left at the station.

It is a little less than a year since Julie Silver’s course presented me with a new fork in the road. With Rusty Shelton at my side, we have developed a website, www.richardsenelick.com with books, articles and an active blog. We developed a professional “facebook” page (facebook.com/richardsenelick) and I am even starting to use Twitter. (twitter.com/richardsenelick)  Interviews and other writing opportunities have followed. It wasn’t much later that I received a major opportunity to blog for the Huffington Post (http://www.huffingtonpost.com/richard-c-senelick-md) which has been more fun than I can remember. I have been asked to guest blog on other people’s websites and am getting fully integrated into social media. Not only has it been invigorating, it has allowed me to play a role in the national dialogue that will ultimately impact providers, patients and their families.

No matter what you are thinking of writing, social media and the opportunities it provides should be a major part of your plan. Thanks to Dr. Silver’s course, it is now a major part of mine.

About: Richard C. Senelick MD is a neurologist who serves as the  Medical Director of RIOSA, The Rehabilitation Institute of San Antonio, and Editor in Chief of HealthSouth Press, the publishing arm of one of the nation’s largest hospital systems. He is a frequent lecturer on both a national and international level. Dr. Senelick writes a regular Blog for the Huffington Post.  Amongst his many books and publications, he has authored Living with Stroke: A Guide for Families, Living with Brain Injury: A Guide for Families, The Spinal Cord Injury Handbook, and Beyond Please and Thank You: The Disability Awareness Handbook.

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Physician Creativity & Disruptive Innovation In Medicine

Making way for your creativity.

Whoever said “a creative mind is rarely a tidy mind” was on to something. Who hasn’t had a great idea for a new product that they are sure would make them rich? Whether it’s a new medical device that fills a client need or a new service that will increase your revenues, how do we know what really makes an idea “great”? Why do certain bad ideas get to market and great ideas never make it to market?

Inventions that have taken a forward-thinking approach at their very beginning often appear backwards in their thinking given a few years (or decades) of retrospect. For example, what about the birth of individually packaged goods, which made food both convenient and transportable? Was anyone thinking about how all the materials they were using were creating more waste for landfills? The side effects of our creative ideas can’t always be anticipated. 

Innovation flourishes when there is a desire to make our world stronger, faster, cheaper, convenient and more beautiful. These are the desires that keep the most creative innovators inspired. But, some of the most innovative ideas and solutions we imagine can create other problems as a result.

The best way to reduce the risk of negative side effects is to follow a series of “filters and qualifiers” that will help separate the brilliant long-term solutions from the quick fixes and the genuine needs from the flash-in-the-pan fads.

Certainly medicine and health care has it's own set of filters, but there are basics that apply across all playing fields. Following are a blend of the best practices from the world of medicine, architecture and social entrepreneurialism. You can use these with confidence when fleshing out your ideas. Review them, use them and embrace them – they will save you both time and money. 

Step 1:  Take the time to understand your market

This step starts with the simple question “Is my product idea needed”?  If a product or service already exists in the market, then your products must truly be better, cheaper, or more convenient to be successful. And in some cases, it would need to be better and cheaper to catch the consumers’ attention.

When considering this question even further – in terms of production, quality and sustainability – you can easily determine if the product or service is deserving of the required resources.

Step 2:  Think beyond your lifetime

Some of the most socially responsible and successful companies look out 20 – 30 years before commercializing a product.  They may over-engineer a product, far beyond the initial scope, in order to open the way for future revisions or adjustments.  For example, an architect may design a project making use of reclaimed materials and energy-generating materials in anticipation of future advancements and needs. 

Step 3:  You are a resource too

When considering product success and sustainability, you need to think beyond the actual materials that will be required.  You need to ask yourself, “How committed am I to this idea?  Will I be as excited and passionate about this product in 5 years as I am today”?  Personal sustainability can no be underestimated because your idea’s success will need you year after year

Step 4:  Happiness counts

Some ideas may be difficult to measure in terms of social responsibility.  For example, how would the launch of another dermal filler be considered “good for the people”?  So instead, some projects – like amusement parks or comic books – should be measured in how much happiness will result from their use. 

If an idea doesn’t pass the social responsibility test, then run it through the “happiness quotient”.  Will your product or service bring more happiness and joy to the world?  If not, then scrap the idea.

Step 5:  The buck stops here

One of the hardest parts of evaluating an idea is assigning a dollar amount to our vision.  It has been proven that there is a direct correlation between a project’s profitability and it’s sustainability.   While some products make a boatload of money over 6 months and then disappear (think Pet Rock…), the ideas most of us have are those with real legs that will be profitable year after year.  Do the financials, understand your profit potential and evaluate your risks. 

Now go innovate!

The Vaccine Scare + Lawyers

Are lawyers looking to sue drug companies behind for the bogus vaccine autism study?

There's a lot of news about Dr. Andrew Wakefield and the dirty vaccine study.

Here's part of a  CNN story. What I find most disturbing is a sentence that I've bolded at the end.

Vaccination rates dropped sharply in Britain after its publication, falling as low as 80% by 2004. Measles cases have gone up sharply in the ensuing years.

In the United States, more cases of measles were reported in 2008 than in any other year since 1997, according to the Centers for Disease Control and Prevention. More than 90% of those infected had not been vaccinated or their vaccination status was unknown, the CDC reported.

"But perhaps as important as the scare's effect on infectious disease is the energy, emotion and money that have been diverted away from efforts to understand the real causes of autism and how to help children and families who live with it," the BMJ editorial states.

Wakefield has been unable to reproduce his results in the face of criticism, and other researchers have been unable to match them.

Most of his co-authors withdrew their names from the study in 2004 after learning he had had been paid by a law firm that intended to sue vaccine manufacturers -- a serious conflict of interest he failed to disclose...

...According to BMJ, Wakefield received more than 435,000 pounds ($674,000) from the lawyers.

A law firm that intended to sue vaccine manufacturers paid the doc almost seven hundred thousand dollars to fund a study so that they could begin suing manufacturers? This may be the most cynical ambulance-chasing I've ever heard of.

Physician Poetry

By Dr. Jon Wolston

“Bitch is... we’re all close.”

When I heard a patient speak those words years ago, something happened to me that I still don’t fully understand. I felt like I had just been bestowed a gift in that moment, a gift that had to somehow remain unspoken about between us, but that nevertheless deserved to be acknowledged more widely somehow and eventually recognized publicly in some sense.

My outpatient practice began to take on an added dimension of “word mining” so to speak. The enduring value of certain words in and of themselves seemed to blossom overnight, yet the nature of their power remained mysterious to me. I couldn’t deny the potency of this experience, but I was still at a loss as to how to account for it except that it reflected some aspect of an intimate moment.

Eventually I learned about the tradition of “found poetry” and began to write what I heard in poetic format. I looked into poetry therapy as an adjunctive treatment modality, because I could sense its transformational heft. The National Association for Poetry Therapy is a wonderful organization, highly recommended, but it still wasn’t quite what I was after. Meanwhile, the poems continued to appear. Would they continue to emerge or would they mysteriously wane, like so many of the other things we hold precious? In a way I had difficulty claiming sole authorship. It seemed like the intimate moment was the author and I the transcriber.

Fortunately, I signed up for Dr. Julie Silver’s course in 2007, which was a godsend. Here were established authors of all stripes with tales to tell, professionals from all facets of the publishing world, and bemused newbies opening to the power of words. Julie helped me accept that I was evolving into a physician-writer and that I had good company among other emerging practitioners of this art. I’ve enjoyed keeping in touch with many of the participants since. One lasting understanding that I gained was that any book you see reflects the work of many different individuals, not just the author. Maybe this is a lesson of particular value to physicians.

Soon I began to attend all the poetry readings I could muster in my hometown, dragging friends along whenever possible. I met some inspiring poets, particularly on the nearby Brown campus, and corresponded with those who struck a chord and were kind enough to respond to me. I joined the writing group at the venerable Providence Athenaeum, an invaluable source of support and former hangout of Edgar Allen Poe. I started compiling first email lists and later blogs to send out poems for critique. Readings came by invitation. My favorite is probably the Super Bowl halftime reading my son Chris requested. You had to be there.

With the help of my good friend and publisher Bill Connell, I put together a manuscript of a poetry collection, “Paradise Root-stock,” printed in April 2008 . Bill’s advice was, “Publish when you feel like you have a certain ‘body of work’ that you’d like to represent.” In this collection I look to capture the sense of awe I still feel about where this all came from. The process still mystifies me. The title comes from a Galway Kinnell poem called “The Stone Table.” He names the most common apple-tree cultivar in New England as emblematic of his tenacity in the face of our notoriously tough growing conditions.  The title also alludes to what is probably my favorite poem in the collection, called “Nor’easter”:

     Poems are windfall
     of the orchards of my soul. . .
     some bruised some glowing,

     all with secret seeds
     ready to be swallowed up
     when God is hungry.

In hindsight, my friend the historian Dr. Doug McVicar was also a big help in getting PR-S into print. He issued a “dare” in 2007 to see which one of us would publish first! I think physicians thrive on healthy competition. If you’re feeling a little stuck with your writing, consider old-fashioned dares.

Four of the poems in PR-S were selected by the Poetry Society of New Hampshire for inclusion in their 2010 Poets’ Guide:More Places, More Poets. In doing promotion, I found that smaller independent bookstores love to have you read for them to help draw business. They are also more likely to be interested in stocking your poetry book afterwards than a chain or large bookstore would. Two of my all-time favorite bookstores: http://www.lexingtonbooksandco.com in Virginia and http://www.bayswaterbooks.com in New Hampshire. Both these wonderful venues allow an intimacy to develop, on account of their size, that is distinctive, and particularly conducive to poetry readings.

For physicians interested in developing as writers, Dr. Julie Silver’s Harvard course is invaluable and highly recommended.

About: Dr. Jon Wolston is a psychiatrist who transitioned to retirement by finding unexpected pleasure and meaning in writing poetry and publishing it, both in print (“Paradise Root-stock” 2008) and online at http://jonwolston.wordpress.com.

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