Health

Why every doctor should have a side gig

Published

2 months ago

January 29, 2023

Why are doctors looking for alternative ways to increase their income? It might seem counterintuitive for busy clinical physicians to have a side job, why? In a post-pandemic era, doctors are plagued by colossal debt and soaring burnout rates. More than 100,000 doctors have given up their profession since the start of the COVID-19 pandemic. My colleagues are frustrated, tired and looking for a way out. For many, part-time income provides an exit ramp. That’s why every doctor should have a part-time job.

The doctor’s dilemma

For the rest of the world, doctors are rich. What most misunderstand is that the majority of doctors are drowning in debt. The average medical student carries around $203,000 in educational debt. Physicians are also getting a late start when it comes to building up old-age provision. Physicians with longer training periods are usually in their mid-thirties before they reach their earning potential.

True, our time in education is an investment in a high-paying career, but to what end? While doctors are stuck until midlife without building a nest egg, others have saved for a decade or more. After completing their training, doctors spend the next five to ten years working to reduce debt. The weight of their loan repayments, complicated by demanding careers, created plenty of tinder necessary for disaster … and the pandemic was that spark.

Enter COVID-19

For doctors, nurses, and healthcare workers alike, the pandemic has forced us to recognize that our current work-life balance is insufficient to justify the long hours, stress, or bipolar feelings being forced upon us by an anxiety-ridden nation will. Many doctors love their job, but there are limits. Side jobs offer more than just income to the medical community. Side jobs offer medical professionals an opportunity to explore business interests outside of medicine…an often-welcomed respite. These hustles are a way to diversify your portfolio while building financial security.

Diversifying your income portfolio

Most entrepreneurs (I suspect) would agree with the fact that diversifying your cash flow is a good thing. Although doctors’ income is their financial superpower, it also allows them to invest their money in other means of income generation.

Enter the side appearance. Side jobs (or side hustles) are a person’s business activities to create a source of income in addition to their main job. For example, I started blogging and wrote as The Motivated MD. I hope to use the platform I’ve created to interact with like-minded people with similar financial issues while also monetizing the site. For others, side gigs can take the form of podcasting, creating online courses, real estate investing, and more. This rush isn’t always lucrative, but it offers physicians the opportunity not to rely on their medical careers to sustain their lifestyles.

Financial security

Financial security seems guaranteed in healthcare professions…but nothing is certain. It is reasonable to assume that individuals will always have health concerns. With advances in modern medicine, these individuals are living longer while accumulating more comorbidities. This means that each subsequent patient is usually older and more complicated. This puts further pressure on an already strained healthcare system.

When physicians can generate income through dividend investing, the creation of digital products, or real estate, it provides a monetary avenue to offset their clinical burden. Maybe they don’t take that extra shift? Maybe they don’t need to be on call that often. The income generated from a profitable side business can create opportunities that contract negotiations often do not.

Accelerating Financial Independence

As I have already indicated, physicians often delay building their retirement savings. While it is true that physicians are paid during their residency training, reimbursement is generally well below the US median household income based on 2021 census data. As a result, once physicians complete their training, they lag behind their non-physician peers in terms of retirement provision.

Side jobs for doctors create opportunities for doctors to “catch up”. Ancillary income generation is variable, but being able to see your net worth improve faster than it would otherwise is a relief. This can be especially true for those leaving an education with educational debt. In addition, a subgroup of the medical profession wants to go one step further; Achieve financial independence and retire early. This is often referred to as the FIRE movement.

Live like a resident

There are a few ways for Doctors to speed up FIRE. One is to live drastically below their means. This can mean saving 50 percent or more of your annual income. “Live like a resident” is often said. 5 to 10 years after you graduate, treat your expenses as if you were still an apprentice. This is one way to accelerate financial freedom. This strategy is simple, but it is not easy. It can be financially, mentally, and emotionally challenging to ask a person who has delayed their income potential for decades to limit their quality of life for another decade.

Another way is to start a business. For physicians with the time, courage, and start-up capital, a part-time job can grow into a business that generates income alongside their medical career. This is a great way to accelerate financial independence. It can also provide an outlet for burnout sufferers in a challenging job.

prevent burnout

As mentioned above, the global pandemic has put a tremendous strain on an already stressed healthcare system. Individuals in all positions in the medical community have felt this pressure. It has led to a mass exodus from the profession that is not limited to the medical profession.

While altruism is critical to healthcare careers, it can be a finite resource. Relying too much on the altruism of others risks extinguishing the very fire that fuels their calling. Burnout is quickly becoming the most pressing crisis in modern healthcare professions. Generating other streams of income is not the solution our healthcare system needs, but for many people it offers an opportunity when their job overwhelms them.

take points home

I’m sure there will be many who read this article and disagree. I welcome these answers. For others, myself included, the medical profession has not met all my expectations. Do not get me wrong; I love taking care of patients. I enjoy the investigative work that is necessary to properly treat an illness. But the financial milestones that I thought could only be achieved through a career in medicine left me… wanting.

Entrepreneurship can take many forms. For doctors, it can be a passion or an extension of a hobby. A necessity for others. Regardless of your financial base, it’s good advice to seek multiple sources of income. For physicians servicing a stressed healthcare system, it can provide an exit ramp. I suspect that you will continue to find more doctors and healthcare professionals doing the entrepreneurship. Every doctor should have a part-time job.

The author is an anonymous physician, available at The motivated MD

Health

How Have Costs Associated With Obesity Changed Over Time?

Published

47 mins ago

March 25, 2023

Ella Valadez

The analysis examines the costs associated with obesity for individuals with large employer private insurance, using data from Merative MarketScan’s commercial claims and encounters database from 2011 to 2021. Pocket spending as people without an obesity diagnosis. The analysis also examines the costs of common surgical and pharmacological treatments for obesity.

The analysis is available via the Peterson-KFF Health System Trackeran online information center that monitors and evaluates the performance of the US health care system.

Health

Catholic Church issues trans care guidelines for Catholic hospitals

Published

2 hours ago

March 25, 2023

Ella Valadez

Catholic bishops in the United States have issued guidelines aimed at blocking Catholic hospitals from offering care for gender transition, a move that LGBTQ advocates say is damaging to the physical and emotional health of transgender people within the church could.

The 14-page teaching note, titled “Moral Limits to Technological Manipulation of the Human Body,” provides guidelines for changing a person’s gender, particularly in adolescents. The document, released Monday, says Catholic hospitals “may not perform any surgical or chemical procedures aimed at converting the sexual characteristics of a human body into those of the opposite sex, or engage in the development of such procedures.”

Transgender Catholics have received mixed reactions across the US church. Some have found acceptance in certain communities and rejection in certain dioceses, including those that prevent church personnel from using trans people’s preferred gender pronouns. Bishops’ recent guidance on Catholic medical centers could prevent trans people from getting the medical care they need, said Francis DeBernardo, executive director of the New Ways Ministry, which works to promote greater LGBTQ acceptance in the church.

Catholic hospitals make up a sizable portion of the US healthcare system, and in some communities they are are the only option. The Catholic Health Association, which includes more than 600 hospitals and 1,400 long-term care and other healthcare facilities across the United States, says more than one in seven US hospital patients receive care in a Catholic facility.

“These decisions are made at a much higher level without knowing the individuals involved and the individual cases,” DeBernardo said. “When transgender people are not allowed or restricted from transitioning in ways they see fit, it can lead to depression, anxiety, or even self-harm, including suicide.”

The bishops’ guidelines “are not going to change much” when it comes to the care of transgender patients in Catholic hospitals, said Rev. Charlie Bouchard, CHA’s senior director of theology and sponsorship. Transgender people continue to be always admitted to Catholic hospitals and treated with dignity and respect, but may not receive all the gender-affirming care they demand because of the church’s theological and moral teachings, he said.

“As we look at the bishops’ document, we remember that we have a history of caring for the marginalized and we view transgender people very strongly as a marginalized group,” he said.

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Catholic hospitals see transgender patients with a variety of health needs, from broken bones to cancer treatments and heart attacks, Bouchard said, adding that the hospitals would not perform cosmetic procedures like reconstructive surgeries, hysterectomies, or treatments like sterilizations on request unless there is a medical need for them.

He said Catholic hospitals also train staff to be respectful of transgender patients: “When a patient checks in, we ask staff to be respectful of questions. We want to validate transgender people as individuals and provide them with spiritual care and psychological counseling.”

Bouchard said Catholic hospitals “base healthcare on science and continue to follow science when it comes to transgender people.”

“But we don’t deal with ideology,” he said. “We treat patients who are really suffering. There are things out there regarding gender fluidity that we don’t agree with. But as Catholic hospitals we are subject to the same standard of care as other hospitals.”

DeBernardo disagreed, saying that the bishops’ doctrinal guidelines hurt rather than heal people by ignoring science.

“The bishops’ unwillingness to confront any evidence from the scientific community or the experiences of transgender people is neither good theology nor acceptable pastoral care,” he said.

DeBernardo said he sees hope with many more Catholics in the pews showing a greater understanding of the lives of transgender people. He pointed to instances of Catholic parents supporting their transgender children against restrictive policies in Catholic schools, including bans on puberty blockers and preferred pronouns on campus and in parishes.

Christine Zuba, a transgender woman living in New Jersey, said she feels accepted in her local community but is upset that the national church “continues to deny our existence and our need for health care.” Zuba said she was disappointed to see that transgender people weren’t even mentioned in the 14-page document.

“I feel unconditionally accepted in my community just the way I am,” she said. “But that is missing in our hierarchy. There is no willingness to engage with us and understand our lives.”

Zuba said she looks forward to more engagement and interaction in some dioceses. In Davenport, Iowa, Bishop Thomas Zinkula formed a gender committee that called on Catholics to “listen to those on the fringes” and called serving LGBTQ people — particularly trans people — “a life’s work.” In a column published in Catholic Messenger, Zinkula said he was haunted by the story of a transgender youth who attempted suicide after being refused communion.

“This should never happen again,” he wrote.

Zuba said she would like to see that kind of commitment to listening and learning in the upper echelons of the church.

“All we ask is that you listen to us as a group and as individuals,” she said. “Open your hearts and try to understand.”

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Health

Anxiety, Depression Climbing Among People with IBD

Published

2 hours ago

March 25, 2023

Ella Valadez

March 24, 2023 – Joshua Denton was diagnosed with ulcerative colitis as a junior in college. Not only was he concerned about a new health diagnosis, but how it might change the rest of his life.

His initial fear was “having something that is technically considered incurable”. Next came the daily challenges of living with Inflammatory Bowel Disease (IBD).

“There’s just a level of concern about what your quality of life is going to be like. Will it ever be like that again, will it get better or worse over time?” said Denton, now a 37-year-old aerospace project manager in Dallas.

People with IBD report higher rates of anxiety, depression and other life problems compared to 6 years ago, according to an American Gastroenterological Association (AGA) survey of more than 1,000 people.

At the same time, many healthcare providers believe patients’ mental health needs are being met, according to an accompanying survey of more than 100 healthcare professionals who treat Crohn’s disease and ulcerative colitis.

So why the inequality? People with IBD are sometimes reluctant to talk to their doctor about relationship issues or difficulties at work, saying they don’t want to be a burden, said Laurie A. Keefer, PhD, a psychologist and professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City, specializing in helping people with IBD develop coping skills and resilience.

Doctors sometimes don’t want to ask questions that might be inappropriate or make people feel uncomfortable. “There’s a lot of good intentions on both sides,” Keefer said. “But I think there’s a real disconnect, which actually needs to happen.”

Survey results showed that 36% of people with IBD report anxiety and 35% report depression. This reflects a steady increase in anxiety and depression diagnoses since 2017 The national anxiety rate is 19% and for depression, 8%, according to a 2017 report by the National Alliance on Mental Illness.

what is the connection

There are likely two reasons that explain why anxiety and depression are more common in people with IBD, Keefer said. It is increasingly recognized that these conditions share inflammatory pathways with autoimmune diseases, particularly pathways associated with the brain and gut.

“The second problem is that these conditions themselves cause depression because there’s so much to deal with,” she added. “You don’t feel good when you stop going out and doing things, and for some people that really just manifests as depression.”

The risk of depression can also increase when someone’s IBD is active. Keefer said, “When you’re sick and you’re in bed and you’re not at work and you don’t see your friends, you get more and more depressed.”

The survey also reveals the impact IBD can have beyond mental well-being — including challenges in relationships, in the workplace, and in educating others about the conditions. AGA used the results as the basis for a new resource called My IBD Life.

“The idea is to really simplify the conversation about the emotional toll of IBD,” Keefer said. My IBD Life features real people with IBD sharing tips on how to talk to friends and family about these challenges, how to manage their work-life balance, and how to travel. “Many of my patients don’t take vacations that require them to fly by plane.”

The campaign also focuses on helping younger people, as IBD is generally diagnosed when people are in their teens or early 20s. “The mental health needs of young adults are high and they are increasing post-COVID,” Keefer said. “These are also people who are trying to get their lives together and then the disease sweeps over them.”

Unpredictability increases fear

Kamila guides was diagnosed at the age of 12 and has had Crohn’s disease for more than 20 years. She shared some challenges beyond the IBD itself.

“Relationships are always important — try to figure out when you’re having that conversation with Crohn’s,” she said. It can be especially difficult for people who have had their colon removed and are living with a colostomy bag. “How do you talk to someone about this in a relationship or even before sex?”

Joint errands can also induce anxiety, Denton said. “There are things that people with normally functioning bodies take for granted. I have to think, “Hey, can I go to the store and buy groceries without worrying about going to the bathroom or having an accident?” ‘Can I go on a date and eat and drink comfortably – and not eat anything that’s going to trigger a flare-up?’”

There can be issues with friends and family who don’t understand the urgency of always being near a bathroom, said Guiden, a digital marketing expert at JPA Health, a public relations and marketing agency that has helped develop it the My IBD Life campaign.

Keefer, who is also an advisor to the campaign, said that “a lot of GI disorders, not just Crohn’s disease and ulcerative colitis, come with a lot of unpredictability that can increase anxiety.” Uncertainty is what separates IBD from many other chronic conditions.

What do you need a break for?

Employers cannot understand the need for time off. People with IBD may be reluctant to ask for time off from the office to avoid being seen as unable to work. For Guiden, it was college professors who were unwilling to forego her absence if she missed class because of her IBD.

“Communication is very important to having a chronic illness and getting the housing you need. Also, don’t be afraid to escalate if necessary,” Guiden said.

The campaign also aims to help providers take a more active role in fighting IBD beyond the physical symptoms. Many providers in the survey said they felt less able to treat the emotional issues than the physical aspects of IBD.

education and awareness

“The subject can be very uncomfortable for a lot of people, including myself at times, admittedly, and it leads to a kind of self-censorship,” Denton said. He’s trying to figure out how much his conversation partner wants to know about his personal IBD challenges.

At the same time, he added, “Anyone you meet who doesn’t know about IBD is an opportunity to educate.”

This is another way the My IBD Life website can help. If someone is uncomfortable discussing the details or IBD, those affected can refer others to this resource. That way, Denton said, people can take their time and learn as much as they want about living with Crohn’s disease or ulcerative colitis. The personal stories shared on the site really “humanize” IBD.

Keefer agreed. “The campaign really breaks down patients’ common emotional concerns and offers them real tips and tricks based on real patients and providers. It’s a very evidence-based guide, but also very practical, tangible information for patients.”

The patient survey, with responses from 1,026 people aged 18 to 59 years with IBD, was conducted from June 27 to July 5, 2022. The provider survey, with responses from 117 gastroenterologists, was conducted at the same time.

IBD and inequality

The survey also found that different communities may experience the challenges of IBD in different ways. For example, one question asked respondents to rate my experience on a scale of 0 to 10, with 0 representing “not applicable” and 10 representing “very good,” the following: “My IBD journey was enhanced by my race , ethnicity and culture influences , sexual orientation, gender identity and/or age.”

The average rating of all 1,026 respondents was 3.57. However, People of Color gave this statement a 4.5 and Black patients gave it a 4.7.

“I will not attempt to speak for those behind the survey, but I will speak through the lens of myself, who is an IBD patient and also part of a non-profit organization Color of Crohn’s and Colitis Foundationa nonprofit organization focused on improving medical access and equitable resource-based treatment for black and brown IDB patients,” said Denton.

“Unfortunately, it’s rooted in a bit of systemic discrimination,” referring to the historical treatment of black and brown patients, he added. Topics include equal access to care and treatment, and participation in clinical trials that are more representative of the United States population. “Certain things have very little to do with who we are as actual individuals and have a lot more to do with the structure of the medical environment.”