Yes! You can open your dream clinic—without completing residency. →

Hi, my name is Dr. Kat Lopez and I unfortunately know what you are going through if you are suffering in conventional medical training or a conventional treadmill medicine job. I was really afraid of going to residency because I had heard of the abuse that I would undergo. And even though my residency program in family medicine was overall a great and supportive program,

I came to feel during my first year of training that the medicine that I was practicing was simply a training to become a robot doctor. It was to be able to see patients as fast as possible as we were given shorter and shorter time slots in clinic. And it was to learn how to both prescribe and manage a polypharmacy of drugs as efficiently as possible and with the least amount of litigious risk.

And this was never the type of healing that I signed up to learn. And I was deeply hungering to learn about nutritional healing of disease, nutritional prevention of disease, alternative approaches including mind-body-medicine, Chinese medicine. What about these things people have been using for centuries?

Kat Lopez MD

I grew more and more bored and more and more desperate to start to live my passion and my dream of becoming the doctor that I knew could do great things in the world and my residency program was not able to educate me in that way. So I actually resigned from my residency program after the first year. I announced about halfway through and completed my intern year in my family medicine program. I did this with the support of several mentors in my life and I also learned that in a number of states in our fine union physicians can obtain their general medical license with only one year of post-graduate training. I had never been told that. Nobody ever talked about that. There are even D.O. [Doctor of Osteopathy] PGY-1 spots all over the country that are intended to be complete for one year if that D.O. will be going into primary care. 

So I spent about all told from the beginning of residency until I found my dream (where I live now) just in absolute emotional turmoil from feeling like a total failure, a total screw up, feeling like my genius was absolutely unappreciated and unimportant. That all these passions I had for real health and real healing were useless at best and dangerous at worst, that were causing me to become a problem to my residency program and a problem to the conventional medical system in general. I was in absolute grief and despair over thinking that I could never be the healer I was meant to be. I started looking at other educational programs and thought what I can do other than work under my medical license if I can’t get my medical license. I considered things like selling my soul to the pharmaceutical rep industry and taking a job there so I could be paid to drive around and sell devices or pharmaceutical medications. 

And then through meeting Dr. Pamela Wible—who is a liberator of physicians from treadmill medicine—I started to realize that I have all of the emotional intelligence, the educational prowess, the passion and the drive to truly live my personal dream even though I did not have a mentor outside of myself to show me “Hey I want to practice like you. I want to do what you do. I want to work like you work.” I did not have that exactly presented to me and I was empowered by Dr. Wible to define that for myself. Ultimately her support of patting me on the back and saying, “You can do it! You’re going to be great! Your patients will love you!” gave me this fuel through a lot of other healing processes to define what I wanted to be really in my life. And how I wanted to live each day both impassioned by the subject matter in front of me, both in service to the people who can benefit from my personal form of healing and genius and to make a lot of money while doing it. 

So what I ended up creating in my life was a beautiful collaborative practice where I met an experienced mentor in naturopathic and Chinese medicine, Dr. Satya Ambrose. She had just opened a new wellness center in Happy Valley, Oregon, which is about half an hour outside of Portland (where I lived at the time) and she became a close mentor and teacher of mine and over the past two years I’ve essentially developed my personal private practice as an independent contractor in a group of really forward-thinking, loving, relaxed, interesting people with diverse capabilities of healing from acupuncture to body work to naturopathy and as an independent practitioner work on a percent-split basis to enjoy the benefits of the wellness center staff. I have my own staff. I have assistants. I have front office scheduling and website maintenance and these kind of things. In addition, I’ve gotten to essentially grow into a functional medicine approach to diagnosing and treating both complex chronic disease and simply prevention medicine for the people who are feeling kind of crappy in their fifties and maybe 30 pounds overweight and need a little bit of guidance to kind of guidance to get healthy in this second phase of their life.

I not only as my own boss have all of the ability to dictate my schedule, how much money I really want to make, how to go into my community as a grassroots marketer of myself whereby interacting as a teacher, a lecturer, a demonstrator, a colleague, I am basically marketing my group and myself as the community-based wellness-type of physician that I truly am. So marketing feels effortless, attracting patients has felt completely effortless and over the course of two years my practice is filling beautifully with basically no effort on my own other than personally following my passion to learn the functional and natural medicine approach to complex chronic disease. So I am happier amd more fulfilled than I could have possibly imagined. 

This type of practice which is both financially sustainable and extremely fun and basically a deep and intensive learning process as I expand my toolbox from sort of from the pharmaceutical-based medicine that I was taught and trained in. This process has been so easeful and harmonious as soon as I got in touch with what I really cared about, the vision I really held for my life, and got empowered to learn what I needed to learn to make that happened as well as connected with people who were right there helping me from the business sense to how do you write office policies. Well, I guess I can make them up myself. What do I want my office policies to be? So currently I work as an out-of-network doctor. I’m not contracted with any insurance companies and I have a scale for my cash-pay patients, many of whom are uninsured. I give discounts for various things such as for people who have Medicare. I also have a biller in my office who will bill people’s insurance if they have out-of-network benefits for our office visits.

The care that I am able to provide absolutely fills me and my patients with joy. And learning along this process has been so empowering and liberating from the do medical school, do a residency, and get a job—one of these jobs that you’re offered on a piece of paper sent to you in the mail at a big-box clinic. I knew that that job wasn’t for me. It wasn’t harnessing my genius. And I could not express my personal passion for health and wellness through that model. Guess what? I’m not a quick doctor. I would have never succeeded in anyone’s model that requires me to see people in 10-20 minutes. Just never. So fortunately I get to succeed as my own boss in my own practice with a beautiful group of collaborative naturopaths who are helping each other and see our patients together to do an awesome, awesome brand of really true healing. 

So if you’re an exhausted, overworked medical student, intern, resident, or physician in treadmill medicine, I want to summarize for you that I was hopeless, totally discouraged, very, very bored by the type of treadmill medicine I was being trained in and exhausted physically from lack of sleep. I was undernourished and filling up on more junky sort-of calorie-dense stuff so I could make it through the day while shoving as little volume down my mouth and in the bathroom stall as I could so I could not pass out on rounds, really, really suffering in the system that is designed to disempower very intelligent people and wring every bit of productivity out of you as deeply as possible no matter the personal price. And now as my own boss having been supported by other doctors to realized that I can figure all this out on my own just like the dry cleaner business down the street can take money from satisfied clients to do their business. Gosh darn it I can learn how to do the same thing in medicine.

I roll into work at nine or ten or eleven or twelve, depending on the day. I set my own schedule. I can block off days for any of the things I would like or need to do—educational purposes, recreational purposes. And in my clinic itself, the staff juices for us green juices everyday. I can wander around between patients with a quick acupuncture treatment. If I drop something on the floor, I don’t feel like I have drug resistant bacteria everywhere, but can like wash it off and put it back on the table where I was eating. It’s a clean, wholesome environment that I just never thought would be possible. Medical students come through from the naturopathic school and practice their massage and craniosacral work on me so I truly am living in a wellness center where we practice what we preach and I had no clue it could be this good. Just two years after quitting my residency, I’m truly living my dream. I have enough and the horizon is only growing brighter. So thanks for listening! Contact me to find out more!

STATE-SPECIFIC REQUIREMENTS FOR INITIAL MEDICAL LICENSURE

Pamela Wible, M.D. is a family physician and “liberator of physicians from treadmill medicine.” This video was filmed by GeVe at our biannual physician retreat. Come join us! Questions? Contact Dr. Wible.

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Are euphemisms killing physicians? →

Pamela Wible Euphemisms Kill

A euphemism is a vague and indirect expression substituted for a fact to avoid something unpleasant or embarrassing.

Each year more than one million Americans lose their doctors to suicide. Across the country, our doctors are jumping from hospital rooftops, overdosing in call rooms, found hanging in hospital chapels. It’s medicine’s dirty secret. And it’s covered up by our hospitals, clinics, and medical schools—often with euphemisms.

That’s not science. It’s deception.

Though suicides may be investigated, we rarely learn the truth. No follow-up articles. Autopsy reports never revealed. So how can we solve a medical condition that’s actively hidden by our own medical institutions? We can’t.

To date, I’ve compiled 265 cases of physician and medical student suicides. Here’s how some suicides are actually reported by medicine and the media to the public:

      Euphemisms to cover up doctor suicides

  • Doctor passed away unexpectedly in his sleep.
  • Doctor found dead in hospital. Declared non-suspicious. 
  • Doctor’s death an inconvenience for patients.
  • His light went out too soon.
  • Medical student passed into eternity.
  • Doctor found dead on interstate. No foul play.
  • Doctor died by “accidental overdose.” (unlikely—doctors dose drugs for a living)
  • Doctor died suddenly.
  • She passed away peacefully at home.
  • He went to be with the Lord.

Words matter. When we hide the truth, we prevent the collection of data and the implementation of strategies to prevent suicides. Hiding behind misleading phrases that obscure diagnoses will never prevent suicide. So what can we all do now?

Here’s an idea—Let’s tell the truth.

Pamela Wible, M.D., is a family physician, truth seeker, and activist in physician suicide prevention.

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Should this doctor quit her job? →

PamelaWiblePostcard283 copy

Hi Pamela,

I started a new job.

So I asked to be in the new satellite clinic as there would be 3 exam rooms and an office. I was told I could. My first day there I was told I couldn’t. They put me in the basement of this old building. I never would have accepted the job if I had to work there. It’s crowded and I have only one exam room. I need to bring patients to me and sit with them while completing electronic chart. I hate it. I have no phone (only my cell phone).

Two weeks now and I realize they are telling patients I am the new diabetes and stroke expert. I am not! I did not sign up for that! I have never handled complicated diabetes on insulin or pump!

Nobody is helping me. LACK OF STAFF! They tell me that it will get better.

Last week a patient waited an hour for discharge instruction after surgical procedure and was then told by a nurse practitioner to go home without them. Now a complicated wound infection.

They dumped a sick child in my exam room and left. I had to find someone to get vital signs. She came but didn’t do her job. No heart rate. No respiratory rate or oxygen sats were measured. I have no medical assistant helping me.

I am being asked to do allergy testing interpretation and management without proper training

The EMR is awful!! Still trying to learn it. Nobody seems to want to help. Notes in EMR are awful there is NEVER AN ASSESSMENT/PLAN from other providers. I am writing it on my PLAN page.

So have no clue what is going on really with patients.

Specialist notes are not up to date.

Immunizations are not recorded in EMR.

I am thinking of quitting after 2 weeks. I can’t stand this!

Should I put up with this?

Elena

My advise: QUIT YOUR JOB.

What do you think?

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Teaching hospitals teach discrimination. Here’s how we stop it. →

Meet Dr. Svetlana Kleyman, a powerhouse chief surgery resident with a heart of gold, who works 16-hour days and runs marathons in her free time. Just 18 months before she was to graduate from SUNY Downstate, she developed a spinal infection that left her paralyzed from the waist down. After months of rehab, she was cleared by her doctors to resume work (with proper accommodations surgeons continue to operate successfully). Svetlana was ready to return to the operating room. Her surgery residency told her not to come back.

Svetlana

Her story was published in the New York Post. I shared her plight on Facebook. The response: Outrage.

“This goes against the Americans with Disability Act. Completely unethical and I feel goes against the oath that all doctors must take to first do no harm!” ~ Renea Turner Clark

“The obvious, nauseating irony is that teaching hospitals, of all institutions, should take an exemplary approach and lead the way in cases like Dr. Kleyman’s.” ~ Bradford Harriman

“And she was probably exposed while on shift as chief resident. What a shame. It’s going to be an expensive payout by SUNY.”  ~ Daniel Ojala

“Wow—isn’t that illegal?” ~ Shanthi Madireddi

“I don’t see why the ACLU can’t help her get an immediate judicial injunction to mandate her immediate re-instatement as she pursues what should be a multi-million dollar lawsuit with an additional 100 million in punitive damages. The medical training establishment needs to be taught a memorable lesson. As a state university, Governor Cuomo’s office should be contacted to alert him to the multi-million dollar liability this has exposed his state to. Since she has already filed a lawsuit, I would imagine something like this has already be pursued. But it needs national exposure on morning news shows. Under ADA, an employer is required to make ‘reasonable accommodations’ just like physicians’ offices and hospitals are required to make reasonable accommodations for the disabled what with wheelchair access and roomy bathrooms with rails and whatnot. Where is the ACLU on this, or is all their time taken up with transgendered issues?’’ ~ Lawrence M. Slocki

“This is straight up bull.”  ~ Carolyn Smith 

“If this is in the U.S. I don’t think they will get away with it. I’m paralyzed also and that’s ridiculous.” ~ Darby 

It is ridiculous. Our hospitals. In the USA. Breaking the Americans with Disabilities Act. Shameful.

Want to help Dr. Kleyman be the amazing surgeon she was born to be?  Please sign this petition and then call Dr. Lisa Dresner (program director) via Natasha Sagal (program coordinator) at 718-270-3302 and Dr. Antonio Alfonso (department chair) at 718-270-1421. Demand that Dr. Kleyman be reinstated in her residency program. Afterwards feel free to contact the ACLU, Governor Cuomo, and the TV networks.

Thanks,

Pamela Wible, M.D

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Please sign my physician suicide letter →

Petition to end medical student and physician suicide

Dear AAMC and ACGME,

This week we lost another bright, young soul to suicide. Sean Petro was in his third year at the University of Southern California Keck School of Medicine and is the third tragedy at his school in the last two years.

Medical student and physician suicide is an epidemic. It is estimated that 400 doctors die by suicide in the United States each year. That’s the equivalent of an entire medical school gone! The second leading cause of death among medical students is suicide—a well-known occupational hazard in medicine. Yet no medical organization is tracking these suicides. So how can we solve a problem that’s hidden?

The AAMC (Association of American Medical Colleges) and ACGME (Accreditation Council for Graduate Medical Education) claim to improve the health care of all through serving the academic medicine community and advancing the quality of physician education. How can this be achieved when so many of us are contemplating or completing suicide?

The fact is we enter medicine with our mental health on par with or better than our peers. Medical education too often involves years of public humiliation, bullying, and sleep deprivation. Those who seek help risk punishment. Mental health remains stigmatized within the medical profession to the detriment of all. 

As physicians who are dedicated to caring for the physical and mental health of others, we’re appalled at the level of inaction among our own organizations when it comes to caring for us. We urge the AAMC and ACGME to track medical student and physician suicides, to end the highly abusive culture of medical training, and to offer routine and confidential on-the-job psychological support to all medical students and physicians.

Inaction and ignorance are no longer an option. Lives are on the line. This is a public health crisis that impacts us all.

Sincerely,

 Ashley Maltz, M.D., M.P.H., and  Pamela Wible, M.D.

(Attention physicians: please support this letter with a blog comment and add your name to the petition.)

Pamela Wible, M.D., is the author of Physician Suicide Letters—Answered. Please join us in shining a spotlight on physician suicide. Need help? Contact Dr. Wible.


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