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The 10 Best-Paying Medical Specialties

Here’s how much the highest-paid doctors in the top recruited specialties make, according to consulting firm Merritt Hawkins & Associates’ pending 2013 Review of Physician Recruiting Incentives. The average pay is the base salary or guaranteed income that is offered, not including signing bonuses, production bonuses, or benefits. 

Merritt Hawkins’ numbers do not reflect total physician incomes, but rather starting salaries physicians are being offered when they are recruited, either from residency programs or from other practice settings in which they may be established.

No. 1 Orthopedic Surgery

Average: $464,500

No. 2 Cardiology (invasive)

Average: $461,364

No. 3 Cardiology (non-invasive)

Average: $447,143

No. 4 Gastroenterology

Average: $441,421

No. 5 Urology

Average: $424,091

No. 6 Hematology/Oncology

Average: $396,000

No. 7 Dermatology

Average: $370,952

No. 8 Radiology

Average: $368,250

No. 9 Pulmonology

Average: $351,125

No. 10 General Surgery

Average: $336,375


6 medical Symptoms You Shouldn’t Ignore

Most aches and pains aren’t a sign of something serious, but certain symptoms should be checked out. See a doctor if you feel any of these things:

1. Weakness in Your Arms and Legs

If you get weak or numb in your arm, leg, or face, it can be a sign of a stroke, especially if it’s on one side of your body.

You could also be having a stroke if you can’t keep your balance, feel dizzy, or have trouble walking.

Get help quickly if you suddenly can’t see well, get a bad headache, feel confused, or have problems speaking or understanding.

“Caught early, it is often reversible,” says internist Jacob Teitelbaum, MD.

Don’t wait to see a doctor. Call 911. If you get a clot-buster drug within 4.5  hours of your first symptom, you can lower your risk of long-term disability from stroke.

2. Chest Pain

When it comes to chest pain, it’s better to be safe than sorry.

“Any chest pain, especially accompanied by sweating, pressure, shortness of breath, ornausea, should be evaluated by a medical professional right away,” says Shilpi Agarwal, MD, with One Medical Group in Washington, DC.

Chest pain or pressure can be a sign of heart disease or a heart attack, particularly if you feel it after being active. It may also mean that you have a blood clot moving into yourlung, Teitelbaum says.

If your chest feels tight or heavy, and it lasts more than a few minutes or goes away and comes back again, get help. Don’t try to tough it out.

3. Tenderness and Pain in the Back of Your Lower Leg

This can be a symptom of a blood clot in your leg. It’s called deep vein thrombosis, orDVT. It can happen after you’ve been sitting for a long time, like on a long plane ride, or if you’re sick and have been in bed a long time.

If it’s a blood clot, you may feel the pain mostly when you stand or walk. You may also notice swelling.

It’s normal to feel tenderness after exercise. But if you also see redness and feel heat where it’s swollen or painful, call your doctor.

Teitelbaum says you can also check for what’s called the Homans sign. “If you flex your toes upward and it hurts, that’s also suggestive of a blood clot,” he says. “But don’t rely on that. If it’s hot, red, and swollen on one side, go to the ER.”

It’s important to catch a blood clot before it can break off and block your blood flow, which can lead to complications.

4. Blood in Your Urine

Several things can cause you to see blood when you pee.

If you have blood in your urine and you also feel a lot of pain in your side or in your back, you may have kidney stones. A kidney stone is a small crystal made of minerals and salts that forms in your kidney and moves through the tube that carries your urine.

Your doctor may take X-rays or do an ultrasound to see the stones. An X-ray uses radiation in low doses to make images of structures inside your body. An ultrasound makes images with sound waves.

Many kidney stones eventually pass through your body when you pee. Sometimes your doctor may need to remove the kidney stone.

If you see blood in your urine and you also have an increase in feeling that you urgently need to pee, make frequent trips to the bathroom, or feel burning when you urinate, you may have a severe bladder or kidney infection, Teitelbaum says. Don’t wait to see your doctor, especially if you have a fever.

If you see blood but don’t feel any pain, it may be a sign of kidney or bladder cancer, so visit your doctor.

5. Wheezing

Breathing problems should be treated right away. If you’re wheezing, or hear a whistling sound when you breathe, see your doctor.

“Without urgent evaluation, breathing can quickly become labored, and it can be catastrophic if not evaluated and treated quickly,” Agarwal says.

It may be from asthma, a lung disease, a severe allergy, or exposure to chemicals. Your doctor can figure out what’s causing it and how to treat it. If you have asthma, an allergist will create a plan to manage it and reduce flare-ups.

Wheezing can also be caused by pneumonia or bronchitis. Are you coughing up yellow or green mucus? Do you also have a fever or shortness of breath? If so, you may havebronchitis that’s turning into pneumonia. “Time to see your doctor,” Teitelbaum says.

6. Suicidal Thoughts

If you feel hopeless or trapped, or think you have no reason to live, get help. Talking to a professional can help you make it through a crisis.

Go to a hospital emergency room or a walk-in clinic at a psychiatric hospital. A doctor ormental health professional will talk to you, keep you safe, and help you get through this tough time.

You can also call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). It’s free and available 24 hours a day, 7 days a week. It’s confidential, so you can feel safe about sharing your thoughts.

cardiac examination

7 Medical Myths Even Doctors Believe

Popular culture is loaded with myths and half-truths. Most are harmless. But when doctors start believing medical myths, perhaps it’s time to worry.

In the British Medical Journal this week, researchers looked into severalcommon misconceptions, from the belief that a person should drink eight glasses of water per day to the notion that reading in low light ruins your eyesight.

“We got fired up about this because we knew that physicians accepted these beliefs and were passing this information along to their patients,” said Dr. Aaron Carroll, assistant professor of pediatrics at the Indiana University School of Medicine. “And these beliefs are frequently cited in the popular media.”

And so here they are, so that you can inform your doctor:

Myth: We use only 10 percent of our brains.

Fact: Physicians and comedians alike, including Jerry Seinfeld, love to cite this one. It’s sometimes erroneously credited to Albert Einstein. But MRI scans, PET scans and other imaging studies show no dormant areas of the brain, and even viewing individual neurons or cells reveals no inactive areas, the new paper points out. Metabolic studies of how brain cells process chemicals show no nonfunctioning areas. The myth probably originated with self-improvement hucksters in the early 1900s who wanted to convince people that they had yet not reached their full potential, Carroll figures. It also doesn’t jibe with the fact that our other organs run at full tilt.

Myth: You should drink at least eight glasses of water a day.

Fact: “There is no medical evidence to suggest that you need that much water,” said Dr. Rachel Vreeman, a pediatrics research fellow at the university and co-author of the journal article. Vreeman thinks this myth can be traced back to a 1945 recommendation from the Nutrition Council that a person consume the equivalent of 8 glasses (64 ounces) of fluid a day. Over the years, “fluid” turned to water. But fruits and vegetables, plus coffee and other liquids, count.

Myth: Fingernails and hair grow after death.

Fact: Most physicians queried on this one initially thought it was true. Upon further reflection, they realized it’s impossible. Here’s what happens: “As the body’s skin is drying out, soft tissue, especially skin, is retracting,” Vreeman said. “The nails appear much more prominent as the skin dries out. The same is true, but less obvious, with hair. As the skin is shrinking back, the hair looks more prominent or sticks up a bit.”

Myth: Shaved hair grows back faster, coarser and darker.

Fact: A 1928 clinical trial compared hair growth in shaved patches to growth in non-shaved patches. The hair which replaced the shaved hair was no darker or thicker, and did not grow in faster. More recent studies have confirmed that one. Here’s the deal: When hair first comes in after being shaved, it grows with a blunt edge on top, Carroll and Vreeman explain. Over time, the blunt edge gets worn so it may seem thicker than it actually is. Hair that’s just emerging can be darker too, because it hasn’t been bleached by the sun.

Myth: Reading in dim light ruins your eyesight.

Fact: The researchers found no evidence that reading in dim light causes permanent eye damage. It can cause eye strain and temporarily decreased acuity, which subsides after rest.

Myth: Eating turkey makes you drowsy.

Fact: Even Carroll and Vreeman believed this one until they researched it. The thing is, a chemical in turkey called tryptophan is known to cause drowsiness. But turkey doesn’t contain any more of it than does chicken or beef. This myth is fueled by the fact that turkey is often eaten with a colossal holiday meal, often accompanied by alcohol — both things that will make you sleepy.

Myth: Mobile phones are dangerous in hospitals.

Fact: There are no known cases of death related to this one. Cases of less-serious interference with hospital devices seem to be largely anecdotal, the researchers found. In one real study, mobile phones were found to interfere with 4 percent of devices, but only when the phone was within 3 feet of the device. A more recent study, this year, found no interference in 300 tests in 75 treatment rooms. To the contrary, when doctors use mobile phones, the improved communication means they make fewer mistakes.

“Whenever we talk about this work, doctors at first express disbelief that these things are not true,” said Vreeman said. “But after we carefully lay out medical evidence, they are very willing to accept that these beliefs are actually false.”


4 benefits of using iPads in medical schools

IPads are used in roughly one quarter of U.S. medical schools, free of charge or as a mandatory tool for learning. University of California at Irvine School of Medicine began using them in 2010. As these classes progress, it and other medical schools have found that the use of iPads is having some unintended consequences, particularly when it comes to how faculty use them in their courses and how their students have adapted.

More effective use of time

Dr. Warren Wiechmann faculty director for instructional technologies at the University of California Irvine School of Medicine, said in his regular conversations with other medical schools that require iPads or the equivalent one of the biggest challenges each medical school has faced was how to make it workable for faculty. After all, universities can’t just force faculty to adopt iPads like, say, students.

“They have seen fads come and go, and their initial reaction was, ‘why should we put all our eggs in one basket?’” Weichmann said in a phone interview. But since 2010 it’s made a huge difference on time management. At many medical schools at least some of the lectures are broken down into shorter, focused podcasts. Professors keep electronic office hours. They use the rest of the class time to teach in small group sessions. Clinical faculty have interactive rounds to reinforce core concepts Weichmann said. Stanford medical school took it a step further and has done away with lectures altogether in favor of podcasts. For newer medical schools like the University of Central Florida, they have built iPads into the curriculum almost from the start so the transition hasn’t been as complex.

Getting students used to using iPads in hospital environment earlier

Irvine’s third year students were the first class “the guinea pig class” to receive the iPads. With a class of roughly 100 students, they are probably the largest group of tablet users for a hospital. They have been learning how to use EMR and from the patient bedside have been using the iPads to improve patient education. They can do mini teaching sessions with the patient using diagrams and videos on the iPads to illustrate a procedure they will have.

Lower costs than standard textbooks

Students typically spend less than $50 on textbooks now, although many still want to have an anatomy textbook. But they have been good at finding appropriate digital content to complement the classes. One of the stated goals for medical schools introducing iPads is reducing paper costs. Even if students are required to pay for it themselves, an iPad works out to be cheaper than a year’s worth of textbooks, which can cost upwards of $800-$900.

A shift back to the Socratic method of teaching.

For years, medical education has tried to get away from didactic learning in favor of the Socratic method,Weichmann said, in which there are smaller groups of students having a more engaging question and answer session and debate with a professor. Although these developments didn’t necessarily have to happen because of iPads, the technology shift on med school campuses have advanced to the point where using the Socratic method has become doable.


Why Physicians Are Abandoning General Practice

Doctors don’t want to be general care physicians, they want to specialize, and it is a problem that will only get worse because it involves money.

Primary care physicians are at the heart of health care in the United States, they are the first to diagnose patients and e


ure those patients receive the care they need. But faced with increased regulations, paperwork, the onslaught of defensive medicine, malpractice costs and staggering medical school bills, many are instead opting to become specialists.

In Medical Education, a survey of more than 2,500 medical students attending New York Medical College and the Brod
The researchers then looked at those students planning to pursue a career in primary care, as well as those students planning to pursue any of the 12 specialties with a median income of more than $300,000 per year, based on 2010 salary data. By comparison, primary care physicians had a median income of just under $200,000 per year. Primary care consists of internal medicine, family medicine and pediatrics.y School of Medicine at ECU between 1993 and 2012 solicited answers at the beginning of their first year of medical school and just before graduation four years later. It asked the students what sort of medical career they planned to pursue, to estimate their final student loans and to rate the value they place on income.

The study found that anticipated debt was a significant factor in the students’ career decisions. Graduating students

who pursued high-paying specialties were facing average student loans of approximately $104,000, whereas those who chose primary care faced an average debt of less than $94,000. Students facing higher debt were also more likely to switch to high-paying specialties – including more than 30 percent of students who had expected to become primary care physicians when they entered medical school.

“We found that students who placed a premium on high income and students who anticipated having a lot of student debt were significantly more likely to pursue a high-paying medical specialty rather than become primary care physicians,” says Dr. Lori Foster Thompson, a professor of psychology at N.C. State and co-author of the paper describing the research. “This held true even for students who entered medical school with the goal of becoming primary care physicians – they often switched to high-paying specialties before graduating.”

First-year and graduating students who chose to pursue one of the high-paying specialties also rated income as being sign

ificantly more important than students who chose to pursue primary care. In addition, those graduating students who felt income was more important than they had as first-years were more likely to have switched to a high-paying specialty.

Other factors that guide student decisions about what specialty to pursue include parental or peer pressure, lifestyle desires and the exposure to more specialties once students reach medical school, though this study did not look at those issues specifically.

“The other major factor in choosing a primary care career is a service commitment – wanting to help others,” adds Dr. Da

le Newton, a professor of pediatrics at ECU. “Measuring such a commitment in a research setting is very difficult, however.”

The study suggests that measures should be explored to encourage primary care careers such as incentive pay, debt fo

rgiveness, additional scholarships and higher reimbursement for primary care services in order to meet the growing need.

You read that right. Their solution is to let schools charge whatever they want, 30X the rate of inflation in the last 20 ye

ars, and then forgive the student loan debt.

Yet Newton believes the Affordable Care Act will raise income of primary care physicians, which will make taxpayers nervous. “If the current efforts at health care reform continue, the incomes of primary care physicians should improve over the next few years. Primary care has to play a major role in the new health care paradigm.”

The study’s findings come as the Association of American Medical Colleges projects a shortage of 63,000 physicians by 2015, the vast majority of those in primary care. Given that, recommendations have come out saying that as the government takes over more of health care, doctors should do less of it. But patients want to use specialists more and more and that will only increase as government and insurance companies are required to take over more costs.

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