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5 podcasts that will make you a better doctor

Physician Sense, for MDLinx | September 06, 2019

How do you use your commute time? Do you spend it mindlessly listening to top 40 radio, pounding your fist on the steering wheel, or ruminating on your day ahead? There’s a better way to ease your way into the workday. Podcasts help prepare your mind for the rigors of practicing medicine, turning what would be an aggravating or mindless morning commute into an intellectually stimulating experience. Doctors should start with these 5 podcasts.

The Peter Attia Drive Podcast

Dr. Peter Attia is a physician who made the transition from emergency medicine to specializing in longevity and wellbeing. Though, like any ethical doctor, he never names his clients, many of his guests have talked about working with him. Some you might recognize, such as legendary music producer Rick Rubin and Silicon Valley guru Tim Ferriss. The Drive brings leading minds of medicine and science to discuss their work. Physicians are sure to glean insights they can carry into their own practice. To get a taste for what Attia is all about, start with his episode with sleep expert Matthew Walker, PhD.

Found My Fitness with Dr. Rhonda Patrick, PhD

Dr. Rhonda Patrick exploded onto the podcasting scene after several marathon appearances on Joe Rogan’s Podcast. Her doctorate is in biomedical science, and as a result, Patrick gets really granular with the biological and chemical underpinnings of modern disease and illness. What makes Patrick so fascinating is how she synthesizes her knowledge in such a way that clinicians and even laypersons can practice what she preaches. Guests frequently include some of the world’s leading researchers. Start with this episode with Dr. Dominic D’Agostino for a deep dive into carb-restricted diets.

The Tim Ferriss Show

This isn’t a medical podcast, but it can’t be all medicine all the time, doctor. You need some balance. Tim brings experts from industry, sports, music, you name it, to pick their brains about what drives them toward excellence. As a result, Ferriss might just be the most well-rounded person alive. There are a myriad of life and work lessons to be gleaned from Ferriss’ guests. The best part about Tim’s interviews is they almost always deliver tips you can put into action immediately. Start with this episode with chess champion and learning theorist Josh Waitzkin.

Warning signs of too much fiber

Naveed Saleh, MD, MS, for MDLinx | September 05, 2019

Fiber is vital for a healthy digestive system. It facilitates fermentation and gas formation, and helps improve the bulk and regularity of bowel movements. In addition, a high-fiber diet can help with the regulation of lipid and blood pressure levels, diabetes control, and weight maintenance.

But is it possible to get too much of a good thing?

As with most everything, moderation of this carbohydrate is key. Eating too much fiber (> 70 g daily)—as is common with whole- or raw-food diets—can result in you making a beeline for the bathroom, as well as other uncomfortable side effects.

Fiber requirements

The American Heart Association recommends fiber intake from a variety of foods. Total dietary fiber consumption should range from 25 to 30 g daily from food—not supplement—sources. More specifically, the Academy of Nutrition and Dietetics recommends 25 g of fiber per day for women and 38 g a day for men. Adults aged 50 years and older should consume less fiber, at 21 g per day for women and 28 g per day for men. Pregnant or lactating women should eat 28 g of fiber per day.

Types of fiber

Fiber exists in two forms: soluble and insoluble. Even though the body can’t absorb either form, they are both necessary. Soluble fiber breaks down in water and forms a gel that keeps feces soft while slowing digestion. Insoluble fiber does not break down, instead adding bulk to stool and decreasing transit times. The body needs both types of fiber, so most research simply focuses on total fiber intake.

Too much fiber

Symptoms of eating too much fiber can include bloating, gas, cramping, constipation, diarrhea, reduction in appetite, and early satiety.

One of the negative side effects of overconsumption of fiber includes the underabsorption of key micronutrients, since fiber binds with minerals, such calcium, iron, magnesium, and zinc. Furthermore, high-volume meals can make it difficult to keep up energy intake, resulting in weight loss or lack of weight/muscle gain. Lastly, intestinal obstruction can occur in the setting of copious fiber intake but limited fluid intake.

Physician pay is on the rise, but for which specialties?

John Murphy, MDLinx | September 05, 2019

Physician compensation increased, but improvement in productivity remained low in 2018, according to data from the American Medical Group Association’s (AMGA) new 2019 Medical Group Compensation and Productivity Survey. Among specialties, primary care physicians and psychiatrists earned significantly more, while other specialists—notably pediatricians, radiologists, ophthalmologists, and OB/GYNs—had a loss in compensation.

Income on the rebound

Overall, compensation among all physicians rose by a med­ian of 2.92% in 2018, compared with a 0.89% increase the previous year. Meanwhile, productivity (as measured by work relative value unit, or wRVU) increased by only 0.29%, but that’s in comparison with a 1.63% decline in 2017.

“The 2019 survey shows that physician compensation in 2018 rebounded from a stagnant 2017,” said Fred Horton, MHA, president, AMGA Consulting, Alexandria, VA. “While productivity also increased, it did not increase enough to surpass the decline we saw in last year’s survey, meaning productivity still has not risen since 2016.”

AMGA Consulting (an AMGA subsidiary) conducted the survey by compiling data submitted by 272 medical groups, representing 117,030 providers from across the country.

In 2018, compensation-per-wRVU ratio increased 3.64%, compared with a 3.09% increase the previous year. Hospital administrators and employers use this ratio as a guide to align productivity relative to compensation.

Primary care compensation

For all primary care specialties, median compensation increased by 4.91% in 2018—a significant gain from the 0.76% increase in 2017. Meanwhile, productivity was flat, with wRVUs increasing only 0.21% in 2018. As a result, the median compensation-per-wRVU ratio increased 3.57%—the largest increase for primary care specialties in 4 years. 

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