practice makes perfect

Cost of Living Stats...and More

I'm adding a few resource links to both blogs that provide a wealth of information that could play into your decision on where to practice. There are so many things to consider when making a life-altering and financial decision simultaneously, and one can have a direct effect on the other.

The first site link is to the U.S. Census Bureau's official census regions and divisions of the United States, prepared by the Geography Division of the U.S. Dept. of Commerce. Not only is each region divided into divisions, but both regions and divisions have had some name changes over the years. The Midwest Region used to be called the North Central Region, and the East North Central division is what we used to affectionately call the Great Lakes Region. Be careful helping your elementary school student with their geography homework! At least they haven't changed the state capital names - yet.

Once you've located some areas of interest, you can go to Sperling's Best Places and pull-up detailed information on any area. You can even create multiple side-by-side comparisons on topics as varied as: people, crime, economy, health, housing, transportation, education and climate. The 'general' link gives you a high-level overview, including the most important stat - the number of Starbuck's locations? Yes, that's right, the number of Starbuck's locations, or how far to the next caffiene fix. Seriously, though, there is a lot of detailed stats here, including per capita figures for the number of physicians, healthcare costs, illnesses, air and water quality, even the number of Superfund sites.

True cost of living considerations such as housing, food and education costs can make a big difference over the years in your disposable income, savings rate, and general quality of life. Many out of the way locations offer bright prospects for future economic and population growth, while offering a wonderful quality of life for a growing family.

We are truly blessed to live in a country of such vast diversity in geography, climate, cuisine and culture.
In this age of technology, a little online research can make the process of making your medical practice and lifestyle choices easier.

Word Etymology

After I named a category 'Practicing out in the Boonies', I thought, hey, this is shortened slang for another slang term "boondocks". But where in the world did that word come from? I went to the bookmark for one of my favorite sites: Merriam-Webster Online. It is free and gives you a great interface for both a dictionary and thesaurus. I was in for a big surprise on this word's origins. Merriam-Webster shows the etymology as:
Etymology: Tagalog bundok mountain
1 : rough country filled with dense brush
2 : a rural area : STICKS

Well, the first thing I asked myself was, what language is 'Tagalog'?
Tagalog - Pronunciation: t&-'gä-"log, means
1 : a member of a people of central Luzon
2 : an Austronesian language of the Tagalog people -- compare PILIPINO

Central Luzon? Austronesian? My mind is on the wrong continent now - If the meaning is mountain, I picture a Swiss Alpine scene and someone saying "Bundok!" But that reference to 'Pilipino" and the 'nesian' on the end of 'Austro' starts my mind awandering elsewhere in the world:

Again from Merriam-Webster:
Etymology: Austronesia, islands of the southern Pacific
: of, relating to, or constituting a family of languages spoken in the area extending from Madagascar eastward through the Malay Peninsula and Archipelago to Hawaii and Easter Island and including practically all the native languages of the Pacific islands with the exception of the Australian and Papuan languages

In middle English and in Norse, the term 'sticks' is applied to mountainous areas of dense brush and woods. This is a synonym for 'boondocks'. I am always fascinated at the number of unusual words we use with a precise vision of their meaning in our mind, but no consciousness of where they came from.

A few weeks ago, my husband and I watched one of the less covered 'sports' on ESPN - the national spelling bee finals. In fact, we enjoyed it so much, we tuned in when it was repeated several days later to see the part we missed. (Don't worry, we do get out once in a while, too.) We were very impressed with these 12 - 15 year olds standing under hot lights, spelling impossible words. They methodically asked questions of origins, meanings, pronunciations, and usage examples to derive the correct spellings in their mind - no paper or pencil allowed.

Perhaps their gift for understanding Latin, Greek, and other language forms will help them in medical school one day!

Other or New Category Please!

Well, I came up with the list of categories you see to the left, trying to think through the different topic areas that might be of interest to physicians just starting out, or those contemplating a move. Categories without a post yet are:
Practice Economics
Flying Solo
Practice Politics
Relocatiing Family
Making the Decision to Make A Change
Suburbia
Quality of Life
Other/New Category Please is the catch-all, miscellaneous, and all the categories I never thought of choice.
I'll be including some bits of research in all these areas, so please send me a comment on your interests.
Thanks.

Healthcare Access in the Country

When I was a toddler, I had asthma attacks fairly often. At least several times, I know my parents raced me over country roads to the doctor's office some 15 miles away for a shot of adrenalin. At that time, before the advent of the federal interstate highway system, living 30 miles from Philadelphia was considered the "exurbs" - beyond the suburbs, a catchy new name for rural communities outside large metropolitan areas.

When I-95 came plowing through, however, some small villages and the adjacent farmland became hubs of growing populations from housing developments, with widened roads and shopping strip sprawl. Others went by the wayside, becoming nothing more than crossroads with names only known by locals whose families had lived here for generations. Newcomers wondered why roads took 90 degree turns. (Originally, to respect each farms boundaries)

Even now though, living smack-dab in the middle of the northeast corridor, somewhere between Philadelphia, Allentown, and Princeton, I travel on and over some of the last dirt roads and stream fords left in this area of the country. When I need to go grocery shopping, or to the doctor or hospital, I still travel 1/2 an hour to get there. To me, this is a small price to pay for peace and tranquility, but it sure is inconvenient when you don't feel well and need to fill a prescription.

There certainly are far more remote areas in much less populated areas of this country where people travel much further than I to get medical attention. I've often wondered whether doctors that practice in these remote areas do so because it has always been their home, or if they have made a choice to do so because, for some reason, they were attracted to a lifestyle much different than their up-bringing.

Top 10 - Fastest Growing Cities

Physicians are needed everywhere, but there is particular need (and opportunity) in areas where the population is growing faster than services can catch up.

Here are the top 10 fastest growing cities in the U.S., as listed on http://www.govspot.com:

Metro Area Growth* Population
1. Las Vegas 83.3% 1,563,282
2. Naples, Fla. 65.3% 251,377
3. Yuma, Ariz. 49.7% 160,026
4. McAllen-Edinburg-Mission, TX 48.5% 569,463
5. Austin-San Marcos, Texas 47.7% 1,249,763
6. Fayetteville-Springdale-, AR 47.5% 311,121
7. Boise City, Idaho 46.1% 432,345
8. Phoenix-Mesa, Ariz. 45.3% 3,251,876
9. Laredo, Texas 44.9% 193,117
10. Provo-Orem, Utah 39.8% 368,536

Source: U.S. Census Bureau

* Growth rate from 1990 to 2000

I would be interested to know what the outlook is where you are currently, or where you are considering practiciing. Is this a big factor in your choice of where you want to practice medicine?

Community Involvement - I'm Curious

Physicians have always played an integral role in the fabric of any community. Every frontier town in the TV westerns had one who was an important character in every episode. Even the new HBO series "Deadwood", filled with gruesome, evil excuses for humanity, has a somewhat benevolent and caring 'doc' trying to patch-up all the inhumanity around him.
The important contributions doctors quietly made behind the scenes in frontier America were probably well known through the grapevine, but in today's fast-paced, high tech, and litigious society, how do you find the time, energy and venue to make a difference outside your office? Are you able to coach a sports team or volunteer in an area outside of medicine? Do those activities relieve stress, or contribute to it? I'm just curious.

Big City Living - Coming Soon

This is an idea for a category where physicians and their families can relate their experiences about practicing and living in the urban landscape. Some interesting stats and research to follow. Any comments?

A short visit to Amazon

No, not to the Amazon, to Amazon - the website. One small search phrase on Amazon leads you from book to book, then topic to topic. It's a jungle of books and other media out there! That must be where the name came from.

Anyway, to get the ball rolling I thought I would throw out a few physican and medical practice related titles I ran across in my search:

How to Join, Buy, or Merge A Physician's Practice, by Yvonne Mart Fox & Brett A. Levine

Caring for Patients from Different Cultures: Case Studies from American Hospitals, by Geri-Ann Galanti

The Successful Physician: A Productivity Handbook for Practicioners, by Marshall O. Zaslove

Caring for Patients: A Critique of the Medical Model, by Allen B. Barbour

The Business of Medical Practice: Profit Maximizing Skills for Savvy Doctors, by Dr. David E. Marcinko, MBA, CFP

I haven't read these books (although the completely unbiased reviewers on Amazon think they are great!). Perhaps you have read one of these - and would, or wouldn't recommend the book to someone else.

What other books do you recommend on practice set-up and management, patient care, or other topics? Perhaps I'll track down a book author or two and invite them to post.

Well, on to another category - let's see, where will my research take me next? Urban practice and living? What to do when your 13 year old daughter will "absolutely die" if you take that wonderful new opportunity 6 states away? Read on - but not too quickly - it takes time to get all these plates twirling at once! Check back soon to see new Categories popping up.