Monday, December 17, 2012

My daughter is 16, what car should I get her?

Here are my recommendations for your daughter:

if you want her to be invisible - Toyota Corolla

if she has Asian looks or a lot of Asian friends - 3 series BMW, only 3 series BMW, only and

exclusively BMW 3 series

if she hangs out with the hispanic crowd - Honda Civic

if she has come out as a lesbian and vacations in Provincetown, MA - Subaru Outback

if she is scared of driving, will likely never drive faster than 25 mph and her serum testosterone is below detectable levels - Honda CRV

if you live on the periphery of town and she helps out around the house - Ford F150

if you want her to look sophisticated and sportive - Audi A4

if you want her to look as bland and boring as possible - Toyota Camry

if she hangs out with those stuck-up, spoiled kids from the leafy suburb - Lexus IS 250

if she is an aspiring supermodel - Mini Cooper

if she plans to go to design school - VW Beetle with flower on dashboard

if she is crunchy, concerned about the environment, wears Birkenstocks - Prius

if you truly love her, want her to be safe, and also want her to have great driving experience - Mercedes C class

Sunday, December 16, 2012

Japanese honor?

Remember those old movies about the Japanese? Honor..... one of their highest values, an essential, basic, profound value. Without honor, they seemed to be unable to go on, without honor, they apparently could not live anymore. Honor lost, meant life lost, sometimes literally. Ahhh, the movies. How sweet..... and how wrong.
Modern day Japanese honor is different. Copying, interpreting, plagiarism - which to me is incredibly close to stealing - is compatible with honor. Reminds me of the honor of the mafiosi. Honor is strictly limited to whatever benefits the family, when it comes to others, to anybody outside the family blackmailing, killing and pretty much everything else is just fine.

Copying, interpreting (or however you want to call it) is OK in Japan, it is now an art form....plagiarism of car designs is good, plagiarism of brand image is good, imitating car types is fine....Every Lexus rolling on our streets is proof that all this is part of the new Japanese honor. A Lexus has to look like a Mercedes or BMW in dim light, or it is not a Lexus....The pick up truck, an original American concept, never needed nor seen in Japan before, now proudly a Japanese product, oh, the Tundra. When are we finally going to see an ad where the Tundra sits on the copier and out comes the copy, the F150?
Strangely enough, other car companies survive and thrive without plagiarism. Ford never steals designs, their cars may not look particularly well (except for pickup trucks and SUVs), but at least their designs are original. They can walk proud. That one Ford 500, later renamed into Taurus, that looked like slightly enlarged VW Passat, yes, we can forgive that and call it a "hommage" to the now classic Passat. Audi never copies, Audi IS COPIED. Audi has emerged in the last decade as one of the most innovative car companies when it comes to design, starting with the TT. The front of many cars, even American cars, owe their design to Audi. And Audi now sets the standard in light design. Volkswagen does not copy, VW made design history with the Passat. Chevy deos not copy, Chrysler does not copy, Subaru, Infiniti, Mazda do not copy (Yes, they are Japanese, I know), BMW does not copy, BMW blazes the way in design.
Turns out that Germany is quite the design power in automobiles. We used to think that Germans were just great engineers, but no, they are great designers as well. Leading the world, actually.

On the other side, Honda copied the 3 series BMW when they created their successful Accord many years ago. When BMW came out with the X6 -what a coincidence - Honda came out with the Crosstour. Acura routinely copied Audi until recently, Nissan's successful Altima and Maxima are based on the design of the VW Passat.

But Lexus, Lexus is in a whole different category. Lexus "copied" automobile design, "brand feeling" and automobile technology purposely, it was a basic, founding principle of the company. They went far beyond what anybody else thought moral.

I recently traveled to Rome, Italy and Freiburg, Germany. Hardly a Lexus on those roads there. I might have seen a single Lexus in the metropolis of Rome, but every politician and wealthy person and powerful appearing Italian had either a) a black Mercedes or b) a black Audi or c) a black Maserati Quattroporte. Those where the cars parked in front of government buildings and the cars that pushed their way through rushhour traffic with Polic escorts. Italians are the foremost experts in taste and beauty. They are very well aware of quality, and they know to distinguish between true class and beauty and imitations. So, no Lexus on their roads...
Germans on the other hand, grew up with the original, with the perfection that Lexus publicly claims to be pusrsuing, with.... Mercedes. And they reject copies and imitations.

When I asked a Japanese aquaintance about the morale behind Lexus and their shameless imitation of Mercedes he said with a smirk "Imitation is the highest form of flattery"
Oh, God. I hope someone "flatters" Toyota and Lexus one day and gives them a dose of teir own medicine. So far, they have nothing much worth copying....

Every Lexus on the road is a symbol of lack of honor, of lack of the ability and decision to build your own car, of going your own path. Every Lexus on the road is a symbol of shameless imitation and of the attempt to hook onto the excellent reputation built by Mercedes over decades of research, engineering and racing expience. As a parasitic design, Lexus lives off the feeling and memories you get when you see a mesterfully built car, a Mercedes-Benz. Lexus tries to steal those feelings, by looking as close as possible to a Mercedes. It tries to steal those feelings and to attach them to their own cars. Not quite honorable.

When is Lexus going to grow up? Other companies al over the world are quite able to manufacture their own cars in their own right and be proud of it. Not just BMW, not only Audi, yes, also Cadillac. Cadillac is a prime example. Cadillacs have very distinctive lines, a clear design that says "I am a Cadillac and I am proud of it". Cadillac does not advertise that it "pursues Medcedes", Cadillac simply announces in their ads that they are a thrilling, powerful and elegant car.

Why is Lexus so terrified to stand on it's own feet? Is the company not aware that it loses all respect by being the copy-cat company, by being the parasites on Mercedes' back, the "moochers"?
Yes, Lexus may have to get rid of that calcified stubborn top management that clings to the notion that only Mercedes and BMW are great cars. The upper management of Lexus is so conservative in their attempt to mimick Mercedes and BMW that they did not copy the Audi lights - the row of small circular lights in the main front headlights. No, they had to wait until Merecedes adopted them too - and "Bang", suddenly Lexus had them too, the lines of little circular bulbs in their headlights. Now even their lights at night are hard to distinguish from a Mercedes.
Guys, stop already. Hire a few original designers, and yes, there are plenty of them around, and go for it. Create your own look. Italians are particular good at design, Californians are good, hey, great designers are everywhere. Although I suspect it is really the upper management at Lexus that has to change before this happens.
Stop being the moochers! Nobody has respect for copiers and imitators. As long as Lexus keep imitating, imitating, persuing, persuing, running after Mercedes, as long as Lexus does that, the company is an embarrassment for it's country. Stand by yourself, grow up! Everybody else does it...

Tuesday, September 11, 2012


I always find it fascinating when a patient tells me that she took acidophilus bacteria by improve her vaginal flora.
I remember learning way back then in medical school that the stomach is a pretty hostile environment, that it is about a hundred times more acidic than Coca Cola and if you left a tooth overnight in Coca Cola it would completely dissolve and disappear. I learned that that stomach acid kills pretty much all bacteria except for tuberculosis bacteria and, I learned this a few years later, H. Pylori. And that this was one of the main barriers for the body to prevent bacteria from coming into the body.
So, those acidophilus apparently just pass the stomach acid unharmed. Not only that, they make it all the way though the bowel and then - miraculously - into the vagina! Ok, that is possible, E. Coli does it all the time. But still...
And why not insert the precious acidophilus directly into the vagina? Does the acidophilus get better after receiving a once-over in the bowel? Does it need to "christened" or "matured" or "pre-digested" or maybe "activated" by stomach acid?
Mysterious indeed, very mysterious!

Reminds me of the latest Geico ad:  Road runner stops by, zooms off again, Wiley coyote gets ready to eat our gecko, but gets buried by safe. Gecko shaking head: "Meep-meep??? What a strange place!"
I love that ad!

Physician - How to find your dream job

A reader of this blog wrote:
"I recently graduated from residency and relocated to the Dallas/Fort Worth area and have been utilizing nothing but job search engines and recruiters without any successful job matches....everything you've said hits home--its scary."

It was scary for me when I started looking after residency. I had graduated from a residency at a Harvard teaching hospital and thought it would be a snap to get a position in Boston itself.
No such luck! Nobody was rolling out the red carpet, nobody at all. Without knowing what I know now I took a position 40 miles from Boston.

I learned quite a bit from these experiences.

1. Ask your residency program director and your chairman for help. Talk to them, tell them what you are looking for, don't be afraid, don't be embarrassed. Ask all your attendings for help. Activate the network they have. Ask your relatives, family, neighbors, friends. Talk, ask.... you never know who comes up with a good lead.

2. Listen to their feedback. I wanted to do gyn only and one attending told me "you have to deliver babies, at least at first". How true, as I know now. This way you get in at a hospital/practice/group etc you like. Then you can work on reducing your OB or quitting OB. Also, once you are in a location you like, it is much easier to get into the loop and hear about good new job openings - because now you have access to the "Hidden Job Market".

Remember, the hidden job market encompasses all the jobs that are never advertised, because they are so attractive that word of mouth spreads about those jobs and they fill almost by themselves.


Recruiters never ever get even close to the hidden job market and they will acknowledge its existence only under duress, since it is not part of their world. All the "great opportunities nationwide", all the "thousands of job openings" did NOT pass the hidden market test. They were not that desirable, they had to advertised, and even worse, much worse, advertisements were not enough, they needed to go through a recruiter. A recruiter is an instrument of last resort for employers, expensive, involved, but sometimes necessary.


3. Do not start your job search by contacting recruiters, do not answer their calls, as seductive as it might sound - "oh, I am sure they will have a job" - Sure they do, but it is a "left-over-job". Starting your job search by contacting a recruiter is the equivalent of shooting yourself in the foot! Stay away from recruiter websites!
Screen the online jobs engines such as NTNJobs and HealtheCareers, especially the ones that advertise jobs with mention of location and income range. That should be a minimum requirement to send a reply.
Everybody seems to just loooove the pathetic expression "competitive salary" - meaningless filler sentence. Oh, really? Competitive? Competing with what? Minimum wage? Average wage? What? And how did the "competition" turn out, did you salary lose or win? More often than not, they lost....

4. Search though my blog. I have given very valuable tips (and vented) for a few years now and you will find most of the headaches of physician job search AND their solution in here

5. Mass mailing! Send your cover letter and CV to hundreds of physicians in the area you would like to practice. The absolute best way to find a job you like in exactly the area you want. I have described the technique in this blog in the past and you can also find it on WIKI HOW "How to find a physician job". You can do it yourself, quite easily, and feel the satisfaction that you - all by yourself - found your dream job!

6. Contact me by email. I'll help you with advice and ore tips

Saturday, February 25, 2012

What was that kid thinking?

Recently I was surprised to see an 18 year old guy, baseball cap sideways on his head, driving a...yes, a.....Silver Camry!
Man, if you want to be cool, and I guess you want to, what other reasons would you have to turn your cap sideways.....if you want to be cool, get the hell out of that car! What are you doing sporting a sideways turned cap in the most vanilla car on the road?

The best way to become completely invisible is a silver Camry! Or even better, an older model dark blue Camry. Nobody will notice that you drove by, nobody will remember you, ever.
The Men in Black are thinking of switching their cars.....

Saturday, February 18, 2012

A classic recruiter attitude towards criticism

In 2007 I posted "Avoid physician recruiters", a blog post where I summarized my bad experiences with recruiters.

Now, 5 years later, someone came across that blog post and sent in the following comment. I am posting it here, because it is a great example of how recruiters think. And it is worth going into the flaws of that attitude:

"Anonymous" comments are in " "- and my comments follow without quotation marks....

Anonymous wrote:

"Your points are only valid dealing with recruiters who are very unprofessional and have no idea what they are doing."

Which makes up the vast majority of the about 150 or so recruiters I have personally dealt with. It is quite a convenient way of escaping criticism to simply say - the others are bad, but this does not apply to me, I am one of the good ones! A variant of this is "of course there are bad apples among the recruiters, as in any other field", usually followed by "but not too many".....
Very strangely, those "good recruiters" only seemed to surface after I posted my bad experiences. Before posting my complaints, the good recruiters were remarkably absent. You know, had I found the job I wanted without all the misleading ads and all that BS that got me so upset, I actually would have been happy and I would have never posted any bad experiences on my blog. Doesn't that make sense? Where were all the "good recruiters" when I was trying to find a job?

"If done correctly we recruiters find jobs that are off the radar - nobody else has these jobs."

This is hilarious!
Recruiters finding jobs that are off the radar....It is hard to believe that recruiters have so little inside in the job finding process that they actually dare to say this. Dear Anonymous, I challenge you to tell me HOW you find jobs that are "off the radar". I would be most interested in your definition of "off the radar" and in your way of finding them.

And here is the executive summary about job finding - for my physician colleagues:

1. The best jobs are passed on among people who know each other personally or have a close working relationship to each other. I hear from a friend over a beer at night that at a hospital nearby, closer to town and near the water a colleague is relocating to another state. Next day I call the chairman and get the job. Another way this may work is that the chairman announces a future vacancy and calls around or announces the position to the graduating residents and / or fellows. The really good jobs are actively pursued by physicians and passed on by word of mouth.
Think Harvard system jobs, close to downtown jobs, jobs in generally very desirable areas.

2. The OK jobs are not snapped up immediately by active physicians that monitor certain hospitals or employers, but require either a longer time in "spreading the word" or even ads in throw away magazines such as "OBGmanagement" or similar. For the employer, this is still an inexpensive option, these ads cost thousand to a few thousand and are usually effective in reaching enough candidates to fill the position. These jobs often are located at the edge or beyond the suburbs of larger cities or have some other drawback, such as lower pay, higher call etc. Recruiters that monitor the throwaway journals find them and often try to present their candidates to these employers. Obvioulsy these jobs are anything but "off the radar".

3. Hard to sell jobs. The community hospital in Desert Gulch, despite being in several "Top Hundred" hospital lists (aren't they all....) consistently has difficulties luring young physicians into their remote location. They are the classic client for recruiters. I have multiple posts on my blog that poke fun at the euphemisms that recruiters routinely use to fudge over undesirable locations, oh the ways they oriented, easy access to, plenty of outdoor recreation, affordable real estate, low crime rate and many more...
Maybe these are the job that "Anonymous" refers to. Yes, these jobs are most certainly "off the radar" for most physicians...and yes, they always are offered through recruiters.

The Munford law applies: The more desirable a job is, the less likely it will be presented by a recruiter. And of course, the inverse is true as well. The less desirable a job is, the more likely it will be presented by a recruiter!

And, yet again, for the n-th time, my definition of what physician recruiters do:
"Physician recruiters specialize in selling the undesirable, left-over jobs that are too hard to fill for the employers - to unsuspecting physicians"

But, back to the comments of "Anonymous"
"We suggest NOT posting any CV online in order to avoid unwanted harrassment and the perception of desperation."

Huh? Who suggests posting CVs online? Most certainly not me. Try to find that recommendation in my blog. Maybe Anonymos did not read much of my blog?

"I only involve myself as much as my candidate wants me to involve myself."

That I do understand, more than that would be pushy and would not get you anywhere....duh.

"My wife is a physician and so are all my friends at Harvard."

Ahaaa! Anonymous has credentials! Many "friends at Harvard". Good going! From now on, we should believe and trust this Anonymous, right? He has friends in high places!
Did I mention that I trained at a Harvard hospital myself? As a physician...?

"I NEVER suggest only using me.. I always help them to apply to groups that won't use recruiters and explain how to get their CV to the decision maker."

Oh, one of the few recruiters that I unfortunately never met. No recruiter has ever offered me such a great deal. No recruiter ever introduced me to groups that do not work with recruiters. Again - all these statements about helping physicians in unconventional ways only surfaced AFTER I started blogging about it. Strange, very strange indeed....

"You really should not make suggestions about ALL recruiters as if they are the same. I feel bad for you because your experience with recruiting is obviously not favorable."

We commented on that before...

"Most likely you are not a physician because if you were you would be entirely too busy, as most GOOD physicians are, to do your own busy work to find great opportunities."

Well, well, well....after preparing the field by slipping in the "all my friends at Harvard", here comes the kill shot - I am most likely NOT a physician!
That caught me by surprise, because last time I checked, and that was yesterday, my MD ID was still in my wallett, my board certification was uptodate, my graduation certificate from a Harvard hospital was still on the office wall...and, ah, what is the title of this blog? Care to notice? It reads "A Physician on...."
But, Anonymous backs it up, he has a very good reason for suspecting that I am not an MD! Wait, wait, wait, he is not done....
Anonymous thinks that "GOOD physicians" (sic!) are "entirely too busy" "to do their own busy work to find great opportunities" (notice the busy..busy in the same sentence?)
Now the cat is out of the bag - I am not a GOOD physician! Damn, that 5 star rating on the web must be an error...And the fact that I have not been sued must be an error as well...
Nice try though...

A basic truth in lfe is that efficient and successful individuals actually do have a lot of time. The inefficient ones don't. Another issue is where you place your priorities, and finding the right place to work was certainly a high priority for me.
What else might "GOOD physicians" not have time for? I can only guess...
But I will certainly remind our president that "GOOD lawyers" should not have time to get involved in politics! There you go!
I love this argument, this link between being GOOD and not having time for a lot of things....

This particular comment was my main reason for posting this. It is a classic recruiter myth that you just need a recruiter to find a job, yes, you need it, because you are such a busy physician. Recruiters hand physicians this compliment and at the same time very smartly push themselves on you. Compliments always, always work, no matter how untrue they are (scientifically proven BTW). Everybody loves compliments. This is actually a very clever marketing and sales trick. Who would not fall for the hidden compliment in that comment "You - as a good physician - are sooo busy" and say "yes" to it. And once the physician started agreeing with the recruiter, once the physicin started saying "yes", it is a much smaller step for the physician to say "yes" again to the recruiter's next statement, which invariably will involve "you need a recruiter". Basic and very effective sales technique. Has been used by used-car-salesmen for decades! Read more about sales techniques in "Influence: The Psychology of Persuasion" by Robert Cialdini. Of course, no GOOD physician would have time to read such a book.

"Hence the three... now four comments."

At this point Anonymous feels he is finishing me off by stating "nobody reads your blog anyway".
Who cares? Those who read it benefit from it - if they are physicians - or get a rare opportunity to explore the dark side of their business practices - if they are recruiters.

My point is: Dear collegue, your job search is by far too important to involve a recruiter!