Tuesday, September 11, 2012


I always find it fascinating when a patient tells me that she took acidophilus bacteria by mouth....to 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