Starting A Company As A Medical Student: An Interview With Stephanie Bravo

Having A Good Mentor Can Make A Big Difference

It has been said that you are the average of the five people you spend the most time around. If that is true, the formula is simple; find people that are doing what you want to do and tag along. Unfortunatly, it's not always this simple; however, StudentMentor.org is changing that. This company is dedicated to helping college students find mentors to help them along their journey. They are working with students from over 700 colleges in the the United States. They are currently partnering with the White House on several national education initiatives. It's an impressive operation!

So how did this whole thing get started? I caught up with Stephanie Bravo who is Co-founder of studentmentor.org. At the time, she was a medical student at University of California Irvine School Of Medicine. She is currently President of the company and works full time with the organization and has alot of good advice for medical students.

How did you decide to start StudentMentor.org?

I decided to start StudentMentor.org after having a life-changing experience with a mentor during my years as an undergraduate. I was a first-generation college student who felt completely lost at a large public university and was unsure about my future. But then I found my mentor through the Stanford University Minority Medical Alliance Medical Mentorship Program, and this experience changed my life. My mentor, Dr. Matthew Goldstein (http://www.studentmentor.org/about-us/advisory-board/#goldstein), was a medical student at Stanford University School of Medicine, and he provided so much guidance throughout my studies, especially during those challenging times when completing college and attaining a career as a physician seemed out of reach. Even more than that, we got to talking about life, family, and a variety of other things where he provided tremendous support for me at times when I had no one else to help me. Because of my life-changing experience, I wanted to help other students connect with mentors who could help them at crucial stages in their academic and career pursuits. Thus, StudentMentor.org was born to help students complete college and enhance their career readiness by connecting them with seasoned professionals from a wide variety of backgrounds and industries.

What where some of the challenges/perks of starting a company while in medical school?

There were not enough hours in the day for me to be a well-balanced person, succeed in medical school, and lead an organization. It was very difficult to maintain my course load and go through the process of creating something from scratch. I had to rely on my StudentMentor.org co-founder and friends in medical school to help me juggle. Shifting between these roles was tough, but both required a great deal of tenacity and a strong work ethic. With those in tow, I pursued both medicine and my startup nonprofit for a while. I managed to survive by being very diligent, disciplined, and organized. But, because I was incredibly passionate about StudentMentor.org and the broader issue of higher education, I decided to fully commit to leading my organization and put becoming a physician on the backburner. I know I made the right decision when we received a call from the White House inviting us to meet the President and speak with officials about StudentMentor.org in December 2011. Additionally, after one year, 5000+ mentors and students from all around the nation are connecting and beginning meaningful mentorships. It’s very exciting to be at the helm of an organization that is soaring to great heights at a record pace.

How can medical students and residents get involved as a mentor and what is the time commitment that a mentor makes?

The time commitment for mentors varies depending on their availability. You can communicate with mentees at any time convenient for you. We recommend that mentors set aside about 30 minutes a week to mentor one student. Since professionals come from a variety of industries and backgrounds, it’s very flexible to their schedules. Medical students all the way up to attending physicians can serve as mentors. We even have resident physicians in the program who somehow find time to help their mentees. I hope that those UncommonStudentMDs will consider joining StudentMentor.org too.

You have become an expert at helping people find mentors. Can you give some advice on how to find and approach a mentor?

The best way to reach out to potential mentors is to ask them if they have time to grab coffee. If you speak candidly about looking forward to hearing their experiences and learning from them, then a potential mentor will be receptive. It’s not a good idea to lead with what you want to get out of the relationship, e.g. a letter of reference, the contact information for their colleague, etc. Like with any relationship, you have to put in the time to build trust, and that starts with putting yourself out there by telling your story, sharing your goals, and realizing that a mentor’s insight is extremely important in helping you achieve your goals.

Do you have any advice for medical students who would like to start a business?

Taking time off from school might be the best move since building a business is a huge time commitment—kind of like medical school, but without a 4-year plan or any other roadmap. That being said, I’ve had amazing classmates at UC Irvine School of Medicine who have written and published novels, created student organizations, and ran underserved clinics while still maintaining a full course load—so it is possible!

Another, big tip is to reach out for help and persuade people to your cause. If you can build a movement that your classmates are passionate about as well, then you’ll have 100+ medical students in your corner to help get your business off the ground. It’s very important to build and utilize your networks in any business, including medicine.

Why did you want studentmentor.org to be a non-profit instead of a for profit company?

There are pros and cons to both entities. In a for-profit entity, the bottom line would always rule and not necessarily doing the most good for the cause. We decided to become a nonprofit to keep the monies accrued by the organization focused toward achieving its goals. Additionally, it was a lot easier to recruit mentors who are all volunteers.

If you could pick one book for every medical student to read what would it be?

I would recommend “The Empowered Patient” by Elizabeth Cohen, CNN Senior Medical Correspondent. It’s great to read books on the “white coat” reading list, but a holistic understanding of the medical profession comes from reading books written for patients as well. This book by Cohen offers patients insight into how patients should go about getting the best medical care possible. She argues for being a “bad patient” by asking questions and not blindingly doing what you are told until you understand what and why you need to do it. As future physicians, it’s absolutely critical to be able to communicate with patients. So, learning more about the patient's perspective and trying to meet them where they stand is a good start to becoming a great physician.

 Video: Why I Started StudentMentor.org

 Video: How StudentMentor.org Works

Say Goodbye to Your Stethoscope: An Interview With Dr. J. Christian Fox

With Portable Ultrasound, Some Medical Students are Already Ahead of the Curve.

So you're on wards, doing your best to look smart, take care of your patients, and get that fine letter of recommendation. Suddenly, the attending thinks he hears an extra sound while doing a cardiac exam. Now, full of joy and self pride, he will take time to let you have a listen. The goal, of course, is so you can develop your powers of cardiac auscultation or look like an idiot, the latter being more likely. Either way, you eagerly place your stethoscope over the patient's chest wall with a very intelligent and contemplative look, all while trying your best not to seem studentish. Tuning in to listen, you even furrow your eyebrow a little, shake your head up and down and mutter, “Hummmm very interesting....yeah...that’s very interesting,” careful not to oversell it. Of course, you hear no murmur, nothing other than good ol’ S1 and S2 lub dubbing along. But, you cannot disappoint your attending who is looking down at you full of pride for catching this slight blip on the radar of the patient's cardiac cycle. He is just glad someone is here to appreciate the level of medical acumen that has just been demonstrated and imparted to a future doctor who will carry on the sacred art.

Learning to identify and diagnose patients based on every little slosh or swoosh heard by your stethoscope is a skill that we are all expected to master as a medical student. However, according to Dr. Eric Tropol, you may never need it as a physician. As I watched the TEDMED talk by Dr.Topol, I learned that we may not need the stethoscope for long. Medical wireless and portable ultrasound companies are developing new devices that make it possible for doctors to carry an Echocardiograph machine in their lab coat. So now I don’t feel so bad about my underdeveloped auscultation powers. If I cannot hear something, I’ll just get and echo or ultrasound; problem solved.

However, now we have another predicament. Have you ever been asked to explain what you see on an ultrasound or echo? I have, and I get the same feeling when looking at a Jackson Pollock painting. Usually, my face gets all wrinkled, I shrug my shoulders and shake my head, utterly clueless. I have also been known to take the 3D Magic Eye approach, pushing my nose to the screen and staring intensely, hoping that a 3D image will magically pop out at me making the diagnosis. Hasn’t happened yet, but I’m still optimistic. There are a few medical students in the nation who are probably reading this and thinking I’m a giant kook because they can read ultrasounds in their sleep. Dr. J Christian Fox is the director of University of California Irvine’s portable ultrasound program. Part of his passion is to give the medical students and residents training in ultrasound techniques. He sees that the use of ultrasound will continue to grow as a tool for diagnosing and treating disease. After the interview, I was left wondering why more institutions aren’t teaching ultrasound in their curriculum.

 To Learn More Visit:

• www.ultrasound.uci.edu
• Search Fox Ultrasound in iTunes for free Podcasts
• www.sonosim.com

Check out our conversation below

Taking Advantage Of Opportunites: Lessons From Dr. King

“If you can choose between opportunity and security, always choose opportunity.”

A couple of months ago, a wise friend gave me that sage advice; but sometimes I wonder, "What type of opportunity should I pursue?" Opportunities come in all shape and sizes. Which ones are important? Which ones will make a difference?

This incredible excerpt from a sermon given by Martin Luther King Jr. shows how he thought opportunities ought to be pursued. It is inspirational, humbling, and poignant.

I’ve also included the original audio below, thanks to archive.org. I think it's better coming from the man himself, definitely worth a listen.

And I say to you this morning, that if you have never found something so dear and so precious to you that you will die for it, then you aren't fit to live. You may be 38 years old as I happen to be, and one day some great opportunity stands before you and calls upon you to stand up for some great principle, some great issue, some great cause--and you refuse to do it because you are afraid; you refuse to do it because you want to live longer; you're afraid that you will lose your job, or you're afraid that you will be criticized or that you will lose your popularity or you're afraid that somebody will stab you or shoot at you or bomb your house, and so you refuse to take the stand. Well you may go on and live until you are 90, but you're just as dead at 38 as you would be at 90! And the cessation of breathing in your life is but the belated announcement of an earlier death of the spirit. You died when you refused to stand up for right, you died when you refused to stand up for truth, you died when you refused to stand up for justice.

-Dr. Martin Luther King, Jr. from the sermon “But, If Not” delivered at Ebenezer Baptist Church on November 5, 1967.

Interview With Dr. Steven Knope: Concierge Medicine, Medical School & Doctors Taking Control Of Their Careers

Steven Knope MD weighs in on concierge medicine, medical school, the future of healthcare, and doctors taking control of their careers.

The television show Royal Pains explores the thrills, challenges, and adventures of Dr. Hank Lawson an Emergency Room Physician who, through a simple twist of fate, became a concierge medicine doctor. Though I’m not an avid fan, I have seen a few episodes and remember thinking, “Sure it makes for great television, but nobody really does that...right?” Well I was wrong. Enter Dr. Steven Knope MD; he has become a leader and innovator in the field of concierge medicine. A quick look at Dr. Knope’s biography and you realize he is part physican, musician, athlete, and ninja. His bio includes a stint as a professional french horn player, triathlete who has completed four ironman triathlons, and a martial artist with a 3rd degree black belt in Kenpo Karate. He is a physician who has always been willing to chart his own course and follow his passion to deliver the best health care possible to his patients. I was able to catch Dr. Knope in between seeing patients and practicing Chuck Norris round-house-kicks to pick his brain a bit; here is what I learned.

How did you get started doing Concierge Medicine?

I was actually asked to start a concierge practice by 4 of my patients 11 years ago.  They wanted more of my time and more access to their physician. They liked my care, but they didn’t like having office visits limited to 10 minutes. They wanted a more personal relationship with their doctor. After they approached me with this request, my initial thought was that this type of practice model was “elitist” and “unethical." How could I limit patients access to my services to only the few who have the means to pay up front? These thoughts forced me to do a lot of reading and soul searching. I ultimately came to the conclusion that our current third-party system was in many ways unethical in it’s own right, and I decided I wanted to begin treating patients on my own terms. So, I started a pilot concierge program with just 4 patients, and it slowly grew into my present full-time practice.

What do you like best about being a concierge doctor?  

I enjoy having the time to practice good medicine and the freedom from corrupt insurance companies, HMOs and the U.S. Government in the form of Medicare.  In short, I am intensely individualistic, and I like practicing medicine on my own terms. For example, in addition to helping my patient when they are sick, all of my patients have a customized nutrition and exercise program. This type of freedom comes with a price, but I feel it is worth the price.

What does a day in the life of a Concierge Medicine Doc look like?  

Every day is different, which is why I like it. In my old practice, I used to see 30 to 40 patients every day!  It was mind-numbing. Every day was the same, and I was always running, always buried in trivial paperwork, always trying to meet my overhead – as Medicare, insurance companies and HMOs determined how much money I was allowed to make.  If you like servitude, you’ll love third-party medicine.  If you are an independent soul, you’ll need to get outside of this system.

What where some of the key lessons you learned while making the switch from a more traditional medical practice to becoming a concierge doctor?  

You have to develop entrepreneurial skills that you never were taught in medical school.  You have to learn to follow your own path and not pay attention to the crowd.  You have to question some of the group-think mentality that was taught in medical school.  As an example, I’ve publicly debated medical professors from academic centers on ObamaCare.  These people pretend to be geniuses in the field, yet they can’t, or simply refuse, to do the simple arithmetic and see that Medicare and Medicaid are going bankrupt. It really does not take a genius to realize that ObamaCare is insane.  They are ideologues, not thinkers.  Learn medicine from your professors, because this is what they know best; but don’t internalize their liberal, socialized medicine dogma without thinking long and hard about it. It is just a simple fact that many academics could not run a private medical practice if they wanted to because they simply do not understand the first thing about making a payroll, paying an overhead, or the basics of “eating what you kill."

What is the best piece of advice you would like to give to today's aspiring doctors?

Think for yourself!  Internal medicine and family practice has sadly become a bad job under the third-party system; there is just no other way to put it. It is almost no longer a profession. The word about primary care has gotten out to students, and very few young doctors are going into these areas of medicine. However, this means that there will be a shortage of primary care doctors, as the demand is continually increasing. There will be great opportunities for young doctors in these areas, provided that they are willing to go into direct practices, without the interference of third-party payers.

You have had some critics. What advice would you give to students on dealing with criticism?

Listen to the criticisms objectively, think about them, and then make your own decisions.  If you think the criticisms are baseless, ignore them.  It doesn’t matter what other people think of you.  Period! Personally, I could give a rat’s ass about what other people think of me.  I’ve written an entire chapter in my book, Concierge Medicine, on the ethical arguments on this topic.  I happily challenge any doctor to debate me on the ethics of our current third-party payer system.  The current system just doesn’t work.  It is corrupt and unethical to its core.  And if you think socialized, government-run medicine is the answer, reflect back on your experiences at any VA hospital.  Does the government provide great care to our veterans?  Not in my experience.  Big government, big business, and crony capitalism are not the answers for our broken system. These things are what broke the system in the first place.  We need to return to the days when doctors ran their own, small private practices if our goal is to provide compassionate, quality, personalized medical care to patients.

You seem to have a lot going in and out of medicine.  How do you stay at the top of your game as a doctor while still maintaining an active balanced lifestyle?

I love medicine, but there is more to life than medicine.  I’m a martial artist and an athlete.  I believe that being physically and mentally strong makes me a better doctor.  You only live once.  You want to be more than a doctor in your short time on this planet.  Be the person you want to be first; this will determine the kind of doctor that you become.

If you could recommend that every medical student read one book what would it be? (In addition to your book, of course)  

Atlas Shrugged by Ayn Rand!  Trust me on this one.  It is a long book, but it will change your life.  If you don’t have time to read it now, put it on your list and read it later.

More: Listen to an hour long interview with Dr. Knope from Medical Spa MD

Radiologists Putting Surgeons Out Of Business?

Looks like the scalpel might be getting replaced by a keyboard and mouse

I recently watched a video where patients underwent surgery without a single cut. It's pretty unbelievable! For the past 13 years, Yoav Medan has been working as a pioneer in MR guided Focused Ultrasound Surgery. As I watched this clip,  I had visions of my future self telling my grandchildren (in a crotchety old man voice) about the good ol' days when we used to get to cut our patients open and slosh through their insides during surgery....those where the days.  I guess surgeons will have to start being a little nicer to the radiologists. They may need a job from them someday.

Medical Specialty Aptitude Test

As every medical student knows, first year of medical school everyone is talking about all the funny new words you get to learn; Tenesmus is my favorite.

Second year is all about studying and USMILE step I. And third year is about deciding what type of doctor you will become. The classic surgery vs medicine approach is a good place to start, but beyond that most things begin to fall apart for a lot of people.

Advice on the subject is almost endless and I have found that the more people you ask the more answers you will get. Never-the-less, it’s good to ask lots of questions and find out as much as possible about your areas of interest. The Univeristy of Virgina has this snazzy Medical Specialty Aptitude Test that may steer you in a good direction. If you are still not sure however, here are son alternative ways you can choose a specialty.

The British Medical Journal published an article in 2005 by Boris Veysman called Physician, Know Thyself, it includes the algorithm, posted above, to use as a guide when choosing a residency. I’m not sure of the sensitivity and specificity but I think most physicans say it's pretty accurate. If that algorithm didn’t solve all your problems this video may help. ZDoggMD and Dr.Harry gives a nuanced break down of a few different types of doctors and what to expect if you decide to join their ranks. Don't let the beatboxing and Justin Bieber impressions distract you from the pearls.

There Must Be A Better Way

10 Steps To Avoid Becoming "That Doctor"

“What man actually needs is not a tensionless state but rather the striving and struggling for some goal worthy of him. What he needs is not the discharge of tension at any cost, but the call of a potential meaning waiting to be fulfilled by him.” - Dr. Viktor Frankl

Recently, I was examining a 4 year old boy who came to the clinic with a cough. As I bent my six foot five inch frame down to his level and pressed my stethoscope to his small chest, he watched me intensely. I flashed him a quick smile; he returned the favor and continue to observe every move I made. When I finished listening to his lungs, his curiosity could no longer be contained. He looked at me and said, “Can I listen to your heart now?” So for a moment we traded places; he became the doctor and me the patient. He was actually quite good at imitating me by quietly tuning in to hear my heart beat and prompting me for a deep breath by inhaling and nodding for me to follow suit. As he was finishing with my exam, his mother, beaming with pride, said, “He wants to be a doctor, and that’s what I want him to do too.” I chuckled thinking at once of my many sleepless nights, stress over exams, and the events with family and friends I had already missed in pursuit of this noble goal, and I’m just getting started.

As the little boy and his mom left the clinic, I began to think about the many overworked physicians I see or speak to, who started out like my young patient then slowly had the wonder and excitement sucked out of their physician experience. Some doctors have even responded to my questions for advice with, “I have no idea why anyone would want to go into medicine any more!” If I’m honest, sometimes I feel they may have a point. Then again, I have met physicians who still love the work they do. Over the weekend, I spent some time with a family friend who is an ER doctor. I asked if he got frustrated by all the “waste of time” consults he sees in the emergency department. Looking at me genuinely he said, “Every patient visit is an honor for me, I see them as a life I can touch.” I guess I shouldn’t have been taken back, but I didn’t expect that response from an ER doc with 30 years under his belt.

The question that begs to be asked is simple, "What’s the difference?" We have all met different versions of both doctors and one has to wonder what makes a doctor bitter, miserable, and look 10 years older than they should and the other still happy to examine or even reexamine a child with a cold because his pushy paranoid mom insists her son needs a prescription right now! Does it all come down to specialty, work hours, who gets paid more, or just personality?

This question is one that I am not qualified to answer, and is one that I will likely continue to answer throughout my career. However, I did find a great start in a comment Dr. Arlen Meyers posted in response to my post on Practicing Medicine In The Year 2050. You can read it there, but it’s worth a reprint.

For those who don’t know, Dr. Meyers is and ENT Surgeon, entrepreneur, author, educator, and CEO and President of the Society of Physician Entrepreneurs.

Here's what I would say to students interested in medicine:

1. Like anything else, follow your heart, not your parents.
2. There are lots of ways to make a difference with an MD degree other than seeing patients.
3. You will need to get your ticket punched (MD degree, residency) to do most of them.
4. Don't tell the admissions officer at the medical school that you have no interest in practicing medicine.
5. Hear all the people who are bitching. Just don't listen to them.
6. Don't be a slave to debt if possible. Sacrifice and pay it off as soon as possible.
7. Taking care of business is a part of taking care of patients. Start learning it as soon as possible on your own because you won't learn it in medical school.
8. Innovate
9. Innovate
10. Innovate

These ten steps are not a prescription for an easy, turn-key career, but they will allow you to have a career on your own terms. I believe that these 10 things will make the difference between physicians who continue to stay engaged and passionate and those who become jaded and defeated.