Turning Late-Night Advice into Big Business: Two Nurses’ Story

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Fri, 08/09/2024 - 15:11

Fevers? Vomiting? Fussiness? How to manage the first night home from the hospital? These are just a few of the hundreds of questions from parents that Atlanta, Georgia–based pediatric nurses Jennifer Walker and Laura Hunter answered well into the night.

Jennifer Walker and Lauren Hunter


It was the mid-1990s, and theirs was the only practice in town that offered on-call nurse responses around the clock. Ms. Hunter and Ms. Walker alternated work-from-home shifts, chatting with many of the practice’s families.

The pair answered the same questions from panicked parents over and over. And they found themselves bridging the gap between medical advice and parenting advice when supporting families.

“Parents were calling us at 2:00 in the morning with all kinds of things they were worried about, and that’s where Moms on Call was born,” Ms. Walker said.

A few decades later, Ms. Walker and Ms. Hunter turned that experience, empathy, and expertise into a thriving business. Moms on Call is often referred to as the “instruction manual for babies,” and the two nurses have consulted with more than 10,000 families. Along the way, they’ve sold more than a million copies of multiple books, created a deep well of online resources, and trained others in their techniques.

So how did they do it?

A Folder, a Swaddle, and a Mission

Ms. Walker and Ms. Hunter literally wrote the book on helping people in the trenches of new parenthood. But it wasn’t quite a book at first. “It was a folder we printed off the computer with those questions coming in,” Ms. Hunter recalled. The nurses developed a way to approach each call with a specific outline of protocols they had designed.

“What if we just go to the [patient’s] house and help them figure that out?” Ms. Walker remembered one of the pediatricians she worked with suggesting in 2002. For example, Ms. Hunter’s swaddle technique that calmed even the fussiest babies worked much better if it was demonstrated in person.

The two embarked on home visits with new parents. But their advice would be practical, not medical. Because they were not classified as traveling nurses, they drew a “definitive line” that they wouldn’t be discussing “major medical issues.”

“Going into the homes here in Atlanta, taking that folder, clipping nails, doing baths, discussing feeding — whether you were doing bottles or breastfeeding — we were going to help parents where they were,” Ms. Hunter said.

The physicians they worked with began recommending their services. Ms. Walker jokes that they didn’t know what they were doing at first; they considered giving their first client their money back. But parents needed what they were delivering, which was advice, validation, and confidence in their parenting.

Just 6-8 weeks into their initiative, other practices started to inquire about whether the nurses could do the same thing for them.

It was a solution to the problem of the 15-minute office visit. “We were helping with those questions so that when [babies] came in for their well visits, those questions were already answered. Not only did we go into their homes, but we supported them in the months after we left,” Ms. Hunter said.
 

 

 

The Ripple Effect

The outcomes were astonishing. “Babies were sleeping through the night. Parents were more confident. We didn’t expect the results, and we were shocked at how consistent it was,” Ms. Walker said. “Laura and I used to call each other in disbelief after we would put these basic principles in place and partner with parents.”

Local pediatricians were grateful for the help. But for the nurses, it was about walking alongside families. The two have countless stories of desperate parents, marriages “on the brink of disaster,” moments when they realized their work was having a ripple effect.

One military family stands out in Ms. Walker’s memory. “The father was fighting for our country overseas, and his wife was struggling alone at home.”

But support from Moms on Call had a powerful impact. “When [the father] came home, he presented Laura with a flag and a beautiful personal note expressing his gratitude,” Ms. Walker said. “Once his wife had a partner to help and felt confident and well rested, his heart could rest as well. We did what he couldn’t, and it made all the difference. After all, that’s what he was fighting for in the first place.”
 

The Gambler Calls

After just 1 or 2 years as Moms on Call, Ms. Walker and Ms. Hunter got an unexpected call from none other than celebrity singer Kenny Rogers, who needed help with his twins.

“I was flipping through the folder, and he said: ‘It’s not copyrighted. It’ll be copyrighted tomorrow morning,’ ” Ms. Hunter recalled.

Mr. Rogers’ attorneys called the next day to provide all the information. “He said: ‘Y’all have got something here. Send this folder to a self-publishing company. Throw up a website. It’ll cost you a few thousand bucks,’” said Ms. Hunter. The business was officially born in 2004.

More of Mr. Rogers’ advice: “You can’t hit a bull’s-eye if you don’t throw a few darts. This is worth throwing a few darts at.”
 

‘They Don’t Teach You That in Nursing School’

The two nurses reimagined their all-knowing folder as a book with a DVD in the back. Because how do you teach parents how to suction noses without showing it? They also wanted to use an outline format — simpler for exhausted parents who just needed to get the information quickly. A few publishers pushed back on these ideas. But the nurses persisted and self-published the first edition.

The original website was basic. Ms. Walker’s Aunt Janet put it together. But grateful clients were Ms. Walker and Ms. Hunter’s best marketing tool, spreading the word to friends and family. The message: Parents know their own children best and can be empowered to help their own kids, rather than leaning on professionals alone.

A community of families also helped them navigate starting a business. A client who was a mergers and acquisitions lawyer helped them form their LLC. “They don’t teach you that in nursing school,” Ms. Walker said. 

Ms. Walker added that they made mistakes. “Not everyone that we encountered viewed or felt the same way about growing a business that is primarily focused on helping families. Sometimes that meant offering services at no charge. Or saying no to certain partnerships that didn’t align with our business model.”

Ms. Walker and Ms. Hunter had an eye on equity in creating multiple ways to access their advice at various price points. They started by charging around $75 for an in-home visit. (Now, if one of the CEOs comes out, it’s around $1000.) But the books, app, and online resources support those who can’t access that, as do an additional 10 in-home consultants around the country.

Along the way, moments told them they were going in the right direction and helped them define their purpose. “It is having a client ‘buy’ us as their go-to [baby] shower gift. It is being able to provide and support a clinic in Kenya or military families around the world. It is helping families realize that they can sleep — that they aren’t alone,” Ms. Walker said. 
 

 

 

On Call 24/7 in the Car, in the Checkout Line ...

The early days of Moms on Call were also a juggling act. As Ms. Walker and Ms. Hunter balanced work and home with 10 of their own kids between the two of them, they took calls wherever they were. A friend and caller once joked that she could tell Ms. Hunter was checking out at the grocery store while she advised her on her very sick son’s vomiting.

“We were still trying to take care of the kids, run the house, and neither one of us had nannies or night nurses or housekeepers,” Ms. Hunter said. “But being on call allowed us to still be at home.”

Ms. Walker remembers taking calls on the way to ball games with her own kids, who by 8 years old could recite the advice for a baby’s fever from the back of the car. “It was like a family affair, and our kids got to see how that works and see their moms in action,” she said.

Through it all, Ms. Walker and Ms. Hunter’s motivation came from knowing that thousands of parents were begging for help — and they had an answer.

“Our shoulders have absorbed so many tears of parents who were exhausted and hurting, some who had been lied to or told their child would never sleep or had to be raised a certain way. When someone steals that confidence, especially from a brand-new parent overwhelmed by information, it makes us want to shout the truth from every rooftop and digital channel available,” Ms. Walker added.
 

Do You Have a Business Idea?

“Boots on the ground” healthcare professionals often see new opportunities to serve patients who might be falling through the cracks of the healthcare system. While not all will become a full-blown business, Ms. Hunter encourages them to break down their idea into “bite-sized pieces.” Just have the next conversation.

“Ask the people around you and the people who are brought to you,” Ms. Hunter said. When the two nurses look back, they see how those pieces of the puzzle were meant to come together. “Ask everyone you know,” Ms. Hunter advised. “And talk to the people you are taking care of. It’s possible they have a gift that will help you get to the next bite-sized piece.”

In short — develop a network of people who believe in your idea. Prioritize those relationships and see where they can take you.

The close relationship between Ms. Walker and Ms. Hunter, as business partners and friends, has also been crucial. They joke that they finish each other’s sentences and sandwiches. “You have to fight for that — we prioritize [that relationship]” too, Ms. Walker said.

Finally, remember why you are doing what you do, Ms. Walker said. “These are the people we help: Wonderful people with jobs that serve us all — the airplane pilot, the anesthesiologist, the pediatrician, the single dad. They are all parents who have felt alone and exhausted. In those lonely moments of a parent’s heart where they fear they are doing the wrong thing, we want to be the voice of hope,” she added. “We let them know that if they ever wondered if they were doing it right, well, only good parents wonder that.”

A version of this article appeared on Medscape.com.

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Fevers? Vomiting? Fussiness? How to manage the first night home from the hospital? These are just a few of the hundreds of questions from parents that Atlanta, Georgia–based pediatric nurses Jennifer Walker and Laura Hunter answered well into the night.

Jennifer Walker and Lauren Hunter


It was the mid-1990s, and theirs was the only practice in town that offered on-call nurse responses around the clock. Ms. Hunter and Ms. Walker alternated work-from-home shifts, chatting with many of the practice’s families.

The pair answered the same questions from panicked parents over and over. And they found themselves bridging the gap between medical advice and parenting advice when supporting families.

“Parents were calling us at 2:00 in the morning with all kinds of things they were worried about, and that’s where Moms on Call was born,” Ms. Walker said.

A few decades later, Ms. Walker and Ms. Hunter turned that experience, empathy, and expertise into a thriving business. Moms on Call is often referred to as the “instruction manual for babies,” and the two nurses have consulted with more than 10,000 families. Along the way, they’ve sold more than a million copies of multiple books, created a deep well of online resources, and trained others in their techniques.

So how did they do it?

A Folder, a Swaddle, and a Mission

Ms. Walker and Ms. Hunter literally wrote the book on helping people in the trenches of new parenthood. But it wasn’t quite a book at first. “It was a folder we printed off the computer with those questions coming in,” Ms. Hunter recalled. The nurses developed a way to approach each call with a specific outline of protocols they had designed.

“What if we just go to the [patient’s] house and help them figure that out?” Ms. Walker remembered one of the pediatricians she worked with suggesting in 2002. For example, Ms. Hunter’s swaddle technique that calmed even the fussiest babies worked much better if it was demonstrated in person.

The two embarked on home visits with new parents. But their advice would be practical, not medical. Because they were not classified as traveling nurses, they drew a “definitive line” that they wouldn’t be discussing “major medical issues.”

“Going into the homes here in Atlanta, taking that folder, clipping nails, doing baths, discussing feeding — whether you were doing bottles or breastfeeding — we were going to help parents where they were,” Ms. Hunter said.

The physicians they worked with began recommending their services. Ms. Walker jokes that they didn’t know what they were doing at first; they considered giving their first client their money back. But parents needed what they were delivering, which was advice, validation, and confidence in their parenting.

Just 6-8 weeks into their initiative, other practices started to inquire about whether the nurses could do the same thing for them.

It was a solution to the problem of the 15-minute office visit. “We were helping with those questions so that when [babies] came in for their well visits, those questions were already answered. Not only did we go into their homes, but we supported them in the months after we left,” Ms. Hunter said.
 

 

 

The Ripple Effect

The outcomes were astonishing. “Babies were sleeping through the night. Parents were more confident. We didn’t expect the results, and we were shocked at how consistent it was,” Ms. Walker said. “Laura and I used to call each other in disbelief after we would put these basic principles in place and partner with parents.”

Local pediatricians were grateful for the help. But for the nurses, it was about walking alongside families. The two have countless stories of desperate parents, marriages “on the brink of disaster,” moments when they realized their work was having a ripple effect.

One military family stands out in Ms. Walker’s memory. “The father was fighting for our country overseas, and his wife was struggling alone at home.”

But support from Moms on Call had a powerful impact. “When [the father] came home, he presented Laura with a flag and a beautiful personal note expressing his gratitude,” Ms. Walker said. “Once his wife had a partner to help and felt confident and well rested, his heart could rest as well. We did what he couldn’t, and it made all the difference. After all, that’s what he was fighting for in the first place.”
 

The Gambler Calls

After just 1 or 2 years as Moms on Call, Ms. Walker and Ms. Hunter got an unexpected call from none other than celebrity singer Kenny Rogers, who needed help with his twins.

“I was flipping through the folder, and he said: ‘It’s not copyrighted. It’ll be copyrighted tomorrow morning,’ ” Ms. Hunter recalled.

Mr. Rogers’ attorneys called the next day to provide all the information. “He said: ‘Y’all have got something here. Send this folder to a self-publishing company. Throw up a website. It’ll cost you a few thousand bucks,’” said Ms. Hunter. The business was officially born in 2004.

More of Mr. Rogers’ advice: “You can’t hit a bull’s-eye if you don’t throw a few darts. This is worth throwing a few darts at.”
 

‘They Don’t Teach You That in Nursing School’

The two nurses reimagined their all-knowing folder as a book with a DVD in the back. Because how do you teach parents how to suction noses without showing it? They also wanted to use an outline format — simpler for exhausted parents who just needed to get the information quickly. A few publishers pushed back on these ideas. But the nurses persisted and self-published the first edition.

The original website was basic. Ms. Walker’s Aunt Janet put it together. But grateful clients were Ms. Walker and Ms. Hunter’s best marketing tool, spreading the word to friends and family. The message: Parents know their own children best and can be empowered to help their own kids, rather than leaning on professionals alone.

A community of families also helped them navigate starting a business. A client who was a mergers and acquisitions lawyer helped them form their LLC. “They don’t teach you that in nursing school,” Ms. Walker said. 

Ms. Walker added that they made mistakes. “Not everyone that we encountered viewed or felt the same way about growing a business that is primarily focused on helping families. Sometimes that meant offering services at no charge. Or saying no to certain partnerships that didn’t align with our business model.”

Ms. Walker and Ms. Hunter had an eye on equity in creating multiple ways to access their advice at various price points. They started by charging around $75 for an in-home visit. (Now, if one of the CEOs comes out, it’s around $1000.) But the books, app, and online resources support those who can’t access that, as do an additional 10 in-home consultants around the country.

Along the way, moments told them they were going in the right direction and helped them define their purpose. “It is having a client ‘buy’ us as their go-to [baby] shower gift. It is being able to provide and support a clinic in Kenya or military families around the world. It is helping families realize that they can sleep — that they aren’t alone,” Ms. Walker said. 
 

 

 

On Call 24/7 in the Car, in the Checkout Line ...

The early days of Moms on Call were also a juggling act. As Ms. Walker and Ms. Hunter balanced work and home with 10 of their own kids between the two of them, they took calls wherever they were. A friend and caller once joked that she could tell Ms. Hunter was checking out at the grocery store while she advised her on her very sick son’s vomiting.

“We were still trying to take care of the kids, run the house, and neither one of us had nannies or night nurses or housekeepers,” Ms. Hunter said. “But being on call allowed us to still be at home.”

Ms. Walker remembers taking calls on the way to ball games with her own kids, who by 8 years old could recite the advice for a baby’s fever from the back of the car. “It was like a family affair, and our kids got to see how that works and see their moms in action,” she said.

Through it all, Ms. Walker and Ms. Hunter’s motivation came from knowing that thousands of parents were begging for help — and they had an answer.

“Our shoulders have absorbed so many tears of parents who were exhausted and hurting, some who had been lied to or told their child would never sleep or had to be raised a certain way. When someone steals that confidence, especially from a brand-new parent overwhelmed by information, it makes us want to shout the truth from every rooftop and digital channel available,” Ms. Walker added.
 

Do You Have a Business Idea?

“Boots on the ground” healthcare professionals often see new opportunities to serve patients who might be falling through the cracks of the healthcare system. While not all will become a full-blown business, Ms. Hunter encourages them to break down their idea into “bite-sized pieces.” Just have the next conversation.

“Ask the people around you and the people who are brought to you,” Ms. Hunter said. When the two nurses look back, they see how those pieces of the puzzle were meant to come together. “Ask everyone you know,” Ms. Hunter advised. “And talk to the people you are taking care of. It’s possible they have a gift that will help you get to the next bite-sized piece.”

In short — develop a network of people who believe in your idea. Prioritize those relationships and see where they can take you.

The close relationship between Ms. Walker and Ms. Hunter, as business partners and friends, has also been crucial. They joke that they finish each other’s sentences and sandwiches. “You have to fight for that — we prioritize [that relationship]” too, Ms. Walker said.

Finally, remember why you are doing what you do, Ms. Walker said. “These are the people we help: Wonderful people with jobs that serve us all — the airplane pilot, the anesthesiologist, the pediatrician, the single dad. They are all parents who have felt alone and exhausted. In those lonely moments of a parent’s heart where they fear they are doing the wrong thing, we want to be the voice of hope,” she added. “We let them know that if they ever wondered if they were doing it right, well, only good parents wonder that.”

A version of this article appeared on Medscape.com.

Fevers? Vomiting? Fussiness? How to manage the first night home from the hospital? These are just a few of the hundreds of questions from parents that Atlanta, Georgia–based pediatric nurses Jennifer Walker and Laura Hunter answered well into the night.

Jennifer Walker and Lauren Hunter


It was the mid-1990s, and theirs was the only practice in town that offered on-call nurse responses around the clock. Ms. Hunter and Ms. Walker alternated work-from-home shifts, chatting with many of the practice’s families.

The pair answered the same questions from panicked parents over and over. And they found themselves bridging the gap between medical advice and parenting advice when supporting families.

“Parents were calling us at 2:00 in the morning with all kinds of things they were worried about, and that’s where Moms on Call was born,” Ms. Walker said.

A few decades later, Ms. Walker and Ms. Hunter turned that experience, empathy, and expertise into a thriving business. Moms on Call is often referred to as the “instruction manual for babies,” and the two nurses have consulted with more than 10,000 families. Along the way, they’ve sold more than a million copies of multiple books, created a deep well of online resources, and trained others in their techniques.

So how did they do it?

A Folder, a Swaddle, and a Mission

Ms. Walker and Ms. Hunter literally wrote the book on helping people in the trenches of new parenthood. But it wasn’t quite a book at first. “It was a folder we printed off the computer with those questions coming in,” Ms. Hunter recalled. The nurses developed a way to approach each call with a specific outline of protocols they had designed.

“What if we just go to the [patient’s] house and help them figure that out?” Ms. Walker remembered one of the pediatricians she worked with suggesting in 2002. For example, Ms. Hunter’s swaddle technique that calmed even the fussiest babies worked much better if it was demonstrated in person.

The two embarked on home visits with new parents. But their advice would be practical, not medical. Because they were not classified as traveling nurses, they drew a “definitive line” that they wouldn’t be discussing “major medical issues.”

“Going into the homes here in Atlanta, taking that folder, clipping nails, doing baths, discussing feeding — whether you were doing bottles or breastfeeding — we were going to help parents where they were,” Ms. Hunter said.

The physicians they worked with began recommending their services. Ms. Walker jokes that they didn’t know what they were doing at first; they considered giving their first client their money back. But parents needed what they were delivering, which was advice, validation, and confidence in their parenting.

Just 6-8 weeks into their initiative, other practices started to inquire about whether the nurses could do the same thing for them.

It was a solution to the problem of the 15-minute office visit. “We were helping with those questions so that when [babies] came in for their well visits, those questions were already answered. Not only did we go into their homes, but we supported them in the months after we left,” Ms. Hunter said.
 

 

 

The Ripple Effect

The outcomes were astonishing. “Babies were sleeping through the night. Parents were more confident. We didn’t expect the results, and we were shocked at how consistent it was,” Ms. Walker said. “Laura and I used to call each other in disbelief after we would put these basic principles in place and partner with parents.”

Local pediatricians were grateful for the help. But for the nurses, it was about walking alongside families. The two have countless stories of desperate parents, marriages “on the brink of disaster,” moments when they realized their work was having a ripple effect.

One military family stands out in Ms. Walker’s memory. “The father was fighting for our country overseas, and his wife was struggling alone at home.”

But support from Moms on Call had a powerful impact. “When [the father] came home, he presented Laura with a flag and a beautiful personal note expressing his gratitude,” Ms. Walker said. “Once his wife had a partner to help and felt confident and well rested, his heart could rest as well. We did what he couldn’t, and it made all the difference. After all, that’s what he was fighting for in the first place.”
 

The Gambler Calls

After just 1 or 2 years as Moms on Call, Ms. Walker and Ms. Hunter got an unexpected call from none other than celebrity singer Kenny Rogers, who needed help with his twins.

“I was flipping through the folder, and he said: ‘It’s not copyrighted. It’ll be copyrighted tomorrow morning,’ ” Ms. Hunter recalled.

Mr. Rogers’ attorneys called the next day to provide all the information. “He said: ‘Y’all have got something here. Send this folder to a self-publishing company. Throw up a website. It’ll cost you a few thousand bucks,’” said Ms. Hunter. The business was officially born in 2004.

More of Mr. Rogers’ advice: “You can’t hit a bull’s-eye if you don’t throw a few darts. This is worth throwing a few darts at.”
 

‘They Don’t Teach You That in Nursing School’

The two nurses reimagined their all-knowing folder as a book with a DVD in the back. Because how do you teach parents how to suction noses without showing it? They also wanted to use an outline format — simpler for exhausted parents who just needed to get the information quickly. A few publishers pushed back on these ideas. But the nurses persisted and self-published the first edition.

The original website was basic. Ms. Walker’s Aunt Janet put it together. But grateful clients were Ms. Walker and Ms. Hunter’s best marketing tool, spreading the word to friends and family. The message: Parents know their own children best and can be empowered to help their own kids, rather than leaning on professionals alone.

A community of families also helped them navigate starting a business. A client who was a mergers and acquisitions lawyer helped them form their LLC. “They don’t teach you that in nursing school,” Ms. Walker said. 

Ms. Walker added that they made mistakes. “Not everyone that we encountered viewed or felt the same way about growing a business that is primarily focused on helping families. Sometimes that meant offering services at no charge. Or saying no to certain partnerships that didn’t align with our business model.”

Ms. Walker and Ms. Hunter had an eye on equity in creating multiple ways to access their advice at various price points. They started by charging around $75 for an in-home visit. (Now, if one of the CEOs comes out, it’s around $1000.) But the books, app, and online resources support those who can’t access that, as do an additional 10 in-home consultants around the country.

Along the way, moments told them they were going in the right direction and helped them define their purpose. “It is having a client ‘buy’ us as their go-to [baby] shower gift. It is being able to provide and support a clinic in Kenya or military families around the world. It is helping families realize that they can sleep — that they aren’t alone,” Ms. Walker said. 
 

 

 

On Call 24/7 in the Car, in the Checkout Line ...

The early days of Moms on Call were also a juggling act. As Ms. Walker and Ms. Hunter balanced work and home with 10 of their own kids between the two of them, they took calls wherever they were. A friend and caller once joked that she could tell Ms. Hunter was checking out at the grocery store while she advised her on her very sick son’s vomiting.

“We were still trying to take care of the kids, run the house, and neither one of us had nannies or night nurses or housekeepers,” Ms. Hunter said. “But being on call allowed us to still be at home.”

Ms. Walker remembers taking calls on the way to ball games with her own kids, who by 8 years old could recite the advice for a baby’s fever from the back of the car. “It was like a family affair, and our kids got to see how that works and see their moms in action,” she said.

Through it all, Ms. Walker and Ms. Hunter’s motivation came from knowing that thousands of parents were begging for help — and they had an answer.

“Our shoulders have absorbed so many tears of parents who were exhausted and hurting, some who had been lied to or told their child would never sleep or had to be raised a certain way. When someone steals that confidence, especially from a brand-new parent overwhelmed by information, it makes us want to shout the truth from every rooftop and digital channel available,” Ms. Walker added.
 

Do You Have a Business Idea?

“Boots on the ground” healthcare professionals often see new opportunities to serve patients who might be falling through the cracks of the healthcare system. While not all will become a full-blown business, Ms. Hunter encourages them to break down their idea into “bite-sized pieces.” Just have the next conversation.

“Ask the people around you and the people who are brought to you,” Ms. Hunter said. When the two nurses look back, they see how those pieces of the puzzle were meant to come together. “Ask everyone you know,” Ms. Hunter advised. “And talk to the people you are taking care of. It’s possible they have a gift that will help you get to the next bite-sized piece.”

In short — develop a network of people who believe in your idea. Prioritize those relationships and see where they can take you.

The close relationship between Ms. Walker and Ms. Hunter, as business partners and friends, has also been crucial. They joke that they finish each other’s sentences and sandwiches. “You have to fight for that — we prioritize [that relationship]” too, Ms. Walker said.

Finally, remember why you are doing what you do, Ms. Walker said. “These are the people we help: Wonderful people with jobs that serve us all — the airplane pilot, the anesthesiologist, the pediatrician, the single dad. They are all parents who have felt alone and exhausted. In those lonely moments of a parent’s heart where they fear they are doing the wrong thing, we want to be the voice of hope,” she added. “We let them know that if they ever wondered if they were doing it right, well, only good parents wonder that.”

A version of this article appeared on Medscape.com.

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How Physician Mortgage Loans Work for Doctors With Debt

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Mon, 05/20/2024 - 16:54

Tell someone you’re a doctor, and the reaction is often: “You must be rich.” But physicians who are just finishing medical school or are in their early careers might feel far from it. The average medical school debt is more than $200,000, with total debts including undergrad climbing well north of $250,000.

That leaves house-hunting physicians in a predicament. A key factor for lending institutions is the “debt to income” ratio, a calculation which indicates if you already have too much debt to pay your mortgage. That single equation could eliminate you from lenders’ mortgage requirements.

But young doctors are also in a unique situation. Yes, they carry above-average levels of debt, but they are on a path to substantial income in future years. That’s where the physician mortgage loan (PML) becomes a useful option. 

What Is a Physician Mortgage Loan?

A PML is designed to help physicians access mortgages despite large amounts of debt. They are also sometimes available to dentists, veterinarians, podiatrists, and others, according to Stephen Chang, MD, a radiologist, and a managing director at Acts Financial Advisors in McLean, Virginia.

The key features, according to James M. Dahle, MD, an emergency physician and founder of The White Coat Investor, include:

  • No required down payment, which is typically 20% with a conventional loan.
  • No private mortgage insurance (PMI). This is often a requirement of traditional loans, designed to protect the lender if the buyer misses payments. PMLs don’t involve PMI even if you don’t put down 20%.
  • No pay stubs. With a conventional loan, pay stubs are often required to prove income level and reliability. PMLs will often allow an employment contract in place of those. 
  • Different consideration of the student loan burden.

Those are the upsides, of course, but there may be downsides. Dr. Dahle said a PML might involve slightly higher rates and fees than a conventional mortgage does but not always.

Who Is Best Suited for a Physician Mortgage Loan?

Financial advisers caution that everyone should first consider their full financial picture before applying for a mortgage, PML or otherwise. “If you don’t have the money saved for a down payment, one can ask if you are financially prepared to purchase a home,” says Cobin Soelberg, MD, an anesthesiologist and owner of Greeley Wealth Management, a financial planning firm serving physician families in Bend, Oregon. 

If your savings are slim, you might need to build those accounts further before pursuing home ownership and the expenses that come along with it.

Your credit score can contribute to the equation. “With any loan product, we always recommend working to optimize your personal credit score as soon as possible before applying for a loan,” said Mark P. Eid, MD, a dermatologist and co–managing director (with Dr. Chang) at Act Financial Advisors. “Once you get into the high 700s, you’ve typically qualified for the best interest rates, so while that perfect 850 is nice to achieve, it’s by no means necessary.”

Also, assess your reasons for purchasing a home and whether it will fit your lifestyle in the coming years. “The main reason that [my wife and I] wanted to buy a home was for stability,” said Jordan Frey, MD, founder of The Prudent Plastic Surgeon. “After living in apartments for years, we wanted a place that was truly our own. We definitely felt disappointed and frustrated when worrying that our student debt may limit our ability to do this.”

Like many physicians, Dr. Frey had taken on a huge amount of debt, to the tune of half a million dollars in student loans and credit card debt when he finished training in 2020. The question Dr. Frey and his wife wrestled with was: “How much debt should we take on in addition to what we already have?”

 

 

What Are the Risks? What’s in the Fine Print?

The eased limitations of PMLs come with potential pitfalls, and physicians should not imagine that they have unlimited buying power.

“Many physicians buy more expensive or bigger houses than they need simply because banks are willing to lend physicians money,” Dr. Soelberg warns. “So, the doctor gets locked into a large mortgage and cannot build wealth, save for retirement, and repay their student loans.” 

As you shop around, beware of omissions and scams. When meeting with lenders, Dr. Frey recalled that some didn’t even present PMLs as an option, and others presented them with unfavorable terms. He was careful to look for disadvantages hidden in the fine print, such as a potential “big hike in the rate a year later.” 

But sometimes, a scam is not outright deception but is more like temptation. So it’s important to have your own best interests in mind without relying on lenders’ advice. 

“When we were shopping around, some mortgage lenders would [offer] $1.5 million, and we thought ‘that makes no sense,’ ” said Dr. Frey. “[Physicians] have big future income, which makes us attractive to these lenders. No one in their right mind would give a mortgage like this to anyone else. They aren’t worried about whether it’s a smart decision for you or not.” 

What Other Red Flags Should You Look Out for?

Dr. Frey recommends medical professionals beware of these red flags when shopping for PMLs:

  • A request for any type of collateral, including your medical practice
  • A rate that is much higher than others
  • A lender is pushing you to borrow a higher amount than you’re comfortable with 
  • A lender attempts to influence your decision about the size of your down payment

Remember, if you are choosing an adjustable-rate mortgage (ARM), your rate will recalibrate on the basis of the market’s rates — for better or worse. This means that your payment might be higher or lower, taking current interest rates into account, based on the market.

Looking back, Dr. Frey said he might reconsider his decision to use a 10-year ARM. He and his wife chose it because the rate was low at the time, and they planned to pay off the mortgage quickly or move before it went up. But the uncertainty added an element of pressure. 

How Can PMLs Contribute to Overall Financial Health?

Dr. Frey says his physician mortgage was “a huge advantage,” allowing him and his wife to put 0% down on their home without PMI. But most importantly, it fit within their overall financial plan, which included investing. “The money that we would have potentially used for a down payment, we used to buy a rental property, which then got us more income,” he says. 

Of course, buying a rental property is not the only path to financial health and freedom. Many people approach a home as an investment that will eventually become fully their own. Others might put that down payment toward building a safety net of savings accounts. 

Used strategically and intentionally, PMLs can put you on a more predictable financial path. And with less money stress, buying a home can be an exciting milestone as you plan your future and put down roots in a community.

A version of this article appeared on Medscape.com.

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Tell someone you’re a doctor, and the reaction is often: “You must be rich.” But physicians who are just finishing medical school or are in their early careers might feel far from it. The average medical school debt is more than $200,000, with total debts including undergrad climbing well north of $250,000.

That leaves house-hunting physicians in a predicament. A key factor for lending institutions is the “debt to income” ratio, a calculation which indicates if you already have too much debt to pay your mortgage. That single equation could eliminate you from lenders’ mortgage requirements.

But young doctors are also in a unique situation. Yes, they carry above-average levels of debt, but they are on a path to substantial income in future years. That’s where the physician mortgage loan (PML) becomes a useful option. 

What Is a Physician Mortgage Loan?

A PML is designed to help physicians access mortgages despite large amounts of debt. They are also sometimes available to dentists, veterinarians, podiatrists, and others, according to Stephen Chang, MD, a radiologist, and a managing director at Acts Financial Advisors in McLean, Virginia.

The key features, according to James M. Dahle, MD, an emergency physician and founder of The White Coat Investor, include:

  • No required down payment, which is typically 20% with a conventional loan.
  • No private mortgage insurance (PMI). This is often a requirement of traditional loans, designed to protect the lender if the buyer misses payments. PMLs don’t involve PMI even if you don’t put down 20%.
  • No pay stubs. With a conventional loan, pay stubs are often required to prove income level and reliability. PMLs will often allow an employment contract in place of those. 
  • Different consideration of the student loan burden.

Those are the upsides, of course, but there may be downsides. Dr. Dahle said a PML might involve slightly higher rates and fees than a conventional mortgage does but not always.

Who Is Best Suited for a Physician Mortgage Loan?

Financial advisers caution that everyone should first consider their full financial picture before applying for a mortgage, PML or otherwise. “If you don’t have the money saved for a down payment, one can ask if you are financially prepared to purchase a home,” says Cobin Soelberg, MD, an anesthesiologist and owner of Greeley Wealth Management, a financial planning firm serving physician families in Bend, Oregon. 

If your savings are slim, you might need to build those accounts further before pursuing home ownership and the expenses that come along with it.

Your credit score can contribute to the equation. “With any loan product, we always recommend working to optimize your personal credit score as soon as possible before applying for a loan,” said Mark P. Eid, MD, a dermatologist and co–managing director (with Dr. Chang) at Act Financial Advisors. “Once you get into the high 700s, you’ve typically qualified for the best interest rates, so while that perfect 850 is nice to achieve, it’s by no means necessary.”

Also, assess your reasons for purchasing a home and whether it will fit your lifestyle in the coming years. “The main reason that [my wife and I] wanted to buy a home was for stability,” said Jordan Frey, MD, founder of The Prudent Plastic Surgeon. “After living in apartments for years, we wanted a place that was truly our own. We definitely felt disappointed and frustrated when worrying that our student debt may limit our ability to do this.”

Like many physicians, Dr. Frey had taken on a huge amount of debt, to the tune of half a million dollars in student loans and credit card debt when he finished training in 2020. The question Dr. Frey and his wife wrestled with was: “How much debt should we take on in addition to what we already have?”

 

 

What Are the Risks? What’s in the Fine Print?

The eased limitations of PMLs come with potential pitfalls, and physicians should not imagine that they have unlimited buying power.

“Many physicians buy more expensive or bigger houses than they need simply because banks are willing to lend physicians money,” Dr. Soelberg warns. “So, the doctor gets locked into a large mortgage and cannot build wealth, save for retirement, and repay their student loans.” 

As you shop around, beware of omissions and scams. When meeting with lenders, Dr. Frey recalled that some didn’t even present PMLs as an option, and others presented them with unfavorable terms. He was careful to look for disadvantages hidden in the fine print, such as a potential “big hike in the rate a year later.” 

But sometimes, a scam is not outright deception but is more like temptation. So it’s important to have your own best interests in mind without relying on lenders’ advice. 

“When we were shopping around, some mortgage lenders would [offer] $1.5 million, and we thought ‘that makes no sense,’ ” said Dr. Frey. “[Physicians] have big future income, which makes us attractive to these lenders. No one in their right mind would give a mortgage like this to anyone else. They aren’t worried about whether it’s a smart decision for you or not.” 

What Other Red Flags Should You Look Out for?

Dr. Frey recommends medical professionals beware of these red flags when shopping for PMLs:

  • A request for any type of collateral, including your medical practice
  • A rate that is much higher than others
  • A lender is pushing you to borrow a higher amount than you’re comfortable with 
  • A lender attempts to influence your decision about the size of your down payment

Remember, if you are choosing an adjustable-rate mortgage (ARM), your rate will recalibrate on the basis of the market’s rates — for better or worse. This means that your payment might be higher or lower, taking current interest rates into account, based on the market.

Looking back, Dr. Frey said he might reconsider his decision to use a 10-year ARM. He and his wife chose it because the rate was low at the time, and they planned to pay off the mortgage quickly or move before it went up. But the uncertainty added an element of pressure. 

How Can PMLs Contribute to Overall Financial Health?

Dr. Frey says his physician mortgage was “a huge advantage,” allowing him and his wife to put 0% down on their home without PMI. But most importantly, it fit within their overall financial plan, which included investing. “The money that we would have potentially used for a down payment, we used to buy a rental property, which then got us more income,” he says. 

Of course, buying a rental property is not the only path to financial health and freedom. Many people approach a home as an investment that will eventually become fully their own. Others might put that down payment toward building a safety net of savings accounts. 

Used strategically and intentionally, PMLs can put you on a more predictable financial path. And with less money stress, buying a home can be an exciting milestone as you plan your future and put down roots in a community.

A version of this article appeared on Medscape.com.

Tell someone you’re a doctor, and the reaction is often: “You must be rich.” But physicians who are just finishing medical school or are in their early careers might feel far from it. The average medical school debt is more than $200,000, with total debts including undergrad climbing well north of $250,000.

That leaves house-hunting physicians in a predicament. A key factor for lending institutions is the “debt to income” ratio, a calculation which indicates if you already have too much debt to pay your mortgage. That single equation could eliminate you from lenders’ mortgage requirements.

But young doctors are also in a unique situation. Yes, they carry above-average levels of debt, but they are on a path to substantial income in future years. That’s where the physician mortgage loan (PML) becomes a useful option. 

What Is a Physician Mortgage Loan?

A PML is designed to help physicians access mortgages despite large amounts of debt. They are also sometimes available to dentists, veterinarians, podiatrists, and others, according to Stephen Chang, MD, a radiologist, and a managing director at Acts Financial Advisors in McLean, Virginia.

The key features, according to James M. Dahle, MD, an emergency physician and founder of The White Coat Investor, include:

  • No required down payment, which is typically 20% with a conventional loan.
  • No private mortgage insurance (PMI). This is often a requirement of traditional loans, designed to protect the lender if the buyer misses payments. PMLs don’t involve PMI even if you don’t put down 20%.
  • No pay stubs. With a conventional loan, pay stubs are often required to prove income level and reliability. PMLs will often allow an employment contract in place of those. 
  • Different consideration of the student loan burden.

Those are the upsides, of course, but there may be downsides. Dr. Dahle said a PML might involve slightly higher rates and fees than a conventional mortgage does but not always.

Who Is Best Suited for a Physician Mortgage Loan?

Financial advisers caution that everyone should first consider their full financial picture before applying for a mortgage, PML or otherwise. “If you don’t have the money saved for a down payment, one can ask if you are financially prepared to purchase a home,” says Cobin Soelberg, MD, an anesthesiologist and owner of Greeley Wealth Management, a financial planning firm serving physician families in Bend, Oregon. 

If your savings are slim, you might need to build those accounts further before pursuing home ownership and the expenses that come along with it.

Your credit score can contribute to the equation. “With any loan product, we always recommend working to optimize your personal credit score as soon as possible before applying for a loan,” said Mark P. Eid, MD, a dermatologist and co–managing director (with Dr. Chang) at Act Financial Advisors. “Once you get into the high 700s, you’ve typically qualified for the best interest rates, so while that perfect 850 is nice to achieve, it’s by no means necessary.”

Also, assess your reasons for purchasing a home and whether it will fit your lifestyle in the coming years. “The main reason that [my wife and I] wanted to buy a home was for stability,” said Jordan Frey, MD, founder of The Prudent Plastic Surgeon. “After living in apartments for years, we wanted a place that was truly our own. We definitely felt disappointed and frustrated when worrying that our student debt may limit our ability to do this.”

Like many physicians, Dr. Frey had taken on a huge amount of debt, to the tune of half a million dollars in student loans and credit card debt when he finished training in 2020. The question Dr. Frey and his wife wrestled with was: “How much debt should we take on in addition to what we already have?”

 

 

What Are the Risks? What’s in the Fine Print?

The eased limitations of PMLs come with potential pitfalls, and physicians should not imagine that they have unlimited buying power.

“Many physicians buy more expensive or bigger houses than they need simply because banks are willing to lend physicians money,” Dr. Soelberg warns. “So, the doctor gets locked into a large mortgage and cannot build wealth, save for retirement, and repay their student loans.” 

As you shop around, beware of omissions and scams. When meeting with lenders, Dr. Frey recalled that some didn’t even present PMLs as an option, and others presented them with unfavorable terms. He was careful to look for disadvantages hidden in the fine print, such as a potential “big hike in the rate a year later.” 

But sometimes, a scam is not outright deception but is more like temptation. So it’s important to have your own best interests in mind without relying on lenders’ advice. 

“When we were shopping around, some mortgage lenders would [offer] $1.5 million, and we thought ‘that makes no sense,’ ” said Dr. Frey. “[Physicians] have big future income, which makes us attractive to these lenders. No one in their right mind would give a mortgage like this to anyone else. They aren’t worried about whether it’s a smart decision for you or not.” 

What Other Red Flags Should You Look Out for?

Dr. Frey recommends medical professionals beware of these red flags when shopping for PMLs:

  • A request for any type of collateral, including your medical practice
  • A rate that is much higher than others
  • A lender is pushing you to borrow a higher amount than you’re comfortable with 
  • A lender attempts to influence your decision about the size of your down payment

Remember, if you are choosing an adjustable-rate mortgage (ARM), your rate will recalibrate on the basis of the market’s rates — for better or worse. This means that your payment might be higher or lower, taking current interest rates into account, based on the market.

Looking back, Dr. Frey said he might reconsider his decision to use a 10-year ARM. He and his wife chose it because the rate was low at the time, and they planned to pay off the mortgage quickly or move before it went up. But the uncertainty added an element of pressure. 

How Can PMLs Contribute to Overall Financial Health?

Dr. Frey says his physician mortgage was “a huge advantage,” allowing him and his wife to put 0% down on their home without PMI. But most importantly, it fit within their overall financial plan, which included investing. “The money that we would have potentially used for a down payment, we used to buy a rental property, which then got us more income,” he says. 

Of course, buying a rental property is not the only path to financial health and freedom. Many people approach a home as an investment that will eventually become fully their own. Others might put that down payment toward building a safety net of savings accounts. 

Used strategically and intentionally, PMLs can put you on a more predictable financial path. And with less money stress, buying a home can be an exciting milestone as you plan your future and put down roots in a community.

A version of this article appeared on Medscape.com.

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Hospital Marriage Proposals: The Good, the Bad, the Helipad

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Tue, 02/13/2024 - 15:05

Picture your marriage proposal fantasy. Do you see a beautiful beach at sunset? The place where you first met your partner? Maybe a dream vacation — Paris, anyone? And perhaps most popular of all ... the ER?

Why not? For some couples who share medical careers, the hospital is home, and they turn the moment into something just as romantic as any Eiffel Tower backdrop. (And admittedly, sometimes they don’t.)

Since we’re approaching Valentine’s Day— often the #1 day of the year for engagements — lovestruck healthcare professionals take note. There are good ways to do it and, well, ill-advised ways. We spoke with three couples whose medical-themed proposals ended in the word “yes!” 

Heaven on the Helipad

When emergency medicine physician Anna Darby, MD, heard a trauma patient was arriving and urgently needed to be intubated, she raced up to the rooftop helipad. As soon as the elevator doors opened, she was met with quite a different scene than expected. There were rose petals ... lots and lots of rose petals.

With her best friends and colleagues lining a red carpet, the roof had been turned into a scene from The Bachelor. Each person gave her a rose. A friend even touched up her makeup and handed over her favorite hoop earrings, transforming her from busy doctor to soon-to-be fiancée. Her boyfriend, cardiologist Merije Chukumerije, MD, stood waiting. You can guess what happened next.

Dr. Chukumerije later wrote in an Instagram post, “We met at this hospital. So, it was only right that I bring her to its highest place as we’ve reached the peak of our union.” The couple actually met in the hospital cafeteria “like all the clichés,” Dr. Darby jokes. For them, the helipad experience was just as Insta-worthy as any braggable, grandiose proposal at a fancy restaurant or on a mountaintop.

“Seeing that scene was totally not what I expected,” Dr. Darby says. “I can’t even describe it. It’s like the second biggest hormonal shift, [second only to] having a baby.” She and Dr. Chukumerije now have two babies of their own, aged 2 months and 2 years old.

Good Morning, Doctor

It was February 2021, the height of the pandemic, and Raaga Vemula, MD, now in her palliative care/hospice care fellowship, was “selected” for a local news interview on COVID-19. Except the interview was really with Good Morning America. And the topic was really a proposal. 

Dr. Vemula met Steven Bean, MD, now doing a sleep medicine fellowship, in 2015. “I first saw her, and thought she was one of the prettiest women I’d ever seen. ... We ended up being in the same study group,” he says. “Let’s be honest, I applied to every med school she applied to.” 

Six years later, Dr. Bean connected with GMA through The Knot, a wedding planning website and registry. The made-up interview request for Dr. Vemula came from the residency program director, who was in on the surprise. Dr. Vemula’s family also knew what was up when she called with the “news.” 

The live broadcast took place at the hospital. Dr. Bean had an earpiece for the producers to give him directions. But “I was so nervous, I walked out immediately,” he says. He ended up standing behind Dr. Vemula. The mistake worked well for viewers though, building anticipation while she answered a COVID-19 question. “We got everybody excited,” says Dr. Bean. “So, when they said ’Raaga, turn around’ it worked out perfectly. She was confused as hell.”

Luckily, Dr. Vemula loves a good surprise. “He knows me very well,” she says. 

For her, the proposal was even more meaningful given their background together. “Medicine means so much to both of us and was such a big part of our lives,” she says. “That’s what shaped us to do this. ... I think in our hearts it was meant to be this way.” 

 

 

Who Says Masks Don’t Work?

Masks conjure up feelings for anyone living through the pandemic, especially medical personnel. But for Rhett Franklin and wife Lauren Gray, they will always symbolize of one of the biggest days of their lives.

Mr. Franklin worked in registration, often following Ms. Gray, an emergency room nurse, around with a wheeled computer station to gather patient information (what’s known as a “creeper,” which isn’t as creepy as it sounds). Eventually, she offered to grab a coffee with him, and when he suggested another coffee, she said it was time for him to buy her a drink. 

Mr. Franklin, now a manager of business operations for nursing administration, originally planned to propose to Ms. Gray on a trip to England. But the pandemic prevented their vacation with its potential castle backdrop. 

Mr. Franklin often picked up shifts making masks for frontline workers, and an alternate proposal idea started brewing. He schemed to have two very special masks made. “Mine was a black tuxedo that said, ‘Will you marry me?’ and hers resembled a white dress that said, ‘I said yes!’ ” Mr. Franklin says. 

But a text almost ruined the surprise. When Mr. Franklin messaged family members about his proposal plan the day before, one relative responded in a group chat that included Ms. Gray. This was when the busy ER came to the rescue — no time to read texts. Family members also started calling Ms. Gray on the hospital’s phoneline as a distraction. Unfazed, Mr. Franklin simply moved up the proposal to that night. 

At their favorite dog beach, as the sunset gleamed on the water, Mr. Franklin pulled his mask out and took a knee. He can’t recall what he said behind that mask. “It was kind of one of those blackout moments.” But Ms. Gray remembers for him — “You said ‘Let’s do this.’ ”

Warning Label

Everyone has different tastes. Some healthcare professionals have taken the medical theme further than these couples — maybe too far. A few have even faked life-threatening emergencies, showing up in the ER on a gurney with a made-up peanut allergy reaction or a severe injury and then pulling out a ring.

But who’s to judge? For some, thinking your partner is “dying” and then learning you’ve been tricked might not conjure up the warmest feelings. For others, apparently, it’s a virtual bouquet of roses. 

A Few Proposal Pointers

If you’re planning to pop the question, this group says, “go for the medical setting!” But according to them, there are other must-haves to get that “yes” and the lifetime of wedded bliss, of course:

  • Make it a hospital-wide morale-booster. “Everyone loves surprises,” Dr. Bean maintains. So, why not bring your colleagues in on the conspiracy? “Involving coworkers will strengthen relationships with their work family by leaving lasting memories for everyone,” he says. “In a busy medical setting, it’s usually unexpected, so it makes it extra special.” 
  • Have a backup plan. As healthcare professionals, you know that schedules get in the way of everything. So, practice that flexibility you will need as a marriage skill. When Mr. Franklin’s first two engagement locations fell though, he says, it was important to adapt and not panic when things went awry.
  • Seize the moment. Think you can’t get engaged during residency? “Planning a proposal during intern year of residency is totally manageable,” Dr. Vemula says. “That way as residency progresses and you have more time, there is more time to focus on the wedding planning.” But she cautions that, “wedding planning during the intern year would be quite difficult.”

A version of this article appeared on Medscape.com.

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Picture your marriage proposal fantasy. Do you see a beautiful beach at sunset? The place where you first met your partner? Maybe a dream vacation — Paris, anyone? And perhaps most popular of all ... the ER?

Why not? For some couples who share medical careers, the hospital is home, and they turn the moment into something just as romantic as any Eiffel Tower backdrop. (And admittedly, sometimes they don’t.)

Since we’re approaching Valentine’s Day— often the #1 day of the year for engagements — lovestruck healthcare professionals take note. There are good ways to do it and, well, ill-advised ways. We spoke with three couples whose medical-themed proposals ended in the word “yes!” 

Heaven on the Helipad

When emergency medicine physician Anna Darby, MD, heard a trauma patient was arriving and urgently needed to be intubated, she raced up to the rooftop helipad. As soon as the elevator doors opened, she was met with quite a different scene than expected. There were rose petals ... lots and lots of rose petals.

With her best friends and colleagues lining a red carpet, the roof had been turned into a scene from The Bachelor. Each person gave her a rose. A friend even touched up her makeup and handed over her favorite hoop earrings, transforming her from busy doctor to soon-to-be fiancée. Her boyfriend, cardiologist Merije Chukumerije, MD, stood waiting. You can guess what happened next.

Dr. Chukumerije later wrote in an Instagram post, “We met at this hospital. So, it was only right that I bring her to its highest place as we’ve reached the peak of our union.” The couple actually met in the hospital cafeteria “like all the clichés,” Dr. Darby jokes. For them, the helipad experience was just as Insta-worthy as any braggable, grandiose proposal at a fancy restaurant or on a mountaintop.

“Seeing that scene was totally not what I expected,” Dr. Darby says. “I can’t even describe it. It’s like the second biggest hormonal shift, [second only to] having a baby.” She and Dr. Chukumerije now have two babies of their own, aged 2 months and 2 years old.

Good Morning, Doctor

It was February 2021, the height of the pandemic, and Raaga Vemula, MD, now in her palliative care/hospice care fellowship, was “selected” for a local news interview on COVID-19. Except the interview was really with Good Morning America. And the topic was really a proposal. 

Dr. Vemula met Steven Bean, MD, now doing a sleep medicine fellowship, in 2015. “I first saw her, and thought she was one of the prettiest women I’d ever seen. ... We ended up being in the same study group,” he says. “Let’s be honest, I applied to every med school she applied to.” 

Six years later, Dr. Bean connected with GMA through The Knot, a wedding planning website and registry. The made-up interview request for Dr. Vemula came from the residency program director, who was in on the surprise. Dr. Vemula’s family also knew what was up when she called with the “news.” 

The live broadcast took place at the hospital. Dr. Bean had an earpiece for the producers to give him directions. But “I was so nervous, I walked out immediately,” he says. He ended up standing behind Dr. Vemula. The mistake worked well for viewers though, building anticipation while she answered a COVID-19 question. “We got everybody excited,” says Dr. Bean. “So, when they said ’Raaga, turn around’ it worked out perfectly. She was confused as hell.”

Luckily, Dr. Vemula loves a good surprise. “He knows me very well,” she says. 

For her, the proposal was even more meaningful given their background together. “Medicine means so much to both of us and was such a big part of our lives,” she says. “That’s what shaped us to do this. ... I think in our hearts it was meant to be this way.” 

 

 

Who Says Masks Don’t Work?

Masks conjure up feelings for anyone living through the pandemic, especially medical personnel. But for Rhett Franklin and wife Lauren Gray, they will always symbolize of one of the biggest days of their lives.

Mr. Franklin worked in registration, often following Ms. Gray, an emergency room nurse, around with a wheeled computer station to gather patient information (what’s known as a “creeper,” which isn’t as creepy as it sounds). Eventually, she offered to grab a coffee with him, and when he suggested another coffee, she said it was time for him to buy her a drink. 

Mr. Franklin, now a manager of business operations for nursing administration, originally planned to propose to Ms. Gray on a trip to England. But the pandemic prevented their vacation with its potential castle backdrop. 

Mr. Franklin often picked up shifts making masks for frontline workers, and an alternate proposal idea started brewing. He schemed to have two very special masks made. “Mine was a black tuxedo that said, ‘Will you marry me?’ and hers resembled a white dress that said, ‘I said yes!’ ” Mr. Franklin says. 

But a text almost ruined the surprise. When Mr. Franklin messaged family members about his proposal plan the day before, one relative responded in a group chat that included Ms. Gray. This was when the busy ER came to the rescue — no time to read texts. Family members also started calling Ms. Gray on the hospital’s phoneline as a distraction. Unfazed, Mr. Franklin simply moved up the proposal to that night. 

At their favorite dog beach, as the sunset gleamed on the water, Mr. Franklin pulled his mask out and took a knee. He can’t recall what he said behind that mask. “It was kind of one of those blackout moments.” But Ms. Gray remembers for him — “You said ‘Let’s do this.’ ”

Warning Label

Everyone has different tastes. Some healthcare professionals have taken the medical theme further than these couples — maybe too far. A few have even faked life-threatening emergencies, showing up in the ER on a gurney with a made-up peanut allergy reaction or a severe injury and then pulling out a ring.

But who’s to judge? For some, thinking your partner is “dying” and then learning you’ve been tricked might not conjure up the warmest feelings. For others, apparently, it’s a virtual bouquet of roses. 

A Few Proposal Pointers

If you’re planning to pop the question, this group says, “go for the medical setting!” But according to them, there are other must-haves to get that “yes” and the lifetime of wedded bliss, of course:

  • Make it a hospital-wide morale-booster. “Everyone loves surprises,” Dr. Bean maintains. So, why not bring your colleagues in on the conspiracy? “Involving coworkers will strengthen relationships with their work family by leaving lasting memories for everyone,” he says. “In a busy medical setting, it’s usually unexpected, so it makes it extra special.” 
  • Have a backup plan. As healthcare professionals, you know that schedules get in the way of everything. So, practice that flexibility you will need as a marriage skill. When Mr. Franklin’s first two engagement locations fell though, he says, it was important to adapt and not panic when things went awry.
  • Seize the moment. Think you can’t get engaged during residency? “Planning a proposal during intern year of residency is totally manageable,” Dr. Vemula says. “That way as residency progresses and you have more time, there is more time to focus on the wedding planning.” But she cautions that, “wedding planning during the intern year would be quite difficult.”

A version of this article appeared on Medscape.com.

Picture your marriage proposal fantasy. Do you see a beautiful beach at sunset? The place where you first met your partner? Maybe a dream vacation — Paris, anyone? And perhaps most popular of all ... the ER?

Why not? For some couples who share medical careers, the hospital is home, and they turn the moment into something just as romantic as any Eiffel Tower backdrop. (And admittedly, sometimes they don’t.)

Since we’re approaching Valentine’s Day— often the #1 day of the year for engagements — lovestruck healthcare professionals take note. There are good ways to do it and, well, ill-advised ways. We spoke with three couples whose medical-themed proposals ended in the word “yes!” 

Heaven on the Helipad

When emergency medicine physician Anna Darby, MD, heard a trauma patient was arriving and urgently needed to be intubated, she raced up to the rooftop helipad. As soon as the elevator doors opened, she was met with quite a different scene than expected. There were rose petals ... lots and lots of rose petals.

With her best friends and colleagues lining a red carpet, the roof had been turned into a scene from The Bachelor. Each person gave her a rose. A friend even touched up her makeup and handed over her favorite hoop earrings, transforming her from busy doctor to soon-to-be fiancée. Her boyfriend, cardiologist Merije Chukumerije, MD, stood waiting. You can guess what happened next.

Dr. Chukumerije later wrote in an Instagram post, “We met at this hospital. So, it was only right that I bring her to its highest place as we’ve reached the peak of our union.” The couple actually met in the hospital cafeteria “like all the clichés,” Dr. Darby jokes. For them, the helipad experience was just as Insta-worthy as any braggable, grandiose proposal at a fancy restaurant or on a mountaintop.

“Seeing that scene was totally not what I expected,” Dr. Darby says. “I can’t even describe it. It’s like the second biggest hormonal shift, [second only to] having a baby.” She and Dr. Chukumerije now have two babies of their own, aged 2 months and 2 years old.

Good Morning, Doctor

It was February 2021, the height of the pandemic, and Raaga Vemula, MD, now in her palliative care/hospice care fellowship, was “selected” for a local news interview on COVID-19. Except the interview was really with Good Morning America. And the topic was really a proposal. 

Dr. Vemula met Steven Bean, MD, now doing a sleep medicine fellowship, in 2015. “I first saw her, and thought she was one of the prettiest women I’d ever seen. ... We ended up being in the same study group,” he says. “Let’s be honest, I applied to every med school she applied to.” 

Six years later, Dr. Bean connected with GMA through The Knot, a wedding planning website and registry. The made-up interview request for Dr. Vemula came from the residency program director, who was in on the surprise. Dr. Vemula’s family also knew what was up when she called with the “news.” 

The live broadcast took place at the hospital. Dr. Bean had an earpiece for the producers to give him directions. But “I was so nervous, I walked out immediately,” he says. He ended up standing behind Dr. Vemula. The mistake worked well for viewers though, building anticipation while she answered a COVID-19 question. “We got everybody excited,” says Dr. Bean. “So, when they said ’Raaga, turn around’ it worked out perfectly. She was confused as hell.”

Luckily, Dr. Vemula loves a good surprise. “He knows me very well,” she says. 

For her, the proposal was even more meaningful given their background together. “Medicine means so much to both of us and was such a big part of our lives,” she says. “That’s what shaped us to do this. ... I think in our hearts it was meant to be this way.” 

 

 

Who Says Masks Don’t Work?

Masks conjure up feelings for anyone living through the pandemic, especially medical personnel. But for Rhett Franklin and wife Lauren Gray, they will always symbolize of one of the biggest days of their lives.

Mr. Franklin worked in registration, often following Ms. Gray, an emergency room nurse, around with a wheeled computer station to gather patient information (what’s known as a “creeper,” which isn’t as creepy as it sounds). Eventually, she offered to grab a coffee with him, and when he suggested another coffee, she said it was time for him to buy her a drink. 

Mr. Franklin, now a manager of business operations for nursing administration, originally planned to propose to Ms. Gray on a trip to England. But the pandemic prevented their vacation with its potential castle backdrop. 

Mr. Franklin often picked up shifts making masks for frontline workers, and an alternate proposal idea started brewing. He schemed to have two very special masks made. “Mine was a black tuxedo that said, ‘Will you marry me?’ and hers resembled a white dress that said, ‘I said yes!’ ” Mr. Franklin says. 

But a text almost ruined the surprise. When Mr. Franklin messaged family members about his proposal plan the day before, one relative responded in a group chat that included Ms. Gray. This was when the busy ER came to the rescue — no time to read texts. Family members also started calling Ms. Gray on the hospital’s phoneline as a distraction. Unfazed, Mr. Franklin simply moved up the proposal to that night. 

At their favorite dog beach, as the sunset gleamed on the water, Mr. Franklin pulled his mask out and took a knee. He can’t recall what he said behind that mask. “It was kind of one of those blackout moments.” But Ms. Gray remembers for him — “You said ‘Let’s do this.’ ”

Warning Label

Everyone has different tastes. Some healthcare professionals have taken the medical theme further than these couples — maybe too far. A few have even faked life-threatening emergencies, showing up in the ER on a gurney with a made-up peanut allergy reaction or a severe injury and then pulling out a ring.

But who’s to judge? For some, thinking your partner is “dying” and then learning you’ve been tricked might not conjure up the warmest feelings. For others, apparently, it’s a virtual bouquet of roses. 

A Few Proposal Pointers

If you’re planning to pop the question, this group says, “go for the medical setting!” But according to them, there are other must-haves to get that “yes” and the lifetime of wedded bliss, of course:

  • Make it a hospital-wide morale-booster. “Everyone loves surprises,” Dr. Bean maintains. So, why not bring your colleagues in on the conspiracy? “Involving coworkers will strengthen relationships with their work family by leaving lasting memories for everyone,” he says. “In a busy medical setting, it’s usually unexpected, so it makes it extra special.” 
  • Have a backup plan. As healthcare professionals, you know that schedules get in the way of everything. So, practice that flexibility you will need as a marriage skill. When Mr. Franklin’s first two engagement locations fell though, he says, it was important to adapt and not panic when things went awry.
  • Seize the moment. Think you can’t get engaged during residency? “Planning a proposal during intern year of residency is totally manageable,” Dr. Vemula says. “That way as residency progresses and you have more time, there is more time to focus on the wedding planning.” But she cautions that, “wedding planning during the intern year would be quite difficult.”

A version of this article appeared on Medscape.com.

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How physician-inventors create new, life-saving products

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Wed, 06/21/2023 - 12:17

WakeMed emergency department physician and medical director, Graham Snyder, MD, has seen his fair share of deaths: an average of one or two per day. That’s part of the job. Some of the deaths were the result of risky behavior, ongoing health problems, and other natural causes.

But what he didn’t find acceptable was losing a 6-year-old girl in a backyard pool drowning at what was meant to be a celebratory birthday party and family reunion.

“There were aunts and uncles and brothers and sisters and cousins, and the pool was packed, and they’re having a great time. One of the parents looked over and saw that she was swimming around underneath but acting weird. A relative pulled her up by the arm, and she was dead,” he said. “What nobody could tell me, and what they’ll live with the rest of their life, is how long was she under water?”

So Dr. Snyder invented a solution. The catch: He’s among an interesting set of doctors whose side gigs are solving critical problems affecting patients where they live. These are not medical devices for clinical use. They’re innovative products that everyday folks can use to make their lives safer and healthier. The goal: Improving systemic and “unsolvable” issues that harm society.

The cool part: Any MD with an idea can get in on the game.
 

Keeping little heads above water

Drowning is the leading cause of death in young children ages 1-4 years, and the second leading cause for children ages 5-14 years. The issue, Dr. Snyder explained, is not that rescuers couldn’t get to these children in time. “It’s that nobody knew to start looking.”

Dr. Snyder created a collar that alerts those around the swimmer that they are in trouble. The SEAL SwimSafe drowning prevention technology sets off an alarm system if a child is under water for too long. The necklace has been used to protect more than 10,000 children, including at larger swim facilities, such as the YMCA. 

When Dr. Snyder first started pursuing his invention, he asked himself two key questions: “Has someone already tried this? And if they did, why did they not succeed?” These questions help counteract the potential arrogance, he says, with imagining that you are the first person to have a certain idea. And using whatever reason others didn’t succeed as your “secret sauce” helps lead to more success. He also had to consider obstacles. People might resist wearing a collar or necklace while swimming or putting one on their child, like the reluctance around wearing bicycle helmets when they gained popularity in the 1980s. He concluded that the collars would work best at larger facilities, where they were mandated.

Another obstacle was false alarms. “It was possible to trigger a false alarm, and that could really scare people,” Dr. Snyder said. He is still considering systems to prevent the collars from being stolen or from “13-year-old boys hiding them in the water drain and making everyone really scared when an alarm is going off.”

The demand is real, however, and is based on alarming data. Safe Kids has reported that 66% of natural water drownings and around half of pool drownings happened with an adult supervising. They added, however, that supervision is often lacking or insufficient, such as a parent not being within arm’s reach of a young kid. As Dr. Snyder told reporters in a 2018 story, even the most well-intentioned parents still “miss something” sometimes, and this technology is for that moment.

“This is a completely solvable problem, but not a flip-a-switch, one and done,” he said, pointing to his product as a part of a more comprehensive approach, such as in Europe, where mandated public school swimming lessons are helping to decrease drowning deaths.

The pandemic slowed progress for the SEAL SwimSafe collar, which is currently waiting on a new funder or investor to take the reins. But the concept is alive and well with competitors pursuing related ideas. Dr. Snyder is holding out hope that entrepreneurs, scientists, public health workers, researchers, and others will be interested in continuing this work.
 

 

 

Eliminating the stigma of incontinence

Ever had an accident before making it to the bathroom? So have two-thirds of adult women, and almost one-third of older men. Incontinence is linked to a wide variety of conditions, from pelvic-floor trauma to neurological issues to diabetes, and others. Urologist Jessica Lubahn, MD, in Portland, Ore., saw one too many patients feeling this type of shame, unaware that the condition was so common. In addition, she personally experienced childbirth-related incontinence, and helped a relative who was having incontinence after prostate cancer surgery.

“He had a great result, but he had confided in me ... it was one of the only times in his life that he’s been truly depressed,” Dr. Lubahn said. “It’s not even the amount of leakage, but the smell, the stigma is so embarrassing, that not only is it an inconvenience, but [it affects] your entire psyche.” She thought there had to be a better solution than the “demeaning” act of wearing adult diapers.

Noting the explosion of the period panty industry in the past decade, Dr. Lubahn wanted to “destigmatize” incontinence in the same way menstruation education and products have been. She created ONDR incontinence underwear, specifically meant for urine, to ease the mental and physical burden on her patients and many others.

Dr. Lubahn said a process happens when you decide to start talking about the product you want to make rather than trying to find answers on your own. “A lot of people are so afraid to talk about their ideas because they’re afraid it’s going to get stolen or scooped, or it might fail,” she said. “I just openly discussed it, kind of like cocktail party conversation – ‘Wouldn’t it be funny if you just pee into your underwear?’ ” She noticed each connection led to finding more people to help her along her journey.

Dr. Lubahn studied the apparel industry, learning that overseas manufacturers were more helpful and cost-effective. She navigated issues such as a special stitch that prevented leakage and other details. She was also intent on using eco-friendly products that offset the environmental impact of pads, liners, and diapers. She said there’s a strong entrepreneurship community that can help other physician-inventors get grants, be part of accelerator programs, and receive support.

Six years after the original idea, Dr. Lubahn’s product was released in 2020. She now sells eight types of underwear for women and men’s boxer briefs. She wears them herself daily.
 

Deterring carjackers, saving lives

In 2022, carjackings tripled in Chicago and Memphis. The areas have the highest rates in 30 cities that the Council on Criminal Justice analyzed in a report on pandemic crime rates. According to the report, nearly 40% of offenders used a firearm, more than a quarter of victims were injured, and only around half of the vehicles taken were recovered. In addition, vehicles are sometimes used in secondary crimes, such as drive-by shootings. William Yates, MD, former trauma surgeon, now turned hair restoration surgeon in Chicago, saw the evidence of those crimes daily.

“I was perplexed by carjacking because there wasn’t any answer, and it just kept getting worse and worse. A lot of innocent people were being affected,” he said. “I was seeing deaths – needless. If you give them any push back at all, they will shoot you.”

As a deterrent to counter this “easy crime,” he invented the Yates Device, an alarm system designed to prevent or interrupt carjacking. The driver can activate a switch located beneath the foot pedal or an app on the phone to trigger a programmed high-decibel alarm. Critically, it allows the carjacker to drive a safe distance away from the victim before it starts going off.

The alarm “turns your car into a very noisy Christmas tree on a time delay,” Dr. Yates explained. An external siren blares “stolen vehicle” repeatedly. A camera records everything in the car. Lights flash. Only the original driver can turn off the system. Later, once the car is abandoned, the police can help recover the vehicle.

In Dr. Yates’ experience, the invention process takes longer than you think. He worked through earlier iterations with strobe lights, but these could lead to bystanders getting hurt if the carjacker couldn’t see, for example. Developing the final product and applying for patents was a two-part process.

“The first is part is a pending patent phase, which secures your place in line,” he said. “After 1 year, we filed the utility patent as the final documentation that the invention is truly unique. That has been in process for a year now and the attorneys say we should receive approval soon.”

The product has initially been tested in seven cars for about 1 year. Dr. Yates is measuring how the system performs in all types of weather, including Chicago’s below-zero temperatures. The product is not available to the public for purchase yet because Dr. Yates is still seeking funding to have it mass produced, but it is currently being evaluated by Korean automakers for their car manufacturers.

“Everybody was saying ‘Let’s do something about this,’ but I didn’t see anybody doing anything yet,” Dr. Yates recalled. In the surgeon’s lounge, everybody has ideas. “You go around the room, and every doctor would have five ideas that would make them the richest doctor, but nobody takes it beyond that stage – talk. You have to synthesize that into a plan, to take action.”

Dr. Yates said that many doctors have the intellect to invent, but they aren’t in a network like entrepreneurs to bring their ideas to life.

For Dr. Yates, it takes a curious mindset to solve these daunting problems. “I’m always curious, always looking for how to improve something, to get better outcomes you have to be asking questions and just never let it go.”
 

A version of this article originally appeared on Medscape.com.

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WakeMed emergency department physician and medical director, Graham Snyder, MD, has seen his fair share of deaths: an average of one or two per day. That’s part of the job. Some of the deaths were the result of risky behavior, ongoing health problems, and other natural causes.

But what he didn’t find acceptable was losing a 6-year-old girl in a backyard pool drowning at what was meant to be a celebratory birthday party and family reunion.

“There were aunts and uncles and brothers and sisters and cousins, and the pool was packed, and they’re having a great time. One of the parents looked over and saw that she was swimming around underneath but acting weird. A relative pulled her up by the arm, and she was dead,” he said. “What nobody could tell me, and what they’ll live with the rest of their life, is how long was she under water?”

So Dr. Snyder invented a solution. The catch: He’s among an interesting set of doctors whose side gigs are solving critical problems affecting patients where they live. These are not medical devices for clinical use. They’re innovative products that everyday folks can use to make their lives safer and healthier. The goal: Improving systemic and “unsolvable” issues that harm society.

The cool part: Any MD with an idea can get in on the game.
 

Keeping little heads above water

Drowning is the leading cause of death in young children ages 1-4 years, and the second leading cause for children ages 5-14 years. The issue, Dr. Snyder explained, is not that rescuers couldn’t get to these children in time. “It’s that nobody knew to start looking.”

Dr. Snyder created a collar that alerts those around the swimmer that they are in trouble. The SEAL SwimSafe drowning prevention technology sets off an alarm system if a child is under water for too long. The necklace has been used to protect more than 10,000 children, including at larger swim facilities, such as the YMCA. 

When Dr. Snyder first started pursuing his invention, he asked himself two key questions: “Has someone already tried this? And if they did, why did they not succeed?” These questions help counteract the potential arrogance, he says, with imagining that you are the first person to have a certain idea. And using whatever reason others didn’t succeed as your “secret sauce” helps lead to more success. He also had to consider obstacles. People might resist wearing a collar or necklace while swimming or putting one on their child, like the reluctance around wearing bicycle helmets when they gained popularity in the 1980s. He concluded that the collars would work best at larger facilities, where they were mandated.

Another obstacle was false alarms. “It was possible to trigger a false alarm, and that could really scare people,” Dr. Snyder said. He is still considering systems to prevent the collars from being stolen or from “13-year-old boys hiding them in the water drain and making everyone really scared when an alarm is going off.”

The demand is real, however, and is based on alarming data. Safe Kids has reported that 66% of natural water drownings and around half of pool drownings happened with an adult supervising. They added, however, that supervision is often lacking or insufficient, such as a parent not being within arm’s reach of a young kid. As Dr. Snyder told reporters in a 2018 story, even the most well-intentioned parents still “miss something” sometimes, and this technology is for that moment.

“This is a completely solvable problem, but not a flip-a-switch, one and done,” he said, pointing to his product as a part of a more comprehensive approach, such as in Europe, where mandated public school swimming lessons are helping to decrease drowning deaths.

The pandemic slowed progress for the SEAL SwimSafe collar, which is currently waiting on a new funder or investor to take the reins. But the concept is alive and well with competitors pursuing related ideas. Dr. Snyder is holding out hope that entrepreneurs, scientists, public health workers, researchers, and others will be interested in continuing this work.
 

 

 

Eliminating the stigma of incontinence

Ever had an accident before making it to the bathroom? So have two-thirds of adult women, and almost one-third of older men. Incontinence is linked to a wide variety of conditions, from pelvic-floor trauma to neurological issues to diabetes, and others. Urologist Jessica Lubahn, MD, in Portland, Ore., saw one too many patients feeling this type of shame, unaware that the condition was so common. In addition, she personally experienced childbirth-related incontinence, and helped a relative who was having incontinence after prostate cancer surgery.

“He had a great result, but he had confided in me ... it was one of the only times in his life that he’s been truly depressed,” Dr. Lubahn said. “It’s not even the amount of leakage, but the smell, the stigma is so embarrassing, that not only is it an inconvenience, but [it affects] your entire psyche.” She thought there had to be a better solution than the “demeaning” act of wearing adult diapers.

Noting the explosion of the period panty industry in the past decade, Dr. Lubahn wanted to “destigmatize” incontinence in the same way menstruation education and products have been. She created ONDR incontinence underwear, specifically meant for urine, to ease the mental and physical burden on her patients and many others.

Dr. Lubahn said a process happens when you decide to start talking about the product you want to make rather than trying to find answers on your own. “A lot of people are so afraid to talk about their ideas because they’re afraid it’s going to get stolen or scooped, or it might fail,” she said. “I just openly discussed it, kind of like cocktail party conversation – ‘Wouldn’t it be funny if you just pee into your underwear?’ ” She noticed each connection led to finding more people to help her along her journey.

Dr. Lubahn studied the apparel industry, learning that overseas manufacturers were more helpful and cost-effective. She navigated issues such as a special stitch that prevented leakage and other details. She was also intent on using eco-friendly products that offset the environmental impact of pads, liners, and diapers. She said there’s a strong entrepreneurship community that can help other physician-inventors get grants, be part of accelerator programs, and receive support.

Six years after the original idea, Dr. Lubahn’s product was released in 2020. She now sells eight types of underwear for women and men’s boxer briefs. She wears them herself daily.
 

Deterring carjackers, saving lives

In 2022, carjackings tripled in Chicago and Memphis. The areas have the highest rates in 30 cities that the Council on Criminal Justice analyzed in a report on pandemic crime rates. According to the report, nearly 40% of offenders used a firearm, more than a quarter of victims were injured, and only around half of the vehicles taken were recovered. In addition, vehicles are sometimes used in secondary crimes, such as drive-by shootings. William Yates, MD, former trauma surgeon, now turned hair restoration surgeon in Chicago, saw the evidence of those crimes daily.

“I was perplexed by carjacking because there wasn’t any answer, and it just kept getting worse and worse. A lot of innocent people were being affected,” he said. “I was seeing deaths – needless. If you give them any push back at all, they will shoot you.”

As a deterrent to counter this “easy crime,” he invented the Yates Device, an alarm system designed to prevent or interrupt carjacking. The driver can activate a switch located beneath the foot pedal or an app on the phone to trigger a programmed high-decibel alarm. Critically, it allows the carjacker to drive a safe distance away from the victim before it starts going off.

The alarm “turns your car into a very noisy Christmas tree on a time delay,” Dr. Yates explained. An external siren blares “stolen vehicle” repeatedly. A camera records everything in the car. Lights flash. Only the original driver can turn off the system. Later, once the car is abandoned, the police can help recover the vehicle.

In Dr. Yates’ experience, the invention process takes longer than you think. He worked through earlier iterations with strobe lights, but these could lead to bystanders getting hurt if the carjacker couldn’t see, for example. Developing the final product and applying for patents was a two-part process.

“The first is part is a pending patent phase, which secures your place in line,” he said. “After 1 year, we filed the utility patent as the final documentation that the invention is truly unique. That has been in process for a year now and the attorneys say we should receive approval soon.”

The product has initially been tested in seven cars for about 1 year. Dr. Yates is measuring how the system performs in all types of weather, including Chicago’s below-zero temperatures. The product is not available to the public for purchase yet because Dr. Yates is still seeking funding to have it mass produced, but it is currently being evaluated by Korean automakers for their car manufacturers.

“Everybody was saying ‘Let’s do something about this,’ but I didn’t see anybody doing anything yet,” Dr. Yates recalled. In the surgeon’s lounge, everybody has ideas. “You go around the room, and every doctor would have five ideas that would make them the richest doctor, but nobody takes it beyond that stage – talk. You have to synthesize that into a plan, to take action.”

Dr. Yates said that many doctors have the intellect to invent, but they aren’t in a network like entrepreneurs to bring their ideas to life.

For Dr. Yates, it takes a curious mindset to solve these daunting problems. “I’m always curious, always looking for how to improve something, to get better outcomes you have to be asking questions and just never let it go.”
 

A version of this article originally appeared on Medscape.com.

WakeMed emergency department physician and medical director, Graham Snyder, MD, has seen his fair share of deaths: an average of one or two per day. That’s part of the job. Some of the deaths were the result of risky behavior, ongoing health problems, and other natural causes.

But what he didn’t find acceptable was losing a 6-year-old girl in a backyard pool drowning at what was meant to be a celebratory birthday party and family reunion.

“There were aunts and uncles and brothers and sisters and cousins, and the pool was packed, and they’re having a great time. One of the parents looked over and saw that she was swimming around underneath but acting weird. A relative pulled her up by the arm, and she was dead,” he said. “What nobody could tell me, and what they’ll live with the rest of their life, is how long was she under water?”

So Dr. Snyder invented a solution. The catch: He’s among an interesting set of doctors whose side gigs are solving critical problems affecting patients where they live. These are not medical devices for clinical use. They’re innovative products that everyday folks can use to make their lives safer and healthier. The goal: Improving systemic and “unsolvable” issues that harm society.

The cool part: Any MD with an idea can get in on the game.
 

Keeping little heads above water

Drowning is the leading cause of death in young children ages 1-4 years, and the second leading cause for children ages 5-14 years. The issue, Dr. Snyder explained, is not that rescuers couldn’t get to these children in time. “It’s that nobody knew to start looking.”

Dr. Snyder created a collar that alerts those around the swimmer that they are in trouble. The SEAL SwimSafe drowning prevention technology sets off an alarm system if a child is under water for too long. The necklace has been used to protect more than 10,000 children, including at larger swim facilities, such as the YMCA. 

When Dr. Snyder first started pursuing his invention, he asked himself two key questions: “Has someone already tried this? And if they did, why did they not succeed?” These questions help counteract the potential arrogance, he says, with imagining that you are the first person to have a certain idea. And using whatever reason others didn’t succeed as your “secret sauce” helps lead to more success. He also had to consider obstacles. People might resist wearing a collar or necklace while swimming or putting one on their child, like the reluctance around wearing bicycle helmets when they gained popularity in the 1980s. He concluded that the collars would work best at larger facilities, where they were mandated.

Another obstacle was false alarms. “It was possible to trigger a false alarm, and that could really scare people,” Dr. Snyder said. He is still considering systems to prevent the collars from being stolen or from “13-year-old boys hiding them in the water drain and making everyone really scared when an alarm is going off.”

The demand is real, however, and is based on alarming data. Safe Kids has reported that 66% of natural water drownings and around half of pool drownings happened with an adult supervising. They added, however, that supervision is often lacking or insufficient, such as a parent not being within arm’s reach of a young kid. As Dr. Snyder told reporters in a 2018 story, even the most well-intentioned parents still “miss something” sometimes, and this technology is for that moment.

“This is a completely solvable problem, but not a flip-a-switch, one and done,” he said, pointing to his product as a part of a more comprehensive approach, such as in Europe, where mandated public school swimming lessons are helping to decrease drowning deaths.

The pandemic slowed progress for the SEAL SwimSafe collar, which is currently waiting on a new funder or investor to take the reins. But the concept is alive and well with competitors pursuing related ideas. Dr. Snyder is holding out hope that entrepreneurs, scientists, public health workers, researchers, and others will be interested in continuing this work.
 

 

 

Eliminating the stigma of incontinence

Ever had an accident before making it to the bathroom? So have two-thirds of adult women, and almost one-third of older men. Incontinence is linked to a wide variety of conditions, from pelvic-floor trauma to neurological issues to diabetes, and others. Urologist Jessica Lubahn, MD, in Portland, Ore., saw one too many patients feeling this type of shame, unaware that the condition was so common. In addition, she personally experienced childbirth-related incontinence, and helped a relative who was having incontinence after prostate cancer surgery.

“He had a great result, but he had confided in me ... it was one of the only times in his life that he’s been truly depressed,” Dr. Lubahn said. “It’s not even the amount of leakage, but the smell, the stigma is so embarrassing, that not only is it an inconvenience, but [it affects] your entire psyche.” She thought there had to be a better solution than the “demeaning” act of wearing adult diapers.

Noting the explosion of the period panty industry in the past decade, Dr. Lubahn wanted to “destigmatize” incontinence in the same way menstruation education and products have been. She created ONDR incontinence underwear, specifically meant for urine, to ease the mental and physical burden on her patients and many others.

Dr. Lubahn said a process happens when you decide to start talking about the product you want to make rather than trying to find answers on your own. “A lot of people are so afraid to talk about their ideas because they’re afraid it’s going to get stolen or scooped, or it might fail,” she said. “I just openly discussed it, kind of like cocktail party conversation – ‘Wouldn’t it be funny if you just pee into your underwear?’ ” She noticed each connection led to finding more people to help her along her journey.

Dr. Lubahn studied the apparel industry, learning that overseas manufacturers were more helpful and cost-effective. She navigated issues such as a special stitch that prevented leakage and other details. She was also intent on using eco-friendly products that offset the environmental impact of pads, liners, and diapers. She said there’s a strong entrepreneurship community that can help other physician-inventors get grants, be part of accelerator programs, and receive support.

Six years after the original idea, Dr. Lubahn’s product was released in 2020. She now sells eight types of underwear for women and men’s boxer briefs. She wears them herself daily.
 

Deterring carjackers, saving lives

In 2022, carjackings tripled in Chicago and Memphis. The areas have the highest rates in 30 cities that the Council on Criminal Justice analyzed in a report on pandemic crime rates. According to the report, nearly 40% of offenders used a firearm, more than a quarter of victims were injured, and only around half of the vehicles taken were recovered. In addition, vehicles are sometimes used in secondary crimes, such as drive-by shootings. William Yates, MD, former trauma surgeon, now turned hair restoration surgeon in Chicago, saw the evidence of those crimes daily.

“I was perplexed by carjacking because there wasn’t any answer, and it just kept getting worse and worse. A lot of innocent people were being affected,” he said. “I was seeing deaths – needless. If you give them any push back at all, they will shoot you.”

As a deterrent to counter this “easy crime,” he invented the Yates Device, an alarm system designed to prevent or interrupt carjacking. The driver can activate a switch located beneath the foot pedal or an app on the phone to trigger a programmed high-decibel alarm. Critically, it allows the carjacker to drive a safe distance away from the victim before it starts going off.

The alarm “turns your car into a very noisy Christmas tree on a time delay,” Dr. Yates explained. An external siren blares “stolen vehicle” repeatedly. A camera records everything in the car. Lights flash. Only the original driver can turn off the system. Later, once the car is abandoned, the police can help recover the vehicle.

In Dr. Yates’ experience, the invention process takes longer than you think. He worked through earlier iterations with strobe lights, but these could lead to bystanders getting hurt if the carjacker couldn’t see, for example. Developing the final product and applying for patents was a two-part process.

“The first is part is a pending patent phase, which secures your place in line,” he said. “After 1 year, we filed the utility patent as the final documentation that the invention is truly unique. That has been in process for a year now and the attorneys say we should receive approval soon.”

The product has initially been tested in seven cars for about 1 year. Dr. Yates is measuring how the system performs in all types of weather, including Chicago’s below-zero temperatures. The product is not available to the public for purchase yet because Dr. Yates is still seeking funding to have it mass produced, but it is currently being evaluated by Korean automakers for their car manufacturers.

“Everybody was saying ‘Let’s do something about this,’ but I didn’t see anybody doing anything yet,” Dr. Yates recalled. In the surgeon’s lounge, everybody has ideas. “You go around the room, and every doctor would have five ideas that would make them the richest doctor, but nobody takes it beyond that stage – talk. You have to synthesize that into a plan, to take action.”

Dr. Yates said that many doctors have the intellect to invent, but they aren’t in a network like entrepreneurs to bring their ideas to life.

For Dr. Yates, it takes a curious mindset to solve these daunting problems. “I’m always curious, always looking for how to improve something, to get better outcomes you have to be asking questions and just never let it go.”
 

A version of this article originally appeared on Medscape.com.

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