A Terrible Medical Profession
If you had to design a medical career that was subpar and all around disappointing then I suppose this is what it would look like:
The employees in this profession would be under a heavy burden of debt, needing to choose the specialty within the profession more based on income rather than what suits them most.
The legal scene of the profession would make it much harder for you to open up your own medical practice due to heavy regulation, often favoring the large medical groups.
You wouldn’t have the same protection as other employees. You wouldn’t get overtime and you couldn’t join a union. You would be regarded as a “highly compensated employee” and so your employer can get away with offering you less incentives.
You would be taxed more because you make more, disproportionately based on a percentage of your income. Even those who live a very comfortable like at $120k/year get far better tax rates than the going rate for a physician.
On the flip side, you wouldn’t be allowed to set aside more proportional to your income, you would be capped at a certain IRS mandated number. Saving in a traditional savings account will hurt you because you lose most of the profits due to the higher tax rate you’re in.
You can get sued by patients if you make a mistake but you won’t get paid more if you do everything right. Your mistake could mean the end of your career, a massive lawsuit or job-loss at the very least. You are constantly pushed to see more patient, with fewer resources, with more restrictions – all while trying to decrease bad outcomes.
You get a push from medical societies to not overuse imaging and overuse antibiotics but you have to deal with medical device and pharmaceutical companies advertising their products directly to the unknowing consumers.
You are expected to make no mistakes but the time you have with a patient is steadily decreased, your attention is pulled in more and more different directions other than the patient’s. You are expected to navigate more and more complicated electronic medical record systems and should things go really wrong, you are left with no recourse.
You are at the mercy of occasionally incompetent staff members, nurses, medical assistants and OR techs. Their unions protect them from you, the patient, and the medical group but nothing protects you against them except the chance that their manager will “write them up”.
You would be regulated by corrupt medical societies that have no real power or oversight over the day-to-day of your profession.
Insurance companies, pharmaceutical companies, medical device industries, lawyers and bureaucrats are digging their claws deeper and deeper into the pockets of medicine. You just try to walk the tightrope as long as you can before getting pushed off.
An Ideal Medical Profession
In comparison, what would a really good medical career look like? It would be something unrecognizable from the mess above. It would be something that you would be looking forward to after 13 years of schooling – not something you’d have to battle for 3+ decades.
With seniority your hours would be more flexible, allowing you to build your time at work around your lifestyle, decreasing your stress and allowing you to be the best physician possible.
You would be considered the expert in your chosen profession. It wouldn’t just be a job but you would be the person to make the final decision on someone’s health – with the patient retaining the right to follow or disregard it.
Any incompetence on your part would be addressed by your peers. Instead of shitty board interventions and useless CME’s, you’d be able to run your practice style and charts by your peers and receive feedback.
Lawsuits wouldn’t exist. After all, why bite the hand that feeds you. Patients would do more of their own research before choosing a doctor. The good doctors would be happy with their workload and the weaker doctors would make more money driving taxis than seeing patient.
These patients wouldn’t be fed erroneous information. The medical societies that doctors are part of would take it upon themselves to be fact checkers – dispelling myths online or any other medium of publication and educating the public.
Since there is no way to become a doctor in the US without medical school debt, your employers would make paying off your debt their priority as long as you would commit to working with them for a period of time.
You would have as much time for furthering your knowledge and expertise as you would have seeing patients. Useless CME time would be spent in great discussions with colleagues, especially those with more experience.
Since the art of medicine isn’t something you can take a course on, you would be encouraged to discourse with doctors from all over the world, working in all sorts of settings in order to put your practice into perspective.
Income would never be tied to how many patients you see, how many surgeries you perform, how many patients you radiate but how well your patients do.
As your expertise increases, you would have more time per patient. You are considered someone with many years of experience and a lot more knowledge. Therefore, you would naturally get the more complicated patients but with a lot more time to manage them.
Why This Discussion Even Matters
Of course, every specialist from librarian to a farmer would want these same idealistic provisions. No barista would want to be yelled out by the angry mocha lady and no investment banker would want to lose her job because some idiots decided to play around with subprime mortgage notes.
But guess what, when you make $9.50 and hour and would have a gross income of $1,500/month working full-time then you have very few choice, very small voting rights and not much room to rebel.
It’s 2017 now, a Family Medicine doctor easily makes $300k. Traditionally one of the lowest paid specialties in medicine, my ass can work 40 hours a week and take home around $200,000/year or $16,000/month or $4,100/week.
No doubt that as physicians we have chosen to use this income to buy ourselves the illusion of a better lifestyle. Some of us are so bold to think that the barista making $10/hour must have a shitty lifestyle – that they are deprived of all the good this world has to offer.
- Is that $500k house really that much worse than your $1 million house?
- Would you really suffer if you ate out less?
- Do you really need a brand new $10,000 road bike?
- Does your family need 2 cars?
- Is that $10k Honda really that much less reliable than your $60k BMW?
- Are you truly living a better life because you spent $7,500 on a ski trip to the Alps?
- How much better is your life because you have a $194/month of cable TV?
- Does a kitchen $400 kitchen mixer really improve your cooking?
- Are you making much of a difference by paying $500/month for golf lessons for your child?
Vote With Your Money & Your Presence
It’s such a bold statement but think about what you really have in this world that you can use to leverage to enjoy the lifestyle you desire. It’s your money and your presence.
If you so vehemently disagree with something that is going on around you then you can choose to not be there. Your physical vote is much more democratic than that single ballot you cast off into the abyss.
I didn’t want to live in a State full of traffic, poor air quality, stress and the lack of camaraderie. I voted against California, and my vote counted, I am no longer there, I don’t pay my 10% state taxes nor my nearly 10% sales taxes.
I can vote with my dollars as well. I won’t pay for a consumer product that was made by making animals suffer. I won’t own anything that needs gasoline to run and I refuse to increase my taxable income and instead focus on tax-free income.
I stopped enjoying my medical career and how I was forced to practice it. Medicine no longer was an ideal medical profession. I voted myself out of it and the market responded by offering me better alternatives.
Remember That You Have Options
It’s easy to get tricked into thinking that you don’t have any other options but to buy a luxury automobile, purchase an expensive home, constantly take on more debt, or work your ass off inside a building for 30+ years.
And I am not saying there is anything wrong with owning that stuff. Well, there would be something wrong if you don’t think that those are sustainable possessions. But, what I am trying to harp on is that there just might be something better than purchasing that stuff and you’d be able to enjoy it if you were less dependent on your income.
Our medical profession isn’t all-terrible. There are wonderful aspects to medicine but those have to be teased out. In order to enjoy them you have to carve out your own niche.
Imagine if more of us did that. Imagine if 55% of healthcare professionals were using their high income to break free from the career-track of medicine and designing their own ideal medical profession. The only thing these larger medical groups could do is offer us better quality work experiences in order to keep us at work a few years longer – it’s not like you can print another doctor in some shop.