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The Dangers Of Being A Career Doctor

I have been wanting to write this post for some time but couldn’t quite get my thoughts organized for it. I know in my heart that being a career physician is almost always a bad thing. We are rewarded with recognition and a higher salary for our continued hard work. As medicine is becoming more and more monetized our outcomes are even more scrutinized.

It’s easy to start in a large medical group with the partnership carrot getting dangled in front of you. Once you make partner the last thing you want to do is lose that title. And if it’s not called partnership it’s called seniority or tenure.

The Medical Group Profits More Than We Do

We are made to  believe that we are the ones getting rewarded for our continued dedication and hard work. The medical group profits off of us quite well and hiring a new physician is quite expensive – somewhere in the $100k range to on-board a new clinician. The truth is that the medical group is building its reputation and deepening their pocketbooks off of our backs.

Being Pushed Out Of Our Comfort Zone Becomes The Norm

We start drinking the cool-aid after some time. We feel a sense of loyalty to the organization. Maybe even thinking that this medical group is much better than others out there. We start learning our particular system quite well which makes us of course more afraid of learning a different system. We are pushed more and more to perform and cut costs and control LDL’s and close care gaps and code medicare refresh crap. We are expected to see sicker patients in the outpatient setting to cut ED costs.

I’m not trying to say large medical groups are evil. But they aren’t in it for the healing, they are in it for the money. And don’t start lying to yourself saying “Please, of course it’s all about money! Medicine has been all about the money for a long time.” I wouldn’t even disagree with you. No doubt, the medical field sold out eons ago. But aside from the paycheck the only pleasure we derive is the healing we provide. It may be reassurance, it may be resuscitating a patient, draining a nailbed hematoma or removing a FB from the cornea.

Doctors Are Still In High Demand

I just witnessed one of our weakest physicians, who we had to fire, get hired by a very large well-paying local medical group. This was done without even checking her references or conferring with her old employer. Doc’s are in high demand. Let’s not abuse this opportunity but let’s turn this shit on its head and take back what we deserve.

How do we do it? By becoming financially independent way ahead of time. Uncle Sam don’t need to tell me when to retire! My medical group isn’t gonna boss me around for 25+ years. I’m not gonna trade in what I love for a higher paycheck… okay, I will but only for a few years until I reach financial independence and then I’ll pursue my real passions.

You Are Rewarded For Working Harder And Committing More Time

Eventually this will make us institutionalized; many of us already are. Working harder and harder becomes the norm. Over the years I have been trained to slowly cut meaningful things out of my life. Going for a relaxing walk during a busy workday, taking the vacation I want when I want, and calling in sick for a mental day… out of the question! We got Pavlov’d ever since medical school to work our asses off. I feel like I just continued that behavior right up until a few months ago.

I’m not surprised to see my former Southern California colleagues getting deeper and deeper into debt just to afford the So-Cal lifestyle. They rely on that steady paycheck and bank on it going up every year. They are following the same path as other docs around them.

You Miss Out On Developing Your Person

Some of you probably cruised through undergrad and med school, worked a few long hours in residency but otherwise didn’t break a sweat. I fucking killed myself to get through that shit. It was basically one long torture episode – I loved what I learned but man, it wasn’t easy. I didn’t do much personal development in that time. And let’s be honest, many of us (me) regressed quite a bit.

By achieving financial independence and no longer having to rely on a steady income we can pick up where we left off. Go spend a few months in a poor but peaceful country. Go spend some time with some enlightened folks. Read some Eckhart Tolle. Do a yoga retreat or a spiritual retreat. Sign me up!

Going Part-Time Is Frowned Upon

Most medical groups will give you shit if you decide to go part-time. Even worse, if you try to have a flexible schedule you will have your chief give you shit. It doesn’t make sense. The medical work force is stronger than ever, building a schedule to allow for more flexibility isn’t hard at all but we are as archaic as the suits working in cubicles.

Even worse, if you decide to work per diem you are given almost no benefits. Yes, I realize that it’s hard for a large organization to run efficiently without set scheduled workers. But as we get older having time flexibility becomes more and more important. Being locked down in a set schedule is just miserable.

You Become Reliant On A Steady Paycheck

Our jobs are fairly secure as physicians. However, it’s hard to predict how the economy will change in the future. Becoming overly reliant on a steady paycheck is sort of putting all your eggs in one basket.

Just like I have talked about investment diversification before, we need to diversify our income sources. It’s great to work hard, earn that paycheck during the wealth building years. But we have to work on becoming financially independent so that even if that paycheck stream dries out a bit it won’t hurt us financially.

We could also achieve this by having a side-income. For some it may be a rental property. For others it might be a small business, writing or consulting.

You Might Miss Out On Better Opportunities

I would love to set up shop in a low income neighborhood, see patients with very little out of their pockets and do more education instead of dishing out medications. Is it idealistic? maybe. But who cares, I’m dreaming. It’s never good to be dissatisfied with the current circumstances, by being miserable we are making an enemy of what is around us and creating even more stress. At the same time, it doesn’t mean that we cannot have something more meaningful to work towards.

A colleague of mine travels to other countries on medical mission trips while employed full-time with our medical group. Imagine what he could accomplish if he had more free time. He is planning on retiring at 58 and is current 46.

Another friend has built up a medical service that provides care to 2 orphanages in Bolivia. Unfortunately, he struggles a lot with his finances and with 4 kids of their own financial independence isn’t in their near future. He is also employed full-time with my former medical group.


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