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Wartime and peacetime in my Career in Medicine

I’m in peacetime mode and feel that I’m just now recovering from the wartime portion of my career. 8 years of all-out work with increasingly diminishing enjoyment. 2009 is when residency ended and when I signed up full-time with Kaiser Permanente. By 2013 I was over it – it felt like I was a barista at Starbucks.

Higher calling? Maybe with a bong.


Wartime Medicine

Wartime in my medical career was fighting to make sure my paychecks were accurate every pay cycle. Even though Kaiser used software for figuring out my paychecks, they managed to short me every other month.

Wartime was feeling all the pressure of the urgent care because the nurses came to me with all the problems. Another doctor falling behind, go to Dr. Mo. A last-minute walk-in, give them to Dr. Mo. It was both an honor that the staff trusted me enough to make me their go-to person, but it also wore me down. I wasn’t getting compensated more for this. I wasn’t given more slack if something went wrong. Just more work for nothing else in return.

Wartime was not knowing anything about finances and having to learn it all myself. What is a 401k? A profit sharing plan? How does the IRA things work? Should I invest in my Keogh? Fuck – wartime was not having anyone else I could go to about that stuff. My physician colleagues just didn’t know. And the ones who knew were in their 60’s and didn’t feel comfortable talking about finances.

Wartime was being told that I had to live better than others. That because I’m a doctor I deserved more or should spend more and have more. Wartime was trying to figure out how to disidentify from being a doctor and just be me.

Wartime was making payments on my Sallie Mae student loans only to realize that my payments were only covering part of the interest. That every month a little more was added to my principal. Wartime was learning this 4 years into making diligent payments and just wanting to throw my hands up and say fuck it.

Wartime was having to learn how to budget. My parents had zero budgeting skills. They both came into money early and always lived well until shit hit the fan. I found YNAB but learning YNAB was more wartime for me because I’m not a budgeter by nature.

Wartime was figuring out when I could stop practicing medicine full-time. When I could drop down to part-time and eventually per diem. How to convince those around me to get off my sack about how I’m just lazy or wasting my medical skills if I didn’t continue practicing. That was wartime – to the Nth degree.

Wartime was trying to figure out what else I could do besides medicine when I was having panic attacks in the exam room. When I would have to have a drink just so I could fall asleep. Wartime was trying to come to terms with having to practice medicine forever.

Wartime was dealing with patient grievances which were actually customer complaints. Which went to nursing managers and the complaint department – as if I was Comcast Cable. Wartime was being afraid to say no to a patient. Wartime was thinking constantly about my patient satisfaction scores.

Wartime was being afraid of a bad patient outcome, even if it was out of my hands. Wondering if I should have gotten the CT or given the antibiotic. Wartime was realizing that as a doctor I could make very few mistakes before getting the axe.

Wartime was getting fucked over by my own medical group. The same medical group where I got deflowered in 2009 and then got the big D in 2018. Wartime was realizing that I’m just a little gnat against big Kaiser. They decided to not offer me legal representation against my medical board investigation despite what was promised when I first signed on – “it wasn’t in their best interest”.

Wartime was getting bulldozed by the medical board. Who?? The medical board! I thought they investigate like child molesting pediatricians and anesthesiologist who lick the tops of their fentanyl bottles! Wartime was dealing with piece of shit medical board investigators – lowlives. No morals, no ethics – just a vendetta.

Wartime was seeing my colleagues burn out and constantly complain about their careers. Outpatient, inpatient, surgery, primary care – it didn’t matter. Nobody was having it better. Few found their calling, but the rest of us were barely floating.

Wartime was realizing that I’m a drug pusher, not a healer. That I could practice medicine any way I liked as long as the lawyers and the medical boards and the medical groups approved of it. Wartime medicine was finally realizing that I was causing way more harm than good.

Peacetime in Medicine

Once there was war, but then there was peace. Wartime was totally worth it to enjoy this peacetime. Had I been wiser, I would have planned it better and not suffered as much but that’s why I write about this shit. No reason for any physician to get fucked over by the ABFM, by their medical group, or their medical board.

Peacetime is not setting an alarm clock. Peacetime is going to bed when I’m tired and waking up whenever my body decides to wake up. Last night I went to bed at 1am and woke up this morning at 10am.

Peacetime is working 45 minutes doing telemedicine and then closing my laptop when I got bored of it. Peacetime is working just enough to pay for the lap dances for the big guy.

Peacetime is not worrying about student loans. Or a mortgage. Or credit card debt. Or car debt. Or a HELOC. Or owing money to my parents. Peacetime is enjoying the feeling of financial freedom = being debt-free.

Peacetime is knowing that I have as much control over my money as humanly possible. It’s knowing what investments are safe and which are excessively risky. Peacetime is knowing how to evaluate a new investment option and making the best possible decision about it with the guidance of my financial advisor. Peacetime is having my finances on cruise control.

Peacetime is knowing how to budget – mastering the shit out of it karate style. And budgeting based on my priorities and not how others want me to spend and live. Peacetime is having a 6th sense for when I’m spending too much and being able to go into financial lockdown¬†on cue.

Peacetime is realizing that being a doctor isn’t a privilege like everyone else tells me. That’s the kinda shit you tell a slave – “You don’t know how good you have it boy! Iss privilege for you to be working inside in the house rasping them corns off of the masta’ feet! You don’t wanna be pickin’ no cotton out there wrecking up yo’ hands!” Dear people, my 20’s sacrificed is my gift to you and if you don’t like it then go see a shaman for you cough.

Peacetime is being an indian giver with this gift once my services are no longer wanted. Peacetime is not having to resent others for my hard work because I have stashed something away in my heart and my bank from the experience.

Peacetime is realizing that I can develop any skill I like. Peacetime is realizing that I can make money writing, teaching at a community college, consulting for other companies, selling products online, and even repairing cars.

Peacetime is working 1-2 hours a day and having the rest of my day to myself. Peacetime is realizing that even those couple of hours are optional. Peacetime is realizing that I have saved and invested enough that I can go live in Seville, Spain for $1,000/month.

Peacetime is having enough free time to spend it with family friends. Peacetime is being able to read as many books as I like. To listen endlessly to podcasts and take online courses until I throw up.

Peacetime is having time to make my breakfast, lunch, and dinner and shop for my own groceries. Peacetime is not having to rush through a meal and being able to take a nap after a meal.

Peacetime is having multiple income streams. Peacetime is not having to worry that my license will get taken away – or at least not giving a fuck if it is. It’s being able to cultivate multiple skills just in case someone thinks they can own me.

Peacetime is being able to lounge at a coffee shop for 2 hours in the morning, go home and make lunch, take a nap, go to the gym, come home and make dinner, and go meet friends for a good conversation.

Peacetime is never having to stare at the ugly face of an angry patient who wants to take her frustrations out on me. Peacetime is not having to work next to a lazy PA who is hiding behind her union position. Peacetime is being able to earn twice my hourly wage as a per diem than what I earned working full-time.

Peacetime is having amazing conversations with entrepreneurs who are trying to improve healthcare and not having to worry about a paid position with them. Peacetime is me doing the work which means something to me while learning a new skill.

One reply on “Wartime and peacetime in my Career in Medicine”

Amen, brother. Great writing. I really enjoy reading your stuff. I think you pegged how a lot of us feel.

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