"Regardless of ages of physicians, changes in medical
practice over eight decades, and the gradual takeover
of healthcare by our government, there remains an
unsolved tragedy that will continue to destroy
the medical careers of physicians for years to
come, unless the truth be told."
Anyone who believes that the new generation of medical students and new physicians aren't as committed to a career in the practice of medicine as us older wrinkled physicians were,
has to be insane.
In fact, these new physicians are facing more obstacles, barriers, and obligations that far surpass what those older physicians faced even 40 or 60 years ago. You might look at their situation like Friedland described, "The situation is hopeless, but it's not serious."
When you then add to that these mentally unsanitary factors and sissy issues that make a medical student consider self-immolation, it's no wonder medical school recruiting of medical students has become a permanent job position year-round.
Think about these as paving the cow-path to continuous desperation...
- Average medical educational debt accumulated by graduation
time...$160,000 plus.
- Impossibility of learning everything in medicine, that doubles in
amount each year
- Face inevitable governmental control of healthcare as well
as physician fees and ways of practicing
- Forced to tolerate practice in states with no medical malpractice
verdict caps---about 43 of them at last listing
- Increased government control of healthcare, medical practice, and
eventual control of the medical profession itself
- Persistent reduction in private physician incomes today whether
employed or not and worse when our government controls it all
- Managing a private medical practice business with no essential
business education to ensure it is profitable and not fail
These are just a few things to think about... and then wonder where the passion to become a physician comes from, in light of their future in medicine. How is it possible to find any college student tough and persistent enough to run the gauntlet of private medical practice?
What I'm doing to discover why students are willing to volunteer for a life of secular priesthood... medical practice.
Today, I'm including an interview with a medical student that I consider has an elite and unusual, but passionate view, of reality you need to think about. His name is not important, nor is his medical school. What he says is!
The interview content:
Q. #1---You must have had a very good reason for giving up your financial career and going into a career in medicine. Please tell me why you would ever do such a thing. With all the issues students face in medicine, how do they, and you, rationalize going into a medicine career today?
"Before I got into medicine, I was an accountant. By my second year, I was extremely bored with work and needed to do something else. I could not see myself doing accounting for the rest of my life. So I decided to become a doctor.
That decision was made without having all the information. I assumed that being a doctor will guarantee me a life-long, high-paying job. And as a bonus, I will get to help people (whatever that means). Tuition would be a moot point because I can eventually pay it off with a doctor's salary.
But once I got into medical school, I began to do more research about being a doctor that practices medicine. I learned the following:
1) If you want to be board-certified, you will be taking tests for the
rest of your life. (I hate taking tests.)
2) The third-party payer (either government or insurance companies)
will place an artificially low price on your services.
3) Everyone thinks doctors are moneybags. Therefore, expect to
spend a lot to practice medicine (from going to medical school to
taking certification exams to pay for malpractice insurance)."
Q. #2---Have you already discovered your medical skills and talents and decided on which specialty you intend to train in relative to your interests and skills? This question is about whether students make those decisions at the last minute of medical school, or if professors are helpful in pointing you in the best direction.
"I decided on my specialty before entering medical school. My goal was to be the most help to as many people as possible. And I wanted to practice on my own as fast as possible. Therefore, I chose family medicine.
The most help in medical school for choosing a specialty is third year when you are rotating with different doctors. You will get to see what each specialty is like. But take what you experience with a grain of salt. Your rotation experience will depend a lot on the doctors who are teaching you. If you got a crappy preceptor, your experience will be crappy."
Q. #3---What are your expectations for yourself in medical practice eventually? Do you have in mind a clear view of what you intend to do, the path you have already planned out, or are you letting circumstances direct you where you will end up in your career? In my time in med school, most students kept waiting for some opportunity, or sudden challenge, or events to unfold to show them what they should do in medicine.
"I have a clear idea of my future medical practice. I have already determined what city I want to practice. I research asset protection laws, demographics, median family income, and lifestyle
of the city.
I am constantly planning what services I offer and how I will differentiate my practice from other medical practices. I researched the fees that other cash-based practices charge so I can pick and choose the best ones to implement to my practice.
President Bush allegedly said, "If you don't set your own agenda, others will set it for you." Although many people made fun of him for being dumb, he is still one of the most wealthiest
and powerful people in the country. (Read Confessions of an Economic Hit Man to find
out what I mean.)
So if you wait around until the very last moment before deciding on how you want to practice medicine, it is very, very likely you will go along with the flow and join a hospital or big practice. There is nothing wrong with that if you want to work for someone else. Others will set your agenda for you. You will see this many patients. You will work this many hours. You will
accept only so much money for your services. You will not be in charge of your destiny.
But if your intention is to be your own boss, make your own rules, and set your own pay, start being a boss now rather than later."
Q. #4---What are your fears or worries about the future of healthcare and medical practice, if any? All sorts of changing good and bad information come your way daily about medical practice...like ObamaCare, heavy educational debts to be paid back, malpractice increasing, how much money you will be able to make to meet your obligations to yourself and family, how you intend to earn that money in practice in view of increasing fee restrictions on doctors. Just some thoughts to churn around in your head.
"My main concern is if doctors are forced to take Medicare and Medicaid. In my practice, I will not take them. I would rather see Medicare and Medicaid patients for free. Too many doctors are losing money on those visits. If accepting Medicare and Medicaid is mandatory for all doctors, I would quit practicing medicine.
My other concern is the huge educational debt. Some medical students will have more than $200,000 in medical school loans by the time they graduate. At the 6.8% interest rate or higher, these loans are more expensive than mortgages! Student loans are now the biggest debt young people have, even more than credit card debt. America is living for the short term by shackling the next generation into so much debt.
Doctors can take advantage of income-based repayment if they have a federal loan. It can help ease the debt burden a little. But I strongly feel that sometime in the future, there will civil unrest because so many people will have unpaid student loans. The government will definitely have to do something about that. It may even make the loans dischargeable in bankruptcy.
Other than that, I am not too concerned. With ObamaCare, many more people will be insured. That means the demands for primary care providers will go up. That means demand for my services for go up. People may be more willing to pay cash because there are not enough primary care doctors for everyone.
I really plan to practice medicine in my own way, with as few restrictions as possible. I will only comply with something if there is a law that mandates me to do a certain thing (i.e. have a medical license). Malpractice insurance, certifications, accepting insurance, etc. are all optional and will be subject to a thorough analysis, questioning if having them will make financial sense or not."
Q. #5---Do you see the future of private medical practice disappearing rapidly? Since surveys now show that at least 50% of medical students presently intend to join some type of medical management facility and remain an employee forever... meaning that they have to tolerate the restrictions of being an employed physician, no means of increasing their income significantly in such an environment, all medical practice freedom lost making it nearly impossible to reach your personal dreams and goals you had at the start.
Smaller, traditional medical practices will have harder and harder time to survive, due to these main reasons... (author's comment)
"1. Medical practices are small businesses. Yet, most doctors do not have business skills. So what do you think happens when you get someone with no business skills running a business? Most likely than not, it will fail.
2. Doctors are wimps. All they do is complain, but they don't take any action. Too many people want a piece of the doctor's pie, and the doctor doesn't even fight back. Reimbursements are decreasing. Doctors need to see more patients just to pull the same income as last year.
Malpractice premiums keep going up and up. Board certification changed from being life-long to lasting only several years, resulting in more money and more time to keep the few letters after your name. And doctors don't stand up for themselves and say, "No." Eventually, there won't be any piece of the pie left for the doctor.
There will be a few independent, financially successful medical practices. They are ones run by business-savvy doctors who follow their own rules. They see the struggles that their colleagues went through and were brave enough to do something different."
******************************************************************
Note: Nothing has been edited out of the interview, or changed. This medical student (young doctor)... a term used by most of my medical school instructors and professors to introduce a medical student to their patients. Something that I considered was a reflection of respect and documentation of my value to him or her.) is one of the few who reads, understands the broader picture concerning the practice of medicine, and is courageous enough to recognize the importance of business knowledge in addition to medical knowledge.
(Interview taken, 2015)---Since that time the egregious impact of increasing government restrictions and mandates placed on private medical practice physicians has increased greatly.
Today, in 2022, the nationwide disintegration of private medical practice is rapidly increasing because of the lack of a business education for medical students, well beyond the MBA level.
The ultimate end of the progressive's political agenda of our government is Socialized Medicine. Are you ready for that?
“There is nothing more difficult to take in hand,
more perilous to conduct, or more uncertain in its success,
than to take the lead in the introduction
of a new order of things.”
—Niccolo Machiavelli
“The greatest danger in times of turbulence
is not the turbulence—it is to act
with yesterday’s logic.”
—Peter Drucker
“After you've done a thing the same way
for two years, look it over carefully.
After five years, look at it with suspicion.
And after ten years, throw it away
and start all over.”
—Alfred Edward Perlman
----Professional Probe----
"Like this driver who knows the danger, yet continues down
the street, is similar to the way physicians see the medical
profession today, all hanging on the string of a
business education never offered or provided."
"No wonder male college students aren't applying to medical schools anymore.
No wonder medical schools have been forced to recruit women and foreign medical students to
fill their classes.
No wonder thousands of private medical practice physicians over the years have lost their private medical practices for financial reasons.
No wonder there now is a lack of physicians to meet our healthcare needs.
No wonder over 65% of physicians in surveys admit severe frustration with their medical practice and careers.
No wonder that most physicians are reaching the stage of full burnout, whether they admit
it or not."
It only takes a few minutes of diligent thinking to comprehend how one factor, if recognized, can resolve almost every one of these tragedies happening in medical practice and healthcare today. Clear your mind and then relate how all of these problems can directly be related to one increasing factor---lack of physician income!
Then factor in the cause of the lack of adequate income, or more profoundly the amount of income that is appropriate to the prolonged education and training, unique skills and knowledge, and the dedicated commitment to their profession that all physicians have.
Add to those issues, the world-wide proven business principles of what comprises a successful business, so well summarized in the books written by Phil Drucker, world renowned business expert. Once you do that, you will be able to compare the differences between any other business success principles with that of every private medical practice business success. Can you see the
obvious difference?
The difference is that all successful and profitable businesses worldwide are successful because a business education is required.
The story behind this medical student interview...
About two years after I had launched my physicians website online offering all physicians, and any other person who had a desire to learn what business and marketing knowledge could add to their career successes, the opportunity and details to learn about the business of medical practice, a young male second year medical student contacted me by email.
He had trained for an accounting career, earned an MBA, worked in that industry about two years after which he decided to do something else in his life to escape the boredom of accounting. As he explained it, his desire was to have a career that would fulfill his desire to help people, make a difference, and yet allow him to control his life, career, and destiny while using his talents and skills to their fullest degree. He chose the practice of medicine.
His reason for contacting me was not to ask for anything, but to tell me how much of a difference he could make in his life with a real business education. He had spent a number of hours in the process of finding online, the means to take a far greater advantage of his MBA. He had stumbled onto my physician education website, www.marketingamedicalpractice.com that contained nearly a hundred articles explaining how to use the contents and articles details about business and marketing to be successful in any business, including medical practice management and medical practice marketing for physicians.
Not only did he explain to me that my articles and advice were so detailed that he became aware of how superficial the MBA education was compared to my website business and marketing information, but also how critically important it was to learn and use the detailed knowledge about business and marketing that I provided FOR FREE and that provided a path to reaching one's optimal potential and income in the medical profession.
What impressed me the most was the fact that an MBA qualified intelligent medical student took my advice and instruction serious enough to take the time to contact me and even reassure me that all my information was not only of high academic quality, but also something that all medical students should know about and learn to use in their own private medical practices businesses in the future.
A trickle of others who contacted me said the same thing to me.
After becoming aware that the book that I published in 2014 on the same topic titled-- THE WOUNDED PHYSICIAN PROJECT-- was never bought and read over the next 5 years, I believed that no one cared to know about how to become better physicians as well as make far more income in their private medical practices for some reason that I still do not understand today. So, the teaching website faded away slowly from lack of attention. I had simply given up on my mission to push medical schools to provide a business education curriculum for all medical students.
Suddenly, a miracle happened, that enabled me to take up the quest where I left off, regardless of the complete public and physician inattention to the problems in our healthcare and quality of medicine becoming worse almost daily.--also what other fail to notice.
My belief today in 2022 is that I don't have to prove anything to anybody anymore. The evidence is all around us in plain sight where it can be seen by anyone who cares to notice. Like the Bible says, have ears but don't hear, have eyes but don't see.
I have no expectations that this dilemma will ever change at this point. However, a breakout will occur in the future to resolve the healthcare problems, the physician business education problem, and the government takeover problems of healthcare and the medical profession.
Curtis G. Graham, MD, FACOG, FACS
----Professional Probe----
