Success, Money and Medicine

Edwin Leap over at edwinleap.com will be hosting grand rounds and started a topic that got me thinking about money and medicine. My experience in the medical field is limited to being a paramedic for a volunteer agency, working in an ER, doing some shadowing and currently trying to stay sane as I traverse the challenges of the first year of medical school.

I have two neighbors who are both internists. They went to the same medical school and residency program. They are also partners in a private practice. The one who lives to the left (Dr.Left) works 4 different jobs as a salaried employee. He was a physician in his home country and he went to medical school again here in the states. He is in the upper middle class bracket.
The one on the right (Dr.Right) has the biggest house on the block. He drives nicer cars. He makes more money and works fewer hours. They have the same level of education, and post-graduate training. The doctor on the right is a better businessman. He is aggressive. He takes charge. He squirrels around in search of a way to make a quick buck. The one on the left is way more passive in his approach in making money. Obviously he needs to support his family but he is just not as cutthroat. Dr. Left works 6/7 days a week. Dr. Right never works more than 4 days. Dr. Left does not take risks. Dr. Right does.

Who do I consider to be the more successful physician? After my training, which lifestyle would I prefer to live? That’s right. All puns always intended.

Besides my family, nobody sacrificed anything for me. Nobody went to college, worked, volunteered, studied, and trained for me. And I am not obligated to do so for anybody. Nevertheless, I still volunteer on an ambulance, and I plan on doing so for a long time. I will continue to help people in third world countries because I have a skill-set that can potentially save a life, and for selfish reasons medical work abroad really keeps me grounded in life at home. But I do not feel like I need to give donations in my everyday job. My mechanic never fixed my car for free, he doesn’t care that I’m an unemployed student in debt. My dentist takes all he can get from my insurance company, nothing for free. So how can anyone look down on me if I want to be compensated very well for my job? It makes no sense.

Being a successful businessman is almost as important as being a successful student. I am thinking about making money all the time. That doesn’t mean I’m not thinking about good patient care. These things don’t have to be mutually exclusive. I strongly believe that anyone who wants to be rich and went into medicine is in for a surprise. You don’t go to medical school if you want to be extremely wealthy. It’s a service industry, where you bill for the hours you worked. Yes, you can hire other physicians to work for you, you can have a good business model like Dr.Right, but to make millions doing solely medicine is very unlikely. That doesn’t mean physicians shouldn’t be compensated and shouldn’t look out for their own pockets.

I look down on the doctor who is rude to his/her patients, who thinks they are superior to others, who thinks they are always right, but I would never look down on a doctor who makes a lot of money, I admire those.