Physicians caught in the tentacles of employment as a means of possibly earning higher incomes and, unfortunately, believing such a platform of medical practice is the panacea of satisfaction and reaching your medical practice expectations that permeate your retirement with regrets.
During my 14 years of clinical medical practice in various settings, including the military, HMOs, and as a hospitalist, my experiences disrupted my initial career plans and intensified my desire for professional freedom and my quest to reach my full potential as a physician. These experiences ultimately altered my initial expectations for private medical practice.
The practice of medicine is labor prompted by our love of what the practice of medicine accomplishes for ourselves and our medical patients. It’s a dynamic productivity demonstrating our commitment to our nation’s health care. All physicians can accomplish that only within the private practice of medicine.
Are you in total control of your medical career destiny? Or have you committed your life, career, and income to the employers you must tolerate and who insist that you practice medicine in the only way that produces the greatest income for the medical facility?
If someone had told me how employed medical doctor predators continue to hide the intolerable and compulsive medical practice disrupting situations, at least I would have demanded far more detailed working circumstances in my employment contracts.
My list of unbelievable conditions and events that I faced
1. A California HMO demanded that I never practice infertility work with OB/GYN patients, or I would be fired. I quit.
2. A Michigan hospital employed me to manage its women’s clinic and supervise nine midwives. Suddenly, I was required to also cover their satellite hospital on a rotation schedule twenty miles away—no extra pay.
3. The same hospital ordered me to remove my personal ultrasound machine from the hospital/clinic—used by me only to confirm OB/GYN findings which I never charged anyone for. Radiologists said they were losing money by my not sending all U.S. cases to them.
4. On two separate occasions at the same hospital’s OB/GYN clinic, the chief of service, neonatologist, and my boss intervened with my patients, citing my perceived incompetence and poor medical care.
First, a 300-pound woman with low blood pressure underwent a post-op laparoscopic tubal ligation. The chief assumed she was experiencing internal hemorrhaging due to a nurse’s insistence in the post-op area. A repeat surgery was ordered, revealing a normal surgical site with no hemorrhaging. The patient recovered normally.
Second, a nurse midwife believed a fetal monitor strip from a term pregnancy indicated fetal distress, but I disagreed. The neonatologist took over and performed an emergency C-section, resulting in a healthy baby with no complications. Later, he admitted that the C-section was unnecessary and was performed for political reasons.
5. A nurse administrator and I were arguing in the side hallway. Another nurse supervisor loudly ordered me to shut up and take the problem inside the room. I told her never to disregard my status as a physician again in front of several other nursing staff members. I was ordered to apologize to that nurse or leave.
6. After eight years of doing advanced laparoscopic surgery elsewhere (in California), the Michigan OR supervisor confirmed they had all the necessary instruments. No one in that town had done anything more than tubal ligation with the laparoscope. The hospital had no advanced laparoscopic surgery surgical credentials for physicians to be approved for privileges. I gave them the ones I had written for the previous California hospital. I quit doing those cases because they lacked the necessary instruments and OR nurse training. They were about eight years behind the hospital I previously did surgery at.
7. The military puts you wherever they choose. Recruiting physicians for the Vietnam War, I chose the Navy for my internship. I finished the flight surgeon training in Pensacola, expecting a Navy carrier as my assignment, and was assigned instead to a Marine helicopter squadron. About 14 months after my Internship, I was in combat with my squadron 1964-65. After about 90 combat missions, it was wonderful being home. PTSD had not yet made the “book” of medical diagnoses in 1970.
The abuse of physicians, even in private medical practice, is also subject to many relentless intrusions into their medical practice careers. Every physician should anticipate a constant shift in their medical practice careers. However, you are still in full control of those disruptions and their consequences. Employed physicians do not.
When it comes to compensating for these many changing circumstances in our medical careers, there is no doubt that your medical practice business management will always come into the conversation. The purpose of a business is to make income. It seems logical that the most important solution for physicians in any area of medical practice is to engage in a serious decision-making process about business education.
After all, your increasing income in private medical practice results from a masterful application of the business tools necessary for any business’s financial success.
So, I ask you, why is it that all our medical schools are not permitted to create and deploy a curriculum of business education, which would inevitably increase your income triple what it presently is? It could all be accomplished on a digital platform at every student’s convenience in a section of the medical school library. It would surely remove many of the financial problems we observe today in our profession.
I offered that education on my medical website in 2010. That upgraded website will be online very soon for those who understand the value and benefits of such an education. Save $40,000 for an MBA and learn it all at home while you continue to practice. I just needed to give you a heads-up.
Curtis G. Graham is a physician.
