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The medical-industrial complex: Why physicians shouldn’t expect wealth

Curtis G. Graham, MD
Finance
May 6, 2023
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The gradual influence of what’s called the “medical-industrial complex” has its tentacles wrapped around every physician’s medical career to the point that any practicing physician should expect no guarantee about becoming wealthy. Even the optimistic nature we carry along with our passion for improving our life circumstances and making a welcome difference in the health care we provide over the years will become tempered to reflect the demands of our failing and desperate government.

Recent surveys of dissatisfaction among private practicing physicians over the last decade reveal an increasing number of financial, social, and stress-related problems. Those problems interfere with and exaggerate physicians’ attitudes about their value to the medical care system, especially when we are mixed in with other non-professional providers. Solomon had the same problems.

Solomon’s journey to find meaning — in money, wisdom, work, and accomplishments — is a reflection describing what every medical doctor must resolve in their own minds. Of course, male physicians seldom have 700 wives and 300 concubines to distract them from understanding the value of money when applied to the sum of their accomplishments in medical practice.

To believe that money is the primary means of everything you accomplish in your medical care of patients can’t be hidden behind colored glasses. Although there are numerous and variable extents as to how far each physician is willing to go to maximize their accomplishments in their profession, the fact that having available money/income to expand those limits is key to their success or failure.

We repeatedly hear from some physicians, “For every physician practicing medicine, their top reason for becoming a physician is to resolve medical problems that patients seek treatment for — not to make a pile of money.”

This belief faded out the day the industrial revolution hit our society. The suggestion that the struggle to reach our ultimate potential as a physician and our greatest benefit to our medical patients is far more dependent on how much income we make, not on our original intentions to make health care better for our patients and our nation. If you disagree, try practicing medicine for free on a street corner where most of those kinds of medical patients hang out.

What we observe daily in our medical environment today are the consequences of saluting the wrong flag.

When physicians can earn enough income to afford to do everything in their medical practice that they want to do, wouldn’t it become a medical school recruiter’s dream come true? It’s especially true today when medical schools are downgrading the requirements for med school admission. Now we need to search out the evidence of why this issue will never happen. The abuse of physicians is an old story, yet important to this topic.

I still remember the day, after 20 years of building my practice in my OB/GYN specialty, when I realized that losing my practice for financial reasons had been happening over the prior couple of years and I never noticed. I was sure that I had done nothing wrong, yet I knew something was very wrong.

What hurt the most was that I had unknowingly caused the problems, betrayed my family, ruined my reputation, and had to somehow start all over again and might repeat the problems the next time — never knowing what needed to be fixed.

This nationwide failure of medical practices involves far more consequences than anyone cares to confront — primarily beginning at medical schools and regarding medical education scholars. I discovered the answer to these problems that we hear about far more often today. My discovery came about 15 years after I had retired from medicine, only to notice that I had innumerable physician compatriots.

What my research uncovered was a well-camouflaged area of medical education and medical practice that has been purposely kept from the eyes and ears of medical students for the last century — and completely disregarded. Have you ever heard, “Physicians don’t need a business education to practice medicine?” I believe that the myth was never updated or completed. The second half of the myth should say, “…if physicians can tolerate a lifestyle living on the edge of poverty for the rest of their medical careers.”

One can dignify the previous paragraph of information by asking if you, as a medical student, were ever informed of the value and benefits of business education in medical practice. I haven’t found one physician that says: yes.

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Why has the medical-school education system cut that out of every medical school curriculum? And why hasn’t any person or medical organization corrected the issue?

The greatest consequence of such deliberate sanctions on the medical school curriculums is one that about 52 percent of medical school students will face following graduation, internship, and residency training today. All private practice candidates are expected to design, create, and grow their own medical practice, when none have ever been taught how to do that.

But still, most physicians are so arrogant that they know enough about business management that they can convince themselves that they are just as smart as any business experts. Thus, they tolerate far less income for their careers and tell everybody their practice income is good. They don’t know what they don’t know and wonder why they still have persistent intentions to upgrade their practice that they can’t afford to do.

So, all these young physicians build their practice by following the hand-me-down information offered to them by local medical doctors and offices. Sounds OK, right? What really happens is a disaster. Not only is all the borrowed information derived from people who had no business education, to begin with, but also, the medical practice business never seems to earn enough income to meet their needs later.

Physicians spend the rest of their careers running their medical office business while constantly trying to make the business profitable when they don’t have the business tools to do it properly, efficiently, and persistently. This is exactly what I was confronted with in my practice and what I also did — and lost the game, as thousands of other physicians are still suffering from today.

If the AAMC controllers of medical school education are being totally controlled by the government medical and health care oversight committees, as I suspect, then my 20-year mission to coerce medical schools to independently provide business education curriculums for all medical students may be chasing the wind after all.

The last laugh may well be mine, because the first medical schools to provide business education, whether required or voluntary, whether provided in a manner like college classes or by a digital business education platform, will become the medical schools that will never have to worry about recruiting top student candidates ever again. I feel sorry for those ignorant medical school educators who continue to disregard the need for the business education of medical students.

Curtis G. Graham is a physician.

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The medical-industrial complex: Why physicians shouldn’t expect wealth
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