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Why doctors are burning out: the missing piece in medical education

Curtis G. Graham, MD
Physician
May 1, 2023
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It is staggering to think that our medical school scholars have fallen in line with the dictatorial components of the “deep state of medical education.” John Abramson, MD, a graduate scholar of Harvard, Dartmouth, and Brown medical education institutions, recently published in “Imprimis,” a publication of Hillsdale College, eloquently and astutely links the disintegration and decreasing quality of health care in our nation to the “medical-industrial complex,” let alone, the primary goal of American health care.

Personally, I prefer to deal with the closer-to-home, physician-to-physician interaction within our individual lives while working in the medical profession. We have all been abused to the point of being financially handicapped throughout our professional life. Over 98 percent of physicians, after many years of medical practice, learn how to tolerate their compromised incomes. Some don’t even see this as a problem or recognize that it affects them.

When our income tolerance level, however, reaches our threshold of endurance, which it commonly does, we naturally tend to start rationalizing our reasons for remaining in this situation. It enables us to blame ourselves for the problem, even when we have no idea we are doing wrong, and consequently have no way to resolve the income problem we don’t know the cause of. What have I done to deserve this?

We have no idea how to fight the problem because we have never had business education tools to predict the problem happening, correct it, and prevent it from continuing for the rest of our careers. Of course, the same problem and cause directly affect our personal and family lives, economically. So, what do we do? We commonly begin shaving off a good portion of our after-tax income from the practice to meet the needs of our growing practice requirements.

Yep, our family and personal life becomes compromised. Our family is forced to tolerate less financial support, right? Remember, the kids don’t have to attend college. You don’t really need to fund your retirement plan, quite yet. And you can cut back on vacations, develop no new medical skills, and tolerate your gradual loss of updates for your medical practice knowledge.

It’s not your fault, because your medical school was never “allowed” to provide you with business education over the last 10 decades. Even worse, in medical schools, we were purposely never told, in detail, anything about the value and benefits of business education when implemented into your medical practice. Why did they do that? Who dictated to them that they could not do it? Research the AAMC (American Association of Medical Colleges).

Like so many of us, we were kept away from learning the most critical block of essential business knowledge, not only necessary for the survival of private medical practice but also from the universally recognized principles required for business success of any type. Medical practice is a business, right?

The abuses of physicians are destroying our profession.

The abuses that I’m referring to here are essentially an accumulation of every universal code of conduct that every business owner adheres to, to reach the top income levels for the business. The international expert in business and marketing, Dan S. Kennedy, reminds us that the singular objective of every business is to make money. Most physicians over the last century in our nation have never been made aware of that fact.

Nearly all physicians believe that their own private medical practice business is primarily for treating medical patients—wrong!

It takes money to recruit enough medical patients to maintain and grow the business. The amount of income must be high enough to:

  • Pay all the overhead of the practice-business
  • Support the functions of the physician’s family
  • Afford to maintain his or her cutting-edge medical knowledge and new medical skills, fund a retirement plan, pay for kids’ college education, and enough to reach their personal expectations for their medical careers, among others.

This list opens the gates to the flood of abuses that continue today in the profession. No medical student signs up to live at the poverty level or to lose their private practice for lack of income. The lack of a business education leaves every physician in our nation without the knowledge to ever reach their maximum potential in medical practice, except for those who are from wealthy families.

Far beyond the inability of large numbers of physicians to earn enough income to attain all their desires is the fact that our medical schools fail to prepare every physician to defend themselves against the common consequences of financial external disruptions that they have no control over. The COVID pandemic is a real example.

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The lack of business and marketing tools, I firmly believe, accounts for increasing problems in the profession, of burnout, physician attrition, physicians living at the poverty line, disappointment with their practices, anxiety from government fee restrictions and medical practice mandates, never able to afford retirement, and many other waves of abuse.

When all physicians have the business and marketing tools, they will be able to fight against all these abuses. Think about that. Why do physicians give up and quit—not only medical practice, but also their motivation to stay above the “good enough” quality of medical care? Physicians have no backup education to handle all these critical issues—no wonder health care is disintegrating.

The unique backup of business education provides numerous strategies to prevent as well as overcome nearly all these medical issues. But no one seems to want to provide that backup—except for me.

Public schools, colleges, and medical schools don’t provide this financial backup.

Physicians without weapons to fight against all these disastrous challenges, the disintegration of health care and physician’s medical care will increase.

Curtis G. Graham is a physician.

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Why doctors are burning out: the missing piece in medical education
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