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The medical profession’s silent struggle: Business knowledge matters

Curtis G. Graham, MD
Finance
February 18, 2024
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Isn’t it incredible that generations of physicians today still do not know how to make money in a professional business way that is easy to learn, implement, and use?

Aside from the fact that every medical school in our nation over the last century has refused to even tell medical students that they would benefit from business education, you’d think that they had somehow been blinded to the fact that all private medical practices are legal small businesses and must adhere to the proven business rules for profitability and success.

Even more unbelievable is the fact that nearly every physician during all those years while in medical school and later in private medical practice persisted in believing the myth that arose ubiquitously in the medical profession, about the time the system of trading for payment of medical services disappeared. Thanks to the beginning of paper and coin currency for helping the change along.

“Physicians don’t need a business education to practice medicine” continues to have a permanent stranglehold on physicians and medical school students today. I was finally recognized as a member of that same tribe in the 1980s when I lost my private medical practice for what I guessed were financial reasons.

What the myth statement left out, however, was the fact that practicing without a business education leaves all physicians fighting the “professional poverty” line for the rest of their careers. Does it come as a surprise that the attrition of hundreds, if not thousands, of physicians continues to rise exponentially?

Thousands of other physicians have been sucked into the professional poverty zone because we were either so distracted by over-serving our medical patients or we believed we were arrogant enough to overcome anything. Every one of us has had an experience when not enough income has led to many consequences in our medical practice and personal lives that lead to burnout, or worse.

The one factor that bothered me the most about losing my practice was the personal conviction that I had done nothing wrong. I was absolutely sure about that at the time. I was totally business-ignorant at the time and never realized it.

I would spend hours trying to figure out what I had been doing wrong. That persistent belief continued to harass me until I invested over 20 years of research after my retirement in 1999 on what might have caused the loss of my practice.

After that loss, I was severely depressed, had no money, and no income, was divorced, and had peer associates who were glad I was leaving the area. I was then employed at a hospital in Michigan.

Again, I had to tolerate the multiple guardrails hospital administrators demanded concerning how to practice medicine and deal with other staff members—the same pressure I tolerated at an HMO job earlier in my career. (“No, you are not allowed to do any infertility treatments on our patients.”) I quit.

The breakthrough for me

About 98 percent of physicians without effective business tools to use find themselves today unable to reach their maximum income potential. All your earlier expectations that your practice was supposed to provide you and didn’t must be adjusted downward.

Many physicians continually pretend to others that they have a fantastic medical practice business while their income leveled off in mid-career—unable to know what the cure might be or how to fix the issue. Yep, work harder and see more patients. But how do you get a good burst of new patients and one that persists?

So, what happens to those medical doctors? What surprises me is that instead of obtaining a business education, the major factor that enables physicians to bypass or survive losing their practice, they are being overwhelmed by medical articles advising physicians to get outside jobs/income to bolster their practice income that is insufficient to continue practicing.

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Instead of spending the time and money to find outside jobs while practicing or trying to invest in real estate when you have no stored income bundle—it would be far better to obtain business knowledge.

Physicians with a business education never have this problem because they can recognize the signals indicating problems coming. And they are aware of what needs to be done to reverse the process and eliminate the problem (business tools).

This risk probably should be included in your prenuptial agreement if you don’t have the academic kind of business management and marketing methods on hand or in the brain.

Why do physicians force themselves to tolerate such an important income problem that endangers their careers?

Physicians have no backup financial and business knowledge to fall back on when such things as the COVID-19 pandemic, hospitals closing, wartime, inflation, fired from their medical jobs, happen, and they are forced to tolerate all the consequences resulting from professional poverty level of incomes.

What about the business education imperatives you were never told about

Why don’t physicians jump on the business education train? Most likely the cost of that education in the past has been limited to college or university courses, costing $40,000 to $60,000 for an on-campus two-year MBA. The only medical school that adds an MBA to the medical education curriculum that I know of is the Kevorkian School of Medicine in Las Vegas, NV.

The problem with the MBA is that it is too superficial to be of much value to physicians, as my interviews with medical students who have followed my approach to business education in mind.

My mission since I lost my private medical practice has been to do all I can to either force all medical schools to provide a business education to all medical students (an impossible mission) or do all I can at my age to prevent the increasing attrition of our physicians, that no one, including physicians, seems not to care about no matter where it leads to.

This refusal of medical schools to provide business education has resulted in the slow death of private medical practice. It’s the one remaining barrier that continues to prevent our government from total control not only of health care but also of the medical education system itself: socialized medicine.

When you are appointed to the medical school they have decided, directed you to practice in some area of the country you hate, force you into a specialty you hate, dictate to you their way of practicing medicine (making income for the government), eliminate your control of your medical career destiny, and expect that you will remain in practice for all those years, is insanity.

Curtis G. Graham is a physician.

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The medical profession’s silent struggle: Business knowledge matters
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