How to be an Authentic Doctor #1: Don’t Be Employed By A Hospital


It has been 20 years since I graduated from medical school.  I have seen lots of patients over those years.  Let’s say I saw 100 patient visits a week for 50 weeks during that time then I would have had seen 5000 patients a year for 20 years.  That’s roughly 100,000 patients during that time, as an estimate.   That doesn’t count call, weekends, etc.  This is just an an estimate.  I think I am a pretty good doc.  Not the greatest doc, mind you,  but I think I hold my own.  I have also been through my fair share of administrators and hospitals and I think I know their inner workings pretty well.   I have had some great medical partners, staff, patients as well.  Lastly, and mostly importantly, I have been thinking about and writing about the crap that goes on in healthcare for 13 of those 20 years.   For ten years I lampooned it with the Placebo Journal, which was the only print medical journal that made you laugh (on purpose).  For twelve years I have been writing this blog and e-newsletter.  I can’t even stop.  I just tend to obsess about this stuff a lot because it drives me crazy.   So I have decided that I am going to vomit it back up to you….slowly.  I have decided to keep an ongoing list (my goal is 100) on “How to be an Authentic Doctor” here, which I may eventually expand into some type of book for prospective medical students, residents, young docs, etc.  Please add your thoughts in the comments section or email me some other pointers!

Let’s start with number ONE but these are in no specific order:

1. Don’t Be A Hospital Employee

What?  How else will I get a job a job?  That will be discussed at another time but it doesn’t matter.  The fact that saying this sounds like heresy shows how bad things have gotten.  Right now, administrators are reproducing at an unbelievable and alarming rate.  They are like the Tribbles from Star Trek.  They are Administribbles. The present economics cannot sustain them so they must pay doctors less while also making them work harder in order for their species to survive.   In nature, parasites normally don’t kill their host but, you know, sometimes they do.   And administrators are killing us.  Do not be a host for these parasites.

Can you imagine the doctors in the old days, who were our heroes, being employed by their hospitals?  They would turn over in their graves.   “The hospital makes money when patients are there and you’re job is to keep a patient out of the hospital.  Do you not see that as a conflict of interest?”, I would see them asking.   And they would be right.

Here is a running list of other reasons not to be a hospital employee.  There are so many more.  Please add to them in the comment section:

  • Once the honeymoon period is over they don’t want to hear a peep from you again.
  • You are their bitch, plain and simple.  Like in a chess set, you are just a pawn that can be moved around wherever they want, sacrificed at a moment’s notice and easily replaced at any time.
  • Your contract means nothing.  Once they sign you and get you settled in then they will continue to try and cut your salary, incentives, etc.
  • You are as happy in life to the degree of control you have in life.  Hospitals and administrators control you.  Hence, you will not be happy.
  • They lie.  They bullshit.  They hide information.  Their job is to keep you working and producing bills.  Remember, a hospital is just a building with walls.  Without doctors and nurses, no one makes money.  That being said, they will continue to convince you that YOU are nothing without THEM.  And you will be believe them because that is the definition of “learned helplessness”.
  • They do not respect you.  They may do the “Administrator Dance” in front of you but behind closed doors and in meetings they talk about you like you are just a commodity.  And you are because you sold your soul to them.
  • Almost every level of administrator thinks you are a pompous prima donna in need of getting your ears slapped back.  Forget the fact that you gave your life and youth to this career and they have a fresh little hospital administration degree (online?).  So they talk about you with disdain, like you are a pain in the ass.
  • This will never change unless doctors declare their independence again. Once that happens then a funny thing will happen.  These same administrators will kiss your ass because they want your business.  Until then, you are the cause for your own suffering.  And you will suffer.


49390cookie-checkHow to be an Authentic Doctor #1: Don’t Be Employed By A Hospital