Reclaiming Our Happiness as Doctors?
In the 1980s air traffic controllers had had enough and they decided that they thought they should strike. They wanted to get their way in negotiations and for many weeks and months they were very vocal about their plans to strike. They were aware it was illegal to strike, and they were aware that the threat was that they would be instantly fired and could never be an air traffic controller again. So they went on strike, and President Reagan, much to his credit, fired them all and banned them for life. It was very difficult to keep the skies running during that time: military and retired and other air traffic controllers were used, but we got through that time. It was decades later that they were finally pardoned. The reason I mention that is because that is also a rule for policemen, firemen, soldiers, and us. We are not allowed to strike, in fact, we are not allowed to unionize.
Not only unionize, if I mention any amount of information about what I charge for any medical procedure to another medical provider then I am guilty of price fixing and collusion. Now all these ridiculous rules come from, one place: it comes from previous generations of physicians acting in bad ways. We are saddled with these fixes to bad behavior in the past and we cannot get away from it.
So I am thinking of a way to get around it.
I have opined on this site that as a country, we value teachers and civil workers far more than we do physicians as we do not have a national retirement system other than Social Security that we can pay into. Only four hours ago I helped move the final files and items out of a dermatology office for a dermatologist who is retiring in his mid-70s for health-related reasons. He will in all likelihood die within six months of retirement. He did not want to work this late into life, he had to. I’m sure there were financial decisions that could’ve been better, but giving us an option to pay into a nationalized retirement system would be very helpful, and giving us an option for a nationalized healthcare insurance would also be extremely important; such as is available to civil servants and teachers – and this insurance would need to be available to our employees as well so we could compete with huge hospital systems and firms that are buying and controlling more and more clinics across our country.
We don’t have these options and as of last counting, there are zero fucks given about this across the world. Nobody cares about doctors until we don’t show up. So: they have made it illegal for us to strike, and essentially impossible for us to quit. So, I think we need to slow down. For the last several years I have been telling my medical students who rotate through my clinic that they should absolutely never do what I did. Starting a practice on your own is not good for the soul. I don’t care what it does to the pocketbook, it is damaging to the psyche to have no one else to back you up and to be unable to take sick days and adequate vacation days and it requires for you to work extraordinarily long hours. You will eventually find that your kids don’t know you and you don’t know yourself.
So, I tell them to get a job where they punch a clock – they punch in and they punch out and at the end of fifty hours a week they are done and if anyone asks them to work one minute past fifty hours they should quit. They will always say that there are more sick people and there are more dying people and you can’t stop, but it turns out we are indeed able to stop. We fought an entire war as a country for the ability for some people to say that they didn’t want to work more than that, or they don’t want to work at that job right now.
My staff in my office has been told in the last four weeks multiple times by patients as I am shrinking my practice down that “he can’t do that!“ Meaning, I cannot slow down or change my practice model because it infringes on their rights to have healthcare with me, and they have a history with me so they have a right to demand that I do not stop taking care of them.
I disagree. I think if every MD and DO in America said we will stop at 50 hours of work we would be appreciated, and it would be unlikely that the justice department would be able to call that a strike since we are still working or a slow down because we are working 50 hours a week.
I think working in the corporate environment would allow most medical physicians to take a sick day here or there which I have not taken since college. I have over the years been sicker than many people I’ve treated, been more depressed than many people I’ve treated, been more suicidal than many people I’ve treated, and this eventually has taught me that my worth is less than everyone else’s: an echoing of an early misguided Christianity I was raised with.
In the past, I had found people to surround me that agreed with my initial premise: that they are more important than me. That needs to stop as well. And it all starts with personal responsibility because the hours I have worked for the last 23 years are no one‘s fault but mine.
We are not, happy people as a whole, we physicians. We need to reclaim that happiness and swagger again to be able to soak again in the honor of being a part of stranger’s life, and helping, and caring – and that only happens when we have more control and a little more care.
What’s the old saying about boats – Your happiest days are the day you buy the boat, and the day you sell the boat.
Your happiest days are the day you got accepted to medical school, and the day you retire from medicine.
I agree but never owned a boat. Knew folks that did and arf’s supposition sounds correct from what I heard from large boat owners I knew. I agree my happiest day in medicine is when I retired at age 64 from F.P./geriatrics. No more call, no more hospital work and no more office work. It was a classic group practice though I understand many F.P.’s just do office work these days. Might be a bit easier on them.
Nobody cares about doctors until we don’t show up.
Physician — One upon whom we set our hopes when ill and our dogs when well.
Ambrose Bierce
There is a physicians union, the UAPD, “Union of American Physicians and Dentists”. UAPD has organized medical groups and hospitals in various parts of the country.
The countries that are supposed to have such heavenly medical systems, UK and Europe for example. Google terms like “physician strike” or “doctor strike” AND the name of the country in question, read about the physician strikes they have in other countries. I can’t imagine what would happen if a UK/Europe-style physician strike happened in the USA.
It’s too late to worry about “the system” or some group movement. It’s never going to happen. Doctors are idiots and most of them are complete masochists. They like being abused just do they can talk about how abused they are. Look out for yourself.
I made a mid career change to leave private practice and work for the Veterans Administration. I had time to be with my wife, and with my son as he grew up, and gave up a 7 day and multiple night surgical life. I became more involved in teaching and policy, and had paid educational time, sick days, and vacation days. The veteran patients are grateful for the care we give them, care they earned by putting their butts on the line for our country, sometimes to their great detriment. The soulless unethical VA leadership was less evil than the insurance companies had been and didn’t stop me from taking good care of patients in exchange for a low wage but good benefits. The VA allowed me to do work I am proud of, being able to have time with and honor my family. I hope you find a better pathway that allows you to better control your life while continuing to enjoy and be proud of practicing good medicine
Well said. Doctors are imperative to us as a society. The public needs to do better.
Physicians walk a long and arduous road in life and I thank you for your candor. What you’ve shared is valuable and sobering. Wish you all of the good things that life has to offer.
This is ridiculous. Physicians have a privileged role and are accordingly compensated. If they can’t get their act together, not sure they should be responsible for someone else’s life.
Thank you for confirming so much of what I have written here over the years. May you enjoy the health care you truly deserve.
I have, an odd, disease. Too many, commas. I generally start blogging on my phone, and Siri adds commas,,, everywhere. My editing skills are inferior. Sorry. I still feel my point is solid.