The Business of Medicine: Old paradigm and new 

I wish I was a young buck looking for my first job. Recently, I received an email promoting a new position:

Hi Dr. …,

Hope this email finds you well! I’m contacting you regarding a Dermatology Opening in [a scenic rural area]  Please see below for details and send CV if interested.

Seeking a BE/BC Dermatologist to join its medical staff.  Join the most trusted hospital in the area due to its highly trained physician staff and its arms-length affiliation with the University of [X] Hospital in {Y]. The community itself is an attractive university town located in the Foothills of the redacted Mountains.

Reasons to Join the Team:
•Improved work-life balance
•Monday-Friday schedule
•Base Salary of $500,000.00
•RVU Productivity Bonus, with no cap on upside earning potential
•$45K Signing Bonus
•Up to 15K in relocation
•23K per year loan repayment
•Malpractice insurance
•403(b) and 457(b) retirement plans


Clearly things have changed since I left residency for my first job almost 40 years ago. This offering is worth $583,000 per annum to a freshly minted dermatologist There’s a new paradigm of practice, one in which self-interest and salary concerns rule.

Osler wrote: “More than any other, the practitioner of Medicine may illustrate the second great lesson, that we are here not to get all we can out of life for ourselves, but to try to make the lives of others happier. The practice of medicine is an art, not a trade: a calling not a business; a calling in which your heart will be exercised equally with your head. Often the best part of your work will have nothing to do with powders or potions, but with the exercise of an influence of the strong upon the weak, of the righteous upon the wicked, the wise upon the foolish… Courage and cheerfulness will not only carry you over the rough places of life, but will enable you to bring comfort and help to the weak-hearted, and will console you in the sad hours when, like Uncle Toby, you have ‘to whistle that you may not weep’. 

Clearly, his philosophy is ridiculous and old-fashioned in the second decade of the 21st Century. Perhaps, we should rephrase St. Osler for newly minted practitioners:

More than any other, today’s practitioners may illustrate the great lesson, that we are here to get all we can for ourselves. The practice of medicine is now a trade and a business: no longer an art and a calling; and your heart will be exercised equally with your head for self-interest and the bottom line. These days, the best part of our work will have nothing to do with patients and their families, but with an eagle eye focused on the complexities coding and billing…. 

Or, more succinctly by Brian Maurer LLC:
The business of medicine is an art and a calling in which your entrepreneurial savvy will be exercised equally with a deep-seated lust for wealth acquired at the expense of poor suffering patients…” 

Evidence abounds. In the business section of today’s NY Times a real estate article relates the case of a Beverly Hills plastic surgeon who has just spent $250,000 for a personal gym in his new home.

“With his divorce completed, Vishal Kapoor, a plastic surgeon in Beverly Hills, Calif., bought a 6,500-square-foot house and began outfitting it for his new life as a single man. One thing he wanted was a gym. So he built one and filled it with the latest equipment.

He estimated that the 250-square-foot gym cost about $200,000 and he spent another $60,000 on equipment. “We had the option of putting it in one of the rooms,” Dr. Kapoor said. “But it was dark and there’s no natural light. The way it is now, there’s a lot of natural light. It just makes it nicer.”

The doctor, arm candy, and the Maserati

The doctor, arm candy, and the Maserati



Related Posts Plugin for WordPress, Blogger...

Comments are closed.