Doctors Money and THE Stigma
Six reasons that will hopefully help to reduce the stigma
Money is not a dirty word in any other profession. But why it is so, when it comes to medical profession? It is as if doctors are committing some sin by making money or are not supposed to make more money!
“Doctors make a lot of money” – a commonly heard sentence coming from a variety feelings- envy, curiosity, respect, questioning integrity…a list goes on.
Why is there is a stigma associated with concept of Doctor and Money, which is not there with any other profession?
There are many professions which make a lot of money than doctors, but are not talked about like this. As an example, no one says with so many emotions- ‘Oh, accountants make a lot of money!’ In today‘s times, online gamers are making millions of dollars annually. Have you heard anyone saying about gamers and money they make? Now-a-days, people even don’t say such thing regarding stock brokers, right?
In many professions, making money is regarded as “making a killing’.
Medicine is a profession where making money is by ‘making a living- by helping someone live’.
There are many reasons why doctors make- not more, but similar -money as in many other professions. Let’s look at top seven reasons (in no particular order), which I hope would help to reduce that stigma.
First is foundational finance principle of ‘high risk= high reward’. An old humor (and I don’t intend to demean any profession) sums it up nicely. An engine mechanic once asked a cardiac surgeon, “You and me both repair hearts- I repair heart of a car and you do it for humans. Then why do you get paid more than me?”. The surgeon said’ “Try repairing the engine when it is running”. Jokes apart, the risk that doctors take are highest- being of human life. And that I guess answers it.
Second reason is hard work. Many people work hard- more than 15-17 hours a day, and so do doctors. It’s a simple principle that reward is in direct proportion to the amount of efforts you invest in. The physical hard work by a landscaper or a builder or time invested by a small shop owner also falls under same category. For General Practitioners, seeing patients with a variety of conditions in 12+ hours days and for surgeons standing for 10 to 12 hours while operating on patients, is equal hard work.
“But they get trained for that”, is common query raised.
That brings us to the third reason- time investment. For any other profession or trade, general time investment to acquire skills necessary to practice that profession or trade is 2 to 5 years. For Medicine that time investment is 6 to 10 years. Other professions or trades can start earning when at approximately 22 years of age. Doctors, even considering they get a smooth career progression, earliest they can start earning is at age of 28 years.
Fourth is economic principle of demand and supply. There is no supply limit on other professions regarding how many professionals or tradesmen (and women) can pursue and practice that profession or trade. As an example, as many people can become accountant, consultant or builder. On the other hand the supply of medical specialties is controlled for various reasons- to ensure quality, to control over servicing- I don’t know all reasons. It is most regulated profession for right reasons and that adds to scarcity. Its Economics 101 that- scarcity increases value / price.
The fifth reason is business savvy. Medicine ‘as business’ comes with similar set of challenges as with other businesses. Knowing this, many doctors who make good money up-skill themselves in finance and other business disciplines. They learn how to manage their money as well as how to manage those who manage their money. They understand key drivers of professional success and focus on reducing clinical risks as well as non-clinical risks.
Sixth and this is most important of all in my opinion- is integrity. Many doctors who are so called successful and rich have highest integrity to their profession. They value patient care over anything else, giving best outcomes for the patient and the doctor. They often say, “I don’t work for money”. They keep doing what they are doing well- delivering exceptional care. The word spreads around, and they become successful, which is manifested in outward riches as well as inner satisfaction for everyone.
I hope we are on the same page by now. I am talking here about a majority of doctors. As with any profession, there would be some exceptions who do wrong things (and I am vehemently against such practices) , but they don’t go long way- same as other professions.
But, every coin has two sides.
Those who earn more, also tend or need to spend more- sometimes willingly and sometimes unwillingly. Some might say, ‘it’s a nice problem to have’, but not so. On an average doctors are charged twice more for any service as compared to other professions- whether it’s fixing a tap or giving financial advice. Its just the nature of industry.
More is about peer pressure acting from all sides. Doctors have to showcase (for lack of better word) that they are doing well. On one hand they have to do that to match with their peers or to enjoy fruits of their success. On the other hand, they have to maintain expectation of their patients that – ‘they know their stuff, are reasonably busy and successful’. Doctors today have to validate such expectations with outside expression of success. What would be the impression of a doctor who has nice modern surgery, dresses nicely, drives a good car as opposed by someone with run down practice premises, wears sandals and drives a basic car? As a patient, which one you would like to be treated by (when you can not know more about them unless you actually see them)?
Irrespective of all perceived rosy picture, doctors undergo lot of stress due to variety of reasons- burnout, responsibility of patient care (which only they have to carry and no one else can relate to or share it), personal circumstances, workplace pressures, business stress, to name a few. Some are leaving profession while some took the extreme approach. After some tragic suicides, mental health of doctors is finally getting its well deserved attention.
Now is it going to be more about Doctors- money and mental health?
Will that reduce or add to stigma?