Professional Blues
Pushing the Boulder
We don’t always make rational decisions in the moment, but over time people tend to be more versus less rational. To this end, the number of physicians retiring early, or leaving the profession for another line of work, hit 11% over the last few years, according to a report the Advisory Board shared over the summer. Amazingly, 46% of those physicians who stayed in the profession changed jobs over the last 2 years. That’s a staggering number and this trend warrants some attention.

The statistics above go well beyond the stress caused by Covid. While Covid was most certainly a big accelerant, these trends have been underway for a decade. If we can identify the problem, we are more likely able to address the problem.

There are at least a few professional pressure points that join Covid at the topic of the list. One is the reimbursement landscape. For years the reimbursement for just about everything has in one direction. Its not unusual for an Orthopedic Surgeon to make less than a few thousand dollars for a complex, time-consuming surgery as one example. As reimbursements have gone down, clinicians have had to work to increase volume and/or reduce costs to adjust.

So where exactly are costs going to get cut with any significant impact? Labor costs have risen, not decreased. The cost of technology, like electronic medical records, has risen, not decreased. Bottom line, you may be able to reduce your supply costs a percentage here and there, but virtually all costs remain fixed or on the rise.

Well how about increasing patient volume? Again, improvements to efficiency are always possible, but they are going to be at the margins versus finding large gaps. Tele-medicine services have added some additional efficiency for many practices and better scheduling and patient follow up tools help reduce no-shows and other areas where productivity can be enhanced. No one is ever against working smarter. But, there are still limits when you are in a profession that essentially trades hours for dollars regardless of whether we call it fee-for-service or value-based. For those of you running your own practice, we highly recommend David Finkel’s book” Grow Your Medical Practice And Get Your Life Back. David is the Founder of consulting firm Maui Mastermind and is authoring an article that will be in a forthcoming issue of MD Next magazine.

Let’s work on the assumption that compensation is going to continue to steadily erode across the board as the industry faces cost pressures. Let’s also assume your practice is continually working on process engineering to be a lean mean care-delivery machine. (For simplicity of the topic, we are not differentiating a great deal between the employed physician and the private practice physician. Certainly there are great differences in the types of work environments and pressures, but the constant is that both are going to be expected to do more and make less over time.) What else is there?

For tens of thousands of clinicians, the answer to this industry malaise is a side-gig. This can include a wide range of things from Industry consulting to startup Advisory work to starting a medi-spa to dabbling in real estate…or all of the above in some cases. Some of these side-gigs are largely pursued to add extra income. Some are more focused on intellectual growth and interest. Still others are designed to accumulate assets so that someday practicing clinical medicine shifts from being a requirement for earning a living to something you do simply because you love doing it. Maybe you reduce your clinical work to 2 days a week and work on your side gigs 2 days a week? How would that change your outlook?

For those that have an interest in the innovation space, the AngelMD Clinical Advisory Board is a great place to start. The time requirements are minimal and completely under your control. You exchange your expertise and a little time for ownership in a startup equity pool. It also gives you a first-hand view of the new startups in the AngelMD network and a chance to line up Advisory Roles if you want to take things a bit further. AngelMD is steadily building out an ecosystem to provide clinicians solid opportunities for career extensions. Between courses on AngelMD Academy teaching you how to serve as a startup Advisor to listings of open gigs on our weekly newsletter, or updates posted on the AngelMD blog, just keep your eyes open for things that strike a chord.
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