One of the biggest changes to health care over the last 20 years has been the corporatization of medicine, from small independent physician practices, to large corporations that now run the show. Medicine has gone from good old Dr. Johnson’s office around the corner, to a world of boardrooms, megamergers and takeovers. This has enormous downstream effects — not least to the way physicians practice medicine and their overall level of happiness in their jobs. I am yet to see any evidence that despite what was promised, making medicine corporate has done anything other than drastically increase costs across the board (please feel free to forward me any cost analyses, if I am wrong).
I’m not going to beat around the bush here. From everything I’ve seen, I believe that long-term job satisfaction as an employed physician is almost impossible (congratulations to any doctor who finds it, because it’s very rare). That’s because at a fundamental level — physicians are simply way too smart and independent-minded, and will rebel as soon as they realize that they have become a widget in a larger corporate system that views health care like an assembly line.
I’ve written previously how I believe physicians should be pretty ruthless in developing and promoting their own brand (read this article I wrote on MedPage Today). I would even extend this beyond health care — to any profession. Do your absolute best and be the ultimate professional. Be as indispensable as you can — but don’t be foolishly loyal to any organization. Because the truth is: they will replace you in a second if they ever need to. I relate one story, in particular, that always makes me laugh a little — but illustrates this point perfectly.
There was a large multi-specialty organization that had a strong presence in the geographical area. One of the highly established physicians, hoping to also climb the administrative ladder, did everything possible to schmooze with all the people necessary to do so. It came to be known that he was so proud of where he worked and attached himself so much to the company, that he even named his dog after the name of the organization (I kid you not).
Anyway, fast forward a couple of years as this new health care world progressed, and he had found himself somewhat out of favor. The organization had merged with others and been taken over at least twice, new leadership had come in, and additional layers of bureaucracy were quickly added. Of course, one of the first things they spent a good sum of money on (hundreds of thousands) was — you guessed it — designing a new logo and changing the name of the organization! So this doctor, who was actually a pretty good clinician, had done all of that sadly to no avail. A bit of a sad story, and as you may have expected — he was gone after not too long. As for the dog, I don’t know whether it kept the same name. But all joking aside (and remember, this really happened), it was silly of that physician to do what he did and feel so enamored by where he worked.
Another more recent thing I came across on social media, within just the last several months. I was browsing my feed and saw a picture of a group of doctors boasting about a new logo after a large corporate merger, saying how proud they were, smiling while all pointing at the new expensive logo. Each to their own. I am proud of many things we do in health care, but I personally wouldn’t be seen within 100 feet of a picture like that.
No physician, with the high-level skills that they have and the supply-demand mismatch that currently exists in health care, should ever fall into the trap of being so crazily loyal to their organization. Sure, be proud of the great work you do and the outstanding patient care you deliver, but keep your options open in this turbulent world. It’s all your own brand of excellent care that happens to be within your health care organization. The only people any doctor should ever be loyal to, are their panel of patients, who entrust them with their lives and well-being. Go the extra mile for them any day. If you still need to be convinced, consider the following quote which I loved: “Don’t be foolishly attached to any company you work for. Because no matter who you are, if you died tomorrow, your job will be posted before your obituary.”
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