Recognize What Motivates You as a Doctor

Drs. William and CharlesMayo, 2 of the most famousAmerican physicians, hadan interesting relationship with theirmoney. Instead of trusting the bankwith their hard-earned cash, theyturned it over to one oftheir employees. Beforethey would start their day,they would stop by thefront desk, request a withdrawal,and fill up their labcoat pockets with cash.Then they would giveaway the cash to patientsthey saw who seemed inneed. And by the end ofthe workday, their pocketswere usually empty.

Sound a little unbelievable?Actually, it's not sounbelievable if you thinkback to your early days.When you first decided togo to medical school, didyou think about how you'd be handlingmoney in the future? If youwere like me, you were too busytraining and anticipating the dayyou'd treat your first patient to thinkor worry about money. Unfortunately,that's not the case today.Sure, you're just as busy with life'sday-to-day activities and still lookforward to treating your patients, butmoney's now a concern.

Physicians' income growth hasbeen falling behind the rate of inflationfor the past decade. As a result,many doctors are feeling overworked,underappreciated, underpaid, anddemoralized. I believe that we doctorswill not be able to come to gripswith the current inflation crisis untilwe come to grips with what moneymeans to us and reconnect with whowe were when we decided to enterthe medical profession.

For the skeptics among my readers,I'm not suggesting that we stuffour lab coat pockets with cash andgive away our money to our needierpatients, as the Mayo brothers did.(No doctor can deny that times werecertainly different then, and we havea responsibility to support our familiesand ourselves.) I'm suggestingthat we need to ask and answer somevery important personal questions:

• What is important to you?
• Where does money fit in thelarger scheme of your life?
• Who are you on the inside, andhow does money shape who andwhat you are?
• What truly makes you happy?

FISCAL EXAMINATION

Most of us would agree that ifwe aren't happy in our profession,then being a doctor isn't worth it.There's too much aggravation. Andmost of us would agree that wedon't define ourselves byhow much money wemake. If that's the case,why do we get so worriedabout how much we earn?Let's examine some of thepossible reasons why wefeel pressure to maintain ahigh-income status.

We need to beable to pay forcertain comforts.It's true that weneed a well-built house, asolid, reliable car, andgood, durable clothes. Wedon't have time to do ourown home repairs, shopfor bargains, and waitaround at the car repair shop. Weneed enough money so that we don'thave to spend our time worryingabout such things.

This is true, but only to a degree.After a certain point, extra moneyand possessions can actually distractus from what we love, which istaking care of patients. The extramoney, instead of making us happy,can actually make us unhappy,because it takes us away from ourpatients, whose care is what reallymakes us happy in life.

We need to give our familiesa comfortable life.Again, it's true that we havecertain responsibilities when itcomes to our families. However, Iwould hope that your spouse marriedyou for love and not for yourhigh-income potential.

Bottom line:

Most spouses probably wouldagree that a high income can nevercompensate for a lack of quality familytime. They may understand thatthey are "number 2" behind patientcare in your life, but they need tounderstand that they are not a distantnumber 2. Giveyour family what they really need,which is probably not money.

We need to make moneybecause we're good doctors.Again, to some extent,this is certainly true. It's "theAmerican way." People expect thatthe best professionals in everycareer get paid well. If they don'tsee you as prosperous, they maythink you're not a good doctor.Theproblem with this argument is thatit lets others decide what is importantto us. We may not agree thatmoney is what defines our worth asphysicians or that money is whatmakes us happy.

We need to be compensatedfor our troubles.Again, it certainly would befair to pay doctors well, and mostpeople, except perhaps insurancecompanies, would probably agreethat we should be paid well for ourintense professional obligations.

In reality, we may never be paidwhat we're actually worth. Andfocusing on this fact will only makeus feel more demoralized than wealready feel. Instead, we shouldfocus on what makes us happy. Andif it isn't money, then what is it? Ifit's doing patient care, then that'swhat we should be focusing on.

We need to have outsideinterests. No matter whatyour profession, there'snothing wrong with participatingin activities that give you a breakfrom work-related stress. But youshould ask yourself, "Am I focusingon this activity because I'mdemoralized and unhappy with myprofession?" If that is the case, youneed to spend some time reevaluatingyour life, and not distractingyourself with entertainment.

We need to make suredoctors get paid well inorder to attract the bestminds. If we don't get paid well,the best and brightest of the nextgeneration will go into other fields,such as investment banking orconsulting. While this may be true,the next generation's best andbrightest need to decide for themselveswhat will make them happy.If only money will do that, thenmedicine may not be the rightcareer decision for them.

APPLES AND ORANGES

Some physicians love havingmoney, love what money can buy,and can't conceive of not beingwell-off. In short, money is veryimportant to them. That's okay;you're not any less of a physician ifthis sums you up. If you've donethe necessary self-introspectionand concluded that this is who andwhat you are, and money makesyou happy, that's fine.

Some physicians aren't as concernedwith money. Instead, theirprimary concern is having whatthey consider the greatest, mostfulfilling job in the world, even if itmeans getting paid less than otherprofessionals. If you've concludedthat this is who and what you areand career satisfaction makes youhappy, that's fine too. You're not sodifferent from the Mayo brothers.Just don't let the insurance companiesand politicians find out.

Louis L. Constan, afamily practice physicianin Saginaw, Mich,is the editor of theSaginaw County MedicalSociety Bulletin andMichigan Family Practice.He welcomes questionsor comments at3350 Shattuck Road,Saginaw, MI 48603;517-792-1895; or louisconstan@hotmail.com.