Cuts, Despair & Opportunity

Students must understand delayed gratification to succeed in school.

The best students go without food and rest.

They dream of ways to work longer and harder.

Top students use simple math: suffering now equals reward later.

Delayed gratification animates doctors. In some ways, it founds the core of our being.

Delayed gratification presupposes hope of tangible success: meaningful work, autonomy and respect, in a dependable career.

Cuts, Cuts and More Cuts

The early 2000s brought raises for doctors: pay back for a decade of ‘social contract’ cuts through the 1990s. Doctors’ incomes finally caught up with their inflation-adjusted incomes from the ‘90s around 2012.

Politicians called the catch up a gravy train. So they cut fees in:

2012: Cut 5% + Cut 0.5%

2013: Cut 0.5%

2014: Cut 0.5% + Cut 2.65% (applied spring 2015)

2015: Cut 0.5% + Cut 2.65% + Cut 1.3%

2016: Cut 0.5%

More Cuts

On top of these cuts, inflation decreased everyone’s incomes by 1.3% per year. And the cost of medical equipment and office supplies (overhead) grew even faster than inflation.

Cuts, plus increasing overhead, plus general inflation leave the average doctor with almost 1/3 less net income today than in 2012.

Many doctors pay personal taxes (after overhead) on earnings less than $100k. Most people could not survive a 30% cut to their taxable income. They would have to get a second job or sell their home.


Many people can bear frustration longer than expected. But at some point everyone despairs.

Despair becomes a habit.

Habit becomes character.

Character becomes destiny, and destiny blinds us. We lose sight of any reason for hope.

Hope deferred makes the heart sick…

Doctors despair at how government has treated them, and with good reason. But the world is much bigger than government. The world is full of opportunity waiting for doctors to fill.


Every other profession embraces opportunity no matter where it’s found. Doctors often see passing thoughts about work outside clinical care as guilty pleasures, private dreams of a better life.

This is nonsense.

Healthcare could not function without doctors willing to serve in leadership, research or education. Patients need doctors who will help insurance companies and sit as medical advisors to industry.

Healthcare needs doctors to expand their careers beyond clinical care.

Despair cannot exist while expanding your career. Tackling a new job inspires us with the same hope we felt while working to get into medical school.  Doctors can do so much more with their training and experience.

As a doctor, you could sell your services as a consultant, build a new clinic to serve a niche group of patients, get a job with Health Canada, become a medical writer, review IMEs, and so much more.

Patients do not get good care from doctors who feel empty, exhausted and unappreciated.

Patients do not benefit from doctors who feel trapped in their jobs, without hope and without opportunity.

Patients need doctors who are full of passion and energy, who feel whole and strong and inspired. Patients need doctors to do more with their careers, not less.

And even if doctors never go beyond clinical care, they need to know that they have options; they are not trapped.

Doctors understand delayed gratification. We own this. We cannot control government attacks, but we can still control how we spend our time. Do not let government shape your future.

Doctors should explore everything the world has to offer.  As doctors, you need to remember who you are and what got you here. Banish despair and reshape your career in 2017. You will feel better, and your patients will notice.

Photo credit: Glori Gaynor “I Will Survive.” 1978

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6 Replies to “Cuts, Despair & Opportunity”

  1. Thank you Shawn ,
    I am looking forward to the non clinical MD fair .
    I for one will be fighting that despair with all my might .

  2. Sadly all you have said is true, but an added layer of misery is the constant attacks on our privacy and constant threat of CPSO Gestapo action that would never pass muster in the court system. And now Bill 87 to strip us of inalienable rights to the presumption of innocence and due process under the law.

    1. Great comment, Ernest.

      Cuts tell only a tiny part of the assault on doctors by this activist government. I don’t know what personal injury motivated this vendetta…it seems more than just political expediency.

      Thanks again for sharing a comment!

    2. I recently read that Ontario doctors were considering the withdrawal of services. What if all doctors held back CPSO membership fees? Would the government not face a potential staffing crisis if there were no doctors licensed to practice? Alternatively, doctors could opt to withdraw their services from the government by billing patients directly rather than OHIP. Non-clinical careers are an option I suppose, but if medicine is your true calling then don’t give up the fight.

      1. Most docs who pursue non-clinical work continue to keep a hand in clinical care. It makes them better clinicians. Having said that, doctors need to know that there are plenty of opportunities to work outside clinical care, if they want to search for them.

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