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%
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