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Do You Have a Love Hate Relationship with Medicine?

One of the best parts of starting PPS is the people I meet through it. A few weeks ago I received an email from Dr. Brett Levine. We ended up chatting on Zoom for about an hour later that week. Despite being at different points in our careers, we had a ton in common. One of the main topics we discussed is the love hate relationship that so many doctors have with medicine.

In fact, both of us had experienced this love hate relationship with medicine. My experience with burnout in medicine is well documented here. But at the time of speaking, we were firmly in the “love” end of the spectrum. And we both have a huge passion to trying to spread our message to get more doctors in the love zone.

With this in mind, I asked Brett to share his thoughts, philosophy, and mission regarding this love hate relationship with medicine.

love hate medicine

This is the result which I love and think you will as well.

Do you have a love hate relationship with medicine?

I loved being pre med and working hard to carry a near 4.0 GPA in college. I loved all the organizations I participated in and learned from. And I loved the massive amount of learning in medical school. That is what opened the door for me to interview patients and examine them and eventually help them feel better.  I loved my residency training, getting hands-on time and experience with patients, learning to perform surgery and finally reaching the point of seeing the outcomes of my time, effort, sacrifice and investment.  

For sure, in medical school and residency, it was like a first date. Uncomfortable but exciting, delving into the unknown, always with idealistic hopes of perfection and bliss.  Every step along the way, I experienced new levels of knowledge and skills, meeting new people, mixing chemicals in chemistry and after work, and dissecting bodies… in anatomy lab or the operating room.

But since I completed my training and entered the “real” world, my relationship with medicine has been a rollercoaster.   Some might say it has become bipolar.

Now after four decades, our relationship has evolved.  

We know everything there is to know about each other. We know each other’s schedules, routines, habits, and occasionally discover a surprise.  Over time, our relationship became more stagnant as we grew to want different things.

Medicine is always evolving.  As a young buck, I was attracted to the advances and innovations in medicine that would maintain me on the cutting edge of the health of my patients and keep my days fresh and exciting learning new treatments as I met new patients.

What I love about medicine 

Medicine allows me to meet 20 strangers each day and not sell them anything. I get to take a deep dive into their lives. It’s a vulnerable and honest experience.  I get to share what I know in order to improve their health.

I love operating. When a surgery goes smoothly and as planned, I love being a surgeon and providing a rapid change with immediate gratification for my patient.  Using my hands to fix someone’s child, or someone’s grandmother gives me an unparalleled feeling of purpose and joy. 

I love the security in the fact that there will always be a need for doctors.  (Most doctors, that is, who cannot be replaced by artificial intelligence.)  No matter what technology and corporate America perceive as advancements in efficiency, patients still truly appreciate the relationship between 2 human beings. Touching, talking, trusting, hearing, and sharing a part of your life with another human being is something that will never be replaced.

Patients provide me daily gratitude.  They remind me every day that I don’t know if today will change my life forever.  Because of my patients, I want to enjoy and value every day.  Their challenges and problems show me all I have to be grateful for.  They also teach me how to be a better doctor and a deeper human being.

What do you love about medicine?

It was all that I did not know about medicine which has caused us to need some serious therapy.

After all, this relationship with medicine was a love hate one.

What I hate about medicine

I don’t like not having all the answers for my patients.  It frustrates me beyond belief. But even as a doctor, I don’t have every answer to everything and some patients don’t understand, accept or respect that fact.  In contrast to decades ago, I know I am not God.  I am human.

When I encounter surprises and an operation does not go as planned, it can be extremely stressful to be a surgeon with another person’s life and future in my hands.  Medicine and surgery do not always follow the rules of a textbook.

Interestingly, what has caused the biggest breakup between me and medicine is less my patients

It’s more the institutions that run medicine: our government, insurance companies and hospitals.

Medicine mandates me to be a slave to the hospital and to insurance companies.  A job in medicine can be very controlling and always demands me to be present even when I need more.

I despise the lack of transparency from health insurance companies. What these companies don’t tell you is that every year what they pay physicians is less and less, no matter how high the risk is for the patient or how many hours we work.  The longer the delays of payment from the insurance company, the more money the insurance company makes in a year.  It is a financial disincentive to be efficient or reimburse physicians in a timely manner.

Where I work in a large metropolitan area, the hospitals do not pay me for being on call, for being available 24 hours a day, 7 days a week, one entire week every month of the year.  At the beep of my pager or the ring of my phone, I am expected to answer a phone call, drop everything and see a patient in the emergency room or perform surgery.  They essentially own me and there’s no doctor’s union to fight that ownership. 

I hate the trend in medicine of the corporatization of doctors

Small business owners and private practices used to dominate our healthcare industry but our government’s system of payment has continuously lowered the professional reimbursement to physicians over decades as the cost of running a practice has increased with higher rents, staff salaries, equipment and supplies and now, massive inflation. 

This has forced more and more new physicians who complete training with hundreds of thousands of dollars in student debt to work in health systems and hospitals that receive much higher reimbursement for facility fees.  Sadly, we are seeing more and more private practices across the country closing their doors or becoming engulfed by larger corporate health systems as these entrepreneurial doctors become employees. 

What do you hate about medicine?

The physician personality profile is motivated by growth, achievement and independence. Squeezing that identity of 20 years into a corporate employed position to clock in and out, be told who, what, where and when to work can suffocate the passion and drive out of that beautiful creative spirit and limitless potential.

Break up

As I became older and more successful, the demands and frustrations of medicine grew and grew until it infected every minute of my day and every fiber of my soul. 

My responsibilities and tasks became suffocating and I knew if it continued on the same trajectory, I would not be able to breathe and last another 20 years.  

I realized we were losing the passion that we had for one another years ago.  

I needed a change.

Therapy

Relationships can be messy.  We both needed help.  

I have experienced years of therapy to change.  Not changing my car.  Not my home.   And not my job… But instead, changing myself.  

I can’t help medicine until I save myself.

From my medical mindset of the expert who knows it all and does more of the same, I had the breakthrough that I didn’t know what I didn’t know!  

BOOMM!

I have had so many lessons to learn so I could grow my gratitude and face my fears.  

All those lessons form the foundation of my mindset philosophy BOOMM.  

Concepts I had never known such as leverage, collaboration, velocity, scale, horizontal income, risk mitigation, and so much more.

As I broke out of my medical mindset, I discovered how to live every day fully and also how to appreciate my blessings and opportunities daily.  

Although we’re still together, we both continue to change immensely. 

I am happier which makes me a better doctor.  

And even more importantly, I love my life.

Ok, it’s me again…

Jordan here. I hope you really enjoyed this read as much as I did. I think everything that Brett brings up is so relatable for all doctors. However, while we feel these things, it is often difficult to put it into words. And that is what he is able to do here.

While Brett focuses, and rightfully so, on the mindset portion of the equation, I am a strong proponent of the financial freedom side of the equation.

Here are some other posts focusing on how financial freedom makes us better doctors (and love medicine more):

What do you think? How has your love hate relationship evolved? How can we as doctors get more in the love zone? What role does mindset play? What about finances? Let us know in the comments below!

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    Jordan Frey MD, a plastic surgeon in Buffalo, NY, is one of the fastest-growing physician finance bloggers in the world. See how he went from financially clueless to increasing his net worth by $1M in 1 year and how you can do the same! Feel free to send Jordan a message at [email protected]

    3 thoughts on “Do You Have a Love Hate Relationship with Medicine?”

    1. I have fallen in and out of love with medicine also. In Canada, most of us are still self-employed contractors. So, building a strong financial base has allowed me to shift my practice around several times over my career. It has helped because when an area grows stale or I feel like I am no longer making the impact that I want to, I can shift focus slightly into another area that is begging for attention. Building a strong financial base has enabled me to do that. The broad opportunities that medicine presents makes many “first dates” possible within the same long-term relationship. My biggest fear for the future of doctors here is that we’ll give up that freedom by either taking a predictable pay cheque and handing over the responsibilities of running our businesses to our government (our version of corporatization of medicine) or by not getting our financial houses in order and trapping ourselves.
      -LD

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    2. This resonates so well with me and unfortunately I am pretty sure that almost all the physicians I know feel this way. I think the only solution is for us to try to take some of the control back. It’s not going to be easy. In fact, it will be very hard but ultimately it will be worth it.

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