9 to 5: Some docs prefer being employees

Board games like Sorry, Monopoly, and Life were my favorites growing up. I loved Life because the little spinny thing looked like the Wheel of Fortune, the cute little cars that we could eventually load up with a spouse and kids, and the career choices we had.

I never, never, went the non-college route, which was faster. My goal was always to land on “doctor” because it had the highest salary. Mind you, today, every lawyer friend has a better salary than mine. That’s Life– er, real life.

Shouldn’t Life have predicted that doctors would become employees of medical centers?

The Washington Post on June 20 reported on the trend of hospital centers hiring primary care physicians (PCP) because of the current medical climate. Hey, if there is Global Climate Change, why shouldn’t there be profession change as well?

My spouse and I spent a lot of money and heart to create our own private practice in Charlottesville. When we felt pushed out because of Amendment One, aka the Marshall-Newman Amendment, we had three conditions for our relocation: 1) no discrimination against same-sex couples; 2) hospital-based practice; and 3) near the beach. Good things come in threes, and Cape May Court House, New Jersey has all three.

Why a medical center practice? Stability!

Reimbursement keeps going down, and medical costs keep going up. I hear health-care employees complaining about not getting raises to meet the increasing cost of living. PCP are on the other end of the spectrum, with decreasing salaries and increasing hours.

Most people think doctors make too much money, but let’s face it: we need strong salaries to motivate young people with good minds to become doctors. Doctors sacrifice their personal lives for others, face litigation everyday, train at least three years, and go to school for eight hard years while accruing huge debt. So my partner and I weren’t going to go into major debt again to start a new practice.

The Post mentioned that some doctors fear becoming employees because they will have less freedom. I understand that. However, while I gave up certain freedoms (such as being able to have full control of my schedule, to make policy decisions on my own, etc.), I have given up many headaches as well (such as being able to have full control of my schedule, to make policy decisions on my own, etc.)

Yes! Does a doctor ever have full control of his schedule? A sense of responsibility never allowed us to schedule a two-week vacation. Our policies– and, in particular, negotiating salaries and benefits with employees– was a hateful, thankless job. When I started my practice, my first year salary was negative $32,000. Still, my staff asked for a higher Christmas bonus.

Medical centers have more power to negotiate better contracts with insurance companies and with medical vendors. The Post article mentions how expensive electronic medical records are, and for a private doctor, the costs are prohibitive.

Today, I have help to keep up to date with all the latest odd rules, such as Medicare prohibits doctors’ using a stamp for the date. (It has to be handwritten.)

In the ‘90s, many hospital-based practices failed. However, now I hope the system works to allow doctors to take amazing care of patients. We are happy with our current medical center-based practice. I hope to see more cars added to our Game of Life.
Dr. Hook cracks a joke or two, but he's a respected physician with an interesting website, http://drjohnhong.com/ Email him with your questions.