14 Mar The Misconception of Physician Wealth and Wellness
Physicians make a lot of money, or it is perceived they do. In fact, the reality is very different. In relation to the number of schooling years after college, an average of 12 years, the remuneration is consistent with but not above other post graduate education professions. Over 75% of Canadian physicians are on a fee-for-service remuneration payment plan. Therefore, one needs to understand that physicians pay all of their expenses from this income, including: office rent, office expenses, secretaries salary and benefits, obligatory association and college memberships, professional insurance, continuing education, meetings and conferences, etc. Suddenly the pie gets smaller.
I do believe that physician’s wealth is a misconception associated with a big dollar sign that is skewing the equation. I would associate physician wealth with physician wellness. Making money is not the most important aspect of the medical profession, and in fact should not be a priority. Physicians are healers, caring for ill people and by our oath, we are to create no harm and make ill patients feel better. It is the single reason why we are physicians: caring for patients, challenged by medical novelties, advancing the medical science and promoting health.
It brings me to the Royal College of Canada CAN Meds Physician Competency Framework. There are 7 roles integral to being a physician, with the role of medical expert at the center. One of the roles is leadership. The key competencies are: to contribute to the improvement of healthcare delivery, to use health care resources responsibly and effectively, to demonstrate leadership, to manage practice and career planning, health care finances and human resources. Specifically, competencies refer to managing time, budgeting and structuring an office, implementing processes for personal practice improvement and integrating one’s practice and personal life. Although the word “wealth” is not used in the key competencies, all of these points do refer to the management of money, be it your office, healthcare resources, hospital administration, or your personal finances.
To me, the CAN Meds Physician Competency Framework is generic in the sense that it is a framework of competencies that a resident in training should learn and that a physician in practice should be able to apply on a daily basis. Unfortunately, I am not sure that the 7 roles are easily teachable. I believe that the contents of each role is excessive, extensive but not all realistic, considering that the medical expert role is taking the most clinical amount of training time and little time is left for the list of competencies in the other roles. I would also suggest that it is a phenomenal job for a program director to be proficient in all competencies and teach all of them to trainees.
Back to wealth and wellness. Who will teach a trainee to set up an office, to plan a budget, to manage an office, to understand the pros and cons of incorporating a private practice, to invest wisely and create a life that is within their financial means and provide for retirement? All of these learnings align with professional and personal responsibility to practice competently. If we fail to recognize that financial resources are a driver of physician’s decisions to continue practicing because they can not see their way to retirement, then we are missing a key influencer of wellness. The ability to manage one’s financial resources directly influences one’s sense of wellness. It is not, and I repeat NOT enriching oneself by making more money. Consider this: one’s wealth is an integrated state of being well and healthy, having the means to to live life fully.