Reaching the cutting edge of medical practice, and losing it


Where I stand today regarding my forty years in clinical medical practice forces me to say things that every physician can personally relate to. After all, we old guys frequently languish in dispensing medical advice to our peers. Most of it comes from the heart.

We all adhere to the presumption that the “best doctors” are derived from an inner desire to help people with health care problems while relying on diligent diagnosis and cutting-edge medical knowledge. CME requirements ensure that we will try to. But even that fiat turns out to be a misconception. Becoming a better physician requires a deeply personal inside-out transition of mental focus for dealing with patients—from their perspective and expectations. It’s one additional necessary conflict for us to adjust to.

A couple of examples I discovered to be valuable in my practice to save time and improve patient compliance were:

1. Handouts about diagnosis, treatment options, use of medications and why they sometimes don’t work, post-op instructions going home, etc. I wrote them myself—not the commercial brochures. Patients wanted to know my thoughts and doing that gave me more credibility and compliance.

I didn’t have to spend lots of time with patients verbally explaining those things—which they would forget by the time they went home. That process considerably reduced phone calls to my office. New patient referrals came in when the patient’s neighbors or family members happened to read my instructions. At that time, no other doctor in town was doing this.

2. Written procedures for my staff to follow whenever another doctor referred me to a patient for a consultation or their transfer of care. In today’s private practice environment, “thank you for the referral” notes and fast communication with the referring doctor create miracles. Do it, or no second referrals for your profit.

These are the small things that superficially make you a better doctor. I am deeply concerned about the factors hindering you from becoming a better doctor. Despite its critical importance to 99% of doctors, no one seems to talk about this issue.

What you are never told that prevents you from becoming a far better medical doctor

I would be very surprised if any physician reading this had ever been told that a good business education was necessary for their ultimate success and income in medical practice. Medical schools carefully avoid the issue. Tradition continues to override the truth. A few medical schools have explored the idea in the last few years. But I predict that such a high-wire action by the medical school education pundits will remain a lap-dog experiment for many years before fruition.

Therefore, more American physicians, medical students, and prospective medical school recruits will increasingly drop out of the health care system.

Because of the financial abuse (no business education is the most critical element required for private medical practice businesses to survive) perpetuated by all medical schools in our nation for the last century, with no efforts to change that dictated mission of keeping most medical doctors completely business ignorant and compromised is suspiciously covert.

Government mandates and fee restrictions that over time continue to be more restrictive financially for physicians in private medical practice to make enough income in their practice businesses to compensate for their professional status and their outstanding skills and medical knowledge that we value for maintaining and constantly upgrading the health care in our nation. Poor incomes lead to inadequate health care and less quality of physicians. You know that, right?

Continued ignorance and forced rejection of medical school education scholars to even talk about or reveal the known and proven value and benefits of business education to all medical students has created a huge gap in medical school education, slowly reducing the quality of medical care nationwide. Additionally, the consequences resulting from poor incomes earned by physicians who don’t know how to earn money in the standard business success way run far deeper, causing more damage to the medical careers and personal lives of all physicians.

If you believe that the premature loss of American physicians for the above reasons is not an urgent problem that requires immediate attention, then you have lost your marbles.

Shall we talk about the many other conflicts all physicians have been forced to tolerate or quit medicine because of?

Resources that are not good enough to meet a physician’s financial and practice needs and expectations

It appears in the medical literature we often read that PhDs, paramedical authors, and non-medical financial advisors, among other non-MD- experts, are incessantly prescribing answers for resolving the crisis in health care and physician care. These authors never seem to substantiate that they are business experts with a business education. Wouldn’t it be a fascinating situation if physicians received their medical practice advice from physicians who are experts in business with a real academic business education (not an MBA)?

The MBA has become the number one medical professional choice for solving the increasing financial conflicts for physicians. Unfortunately, the advice they are being given is contributing to the attrition of physicians. Physicians are now beginning to recognize through those outside business jobs they can earn a lot more income with far less stress than they have been tolerating for decades in private medical practice.

Still, the silence of physicians struggling daily with the consequences of inadequate practice incomes is deafening, even if they already have an MBA. It implies that MBAs are far too superficial for physicians to make significant growth and income in private medical practice.

That issue can be directly confirmed if our medical education scholars and our professional administrators had acquired a superior knowledge level of business education themselves—but don’t have the necessary integrity to approve a curriculum in medical schools for that purpose. Most AAMC members are now too old into tradition and adaptation ever to effect changes that upgrade all physicians’ financial acumen.

In addition to that, all new physicians are ignorant of business education because they have not been taught those tools and how to use them. Yes, the tools that an MBA education skips to a great degree.

Never forget that business education goes far beyond financial knowledge—one has to learn business management to equate it to increased income.

Curtis G. Graham is a physician.






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