30 years ago, if one followed the well-followed paradigm of getting into a solid medical school, residency, and fellowship, a practicing physician was almost guaranteed a prosperous economic livelihood. In the meantime, one could start building a family, buy a large house, save for retirement, and finance their kids’ private education. A physician could then use the remainder to afford the luxuries of life. 50-60 years later, one could “retire”.

However, somewhere along the way, all of that changed.

With globalization, the internet, technological disruption, shifting marketplace dynamics, generational differences, managed care, and unsustainable business models, coupled with “black swan” events including 9-11, the 2008 Financial Crisis, and COVID-19, it is rapidly becoming apparent that the concept of “job stability” that was highly touted as a benefit among the medical profession is a myth that no longer exists.

The current model of healthcare in the United States is no longer viable and is unsustainable. It is extremely expensive, with outcomes that do not justify the expense. There is undue influence by pharma, medical device, insurance companies, regulatory entities, Washington D.C., and Wall Street.

In the upcoming decade, there is a predicted physician shortage. To make up for this shortage, medical schools across the country are increasing their enrollments. However, the ACGME is only marginally increasing the number of residency positions each year. As a result of this, there are going to be more and more graduating physicians forced to pursue alternative means of income.

Adding to this dilemma is the fact that hospitals are in dire need of physicians on the front line. As we are witnessing firsthand with COVID-19, a crisis can easily overwhelm the hospitals. In the midst of all of this, hospitals are laying off or furloughing thousands of employees, demanding that staff risk their lives (many of them volunteers), yet failing to provide adequate PPE, and punishing those who speak up against the system. Even worse is that these CEO’s, administrators, and executives are being compensated many times in excess of a million-dollar salary.

Physicians have undergone over a decade of schooling and training, taken on excessive student loan debt, worked backbreaking hours for low pay, risking their lives, paying excessive malpractice premiums, often times getting nothing in return, yet they are expendable by the system, having to answer to bureaucrats, administrators, insurance companies, politicians, and lawyers.

Not only are their incomes tied to a job, boss, corporate, and regulatory entities that do not have their best interests in mind, but their health insurance, retirement, and other benefits are tied to their jobs.

More frequently, these entities are failing physicians. Too many of today’s physicians are living paycheck to paycheck, have little to no savings, and have large liabilities, with families to support.

What if that source of income was eliminated by no fault of their own? – Just look at COVID-19.

We need to shift paradigms and break out of traditional modes of linear thinking that our profession is so accustomed to. Now, more than ever, it’s not just about having a single high-income wage. A physician now must have multiple backup sources of income outside of their traditional clinical work. This will provide insurance against future existential calamities. Contrary to customary belief, the only key to job stability in today’s age is one’s ability to create one’s own “job stability”. Therefore, the importance of a solid financial education in order to achieve financial freedom and independence is now more important than ever for the physician in the COVID-19 era.

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