In this New York Times article (http://nyti.ms/13n23NR) the writer provides some interesting points about CEO stress vs “learned helplessness” which is characterized by a lack of control over one’s fate. I understand that the lack of control in employment is much different than not being able to find a job or control one’s future which is really what this article is about. I am simply using this article to show how stress is different between business owners (CEO Stress) and employees. Physicians, because of their socioeconomic status, do not fit into the context of this article but I think the stress principle still applies.
“That sense of control tends to decline as one descends the socioeconomic ladder, with potentially grave consequences. Those on the bottom are more than three times as likely to die prematurely as those at the top. They’re also more likely to suffer from depression, heart disease, and diabetes.”
“So the stress that kills, Dr. Marmot and others argue, is characterized by a lack of a sense of control over one’s fate. Psychologists who study animals call one result of this type of strain “learned helplessness.””
This type of stress is most oftentimes experienced by those in the lower income brackets and in traditional employment models. I would like to take the points covered in this article and apply them to current trends in healthcare. I think this same point is one reason why so many physicians are unhappy after moving from being a business owner to an employed physician with a hospital. The lack of control causes a new kind of stress or frustration because the physician is powerless(in most systems) to implement policies or procedures that could remedy his/her frustrations.
This is one of the many reasons why starting a new practice is still something that should be considered by those physicians who prefer to be in control. Many people are okay with being employed but most physicians will find themselves frustrated and dissatisfied with their employment situation. The perception of security derived through employment is also false and very dangerous to someone’s income potential. This perceived security puts people in a box or cocoon where risk is too dangerous and creativity is irrelevant. People who trust employers to provide security oftentimes become complacent and have their ambition enervated by the bureaucracy and layers of decision-making. All employers are not created equal but leaders, in general, have a difficult time not growing discontented by being just another sheep. Nearly all physicians are driven and ambitious individuals who inherently have a difficult time being “happily” employed.
While we recognize that owning your own practice is not all glorious and that it carries with it its own type of stress, we also recognize that it can satiate the soul like nothing else can(except parenting). Building a profitable business provides both professional fulfillment and long term financial security that in most cases cannot be attained through traditional employment models. We hope that this helps someone do some introspection prior to signing a deal with the hospital. If you are tired of running your business, look for alternatives to employment where your autonomy and leadership will not be squelched at every turn.
The goal of quality and cost-effective medicine will be lost if we lose the private practice.
There is no security except what you create for yourself.
Author: Andrew Eriksen