Dr. Leap responds: I can't imagine a better line than “Debt is the new shackle.” Dr. Sims is dead-on. Physicians are held in check by income, by the need for income, and by those who manage and provide income. The irony is that physicians seeing patients actually have to go through someone else to decide how much they “deserve” to get! I once interviewed for a group where no one knew the bonus calculation formula, and no one in authority would talk about it. Fortunately, a kind physician courageously took me aside, and said. “Don't come here!” There are so many good places to work and so many good jobs to have! I have never regretted coming to my little hospital in South Carolina, except in the summer when it's hot as Hades. My job is fantastic, my partners exemplary, and our position in the hospital one of respect. Contrasted with other groups that struggle every day, I feel very blessed.
Sometimes I wonder what I would do if I lost my job here. I think I would go to a small hospital somewhere else, where my skills and training were valued, and where, even though I might make less, I would have more control and a better lifestyle. Emergency physicians not only are married to the idea of large salaries and blinded to problems they should address, but they often are so convinced that a large hospital is the only proper place to practice. I think that's an unfortunate belief that leaves rural areas without the excellent skills we could bring to them.