I really love blogging. As WCI grows into a multi-media business, I spend more and more of my time working on the business — training staff, building partnerships, dealing with endless emails, promoting the business, creating and implementing new “products”, and troubleshooting problems. It's fun to be an entrepreneur, create jobs, and try to build something bigger than yourself. But sometimes I miss blogging. Just typing some random crap into the internet and wondering if anyone else is going to read it or like it or implement it. So today I just want to sit down and write something. I don't care if you like it. I don't care if you share it with anyone or not. I don't care if it ever monetizes well. I just want to blog about something and see what you think of it.
Money Taboos
There is a taboo in medicine. It is becoming less prominent, but it still exists. You're not supposed to talk about money. Not how much something costs a patient, not how much you get paid, not how you invest, and certainly not about the freedom from medicine that financial independence can bring.
This first shows up as you are applying to medical school. You don't want anyone writing a letter of recommendation or heaven forbid an admissions committee to get even a whiff of an idea that you might actually want to receive a paycheck for practicing medicine at some point down the road. It is reinforced throughout medical school and residency and persists throughout your career in interactions with your peers, your professional colleges, your board certification organization charging you thousands to take an online test, and your hospital.
Meanwhile, the business world and particularly the financial services world views you as a whale, ready to be harpooned. And all these little doctors in their own little silos who “love science and just want to help people” are taken advantage of one by one. It pisses me off.
But you want to know what makes me even madder? When I see doctors “money-shaming” each other. Reinforcing this taboo that you can't talk about or even learn about business or finance because it's “filthy, dirty money” and you're a “bad doctor” to think about it. Let me give you an example.
A cool day climbing at Red Rock near Vegas
PIMD Gets Money-Shamed
Passive Income MD, a relatively new member of the WCI network, wrote a blog post a while back about how he is financially free from medicine. I read the post and thought, “That's great. Now he can practice medicine if and how he likes. He'll be a better doctor and take better care of people. Or, if he wants, he can get out of medicine and do something else that he finds more fulfilling. If he practices less or stops altogether, it allows the services of other doctors to be more in demand, keeping salaries high for everyone. How wonderful!”
Well, his post gets picked up by Doximity and shared. That's wonderful too. I love it when my stuff gets shared with a larger audience, and I'm sure PIMD does too. There really is (almost) no such thing as bad publicity in this business. So I saw it in the email that Doximity sends out every now and then and took a look at some of the comments below his post. Most were very supportive, until I ran into one written by a psychiatrist, published under his real name (which I'll leave out as it really isn't relevant to my point.)
Why did you go into medicine in the first place? It sounds like to get rich. Congratulations. Patients were a lousy revenue stream, too much maintenance. So you are free from an opportunity to do work that actually relieves suffering, and if you are half-as clever financially as you claim to be, you could have made a good living at. You are free from having to do the hard work of medicine. After practicing for 40 years, I still value using my competence to lighten the burden of disease on my fellow human beings, more than the fact I make a good salary doing so. You could have made more money if you had started with an MBA and a Law degree, and skipped the fake wanting to practice medicine. You are free from medicine, from hard work, from dealing with truly heavy responsibilities. Your narcissism is normative in American society. You are free giving, and free to take all you want. Enjoy! You exploited the profession, and now you can live the hedonism that is the core of your value system.
Hey kids! Get off my lawn! Seriously though, other doctors read this comment and say to themselves, “Self, be sure you don't talk about money or financial independence to any of your colleagues because some of them are going to react like this.”
To the psychiatrist's credit, he returned later down in the comments section and left a bit of an apology and a more nuanced, less inflammatory explanation of his views on the subject.
Stop Money-Shaming!
I call this sort of thing “Money-Shaming,” and I want you to quit doing it. Some of us are more altruistic than others. That's always been the case. And there is someone more altruistic than you are. You're a family doc working for $180K? Great. There's a classmate down the road who is a pediatrician making $150K. And one who went into the military and worked for $120K while being deployed all over the world taking care of those defending your freedom. And someone else who works 3 days a week in the homeless clinic for a pittance. And someone who spends their vacation time in Colombia drilling wells for mountainous villages.
But the truth of the matter is that VERY FEW of us are willing to practice medicine for free. Especially on a full-time basis. In fact, it turns out that MOST of us wouldn't be practicing as much as we do now if it wasn't for the money. I have surveyed many groups I have talked to. I ask them if they'd report to work tomorrow if I wrote them a check for $10 Million today. They almost all say yes. But when I ask them if they'd be working less in a year (fewer shifts, shorter days, fewer patients per day, less call etc), they almost all raise their hand. My conclusion? Most doctors are working, at least partially, for financial reasons.
Why should that be a surprise? And why would it be a bad thing? Adam Smith pointed out centuries ago that, in general, we benefit each other and society as a whole as we pursue our own self-interest. That's capitalism. And it has led to the greatest increase in freedom, wealth, and humanity that this planet has ever seen. Nurses get paid. Teachers get paid. Garbagemen get paid. Judges get paid. Politicians get paid. Uber drivers get paid. That doesn't diminish the value of the work they do. There's a reason it's called “work”–because they have to pay you to do it.
In fact, I would argue that the MOST selfless and altruistic doctors among us are the ones who are financially independent and still practicing because they love it. I would love to shorten the average time period between when a doctor comes out of residency and when she can practice merely because she loves it. But even then, I don't expect her to work for free.
Celebrate the Financial Success of Your Colleagues
So my challenge to you is that rather than money-shaming your colleagues, you celebrate their successes. What a difference between going to FinCon (a conference of financial bloggers where you are invited to give a talk and everyone celebrates your achievement because you doubled your income) and a medical conference (where financial or business topics are generally given short shrift)!
When we start talking about paying off our student loans and our mortgages and avoiding whole life insurance and becoming millionaires and becoming financially independent then we'll all, doctors and patients alike, be better off. If nothing else, at least a lot of salesmen masquerading as financial advisors will be driven out of business.
What do you think? Why do we money-shame each other? Is it jealousy? Is it a desire to preserve the purity of “the greatest profession?” Is it simply doing what others before us have done? Comment below!
But when I ask them if they’d be working less in a year (fewer shifts, shorter days, fewer patients per day, less call etc), they almost all raise their hand.
This is the crux of the matter, for many, and me. Balance. The term “work-life” balance gets written about endlessly and from all angles, but int he end it’s really about that. Most of us want to contribute and work at our jobs, but perhaps not 40-50 hours a week with only 2 days off to enjoy other parts of life. That’s why I went part-time and I’m finding that 20 hours a week at my W2 is a whole world of difference better. And I’m still contributing.
Completely agree. And wrote a post recently that was picked up by doximity talking about this topic shortly after POF got slammed for his business insider “week of spending” piece.
Glad to see some support on my post after the flame throwers came out on his. I’ve found this financial community far more supportive than I’ve ever found medicine to be, honestly.
And, as an academic attending, I try to make money as far from a taboo topic as possible. Otherwise, I am failing to teach my residents about topics that will most certainly impact their contentment, happiness, and ability to practice medicine.
Well said, WCI.
TPP
I didn’t see where POF’s piece was picked up by Doximity, but I guess I’m not surprised.
This was POF’s
https://www.doximity.com/doc_news/v2/entries/13543812
This was mine (written coincidentally)
https://opmed.doximity.com/its-wrong-for-doctors-to-retire-early-3cb4308f6117?gi=4bed7f730871
I don’t see any Doximity comments at the bottom of PoF’s. Am I missing a link there somewhere or are they turned off now?
When I open that link above (POF’s) from my computer there is a comment button on the top left that marks “147 comments.” But if you click on it, it doesn’t bring up the comments.
If you have the app and search for the title of the article, you will be able to see the comments there.
Don’t know why Doximity makes it so hard to share their stuff.
I tell my husband’s MBA students that I hope they make a “sh___ “ load of money like Bill Gates ,
Warren Buffet , and create a philanthropic foundation .
Money can have good power .
The greatest joy is in giving and empowering someone to the economic ladder .
Gates does not have that degree, I think he does not even have one, I checked he dropped out. Buffet does but not an MBA. Great points about what a person with great wealth can and should do. Some of those in the past did some good to offset their aggressiveness. Vanderbilt is a great example.
Not to be that guy, but money shaming those who choose not to give to charity is as bad as money shaming those who make money.
I actually don’t agree that this was money shaming not giving to charity, just a reflection on the power that generating wealth can have very positive impacts on the community.
Why so sensitive?
To celebrate and honor the act of giving does NOT equate to shaming the inverse.
I saw that comment to PIMD on Doximity and it really rubbed me the wrong way, coming from a psychiatrist no less who is supposed to have empathy as part of his professional calling.
I thought that was bad until I saw the vitriol spewed at Physician on FIRE when his article got picked up on Doximity. Even some of my posts on Doximity have hateful comments and it all has to do with attacks on financial independence and money shaming as you put it. The wild part about this is Doximity seems to be the worst with regards to doctors doing this and they do it with their real names published. It’s not like they are anonymous internet trolls. I would think if you have to comment with your real name it would be more sugar coated, but it is not.
When I first published my post, “The Great FIRE Debate (https://xrayvsn.com/2018/06/19/the-great-fire-debate-my-inspiration-for-fire/), some commented that they never came across these arguments against FIRE before (which was money shaming), but lo and behold the negative comments on Doximity for Physician on Fire’s Business Insider article were perfect examples.
I thought that there was a real movement with physicians getting better with finance and supporting each other, but now see that I was severely biased because of the interactions I deal with blogging are the (unfortunately) very small group of physicians who financially get it. There is such a larger % of physicians that do not get it apparently (and Doximity is their vehicle of choice) which shows that no matter how much proliferation physician financial blogs have, there is still much more needed to reach the true masses.
Glad you wrote a personal blog again Jim, it is your style of writing that made WCI what it is and nice to see you go back to your roots. Hopefully more will come down the line.
Well said WCI. The more open docs become about money the less likely they can be cheated by insurance salespeople and hospital administrators. Stop shaming and start learning what others have done to become financially independent.
It’s a mixture of envy & the old school “work till you drop dead” attitude that many older docs have.
If you think he got ripped on Doximity, try cross-posting the story to Sermo. Hoo-boy.
Nice post. Doximity and Sermo are websites that breed some interesting opinions. In my opinion, it tends to bring out the doom and gloom physicians, which I’m not interested in surrounding myself with. I have spent about 5-10 minutes on each and did not return. POF also got flamed on one of these recently by ‘altruistic’ (jealous, self-important) doctors. Each to their own, live the life you want to live.
I definitely see the Doom and Gloom on Sermo, but never really seen a money-shaming vibe there. There’s even a finance subsection of the forums.
Amen!
Money sham aing is unfortunately the norm in America, which is ironic since we’re the richest capitalistic society on the planet. Go in to interview for any job in any sector. You know the #1 rule of what not to do during an interview? Ask anything about the salary associated with the position! Which is nuts. But apparently if you do that, then the organization thinks you’re applying to the job “for the money.” Which is of course true! Why else would we work, when it comes down to it? Putting a roof over your head and having food to eat costs money, and the money has to come from somewhere!
Instead we have to play games and wait for the organization to ask “what are your salary expectations?” And then you’re not supposed to put an exact number in there, for fear that it might be too high and will put you out of contention, or for fear that it might be too low and then you’ve shot yourself in the foot. Instead, you give a range, probably in the $10-$20k range, and try to negotiate that amount up to the right end of the range once the company finally provides an offer with a hard number. The whole game is ridiculous, and one of the reasons people should want FI
Would you rather see the financially secure surgeon who is operating because he or she loves what she does or the surgeon who HAS to do as many procedures as possible to cover his or her nut?
I teach my students that it is their responsibility as a physician to stabilize their financial life as a service for their patients.
We are very lucky as physicians to be in a profession where financial security is a real possibility with some self-discipline. We can then take that financial security and provide a great service using our talent to help people.
I like that very much. Thanks.
Amen.
This is a little oversimplified. A surgeon who operates on someone (when it’s not indicated) for money has a lot more wrong with them than not being financially independent.
I only operate on the appropriate indications, not because I am financially independent (I’m not, but I’m only 35), but because it’s the right thing to do.
As a fellow surgeon, we know there are absolute and relative indications. It is not always clear cut when surgery is indicated. When you are not FI, you are more likely to be doing surgeries that are less than indicated because you don’t get paid for non operative management. This has nothing to do with surgical skill.
I agree that there is a continuum of indications for surgery.
Otherwise, I completely disagree. Knowing when to operate and when not to is the most important surgical skill to have.
I’m not FI, but I am not more likely to do a surgery that is only relatively indicated than someone who is FI. In conditions that are not absolutely indicated for surgery, you have a risk/benefit discussion and the patient chooses.
Again, a surgeon who is more likely to operate because they “need” the money has a lot more issues than money.
There’s a lot to it, including how the surgeon is paid. For instance, some surgeons don’t make any more money if they operate versus if they don’t. No conflict of interest there (actually maybe a disincentive to operate because it’s more work and brings on more malpractice risk.) But to pretend we don’t respond to incentives is probably a little naive. Surgeons are people too. You will have to constantly be on your guard to mitigate this conflict of interest that likely operates at least at a subconscious level.
Two patterns of emotions driving reactions:
1) Greed- many examples in many professions have real concrete examples of abuse. Doctors performing unnecessary procedures, prescriptions and unethical practices. Lawyers, accountants, financial advisors, mechanics, bankers and every walk of life have their bad elements.
2) Work ethic- the incredible contribution a physician can make is basically the cream of the crop not only in intellectually but the discipline and time devoted to developing and the finess needed is extremely rare. Not only “do no harm “, but mending those with injury or illness is the core of a physician.
1) Greed-clearly no one is taking the approach of pumping up the volume. Personal financial discipline is the only actions implied.
2) Work Ethic – virtually everyone plans on using their skills, but in a different way than the traditional practice. Most seem to actually be open changing their minds in the future. Financial independence doesn’t require traditional practice for a specified number of years nor the setting. If not controlling ones paycheck, the why have a view on someone’s work?
Couldn’t agree more with TPP and Xrayvsn about the personal finance blogospheres and those that interact with it being the most inviting and encouraging corner of the internet. It’s great.
We are all conditioned from the very first to think of medicine as a profession you go into for just and moral reasons and so talking about money must be off limits. What kind of person who cares about helping people at all cost could possibly consider their paycheck, their own self worth? Where is the sacrifice and dedication! There is a twisted sort of logic here.
I definitely fall into the ‘work less camp’ when we finally find financial independence. Having more of our precious waking hours with family and friends and still being able to find satisfaction and fulfillment from a part time career seems ideal.
FI is the way to go and the only way to get there is to keep learning and talking about money and more importantly, what to do with it!
Yes, yes and yes. No other profession hounds people for wanting to make money. You think lawyers say that those in big law are not true to their profession?
No way. So I don’t know what is wrong with us doctors and refusing to accept that making money and working part.time are good things.
Hey, DDD… you forgot the Oxford comma. That’s what I refuse to accept.
Just kidding. Kinda 🙂
But, seriously.
TPP
Stop it, you two! https://www.youtube.com/watch?v=P_i1xk07o4g
It is interesting that this is even a thing. I think some of this comes from shaming of business in our media. It is common to see in movies or tv shows that businesses are evil or corporate greed is the norm. Too bad that shaming capitalism is a bad thing. It has done more for prosperity than any other system. A book that talks about shaming of capitalism is “Thou Shalt Prosper” by Daniel Lapkin.
Most jobs in medicine are high stress and there is no way we would all do them for 50k a year. I think we should be happy someone dedicated their entire life to 11 plus years of training to do what they do. We should reward hard work and dedication. I know of some of the best doctors I know and am so thankful they decided to go into medicine. They have taught me so much.
One doctor that trained me stated, be focused on medicine and the money will come. You never have to focus on the money. It has been great advice.
I would be a better doctor being financially independent. I wouldn’t worry about when I get paid. I wouldn’t worry about getting a raise or chasing a higher salary. I would just focus on my job, being a great doctor. I can’t think of any way to be a better doctor than to be financially independent.
Thanks again WCI, this is a great post.
Interesting. Never really thought about it but I do see a lot of “business-shaming.” Hit on that in this post:
https://www.whitecoatinvestor.com/in-praise-of-business/
I’m not sure the “focus on medicine and the money will come” advice is quite accurate. You’ve got to spend at least a little time on the business and of course your personal finances.
The holier-than-thou attitudes of some of those docs on Doximity is really off-putting and sad, frankly. How about this one from that same article from PIMD:
“Congratulations, your a realtor and a sleezy marketer. Caring for the sick shouldn’t be your hobby but your passion. Enjoy your vacations.”
Nothing but anger, contempt, transference, and a touch of bad grammar. I liked PIMD’s take when I took similar heat on Doximity recently (https://www.doximity.com/newsfeed/66015766). Dr. Kim said he feels bad for these people. “Hard to live a fulfilled happy life when you need to tear others down to feel more significant.” So true.
I’m a live-and-let-live kind of guy. We all make different choices for different reasons. There’s no need for this incivility and shaming.
Cheers!
-PoF
Those sites tend to be a cesspool of the angriest, meanest and loudest doctors, many of which seem to hide their anger/burnout by stating how caring they are for their patients. I imagine they are the ones throwing surgical instruments in the OR and stomping their feet all over the hospital. Unfortunately, we all know some of those unhappy physicians in real life. Much like how the WCI forum tends to breed decent people, those others breed something much different.
That’s a very nice compliment for the forum members.
Great post. I hope that every doctor continues to work as long as they can no matter their wealth. I hope that because we don’t have enough good doctors and we have a lot of unhealthy people. That said what you think and enjoy when you are 25 might change a lot when you are 50. We celebrate when older workers find a second or third job that better meets their current needs so doctors should be no different. This blog provides a lot of value for those that read it, I recommend it not only to high income folks, but almost everyone who wants financial security. We also need to remember that we don’t control who sees and reacts to our comments.
Thanks for this post, WCI. This money-shaming really harms us as a profession. Denial of the reality of our financial needs/wants and the impacts of that is like neglecting the fact that a body needs food. Some people even like eating for more than basic nutrition. We are much healthier if we simply acknowledge it and eat well.
It has been an interesting dynamic the past few years in Canada. Our governments and media have been pretty aggressively money-shaming docs to justify target cuts to our fees (we are a public single-payer system) and surgically targeted taxation of our business income. The taboo of money in medicine has made us an easy target. I would imagine that there are similar narratives in the U.S.
On the bright side of that, I think that the external hostility has galvanized more docs to stick together and actually talk about money rather than contribute further to the money shaming. I am fortunate to be part of a very financially successful practice. We have used that financial success to not only better our personal lives and work environment, but also to propel our academic and clinical missions to a higher level than most. Ten years ago, I heard a lot of “you folks make a lot of money, must be nice” in a derogatory fashion from colleagues. Now, I get more of “You have created a strong financially sound department – how did you do it?”
I think that there is hope, but it requires voices like yours and others speaking out. Thanks for that.
-LD
Interesting topic. I have found myself considering whether there should be a difference in compensation between doctors and myself, an international tax attorney (now retired). Do the principles of capitalism apply equally to both, or is there something different about doctors? In that regard, Loonie Doctor’s post speaks volumes. Excellent post LD.
“Would you rather see the financially secure surgeon who is operating because he or she loves what she does or the surgeon who HAS to do as many procedures as possible to cover his or her nut?”
Isn’t this comment, from above, also slightly money shaming. The unsaid assumption is that a FI surgeon who LIKES to operate is technically better than a surgeon who HAS to operate.
As I am sure we all know, physicians abilities are quite diverse, with no 100% correlation with how much money they charge/have, what their motivations they have, etc. One could argue that a busy full time surgeon, doing many cases (for money) may have better outcomes than a partime MD doing many fewer.
You raise a good point.
No reason to think that the financially secure doc is working part time, however. Maybe he or she wants to work crazy hours for fun. Who knows? It’s easier to do that then HAVE to work crazy hours.
Simplify your life and more options open up.
Yes, I agree that someone operating more may be better. Of course, the financially secure doc doing less likely has more total experience than the younger doc who still has to work, so maybe that offsets it.
Doximity, Medscape, etc,…..skip the crap and stick to WCI and the Like and you life will be more fulfilling.
I recently read books by Brad Klontz, a psychologists who writes about “money disorders”, and “money scripts”, for people who have counterproductive negative feelings towards money and wealth, for a variety of reasons, often due to messages from their parents, or a form of “sour grapes” when they are unsuccessful. I hadn’t realized that this was a thing, and had never encountered it until reading this post.
The hostile replies to the original post are most likely from doctors who live paycheck to paycheck but justify it by saying that they aren’t in it for the money. These are also the guys with stock brokers who churn their accounts and sell them whole life policies.
Hey Alexxt: I’m a Certified Financial Planner and a big fan of Dr. Klontz and his money scripts theory. I read WCI to get a different perspective on how wealth is viewed from a health care professional’s eyes. It’s great that you bridged this money-shaming discussion with money scripts.
Money scripts come in as many variations as there are individuals alive. Therefore, the people that read this blog are working with their own unique money script. Dr. Klontz also writes about financial neighborhoods, which is most likely where your medical colleagues have developed their money scripts.
The influence of the financial neighborhoods filled with medical professionals must weigh heavily, good or bad.
I, for one, have been enlightened to the stress and pressures of people in the field of medical care. As far as the wealth aspect, I realize that having lots of money can be difficult to manage, so no judgment here.
That sounds like a worthwhile read. I agree we all come “preprogrammed” somewhat. Too cheap, too spendy, too risky taking, too risk averse etc. Most of us will need to overcome something to really be successful.
Ever since your podcast started I now read this with your voice in my head. I can hear the seething tone!
I “seethe” on the podcast?
White coat- I think it would be awesome if you did a breakdown of current salaries and what to expect for fresh out physicians to expect for salaries ranging from internist to specialist? Particularly interested in pediatrics and internal medicine realizing that you focus on specialists.
People on here are newly signed physicians for first time. Feel free to throw out what you are making and we can help each other out.
Thanks!
Probably best to get better quality data such as MGMA data if you actually want to do something with the data.
WCI,
I hope for more of your “old-style” blog posts too. You are able to articulate your ideas well and sharing your thoughts helps the rest of us.
Money is a complex and taboo subject. That is true throughout America still. It is odd given our capitalistic history. It is magnified in academic medicine.
I tell people that if how they think and what they do gets them to where they want to be, then great. No shame, no blame. Everyone is different. However, there are way too many middle-aged doctors who despite six-figure incomes for two decades are not financially free. They feel bitter and trapped. They can barely make ends meet, let alone cut back on work or enjoy their practice. Some of them had wrong ideas about money years ago that are biting them now. Others have gotten ripped off by financial industry “helpers.”
For those folks, we in this community have a lot of work still to do.
Can you point out some “old-style” and some “new-style” posts so I can tell the difference?
I think as more and more physicians become employed by large institutions they’re going to have to have more open discussions about salaries and fair and equitable treatment. The CEO of the hospital system where I work took home $8 million last year and the hospital made a $400 million profit. Yet the doctors’ salaries as a group (in my department) are in the bottom 25th percentile nationally and our workload targets just go up and up as we take over competing hospitals with no change in our salaries.
RadDoc6876,
The fact that the doctors in your department as a group are in the bottom 25th % is the reason, at least in part, the CEO at your hospital took home 8 million. They rewarded your CEO for keeping the salaries at the low end . This probably takes place throughout most if not all healthcare systems(big or small) in this country on daily basis. The question we have to ask is why one person(CEO) is taking in so much money. What value do they add to the healthcare system. I read an article a few weeks ago raising this exact question. The article also mentioned that hospital CEO salaries are growing at an exponential rate while physician salaries are stagnant or only rising at an insignificant rate. The article states that the cost of healthcare CEO salaries has exceeded the cost of physician salaries when looking at the healthcare pie. As you mentioned, they create unattainable goals(wRVU’s) for minimal reward. They are trying and succeeding at downgrading our profession by using the term provider. When I worked for large healthcare systems the managers would refer to me and other physicians as providers and would implicate that I was no different than any other employee in the system. The same goes for the medium sized county hospital I work for now. They turned our profession into a business. The patient is the customer now with most of the power(they call the clinic wanting MRI’s, x-rays, Abx, unnecessary referrals, pain meds, etc) and we are the providers ordering and giving them what they want. That is the model that has been created by the CEO’s. No wonder healthcare is broke. I believe it’s the patient(customer) that wants it this way. Just like any other business, the CEO looks at what the customer wants and gives it to them. The patient is now the most important part of the equation whereas the physician is the least important. If the physician leaves, no problem, just replace them with a PA/NP(less expensive) or call a recruiting firm and choose from a variety of applicants. I wonder if they are working on producing radiology PA’s or NP’s. I guess that day is still to come.
What I’ve noticed in my personal life is that those who money shame you are the ones who wish they could have achieved what you have. I think it’s an indirect way of saying I wish I had what you have. And if I can’t have it, I’m going to shame you for it. It’s really nasty. Hopefully PIMD was able to brush off that comment and not let it trouble him. Being a financial blogger often has to come with a thick skin…
Yes, a thick skin is very helpful on the internet and in life in general for that matter.
In Australia, we have a similar money-shaming culture amongst doctors. Many doctors split their time working as “visiting medical officers” in both public and private hospitals. The financial reward is much greater in the private sector but doctors often continue to work in public hospitals for kudos, academic interest or a sense that they should put back into the public system that trained them. I find that the public hospital always wants me to give more of my time, for less or no money (committees etc) and that we get shamed into it making these commitments often by other doctors. I had a discussion with a public hospital executive yesterday about why our hospital isn’t attracting a certain type of specialist. I told him that, among other things, they needed to propose a more competitive financial offer – he felt that focussing on the financial aspects was a “short-term” approach and quickly moved on the other reasons why we weren’t attracting doctors to the hospital. Money is often the elephant in the room that we doctors are not comfortable talking about and there is nothing “short-term” about the implications of not getting a fair deal..