New physicians and pro baseball players have more in common than you might think. The similarities begin at an early age, when promising youngsters begin to express their talents (be it academics or athletics). They grow up with lofty expectations—their performances scrutinized at every step. And when it comes to managing their careers, both “docs” and “jocks” commit the same four professional errors. Error #1: Banking too much on a big future payout. Delayed gratification has become an unwelcome staple of baseball and medical careers. For those who aren’t baseball aficionados, here’s an oversimplified timeline for a major league career. You’ll be surprised how much it resembles the path of an aspiring physician. If you’re selected by a major league team out of high school or college, you’ll spend at least a year or two toiling in the minors. Like a medical or surgical intern, you’ll work long days and sleep in uncomfortable beds most nights—all for what amounts to minimum wage on an hourly basis. Once you’re called up to the majors, your performance expectations increase dramatically though your salary will remain artificially low. Like a resident, you’ll dedicate this time to improving your skills: mental focus, physical stamina and hand-eye coordination. In baseball, you do so with the expectation that, in six years, you’ll become eligible for free agency, at which point you’ll sell your services to the highest bidder—a sweet payoff for all those years of hard work and sacrifice. At least, that’s how it used to be. As Spring Training 2019 gets underway, at least 100 free agents—talented professionals who have “paid their dues”—will be without a signed contract or a team to play for. Similar economic woes are becoming all-too routine in American medicine. Whereas the end of one’s residency or fellowship once marked the start of financial freedom, medical school graduates now carry an average debt of nearly $200,000. Although very few physicians go into medicine just for the money, this generation of doctors face a very different set of financial challenges. To avoid spending a decade buried beneath a mound of debt, live frugally your first couple of years after training. Instead of thinking of this as a time to spend, pay off your credit cards and unload your debts as quickly as possible. Do that, and by the third year, your lifestyle and bank account will improve dramatically. Error #2: Mistaking promises for written agreements. Back in the 1960s, pro baseball players formed a union, hoping for fairer negotiations with the league’s rich and powerful owners. And though the game’s economics have become more player-friendly in recent years, it’s clear the owners still maintain the upper hand. For many years now, owners have all but promised its players a huge free-agency reward in exchange for six years of hard work and dedication (at the “the league minimum” salary). Now that those promises aren’t materializing, some players and their agents have accused the owners of collusion—forming a tacit agreement to keep base salaries low and contract lengths short. Many outside of the MLBPA see it differently. Experts say it’s simply cheaper and smarter for clubs to sign talented young players at lower base salaries than to pay older free agents three or four times more. They question why the players didn’t see this coming when they ratified the last agreement. In medicine, some new physicians are sliding head-first into similar risks. As they join a physician practice or medical group, they agree to a livable (but relatively low) salary, based on promises made by senior physicians that (in a year or two) they’ll be earning three times as much. This implicit agreement requires that successful associates refer new patients with reliable insurance coverage. And while this happens more often than not, there’s only one way to ensure it happens: Get the details in writing. Senior partners, hoping to recruit top talent, may offer eye-catching projections with the best of intentions, but they can’t guarantee the future. If, for example, large businesses unite to drive down medical costs or Congress implements Medicare for all, physician payments could be slashed across the board. When it comes to promises, there’s no harm in being optimistic about great opportunities so long as you’re wary of implicit guarantees. If you want to stake your future on someone else’s word, get it included in your contract or written agreement. Error #3: Taking your eye off of the ball. During a baseball game, an “error” is committed when a fielder misplays the ball and lets a runner advance. This usually happens because the fielder looks up to see where the runner is, rather than fielding the ball. Baseball players are committing similar errors off the field. Those 100 unsigned free agents got ahead of themselves, assuming they’d be offered lucrative, long-term deals like future Hall of Famers Manny Machado and Bryce Harper. Instead, most will be fortunate to sign a one- or two-year offer at a fraction of what they imagined. Some will end up with no offer at all. I see many residents and newly trained doctors making the same mental error of getting ahead of themselves in their careers. For example, given my background as CEO, medical students and new physicians often ask what they should do to become a future healthcare leader. Many are contemplating whether to put their medical practice on hold to pursue an MBA. My advice is simple. No matter your long-term aspirations, spend the first five years of your career becoming a great clinician. Just like in baseball, a doctor’s value is based on skill, performance and great teamwork. Machado and Harper will be set for the rest of their lives because of what they proved on the field. Remember, if colleagues don’t respect your medical, surgical or diagnostic skills, they’ll never trust your judgement or ability as a leader. Error #4: Naming a price and assuming someone will pay it. Even baseball’s most talented players are settling for less money and shorter lengths of contract than they might have projected. That’s the new reality of baseball. It’s not that owners don’t appreciate great talent. There are simply limits to what people, even billionaire owners, will pay. In healthcare, primary care doctors deserve to be paid more. In fact, based on their proven ability to prolong life expectancy, they deserve to be paid much more. However, insurance companies set the terms. And, so far, they aren’t budging. As healthcare policy shifts to pay-for-value, we may see even today’s highly paid specialists (surgeons and medical interventionalists) earning less in the future. In medicine, there’s no guarantee that what worked in the past will work in the future. For example, consider the practice of doctors forming single-specialty groups (signing up all local physicians in that clinical discipline) to provide radiology or emergency services to hospitals. Having cornered the market, they were confident they could charge whatever they wanted. That too is changing. In many locations, both hospitals and healthcare systems have replaced doctors overnight, bringing in an entirely new group of emergency physicians or outsourcing X-ray services by switching from in-person to telemedicine. The lesson is straightforward: Great medical care increases your value and should provide you with fair compensation in return. Don’t get greedy or arrogant. Demanding that people continue to pay yesterday’s inflated prices—or assuming you’re too valuable to be replaced—is like taking too big of a lead at first base. It’s too big a gamble and not worth the risk. Prepare. Then, enjoy the season. During spring training, baseball players practice and prepare and for the upcoming season. Then they focus on the joy of the game. Physicians should do the same before starting their careers. Getting your finances in order, doing your homework and honing your clinical skills are simple steps that can help you avoid these four common career mistakes. And once you’ve finished your prep work, you can enjoy the fruits of your labor: helping patients, working with supportive colleagues and earning fair compensation. The economics of baseball and medicine are growing increasingly problematic. But they’re both great and gratifying professions. Be wary when it comes to business of medicine, but don’t let your caution erode the fulfillment you’ll derive from helping and healing people in need. Source
