Blog | Wednesday, January 3, 2018

How my own negative experience of clinical practice led me to co-found a company

Those of you who regularly read my blog know that a lot of my articles reflect today's frustrations and disappointments with everyday medical practice. There is indeed so much work to do.

I have been a hospital physician for a decade since finishing my residency and have worked in numerous different types of hospitals up and down the East Coast, from large academic medical centers to rural community hospitals. Sadly, I have seen a similar pattern taking place everywhere I've worked, as health care continues its tumultuous journey. Increasing bureaucracy, the decimation of smaller private practice offices in favor of large corporations, top-heavy administrations, and physicians needing to work with suboptimal and clunky electronic medical records.

All of these things have taken their toll across all specialties. Yet I do still remain an optimist, because the drive for positive change will ultimately come from our patients, and the doctor-patient interaction will always remain at the core of good clinical care. I still find medicine an immensely rewarding profession and have no regrets whatsoever choosing this career. Despite all the challenges we face (and truth be told, there is no such thing as a perfect job or ideal world), the positives far outweigh the negatives.

I graduated at a time of great upheaval in U.S. health care. Had I done so a few years earlier, I almost certainly would have gone down the route of trying to start my own practice, when the conditions for doing so were a lot more favorable. But it wasn't to be that way. Due to a combination of regulations and changes in reimbursements, it's now almost impossible for solo or small-group practices to exist.
 As for my clinical work schedule now, after going through many jobs on my travels and suffering some discouragements along with them, I've discovered my way to maintain my passion for medical practice and combine this with a healthy work-life balance. I've found that I am much happier when I can create my own schedule and work in different places—with a combination of part time, per-diem and moonlighting work—as a more independent physician. It's obviously easier to do this in generalist specialties such as mine, but it's actually catching on in lots of sub-specialties as well.

I've written previously about how, on so many levels, physicians are simply way too independent-minded and creative to ever be happy in a long-term employed job in today's medical practice environment, especially if that means working for a large corporation. You can read that article here. There is a yearning among all physicians for more independence and autonomy. Avoiding being a full-time employee for only one organization is a great way to do this.

In other words, physicians become more like an independent contractor. This may seem like a risky thing to do on the surface, but the supply-demand mismatch is heavily on the physician's side. Think about this: there's estimated to be a shortage of almost 100,000 physicians by 2025. That's a staggering number! The job security for most physicians is therefore unparalleled compared to almost any other industry—with a professional skill set that is uniquely portable. As long as you are savvy, thoughtful and flexible about how you work, you can not only gain more freedom, but also keep life more interesting and fun by breaking up the monotony. Other advantages for physicians include:

1. Avoid administrative stresses

Physicians who work like this are typically happier because they avoid a lot of the administrative headaches that go with being a full-time employee. That's not to say that these doctors aren't engaged in the organization or any less competent clinically. They just choose to work in a different way.

2. Job security

There's an argument to be made that it's actually more secure to work like this, because you are not putting all your eggs in one basket and being reliant on only one source of income. Sure, you can have one main clinical base even on a part-time basis, but the other clinical work you do can be spread out among other sites. With the way healthcare is going, who knows what's around the corner or who you will even be working for in a few years? So it's right to extend your wings and expand opportunities.

3. Lifestyle

Importantly, as would be desirable in any line of work, you can earn more while working less. Combined with the ability to create your own schedule, it is an understandably popular way to work. Interestingly, many physicians who do this sometimes end up working more than a full- time employee, and are perfectly okay doing so because it's all on their own terms.

For health care facilities, having moonlighters and per diem physicians on staff helps fill urgent coverage gaps, and also reduces the burden on regular full-time physicians who are increasingly stretched. It's therefore good for the doctor and good for the hospital or clinic to have this option available to them. It's also great for the country to have doctors helping out in communities that have critical healthcare needs.

Not so long ago, I was on-call with a colleague in the emergency room, and we were having a random discussion about our careers and how we structure our clinical work. From that conversation, we decided to do something unique and creative, which combined our passion for clinical medicine and improving patient care, with making working life more enjoyable for physicians. We wanted to do something positive for the system and our fellow colleagues. Lots of discussions and hard work later, the four of us cofounders—myself, Ben, Peter and Allison—had a company up and running that was helping physicians across the country also regain their independence. You can read more about the four of us here (of course, you already know me if you read this blog!). We are two hospital physicians, a private practice cardiologist, and a business-trained human resources professional.

DocsDox is a service that helps doctors work in a more freelance fashion by connecting them with local healthcare facilities in need. And most importantly, we do this minus the expensive middle man agency or 3rd party recruiter. We have unfortunately only ever had negative experiences with locums agencies and physician placement companies, who can be very pushy and unauthentic, as well as costing the health care system an outrageous amount. We were determined to do a better job and allow the two parties to negotiate between themselves with no external interference.

In just the last several months, we've been overwhelmed by the number of physicians we've been able to help and the feedback we've received. DocsDox empowers physicians of all specialties to regain their independence, autonomy and joy of practicing medicine. We look forward to continuing our exciting journey!

Physician registration here.

Suneel Dhand is an internal medicine physician, author and speaker. He is the founder of DocSpeak Communications and co-founder at DocsDox. He blogs at his self-titled site here.