Save Yourselves and Prosper

When our colleagues want to criticize our approach to medicine in the wild, wild west, they call us "cowboys". So be it. And guess what? You too can take to the road with your skills and wits only and be paid what you are worth. You can be kinda like this guy above... instead of a gun you will carry a telephone. The telephone will be a deadly weapon against your consultants. You can not, however, use it to beat your waste-of-time-and-money patients (or you will be arrested).

And there's another funny thing... Our colleagues, especially on the surgical side, can not do this. They are tied to their hospitals, they can't operate, at least to do the big cases, without hospital privileges. I feel bad for them, because this can be held over their heads. Same with folks establishing a practice in a town associated with a hospital, or folks working solely in a hospital.

Locums companies are now offering me almost twice what I make working for my group to travel, be put up in a nice hotel, and cover the uncovered military ER in Bumfoodle USA, or the VA "ER" in East Tiddely-fa. Seems to me that rather than go through a locums company that I can just put send out a few letters, offer my services as a hired gun, and cut out the locums company making $50 an hour off my back. Then again, I am burned out and leaving and wouldn't do it for the money, but YOU guys, especially you medical students and residents, think seriously about this.

You may have to work out in a group for a couple of years, but after that, after you get your sea-legs, why send thousands a dollars a month to your group director(s) or your hospital? Become a traveler, an itinerant doc, a gunslinger. Go stay at the beach on someone else's dime, go to the mountains the same way. Go make twice as much and when you find a crappy hospital walk away and go to the next one. You may just keep your sanity AND be able to retire a lot sooner. Everyone else sees you as a commodity, why not behave accordingly?

Use the logic of the professional athlete, for it is sound. You have an increasingly unique and valuable skill... make your best deal. You only have a few years at it, ten on average (per our own college's statistics), so protect you and yours and get paid yo!