It’s something we are taught from when we are very young and is a core middle class belief: work hard, get a qualification, and then you’ll be able to find a good employer who will send you a nice pay check every month. On some levels, this seems like an attractive option. Yet on so many others, it falls apart. For physicians in the United States, the concept of “employment” is relatively new, because prior to the corporate takeover of healthcare over the last 20 years, nearly all physicians were self-employed—so essentially working for themselves. I was recently having a discussion with a colleague about physicians breaking away from full-time medicine and working in a more flexible way. As many readers of my blog know, I took the decision after a few years of working as a full-time employee that there was no way I could carry on like that in the current healthcare environment. I took the decision to independently contract with facilities on a regular basis, doing a mix of inpatient and outpatient work—but on my own terms. This allowed me to (i) not burn out, (ii) avoid getting dragged into excessive administration and bureaucracy, and (iii) spread my skills and avoid monotony. Dare I say, earn more and work less too (which any professional, not just a physician, can do—you just have to be savvy).

 

I love clinical medicine, serving my patients, and have no intentions of ever leaving the frontlines. I’ve never been happier and moreover have ample time for other creative non-clinical ventures too. The arguments I’ve heard against working in this way are most often along the lines of: “I need job security”. I hate to break it to anyone, doctor or not, but there is no job security as an employee. You will always be beholden to your employer and the nature of your job could change on a whim. Been loyal and dedicated for 10, 20, 30 years? Well guess what, no matter what your position, your organization would fire you in a second if they ever needed to. It’s a total illusion to think that an employer gives you security. That may be what your corporation wants you to think, to get you hooked on them and completely dependent. Yes, that will suit them well. But think about this: look at any of the top executives. Most of them are on a merry-go-round of promotion after promotion, company after company. That CEO who completely reorganized things, trimmed down departments in the name of “efficiency”, and gave a speech about how proud of the place he or she was—is gone after a few months. Nowhere to be seen. If they get it, so should you.

What you should believe gives you security, however, is this: Your own skills in whatever you do. Keep working on them, be as good as you can possibly be, and make yourself indispensable. An asset to anywhere that hires you. Know that if you ever needed to, you could walk away in a minute and be totally okay. If you are in a market where demand far exceeds supply, you’ll be just fine. And even if you are in a market where demand doesn’t exceed supply, and you’ve made yourself far from average, you’ll be just fine too. That’s where your security lies. Ironically if you have this attitude in your career, your employer will also respect you more too. Healthcare or not, the era of our parents and grandparents joining an organization and staying there throughout their 40-year career, is long gone. Millennials realize it, hop from job to job, frequently freelance, and are on an upward curve always seeking the best possible deal. And that’s how it should be. If you work in healthcare, whether you’re a doctor, nurse, or any other frontline professional, focus relentlessly on your own skills and be secure in the knowledge that they will always be needed.