My seven-year-old son’s soccer club motto was “Audentes Fortuna Juvat,” which translates as “fortune favors the bold.” Many years later, I discovered that this concisely stated philosophy is adhered to by the Trumbull College at Yale University, several U.S. Navy ships, and the 80th TAC Fighter Squadron, among others. In reflecting on my own path in life, I cannot think of a more fitting model that is likely to ensure one’s long-term success. And, you do not have to suffer from testosterone excess to believe in this approach to success in any of life’s endeavors.
By following this philosophy, I progressed over my lifetime from losing my father at 6 years of age and growing up poor in a single-parent household to escaping the unrelenting grip of poverty through a focus on education, both formal and self-education. I focused on the goal and calculated boldness of action. Despite my humble beginnings, I was able to gain financial independence and retire at 53 by being in control of my own destiny.
After my father’s death, my mother raised my brother and I on a New York City school teacher’s salary. From a young age, I understood that I had primarily myself to rely upon in order to escape the meager existence that I was destined to lead if I were to depend on others. By focusing on education as a portal to a better future, I was able to go to college and medical school. It was I, and not someone else who had to succeed academically and to figure out how to pay for it.
During my anesthesia residency at UCSF, I decided to do a fellowship in pain management — in part due to my academic interests but also because I wanted to be in a specialty where I controlled my own fate. I understood that my ability to control referrals was paramount to my long-term success. I stayed on faculty at UCSF and became the director of the pain service. While I thoroughly enjoyed academic medicine, I felt tremendous economic insecurity due to cuts in compensation as well as the exorbitant cost of living and raising a family in San Francisco. Like many of my colleagues, I could have stayed in my situation and bemoan the adverse financial impact of that decision. My husband and I made a difficult choice to leave San Francisco and California to improve our finances and, subsequently, our quality of life.
When I came to Baton Rouge, I joined an anesthesia group that insisted they wanted a pain management specialist without fully understanding what practicing as one truly entailed. I quickly realized that this was not going to be a fit, and that I had a choice. I could be passive, be unhappy, and stay as an employed physician without much prospect for furthering my career goals. Alternatively, I could take control of my future, make the bold move, and start my own practice. I understood that as long as I was proactive and relied on my sense of self-determination, I was likely to succeed.
I started as a sole provider with a single billing clerk. Over the next several years, as the practice grew, I brought on additional providers and staff. I was undeterred by the ever-changing landscape of medical practice economics and competition from other larger practices, both private and hospital-owned, and managed. I established a reputation and a niche for myself and my practice.
Understanding that I did not fully realize my practice’s potential without branching out to various ancillary services, I approached the large local hospital with a joint venture proposal. They considered me to be too small, insignificant, and perhaps irrelevant, and declined my proposal. Once again, I was in a situation of relying on myself to make the next step. But I felt that as long as I was in control of the situation and was willing to take the risk, the rewards would justify the effort. I was bold but not rash or foolhardy.
Before undertaking the venture to develop a 25,000 square foot building to house my clinic and an ambulatory surgery center (ASC) where I could do procedures and capture the facility fee, I developed a detailed pro forma. I understood that controlling the factors influencing the success of the venture would mitigate most, if not all, of the risks. As I anticipated, the practice continued to grow—ultimately to 11 providers. The ASC, initially launched as a single-specialty facility, expanded to a multi-specialty ASC within a few years. I added horizontally and vertically integrated services with my practice, including imaging, physical therapy, laboratory, weight loss, psychology/counseling, chiropractic care, and an anesthesia company, among others.
Now, perusing social network sites in my free time, I can’t help but notice the overwhelming number of physicians who complain about the practice of medicine. Many are burned out, dissatisfied, complaining about lack of work-life balance, the encroachment of corporate medicine, and looking for gigs and careers outside of medicine to supplement their shrinking income. I can’t help but feel that if only they were strong and bold enough to exert control over their practice and their fate, the level of professional satisfaction would be significantly higher.
I firmly believe that if physicians leveraged themselves and their knowledge of medicine, there would be no need to for them to undertake ventures in the fields that they know little about. The old adage goes like this: Physician, heal thyself. I call on my fellow physicians to heal themselves by dropping the cloak of victimhood and taking charge of their professional and personal destiny. We all spent years in medical school, residency, and for many, fellowship to become experts in our field. Let’s apply that expertise and regain control of the practice of medicine by understanding the business of medicine in order to secure the integrity of medical practice and our financial future. If I could do this, so can everyone else. Audentes Fortuna Juvat.
Sandra R. Weitz is an anesthesiologist.
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