The unintended effects of physician side hustles

A movement is growing in the underbelly of the internet.

On Facebook, a group called Physician Side Gigs has over 11,000 physician members trading tips and words of encouragement with other doctors looking to supplement their clinical careers via side hustles.  Physician on Fire and the White Coat Investor are encouraging doctors to achieve financial independence in order to relieve ourselves of the daily grind from work and experience freedom.  There are several reasons for doing these side ventures, i.e., creative outlets or creating passive income streams, but the harsh reality is, there is an underlying growing discontent for clinical medicine.

Medicine used to be a calling, a passion, if you will.  Many of us were lured into the field with dreams of helping people and saving lives.  But, if we are living the dream now, why are physicians now seeking work outside of face to face interactions with patients?

Perhaps it is due to the fact that patient-physician interactions are becoming a smaller and smaller portion of our workday.  For every hour of clinical patient interaction, 2 hours of electronic health record-related tasks are generated, thus leaving less time for direct patient care.  Perhaps it’s the daily brawl with insurance companies to get patients the imaging/medication/services they need.  Perhaps it’s the burnout that results from the public’s growing distrust of science and the medical establishment in general, for which we are the first point of contact.

Regardless of the reasons, the ramifications of physicians looking to cut back on clinical medicine are far-reaching and potentially devastating.  There is already a predicted physician shortage of between 40,800 and 104,900 doctors by 2030 according to a 2017 AAMC study.  In primary care specifically, the shortfall will be between 7,300 and 43,100 primary care physicians.  Meanwhile, if my colleagues currently practicing medicine are planning on side hustling in an effort to cut back on clinical medicine OR plan on retiring early by 2030, where does this leave the future of medicine in general?

There has been a lot of focus on how to recruit new physicians to combat this future shortage, but this should serve as a reminder to not forget those of us currently in the trenches.  Dissatisfaction with the current climate in medicine and its subsequent burnout are driving us away from our original intent to help people.  We need to be heard too.

When I first started my journey into medicine, a primary care physician tried to convince me it wasn’t worth it and to pursue something else.  In my millennial idealism, I ignored it and went full core press.  Now looking toward the future generation of physicians, I honestly can’t say I wouldn’t try to convince a potential medical school applicant to pause and at least think about an alternative career.  In addition, the next generation is growing up alongside the anti-vax movement, a rising distrust of science in general and a misguided swell of anger against physicians for increasing healthcare costs.  If they look to currently practicing physicians as mentors, see us take an intentional step back from clinical medicine and see the unfavorable climate, could we really convince them to step up next in line and do what we say, not what we do?  And how do we keep them active in clinical medicine if they do choose to join us?

We need to address the reasons why people are looking to escape from clinical medicine and make real changes to the industry as it stands now.  We need to take back the practice of medicine from the time suck of electronic health records, checkboxes of meaningful use and dictates of insurance companies.  We need to come back to why we embarked on this journey in the first place:  To help and take care of people, face to face.

“Millennial Doctor” is an internal medicine-pediatrics physician who blogs at Reflections of a Millennial Doctor.

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