My very first job after graduating from college was in a staffing agency. A staffing agency acts as the human resources department for its clients (usually local businesses), by matching the right candidate to jobs.
It basically wants to collect information from as many job seekers as possible. It wants a huge database. This way, whenever a job needs to be filled, the client will have a plethora of options to choose from. When the client is satisfied and chooses a candidate to work, the agency then gets paid.
Because the number of people looking for work vastly outnumbers the number of jobs available …
Because the money comes from businesses, and not from people looking for work …
The common person looking for work, John Doe (or Jane Doe), is expendable. They are just another name in the vast database. You can lie to them. You can mislead them. You can make fun of them. You can let them down.
The agency I worked for lost sight of doing good for humanity (or may never have had it in the first place), and wanted to do good for itself instead.
Sadly, the behavior is not unique to the placed I worked at. The toxic culture permeated throughout the whole staffing agency industry. I tried signing up as a candidate in other agencies. And my experiences were similar: wasted days, unnecessary attitude, and lies.
After a few months working, I just had to get out.
(For those who believe in karma … the summer before starting medical school, I went back to visit. Instead of finding my former co-workers, I found an empty office. I later discovered that it folded.)
Why You Get Better Care from Cash Practices
This is a clear example of incentives. Greed and the insensitivity of those who cannot help you don’t just apply to the staffing industry. They are everywhere. If someone is directly benefiting you (i.e. the local businesses to the firm), you’ll treat him with more attention and care. It someone is not directly benefiting you (i.e. the job seeker to the firm), you won’t.
That is why hospitals and doctors are more willing to bend backwards to accommodate insurance companies, rather than accommodating patients. That is why patients get second-rate care … wait 50 minutes to get 5 minutes of face time with the doctor.
Patients who want first-rate care must be the ones who directly pay for the service. That is why you’ll most likely get better care in a cash-only practice. At the very minimum, you’ll get more face time and less wait time.
Many people erroneously assume that only wealthy people can afford to go to a cash-based practice. The original concept (concierge medicine) was geared to the extremely rich. The thinking was … if you paid enough money, you can have your very own doctor. The doctor had only a few patients, so he can see you whenever you wanted — 24/7.
But these days, there are many different models for a cash-based practice. You can visit one for as low as $50 a visit. As insurance premiums increase and benefits decrease, it makes a lotta sense to establish a cash-only practice that accommodates the common person.
Making Money vs. Helping Others
If you seek to break away from the system and go your own way, it raises an important question:
How do you balance making money with helping society?
I encountered a thought-provoking article about why you should raises prices for your medical services:
- High prices enhance the perceived value — which means that patients will view your services as high-quality. (Kinda like Coach bags, even if they are made all in China.)
- Higher prices generate customer loyalty. No one wants to admit he has been duped into paying more than he should have. So he keeps on paying the higher prices … reaffirming he made the right decision all along.
(The two reasons for increasing prices are solid and are rooted in human psychology.)
Who wouldn’t like to work less and make more money? But if you’re only helping the rich, what about everyone else who cannot afford your services? What should you do?
There is no right answer …
For some people, the answer may be to stay in the broken healthcare system. Heck, someone gotta do it, right?
For others, the answer may be to embrace the cash-only system, but to charge a price most people can afford. (Currently, this is what I’m leaning towards.)
For the rest, the answer may be to cater to the rich, but to volunteer your time treating the poor.
I came across an intriguing story from a doctor from the other side of the world …
He is US-trained doctor, who is currently practicing overseas. He founded a surgical clinic that catered to tourists. As more and more people go abroad for medical care (which is another way to escape from our broken healthcare system), he is making more and more money — $400,000 for only 30 hours a week of work.
Other jealous doctors who heard his story cried out, “You greedy bastard! All you care about is making money! What about service to society?”
This doctor retorted, “Each week, I volunteer 1 whole day to give medical care to the needy. How much time do you volunteer?”
The Biggest Tragedy
Bottom line is … there is no right answer. There is nothing wrong with carving out your own path and make lots of money. There is nothing wrong with staying on a well-trodden path and make comparatively little money.
Only you can decide how to live your life. Only you can decide how to balance helping yourself and helping others.
But the biggest tragedy is to endure through a wrong decision. It will lead to burnout and to another fine doctor quitting medicine altogether. In this situation, everyone loses out.
Attention! Do you want to make more money as a doctor? Do you want more freedom? Are you sick of all the useless, time-wasting paperwork? Do you wanna learn how to set up and run a profitable practice that only takes cash, from someone who has “been there and done that?” If yes, check out My Cash-Based Practice: Essential Knowledge for Creating a Successful Private-Pay Physical Therapy Practice — the best book I have found on starting and running a cash practice.
At the very least, check out the book review.
This article is part of the Money in Medicine series. Click on the link if you want all the money-making secrets available to doctors.