Golden Handcuffs: The Ultimate Doctor Restraint
You finally made it. The grueling and exhaustive medical training is now over and recently you landed your dream job with a six-figure salary that’s going to provide a sweet lifestyle. Not to mention a MUCH better way to pay off that $400,000 worth of student loans and mounds of credit card debt.
However, as time moves on, the difference this makes begins to fade. The day-to-day grind the last ten years has taken both a mental and physical toll on your body.
Treating patients and dealing with employees all day every day has completely drained the good life and “excitement” out of your system.
You understand and still appreciate that the extra money you’re paid compared to others and have no doubt that you could also earn a comparable salary elsewhere.
But there’s just one problem. You dread putting on scrubs each morning to face a job that makes you miserable.
Thinking back, you recall hearing about something called doctor burnout but thought it could never happen to you.
But the constant mandates from the corporatization of healthcare, government, insurance and patient satisfaction score have chipped away at you.
Recently you came across a comment from an online forum by a physician that hates being a doctor:
“I hate being in the medical profession in the United States. It’s all about seeing new patient numbers rise, billing more, doing more clinical work, following outdated guidelines or else CMS won’t pay us… I went into clinical medicine to help people, and now I’m at a tipping point as I can’t connect with my patients or the system. I don’t know what else to do because medical practice has been my life. I’m not qualified for anything else.”
You’ve now come to the conclusion that if something doesn’t change, that person will become you.
What are you supposed to do?
Even though you no longer have passion, drive or motivation, the money and benefits are too good to quit.
What other career is going to help pay off that six figure student loan bill? What about finding something that will allow you to continue living the “doctor” lifestyle you’ve become accustomed to?
Welcome to the world of golden handcuffs.
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Why Are Doctors So Miserable In The First Place?
Whenever I have a conversation with someone who’s NOT in the medical profession about the alarming number of doctors burning out that hate their jobs, they don’t believe me.
I guess the saying, “It takes one to know one” is true.
Here’s the top 3 top reasons doctors are miserable:
If the average medical/dental education is costing us $300K – $700K then who can leave the profession?
Few of us are raised with a silver spoon in our mouths and most of our parents aren’t in a position to help with our financial problems.
If we decide to quit our jobs, how would we ever make enough to pay off our debt?
A general practitioner (MD) was making $185,000 a year in 1970 (average inflation adjusted) vs making only $161,000 a year in 2015.
Don’t forget to add in the fact that doctors are having to see double the number of patients now than they did in the 70’s.
It seems that this trend is here to stay. If you want to continue to see your income rise, you must continue to work more and more hours trading your time for money.
#3 The Rise of Bureaucracy
Years ago when we had to switch from paper to electronic records, it forced many “old timers” out that were fed up being told how to treat patients. For many of us, it’s as if we spend MORE clinic time documenting care instead of providing it.
Studies show that doctors spend almost an hour a day and $83,000 a year dealing with paperwork for insurance companies.
Their office staffs spend more than seven hours a day.
Is it any reason why doctors feel like pawns in a battle between insurers and the government?
What Are Golden Handcuffs?
Unlike a golden parachute which provides long-term employees with a soft landing, golden handcuffs are financial incentives given to employees to discourage them from leaving a company. It’s similar to dangling a carrot over their heads.
People don’t leave because they can’t get the same retirement benefits anywhere else.
- solid compensation package
- matching retirement contributions
- insurance package such as disability and life insurance
- company cars
- stock options
- paid vacations
Initially his taxable income was high but so were his expenses. He calculated his family was spending a whopping $340,000 a year, yikes!
Seeing this cash flow out of his pocket was a wake up call making him and his wife understand why there was so much pressure to bring home their paychecks every two weeks.
This pressure made them feel trapped and dependent on their day jobs. Despite his 60 hour work weeks and 10 hours of commuting every week, he had NO CHOICE but to keep on going.
He understands that he could leave anytime but he’s like others in this situation… he liked the money, benefits and prestige that went along with being a doctor.
The funny thing about golden handcuffs is that the key is in your pocket. But most don’t use the key because who wants to let go of gold?
What other industries are most affected by the golden handcuffs?
Besides medicine/dentistry, what other industries also wear the golden handcuffs?
Typically you’ll find careers that offer time-related incentives to employees with unique skills such as:
If You’re A Practice Owner, Encourage Your Top Employees To Stay
I’ll admit, as a self-employed periodontist, one of the ways that I’ve kept my best employees from leaving is incentivizing with several different types of bonuses.
Now that I think about it, I’ve put them in golden handcuffs too!
After performing research, I found out that companies that use golden handcuffs plans can accomplish 6 important outcomes:
#1 Mitigate risk of leaving early
Many companies create future compensation payout to keep employees around longer. A common example is the time required for an employee to be vested in a 401k Employer Match or profit sharing plan. If they leave before becoming fully vested, they give up the right to the non-vested component of the Employer Match/Profit Sharing value.
#2 Sustained company growth
Once employees are incentivized with future compensation payout, it gets them focused on achieving the company’s long-term business goals.
#3 Keeps customers/patients happy
I love traveling and getting to see the same employees time and time again. Your business/practice is no different. Your returning customers/patients become more loyal the longer you can retain the best people possible which helps keep the great culture going in your practice (as long as they are providing great customer service).
#4 Enhance value at exit
For the person or group that plan on purchasing your business/practice in the future, they tend to see greater value if golden handcuffs plans have been effectively implemented.
#5 Express gratitude
As a practice owner, I’d love to see all of my employees stay until the day I exit. By having golden handcuff plans in place, you’re able to do this.
#6 Attract best talent
Owners that offer competitive pay along with other perks can typically recruit and attract the best talent even from their competitors with a great golden handcuffs deal.
Specialists Are (SUPER) Trapped
Back in the 50’s and 60’s, a general practitioner handled everything from chest pain to delivering babies.
Times have certainly changed.
Not only do we have specialties such as: dermatology, anesthesia and allergy and immunology, but we’ve also seen the rise of sub-specialties such as:
- pediatric anesthesiology
- interventional radiology
- clinical cardiac electrophysiology
Rich Dad Poor Dad author Robert Kiyosaki said it best, “The more specialized you become, the more you’re trapped and dependent on that specialty.”
After dental school, I trained four more years to perform periodontal (dental) surgery. This means that I’m NOT allowed to perform the general dental procedures such as root canals, crowns and fillings as I was originally trained to do.
For physicians in sub-specialties, they also gain skills and experience needed to perform treatment/surgery which gives them a nice paycheck but also ties them tightly to their employer.
Theoretically they could switch employers or start up a scratch practice but there’s a lot of risk tied to a career move like this.
Many of the docs get used to spending $30,000+ per month and anything that could interrupt their paycheck is downright scary.
I’ve Got A Pair On Too
How To Break Free Of The Golden Handcuffs Forever
#1 Get your financial house in order
#2 Invest in assets that pay YOU now
- retire early
- working at your current job on your own terms
- seek new career opportunities
- focus on meaningful work that fuels your purpose