What exactly are you paying for when you spend your money on medical services? This question was inspired by a post on another blog that I regularly visit. It’s pretty obvious when you go to the supermarket, you come home with bread and eggs in exchange for the dollars that you leave there. When you go to the electronics store, you can exchange your dollars for a wide screen TV, XBOX or an IPOD. However, in medicine, you are paying for a service, not a product. Your money is not going towards the purchase of a material object. More precisely, you are paying for a set amount of your doctor’s time. For example, if you go to the hairdresser, you are paying for 45 minutes of that person’s time. When you watch a movie, you are paying for the cumulative time of the actors, the screenwriters, director, crew, distributors and for the time and energy that the producers put into gathering all these players together in the first place.
When I enter into a doctor-patient relationship, I see it as a prime example of how the world’s economy works. We, as people, engage in mutually beneficial exchanges of our time to make life better and safer for each other. My patient, the piano teacher, spends her time enriching the musical growth of students, for which their parents pay her. My patients, the policeman and his wife, give their time to make my world less dangerous for me and my loved ones. I could go on and on, but you get the point. Everybody contributes their time and energy to make the world better and gets money in return, as a less-than-perfect, but better-than-nothing way of keeping score of how much they contribute. Then, that money can be exchanged to make their own lives better. Every economic interaction involves people contributing something to make someone else’s life better, with the exception of occupations that involve taking money from people by force, without giving anything of benefit in return. Examples would include overt criminals and people who engage in legally-sanctioned unethical behavior. But those are just the exceptions.
When I talk about my being paid for my time, I’m not talking just of the time I spend talking with patients, examining them, performing procedures on their behalf and directly interacting with them. I am also referring to the past time I spent in school, studying and learning to acquire the knowledge that I have. I’m referring to the time I spend carefully screening my staff and diligently training them. I’m referring to the time I spend making decisions and carrying out actions so that there is a safe, pleasant environment (my office) where I can interact with patients. I am referring to the sleep lost when I wake up at 6 AM to do surgery or the personal time lost when I stay at work until 8 PM on particulary hectic days.
This weekend, for example, we are replacing the carpet in our office, so I need to come in and supervise the process. This is time I will not be spending with my family and friends, reading my favorite magazines, nor training my dogs. However, I realize that this is just part of life. I am blessed to have the chance of doing something that I truly love every day and I am even more thankful that by doing what I do, I am compensated with the means and options to pursue other worthwhile things in life, as well as prepare food and shelter for my future, when someday, I am no longer able to work.
If you feel that this post has been silly and/or obvious, then you might not be aware of how some other people think. So many people approach life with the question "How can I get money?" My advice to people who are contemplating this question is to think of a different question. Instead, ask yourself what it is that you can do now (or eventually learn to do someday) that will make other people’s lives so much better that they will be willing to pay you well for it. Those who are happy, successful, productive members of society have already asked themselves this and taken the right action.
So back to my case specifically, I view my past and current life choices as taking a series of steps to learn the skills I have so that I can assist people in boosting their chances of a healthy pregnancy. I sell my time and services. I do not sell a product. On the contrary, if you consider the 500 or so babies as a "product" that I’ve helped people conceive and multiply that by whatever dollar figure you try to put on a life, then paying me THAT would easily provide for me in my retirement years.
