Let’s assume that you’re a partner in a practice or an emergency medicine doc or a hospitalist somewhere. Let’s also assume that I own a pencil manufacturing plant. We’re also assuming that this is a scenario to illustrate a point. Thanks for playing along…

I get an order for 100,000 pencils. I fulfill the order and profit. I leverage my employees to create pencils for me and fill the order. If I need extra help for the order, I hire it.

You get an order for 100,000 patients.

You can only feasibly see 50 patients per day, so you tell approximately  99,550 patients to go elsewhere. You can’t hire extra help to see the patients because the extra help eats all of your bottom-line profit.

The Service Business

My point is that medicine is a service business. You can only do so much yourself when you’re serving others. If you want to progress beyond a certain income level, you’ll need to figure out a way to duplicate yourself. We can’t duplicate ourselves, so game over. Service businesses lend themselves to income caps. Income caps don’t play nicely with large (very large) incomes.

In other words, if you want to get rich, you need to get out of the service business. Which means, getting out of medicine. Sure, medicine will give you an incredibly “comfortable” life. I got tired of watching my parents be “comfortable” and decided to change. Will you?

There’s nothing wrong with banking a couple hundred thousand per year in medicine and living comfortably. But, you’ll never be rich so get used to that now. People all around you are making 5 times your income and working less than half of the time of your favorite attending. It may not seem like that or that cut and dry, but just trust me when I say that it’s true.

It’s all about passive income, and medicine alone doesn’t afford a passive income. You’ll always need to see patients or sign out a case to get paid.

And, that’s not the way to live. In my opinion, anyway.

Discuss.

Popularity: 1% [?]

Awhile back I had requests to set up a forum. I never got around to it, but here they are now. Nothing fancy, hell it doesn’t even match the main site. But, I’m about to retire the old MSH theme and get a brand spanking new one, anyway.

So, here it is. I’ll try and answer questions as much as I can, but I’m pretty much leaving it up to you guys to get shit started. If it dies I’ll pull it, but hopefully it can be a decent resource once some solid discussions get going.

Popularity: 2% [?]

What the fuck is with all of the hate recently? I’ve seen a huge increase in the amount of comments directed towards me and questioning why I still update this site since I’m out of medicine.

Don’t worry about what I’m doing and go save some lives. Seriously, get a fucking life and don’t worry about me updating this blog. I’m actually starting to think some of you guys have stalking issues.

Let’s take a look at some of the recent comments. ‘MD’ is my favorite commenter lately:

If sleeping in every day and playing WoW makes you feel fulfilled, by all means do it. And if you are going to look back on life with a sense of pride and feel that you had a meaningful existence in doing so, then by all means make yourself happy. I can promise you I’ll never devote a blog to why your ways are wrong or what I don’t like about it.

What the fuck? Do you actually think I sleep in every single day and play WoW all day long? I run a company doing 7-figure revenues every year and you think I play WoW all day?  I don’t give a fuck about ‘being fulfilled’ and ‘contributing to society.’ What I care about is my bottom line and financial security for the future. Nothing more, nothing less. Like I’ve said time and time again, it’s all about the Benjamins.

MD will never devote a blog to me because he simply doesn’t have the time. If you think you have the time while practicing medicine, I challenge to you start one that becomes more popular than MedSchoolHell.

Don’t lie to yourself and think it’s about anything else, either. You want money just like the next guy, and you want to obtain it with the least amount of work possible. Fuck all of this “contributing to society” crap that’s been rehashed over and over. That shit is tired, get over it.

I’m not going to lie and say I don’t sleep in regularly and play games a lot. I do. But, I still run a successful company. I have a lot of “free time.”

I love what I do not only because it’s very interesting to me, but also because it gives me an insane amount of freedom to do what I want, when I want.

The Hatorade drinkers like ‘MD’ are really just pissed that they have to wake up each morning at the ass-crack of dawn and go into work while I snooze it up for a few more hours.  I can do what I want, when I want while they have to ask for time off and put up with patient care issues while pretending to “feel good” about what they do for a living. Whatever, I see through that shit like saran wrap.

That’s honestly the nuts and bolts of all of the negative comments I’ve received lately, and if you feel differently, please let me know in the comments.

Popularity: 2% [?]

So I’m not sure who the original author is, but apparently this was found on a 3×5 card in a resident room in some hospital. The person must have been bored during his/her surgery rotation. Enjoy!

Fuck Surgery - By: Anonymous
—————————-
Fuck surgery.
The hours murder me.
No one here’s concerned with me,
and no one says a word to me.
And all I do here is waste my time.
I stand around and don’t say shit like a motherfuckin’ mime.
I get up all early for no fucking reason.
When it comes to my will to live, it’s like it’s open season.
Cause I wanna die like every fucking day.
Please someone shoot my ass to take the pain away.
But that thought makes me nervous,
cause I’d hate to end up a patient on my own fucking service.
Cause don’t I already spend enough time here?
Damn, I need a beer.
And how come these guys never wanna go home to fuck their wife?
Please Lord, don’t let me be a surgeon and waste my whole fuckin’ life.
I ask why I am here, but I never get an answer.
That shit gives me visceral pain like pancreatic cancer.
I look for good reasons, but I can never find ‘em.
That shit is about to kill me like a widened mediastinum.
Here we go again, rushing to the OR quick.
This has got to be some kinda trick.
Cause doing nothing makes me sick.
And I’ve been standing in this surgery 10 hours now, holding my dick.
And does it get any worse,
than that bitchy scrub nurse?
Yes, bitch, I got the fucking gown.
And I got my gloves too, you need to settle down.
And don’t tell me shit about no sterile technique,
I’ll look in your direction if I want you to speak.
I don’t know why you think this job really rocks,
but talk shit and I’ll slap you back to your old job at Jack-In-The-Box.
And these residents, they got me trippin’ too.
Just let me go home, man, you act like I got nothing better to do.
If it’s past 6:30, and I am still here, you are not my homey.
And I’m telling you right now: I have seen my last lap chole.
If you want me to scrub, you can blow me,
and if you think I give a shit, clearly you don’t know me.
And the way you’re acting like you’re the boss,
that shit’s got me at a loss.
Cause you’re just a resident.
You musta forgot what that meant.
That means you’re not the attending,
so stop pretending.
You talk a lotta shit, always running your mouth,
but I can see you don’t know what the fuck you’re talking about.
And if you try to pimp me again on stupid surgical devices,
I’ll put yo’ fuckin’ lights out like an energy crisis.
But the chiefs have got to be the worst.
I’m down to get outta here even if it’s in the back of a hearse.
One guy goes as far as to even salt my game.
Tells me to stop chatting with the cute nurses when I’m working a
number and a name,
The other chief ain’t seen something he didn’t think was edible.
And I swear that fat motherfucker looks like the villain from The Incredibles.
On surgery, why is every day the worst day of my life?
Why do I feel this rotation has become my wife?
Why am I so full of strife?
Why do I have sick fantasies of stabbing y’all in the neck with a knife?
Oh, I know why: cause you took my Thanksgiving.
For that, when it comes to beating your ass, I will have no misgivings.
For this, there will be no forgiving.
Now my Thanksgiving dinner will be McDonalds and a six-pack of beer.
I’ll be laying back drunk and alone, asking how the fuck I ended up here.
Isn’t that pathetic?
I’m pissed off like I was on three different diuretics.
I don’t know what I’m gonna do with myself.
But ah, fuck it man, I gotta quit this bullshit and study for my shelf.

Popularity: 11% [?]

I really do appreciate all of you guys linking back to this site. It’s high time that I did an appreciation post, so here goes. Forgive me for not giving out detailed information about your blogs, but I really don’t have the time.

• Cinnamon and Coffee
• Phey Yee
• Doctor’s Girlfriend
• Unprotected Text
• Doctors of the Caribbean

I’ll be doing these “appreciation” posts more regularly now that I’ve slowed down posting the ranting-type shit to this site. I find which sites to post links to by who is showing up in my incoming links area in WordPress.

Thanks again guys, and keep it real.

Popularity: 1% [?]