Employee Physician Job #1 Creating an Equitable Exchange of Value

Posted by Dike Drummond MD

As an employee physician, your relationship with your job begins when you sign your contract.

Your contract is a legal arrangement known in Latin as a quid pro quo. It's an agreement that each party is going to do something for the other.

Everyday expressions for quid pro quo include tit for tat, you scratch my back I'll scratch yours, give and take.

NOTICE: For all humans who participate in any kind of barter or other give-and-take transactions ... what is the first thing you wonder as you compare the two sides of the deal?


Does it pass the sniff test ... or is it a bit fishy ... am I actually getting ripped off here?

Here's the phrase I use in negotiations that seems to have the most value:

In this blog post

  • Let's take a moment to examine the origin story and the motivations of each side of your current employment contract.

  • Let me show you how to calculate a numerical score of the fairness of this exchange.

  • And show you the path and the tools to begin creating a more Ideal Practice within your current job.


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Let's take a moment to examine the origin story and the motivations of each side of this particular give and take contractual arrangement.

Who wrote the employee contract?

Did you have any personal role in its creation, structure or wording - any role whatsoever?
How can this copy and paste document support the unique needs of your practice? Something feels out of balance from the start now doesn't it?

What is each side giving? What is the quid and what is the quo?

Your Employer:

Your employer is providing you with everything they think you need to just walk in, punch the clock and provide billable encounters to patients within your specialty. Plug and play.

They supply facilities, coworkers and team members, supplies, scheduling, patients and all the necessary legal and business office functions.

They also provide you with salary and benefits.

They also provide you with a production quota a scheduling template that takes away your flexibility, hundreds of "quality metrics", and a multi-layered bureaucracy to consistently push you to see more patients while providing less support.

Hundreds of doctors have also told me that one of the responsibilities of their bureaucracy appears to be - tell them several times a year how much money they're losing the organization. This is especially common for primary care doctors.

All of this is part of the package of being an employee for a simple structural reason.

The bureaucracy's purpose is to make sure your practice provides maximal income to the organization's revenue model. There are only three ways to drive profits - see more patients - cut support expenses (starting with staff) - a little of both.

In the USA, the stated aim of many physician employers (or the companies that own them) is to maximize shareholder value. With that as your rallying cry, the possibilities for abuse of patients and staff for just a few extra dollars are endless. And your value to the organization will always and only be measured in dollars.



How would you describe what you give to your employer? Take a second to think of the words you would use to describe your contribution at work.

You pour in all your training, experience, communication and leadership skills, diagnostic and treatment skills, sympathy, empathy, emotional intelligence and sheer hard work. All inside a system you agreed to work within, but played no role in creating.

Medicine is your vocation, so salary and benefits are very important, but are they sufficient all by themselves to compensate you adequately. Are you just in this for the money?

YOU get to decide here.


Do you feel the quid pro quo as an employee of this organization is an EQUITABLE EXCHANGE OF VALUE at this time?

The current 63% burnout rate for physicians in the USA, leads me to believe many doctors do not consider their current position to be such an equitable exchange.

Here's a simple way for YOU to answer this question.

  • What's your level of satisfaction on a 0 to 10 scale with your current job - over the last month or so?

  • I encourage you to grab a piece of paper put a date on it and write your number down.

  • Now take a breath, close your eyes and as you exhale, open your eyes and look at your number again.

  • How does that number feel to you? You OK with it?

  • Or are you disappointed, or angry, or ashamed, frustrated or any other negative emotion?

  • Back when you decided to go to medical school in the first place, is this how you hoped things would end up?


And now we can see task number one for any employee physician.

After you've made the best decision possible on what job to take and signed the contract ..

It's time to begin an action plan to find the wiggle room in your job description and create the relationships with your leaders to transform the basic quid pro quo into an equitable exchange of value for you and your family.

NOTE: This action plan is above and beyond the activities of caring for your patients.

It is built from seven different skill sets that were left out of your medical education - skills that you can learn and practice now to drive your practice satisfaction to whatever level you would like to experience.

These skills were revealed over the course of the last 14 years and our work with over 40,000 doctors to date. I would love the opportunity to teach them to you so that you can join us in our mission of taking back the practice of medicine.

Logo2If you do not take on this task of building a more ideal practice the only possible outcome is continued struggle. Your current job description, your employer's revenue model, and your current relationship with your leadership team will continue to hold you back to this satisfaction score.

Einstein's insanity trap is a law of nature, just as powerful and predictable as gravity. If you always do what you've always done you'll always get what you've always got.

I want you to know too that you are not alone. Every doctor is struggling with this dilemma today and conditions in the US Health Care industry are worsening rapidly.

As a profession, we take back the practice of medicine one doctor at a time.

If now is the time for you to start building your Ideal Practice, this is my personal invitation to join us inside the BurnoutProof MD 3 Layer Physician Support ECOSYSTEM so I and our tribe of like-minded doctors can support you, your practice and your family.


Together we can create the Equitable exchange of value you have always sought as you poured your life force into your calling as a Lightworker.



What is your current satisfaction score?
Are you OK with that?


Tags: employee physician