Winning the values game

“I think we should talk about values,” said Dr. Sayali Tadwalkar, my life coach. I paused, confused. I’d been talking about not making as much money. What did this have to do with values? “Is your life aligned with your values?” she asked. “Well, yes.” I feel supremely fortunate that I’m financially independent enough to work only the medicine that I want, which leaves me more time for writing and my children. Never enough time or energy for them somehow, but my life otherwise is pretty much exactly what I wanted. “Then that’s what you should aim for,” she said. This was revolutionary, in my mind. We talk about lots of things. Money is a big one. “A nurse practitioner gets paid more than me!” “The naturopath is raking it in with unproven treatments!” “Family doctors are underpaid compared to other specialties!” All unfortunately true. And money is an easy thing to compare. Our society loves ranking people, and numbers are an easy way to rank. Yet, I don’t want to be a nurse practitioner or a naturopath. I don’t especially want a practice, and I sure don’t want to rip people off. It doesn’t matter how much money I could rake in. I have enough money. What about your values? What do YOU want? There are lots of surveys you can do online. Plug “values assessment” into a search engine and see what comes up. Mostly, it’s a list of values and you pick the ones that resonate. I tend to pick things like creativity and independence because I love to imagine new worlds and I don’t want people to tell me what to do. If I weren’t financially independent, or if my partner cheated on me, I might pick security instead. I’m going to talk about female physicians now. I find that women are revolutionizing medicine in several ways. One is better outcomes, as shown in several studies, including this study of 1,583,028 hospitalized patients, showing significantly lower mortality and readmission rates. But this comes at a personal cost, since we’re constantly experiencing more discrimination from patients, colleagues and administrators. So, a second way is women leaving medicine, or closing their practices. I’m sure men are leaving too, but not infrequently, I see the women saying, “See ya” and colleagues cheering them on. Because our system is that broken. I suspect there is a third way. Women are not winning the money game, which is problematic in and of itself. However, I think most are winning the values game. We are practising medicine, and our lives, in ways that align with our morals, our ethics, and what we believe to be right. That means our practice is informed by research. That’s why our patients have better outcomes. (Here’s another study of female vs. male-led codes with improved return of spontaneous circulation and survival to discharge. However, patients don’t recognize this, as shown in this study, which concluded, “Female physicians are not evaluated as highly by their patients, relative to male physicians, as one would expect based on their practice style and patients' values.” The hard work, low recognition, and low pay comes at a price, as I mentioned in my article, "Bill like a bro." Women physicians are at much higher risk of suicide than women in general. But what if we changed the game and put morals first? Don’t compare incomes. Figure out the life you want and if you’re living it. Don’t compare to other people’s lives. You still need to make money because of monstrous med school debt and because that’s the way the world works. But you can sleep well knowing that every day, you’re doing what you want, the way that you want it. Read: Continuing money education: Bill like a bro

Winning the values game

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