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Medical Practice Business Ezine Newsletter    Aug. 2013

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Discover the strategic methods and plans for reaching your maximum potential as a doctor and never have to worry about having enough income ever again.

Article #49  Aug. 2013    

“Are Doctors Choosing The Wrong  
Ultimate Business Goal?”

  Maybe there’s a time when your profession medical career
choice shouldn’t be your ultimate goal?

The medical practice world is rapidly changing before our eyes and will never return to what it was like several decades ago.  

Not only have the new generation of medical students and young doctors radically departed from the traditional views about medical practice, but their personal life priorities now supersede their professional choices. 

These factors have created significant and irresolvable career issues for nearly all medical doctors... such as... 

1.  Is it too late for older physicians to make any changes in their medical practices, or too late to adapt to the changing healthcare mandates after practicing all those years how they chose to do?

2.  Are the younger doctors and medical students on a path
that will lead them to unhappy careers as employees with no good alternatives available for changes they might
want to make? 

3.  Is it possible for any physician of any age able to attain a satisfying, happy and fulfilling life living and practicing under the new healthcare system—whatever it turns  
out to be?

Evidently, the attrition of medical doctors and the widespread frustration with medical practice today requires a great deal of decision-making no one cares to be cornered with. 

If the present trend of increasing disappointment with the private practice of medicine continues to persist, as it likely will, the storm of the century coming will leave few alternatives for rigidly controlled medicine by outside entities to permit medical freedom for doctors to practice. 

The greatest excitement in the past has been the greatest motivation to enter private medical practice and treat patients the way you always thought you would love to do. In the process you expected to be a high-income earner able to live a high quality life with your family.

Well, that advantage is rapidly disappearing. Fees are increasingly being restricted. Medical malpractice continues to run rampant in our society with no end in sight.

The joy and satisfaction is disappearing from medical practice and is seriously affecting the personal lives of private practice physicians as well as other medical care providers.

Do you enjoy working hard in your private medical office practice and not making enough income to keep your practice open? It’s a common happening in medical practice today.

Are you upset because you don’t make the level of income necessary to send your children to the college of your choice or to fund your retirement plan? You should be!

If the right income level isn’t there, you will never enjoy medical practice either. Have you made plans to counter this devastating circumstance?

Some doctors think differently about methods and styles of practice

All liberal arts colleges have a goal to prepare their students to  get a job. The core of graduating college students going into medical school are already brainwashed into visualizing their future as an   employed doctor. It fits their new cleverly manipulated personality and mental behavior.

Those students who find themselves comfortable with a more secure medical career as employees fall into two main groups.

First group, one can easily understand why so many doctors choose to follow a career path in some form of academic medicine. Most are employees of some medical institution. The pay is reasonable. The business of medical practice is all done for them—an important distinct advantage and benefit over private practice. But, they are, for the most part, required to follow a set of practice rules that private practice thinking doctors abhor.

It’s a very secure feeling to get that paycheck every Friday.

The second group of doctors that function well as employees includes doctors who work in a specialty that requires a hospital environment. These doctors often contract with hospitals to do their medical professional work. The effect is nearly the same as being an employee. Their professional medical practice life is controlled by others.

Both groups of doctors can be terminated at any time for many acceptable and valid reasons. When that happens, these doctors look for other medical jobs in other medical facilities and usually find them. It often does mean moving family and everything to another area of the country, a new state medical license possibly, and may have to accept what’s available in medical job opportunities for them at the time.  

Discovery of one troublesome aspect with both of these groups of “employed” physicians seems to be a rather superficial regard for the serious dilemma that private doctors are now facing financially. I’ve found that fact to be true when I approach my old classmates about that issue.  

That attitude is understandable when one considers that a significant amount of their incomes, in one way or another comes from government sources passed down through their hospital or medical facility. It makes for a firm security factor in their work and jobs as well as a mindset highly compatible with socialized medicine when it comes. 

Then again, these doctors have absolutely no real degree of office management, hiring and firing employees, as well as all the business requirements necessary to run a private medical office in addition to practicing medicine. That benefit camouflages their attention to what’s happening outside their medical
community world.

Face it, private practice inspired medical doctors do not have an actively supportive ally within these two groups beyond a superficial understanding they derive from the media.

Now that I’ve rationalized all the issues for the doctor employees on salaries, there are more important factors that you should be investigating ASAP.

Options for private practice medical doctors to remain in private practice in the future

Should our government reach a point where bureaucrats seize total control of America’s healthcare in the near future, then predictably private practice will not exist. Additionally, medical licensure control by the government will wipe-out the possibility of “cash only” practice of medicine and all other methods of private medical practice.  

If these thoughts are not winging through your conscious mind today, then I advise you to make it happen. Never assume that total control of medical care by our government won’t happen.

When our government is able to shred our Constitution like it has recently and get away with it continually today, it’s a good reason to abolish your positive thinking and begin to entertain your “survival mode”. 

When and if these things happen, physicians will have no personal private medical career choices or medical practice freedom if you want to practice medicine outside of the government dominated healthcare system.

However, should there continue to be the existence of private medical practice, I would like to encourage you to look at some alternatives for financial income in addition to your private medical practice.

The additional financial income alternatives that make sense and are within reach of most private practice doctors in a functional medical practice are reasonable solutions. The idea is to prevent being forced out of medical practice for financial reasons. Also, these possibilities are becoming much more important for you to consider right now.

The reasons that should be influencing your decision to remain in private medical practice and should give you the urgency to prioritize that decision today are...

1.  You know that the medical practice incomes have been decreasing steadily over the past 2 decades. It will
continue predictably into the future for many external practice intrusions.

2.  You know that earning more income in private medical practice will require working much harder, seeing more patients each day, hiring more office staff to help you, pushing the edges of medical integrity, and having less
time for family relationships. The reward for these things is  classic total “burnout”  long before you have reached the career goals you have set for doing all this.

3.  You know that medical malpractice risks for physicians remain a significant threat and concern for the majority
of medical doctors who are in medical practice. 

You also know that the trial lawyers who dominate state legislatures will never allow “caps” to be placed on medical malpractice verdicts for “pain and suffering” beyond the
6 or 7 states that already have placed caps on malpractice verdicts and awards.  

In the majority of States that have not placed caps on verdicts, your malpractice premiums will remain high 
and unaffordable.

4.  You know today that over 50% of graduating medical students choose to join employed medical positions primarily with managed care groups. Having to pay off an average of $150,000 educational debt prevents them from starting a private practice. In a real sense, young doctors are being covertly forced by this debt issue to melt into
the intended new government healthcare system. 

The trend will create even more pressure on your medical career path. When you are being manipulated by the above factors, your intuition tells you that you should quit medicine completely, retire earlier than intended, or start another non-medical career.  

Like most doctors today losing their medical practice for financial reasons, becoming an employed medical doctor at a hospital or managed care facility seems to be the only way to continue practicing medicine.

There  are  some reasonable alternatives.

5.  You know that the only financial path to a medical career today is increasingly seeded with government money, in one way or another. And it isn’t all grant monies. If you are aware of the Laws of Influence, then you understand how persuasive the  Law of Reciprocity  is today. It’s the glue that binds new doctors to becoming employees, where you don’t control your own career.

You are conditioned to accept what will lead you to a unfulfilling and unhappy medical career. The freedom to practice medicine just the way you want is what makes your career full of satisfaction, fulfillment, and success. This is well documented in studies and medical literature.

How to remain in private medical practice when you are overwhelmed by external destructive factors that increase your financial distress and put you in monetary quicksand...

Cutting to the core; You will need other sources of  
income outside of medical practice to remain in  
private medical practice, very soon.

New and old ideas of how to do that...

  • Your spouse may need to work full time.
  • It may be necessary for your kids to start a business to help.
  • Wealthy families often provide you with financial support.
  • You choose a high income medical specialty to practice.
  • You make smart investments with your   discretionary money.
  • You decide to live a very frugal lifestyle for the duration.
  • You may feel the impulse to wade into criminal activities.
  • You find a separate additional rare executive business position that  pays high wages.
  • Win the lottery... wishfully

Maybe you’ve already tried these financially helpful methods. Did they work for you? Did they turn out to be a bad idea? Did you wish that there were other options that might be compatible with keeping you out of financial quicksand?

Some physicians are not risk takers and are self-confined to their own comfort zone or “box”. These doctors will never get any further than they are today because of fear and inertia. They can’t be helped.

Before we go any further, there are some assumptions that have to be made concerning my comments...

  • You have an open mind for considering possibilities and are willing to take an action step or steps to get started on something you believe can be helpful to you in your
    medical practice.
  • An assumption that you are a strong believer in your medical freedom and desire to remain in private medical practice as long as possible.
  • An assumption that you can believe what I say because of what I have been reliably saying in my newsletters for the past 4 + years and have never led you astray. There's
    no BS here.
  • An assumption by me that what I tell you is factual, accurate, and can be found on the Internet and elsewhere anytime you choose to check it out.

Considerations regarding extra income strategies

Some female physicians already have two jobs, practicing medicine and running a household with kids. The fact that about 50% of medical school students are now female is a strong indication of more changes in medical practice that will
likely increase and do so rapidly.  

F emale doctors have spouses who earn full time salaries either in medicine or outside of healthcare. This frequently permits female doctors certain advantages. First, income is less of a concern when you have two fulltime wage earners in a household. Second, surveys indicate that 50% of female doctors choose to work part time in medical practice.  

Nearly all male doctors spend full time in medical practice, medical research, or medical academic careers. Private medical practice has some variables that are pertinent to both male and female doctors.

Those variables are such issues as private or group private practice, availability of having other doctor’s cover their medical practice on call or as needed for vacation or illness. Working in a association type of group call coverage, and working as a private medical doctor within a medical facility are good examples.  

(Example; contracted to work in a military hospital or facility, or Indian reservation clinic while maintaining a private medical practice. The rules governing these entities may recently
have changed.)

This leads to your discovering that you have a serious medical practice income problem...  

Most contracted and full time employed medical doctors are restricted from other types of full time medical practice elsewhere or outside jobs that reduces their productivity under their contract. When caught, their employment is  usually terminated. 

The choices for a medical doctor in private medical practice are
essentially unrestricted.  

Private practice doctors are in total control of their medical practice business, their income, their family life, and their career modifications and goals.

As an  employed  OBG doctor you might decide you want to quit doing obstetrics and continue the gynecology part of your practice. In that situation while in an employed position you normally will not be allowed to do so. You would have to quit
your employment and find another facility to hire you just for doing gynecology... not many positions like that available in
my experience.

Let’s say you’ve been in private medical solo practice for over 5
or 6 years. That happens to be about the time when your
medical practice is going very well with lots of patients. You feel great about how you are doing and expect it to continue the
same or better.  

Unexpectedly, you begin to notice that other doctors have moved into your area and your load of patients begin to decrease. Your income also starts to go down.

At this stage, most doctors have no idea that this is happening let alone why it is happening. Within a year or two you may hear some grumbling from your CPA or office manager that they are having a tough time paying all your usual overhead and salaries.

We all know that to earn money in medical practice you have to see medical patients… the more patients you see the more money you make.

The problem is that only one in 5 thousand doctors ever keep track of the numbers of new patients coming in and leaving their practice. They slough off the warning and blame the drop in income as just a seasonal cycle and will come back up in a couple months.  Is this familiar to you?

Then comes a day when there isn’t enough money to pay the office overhead and it’s “temporarily” necessary to dock  your take home pay  to pay all the bills of the practice. 

Once your spouse discovers what’s happening, it’s the time you become seriously worried. But you still don’t recognize the reason for the continuing drop in income, because all you have been checking out is how much gross income you have been earning monthly and trust that financial statement factor. 

Your options:

1.  Hire a medical practice business consultant to
determine the cause?

2.  Get out your office business manual and use
it to check out all the causes listed that might
be the cause yourself, before hiring help? 

3.  Consult with all your friends and medical peers
who seem to be doing quite well in order to
learn what they are doing to stay afloat? 

4.  Decide that it’s a good time to quit medical

5.  Take a job as an employed physician
somewhere… last resort? 

6.  Sell your practice to the nearby hospital and
continue the practice under constant demands
from above?

Well, it’ll cost you about $10,000.00 to hire a business consultant just to help you set up a new medical practice business plan and follow-up. Your "peer friends" will likely not disclose the tactics they are really using to remain afloat.

Digging deeply into your practice financial problems rarely works well because you have never been trained to recognize what is wrong and how to get to the solutions, even if you
recognize them.

Retirement so early in your career is a death sentence because the boredom is not tolerable. You can take a job as an employed physician and hate it every day.

With the governmental restrictions on hospitals being enforced, including the new ratings surveys, as an employed doctor who sold your medical practice to the hospital your job will always
be at risk.  

Now, the biggest decision of your medical career has to be made. 

Fact:  Up to this time almost every medical practice financial problem can or could be promptly resolved if you had been educated in  business and marketing  strategies and tactics. 

It wasn’t your fault. No medical school (supposedly 170 of them in the USA) in the USA teaches medical students anything about running a medical practice business. You are thrown out there amongst your patients to do the best you can with your bare minimum of business knowledge you picked up from discussions with your dad, mom or friends. You have to know how to run a successful business to survive financially.

Rarely do you come into contact with a doctor who is willing to go back and get a business education—first, because they at this point are out of money to pay for the education—second, because taking the time off (about 2 years) from your practice would dump you into bankruptcy.  

Of course, now there are online business courses, abbreviated business courses over 6 months, and libraries to learn from.

What’s left to get you out of medical practice financial distress and keep your private  
practice going?

You probably already know that I am quite knowledgeable in the field of medical practice business and marketing which I have been persistently increasing my learning over the past 10 years…after my 35 years practicing.

Consider the following list of methods of  outside income  you can easily do and make a lot of money without interfering with your practice functions. You don’t have to believe it, but I have so many contacts in the business world who are doing it and making a great deal more money than you ever will in medical practice, one would be foolish to deny the truth.

These options are not related to the stock market, real estate investing, or any other quick “get rich” schemes and are
not for everyone.

At least I want you to know what good options are open to you and that are compatible with full medical practice. They require time, energy, commitment, and persistence. They all relate to Internet online efforts which you can do at home on the couch, Feet up on the coffee table, sip on a cold drink, and work with your laptop.

Come to think of it, your own teenagers are well qualified to do this business activity for you.

The necessary learning is easy, quick, and the passive income “work” can be continued remotely while on your Caribbean or Mediterranean cruises.

This one idea below has to be the one at the top of your list of outside income sources.  

Selling other people’s products online: (Affiliate Marketing)

You, your spouse, and/or your computer elite children are
easily able to create an ongoing resource of passive income quicker than most other money making efforts. In today’s
world the online income ventures offer an opportunity for
creating wealth  independent of other jobs, careers, or income resources you may have. 

You don’t have to create the products you sell online through
your website or blog. You can find them listed on such websites as…
www.ClickBank.com/marketplace    where there are thousands of done-for-you products waiting to be sold.  ClickBank provides very easy detailed instructions that any 12 year
old can follow.

You sign up as an “affiliate” (free) to sell the product for the vendor online (creator of the product and who is already selling their product online) and receive a commission of over 50% of the sale price. You become a “reseller”.  

There are literally hundreds of articles on the Internet that are available (free) to rapidly learn how to function as an affiliate
and make a good income... even millions of dollars as some
have already done.

There are now teen age and college age affiliates who are making a million dollars a year online... not my impression, but is a fact that's well documented.  

Presently online there are over 300,000,000 (million) customers now buying products they want or need while surfing the Internet on their laptop or mobile device (now at exponential growth rate) day and night across the globe.

The basic advantages of the affiliate process...

  • You can become proficient in the affiliate process in less 
    than a week. Keywords like   “become an affiliate”  used in Google brings up 163,000,000 million listed websites on that topic to help you.  
  • The products you choose to sell online usually are sold through your  mini-website you create for the product online. There are hundreds of templates (most are free) available to use to do this.
  • Your affiliate product or one you create yourself is visible on a website online to anyone around the world surfing the web to buy something. The numbers of customers online is increasing exponentially now. It’s an incredible opportunity for anyone.
  • Once a product (eBook, eCourse, videos, washing machines, dental products, anything at all) is online for sale, people will continue to be buying even years later, thus providing passive income forever.
  • Imagine creating a hundred mini-sites each with a different $100 product for sale, where you get a 50% commission on the sale price. If you make one sale each day on each product doing the math you would earn $5,000.00 per day in commissions. You get the idea here.  

    Use your own data and discover what income you can earn each year on the products you could sell.
  • You don’t ever have to create a product to sell.
  • You don’t have to do all the paperwork business associated with selling products, all done for you by ClickBank at very minimal cost.
  • You can leave that website sit on the Internet indefinitely for someone to find and buy that product even years later.
  • You can sell the product on a blog or a website or   even offline.

Basic sequence of the affiliate sale process:

 1. Select a product you are interested in selling. 
    (  www.clickbank.com/marketplace  )

2. Create your affiliate account  online to sell the product.
    (Clickbank tells you how to do that.)

2. Create a mini-website  to offer and sell the product on.
    (Google the keywords,  “create mini-websites”.) 

3. Create a “web hosting account” for your mini-website so 
    customers can find your site on the Internet.
    (Ex.  www.godaddy.com  )

4. Optimize your mini-site so the site will be seen by
    customers on the  first 2 pages of Google website
    listings. The customer uses a  keyword  typed into the
    Internet search engine to find your website and product.
    (Google the keywords,  “optimize my websites” to
    learn the process.)

Recommendations for study and use--       Keywords ... what they mean and how to use them.

ü        Marketing —what it’s about and how to do it.

ü      Copywriting and Persuasion—ways to convince customers that this product is exactly what they
want and need.

ü      Website Building—pay for someone to do it for you—better  to do it yourself because it’s fun and
a lot less costly.

ü        Online Business—learn to start right and earn more... is not hard to learn.

ü       Resources —plan on spending some time for continuous learning about problems you need to
avoid and overcome as you progress.

Subscribe to as many free email newsletters as you can find online that focus on the areas you need to know more about. 

I’m 12 years into this stuff and continue to learn something new every day without fail... exactly like you learn daily in medical practice.

Feel free to contact me about the best resources, books to read, places to find information.   cgmdrx@gmail.com


Trust me, you will in the near future need to have multiple streams of passive income  established above and beyond your medical practice income in order to maintain the standard of living you have worked so hard for, invested so much money in, and absolutely deserve. For most physicians medical practice will not enable the lifestyle you expected.

Taking full advantage of what is possible to earn online now enables you to use the Internet to compete on an even level with the big boys, which has been impossible in the past for any person or small business like medical practice to do.

The usual excuses I hear from doctors today about why they quit practice, retire too soon, change careers, are so frustrated with medical practice (AMA survey—over 50% of doctors), and are fed up with their career in medical practice  can all be resolved if your income was adequate to meet your lifestyle expectations as a professional.

Why is that so hard to understand?

Why doctors won’t make an effort to get the required business knowledge needed for maximum income...  

It’s obvious that physicians  already in practice will rarely ever make the efforts necessary to create high incomes in their medical practice or to even to stabilize their income to prevent
it from dropping. They simply find it easier to deal with the consequences, like losing their medical practice for 
financial reasons.

The singular effort that would be most helpful would be for doctors to spend concentrated time learning business principles and marketing strategies. That effort would involve time away from medical practice and a significant cost for the education,
like obtaining an MBA (about $50,000 for a two year program
at a top University). In both instances they lose money from
their practice interruption.

There are many shortened MBA programs, costing much less available and even some online that would be very beneficial. Would most doctors who recognize their practice is shrinking get the business education to rescue their medical practice? Most won’t do it for a couple reasons.

1. They are so skeptical that getting a business education would not cure their financial problems with their medical practice that no business consultant can get them to believe it will work. 

2.  Another segment of doctors are willing to listen to a consultant and what they recommend, and then refuse to alter their practice to create the recommended business structure and organization necessary to accomplish their objectives and goals. 

Far more disappointing are the doctors who go ahead and give the whole process a try, determine that it isn’t working for them, and go back to the old income  inhibited practice.  

Doctors commonly react this way because they want to see results immediately resulting from the changes they’ve made. It always takes several months to see significant increases in income. Most will not wait.

The barriers that have persistently prevented physicians from rescuing their financially disabled private practices seem to be their inertia, lack of business knowledge, and an arrogant disbelief of the proven business success requirements.

Why I outlined above the easiest and most practical method for a practicing medical doctor today to attract income:   (Business as an affiliate)

  • There is no need to interrupt medical practice to get a  
    business education.
  • No need to fork out a lot of money for an MBA or other  
    educational courses.
  • No need to change the way you or they are now practicing.
  • No reason to pay for huge business consulting fees.
  • No long waits to see results.
  • Because the process is one a 12 year old can easily do.
  • Anyone in the family or an employee can do for the doctor.
  • There is no interference with the medical practice function.
  • Because there is no need to see lots more patients to earn more in the medical practice and burnout as the result.
  • The level of affiliate income is totally determined by you and what you need to have.
  • The affiliate work process is one that any doctor has time to do if he or she chooses.
  • Affiliate business is done completely on a computer,
    beginning to end.
  • Affiliate business online is the least expensive income producing business available, other than carrying a hungry sign standing at an intersection.
  • Affiliate business is perfect for young kids to start a business of their own, as so many of them have  already done.
  • Once someone in the family learns the affiliate business,
    most of the others want to do the same. Teenagers can earn their own way through college.
  • It’s a way to insure your grownup kids won’t have to come back home to live later on. Not that your kids would ever do such a thing.
  • Many more……

Ideas and strategies for successfully producing income is dependent on determination, persistence, and goal setting.

There many other businesses outside of medical practice and online today that have high potential for wealth. You would be surprised at the number of simple online businesses started in high school or college that earn enough income for the students to quit college and expand the business.
(Google “Russell Brunson” for example, as well as the  story behind Domino’s Pizza.)

Remember, there is not a shortage of money out there among the masses in spite of what you hear. People still buy very expensive season tickets to professional sports games, still go to expensive restaurants, always have enough money for booze and cigarettes, still buy expensive jewelry, and etc.

You just have to learn how to send some of it your way. There are millions of ways to do that if you are smart about it. It’s true in any economy anywhere, good or bad.

This is just one idea. There are many more I can describe for you. You are not obligated to do any of what I advise. However, where else do other doctors discover new reliable income ideas
that are free?

“The trick is to make sure you don’t die
waiting for prosperity to come to you.”

              ---Lee Iacocca

The author, Curt Graham, is a recognized author, physician, and entrepreneur with a passion for bringing reality to unacceptable issues about medical practice that demand attention, alternatives, and debate. His desire to make doctors think beyond the boundaries of usual thought is secondary only to his mission to reveal the consequences of having a fixed mind unable to benefit from experience, knowledge, and wisdom.
Learn from his medical publications what isn’t taught in medical schools and that you must know today to maximize your potential and capabilities.
Click here now   to learn how to reach your maximum medical practice potential.  
©Copyright Curtis Graham, M.D., All Rights Reserved.  

      handwritten signature of Dr. Graham

 Business Nudges......

archeology dig--human skeleton giant 18 feet longThings are being dug up every day that you would have never believed unless you saw it yourself. New ideas pop up daily that are coupled with opportunity. This is an archeological dig in southern Europe revealing a human skeleton about 22 feet in height... and you never believed the Biblical story of Goliath in the Bible. Shame on you.

An open mind can take an idea for making income and push it to the highest profitable limits. One of those ideas out of thousands I gave you today. It's a suggestion that has many roots should you be a physician looking for a way out.


“9 Reasons Retirement for Physicians Has Become Virtually Impossible”

Retirement is an option, not a goal.

For highly competent intelligent people who have spent a lifetime intensively engaged in curing sick and injured patients during your medical career, retirement is a quick overrated substitute for, and compromise of, everything you found to be extraordinarily fulfilling.

The exceptions to the usual retirement activities of resting, sleeping, and eating are the physicians who somehow find a means to use all that brilliance stored up education, knowledge, and skills in ways that continue to be fruitful and satisfying. However, it goes far beyond that.

What happens to you in retirement affects everyone around you. Your family wants you to be happy and satisfied during retirement while spending most of your time interacting with them. Friends and family have great difficulty understanding what happens when a fish is pulled out of the water, or a doctor who can no longer offer their expertise daily to those in need.

You spent years developing that mindset and now you’re expected to disregard that mindset like overnight.

The happiest retirees are the ones who pretend to retire and yet continue in some fashion to use their elite talents and knowledge for the benefit of the profession. The desire to teach, write about, or lecture on topics of interest regarding healthcare are just a few of those avenues for continuing to benefit society.

I believe most medical doctors do these things during their “pretend” retirement from medical practice as long as they are in good health.

The fact that the practice of medicine is rapidly changing from practice freedom to practice dictation leaves little room for control of your own medical career. This transformation has created every possible factor for doctors not to retire at all. Obama promised it and we got it.

Retirement from medical practice today (2013) is not a realistic choice because physicians have been selectively cornered with very few alternatives left to consider.

Some reasons why it’s smart to consider not retiring voluntarily...

1.  Most important and quite convincing are the issues relating to financial problems. It’s likely today that the great majority of physicians across our nation and in medical practice today have not been able to fully fund their retirement plans, if they have one at all.

Physician incomes have been dropping persistently over the last 20 years, some specialties more than others. Studies and surveys document the fact.

Physicians are having great difficulty affording to send their kids to college, at least to the preferred and elite ones. It means that doctors have to spend a stack of money to finance college education for their kids. Maybe also support their young people who have to move back into dad’s home.

Many medical practices are now financially in trouble and many are closing completely every week.

What doctor can handle all their increasing financial obligations today if they retire from their medical income source?

2.  With a divorce rate approaching 50% among physicians, who can predict what this secondary financial settlement agreement won’t allow room to pay for other medical  practice needs?    

The divorce settlements are becoming increasingly steep and often leave the doctor permanently stuck in debtor’s prison. I’m sure all of you have known doctors in such a predicament.

The alternatives to avoid this dilemma are few and still can be a source of financial problems.

    ---Never married.

---Marriage between doctors.

---Marriage between two who are
    professionals in their own right.

---Prenuptial agreements.

3. Medical malpractice premiums continue to rise. So while you are smart to have such coverage, you will remain in an escalating bind as your practice
income decreases.

Medical malpractice risks won’t go away. Probably the other 43 states without a cap on court verdicts will continue indefinitely.

Most doctors never consider that there are other even more devastating catastrophes that result from malpractice cases that get settled or with court verdicts. Things like inability to get malpractice insurance or can buy it at exorbitant premiums are not rare. Reputation ruined, no referrals anymore, constant supervision by peers, medical board punishments, are just a few more.

4.  Doctors who suffer health catastrophes as a younger person are left wanting. Automobile wrecks, plane wrecks, climbing accidents, spinal artery clot causing paraplegia, cerebral artery block causing hemiplegia, kidney failure, heart attacks with bypass surgery and loss of vision, are a few that I have known
among my peers.

The first three involved the death of the doctors. Doctors may be the only bread winners as these were. It left those families desperate for help suddenly. The climbing accident was a doctor (cardiac surgeon) and wife when they fell 3000 feet off of the mountain called K1.

5.  Inadequacy of retirement funds may become a factor. Does your retirement account have enough in it to manage and pay for elder care of your parents?

Because of the decrease in quality of medical care, which will get worse under ObamaCare, it is
expected that physicians will become much more involved in paying for better care for their parents
than ever before.

Children become disabled, get cancer, and suffer from permanently disabling diseases. Often, these occur suddenly without any predictability.

6.  For serving a long career in medical practice, long hours, up nights, emergencies, and unlimited compassion always in demand, retirement means incredible boredom, inactivity, and brain drain.

Those three things alone can easily put any physician into depression, perpetual worry and regret, and ignite a sense of worthlessness that can’t be described. It’s what happened to me when I first quit medical practice.

That’s the time when doctors discover how to pretend to be retired while going on to use their medical knowledge and talents for good. It brings back self-satisfaction and self-esteem.

7. From a purely fulfillment perspective doctors as a whole do better in their lives when they are busy, face diagnostic challenges daily and routinely see patients they have treated surgically and medically successfully. It may be a self-esteem builder effect that you still “have it” after all these years.

There’s something that happens during that doctor-patient interaction that excites your soul and confirms your value both to yourself and the patients you manage. It’s something you may find at home but it isn’t the same.

Once you’ve had the experience of practicing
medicine and experienced the rush of passion for curing medical patient problems, it’s something
that’s hard to give up.

8. The continuous implementation of new surgical and medical procedures and the impressive new technology leading to those improvements in treatment are factors that one never gets tired of. It feels good to be part of the forefront of medical care.

Competition in healthcare is a stimulant every bit as effective as it is in sports and in education. It fuels your passion to do more with your skills and do better than others. Of the hundreds of doctors in your community, each one has one or two areas of expertise that is above that of all others. Retirement can ruin your passion and motivation to always be ready for the next step up.

9. Each premed student at the start has a head full of ideas about the practice of medicine and how they
will fit into that career. What seems to happen unconsciously during medical school is for each student to build the essentials of medical practice around their own personality, interests, and
visualized goals. You extract what your intuition
tells you that you need.

You gather the parts of your medical education and training experiences that fit into your visualized future. You use them to fit together an invisible support system for the kind of doctor you intend
to be.

You do the molding of your image yourself. You feel the ingredients you need to be that doctor. It makes you unique among physicians.

When you’re finished with the process, all you have left to do during your medical career is hone your potential down to a sharp focused edge. That person is who everyone in medicine around you, including your patients, sees and reacts to.

The doctor you build yourself into is exactly what makes it difficult to quit the medical profession or retire, especially when you know you are the best doctor that ever came out of medical school in the last century… right?

You did such a terrific job building that doctor’s character, integrity, and reliability, who’d want to throw that doctor away by retiring?


One of the things I regret the most after I pretended to retire in 1999 was the fact that I would never have to maintain a medical license again. My absent mindedness was camouflaged by finally being able to get out of the medicine rat-race.

I knew that I would never again practice medicine by the way I felt at the time, so I was cutting all ties to the career. About two years into my retirement I had this great urge to teach at the medical school nearby. I didn’t recognize that teaching medical students or residents required an active medical license. But that wasn’t all.

When I inquired about obtaining a medical license in Nevada from the Medical Board (I had several inactive medical licenses in other states) I was told it would be a waste of time for me to even try. As an OBG with malpractice suits on record I didn’t stand a chance. I
should have picked another state to practice in early on instead of “malpractice risk heaven” in California.

Since I had no active license in any other state it limited my options to doing a residency over again, go through the torture of activating a medical license in one of the states where I was licensed and kept inactive, or taking the state licensure exams required by most states when one has no active medical license anywhere. For family reasons, we were stuck in Nevada.

My intention to share my years of medical practice experience in OB-Gyn with medical students was foiled.
It’s such a waste of medical knowledge to let it all go to
the wind.

My intention to share my very advanced surgical skills
with residents was foiled. Surgery was my one special
area of expertise, talent, and skills in my career and I
was far ahead of most other OBG doctors.

Lastly, in this new generation of medical practice where doctors are being inhibited in so many ways and quitting practice in droves, one would think that the attrition of doctors would demand new looser rules for medical
practice licensure and practice.

The author, Curt Graham, is a recognized author, physician, and entrepreneur with a passion for bringing reality to unacceptable issues about medical practice that demand attention, alternatives, and debate. His desire to make doctors think beyond the boundaries of usual thought is secondary only to his mission to reveal the consequences of having a fixed mind unable to benefit from experience, knowledge, and wisdom.
Learn from his medical publications what isn’t taught in medical schools and that you must know today to maximize your potential and capabilities.
Click here now   to learn how to reach your maximum medical practice potential.  
©Copyright Curtis Graham, M.D., All Rights Reserved.  

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2. Dr. Graham's Practice
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3. References.

4. Articles Library.

5. Practice Ideas And Tips.

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7. List Of My Medical
    Business Websites.

8. Humor.

Profitable Practice Tips

1. Medical school grads make less than business school grads and take on far more risk. Is this model sustainable?

2. Safeguarding patient info.

What doctors have yet to adopt is the idea of carrying two different wireless data and  communication devices as the best means of securing patient data.

Investment bankers long ago learned that encrypted security data of mobile devices like a Blackberry (now out of business). There is software available for phones and tablets for security of business applications---and now even for newer devices.

A cell phone for personal use is good to carry as well.

Frequent changing of passwords, messages to scare intruders, and changing information into different formats such as Word and Excel no longer protect sensitive information.

3. Using the HTML code of "https" instead of "http" on your website domain URLs for your communications about patient information, provides additional security.

Borderless Humor

"If you don't learn to laugh at trouble, you won't have anything to laugh at when you
are old."

Goals - Plans

You need to be reminded about the increasing numbers of doctors who move each year-- 14% according to surveys by the AMA and others.

Your due diligence in choosing your practice location must be thoroughly researched long before you start your private medical practice.

Your choice of an employed position also requires intensive investigation.

Inspiration Time

To find what you seek in the road of life, the best proverb of all is that which says: "Leave no stone unturned."

---Edward B. Lytton

Views I Only Share With My Friends--

What my medical career taught me.......
Click Here... and how it can help you manage your medical practice business at the highest level of expertise.

 Facts And Stats

1. WSJ 7-22-12 reports a 3% acceptance rate at medical schools, implying there are huge numbers of those applying to med. school.

Harvard accepts 163 students for their class each year out of about 5000 applicants.

What Your Kids
Are Capable Of-

Permit and help your kids to become assets....

When you want to understand what your modern day kids are capable of and have the ability to do, regarding starting a business of their own, then hit the link below and give yourself a dose of inspirational enlightenment.....



New Important

Protect your practice using the strategies in this
  Ebook, w hich  contains the keys to your medical practice survival.

"How To Rapidly Propel Your Medical Practice Income To Unlimited Levels In 6 Months"
Click Here When you need expert help and advice, and when........

red checkmarkyou just don't know where to turn to get honest and reliable help with your battle to fight the external forces that compromise your practice revenue and growth.

red checkmarkyou want to improve your medical practice income dramatically in a short period of time.

red checkmarkyou prefer to find the means to reach your highest level of practice income and productivity.

red checkmarkyou demand effective and reliable means for preventing the financial collapse of your medical practice.

red checkmarkyou are determined to find ways to combat govt. fee restrictions that continue to increase.

red checkmarkyou recognize that what you are missing in your medical business are implementation of business principles and marketing strategies.

red checkmarkyou want to do it yourself and save a bunch of money.

red checkmarkyou are sick and tired of putting up with what you are being forced into doing with your practice to stay afloat.

red checkmarkyou are aware that no other physician author is making any effort to tell you what to do and how to do it effectively to reach your expectations you had for your medical career when you started.

red checkmarkyou understand the severity of being in a business without ever being taught the business knowledge to run it profitably.

red checkmarkyou insist on having a blueprint for your medical practice business that provides every key to your practice success at the highest level. 

References For Maximizing
Outside Income

best references for doctors who invest.......

For Investing advice:


2.The Palm Beach
   Letter--Mark Ford

3. Retirement Millionaire Newsletter.......
published by David Eifrig Jr., MD, MBA, Ophthalmologist, stock  market expert. (my choice)

call 888-261-2693

Note: I have no personal or business connections with these references other than subscriptions to their publications.  I suggest them because I do think they have unique value for investors.  You decide.

My Other Medical Websites







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   photo of Dr. Graham and his two corpsmen in Vietnam 1965     photo Dr. Graham 1970's        photo of Dr. Graham's wife Linda        photo Dr. Graham--1990's        photo of my OBG medical practice group

Flight Surgeon Vietnam 1964-65

Diet Worked 1980

 My Wife Linda

Retired 1999

Our Medical Practice Group
Graham, Mayo, Kaplan, Seibert, DelValle, Chuba

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Curt Graham, M.D.
2404 Mason Ave.  Las Vegas, NV 89102
E-mail = cgmdrx(at)gmail.com
      © 2004-2015  Curtis Graham, M.D., All Rights Reserved.