What Doctors Don’t Understand About the “Value” of the Service They Provide

Confession: I spend quite a bit of time on Twitter. I use the platform as a tool for research. I believe that Twitter is the closest thing that we have as a society to show us what people really think and believe, unfiltered.

A while back, I got into a bit of “rap battle” on Twitter with a few doctors. It didn’t start out that way. I was actually being supportive of a doctor’s position and the doctor took it way wrong. And then the other doctors piled on. (It’s ok, I won in the end.) That “rap battle” is what has led to this blog post.

Throughout the last 20 years or so, I have gained a lot of information and insight into how doctors really think about, and understand, various topics and subjects. Yes, Twitter is a great tool for this. But the greatest amount of information and understanding has come through personal relationships with doctors as a business partner, advisor, consultant, coach, or friend.

Here are just some of the many things I have learned about doctors:

  • Most doctors are upset about the way the current “system” works, and have been for some time. A few doctors are becoming vocal about their frustrations anger
  • Most doctors don’t understand the power they they have
  • Most doctors complain about “mid-levels” – NPs and PAs – doing the “same” work as doctors, but have 18,000 hours less training
  • Most doctors maintain a strange combination of ignorance and arrogance when it comes to things beyond their understanding and training
  • Most doctors have no understanding of basic economics, especially as it relates to “value.” More specifically, most doctors do not understand their value in the marketplace 

This post is about helping medical doctors see what their true value is in the market place. And, it has very little to do with their 20,000 hours of training.

Because those 20,000 hours include 0 hours of basic economics, we must start with a basic lesson. 

The economic theory of value attempts to explain the exchange value of goods and services.

Without going into great detail, there are essentially 2 main, and opposing, theories of economic value:

  1. Intrinsic (or Objective) Theory of Value – This theory holds that something has value “just because” or because it “just is.”
  1. Subjective Theory of Value – This theory holds that value, like beauty, is in the eye of the beholder. Yet, it doesn’t matter how beautiful you think you are; it’s about how beautiful others think you are.

Most doctors tend to believe, without thinking about it, that their value to society is intrinsic. I know this because the doctor’s default argument is always to point to the “20,000 hours” of work they did before become a “Doctor.”

This belief is similar to a subset of Intrinsic Theory of Value known as the Labor Theory of Value. This theory asserts that the value of a product is determined by the amount of labor required to produce it.

However, this is not how the marketplace actually works. Your value to others – whether as a person, business, or product – is not based on what you believe it to be, but as to what others perceive your value to be. How important are you to them?

Value is neither determined by any inherent property of the service you provide nor by the amount of labor to produce your service.

Now don’t get me wrong…I am NOT saying that the study, training, and 20,000 hours of supervised care doesn’t matter. It really does. This is where expertise begins. (True expertise combines training and experience.)

But if you truly believe – even after reading this blog and studying some basic economics on your own – that TRAINING is what gives you value in the marketplace, then you will never understand why your vocation continues to lose validity. (Why are you working more hours and have more responsibilities than you used to while your pay – real income – continues to decline?)

If you are a doctor reading this and you are willing to consider a different view than your own, consider this:

  • In the marketplace, the consumer is ultimately sovereign. That is, the one who pays for a service decides what the service is and how much they will pay.
  • Most people – patients – want a physician, not a “provider.” (A physician is one who is skilled in the art of healing.) The same cannot be said for hospital administrators and insurance companies.

If you want to go further with your introspection, consider these questions:

  • Are you a physician or a provider?
  • Who is the consumer of the service you are providing? Is it a hospital/insurance company or is it a patient?

If your consumer is NOT a patient – and if you’re being replaced by Physicians Assistants and Nurse Practitioners – you are seen by hospital administrators and insurance companies as a white collar factory worker – an interchangeable part – and provide no more value to THEM than a Physicians Assistant or Nurse Practitioner. 

Are you a physycian trying to navigate the complexities of business ownership?

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