Making Hay While the Sun Shines

Ten to 15 years ago, first as a med student and then as a resident, I got accustomed to hearing attending radiologists talk about how the Golden Days of their profession were gone or fading fast. Costs were rising, reimbursements were dropping, rules and regs were getting more onerous, and so on.

From my perspective of miniscule paychecks, oceans of educational debt, and routine call coverage, the post-training world looked like a great place. I recognized that the attendings might well have experienced even better times in the past, but it seemed pointless for me to mourn a paradisiacal past which I had personally never experienced. Indeed, if there was a cycle of boom-and-bust, I could hope that, as good as I expected to have it after graduating, things might cycle upwards and get even better later on.

That doesn’t seem to have happened. To the contrary, the past decade has brought one bad radiological tiding after another. The good news seems to be limited to instances when previously-predicted bad news doesn’t actually come to pass.

Being a doom-and-gloom pessimist doesn’t make one the life of the party, but it’s a little more adaptive than being a Pollyanna. At the very least, one can mentally steel oneself against what is to come. Preferably, one takes measures to weather future storms, a la Aesop’s ants as opposed to his grasshopper.

So, for instance, if you know that you’ll later have to work twice as many hours (and/or read twice as many cases) to get the same paycheck, you might be inspired to crack the whip on yourself a little more harshly now, before times get tougher. Squirrel away the earnings while you can get them, knowing that, when reimbursements get bad enough, you’ll be better equipped to take the hit to your personal revenue. Perhaps even sufficiently to say “the hell with this, I’m retiring early,” and get off of the merry-go-round completely.

Not everyone’s work environment allows for this. If you’re getting a fixed salary in exchange for whatever work crosses your desk, for instance, and you have a “no moonlighting” clause in your contract. One of the things I like about teleradiology is that there is almost always more work to be had, if you have the time and inclination for it. I tend to take a day out of most of my 26 “off” weeks to do an extra shift.

There’s another kind of hay to be made while the sun is shining, however-the sort that doesn’t show on a balance sheet. Simply put, live a little: See friends and family, go on vacations, and indulge in the things that you actually enjoy. Especially early in a career, this seemingly commonsense approach often gets short shrift. You’ll hear newly minted radiologists boasting of how they’re going to kill themselves working huge numbers of hours to sock away a small fortune - and they’ll scale back “later.”

Except “later” has a way of receding ever further into the future. Meanwhile, those friends and family you didn’t see as much as you’d like have gotten older or moved away. Your own health and mobility might not be as good as they are now; those plans you’re currently shelving (say, to backpack in the Himalayas) might never come to pass because, by the time you allow your work to slow down, you’ve gained a bad knee and diminished cardiopulmonary function. Reclining poolside in the Bahamas might be the best you can do. Forget about the declining health - maybe it’s just that after 10 years of killing yourself with extra work, you’ll no longer have the oomph to embark on big adventures.

I think that most folks could probably use a bit more of the former type of haymaking than the latter - especially those who overextend themselves by purchasing the biggest house, car, or boat they can afford, living at the upper margin of their means, and then having no reserve built in for when times get tougher. Perhaps the more educated among us (including highly-trained physicians) would be less likely to fall into such traps, and more inclined to over-prepare and make themselves miserable along the way. To those so inclined, by all means, make as much hay as you wish while the sun is shining. Just be sure to enjoy the sun, too.