When I graduated fellowship in the mid-90’s I opened my own practice. I rented an office, hired a staff and saw children. Everything was fine until one day my office manager came to me and said there wasn’t enough money to pay me. Accounts payable had exceeded accounts received.

My son (now 18) was a few months old at the time. I had to walk into my house and tell my wife that I didn’t have a paycheck. I tightened up my processes, looked at my costs and it never happened again. I figured out that running a clinical operation is a big deal and, as my father used to say, money doesn’t grow on trees.

Coming home without a paycheck changes how you see things. Few doctors who haven’t been responsible for their own operation understand the realities of cost of care. We more often show up and complain about the folks who make the hard decisions to keep the lights on.

Try going home without a paycheck. It will begin to make you accountable. If you don’t have skin in the game then you’re not really playing.

Image via Flickr.