Financial Engineering



Ever wonder how your health system can afford all the buildings, equipment and sky-high compensation for the leadership while personnel cuts and “upgrades” to your EMR slows you down to the point where your productivity is less than half what it could be?



The term you’re looking for is “financial engineering.”



It’s the business strategy of increasing profitability without increasing productivity within a business organization.



Think of it as using the primary business as a front for less visible activities which actually drive profits.



Banks are a great example of this. They don’t make money making loans and holding deposits, They make money by being part owners of the Federal Reserve and reaping the steady, safe dividends.



Car dealers don’t make money selling cars, they make money selling and working service contracts.



And your employer doesn’t make money on your expertise either. The margin on selling your expertise may seem large to you, but it’s not nearly big enough to satisfy your employers.



Your labor merely provides cover to drive revenue to your health system’s high margin service lines—cosmetic services, patient information, and real estate.



You’re a cost center to them, not a revenue center.  That’s why they don’t really care about your productivity—only your expenses.



Unfortunately for you, your labor is all you have to sell.



You’d do better if you sold it in an open market.



Use your employer for debt reduction through loan repayment and as an apprenticeship to help you make the transition out of training.



After a few years, move on.



Telemedicine. Cash-only practice. Locum Tenens. There are options everywhere.



And the clinicians who take advantage of them are far less miserable than those who are employer.



Don’t let yourself be used.



You’ve worked too hard.