American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Coping with Financial Distress

Cynthia Talley, MD, FACS, vice-chair of education and associate professor, division of general surgery/trauma acute care, Medical University of South Carolina, Charleston, and member of the American College of Surgeons Young Fellows Association outlines the struggle to maintain financial security.

Being a physician and a surgeon is a blessing. We create special bonds with our patients, make them more comfortable by eradicating their disease or providing palliative care—and we work with a wonderful team of professionals to make it happen. It truly takes a village to provide the best quality, safety, and compassionate care for each patient. There will always be sick patients, with hospitals and providers to care for them. I have never worried about job security in my profession until now.

During the COVID-19 pandemic, hospitals are being forced to adjust their operations, resulting in a significant loss in revenue. Elective operations at my center were canceled, and many centers during the surge stopped urgent and emergent operations as well. The ambulatory volume, and even inpatient volume, were negatively affected. How should a hospital cope with this crisis?

Meanwhile, physicians are working hard to establish safety protocols, adjusting call schedules to cover new clinical needs out of our comfort zone and putting ourselves at risk of exposure to a deadly virus. We worry that we are bringing the virus home to our families as asymptomatic carriers, wondering when the personal protective equipment will run out. This is an extremely stressful time for all frontline providers and for others wondering when they will be called to serve.

As a physician, my lifestyle is comfortable; I don’t worry about how the bills will be paid. However, I never forget that I come from humble beginnings. Many of my family members still struggle with poverty. Unfortunately, some hospitals are using furloughs and salary cuts to deal with the financial crisis. Hearing that our care team partners have been laid off and that others, including medical directors and program managers, were dealt salary cuts, I feel terrible. While I worry about my friends, I am anxious about my own situation. I called my financial advisor in distress. I had been so good at saving for retirement, a fund that is now being gutted by the economic downturn. But I had never considered emergency funds that would cover a furlough or a salary cut. Suddenly, I feel ill-prepared and vulnerable, remembering childhood struggles. Thankfully, I found a bank that provides special products for physicians that gave me more piece of mind. Why do I get this privilege, when others less fortunate do not?

This pandemic forced innovation in a positive way and led many people to perform compassionate acts for their neighbors. But it also unveiled vulnerabilities in our emergency preparedness. Hearing from a senior surgeon that I should make sure my affairs are in order just seemed prudent. We train for this situation and expect some gaps in preparedness. I had not considered my vulnerability to be financial. Stay safe and healthy my friends so we can endure and get the band back together.