Brian Coates

Trauma Surgeon / Dad / Runner

[White Coat Investor @WCInvestor]

Do doctors owe society for the cost of their education and training?

Hot take: Docs don't owe society anything for that.

Even if they did, everything you earn as a doctor gets taxed at ordinary income tax rates, and usually the highest tax rates. And every bit of that income (barring an S Corp being involved) is taxed at 2.9-3.8% for Medicare. It doesn't take very many years of that to pay back the cost of your residency to Medicare.

For some bizarre reason, you never hear this about any other profession. Nobody says lawyers have to work 80 hours a week until they're 75 because society educated them. Nobody applies this to engineers, astronauts, pilots, teachers, judges, or anyone else that society helped to educate. You don't even hear it about nurses. Just doctors. And interestingly, almost entirely only BY doctors. Maybe it's time to quite shaming each other into a burnout-inducing amount of work.

Yes, there are workforce issues involved when doctors work less or retire early. Yes, there are patient access issues when doctors adopt a concierge model or decide not to see 7 patients an hour. These are very real, complicated problems. But they are problems for our entire society to solve, not problems that can or should be solved by doctors alone. Anyone who thinks these are easy problems to solve doesn't understand the problem. But doctors can't take the entire medical system on their shoulders and carry it to the promised land.

If you want to go part-time, have a baby, start a concierge practice, take Wednesday afternoons off, cut back to full-time, retire early, or leave medicine all together, go ahead and do it.

You should feel no guilt about doing so.

You don't owe anything to society.

Do you think doctors should be required to continue working full-time and forever? Why?

[Brian Coates @1coatesbrian]

@mechang22 @UofAZSurgery @ImanGhaderi @ValNfonsam @TaylorRiall @lilahfran Congrats!!

[Anthony Scaramucci @Scaramucci]

“You are a nobody until somebody hates you.”— Tom Wolfe

[Dan Orlovsky @danorlovsky7]

The harder thing to do and the right thing to do are usually the same thing

[Brian Coates @1coatesbrian]

@DrNasrien But ur whole message on social media is and has been equity. Specifically equity as it relates to access to healthcare. Trolls be damned Keep doing inspiring things

[Ryan Clark @Realrclark25]

Don’t fatigue yourself so much that you can’t be the source of your own happiness, source of joy. There are non negotiables in life, & responsibilities that are inevitable. You can’t allow those things to wear you down to the point where you depending on ALL outside factors to provide internal peace.

Ultimately man will let you down. Whether it be significant others, friends, family, hell even your favorite football team. It’s not that you can’t count on people. It’s that you never want to be in a place that they’re your only sense of joy. God will provide what you need in many forms, and one of those forms is help mates, but we can’t allow things we can’t control to control us!

@thepivot kick back!!

https://t.co/8ifLCpuKJG

#Happiness #Joy #Peace #Love #ThePivot

[Elliott R Haut, MD, PhD, MAMSE @elliotthaut]

EVERY doctor should read this article about the mental health challenges for physicians. Our work is demanding. We have all lost friends/colleagues to #Suicide. We need to be more open about the topic. @lubitz_carrie @guardian @AcademicSurgery https://t.co/nCHublcZXz

[Dan Orlovsky @danorlovsky7]

🙏

[Brian Coates @1coatesbrian]

Anyone who truly believes in American exceptionalism has never been on a European high speed train

[Brian Coates @1coatesbrian]

@FedeSerrotMD @EmorySurgery @CleveClinicFL @ccmartinhealth @AmBdSurg @SAGES_Updates @LatinoSurgery @AmCollSurgeons @EdLinEmory @AnkitPatelMD @RaulRosenthalMD @YANKEEDOC44 Congrats. That’s fantastic.

[Brian Coates @1coatesbrian]

@TommyTranMD Congratulations. Outstanding group of surgeons

[Brian Coates @1coatesbrian]

@JosephSakran @WesternTrauma @prytimemedical Science should be presented. No industry needs to be allowed a preemptive response…..how would that change data? Respect to @WesternTrauma and @topknife

[Brian Coates @1coatesbrian]

@VirajPandit @mikeditillo @NKulvatunyou @Lokhandwala There is room and a need for both of these highly trained specialists to provide surgical care in these trauma patients. Who does what and when depends on many variables. Important concept is that we work together with respect and collaboration. If we do that patients win.

[NYT Health @NYTHealth]

From @nytopinion: “Many physicians are now finding it difficult to quash the suspicion that our institutions, and much of our work inside them, primarily serve a moneymaking machine,” writes @_Eric_Reinhart. https://t.co/pJ3jUyunbX

[Brian Coates @1coatesbrian]

@topknife There is real opportunity for a forward thinking leader in trauma and acs to develop a robotic program within their trauma acs fellowship. Many places utilize robotics in emergency general surgery. Could produce very well rounded surgeons. I wonder if u know of anyone 🤔

[Brian Coates @1coatesbrian]

@PipeCabreraV Old people tolerate operations. They don’t tolerate complications. Sigmoid colectomy end colostomy equals A few more birthdays.

[Lex Fridman @lexfridman]

"In three words, I can sum up everything I've learned about life: it goes on." - Robert Frost

[Dez Bryant @DezBryant]

WE NEED TO CANCEL @RealSkipBayless ASAP!!!

[Robert Griffin III @RGIII]

Please don’t share the video of the Damar Hamlin play. Share this because we are all Praying for him and his family.

[Wajahat Ali @WajahatAli]

.@NFL needs to cancel and postpone this game, man. Come on.