In these times of record rates of nurse and physician burnout, private equity takeover of medicine, patient violence against providers, and overwhelming bureaucratic oversight and paperwork requirements, it's all too easy to believe that healthcare has become the most physically and emotionally taxing profession.
Chronic disappointments, setbacks, and obstacles to putting patients first are contributing to a growing physician shortage that is projected to swell to according to the Association of American Medical Colleges.
Who can blame young people for choosing other occupations? The downstream effects of seismic changes in healthcare include reports of patients in the primary care system and in providers themselves. The crisis of confidence affects not just doctors but nurses as well -- nurse job openings are expected to than all other occupations through 2026.
All of this has had me wondering whether I'd still choose a career in medicine if I were to do it over again. Either way, I can definitively say what my other career choice would not be: show business.
Betting on the entertainment profession as a path to fame, fortune, and work satisfaction is about as safe a wager as buying a Powerball lottery ticket to pay off millions in personal debt. Which brings me to one of the most successful show business professionals today: Taylor Swift.
Let me declare that I'm not a "Swiftie." Yet, I believe that had Swift gone into medicine instead, she would be a super-star in that profession. This is because her stardom springs from three powerful forces applicable to healthcare: active listening, over-delivering, and persistence.
Swift is world famous for concerts so electrifying that fans will pay as much as . A big reason is that she listens to her fans in unique ways.
For example, she is active on social media. During her 1989 era, she was known for to followers' posts on Tumblr, , and expressing gratitude for their support. In addition, she has organized "secret sessions" in which she invites a select group of fans to an exclusive listening party before the release of a new album. These events serve as focus groups for gathering reactions to her new music and making tweaks.
She also hosts fan events and meet-and-greets during tours, meeting fans in person, allowing them to ask questions and share their experiences. From all this she knows fans' expectations intimately, and she delivers on them.
Similarly, had Swift gone into medicine, chances are she would have a firm grasp on the expectations of patients, colleagues, and referring physicians. She no doubt would be at least occasionally active on social media and on rate-your-doctor websites in search of addressable themes in patient needs and wants.
Like the secret sessions, from time to time she might also conduct informal evening gatherings of small patient groups to keep a pulse on shifting patient sentiments in changing times.
She would uncover ways to exceed patient expectations, just as singer/entertainer Swift now exceeds fans' expectations. She would find ways to ensure staff answer the phone in three rings and the caller speaks to a human. She would endeavor to make sure all calls and emails are returned by someone in the practice within 24 hours, and that each patient has all questions answered at the end of an appointment. She would further avoid slotting each patient into a 15-minute appointment, and instead provide appointment times based on the medical condition and the patient's personality.
Eye roll check: Because as much as are now hospital system or corporate employees, many of you are no doubt scoffing in protest over a lack of control over these matters.
Then, I say, ask yourself: what would "Dr." Swift do?
I believe she would find a way to gain more control. After all, record producers, record labels, and concert promoters often exert commanding control over entertainers, too. They typically tell the artists which songs to record, how many concerts they must perform, and how many tickets and recordings they must sell. This is where persistence comes in.
Fact is, star performers earn respect and power by persistently giving powerful performances. In her concerts, Swift performs non-stop, singing 44 songs to stadiums of 70,000+ fans for 3 hours. She changes outfits frequently and executes well-choreographed dance routines against constantly shifting unique backgrounds.
The intensity of her planning, practice, and attention to detail are evident to the audience. From the concert's opening moment -- when a large clock counts down to her entrance -- to the final scene where she is seemingly swallowed up by the stage, Swift persists to outperform others who aspire to uber stardom.
Her persistence is conspicuous in the Netflix documentary, "Ms. Americana." In one scene she is waiting by the phone to hear if her recent album, "Reputation," was nominated for the Grammy Awards. Her publicist tells her she was not selected, and you feel her disappointment. "You know what? This is fine," . "I just need to make a better record."
Previously, in 2016, she had a public dispute with artist Kanye West and Kim Kardashian and felt "canceled," -- a moment she herself called "." Swift could have made excuses about how she was unfairly treated by the media and the West dispute. Instead, she rallied -- just look at where she is today.
The years following "Reputation" became her most prolific period. She produced eight albums and won a Grammy for Album of the Year (Folklore, 2021); American Music Awards' Artist of the Decade (2019) and Artist of the Year (2018, 2019, 2020, 2022); Billboard's Woman of the Decade (2019) and Top Female Artist (2021). She celebrated by launching the most successful tour in music history, grossing to date, and will be wrapping up an international tour in 2024.
Her persistence demonstrates that success isn't from doing one thing 1,000% better, but from doing 1,000 things 1% better. Taking action does not come from motivation alone; motivation comes from taking action. When a setback arrives, we can retreat, or we can shake it off and keep moving.
One phenomenon I've witnessed repeatedly in many years of practice is that star healthcare performers eventually gain the respect and freedom from bureaucratic micromanagement through high-performance listening, over-performance, and persistence. With apologies to F. Scott Fitzgerald for twisting his words, they succeed by beating on, boats against the current, borne ceaselessly into the future.
Neil Baum, MD, is a urologist in New Orleans, the corporate medical officer of , adjunct professor of the Tulane University School of Medicine in New Orleans, and the author of The Complete Guide to a Successful Medical Practice.
Disclosures
Baum has no affiliations with any pharmaceutical companies or medical device companies, and has had none for years.