How to Make Yourself Unbreakable

You can’t be serious?  Like many of you, hearing one of the largest hospital systems in Oregon dumped Oregon’s biggest anesthesiology group was shocking.  Most of my readers were either directly impacted by this decision or knew a friend or colleague affected.

For many physicians, this was their first time experiencing the “It’s not personal, it’s just business” side of medicine.  Here was another example of healthcare systems choosing profit over patient safety.

The first thing I want to say to all my friends and colleagues impacted by this terrible and short-sighted decision is I’m sorry this happened. So what’s next?

How can an anesthesiologist make themselves unbreakable in these times of hospital consolidation, decreasing reimbursement, and continual uncertainty?

How can you feel safe and financially protect yourself and your family?  While I don’t have any magic sauce to prevent you from losing a job or contract, I have some thoughts on wealth and protecting your downside consequences.

I don’t recall when I first read about the multiple types of wealth, but I remember the concept immediately resonated.  The basic idea is that wealth encompasses more than simply money.  In fact, there are several forms of wealth we’ve discussed before in the newsletter.

  • Financial –  The default form of wealth partly because it’s easy to measure and track. Also, it is easy to compare how you are doing to others.
  • Health – This might be the most essential form of wealth.  If you lose your health, you may not get it back.  And all the money in the world won’t matter.
  • Relationships – Another critical form of wealth.  This could be your family, children, and close friends.
  • Knowledge – The skills and education that allow access to certain types of work.  Also, continual curiosity, learning, and growth.
  • Time – Controlling how you spend your time and most importantly, your attention.

Once you understand all forms of wealth, you recognize money is but a small part of your overall wealth and well-being.   So how can we use these varied forms of wealth to make ourselves more resilient?


Two straightforward steps to create more options and less financial stress are paying off your non-mortgage debt (student loans, auto loans, and credit cards) and building a reserve fund.

It wasn’t that long ago, in the early days of Covid that we all lost our clinical work.  Poof – our work evaporated overnight.  Losing a job has similar characteristics – high stress and some fear mixed in, loads of uncertainty, and unsure how this will turn out.

While saving in a reserve fund is never sexy, you will be grateful for that cushion when you need cash.  What are you buying with these reserve funds?  Time.  Time to make better decisions for you and your family.  Time to find a job you enjoy in a place where your family is excited to live.  Time to grieve what was lost.

The other lever to pull is increasing your income.  There is a natural limit to how much you can save.  However, you can almost always increase your income.  Today’s anesthesia market has huge signing bonuses, student loan repayment, and increased salaries.  Now might be the time to think about a new job.


I lost my best friend (and a helluva good anesthesiologist) to brain cancer almost five years ago.  I can’t count the number of days I spent skiing and mountain biking in the Wasatch with Ryan.  He was always playing in the mountains.  Not a week goes by that I don’t miss him. And all the money in the world won’t bring him back.

Whether playing catch with your children or taking a bike tour through Spain, your health is integral to your happiness and well-being, both now and in the future.  I love Peter Attia’s description in his new book, Outlive, of the Centenarian Decathlon.

Peter talks about wanting to travel – so you’d need to be able to lift your luggage into an overhead bin.  Or playing with your grandchildren – and the ability to get up off the ground by yourself.  Start thinking about protecting your heart health and muscle strength today!


Losing a job can be a massive hit to one’s sense of self.  Having strong and supportive relationships is crucial for navigating this period.  Friends and family can support and love you.  This can come in a variety of ways.  Relationships are built on trust, vulnerability, and a whole lot of time.

This is also a critical time to reach out to lean on your network of colleagues you’ve built over the years and ask for help with your job search.  Anesthesia is a (relatively) small community.  It’s rare to need more than two degrees of separation to find someone you know in a practice or department you want to work.


I’ll end with what I’m realizing is our most valuable asset –  the importance of time.  We all have a limited amount of time here on Earth.  How are you spending your hours and days? What are your highest values and purpose?  Are you spending your time and attention in ways that align with your values?  I’ll be the first to admit I am still navigating this and figuring it out – especially as a new father.

While I don’t advocate this as your first step after a job transition, I advocate you take a moment to evaluate what you want your life to look and feel like, and then create your work life around those needs.  A job transition can be sudden and unexpected. Start spending some time this week building up your resiliency and making your life unbreakable!

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