Some men wrest a living from nature with their hands; this is called work.
Some men wrest a living from those who wrest a living from nature with their hands: this is called trade.
Some men wrest a living from those who wrest a living from those who wrest a living from nature and with their hands; this is called finance.
This old British epigram was quoted by John C. Bogle, founder of the Vanguard group.
From my experience, I would add the fourth statement:
Some men wrest a living from those who wrest a living from those who wrest a living from those who wrest a living from nature and with their hands; this is called government.
Each next group is being fed by the work of the previous one.
So where we, doctors, fit in this scenario? We, together with lawyers, teachers, engineers, accountants, and clergy, are professionals and in service business. Our business doesn’t involve creating goods.
I just calculated the amount of money I received from the surgical procedure I did in a hospital. After subtracting office overhead, federal, and state taxes it came down to less than 20% of the original amount fee paid by insurance company. It’s not good, not bad, just the way it is.
And nobody will listen to doctors complaining about it.
