I just got off the phone with Paul, a highly-sough-after plastic surgeon in New York.
“I don’t want to be a doctor anymore,” Paul says. “What else can I do? I have lots of restaurant experience. I’ve worked in 15 restaurants during my life. It’s not easy but I could do it. I did research on chains and franchises and I chose Chick-fil-A. Three months ago I applied to be an owner/operator. I got through the first application and got declined the second round of applications. They are extremely picky. Nearly 20,000 apply and only a few are chosen.”
I’m shocked he was declined.
“It wasn’t a crushing blow,” says Paul. “The Chick-fil-A people were really nice. For whatever reason they rejected me, I don’t hold it against them.” His wife (also a physician) believes he didn’t get the job because he’s a doctor. Is a plastic surgeon overqualified to run a Chick-fil-A?
Apparently Chick-fil-A handpicks each operator after a lengthy interview process. Then they must go through a rigorous training program for months. Yet Paul survived 4 years of medical school, 5 years of general surgery and is board certified. He also did a trauma and critical care fellowship and then 2 years of plastic surgery residency. He completed 12 years of his training in 2002 and now has 16 years of experience. He should be able to run a Chick-Fil-A. Right?
Apparently they won’t allow an applicant to have a medical practice and a restaurant. You have to be an owner operator full time (which is what Paul wants to do). Surprisingly, you don’t need any restaurant experience to open a Chick-fil-A. I asked Paul why he plans to leave plastic surgery for fast food.
Paul’s top 5 reasons for leaving plastic surgery
1) Tired of nasty patients. He’s disgusted by entitled, shallow, superficial patients.
2) Challenges of a private practice. He’s got headaches of owning his office condominium as well as having to pay ever-increasing fees for DEA license, taxes, staffing, certifications and a constant array of government regulations that are absolutely oppressive. He’s constantly getting nickeled and dimed.
3) Fighting for insurance reimbursement. Insurers pre-approve procedures and then decline payment. Paul’s currently fighting 3 different claims for bilateral breast reconstructions. They agreed to pay $10,000 ($5,000 per breast) then after they paid him they said they’d only cover $7500. Insurance company is now demanding he reimburse them $7500 ($2500 per case). “Nobody cares if a plastic surgeon gets paid,” Paul says. “Nobody gives a shit.”
4) Medical malpractice threats. Paul is in the middle of his first malpractice case now. Revision of breast reconstruction. Very common. Nothing had gone wrong. Patient is threatening. He’s trying to help. “Even if I legitimately make a mistake,” Paul says, “I’m trying to help you. And you are trying to extract money from me.” Not only would Paul have a big payout, he’d be publicly humiliated. Physicians are seen as lottery tickets. Patients get big settlements in court. Nobody feels sorry for doctors who get sued. “I don’t want to be anyone’s ticket to overnight riches,” Paul says.
5) Declining income. Paul can no longer pay expenses some months. Not drawing much of a salary. Thankfully he’s got a lean practice with low expenses so he’s scraping by for now.
Paul’s top 5 reasons for wanting a job at Chick-Fil-A
1) He could have his own business. “I want the joys of owning a business without the hassles of constant medical micromanagement and regulation with fear of lawsuits, expensive regulations, and inability to cover expenses.”
2) His income would go up. Chick-fil-A franchises require a $10,000 initial investment to become an operator. Paul paid more more than $200,000 in student loans to become a plastic surgeon. People will pay cash for their own chicken breast sandwich. No revisions. No reimbursement woes. And he won’t have to worry about customers coming back demanding refunds months later.
3) He could really be the boss. “Doctors are not the boss (even in private practice),” Paul laments.
4) Easier to take vacation. He could put a manager in charge and won’t have to rush in when someone is sick. More than once he’s tried to be on vacation and had to rush home for a post-op infection or had to call meds into a pharmacy while away.
Good news! Chik-fil-As are closed for business on Sundays and well as Thanksgiving and Christmas. So Paul would actually be able to enjoy holidays and free time to himself like most non-physicians do on weekends.
5) Life would be less stressful. Having worked in restaurants his entire life, Paul knows it’s very stressful. “But nobody is going to come sue you and drag you into court. You are not worried about someone dying and listening to a jury tell you what a horrible person you are.”
What’s Paul’s real problem?
Paul is looking for a low-risk exit strategy. So he chose something he knew—the restaurant business. (I admit I’ve had escape-medicine-to-fast-food fantasies myself) .Was Paul acting from a place of courage? Not really. He was acting from a place of fear—trying to mitigate and control risk so he completed the application honestly.
When physicians answer applications honestly in regard to exit strategies (whether leaving medicine or leaving the planet due to suicide) it’s probably not going to go so well. And it didn’t go so well for Paul because even Chick-fil-A does not want someone who is torn between two worlds, who is operating with one foot in the medical field and one foot in the food industry.
So he was turned down.
My advice to Paul would be decide how much risk you are willing to take. Is it risky to leave medicine? Of course. Yet you are taking a risk every time you go into a surgical theater for a breast reconstruction. You are taking a risk every time you treat an entitled patient. Every time you talk to a patient you risk being sued. You are nervous, tense. You were hoping to jump from the risks you know that are untenable and take a risk with Chik-fil-A that you felt was less risky.
It doesn’t work that way. If you really, really want out of medicine, then leave. Apply to your franchise of choice, complete the application as someone who is 100% dedicated to a new career and you increase your chances of becoming a successful franchise owner.
Most physicians make fear-based decisions. Yet successful decisions are based on true desire. Pursue your dream. Don’t run away from your nightmare. If your dream is to practice medicine here’s my best advice: hang out with doctors who are loving their lives. Learn from them. Model what works.
I personally do not think it was Paul’s credentials as a surgeon.
Chic E Filet is a Christian based company and have their own beliefs. Perhaps his beliefs and the company’s belief’s were not a good fit.
I have known other companies like Hardee’s who have let a doctor franchise a business.
It all depends on the beliefs of the company and the person who is seeking to run a franchise business.
If it is not a good fit the franchise may fail.
I would suggest for Paul to try a different restaurant to franchise or perhaps find a Mom and Pop restaurant to purchase.
Sorry to Paul for not being able to get the owner/operator license THIS time. He might want to try again another time. Also since Chick Fil A did not expressly state the reason for which he was declined, we should not make assumptions. He is capable of being a surgeon may not have translated into being a savvy business owner or it could be something else. The only way to know would be to ask, that is if they are willing to tell him.
Hello Plastic Surgeon!
I read your article with great interest. I am an RN. My career is not the same as being a physician, but I know what you are talking about.
About 10 years ago, we moved to another state. We lived close to a major national hardware store. They were hiring since the store had recently opened. Well, in high school I worked as a cashier and have had much retail experience. When I went to the interview, I was honest and said that I had been an RN and graduated from a 4 year program. The interviewer immediately was very defensive. The sense I got was that he felt I was “overeducated” for a job in a hardware store. No, I wasn’t hired.
Several weeks later, I met a retired gentleman who had a post retirement job at McDonald’s. He also held a PhD degree from a major university. He said that when he applied for his job, he only listed his education as being a high school graduate. Otherwise, he knew that he would not be hired. Hey, he had the right idea.
As it turned out, I found a job in a department store, only listed my education through the completion of community college. I was hired.
So it goes. Some places are threatened if you have a college degree. But not all places.
Never never give up!
Can somebody explain the mystery here in which many practicing doctors truly complain about their work and want to leave the profession while every year thousands of doctors are dying to get into residency to no avail for lacking available positions?
I think of two factors that are playing negative role in Paul’s situation based on his specialty, 1- He is dealing with many unreal patients who for all intensive purposes are perfectionists. 2- The insurance has big room for maneuver for denying payments based on the notion that the surgeries or the procedures are medically unnecessary.
Paul has two advantages over those doctors who did not get residency and who for all intensive purposes can’t get meaningful job :1- He may have some capital. 2- He has license therefore, I like him to think about practicing as primary care physician in some clinic or urgent care and I think that is less stressful than the plastic surgery.
Mismatched expectations. Kind of like marriage. Everyone is so excited on ther wedding day to live blissfully together and then the divorce rate skyrockets when people realize that it’s not like the image they had in their mind when they fell in love with the idea of marriage and happily-ever-after.
Premeds have pretty much no idea of what their lives will be like in med school, residency, and in their chosen specialty until they are trapped with tons of student loans and all these patients. The lack of legal protection and chronic human rights violations are also unforeseen and extremely damaging. I could go on . . . (I think you get it)
was the click-bait necessary. he was not declined a job as a team member, he was declined a job as a owner of a store