The Impact Physician Give-Greed Continuum

*This post is revised from previously published Give/Greed post to emphasize Impact Physicians and healthcare – there is more info in that blog – so check it out

We’re necessarily looking to “change the world.” At least not in the sense that everyone else talks about it.

There are many people trying to “change the world” and many more teachers, pastors, coaches, business leaders, and politicians, to name just a few, who are encouraging others to “change the world.”

But what happens if my change is incongruent with your change?

That is, what if my change comes into conflict your change?

And do I have to change what you just changed?

The desire for “change” often arises to move away from greed and incorporate more elements of giving.

“We can change the world by giving everyone free healthcare,” shout many politicians and activists. But what are the consequences of this? And who do they expect will pay for everything?

As we go further into this document, please recall that the Impact Physician platform is built on the Impact Capitalist platform, where we believe that it is good to righteously pursue both impact and profit.

My business partner, Tom, and I have developed something we call the Give-Greed Continuum to help explain this fascination with changing the world. “Give” is on one end of the spectrum with “Greed” at the other end. We’ve crudely drawn the continuum to look like this:

Give                                                                            Greed


Tom, as an expert in human behavior, often refers to humans as “cognitive misers.” It’s true; we try to create mental shortcuts to describe complex situations. This is true when we, as humans, use mental shortcuts to explain things like “give is good” and “greed is bad.” But people fail to look at the consequences of each of these concepts. Greed is seen as being “selfish” and to Give is seen as “self-less.”

But, when do I stop giving?

Am I greedy if I stop giving?

What if I give everything away, am I now not one who needs someone else to give to me?

And, why do people give? In fact, don’t we actually profit in some sense, whether through a tax break or an ease of conscience?

Is it possible that giving can also be selfish?

Let’s be completely clear: We are not trying to justify greed, per se. It is, after all, one of the 7 deadly sins. Greed is selfish. Being a Crony Capitalist is about being greedy and selfish (see post: Stealing Capitalism Back or Stealing Medicine Back).

I have often joked that Americans have BIG hearts and tiny brains. Americans are fabulous in times of crisis, but do not understand – or at least they fail to calculate – the negative consequences of continuing to give to “causes.” I have run both for profit companies and a social, non-profit venture, along with living in a third world country. I have seen the good produced by giving but also the unintended harm.

It’s evident that many others have seen and/or experienced this as well. That’s why “Social Entrepreneurship,” “Social Ventures,” and “Free Healthcare” have become such hot topics and promoted in universities and political spheres across the world.

Social ventures have been started by people with the desire to help, knowing that they can’t give everything away, but that they need to “use the principles of business” to be able to change the world.

So, if we go back to the Give-Greed Continuum, we can now add Social Entrepreneurship (SE).

Give           SE                                         Greed


Most social ventures are considered “better” or a more “righteous approach” (self-righteous?) to business because there is a desire to only get to sustainability, or enough to keep going. This way, many social entrepreneurs, politicians, and hospital administrators (and Bezos, Buffet, Dimon?) wrongly believe, they can eliminate the profit motive, because if the profit motive can be eliminated, so can greed. But, as we’ve seen now, it can shift to other forms of greed. 

Another problem with social ventures is that social entrepreneurs, many of whom are seemingly trying to fix the world’s social problems, are also often driven by ideology or activism, and not necessarily by what the market is asking for. Free Healthcare, it can be argued, is actually greedy (but that’s an argument for another post).

Where does the physician (Dr) who is trying to build or maintain a practice fall on this continuum? Physicians fall all across the spectrum, but traditionally, this group, on average, is likely closer to the “Greed” side of the continuum.

Give           SE                                   Dr            Greed


Let’s be completely clear about the following:

– self-interest is not equal to greed

– profit is not evil

– profit (money) can be used as a tool and a force for good

But what about the Impact Physician…the physician that wants to make an impact on their patients through the art of healing, and yet make a profit for themselves and their family? Because the Impact Physician is pursing both an impact and a profit, this kind of physician would be right in the middle of the continuum.

Give            SE                IP              Dr             Greed


Being an Impact Physicians requires one to find a balance between one’s self interest and the needs of others. This is how we make an impact AND profit.

So, why is this important to physicians?

Well, there are two reasons.

The first reason: it’s time for Physicians to get greedy.

“WHAT?! They are greedy with their huge incomes,” scream social activists, insurance executives, and hospital administrators.

OK…it’s time for Physicians to start to think more like capitalists – true, free-market capitalists – instead of being compensated by the government-mandated gravy train of health insurance.

The second reason: “Health care for all!”

No one knows for sure whether there will be universal health care in the United States (our prediction is that it is coming – unless Impact Physicians prevail). But what we do know is that the current model is unsustainable.

Being an impact physician allows you to think like a capitalist. And, in order to act like a capitalist – a true, free-market capitalist – you need to find a way to be compensated for your services at market rates, not based upon what some government mandate is giving you.

If you can do this, ironically, you’re going to change the world.

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