Biswajit Dutta Baruah
@itsbiswajit.bsky.social
Surgeon → Online Mentor | Helping young surgeons avoid burnout & build wealth | Ultra runner | Author | 🏥→💻
2 AM emergency call.
You operate for 3 hours.
Senior sleeps on changing room couch.
Your fee: ₹15,000.
His fee: ₹45,000.
For being "present."
This is ghost surgery economics.
You do the cutting.
They do the collecting.
Your skill funds their leisure.
Your exhaustion pays their EMIs.
You operate for 3 hours.
Senior sleeps on changing room couch.
Your fee: ₹15,000.
His fee: ₹45,000.
For being "present."
This is ghost surgery economics.
You do the cutting.
They do the collecting.
Your skill funds their leisure.
Your exhaustion pays their EMIs.
October 19, 2025 at 1:02 AM
2 AM emergency call.
You operate for 3 hours.
Senior sleeps on changing room couch.
Your fee: ₹15,000.
His fee: ₹45,000.
For being "present."
This is ghost surgery economics.
You do the cutting.
They do the collecting.
Your skill funds their leisure.
Your exhaustion pays their EMIs.
You operate for 3 hours.
Senior sleeps on changing room couch.
Your fee: ₹15,000.
His fee: ₹45,000.
For being "present."
This is ghost surgery economics.
You do the cutting.
They do the collecting.
Your skill funds their leisure.
Your exhaustion pays their EMIs.
Morning surgery: Saved senior citizen's mobility.
Afternoon: His son negotiating 40% discount because "pension limitations."
Evening: Son's Mercedes in parking lot.
Afternoon: His son negotiating 40% discount because "pension limitations."
Evening: Son's Mercedes in parking lot.
October 18, 2025 at 1:00 PM
Morning surgery: Saved senior citizen's mobility.
Afternoon: His son negotiating 40% discount because "pension limitations."
Evening: Son's Mercedes in parking lot.
Afternoon: His son negotiating 40% discount because "pension limitations."
Evening: Son's Mercedes in parking lot.
Friend joined new hospital last month.
Offer letter: ₹3 lakhs monthly.
Sounds good.
Contract fine print:
First 3 months salary held as "security deposit."
Released only after completion.
Month 1: Generated ₹47 lakhs in surgeries.
His bank account: ₹0.
Offer letter: ₹3 lakhs monthly.
Sounds good.
Contract fine print:
First 3 months salary held as "security deposit."
Released only after completion.
Month 1: Generated ₹47 lakhs in surgeries.
His bank account: ₹0.
October 15, 2025 at 1:28 PM
Friend joined new hospital last month.
Offer letter: ₹3 lakhs monthly.
Sounds good.
Contract fine print:
First 3 months salary held as "security deposit."
Released only after completion.
Month 1: Generated ₹47 lakhs in surgeries.
His bank account: ₹0.
Offer letter: ₹3 lakhs monthly.
Sounds good.
Contract fine print:
First 3 months salary held as "security deposit."
Released only after completion.
Month 1: Generated ₹47 lakhs in surgeries.
His bank account: ₹0.
Medical conference registration: ₹45,000.
Same fee for everyone.
Senior surgeons:
Business class flights: ₹62,000.
Five-star hotel suite: ₹18,000/night.
Sponsored by equipment companies.
Young surgeons:
Economy flight: ₹8,500 (self-paid).
Budget hotel: ₹2,200/night.
Four of us sharing one Uber.
Same fee for everyone.
Senior surgeons:
Business class flights: ₹62,000.
Five-star hotel suite: ₹18,000/night.
Sponsored by equipment companies.
Young surgeons:
Economy flight: ₹8,500 (self-paid).
Budget hotel: ₹2,200/night.
Four of us sharing one Uber.
October 13, 2025 at 12:27 AM
Medical conference registration: ₹45,000.
Same fee for everyone.
Senior surgeons:
Business class flights: ₹62,000.
Five-star hotel suite: ₹18,000/night.
Sponsored by equipment companies.
Young surgeons:
Economy flight: ₹8,500 (self-paid).
Budget hotel: ₹2,200/night.
Four of us sharing one Uber.
Same fee for everyone.
Senior surgeons:
Business class flights: ₹62,000.
Five-star hotel suite: ₹18,000/night.
Sponsored by equipment companies.
Young surgeons:
Economy flight: ₹8,500 (self-paid).
Budget hotel: ₹2,200/night.
Four of us sharing one Uber.
Patient's driver: ₹500/hour.
Charges for waiting time.
Charges for traffic delays.
Charges for parking.
Me after 12 years of training: ₹300/hour.
Free if patient shows up late.
Free if case gets delayed.
Free phone consultations at midnight.
The driver learned pricing in one month.
Charges for waiting time.
Charges for traffic delays.
Charges for parking.
Me after 12 years of training: ₹300/hour.
Free if patient shows up late.
Free if case gets delayed.
Free phone consultations at midnight.
The driver learned pricing in one month.
October 12, 2025 at 4:28 AM
Patient's driver: ₹500/hour.
Charges for waiting time.
Charges for traffic delays.
Charges for parking.
Me after 12 years of training: ₹300/hour.
Free if patient shows up late.
Free if case gets delayed.
Free phone consultations at midnight.
The driver learned pricing in one month.
Charges for waiting time.
Charges for traffic delays.
Charges for parking.
Me after 12 years of training: ₹300/hour.
Free if patient shows up late.
Free if case gets delayed.
Free phone consultations at midnight.
The driver learned pricing in one month.
Attended 10 surgical workshops in 3 years.
₹2.5 lakhs spent on registrations and travel.
Improved my techniques.
Income stayed flat at ₹18 lakhs annually.
Read one financial book.
₹500 on Amazon.
Started systematic investment plan.
₹2.5 lakhs spent on registrations and travel.
Improved my techniques.
Income stayed flat at ₹18 lakhs annually.
Read one financial book.
₹500 on Amazon.
Started systematic investment plan.
October 11, 2025 at 8:29 AM
Attended 10 surgical workshops in 3 years.
₹2.5 lakhs spent on registrations and travel.
Improved my techniques.
Income stayed flat at ₹18 lakhs annually.
Read one financial book.
₹500 on Amazon.
Started systematic investment plan.
₹2.5 lakhs spent on registrations and travel.
Improved my techniques.
Income stayed flat at ₹18 lakhs annually.
Read one financial book.
₹500 on Amazon.
Started systematic investment plan.
Free surgery patient.
₹3.2 lakhs waived.
Perfect outcome.
Minor scar on knee.
Family threatened legal action.
"Negligent doctor ruined his future."
Same week.
Paying patient.
₹3.2 lakhs paid.
Identical outcome.
Identical scar.
Sent flowers.
Five-star Google review.
₹3.2 lakhs waived.
Perfect outcome.
Minor scar on knee.
Family threatened legal action.
"Negligent doctor ruined his future."
Same week.
Paying patient.
₹3.2 lakhs paid.
Identical outcome.
Identical scar.
Sent flowers.
Five-star Google review.
October 9, 2025 at 1:29 PM
Free surgery patient.
₹3.2 lakhs waived.
Perfect outcome.
Minor scar on knee.
Family threatened legal action.
"Negligent doctor ruined his future."
Same week.
Paying patient.
₹3.2 lakhs paid.
Identical outcome.
Identical scar.
Sent flowers.
Five-star Google review.
₹3.2 lakhs waived.
Perfect outcome.
Minor scar on knee.
Family threatened legal action.
"Negligent doctor ruined his future."
Same week.
Paying patient.
₹3.2 lakhs paid.
Identical outcome.
Identical scar.
Sent flowers.
Five-star Google review.
Performed 47 surgeries this year.
One complication.
2% rate.
My senior performed 52 surgeries.
Four complications.
8% rate.
My complication: "Careless young surgeon."
His complications: "Complex cases, unavoidable outcomes."
Same hospital. Same audit committee. Different rules.
One complication.
2% rate.
My senior performed 52 surgeries.
Four complications.
8% rate.
My complication: "Careless young surgeon."
His complications: "Complex cases, unavoidable outcomes."
Same hospital. Same audit committee. Different rules.
October 9, 2025 at 1:01 AM
Performed 47 surgeries this year.
One complication.
2% rate.
My senior performed 52 surgeries.
Four complications.
8% rate.
My complication: "Careless young surgeon."
His complications: "Complex cases, unavoidable outcomes."
Same hospital. Same audit committee. Different rules.
One complication.
2% rate.
My senior performed 52 surgeries.
Four complications.
8% rate.
My complication: "Careless young surgeon."
His complications: "Complex cases, unavoidable outcomes."
Same hospital. Same audit committee. Different rules.
Fellowship completed.
₹3 crore in debt.
Resume looks impressive.
Bank account looks terrifying.
That prestigious foreign fellowship?
₹50 lakhs tuition.
₹30 lakhs living costs.
₹2.2 crores in compound interest over 15 years.
Total damage: ₹3 crore.
₹3 crore in debt.
Resume looks impressive.
Bank account looks terrifying.
That prestigious foreign fellowship?
₹50 lakhs tuition.
₹30 lakhs living costs.
₹2.2 crores in compound interest over 15 years.
Total damage: ₹3 crore.
October 6, 2025 at 1:59 AM
Fellowship completed.
₹3 crore in debt.
Resume looks impressive.
Bank account looks terrifying.
That prestigious foreign fellowship?
₹50 lakhs tuition.
₹30 lakhs living costs.
₹2.2 crores in compound interest over 15 years.
Total damage: ₹3 crore.
₹3 crore in debt.
Resume looks impressive.
Bank account looks terrifying.
That prestigious foreign fellowship?
₹50 lakhs tuition.
₹30 lakhs living costs.
₹2.2 crores in compound interest over 15 years.
Total damage: ₹3 crore.
Financial advisor to surgeon friend:
"Perfect investment for doctors like you."
₹20 lakhs invested.
₹3 lakhs commission (hidden in fine print).
5 years later: ₹19 lakhs returned.
Lost ₹1 lakh.
Advisor made ₹3 lakhs.
Highway robbery with paperwork.
Yesterday: Crypto will make you rich.
"Perfect investment for doctors like you."
₹20 lakhs invested.
₹3 lakhs commission (hidden in fine print).
5 years later: ₹19 lakhs returned.
Lost ₹1 lakh.
Advisor made ₹3 lakhs.
Highway robbery with paperwork.
Yesterday: Crypto will make you rich.
October 5, 2025 at 3:04 PM
Financial advisor to surgeon friend:
"Perfect investment for doctors like you."
₹20 lakhs invested.
₹3 lakhs commission (hidden in fine print).
5 years later: ₹19 lakhs returned.
Lost ₹1 lakh.
Advisor made ₹3 lakhs.
Highway robbery with paperwork.
Yesterday: Crypto will make you rich.
"Perfect investment for doctors like you."
₹20 lakhs invested.
₹3 lakhs commission (hidden in fine print).
5 years later: ₹19 lakhs returned.
Lost ₹1 lakh.
Advisor made ₹3 lakhs.
Highway robbery with paperwork.
Yesterday: Crypto will make you rich.
Your bank account is more unstable than bleeding trauma patient.
One financial course stabilised both.
₹2 lakhs one month.
₹8 lakhs the next.
Zero the month after.
Living like this for 15 years. Premium car, zero savings.
Then spent ₹5,000 on a basic investment course.
Learned:
One financial course stabilised both.
₹2 lakhs one month.
₹8 lakhs the next.
Zero the month after.
Living like this for 15 years. Premium car, zero savings.
Then spent ₹5,000 on a basic investment course.
Learned:
October 5, 2025 at 12:30 PM
Your bank account is more unstable than bleeding trauma patient.
One financial course stabilised both.
₹2 lakhs one month.
₹8 lakhs the next.
Zero the month after.
Living like this for 15 years. Premium car, zero savings.
Then spent ₹5,000 on a basic investment course.
Learned:
One financial course stabilised both.
₹2 lakhs one month.
₹8 lakhs the next.
Zero the month after.
Living like this for 15 years. Premium car, zero savings.
Then spent ₹5,000 on a basic investment course.
Learned:
3 AM emergency. Unstable fracture.
I operated. Stabilised. Saved.
Morning: Senior discussed "his challenging case" with family.
My name? Nowhere.
You write the paper. They add their name first.
You prep the presentation. They deliver it.
You do the work. They collect applause.
I operated. Stabilised. Saved.
Morning: Senior discussed "his challenging case" with family.
My name? Nowhere.
You write the paper. They add their name first.
You prep the presentation. They deliver it.
You do the work. They collect applause.
October 5, 2025 at 12:24 PM
3 AM emergency. Unstable fracture.
I operated. Stabilised. Saved.
Morning: Senior discussed "his challenging case" with family.
My name? Nowhere.
You write the paper. They add their name first.
You prep the presentation. They deliver it.
You do the work. They collect applause.
I operated. Stabilised. Saved.
Morning: Senior discussed "his challenging case" with family.
My name? Nowhere.
You write the paper. They add their name first.
You prep the presentation. They deliver it.
You do the work. They collect applause.
Accessibility paradox:
The harder I became to reach, the more patients valued my time.
WhatsApp at 2 AM = ₹500 consultation.
Appointment only = ₹5,000.
Same surgeon. Same advice. 10x difference.
I'm not an ambulance.
I'm not superhuman.
I need sleep like everyone else.
The harder I became to reach, the more patients valued my time.
WhatsApp at 2 AM = ₹500 consultation.
Appointment only = ₹5,000.
Same surgeon. Same advice. 10x difference.
I'm not an ambulance.
I'm not superhuman.
I need sleep like everyone else.
October 4, 2025 at 3:26 AM
Accessibility paradox:
The harder I became to reach, the more patients valued my time.
WhatsApp at 2 AM = ₹500 consultation.
Appointment only = ₹5,000.
Same surgeon. Same advice. 10x difference.
I'm not an ambulance.
I'm not superhuman.
I need sleep like everyone else.
The harder I became to reach, the more patients valued my time.
WhatsApp at 2 AM = ₹500 consultation.
Appointment only = ₹5,000.
Same surgeon. Same advice. 10x difference.
I'm not an ambulance.
I'm not superhuman.
I need sleep like everyone else.
You're earning ₹30,000 monthly as senior resident.
Working 80-hour weeks.
Skipping your kid's birthday.
Postponing that family trip "until things settle."
Your HOD just posted Phuket beach photos.
Fifth international vacation this year.
Here's what they won't tell you:
Working 80-hour weeks.
Skipping your kid's birthday.
Postponing that family trip "until things settle."
Your HOD just posted Phuket beach photos.
Fifth international vacation this year.
Here's what they won't tell you:
October 2, 2025 at 2:00 PM
You're earning ₹30,000 monthly as senior resident.
Working 80-hour weeks.
Skipping your kid's birthday.
Postponing that family trip "until things settle."
Your HOD just posted Phuket beach photos.
Fifth international vacation this year.
Here's what they won't tell you:
Working 80-hour weeks.
Skipping your kid's birthday.
Postponing that family trip "until things settle."
Your HOD just posted Phuket beach photos.
Fifth international vacation this year.
Here's what they won't tell you:
Senior surgeon told me: "Money talk is unprofessional."
Same surgeon:
→ Three hospitals
→ Two Audis
→ Daughter in London for MBA
→ Son doing fellowship in US
Meanwhile, his advice to me:
"Focus on serving patients. Finance will follow."
Same surgeon:
→ Three hospitals
→ Two Audis
→ Daughter in London for MBA
→ Son doing fellowship in US
Meanwhile, his advice to me:
"Focus on serving patients. Finance will follow."
October 2, 2025 at 4:21 AM
Senior surgeon told me: "Money talk is unprofessional."
Same surgeon:
→ Three hospitals
→ Two Audis
→ Daughter in London for MBA
→ Son doing fellowship in US
Meanwhile, his advice to me:
"Focus on serving patients. Finance will follow."
Same surgeon:
→ Three hospitals
→ Two Audis
→ Daughter in London for MBA
→ Son doing fellowship in US
Meanwhile, his advice to me:
"Focus on serving patients. Finance will follow."
Senior surgeon saw young colleague as competition, not mentee.
The junior learned techniques while building beyond limitations.
Taught him just enough to assist.
Never enough to surpass.
Every complex case: "You're not ready yet."
Every innovation suggested: "We don't do that here."
The junior learned techniques while building beyond limitations.
Taught him just enough to assist.
Never enough to surpass.
Every complex case: "You're not ready yet."
Every innovation suggested: "We don't do that here."
September 30, 2025 at 3:02 PM
Senior surgeon saw young colleague as competition, not mentee.
The junior learned techniques while building beyond limitations.
Taught him just enough to assist.
Never enough to surpass.
Every complex case: "You're not ready yet."
Every innovation suggested: "We don't do that here."
The junior learned techniques while building beyond limitations.
Taught him just enough to assist.
Never enough to surpass.
Every complex case: "You're not ready yet."
Every innovation suggested: "We don't do that here."
Free consultation equals worthless advice in patient's mind.
₹2000 consultation creates compliance.
Premium pricing creates value.
Same knee pain. Same diagnosis. Same treatment plan.
Free camp patient:
→ Skips physiotherapy
→ Questions every decision
→ Never follows up
→ Zero referrals
₹2000 consultation creates compliance.
Premium pricing creates value.
Same knee pain. Same diagnosis. Same treatment plan.
Free camp patient:
→ Skips physiotherapy
→ Questions every decision
→ Never follows up
→ Zero referrals
September 30, 2025 at 12:59 AM
Free consultation equals worthless advice in patient's mind.
₹2000 consultation creates compliance.
Premium pricing creates value.
Same knee pain. Same diagnosis. Same treatment plan.
Free camp patient:
→ Skips physiotherapy
→ Questions every decision
→ Never follows up
→ Zero referrals
₹2000 consultation creates compliance.
Premium pricing creates value.
Same knee pain. Same diagnosis. Same treatment plan.
Free camp patient:
→ Skips physiotherapy
→ Questions every decision
→ Never follows up
→ Zero referrals
Disrespected nursing staff.
Surgeries mysteriously delayed.
Respected them.
Mountains moved for my practice.
Nurses run hospitals.
That senior surgeon who treats nurses like servants? His OT gets "emergency" bumps daily.
Surgeries mysteriously delayed.
Respected them.
Mountains moved for my practice.
Nurses run hospitals.
That senior surgeon who treats nurses like servants? His OT gets "emergency" bumps daily.
September 29, 2025 at 1:50 AM
Disrespected nursing staff.
Surgeries mysteriously delayed.
Respected them.
Mountains moved for my practice.
Nurses run hospitals.
That senior surgeon who treats nurses like servants? His OT gets "emergency" bumps daily.
Surgeries mysteriously delayed.
Respected them.
Mountains moved for my practice.
Nurses run hospitals.
That senior surgeon who treats nurses like servants? His OT gets "emergency" bumps daily.
What continues healing people after you're gone?
Your surgeries end when you die.
Your systems heal for generations.
That protocol you created? Still saving lives in 2050.
That technique you taught? Multiplied through 100 students.
Your surgeries end when you die.
Your systems heal for generations.
That protocol you created? Still saving lives in 2050.
That technique you taught? Multiplied through 100 students.
September 28, 2025 at 12:34 PM
What continues healing people after you're gone?
Your surgeries end when you die.
Your systems heal for generations.
That protocol you created? Still saving lives in 2050.
That technique you taught? Multiplied through 100 students.
Your surgeries end when you die.
Your systems heal for generations.
That protocol you created? Still saving lives in 2050.
That technique you taught? Multiplied through 100 students.
Every empire was built on systems, not talent.
Systems create freedom. Talent creates dependency.
The brilliant surgeon who does everything himself?
Prisoner of his own skill.
Can't take leave. Can't delegate. Can't scale.
Systems create freedom. Talent creates dependency.
The brilliant surgeon who does everything himself?
Prisoner of his own skill.
Can't take leave. Can't delegate. Can't scale.
September 28, 2025 at 2:34 AM
Every empire was built on systems, not talent.
Systems create freedom. Talent creates dependency.
The brilliant surgeon who does everything himself?
Prisoner of his own skill.
Can't take leave. Can't delegate. Can't scale.
Systems create freedom. Talent creates dependency.
The brilliant surgeon who does everything himself?
Prisoner of his own skill.
Can't take leave. Can't delegate. Can't scale.
Surgical skills worth zero if not priced properly.
Expertise without monetisation is expensive hobby.
You spent ₹50 lakhs on medical education.
10 years learning complex procedures.
25 years perfecting your craft.
Then charge ₹500 for consultation.
Your plumber charges more per hour.
Expertise without monetisation is expensive hobby.
You spent ₹50 lakhs on medical education.
10 years learning complex procedures.
25 years perfecting your craft.
Then charge ₹500 for consultation.
Your plumber charges more per hour.
September 27, 2025 at 3:28 PM
Surgical skills worth zero if not priced properly.
Expertise without monetisation is expensive hobby.
You spent ₹50 lakhs on medical education.
10 years learning complex procedures.
25 years perfecting your craft.
Then charge ₹500 for consultation.
Your plumber charges more per hour.
Expertise without monetisation is expensive hobby.
You spent ₹50 lakhs on medical education.
10 years learning complex procedures.
25 years perfecting your craft.
Then charge ₹500 for consultation.
Your plumber charges more per hour.
Career peak is when you choose, not when biology chooses.
Built systems that multiply impact beyond physical limitations.
Your hands age. Your eyes weaken. Your stamina drops.
But your knowledge? That's immortal.
One surgeon performs 10,000 surgeries in a lifetime.
Built systems that multiply impact beyond physical limitations.
Your hands age. Your eyes weaken. Your stamina drops.
But your knowledge? That's immortal.
One surgeon performs 10,000 surgeries in a lifetime.
September 27, 2025 at 7:27 AM
Career peak is when you choose, not when biology chooses.
Built systems that multiply impact beyond physical limitations.
Your hands age. Your eyes weaken. Your stamina drops.
But your knowledge? That's immortal.
One surgeon performs 10,000 surgeries in a lifetime.
Built systems that multiply impact beyond physical limitations.
Your hands age. Your eyes weaken. Your stamina drops.
But your knowledge? That's immortal.
One surgeon performs 10,000 surgeries in a lifetime.
Compliant surgeon who never questions becomes department head.
Excellent surgeon who challenges protocols gets suppressed.
System rewards obedience.
Not competence.
The surgeon who points out outdated protocols? "Difficult."
The one who suggests better patient flow? "Disruptive."
Excellent surgeon who challenges protocols gets suppressed.
System rewards obedience.
Not competence.
The surgeon who points out outdated protocols? "Difficult."
The one who suggests better patient flow? "Disruptive."
September 27, 2025 at 5:09 AM
Compliant surgeon who never questions becomes department head.
Excellent surgeon who challenges protocols gets suppressed.
System rewards obedience.
Not competence.
The surgeon who points out outdated protocols? "Difficult."
The one who suggests better patient flow? "Disruptive."
Excellent surgeon who challenges protocols gets suppressed.
System rewards obedience.
Not competence.
The surgeon who points out outdated protocols? "Difficult."
The one who suggests better patient flow? "Disruptive."
"Built my practice with exit strategy in mind.
Practice without exit plan is expensive prison where you're guard and prisoner."
Dr. Rajesh told me this 5 years ago.
Didn't understand then.
Last month, his son joined a tech company in Bangalore.
His daughter's doing psychiatry in UK.
Practice without exit plan is expensive prison where you're guard and prisoner."
Dr. Rajesh told me this 5 years ago.
Didn't understand then.
Last month, his son joined a tech company in Bangalore.
His daughter's doing psychiatry in UK.
September 25, 2025 at 2:58 PM
"Built my practice with exit strategy in mind.
Practice without exit plan is expensive prison where you're guard and prisoner."
Dr. Rajesh told me this 5 years ago.
Didn't understand then.
Last month, his son joined a tech company in Bangalore.
His daughter's doing psychiatry in UK.
Practice without exit plan is expensive prison where you're guard and prisoner."
Dr. Rajesh told me this 5 years ago.
Didn't understand then.
Last month, his son joined a tech company in Bangalore.
His daughter's doing psychiatry in UK.
"One Google review with photos reaches 1000 searching patients.
One verbal referral reaches one.
Digital reputation is exponential word-of-mouth."
Heard myself say this yesterday.
Then realised I'm contradicting my own belief.
One verbal referral reaches one.
Digital reputation is exponential word-of-mouth."
Heard myself say this yesterday.
Then realised I'm contradicting my own belief.
September 25, 2025 at 1:02 AM
"One Google review with photos reaches 1000 searching patients.
One verbal referral reaches one.
Digital reputation is exponential word-of-mouth."
Heard myself say this yesterday.
Then realised I'm contradicting my own belief.
One verbal referral reaches one.
Digital reputation is exponential word-of-mouth."
Heard myself say this yesterday.
Then realised I'm contradicting my own belief.