Future of Rads vs Ortho??

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Are you speaking to the physical nature of a surgical field or their hours? How age prohibitive are surgical fields in your opinion? Why do you think that peoples personalities change @ 50 +?

Originally Posted by shark2000

When I say screw your life I mean it. I am a senior resident, but older than many of you because I have done a lot of other things in life before doing medicine. You have to think what you want to do at the age of 50 and 60. It may seem challenging to you now, but is it sustainable for 30 years ? I understand some people may like it, but IMO you are screwing your life. My best evidence is that MOST SURGEONS are chronically exhausted with a very malignant abnormal personality after a certain age (like 50). You do not see the same in family medicine, IM, Peds, Rads, Patho, DERM, .... For sure there are exceptions.

Good Luck.

Originally Posted by shark2000

DERM vs Radiology:
1- Rads is much more challenging, at least to me. To me it is more scientific and exciting.
2- Hours: Derm beats rads any time.
3- Diversity: Rads beat Derm any time.
4- Income: Derm has more potential. Less amenable to pay cuts.
5- Study material : radiculous for rads. Pretty light in Derm.
6- Worst part of DERM: you have to deal with crazy histrionic personalities. Though, still better than doing IR screwing your life.

I pretty much agree with everything you say in general.

Regarding income, rads compensation is significantly higher than derm on average ($350k vs. 300k, which over the course of a career is ~$1.5M more). I do agree that there are niches in derm where the potential is far higher, though. Still, derm has been significantly affected: Mohs surgeons used to make $1M per year working 40-50 hour weeks. After the cuts, they're making ~$400k for the same time. Also, I'm not sure to what extent it was under their control, but derm and plastics did a horrible job of monopolizing the Botox market.

Regarding study material, my derm buddies tell me they have a f***ton of reading to do during residency and many derm programs have daily lectures at 7 or 8 AM!

Why even put up these weak numbers lol.

Originally Posted by Dumb

Squat 305
Bench 205
Dead 315

Originally Posted by yappy

Why even put up these weak numbers lol.

Hahaha.

Posrep.

Originally Posted by yappy

Why even put up these weak numbers lol.

Haha...gotta love it when pre-dental students come to the rads forum. Just got off a cutting cycle brah, get off me

Originally Posted by shark2000

Urology need its own personality.
Has tough residency, but as attending it is almost a 8-5 job unless you want to kill yourself working.
Barely you see a urologist in the hospital after 7-8 pm. No weekends, light calls. Very few if any emergencies.
Currently for the amount of work it is a good gig.
IMO, its future is no different that other similar fields. It is on safer side than GI as they have more than 1 or 2 money making procedures.
Do it only if you like it. I'd rather be jobless than be a urologist.

Largely true but bear in mind some of the cystectomy, nephrectomy and advanced cancer patients can still get pretty sick pretty quickly and will need frequent reviews.

I used to think urology is mickey mouse surgery until I tried a rotation myself. They can get big and messy at times.

Originally Posted by Dumb

I pretty much agree with everything you say in general.

Regarding income, rads compensation is significantly higher than derm on average ($350k vs. 300k, which over the course of a career is ~$1.5M more). I do agree that there are niches in derm where the potential is far higher, though. Still, derm has been significantly affected: Mohs surgeons used to make $1M per year working 40-50 hour weeks. After the cuts, they're making ~$400k for the same time. Also, I'm not sure to what extent it was under their control, but derm and plastics did a horrible job of monopolizing the Botox market.

Regarding study material, my derm buddies tell me they have a f***ton of reading to do during residency and many derm programs have daily lectures at 7 or 8 AM!

Don't forget, though, that rads hours are, on average, much grater than derm--something like 60 vs. 45. So if derm were to were to work the same hours--on average--as rads, income would probably be equal to if not higher than rads. just sayin'. regardless, both fields pay well, and certainly more than primary care. as for controlling the botox market...you can't. it is an unregulated/uncontrolled market that any physician can enter. many of the derma-spas out there are operated/run/controlled/managed by internists, fp's, etc...heck, even the np's/pa's operate them (so i have heard).

also one more perk of of derm vs. rads: autonomy.
there is little autonomy in rads, where as derms can reasonably operate solo or in a small group independently of a hospital with relatively little overhead. pretty cool imo.

Problem with ortho is that the US actually has a A LOT of orthopedic surgeons relative to population, and orthopedic procedures are getting more and more efficient. While the demand is high now, the supply is not far behind. This demand can easily be cut in half if Medicare puts more restrictions. Take a look at Canada and you'll see orthopedic surgeons there barely finding employment because of government health care.

Every year we graduate around 680 orthopedic surgeons, and for perspective, 1100 general surgeons (who go on to specialize in five six different ways). Ortho frankly is the largest surgical subspecialty. We have more of them than practicing general surgeons.

Originally Posted by naus

Problem with ortho is that the US actually has a A LOT of orthopedic surgeons relative to population, and orthopedic procedures are getting more and more efficient. While the demand is high now, the supply is not far behind. This demand can easily be cut in half if Medicare puts more restrictions. Take a look at Canada and you'll see orthopedic surgeons there barely finding employment because of government health care.

Every year we graduate around 680 orthopedic surgeons, and for perspective, 1100 general surgeons (who go on to specialize in five six different ways). Ortho frankly is the largest surgical subspecialty. We have more of them than practicing general surgeons.

Hahahaha

You mention general surgeons can subspecialize but forget ortho can as well.

Originally Posted by walkerahl

Hahahaha

You mention general surgeons can subspecialize but forget ortho can as well.

You're missing the point. A thoracic surgeon to a colorectal surgeon is a lot more different than a upper extremity/shoulder orthopod to one who specializes in knees and sports injuries. Aside from maybe hand, a general orthopod can do quite a lot already, while the general surgeon nowadays is more limited to the abdomen. Ortho is already a surgical subspecialty like CT surgery is a surgical subspecialty, and there are a lot of orthopods in the US. Specializing more doesn't really change that fact, just makes you even more vulnerable to Medicare changes.

Originally Posted by naus

You're missing the point. A thoracic surgeon to a colorectal surgeon is a lot more different than a upper extremity/shoulder orthopod to one who specializes in knees and sports injuries. Aside from maybe hand, a general orthopod can do quite a lot already, while the general surgeon nowadays is more limited to the abdomen. Ortho is already a surgical subspecialty like CT surgery is a surgical subspecialty, and there are a lot of orthopods in the US. Specializing more doesn't really change that fact, just makes you even more vulnerable to Medicare changes.

I don't know why you guys argue?
US and Canada are completely different medical systems and different life styles.
To me 700 orthopods are not high number, while we have about 10000 PCPs. Trauma is still number one killer in our country. In large cities half of ERs are full of trauma patients.

Originally Posted by shark2000

I don't know why you guys argue?
US and Canada are completely different medical systems and different life styles.
To me 700 orthopods are not high number, while we have about 10000 PCPs. Trauma is still number one killer in our country. In large cities half of ERs are full of trauma patients.

ERs are full of trauma patients alright, mostly on Medicaid. Adult trauma ortho patients are surprisingly some of the least grateful patients you'll ever see. That and the hours and the lower reimbursement (fracture service at most hospitals operates at a loss) makes it the least popular fellowship in ortho.

"WASHINGTON - Hospitals lose an estimated $30,000 on every patient treated for tibial fractures, according to a study of California Medicaid claims data. On average, tibial fractures cost hospitals $49,358 per case, but they received an average of $19,097 or less in reimbursement."

"'If you look at the distribution ... the majority of patients [resulted in a loss for hospitals of] between $0 and $20,000. Half the patients were in that area,' Jones said."

"The researchers found that hospitals lost more than $100,000 per case in about 8% of cases, 'more frequently than they made even a dollar profit,' Jones said."

It's not all rainbows and unicorns. The grass is greener in every specialty. If you go into ortho, you better really love your joint replacements.

Originally Posted by naus

ERs are full of trauma patients alright, mostly on Medicaid. Adult trauma ortho patients are surprisingly some of the least grateful patients you'll ever see. That and the hours and the lower reimbursement (fracture service at most hospitals operates at a loss) makes it the least popular fellowship in ortho.

"WASHINGTON - Hospitals lose an estimated $30,000 on every patient treated for tibial fractures, according to a study of California Medicaid claims data. On average, tibial fractures cost hospitals $49,358 per case, but they received an average of $19,097 or less in reimbursement."

"'If you look at the distribution ... the majority of patients [resulted in a loss for hospitals of] between $0 and $20,000. Half the patients were in that area,' Jones said."

"The researchers found that hospitals lost more than $100,000 per case in about 8% of cases, 'more frequently than they made even a dollar profit,' Jones said."

It's not all rainbows and unicorns. The grass is greener in every specialty. If you go into ortho, you better really love your joint replacements.

You are stealing the whole post to the place to like to prove what you want to prove.
This is no brainer. These days, almost every specialty is dealing with either non-insured or medicare patients and also there is decreased reimbursements.
I am not ortho person and not interested in it at all, but you clearly express your jealousy towards ortho. Probably you could not match.

I don't know why I am arguing with you.

GL

Originally Posted by shark2000

You are stealing the whole post to the place to like to prove what you want to prove.
This is no brainer. These days, almost every specialty is dealing with either non-insured or medicare patients and also there is decreased reimbursements.
I am not ortho person and not interested in it at all, but you clearly express your jealousy towards ortho. Probably you could not match.

I don't know why I am arguing with you.

GL

What an ass hattery post. If anyone says anything negative about ortho's future prospects, it must be because they are jealous or can't match.

This thread is called "Future of Rads vs Ortho" genius.

If you think rads suck so disproportionately much, maybe it's time to get the hell out.

Originally Posted by naus

What an ass hattery post. If anyone says anything negative about ortho's future prospects, it must be because they are jealous or can't match.

This thread is called "Future of Rads vs Ortho" genius.

If you think rads suck so disproportionately much, maybe it's time to get the hell out.

You are not only jealous of ortho, but also jealous of rads.

Originally Posted by shark2000

You are not only jealous of ortho, but also jealous of rads.

He needs a good neurorectal surgeon to get his head out of his ass.

Originally Posted by johnnydrama

He needs a good neurorectal surgeon to get his head out of his ass.

It's really terrifying that some of you guys might be my colleagues one day. You and shark sound like huge insecure tools, using your specialties to compensate for your penis sizes.

Originally Posted by Jonassen

It's really terrifying that some of you guys might be my colleagues one day. You and shark sound like huge insecure penis measuring tools.

Why would a penis measuring tool be insecure? I'd expect they'd be in high demand and never be out of a job.

Originally Posted by Jonassen

It's really terrifying that some of you guys might be my colleagues one day. You and shark sound like huge insecure tools, using your specialties to compensate for your penis sizes.

Where did you come from all of a sudden?

Unfortunately there is not any penis imaging fellowship in radiology. Once in a while, I read pelvic CTs or MRs from people with penile prosthesis, that is the best we can do.

Originally Posted by shark2000

Where did you come from all of a sudden?

Unfortunately there is not any penis imaging fellowship in radiology. Once in a while, I read pelvic CTs or MRs from people with penile prosthesis, that is the best we can do.

Haha, someone on Aunt Minnie was asking for advice on how to do an ejaculogram a while back.

Don't think the issue was resolved.

Let's please try and avoid using personal attacks.

Originally Posted by johnnydrama

Haha, someone on Aunt Minnie was asking for advice on how to do an ejaculogram a while back.

Don't think the issue was resolved.

Tucker Max did something interesting with a fluoro machine, prolly worth a google search.