Best Advice for Pre-Meds

[OkMd73]

This is the best advice I can give current students thinking of choosing a career in medicine:

DO NOT DO IT! Choose another career. You are bright, motivated, and hard-working. You could receive intellectual, emotional, and spiritual fulfillment from a number of different occupations.

Medicine, as we know it, is a dying field.

If you are thinking of becoming a family doc, an internist, or a pediatrician -- well forget it. That job will cease to exist in the near future as those MDs are replaced by NPs, PA-C's and RNs.

If you think you will be well compensated for your efforts as an MD, well then just forget it. You will not. Go into business instead.

If really want to help people, well then go into business, make your millions and then retire in your 30s and devote the rest of your life to volunteer work.

If you are interested in the scientific aspects of science, well then go to graduate school and get your PhD. At the very least you will be avoiding hundreds of thousands of dollars of debt.

And if after all that you still want to be an MD, then my advice is this: expect to be a hospital or university employee who is instructed by administrators, insurance companies, the government, nurses, and families how to treat your patients.

This is honestly the best advice I can give. Refer to the following links which may shed some light on where I am coming from:

http://www.cnn.com/2009/HEALTH/08/25...tor/index.html

http://sermo.com/blog/2010/01/2/ftf-...nt-lying-again

http://www.theheart.org/article/1037273.do

http://www.askmen.com/money/career_200/210_career.html

[Law2Doc]

Originally Posted by OkMd73

This is the best advice I can give current students thinking of choosing a career in medicine:

DO NOT DO IT! Choose another career. You are bright, motivated, and hard-working. You could receive intellectual, emotional, and spiritual fulfillment from a number of different occupations.

Medicine, as we know it, is a dying field.

If you are thinking of becoming a family doc, an internist, or a pediatrician -- well forget it. That job will cease to exist in the near future as those MDs are replaced by NPs, PA-C's and RNs.

If you think you will be well compensated for your efforts as an MD, well then just forget it. You will not. Go into business instead.

If really want to help people, well then go into business, make your millions and then retire in your 30s and devote the rest of your life to volunteer work.

If you are interested in the scientific aspects of science, well then go to graduate school and get your PhD. At the very least you will be avoiding hundreds of thousands of dollars of debt.

And if after all that you still want to be an MD, then my advice is this: expect to be a hospital or university employee who is instructed by administrators, insurance companies, the government, nurses, and families how to treat your patients.

This is honestly the best advice I can give. Refer to the following links which may shed some light on where I am coming from:

http://www.cnn.com/2009/HEALTH/08/25...tor/index.html

http://sermo.com/blog/2010/01/2/ftf-...nt-lying-again

http://www.theheart.org/article/1037273.do

http://www.askmen.com/money/career_200/210_career.html

While I think some of what's said above is true the "medicine is a dying field" actually isn't. It's an evolving field, sure, and not always to physicians benefit. But not hardly dying. As for the other stuff, I don't disagree. But find it hard to imagine an attending would make this his first and only post. Not buying it.

[serenade]

Must we always have these depressing threads?
i think the only deterrent to my goals in medicine are these threads of doctors that scream run for the hills
though this post is somewhat failish attempt of a person to kill off some pre-med competition
>.>

[Law2Doc]

Originally Posted by serenade

Must we always have these depressing threads?
i think the only deterrent to my goals in medicine are these threads of doctors that scream run for the hills

There's nothing wrong with going down this road with your eyes open. While I'm skeptical about the OP, I certainly would suggest that based on some of the threads too many premeds seem to think that medicine is a path where you can make a boatload of money and have a boatload of free time and take long summer vacations, and not take call and coast through med school and residency and not have any issues balancing life issues.

[serenade]

Originally Posted by Law2Doc

There's nothing wrong with going down this road with your eyes open. While I'm skeptical about the OP, I certainly would suggest that based on some of the threads too many premeds seem to think that medicine is a path where you can make a boatload of money and have a boatload of free time and take long summer vacations, and not take call and coast through med school and residency and not have any issues balancing life issues.

im familiar with all that..
and im more or less contempt with the work portion..
but when people are saying medicine is becoming stagnant and its main work force taken over by nurses..
well i feel really sad with that.. and feel scared that after i complete medical school i'll end up getting paid 80k and working 60 hours for the rest of my life in a faillish attempt to pay off my loans..

[OkMd73]

To clarify, I wrote that Medicine, as we know it, is a dying field. Not medicine itself. I agree that Medicine is evolving (or devolving) depending on how you want to look at it.

Since the new year Medicare has cut re-imbursements by 20%. Consultation codes were dropped by Medicare. The RVUs were not re-adjusted. They were just dropped. No one has any idea how to bill for an inpatient consultation code anymore since no code exists except for the admitting physician. So if you are a cardiologist and you are asked by a PCP to see someone who has chest pain, and you decide that the patient does not require a cath -- there is literally no billing code for you.

Two prominent internists in our community have announced their imminent retirement. They cannot keep up with their rising overhead and falling reimbursements. They will likely be replaced by mid-level providers.

The upcoming health care bill has even more cuts that will take effect in 2014.

If you do insist on going to medical school -- consdider a surgical subspecialty or interventionaly cardiology. Your unique skills will protect you and you will remain in demand -- even though your re-imbursements will be down. If you are planning to do anything else prepare for a mountain of debt.

[serenade]

Originally Posted by OkMd73

To clarify, I wrote that Medicine, as we know it, is a dying field. Not medicine itself. I agree that Medicine is evolving (or devolving) depending on how you want to look at it.

Since the new year Medicare has cut re-imbursements by 20%. Consultation codes were dropped by Medicare. The RVUs were not re-adjusted. They were just dropped. No one has any idea how to bill for an inpatient consultation code anymore since no code exists except for the admitting physician. So if you are a cardiologist and you are asked by a PCP to see someone who has chest pain, and you decide that the patient does not require a cath -- there is literally no billing code for you.

Two prominent internists in our community have announced their imminent retirement. They cannot keep up with their rising overhead and falling reimbursements. They will likely be replaced by mid-level providers.

The upcoming health care bill has even more cuts that will take effect in 2014.

If you do insist on going to medical school -- consdider a surgical subspecialty or interventionaly cardiology. Your unique skills will protect you and you will remain in demand -- even though your re-imbursements will be down. If you are planning to do anything else prepare for a mountain of debt.

alright.. time for dental lol.. or psychology -.-
really if what your saying is right.. which im taking with a grain of ... screw it a bag of salt..
like i was saying.. if that happens then idk.. medical specialists will leave medicine for other fields.. i can think of a few other fields which will pay just as well as medicine in proportion to the hours...

sigh.. this is ridiculous..

[anonymousername]

Because you're not giving personal examples, your argument isn't really compelling. It is easy to say "it won't be worth it" tell me why it wasn't for you and maybe your words would mean more.

[red10]

O look! One of these threads! Never seen one of these before!!

[CaliGirl14]

Lmao. Sometimes I think threads like these are made up of gunners trying to scare us all away.

[YouNeverKnow22]

no attending would come in the pre-med part of SDN and tell kids to avoid medicine. GTFO you're a troll

[DendWrite]

Look guys, attending or not, the guy has a point and you should all be aware of it. I'm no gunner, but make sure you are doing medicine for the "right" reasons. I.e. do you honestly like it? I think that a good test is to ask yourself whether you'd still do medicine if you only made enough to "get by" happily as a middle class American. Don't get me wrong, I'm not saying doctors don't deserve a high salary, but if money, prestige, etc is why you are going into medicine, you might be very mistaken.

I know doctors who -CONSTANTLY- complain about billing and reimbursements. I know one doctor who quit his job and opened up his own cash-only practice in the town where I work because he was sick of dealing with insurance companies.

The only reason that I'm still going for a career in medicine is because I'd do it even if I only got paid like $50k a year. I can't see myself doing anything else with my life that I'd enjoy as much.

[OkMd73]

Originally Posted by serenade

alright.. time for dental lol.. or psychology -.-
really if what your saying is right.. which im taking with a grain of ... screw it a bag of salt..
like i was saying.. if that happens then idk.. medical specialists will leave medicine for other fields.. i can think of a few other fields which will pay just as well as medicine in proportion to the hours...

sigh.. this is ridiculous..

Please read the CNN article I posted. It is from a physician from SERMO.com. A forum of physicians that I am also a member of.

I am in a practice with 3 other cardiologists (2 interventional). I am not an interventionalist so the recent HHS/CMS regs for cutting reimbursements for office-based tests such as TTE severely hurt my practice. I fully support the ACC decision to sue CMS/HSS.


Over the last two years our reimbursements have dropped 28%, though we have 9% more patient encounters. Meanwhile our overhead has increased 11%. Patient complexity has increased at least that much, as everyone I now see has mutiple medical problems and most have known CAD.

The cuts will be more severe this year, especially when commercial insurance starts following the 20% medicare rate cut.

There are still fulfilling days. Patient care in its truest sense is the same but when I am spending 50% of my time dealing with insurance companies, fighting for re-imbursements and filling out the necessary paperwork to get paid, at what point is it no longer worth it? Ask yourself that.

My partners and I met before the new year to discuss a plan to address the upcoming medicare cuts and the proposed health care bill. Our consensus? See as many patients as we can, work as hard as we can and bill as much as we can until 2014; at which point we can either A) opt out of medicare -- if that is still possible -- and go to a cash based practice for office visits or B) make enough money to retire and do something else. And then I asked everyone, is that why we went into Medicine? No one answered.

Lastly, if you find it strange that a practicing MD would come onto your forum to warn you of the perils of a future career in medicine, then please also be skeptical of those who tell you why you should pursue a career in medicine and why it is still such a great field.

[red10]

[serenade]

Originally Posted by DendWrite

Look guys, attending or not, the guy has a point and you should all be aware of it. I'm no gunner, but make sure you are doing medicine for the "right" reasons. I.e. do you honestly like it? I think that a good test is to ask yourself whether you'd still do medicine if you only made enough to "get by" happily as a middle class American. Don't get me wrong, I'm not saying doctors don't deserve a high salary, but if money, prestige, etc is why you are going into medicine, you might be very mistaken.

realisticly the whole why people go into medicine has both extrinsic and intrinsic value .
money is a extrinsic value
intrinsically people with a idealist or positive personality those who can really understand and sympathies with people and from there work to help a person.

rationalizing medicine as a career is a very difficult thing, i think for me the big turn on of medicine is the ability to posses a skill which is forever useful. that was my original interest in medicine. afterwords i decided that i love working with people, so for me its probably either medicine or a social science, of which is why Im majoring in psychology.

i can say that obtaining a high salary isnt a plus.. but i'd be lieing..
medicine is for always a career.. of which someone works for a living..
and the only reason i'm actually considering not going into medicine is if im going to be working 60 hours a week and get paid nothing and die in debt.
if medicine remains a field which gives good pay.. well im still interested.

[YouNeverKnow22]

Originally Posted by OkMd73

Please read the CNN article I posted. It is from a physician from SERMO.com. A forum of physicians that I am also a member of.

I am in a practice with 3 other cardiologists (2 interventional). I am not an interventionalist so the recent HHS/CMS regs for cutting reimbursements for office-based tests such as TTE severely hurt my practice. I fully support the ACC decision to sue CMS/HSS.


Over the last two years our reimbursements have dropped 28%, though we have 9% more patient encounters. Meanwhile our overhead has increased 11%. Patient complexity has increased at least that much, as everyone I now see has mutiple medical problems and most have known CAD.

The cuts will be more severe this year, especially when commercial insurance starts following the 20% medicare rate cut.

There are still fulfilling days. Patient care in its truest sense is the same but when I am spending 50% of my time dealing with insurance companies, fighting for re-imbursements and filling out the necessary paperwork to get paid, at what point is it no longer worth it? Ask yourself that.

My partners and I met before the new year to discuss a plan to address the upcoming medicare cuts and the proposed health care bill. Our consensus? See as many patients as we can, work as hard as we can and bill as much as we can until 2014; at which point we can either A) opt out of medicare -- if that is still possible -- and go to a cash based practice for office visits or B) make enough money to retire and do something else. And then I asked everyone, is that why we went into Medicine? No one answered.

Lastly, if you find it strange that a practicing MD would come onto your forum to warn you of the perils of a future career in medicine, then please also be skeptical of those who tell you why you should pursue a career in medicine and why it is still such a great field.

no you're not. don't you have a job? like practice medicine? oh wait you're a troll.

[XsmallX]

Originally Posted by OkMd73

Lastly, if you find it strange that a practicing MD would come onto your forum to warn you of the perils of a future career in medicine, then please also be skeptical of those who tell you why you should pursue a career in medicine and why it is still such a great field.

good point... thank you very much for bringing a dose of the "other side" to this forum...

but isn't pediatrics supposed to increase in the future? I read on a government site that pediatrics is supposed to increase by 22% between 2010 to 2018

oh man and I wanted to be a pediatrician

[serenade]

Originally Posted by OkMd73

Please read the CNN article I posted. It is from a physician from SERMO.com. A forum of physicians that I am also a member of.

I am in a practice with 3 other cardiologists (2 interventional). I am not an interventionalist so the recent HHS/CMS regs for cutting reimbursements for office-based tests such as TTE severely hurt my practice. I fully support the ACC decision to sue CMS/HSS.


Over the last two years our reimbursements have dropped 28%, though we have 9% more patient encounters. Meanwhile our overhead has increased 11%. Patient complexity has increased at least that much, as everyone I now see has mutiple medical problems and most have known CAD.

The cuts will be more severe this year, especially when commercial insurance starts following the 20% medicare rate cut.

There are still fulfilling days. Patient care in its truest sense is the same but when I am spending 50% of my time dealing with insurance companies, fighting for re-imbursements and filling out the necessary paperwork to get paid, at what point is it no longer worth it? Ask yourself that.

My partners and I met before the new year to discuss a plan to address the upcoming medicare cuts and the proposed health care bill. Our consensus? See as many patients as we can, work as hard as we can and bill as much as we can until 2014; at which point we can either A) opt out of medicare -- if that is still possible -- and go to a cash based practice for office visits or B) make enough money to retire and do something else. And then I asked everyone, is that why we went into Medicine? No one answered.

Lastly, if you find it strange that a practicing MD would come onto your forum to warn you of the perils of a future career in medicine, then please also be skeptical of those who tell you why you should pursue a career in medicine and why it is still such a great field.

read my lips.. MASS MIGRATION of physicians -.-
lol
but yah
i sincerely doubt medical salaries will go down a lot
and if they do..
well then.. we'll all move away and the government will beg for us..

[DendWrite]

Originally Posted by serenade

i can say that obtaining a high salary isnt a plus.. but i'd be lieing..medicine is for always a career.. of which someone works for a living..and the only reason i'm actually considering not going into medicine is if im going to be working 60 hours a week and get paid nothing and die in debt. if medicine remains a field which gives good pay.. well im still interested.

That's the thing. If you are looking for a job where you'll make bank...REALLY make bank, medicine is NOT it (and I think that attendings would agree with this). Doctors make good money, but if you factor in the personal sacrifice that comes with 4 years of med school, a long residency, possible additional training, and the hours that they work per week, malpractice insurance, and little to no free time / vacation time, medicine is NOT a good choice.

This link is a case in point (http://www.reddit.com/r/IAmA/comment...in_the_us_and/) ... guy makes OVER $500k a year. Read particularly the third paragraph:

"I graduated from a mediocre state school in the Midwest. My degree was in Liberal Arts. I started in sales in industrial robotics in San Francisco, moved to Chicago then to Michigan. I came back home - was downsized and started in Medical. I didn't know anyone in the industry. They really don't want you to know anyone or anything about it. They want you "clean" so that they can mold you into what THEY want you to be. We have a 3,800 sqft home that is about 450-500K. It is our first home we paid exactly 301K for it when we bought it and we have it paid for. We are not "rich" like you are thinking. We do it old school - 100% liquidity no debt."

No medical school. Unlimited earning potential. No malpractice insurance, set your own hours. This is just one example. In all of these fields, if you want it bad enough and are a good people person, (and a little lucky) your earning potential is very great. Medicine is a bit more "guaranteed" in that, okay, you will pretty much for sure make $120k+ as an attending, even in family practice. BUT you have to get there, and you have loans. There's a lot to think about.

I just think that money is not a good reason to go into medicine. Yes, there's a good chance that you will always be compensated well enough to live on a medical salary. But I don't think it's prudent to count on the salary making a huge jump anytime soon (and even being comfortable with a 10 to 20% decline).

[DendWrite]

Originally Posted by XsmallX

good point... thank you very much for bringing a dose of the "other side" to this forum...

but isn't pediatrics supposed to increase in the future? I read on a government site that pediatrics is supposed to increase by 22% between 2010 to 2018

oh man and I wanted to be a pediatrician

Trust me, the WORST way in the world to choose a specialty is by basing it on whether it's going to be more "in demand" or not. If you pick something you love and do it well enough, the money will come.

[serenade]

Originally Posted by DendWrite

That's the thing. If you are looking for a job where you'll make bank...REALLY make bank, medicine is NOT it (and I think that attendings would agree with this). Doctors make good money, but if you factor in the personal sacrifice that comes with 4 years of med school, a long residency, possible additional training, and the hours that they work per week, malpractice insurance, and little to no free time / vacation time, medicine is NOT a good choice.

This link is a case in point (http://www.reddit.com/r/IAmA/comment...in_the_us_and/) ... guy makes OVER $500k a year. Read particularly the third paragraph:

"I graduated from a mediocre state school in the Midwest. My degree was in Liberal Arts. I started in sales in industrial robotics in San Francisco, moved to Chicago then to Michigan. I came back home - was downsized and started in Medical. I didn't know anyone in the industry. They really don't want you to know anyone or anything about it. They want you "clean" so that they can mold you into what THEY want you to be. We have a 3,800 sqft home that is about 450-500K. It is our first home we paid exactly 301K for it when we bought it and we have it paid for. We are not "rich" like you are thinking. We do it old school - 100% liquidity no debt."

No medical school. Unlimited earning potential. No malpractice insurance, set your own hours. This is just one example. In all of these fields, if you want it bad enough and are a good people person, (and a little lucky) your earning potential is very great. Medicine is a bit more "guaranteed" in that, okay, you will pretty much for sure make $120k+ as an attending, even in family practice. BUT you have to get there, and you have loans. There's a lot to think about.

I just think that money is not a good reason to go into medicine. Yes, there's a good chance that you will always be compensated well enough to live on a medical salary. But I don't think it's prudent to count on the salary making a huge jump anytime soon (and even being comfortable with a 10 to 20% decline).

babe.. the money is a aspect of why i decide to go into medicine..
if it was the only reason.. i'd really go into law or something frugal which the pre-meds believe is easy to do on this fourm.

and lets not lie my friend, you know that medicine is a career too, you might be drawn to it for reasons which compel you to believe its the right career for you. but if medicine only paid you 20k you sure as hell wouldn't want to go into it right?
there are extrinsic and intrinsic points which guide our behaviors in life.. and to say that your completely uncompelled by the extrinsic... well my friend your lieing and any psychoanalyst would say the same.

like i said before, i like the social aspect of medicine, i love working with people, im a very sympathetic soul and a idealist...
im also a person who wants needs challenge and stimulation..
medicine provides me with those aspects
and the money is but a plus.

[OkMd73]

shocktrooper Emergency Medicine
Posted Oct 29, 2008 at 2:48 AM

"I have the least important job in the hospital--I pick up the chart and go see the patient." This was a recent quote from a colleague.

The problem with medicine right now is that we don't have a savior. We have no on fighting for the greater good. Why? The good clinical docs that love medicine keep taking care of patients and don't have time to fight. Those that get out may have good intentions at first, but then become parasites---that don't realize that they are killing the host. They make their money off the people actually doing the work.

There are good admin people out there. Lationmd I won't direct any nastiness at you, I don't know where you fall on that line. The article that you highlighted where the author 'quit medicine' (at the end of medical school?) and is now going some medical administrator school shows the worst part of the new order.

This doc who does not know her ass from her elbow when it comes to the actual practice of medicine will now be 'in charge.'
imsahagun Pediatrics
Posted Oct 29, 2008 at 9:30 AM

I want to quit medicine so badly but I cannot survive doing anything else. I feel invisible in this country. Am I alone in this??

drpoundsign Internal Medicine
Posted Oct 29, 2008 at 9:58 AM

the third party non payers, the crazy patients the drug seekers the fatties the chain smokers....

still in it but it's getting to be too much!!

latinomd Surgery, General
Posted Oct 29, 2008 at 11:36 AM

Shocktrooper- I agree going into administrative heatlh care management right out of medical school is a bad choice.

I use to be one of those "take care of the patient" all the time guys. But working in an underserved area with little to no support and infrastructure other than my good intentions, social values and excellent university surgical training, the system overwhelmed me.

My colleagues were just as busy if not busier, had no time to fight. Now I am fighting on the side of organized medical groups, coordinated, integrate care delivery systems.

Mange 3000 physicians and 175,000 patients. This group because of local regional influence is very patient/physician centered and has leverage with health plans and hospital systems.

We are returning to physicians $7.25 million in P4P dollars wtih a 3rd year of over $10.5 million in operating profit off of $285 million in revenue.

Great model and California is leading the way - it is our savior. How do we spread our good fortune to other physicians to give them hope.

Group is physician owned and managed.

foursnuff Surgery, General
Posted Oct 30, 2008 at 11:18 AM

"the fatties" - I love that. laughed my arse off. Most of the oral surgery I do stems from pts neglecting their mouth/teeth. Its hard to put up with the drug seekers, crazy patients, fatties etc giving me a hard time in the chair when they did it to themselves.

In med school, the thought of bringing a patient up short and telling them like it is is grounds for dismissal. We are so afraid of confronting pts for fear of losing them, lawsuits etc, it leaves us powerless.

Our profession has the smartest most motivated and caring people in society and yet not the highest paid nor the most respected.

I agree wholeheartedly that we need a spokesperson. I would sign up for the job but Im awfully expensive.

Ginger Emergency Medicine
Posted Nov 02, 2008 at 3:14 PM

"Our profession has the smartest most motivated and caring people in society and yet not the highest paid nor the most respected". Foursnuff, you're right. And we need to do something constructive with that intelligence in addition to seeing patients if we want the system to work better.

I've been to two kinds of conferences in the past year. Physician trade show/assemby, and healthcare executives congress. Here's the biggest (and most depressing) difference I saw.

Both groups (docs and hospital execs) are legitimately (yes, legitimately) worried about making ends meet. Both groups recognize that the other holds some of the cards needed to succeed. Oddly enough, even though docs seem to uniformly feel that hospitals hold all the cards, hospital execs stay awake at night worrying about what happens to their employees, patients and communities if the physicians revolt.

The difference I mentioned? The presenters and attendees at the physician conference spent almost all their time blaming others for the problems physicians face. At the healthcare exec conference they spent the time trying to figure out how to fix it. This will shock the pants off many of you, but one of the biggest topics under discussion was "how do we work together with physicians?" And it was NOT, "how do we get them to lower their guard so we can screw them?"

No doubt there are some total jerks in administrative roles. Most of them, though? I bet not. They've never been a doc. They haven't been to med school. They have never looked back on a bad decision and wondered (known?) that someone DIED from that decision. They don't 'get' the gallows humor, the fear, or the fact that we don't learn business management, "exec speak" and "profit margins" in med school. They don't think like a doc because you can only think like a doc if you are a doc. It's not malicious; they just don't get the way docs see things.

Why does this matter? Because if fixing your part of the system REALLY matters to you then take the time to teach them the physician perspective. If you don't, no one will, and docs will just keep complaining that no one watches out for us and no one understands us. We need to do something other than just complain.

We can't keep treating hospitals like surgeons treated surgical patients in the 1890s ("get in quick, whack 'em, and get out as fast as you can") and expect good results. Think along the lines of chronic disease management ... learn the pathophysiology of administration, diagnose the specific areas in the process that aren't functioning optimally, come up with a coordinated treatment plan, adjust as needed depending on response and follow through.


rurallmd Family Medicine
Posted Jan 13, 2009 at 11:29 AM

I can't help but comment on "the fatties" . 2/3 of our population are obese per recent figures in the news. We have to like the fatties to stay in business.

Bilroth Emergency Medicine
Posted Apr 21, 2009 at 10:57 AM

This has been a fascinating discussion. Interestingly, I am an organizer for a new CME conference called Medical Fusion that is focused on teaching doctors how to leverage their medical training to expand their careers. The website is www.MedFusionConf.org . We're hoping that by bringing together a number of docs who have either moved on from clinical medicine or are supplementing their clinical time with other interests we can provide a lifeline for frustrated docs. Check us out-- it will be at the Las Vegas Wynn in November and we'll be talking about entrepreneurship, law, venture capital, medical devices, writing/publishing, and many other areas, all from a physician's perspective.

Sorry for the infomercial but I just wanted to let you guys know there are folks out there trying to address these issues...

[DendWrite]

Originally Posted by serenade

my friend, you know that medicine is a career too, you might be drawn to it for reasons which compel you to believe its the right career for you. but if medicine only paid you 20k you sure as hell wouldn't want to go into it right?
there are extrinsic and intrinsic points which guide our behaviors in life.. and to say that your completely uncompelled by the extrinsic... well my friend your lieing and any psychoanalyst would say the same.

My parents make about $50k a year each (both are high school teachers) and one has a masters, the other has a B.A. So the $20k figure is ... kind of ridiculous for medicine. No, I wouldn't do medicine for free, but that's because in order to do medicine well you don't have time to work another job in order to support yourself. I'd do medicine if it only paid $50k a year, though, and I was able to have my debt under control. At first when I was a pre-med, I was like, OH YEAH...gonna make $300k+ a year and buy all this stuff and it's going to be great

but then I actually got some exposure to the field and realized that it's not something that you go into for the money, at least not for me. You can feel free to psychoanalyze me, but I'm telling the truth.

[OkMd73]

Have you thought about quitting medicine? What would you do?
Have you ever fantasized about quitting medicine? If so, what would you do instead?
For me, probably day trading and/or something in the music field.





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Category: General Interest

Posting ID: 36455
Posted on May 23, 2009 by Pockey
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Comments (34)
34 RhemaSayers Family Medicine
Posted May 23, 2009 at 1:18 PM

I've been putting off retiring and will continue to put it off at least until the daughters are out of college. And considering their grades this semester, that may be a while.

teckels Internal Medicine
Posted May 23, 2009 at 1:53 PM

I think about it all of the time, but I don't think Walmart greeter would bring in the salary necessary to pay off my student loans.

That's all I'm qualified to do, besides medicine.

doc2007 Pathology
Posted May 23, 2009 at 3:07 PM

I would like to be a tribal elder and teacher someday.

mh2003 Emergency Medicine
Posted May 23, 2009 at 5:07 PM

anything on a quiet, white-sand beach in the virgin islands... don't need much money, just enough to pay for my little hut on that beach.


Flashman Internal Medicine
Posted May 23, 2009 at 7:54 PM

If I could do it all over again, I'd become a race car driver. Or maybe a writer for a car magazine.

Of course, when ever I think about it, my brother reminds me that I can't remember what makes a car even run. Family is always glad to bring me back to reality.

Zeits1 Anesthesiology
Posted May 23, 2009 at 8:11 PM

anesthesia tech.

Sikorsky Anesthesiology
Posted May 23, 2009 at 8:44 PM

When I was a medical student, I spent time on a Peds service on which Gwyneth Paltrow was a volunteer. She liked helping children who were sick, and making a difference in the world.

The grass is always greener on the other side of the fence...

macysmom Family Medicine
Posted May 23, 2009 at 10:13 PM

I would love to do anything other than medicine. I love what I do but cannot make a living doing it. It's pretty sad when you start envying the toll booth operators...

galenofpergamum Family Medicine
Edited May 23, 2009 at 11:28 PM

I want to be a lion tamer.

(a Monty Python reference)

galenofpergamum Family Medicine
Posted May 23, 2009 at 11:30 PM

I've thought about going back and doing another residency sometimes.

Or self-flagellation.

doctoranna Family Medicine
Posted May 23, 2009 at 11:58 PM

Ditto what Galaxy said.

fxneuro Neurology
Posted May 23, 2009 at 11:59 PM

Porn Star if my wife will let me

spamal Internal Medicine
Posted May 24, 2009 at 8:03 AM

From a lecture by her that I heard, this doc seems to have turned her primary care practice into a a retirement/vacation when she goes to work every day:
www.idealmedicalpractice.org

Talk about heaven on earth!


drbarks Emergency Medicine
Posted May 24, 2009 at 9:56 AM

I love medicine...........the art, the science, the personal interactions and yes, the feeling that it gives me when I do slip up and help someone feel better. It is all the other baggage that goes with medicine today that depresses me and causes me to actually reach the point whereby I no longer look forward to going to work. All the community college grads who now know more than I as far as what is best for my pts. The hospital administrators roaming my dept, asking why the waits are so long...........with every room full and thirty still in the waiting room..............not wishing to discuss the fact that they laughed when we tried to get them to build a bigger facility three years ago. Press Ganey...............Joint Commission.................Medicare...........all conspiring to increase the weight on our already overburdened shoulders. I have tired of working harder and harder each year but with less and less take home pay. The drug seekers who try to scam us every day to the point that I have now become jaded and have lost my innate compassion for those poor souls who just cause me more grief with each passing day. The guy who came up with the idea that pain is now a vital sign...............especially when I enter a room of a pt who states his pain is a 12 on a scale of ten, only to find him sitting up in bed laughing at cartoons on the new flat screens the admin placed in the rooms..............but they could not find the money to hire some much needed techs for our dept. Medicine is tough enough..............but when you add all these other issues to the mix, the final cake is just not that tasty any longer.

mohican Family Medicine
Posted May 24, 2009 at 12:45 PM

I'd probably get a Masters in Education and become a school teacher. I think I'd enjoy it.

edwestrfld Anesthesiology
Posted May 24, 2009 at 1:01 PM

already doing it.....open the doors in 6 weeks.

curacao Internal Medicine
Posted May 24, 2009 at 2:10 PM

ed -- your Irish cafe? Cool.

milnomore Internal Medicine
Posted May 24, 2009 at 5:49 PM

Mohican--you don't need a Masters in Education. I teach honors science and math classes in a private high school. Nice, interested kids. It's really great; thankfully I have military retired pay and a working husband 'cause the pay is

basicscience Anesthesiology
Posted May 25, 2009 at 12:56 AM

milnomore, did you need any certification? Besides your M.D. of course! I would like to teach science too. Do you teach full-time? And how long do you think you'll keep practicing medicine?

I'm taking an architecture course. If I was younger (and more artistic, sigh), I'd like to be an architect.

montanadr Emergency Medicine
Posted May 25, 2009 at 8:22 AM

I will be out of medicine in 2 years. I have started some extra activities which are turning out to be lucrative. I also have a book with a publisher and am working on my second.
The sad things is that I used to love medicine. I actually got up in the morning and looked forward to going to work....no more. There are a number of issues to blame, but they have turned the practice of medicine into hell. I won't miss it a bit.

doctoranna Family Medicine
Posted May 25, 2009 at 9:34 AM

basicscience, many school systems are assisting with getting teacher certification, especially for folks who want to teach math or science. It can sometimes be done in one year. Ask your school district about alternative paths to certification.

NYEMMD Emergency Medicine
Posted May 25, 2009 at 10:46 AM

I burned out of Emergency Medicine several eyars ago. Everyone reading this knows the many issues in medicine that, for me anyway, made life miserable as a clinical doc. I have an MPH so I did a public health project for 3 years, and am looking for another job, but the market is a lot tougher right now. Plus I think there is some real age-ism out there, despite the protestations that such bias doesn't exist.

Have others made the transition into fields other than clinical practice?

milnomore Internal Medicine
Posted May 25, 2009 at 3:39 PM

basicscience--when I applied for this position, which is a 'long term sub' for a pregnant teacher, I made the point that I've been a teacher of medicine for over 20 yrs and it went over well. I'll keep seeing patients once per week for a long time, I think. I keep looking at part time MD positions but can't get excited about them, whereas teaching genetics, heart, dissecting to honors kids is fun and challenging. If you are smart enough to make it through med school, residency and years of practice, you are smart enough to be able to handle something else. Try it!

basicscience Anesthesiology
Posted May 25, 2009 at 10:27 PM

Thank you milnomore and doctoranna! I'm excited to look into this.

doctoranna Family Medicine
Posted May 25, 2009 at 10:54 PM

You can be a sub with any bachelor's degree and a background check. You don't need a teaching certificate. It pays 70 bucks a day around here.

milnomore Internal Medicine
Posted May 26, 2009 at 6:04 PM

$120/day for long term in DC area with an MD

steeldoc OBGYN
Posted May 26, 2009 at 7:15 PM

Own a few storage facilities and train for triathalons.

Ebola100 Family Medicine
Posted May 26, 2009 at 7:19 PM

I'd like to be a dog.

curacao Internal Medicine
Posted May 26, 2009 at 11:47 PM

LOL Ebola that's awesome.

My dogs live like "welfare" kings...free medical care, free food, free room and board. They need to get a freakin' job. I get home from work today tired as hell, and the little furry dude is sitting in MY chair, yawning !! as if he had a stressful day or something.

mohican Family Medicine
Posted May 27, 2009 at 12:04 AM

curacao, the dogs' jobs are to protect your territory from evil intruders, such as the postal worker.
My dog is the same. She has a comfortable, somewhat boring life.
Yet dogs' ancestors, the wolves, hunted in packs, ran for miles to corner prey, and shared food in their group. Human packs are much easier on them. They're pretty smart to live with the humans.
Dogs nowadays have entitlementitis!

emb0lus Internal Medicine
Posted May 28, 2009 at 11:58 PM

just got back from my first trip to the Caribbean - i really tried to get my wife to agree to let me look for a job teaching at one of the medical schools down there and having a clinic on the side. She decided she did not want to have to home school 3 kids as she was not sure about the public education on those islands. I will keep trying and keep putting pictures of our trip as the computer desktop's background picture.

[krispy]

The conversation taking place here is strangely coincidental, as I had a nearly identical talk yesterday, by pure chance.

Ultimately, there is a huge conundrum here (obviously, heh). Those of us that have wanted to be doctors since, way back when almost feel betrayed by a system that is reeling from the inertia of when it used to be characterized by autonomy and independence (on another thread, these words are used quite frequently to explain why a LOT of people want to be MDs). These are the very reasons I wanted to be a Dr, instead of say, a NP. But apparently, autonomy is out of the picture, as is any shred of independence.

I love competition, I love the high of achievement that I get after studying for hours and getting a good grade, I also genuinely love people and want to help them in any way I can. After conversations that are particularly earth shattering (like the one I had yesterday with a young man that had gotten his MD, but absolutely regretted it), some of these things seem ridiculous (competition, achievement highs?)...but I guess the question I'm asking myself is: if I never gave medicine a chance, would I always regret it?
The sad thing about this situation is hindsight is always 20/20, and we'll never know until we're in that attending's shoes, if we don't change our minds first. Sigh. This decision is a lot bigger than some of us give it credit for, methinks (after all, people telling me med school is hard work/full of stress has almost become white noise for me).

[Arjuna]

Originally Posted by okmd73

this is the best advice i can give current students thinking of choosing a career in medicine:

Do not do it! Choose another career. You are bright, motivated, and hard-working. You could receive intellectual, emotional, and spiritual fulfillment from a number of different occupations.

Medicine, as we know it, is a dying field.

If you are thinking of becoming a family doc, an internist, or a pediatrician -- well forget it. That job will cease to exist in the near future as those mds are replaced by nps, pa-c's and rns.

If you think you will be well compensated for your efforts as an md, well then just forget it. You will not. Go into business instead.

If really want to help people, well then go into business, make your millions and then retire in your 30s and devote the rest of your life to volunteer work.

If you are interested in the scientific aspects of science, well then go to graduate school and get your phd. At the very least you will be avoiding hundreds of thousands of dollars of debt.

And if after all that you still want to be an md, then my advice is this: Expect to be a hospital or university employee who is instructed by administrators, insurance companies, the government, nurses, and families how to treat your patients.

This is honestly the best advice i can give. Refer to the following links which may shed some light on where i am coming from:

http://www.cnn.com/2009/health/08/25...tor/index.html

http://sermo.com/blog/2010/01/2/ftf-...nt-lying-again

http://www.theheart.org/article/1037273.do

http://www.askmen.com/money/career_200/210_career.html

fail.

[krispy]

Originally Posted by OkMd73

Please read the CNN article I posted. It is from a physician from SERMO.com. .

BTW, I read it and it was pretty heartbreaking, especially knowing that..."nearly half of all doctors surveyed by the Physicians' Foundation have said that over the next three years they plan to reduce the number of patients they see or stop practicing entirely."-Harris

[serenade]

Originally Posted by DendWrite

My parents make about $50k a year each (both are high school teachers) and one has a masters, the other has a B.A. So the $20k figure is ... kind of ridiculous for medicine. No, I wouldn't do medicine for free, but that's because in order to do medicine well you don't have time to work another job in order to support yourself. I'd do medicine if it only paid $50k a year, though, and I was able to have my debt under control. At first when I was a pre-med, I was like, OH YEAH...gonna make $300k+ a year and buy all this stuff and it's going to be great

but then I actually got some exposure to the field and realized that it's not something that you go into for the money, at least not for me. You can feel free to psychoanalyze me, but I'm telling the truth.

Cough.. if your debt was under control..
yah.. 200k debt with a 50k salary..
would leave you in debt for 33 years..
consider you bought a house and burnt it down and have no insurance..
but again thats outside the real world, so a psychoanalysis of you would be a extremely idealistic one not a real one at all.
i dont want 300k a year.. i want enough to get by conformably and support myself and my family. A high school teacher has many pro's in itself.. great pension and job security after 10 years of working. Its a very nice field.. but again different intrisinic and extrinsic aspects in it.


but again.. your acting as if im only in medicine for the sake of the money..
and completely ignore my other reasons for going into medicine..
but thats cool too..

[DendWrite]

Originally Posted by serenade

but again.. your acting as if im only in medicine for the sake of the money..and completely ignore my other reasons for going into medicine..but thats cool too..

There's always financial aid and debt forgiveness programs if you agree to work in a rural area for an underserved population for X amount of time if that actually became a problem.

I'm not trying to imply that you're only in medicine for the money...I was just sharing why I don't think money in general is a good reason to go into medicine. I wasn't trying to attack you or anything.

[anonymousername]

Alright, I'll bite. It's not just this poster who say's they would do it differently.

Why do you keep doing it if you're miserable:
http://forums.studentdoctor.net/showthread.php?t=478369

If you could do it all over:
http://forums.studentdoctor.net/showthread.php?t=195799

Being a doctor worth the debt:
http://forums.studentdoctor.net/showthread.php?t=663924

[serenade]

Originally Posted by DendWrite

There's always financial aid and debt forgiveness programs if you agree to work in a rural area for an underserved population for X amount of time if that actually became a problem.

I'm not trying to imply that you're only in medicine for the money...I was just sharing why I don't think money in general is a good reason to go into medicine. I wasn't trying to attack you or anything.

lol i know but you were mostly just revolving around the money part..
which kinda makes me feel as if your worried if your goals in medicine are as pure as you'd think... but thats just me psychoanalyzing to deeply haha..

but regardless as long as a person has a bedside manner and is sympathetic.. and can feel and understand the patients pain.. they will make a good doctor..

[serenade]

Originally Posted by anonymousername

Alright, I'll bite. It's not just this poster who say's they would do it differently.

Why do you keep doing it if you're miserable:
http://forums.studentdoctor.net/showthread.php?t=478369

If you could do it all over:
http://forums.studentdoctor.net/showthread.php?t=195799

Being a doctor worth the debt:
http://forums.studentdoctor.net/showthread.php?t=663924

i've read all of them..
my end result? i worry my ass off and fear for my mental sanity and the hopes that i dont end up like dr.wilson with 3 divorces -.-

[minicow]

time is money and quite frankly i would never want to work my ass off after years of rigorous training just to earn about $25 an hour (50K a year working only 40hrs/wk)

at a certain point having to deal with all the **** that has nothing to do with caring for patients is not worth it.

its not being greedy to want rewards for your work. ill be sitting back and watching the trend the next few years....if things dont improve im going elsewhere

it would be fine to work for less money if being a Dr was just caring for others and using your skills when they are needed, but its not.



its really kind of sad if you think about it

[krispy]

Originally Posted by serenade

i've read all of them..
my end result? i worry my ass off and fear for my mental sanity and the hopes that i dont end up like dr.wilson with 3 divorces -.-

same

[bobsmith]

Originally Posted by serenade

im familiar with all that..
and im more or less contempt with the work portion..
but when people are saying medicine is becoming stagnant and its main work force taken over by nurses..
well i feel really sad with that.. and feel scared that after i complete medical school i'll end up getting paid 80k and working 60 hours for the rest of my life in a faillish attempt to pay off my loans..

was this a freudian slip or did you actually mean contempt?

[minicow]

Originally Posted by bobsmith

was this a freudian slip or did you actually mean contempt?

[serenade]

Originally Posted by bobsmith

was this a freudian slip or did you actually mean contempt?

possibly haha.. with the animosity of the internet and my fast typing there might have been ahaha the mind does like to finish words of similar beginning and ending.. so yah haha..
i ment content lol

ah psychology.. gotta love it!

[ceng2doc]

Medicine is not dying. Period.

But, I guess, OP is trying to agitate around the new health care reform on the way. Leave the profession, if you don't wanna work any more. But, why to disguise pre-meds?

If OP was a real attending/resident/med-student, s/he shouldn't have discredited his/her profession while trying to jump kick the government's stomach due to that new bill.

[nickmx50]

Interesting comments. I guess this advice would be relavant depending on someone's motivation for going into medicine. I had my first million made before I was 30 and I left a job making $140k year, so I can pursue a career in medicine. If anyone thinks that running a multimillion dollar business is a piece cake, I have to disagree. It is physically and mentally taxing, as well as very uncertain and nerve racking. I loved every minute of it, but medicine has always been my passion. Who truly knows what future medicine and health care will bring? I want to be able to practice medicine and teach young residents in the future. I guess in any profession you can find negative aspects and people to discourage you away from it. I've already met a Doctor who wished he had been a engineer and hate's his family practice. But thanks anyway for the warning.......

[serenade]

Originally Posted by nickmx50

Interesting comments. I guess this advice would be relavant depending on someone's motivation for going into medicine. I had my first million made before I was 30 and I left a job making $140k year, so I can pursue a career in medicine. If anyone thinks that running a multimillion dollar business is a piece cake, I have to disagree. It is physically and mentally taxing, as well as very uncertain and nerve racking. I loved every minute of it, but medicine has always been my passion. Who truly knows what future medicine and health care will bring? I want to be able to practice medicine and teach young residents in the future. I guess in any profession you can find negative aspects and people to discourage you away from it. I've already met a Doctor who wished he had been a engineer and hate's his family practice. But thanks anyway for the warning.......

its funny because people on this fourm all think investment banking and other things are great easy ways of making money and little effort..
i watch my dad run his company.. he sleeps maybe 5 hours a night but makes about the same as a doctor around 200k
so in the end result is medicine will more or less leave you with a conformable lifestyle regardless

[amakhosidlo]

Originally Posted by OkMd73

Please read the CNN article I posted. It is from a physician from SERMO.com. A forum of physicians that I am also a member of.

I am in a practice with 3 other cardiologists (2 interventional). I am not an interventionalist so the recent HHS/CMS regs for cutting reimbursements for office-based tests such as TTE severely hurt my practice. I fully support the ACC decision to sue CMS/HSS.


Over the last two years our reimbursements have dropped 28%, though we have 9% more patient encounters. Meanwhile our overhead has increased 11%. Patient complexity has increased at least that much, as everyone I now see has mutiple medical problems and most have known CAD.

The cuts will be more severe this year, especially when commercial insurance starts following the 20% medicare rate cut.

There are still fulfilling days. Patient care in its truest sense is the same but when I am spending 50% of my time dealing with insurance companies, fighting for re-imbursements and filling out the necessary paperwork to get paid, at what point is it no longer worth it? Ask yourself that.

My partners and I met before the new year to discuss a plan to address the upcoming medicare cuts and the proposed health care bill. Our consensus? See as many patients as we can, work as hard as we can and bill as much as we can until 2014; at which point we can either A) opt out of medicare -- if that is still possible -- and go to a cash based practice for office visits or B) make enough money to retire and do something else. And then I asked everyone, is that why we went into Medicine? No one answered.

Lastly, if you find it strange that a practicing MD would come onto your forum to warn you of the perils of a future career in medicine, then please also be skeptical of those who tell you why you should pursue a career in medicine and why it is still such a great field.

Though I, and I'm sure many others have no problem believing your story, facts and figures, etc, you have to realize who you're addressing. I don't know about anyone else, but aside from medicince, there's really nothing else out there I could see myself doing, and it's not for lack of imagination/effort either. I've tried shadowing in dent, pharm, pa, even legal and business fields. For me, and I'm sure many others, nothing has been as satisfying or exciting, intellectually and personally, as medicine. You tell us to "Go into business" as an alternative. Most of my friends on wall street are coweringbunder their desks hoping not to get canned.

You say medicine isn't the same as when you started. And what of those already in practice for years at the time? Surely medicine's evolution/devolution can't have started the second you arrived on the scene, not to mention the past 5-10 years. Will medicine change radically over the next 10 years? I think it would be naive to think otherwise. Will it still be a field that offers greater personal satisfaction than other prospective fields for certain people? Probably. Though I definitely think, as someone mentioned, it would behoove all of us to consider whether we're part of that group, and whether our choices would be the same if medicine became a "middle-class" profession.



As future physicians we'll all have to worry about midlevel encroachment, declining reimbursements, etc. But do you think people will ever stop getting sick/needing doctors? Prob. Not.

[CaliGirl14]

This thread is complete .

[chman]

I am glad this "attending" could grace us with his deep and well articulated insights into the current medical debate.

EDIT: By the way, there are unhappy people in every career. Why should medicine be any different? In fact, I would say there are more in medicine because so many go into it for the wrong reasons.

[OkMd73]

One down. How many more to go?
Today, a very competent, caring and friendly FP in my town announced that he is throwing the towel. After 25 years in solo practice and with a pt pool of 1500, he is making 2-3K a month after expenses. I know he is a very good doc but suspect he is not much of a business saavy person.

How is the weather in your town? What's the forecast? ........ gloomy with chance of more drop outs?



Tags
practice
Category: General Interest

Posting ID: 45030
Posted on December 29, 2009 by gb2009
View most recent
Comments (85)
85 3churchill7 Family Medicine
Posted Dec 30, 2009 at 12:01 AM

Would be thrilled to earn that much money doing what I love.
It is just that expenses are so high

ladyobgyne1 OBGYN
Posted Dec 30, 2009 at 1:02 AM

My guess is that he has lots of medicare and medicaid and it is tough to make ends meet. Here in Indiana we have high unemployment and those with insurance have high deductibles.

NYUHMCMOM Internal Medicine
Posted Dec 30, 2009 at 2:25 AM

Lots of early retirement in my area.

bodomo Allergy and Immunology
Posted Dec 30, 2009 at 3:40 AM

3K a month is $36K per year. I know times are looking tough and I expect a significant salary reduction but how can it be so low? I made more than this during traing. I wonder if Walgreen could retrain us as pharmacists...they start six figures out of pharm school.

Phillip Surgery, General
Posted Dec 30, 2009 at 8:15 AM

Three internists (out of seven total) in the past 18 months. Starting to get difficult to find docs for all the unassigned patients. No one is now taking new Medicare.

AZdrydoc Family Medicine
Posted Dec 30, 2009 at 8:27 AM

The DC Idiots seem incapable of recognizing this train wreck -- or are they all simply saying, "Oh, no problema -- we'll just plug in more NPs and cover primary care adequately."

orlandoc Internal Medicine
Posted Dec 30, 2009 at 8:44 AM

AZ-
does this reminisce of "Oh, no problema -- we'll just let them eat cake."

orlandoc Internal Medicine
Posted Dec 30, 2009 at 8:53 AM

In my previous area, we used to have constant inflow and outflow of FMGs. Local old boys in private practice made sure they dont find it easy to stay.
Now that J-1 source has almost dried, there is only 1 inflow since 2006. Outflow was ~30. Many primary care local senior boys just threw up towel and joined hospital servitude. This shifted balance of power in MEC etc in favor of hosp. Hosp went aggressive and swallowed many other practices. Now there are only 2 surgeon and 1 FP standing independent.
Pt have access, but at the terms and conditions of hosp. eg you can call after hours but you will hit a blind closed loop of menu tree and it will be just waste of time. Compare that to my private practice where my (good) pt have my cell phone number.

orlandoc Internal Medicine
Posted Dec 30, 2009 at 8:54 AM

BTW, voting is pretty unanimous.

docjayb Ophthalmology
Posted Dec 30, 2009 at 9:10 AM

You can make more than $3000/month by covering ER call alone. I am not surprised that he retired if that was his bottom line. Where was this doctor working?

rurallmd Family Medicine
Posted Dec 30, 2009 at 9:45 AM

I am last one here will take about 1 1/2 years to wind it down. Then will do some part time contract hospital work.

AZdrydoc Family Medicine
Posted Dec 30, 2009 at 10:17 AM

Or, "Y tus madres tambien!"

Heather12 Family Medicine
Posted Dec 30, 2009 at 10:45 AM

That just seems way out of the ordinary--salary wise. I expect it boils down to poor payer mix (medicare/medicaid) and really poor business skills (overhead/costs etc). Any FM doc could pick up the phone and have a job paying more than this anywhere.

maddoc8 Pulmonology
Posted Dec 30, 2009 at 11:16 AM

You need a good crisis to impose extaordinary changes.THEY know what their doing ,if we don't stand TOGETHER we will ALL BE SCREWED.

3churchill7 Family Medicine
Posted Dec 30, 2009 at 11:32 AM

I make less than that.
Looking for other work.
Expenses just too high in Miami.
We don't take HMOs, refuse medicaid,

Traveler Family Medicine
Edited Dec 30, 2009 at 1:37 PM

Within an 8 mile radius since 2007:
Two FP retirements
One FP bankruptcy (took academic position out of desperation)
One FP move to the VA, to avoid bankruptcy
One solo added 2nd PA
One solo added 1st PA
One solo added 2 part time NP's
The times they are a changin'.

nicole10 Allergy and Immunology
Posted Jan 01, 2010 at 12:21 PM


MEDICAL SCHOOLS are in the BUSINESS to train DOCs.. they are increasing enrollment regardless of cost and debt to students AND Specialty Training has DECREASED and is forcing more NEW DOCS into FP.......... somehow we need to Let Kids considering going to Med school KNOW these CHALLENGES..

the FOREIGN TRAINED , of course have NO DEBT ...or next to none.... and the WAY you get HIGH volume PRACTICE, of course , is to be in BIG CITY AREA //.

medicaid in Florida and NY has been a travesty for YEARS.. and should be only with salaried lower level providers AND NOT IN DOCS offices unless it pays for service AND RISK !!! of malpractice suits . IF done stricly by VA clinics , the risk would evaporate. BUT CURRENT ADMinistration WANTS more business for his LAWYER BUDDIES... just as with the Crotch bomber and the 911 guys whose cases have been givin to lawyers on taxpayer funding.. what a travesty........
imdoc1955 Internal Medicine
Posted Jan 01, 2010 at 1:51 PM

I am a busy solo internist, in practice for 25 years. I have had to take desperate measures to stay in business including no disability insurance, no health insurance for my employees, no office insurance, no new Medicare, no Medicaid, and cash or checks only at time of service (to save on the 5% taken out by credit cards and billing costs). I too have about 1500 patients but see 23 per day. I can't afford an EMR and PA's and NP's wanted $50/hr and couldn't really handle complex IM cases. My former partners became hospital employees and the only other solo internist in the area is going out of business. I will stay in practice only because my fiance is an anesthesiologist and makes three times what I make, my house is nearly paid off, I own my office space snd the kiids are finishing college. I can continue practicing but it will be for peanuts soon. I am out of ideas on how to keep my practice model viable.
dredwincruz Internal Medicine
Posted Jan 01, 2010 at 2:29 PM

potpouri of thoughts.

I am sorry for our colleague who is not making ends meet.

Yes, many MDs are thinking about throwing in the towel.
Many reasons; liability and law suits, reimbursement, escalating costs of practicing, runing an office, etc.
Unfortunately, doing it is a little harder than said.
There are the issues of; how does one makes a living, what else if anything do we know how to do, how do we pay for our homes, health insurance, autos, fuel, food,
help your children, etc.
Unfortunately, I learned in Law School that once you, or a group of people, reliquish a right, you never regain that right.
Many years ago, MDs and such provided healthcare and ran the system.
Today, healthcare executives run the system, and get paid very well.
In my area there is a healthcare system executive who earns no less that 1.8 million a year. He has no medical background, I am not sure if he can even put a bandaid on a patient. The FHP executive that I worked for many years ago gave himself 500 thousand dollar bonus. One year we got a picture of him as a gift.

Hospitals could run, at least for awhile without administrators, but hospitals could never, ever run without providers.
We are required to cure all, make everyone happy, and not spend a cent.
Impossible. I think that we are at the bink of healthcare rationing.
Providers are tasked with keeping cost down, curing all, making everyone happy,
and doing what we are told to do by non-healthcare personnel.

I donot think that it will get better, but it will more likely get worse.

[apumic]

Originally Posted by serenade

its funny because people on this fourm all think investment banking and other things are great easy ways of making money and little effort..
i watch my dad run his company.. he sleeps maybe 5 hours a night but makes about the same as a doctor around 200k
so in the end result is medicine will more or less leave you with a conformable lifestyle regardless

You appear to overestimate how much sleep you'll be getting as an attending, young padawan.

[chman]

Originally Posted by apumic

You appear to overestimate how much sleep you'll be getting as an attending, young padawan.

I would say that the young guns on wall street work at least as many hours as an attending.

[DendWrite]

Originally Posted by ceng2doc

If OP was a real attending/resident/med-student, s/he shouldn't have discredited his/her profession while trying to jump kick the government's stomach due to that new bill.

It's a sad day when wanting to get paid = discrediting your profession.

[Spiker]

Originally Posted by chman

I would say that the young guns on wall street work at least as many hours as an attending.

LOL you are comparing recent college graduate to board certified doctor?

Will "young guns" work as much as medical student? NO
Will "young guns" work as much as residents? NO (With calls? hell no)
Will "Old guns" have to work as much as attending? Probably not.

[Spiker]

Originally Posted by DendWrite

It's a sad day when wanting to get paid = discrediting your profession.

Lol yea I agree, Wtf. Every profession benefit from internal criticism and change.

[Bernoull]

Yeah medicine is dying and the world ends in 2012...

It's funny how everyone suggests business, law etc as cash cow careers. Firstly about half of businesses fail within the first year, and not all lawyers rake it in. There's something called an income distribution and there's no guarantee where u'll fall (For each Gerald Hosier, there's tons of public defenders). Medicine will always be among the best paying professions notwithstanding fluctuations. Fellow premeds, follow your passion!!!