"Bad Time" To Go Into Medicine?

[shannonigans]

Hi SDN!

I'm looking into switching careers and pursuing post-bacc pre-med programs to go into medicine (my interests lie in women's health and PM & R, but I know that is bound to change). I've been reading SDN somewhat obsessively since I discovered it and noticed some comments about how it's a "bad time" to go into medicine. My question(s) to you: do you think it's a bad time to go into medicine? Why or why not?

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[deleted92121]

I think the "oh no, the sky is falling" view permeates SDN and is only partially accurate.

I will skip past the health care act, number of medical schools opening, and litigious nature of medicine.

My concerns are on the patient entitlement and hospitals run by administrators demanding high satisfaction scores with minimal staffing regardless of volume or census.

Just a small example but one of the hardest things for me is patients with chronic conditions that don't care for themselves or hold no accountability for their state of health. I recently had a ~500 lb woman with multiple conditions and comorbidities. She was a younger woman too, early forties. She presented with abdominal pain but sure could finish that fast food meal in the waiting room prior to triage. And you know what, this has become commonplace. I wasn't even surprised. To be honest, that is another issue I have. The amount of money spent annually on these types of patients. They are a big reason why health care costs are so high. They could be the nicest person in the world but their lack of accountability has negative effects on us all.

Granted this is coming from someone with 10+ years in one field (EMS/EM), but if you can accept some of these issues and learn to not let them get you down or into a bad place, there is a lot of real medicine going on and pretty dang interesting. It's all about what you make it and how you handle the bad parts.

 

[TheWeeIceMan]

Medicine is most likely past it's "golden age" and seems to be trending in a negative direction. However, it's still a good career, if you have the drive and personality for it.

 

[mavric1298]

Just looking at the projected shortages, I think that we will see changes coming to vastly alter the healthcare landscape, probably more then anything in the ACA. Politics aside, personally I think the shortage will only serve to benefit those in the field as demand grows, and will the leverage providers to return to a greater position to impose their beliefs and standards over those of the admin that can be at odds and only seeing $ and cents.

Also, this is coming from someone who's fiancé is a chargemaster, and I currently just transitioned from a implant/supply coordinator to an analyst position, so I am day in and day out in the middle of the admin/provider struggles and get to see the health of our hospital day to day. And previous to that I was a consultant working with our system to implement EMR, perpetual inventories, and worked with our finance department and state auditors (we are a public hospital).

With that perspective, I think it becomes all the more important to get into it for the right reasons, and because it's what you want to do. The days of fame and $$$ are a thing of the past, for how much time and dedication that goes into it.

 

[Tommyguns89]

1) From a macro view most careers will be unpredictable over time. I remember a few years ago being an actuary was supposed to be awesome, now I hear they are having a hard time finding jobs. Its not that the golden age of medicine is over, its that the golden age of labor in general is over. Unless you make money from capital or time it right and get in the right industry at the right time, you will probably be working more hours for less money(if you are lucky enough to be employed) than people in that industry from previous generations(adjusted for inflation of course)

2) Medicine in the US is especially unpredictable because if we are being honest not only do we have no idea how obamacare will impact physicians, healthcare legislation is going to likely be an issue for many years and new changes will be made.

3) All that being said a physician that doesnt do something drastically stupid will never have to look hard for a job(but they might have to look hard for the right job in the right area) which puts them above most workers in this country in the long term.

 

[QofQuimica]

I would argue that you're asking the wrong question, because no time is a good time to go into medicine for a nontrad. Going to med school is probably a bad financial decision for you, and it's also going to strain your personal life to (but hopefully not beyond) the breaking point. But if it's worth it to you personally in spite of the downsides, then it's also the best time to go into medicine. We can do things for people now that they only dreamed of decades ago, and that aspect of medicine is only going to get better.

 

[Mt Kilimanjaro]

Hi SDN!

I'm looking into switching careers and pursuing post-bacc pre-med programs to go into medicine (my interests lie in women's health and PM & R, but I know that is bound to change). I've been reading SDN somewhat obsessively since I discovered it and noticed some comments about how it's a "bad time" to go into medicine. My question(s) to you: do you think it's a bad time to go into medicine? Why or why not?

I'm no expert, but I'd imagine there was a very similar "sky is falling" refrain being sung by physicians during the capitation days of the 1980s.

I think it might be a somewhat uncertain time compared to other periods in history due to the ongoing implementation of the ACA, but I doubt many of the doomsayers will be proven correct in a decade or two.

 

[Intellex]

Engineering/CS/physics are probably the fields that are in their "golden age" right now. Medicine will continue to evolve into an information technology field while most doctors will become glorified technicians. However, it's a fascinating career nonetheless and has better job security than 99% of jobs out there. Personally, I'm very excited to pursue medicine as a nontrad. But the "prestige" will continue to decline.

 

[68PGunner]

Engineering/CS/physics are probably the fields that are in their "golden age" right now. Medicine will continue to evolve into an information technology field while most doctors will become glorified technicians.

Explain.

 

[DocWinter]

Gunner, It seems intellex is talking about the increasing technology finding its way into medicine. For example, No longer do we cut a patients chest open to repair the heart: we enter a small tool by catheter and control it by joystick.

 

[Intellex]

Explain.

Machine learning/AI are among the most rapidly growing fields in compsci at the moment. Systems (e.g. Watson) are perfecting their ability to synthesize information and make accurate diagnoses. Nobody has a crystal ball and everyone loves to speculate about the timeline of such disruptive technologies, but almost everyone agrees that it's inevitable. Here's an article you may find interesting: http://www.theatlantic.com/magazine/archive/2013/03/the-robot-will-see-you-now/309216/

I'm optimistic, though - doctors have consistently adapted to technological change over the past 100 years and will continue to do so

 

[SN12357]

I think it's a bad time to be entry level in most industries. The most relevant question is not whether it's worse to enter medicine now than it once was, but to compare to the other things you could do and then decide if medicine is still what you want.

This fairly pessimistic outlook brought to you by reviewing resumes today and being aghast at the excess of education in the applicant pool and the comparative paucity of jobs.

 

[68PGunner]

Machine learning/AI are among the most rapidly growing fields in compsci at the moment. Systems (e.g. Watson) are perfecting their ability to synthesize information and make accurate diagnoses. Nobody has a crystal ball and everyone loves to speculate about the timeline of such disruptive technologies, but almost everyone agrees that it's inevitable. Here's an article you may find interesting: http://www.theatlantic.com/magazine/archive/2013/03/the-robot-will-see-you-now/309216/

I'm optimistic, though - doctors have consistently adapted to technological change over the past 100 years and will continue to do so

The article is a simplification on the programming that's needed to make a comparative analysis from a specialist.

Basically, the latest technology is still years away from even scratching that possibility. When it comes to medicine, I think that such tool will be there to help the doctors make better diagnosis on the patient. Likewise, the Da Vinci system is designed for surgeons to improve care, not to replace the work being done by the provider.

Any technology that's designed to replace physicians will be killed on the spot.

 

[mavric1298]

Working with Da Vinci every day, I would have to say it's not as impressive or big of leap forward as many think. Is it cool, useful, etc? Hell yeah. But at the end of the day it's a surgeon sitting in the control booth, manipulating tool just as he would be if he was working laparoscopically. The two major differences are the remote capabilities (which almost no one uses) and the force multiplier for lack of a better term, i.e. moving his hand an inch might result in millimeter movements.I'm trying to find it, but there was study done on Da Vinci and the training/# procedures required to see actual gains, and it was a much bigger number than you would think. We generally are running double to triple OR time to do robotically compared to a typical hysto, with times slowly coming down.

Are there advancements coming? Yes. Is watson a powerful tool? Yes. But they are all in conjunction with physicians, not replacing. It will be a long, long, long, time before we see systems capable of handling the randomness of injuries, presentations, anatomy, etc.. There are just too many variables for any one given case to realistically see anything but humans handling in the near future.

 

[WhippleWhileWeWork]

I think it's a bad time to be entry level in most industries. The most relevant question is not whether it's worse to enter medicine now than it once was, but to compare to the other things you could do and then decide if medicine is still what you want.
.

This, I decided that medicine was the least poor profession for me, right now.

 

[shannonigans]

I would argue that you're asking the wrong question, because no time is a good time to go into medicine for a nontrad.

Oh, my decision to pursue medicine isn't because I want to make oodles and oodles of cash. Health and wellness has always been a passion/hobby of mine and (as cliché as it sounds) I want to be able to use medicine to help people live better lives. I also really miss being challenged by my job.

I've always perceived medicine and doctors as a necessity, so I was surprised to see so many people stating how it was such a "bad time" to go into medicine. I was curious to know if there were only a few people on SDN or if it was shared by a majority.

 

[sazerac]

It's best to figure out what your goals are, and then figure out if now is a "bad time" to go into medicine for you.

Will being a physician enable you to help people in the way you want to help them? Will being a physician challenge you at your job? That is what you should be focusing on. These are questions only you can answer.

For instance, my goals were I wanted an interesting and respectable job that taught me how human biology works and how it can be manipulated. I also wanted to work more with the general public instead of 100% in front of a computer screen. It's a great time for me to go into medicine.

 

[shannonigans]

It's best to figure out what your goals are, and then figure out if now is a "bad time" to go into medicine for you.

Will being a physician enable you to help people in the way you want to help them? Will being a physician challenge you at your job? That is what you should be focusing on. These are questions only you can answer.

For instance, my goals were I wanted an interesting and respectable job that taught me how human biology works and how it can be manipulated. I also wanted to work more with the general public instead of 100% in front of a computer screen. It's a great time for me to go into medicine.

Yes! Exactly!

 

[Rocketdog]

First I'd consider the source (us) with regard to your expected answers. Most of us here are passionate about medicine, that's a given. A group of professionals willing to take their entire lives to the depths of insanity, the brink of financial ruin, with somewhat uncertain results, while waiting YEARS if not decades for a decent return on investment shows dedication of the highest caliber.

Imagine taking ONE snickers bar in to a classroom of third graders: " When is a good time to eat this?" ....they would all probably shout "anytime" in unison!

For me personally and professionally it's a great time. My life is positioned as follows: no wife, no kids, minimal undergrad debt, car completely paid off and a near perfect credit rating. I'm 45 years old and don't need to party in bars or clubs nor do I need to "go find myself" I love to read and learn. Most importantly I love positively impacting peoples lives.

So, yeah, it's a great time to go into medicine!

 

[WhippleWhileWeWork]

so I was surprised to see so many people stating how it was such a "bad time" to go into medicine. I was curious to know if there were only a few people on SDN or if it was shared by a majority.

I think what you're catching is a reflection off of aging doctors who were in medicine during the golden age. From reading memoirs and a few candid conversations the golden age was, put too simply and of course debatable, about: maximum autonomy, ever increasing salaries, little accountability, high prestige factor, minimum paperwork, and a positive public image.

All of these things have changed. Older Docs seem bitter, I'm not sure I can blame them. But coming up in a system that is totally different is, well, totally different. I don't have the expectation of medicine that they did. I'm sure some days it's going to suck. But my current career sucks and I don't get to fix broken people. I'll take the trade up. (I hope I don't come back to eat these words in 10 years).