Considering Family Practice, but Worried about Ethics and Lifestyle

[Noomm]

Internal Medicine $21,950

Obvious typo but it's just funny to imagine that... Man I would be surprised if ANYBODY chose that as a specialty if the compensation was that paltry

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[IlDestriero]

I did the cut and paste from another site, I'm not sure why some stuff was dropped.
But it's a data point for the OP. I would imagine that's supposed to be 219k.
Some make more, some less.
Many things factor into income.
When I was getting out of the navy, one of my friends was thrilled to get a FP job in a tight market for 185 to start. Of course he didn't have any debt to worry about.
Being debt free, or effectively debt free, is quite freeing. I encourage all my residents and fellows to indulge in a luxury or two, but hammer their 6 figure debt down ASAP. Marriage, kids, houses, etc will come along before you know it, and making big progress in the first few years of practice can make a huge lifestyle difference down the line.

 

[LizzyM]

Substitute "physician assisted suicide in places where this is legal" or "euthanasia of disabled infants in places where this is legal" for "abortion" and tell me that physicians must bow to patients (or patient's parents) wishes above their own moral code. Do we want to go down that road?

 

[NotYou20]

What I will chime in is that OP says:

"Before you tell me that my own morals should not interfere with patient care, I want to point out that I do not consider abortion to be a part of proper patient care. To me, abortion should not even be a part of the medical world because it goes against a doctor's duty to preserve life. I want this awful practice eliminated, and I feel that becoming a medical doctor would give me additional influence in the matter."

What about for cases where there was rape or an unplanned sexual encounter? Condoms break, birth control doesn't always work, mistakes happen. Indirectly, your desire to eradicate abortion simply based off your personal belief is a very judgemental statement because you're basically judging people based off their decisions and saying because of their decisions, they deserve to face the consequences regardless of the medical care available. You also realize that you're disregarding the future of the infant right? If a 21 year old becomes pregnant after a stupid mistake, or because a condom broke while she was in a monogamous relationship with her significant other, that person might not have the capacity (finances, maturity ect) to care for a child. She didn't make a stupid mistake, she made a perfectly rationale decision (have safe sex w/ their s/o), why should she have to pay the consequences of an accident? Even if it wasn't an accident, people make stupid choices. I don't think an infant should have to suffer and grow up in that family that might not be capable of caring for them.

The argument is that not murdering a person takes ethical priority over those considerations. This is, obviously, an easily defensible position. The real question is when is a fetus is considered a human life?

 

[Doudline]

Substitute "physician assisted suicide in places where this is legal" or "euthanasia of disabled infants in places where this is legal" for "abortion" and tell me that physicians must bow to patients (or patient's parents) wishes above their own moral code. Do we want to go down that road?

Physician assisted suicide is already legal in 3 states, and under review in multiple others. In a decade or two I wouldn't be surprised if it were widely legalized (by popular will or by court ruling).

A system of referral similar to abortion's would rule out ethical concern over one's own morals.

 

[Strudel19]

There was a great article about physician-assisted suicide in The Economist's June 27th issue. I suggest everyone here reads it!

 

[Yojimbo_OGT]

The real question is when is a fetus is considered a human life?

Anyone else reluctant to go down that rabbit hole?

To stay on topic, a PCP will not be performing or giving the "ok" for abortions. BUT it is the responsibility of the PCP to provide informational outlets for the PT to decide what is right course of action (this is still not implying that doctors will blindly bow down to the PT's will, they have the liberty to refuse an abortion based on personal/religious code). These outlets are referral to an OB/GYN, Planned Parenthood or any like organization, or imploring that the PT speaks to their loved ones. I think what we are all up in arms about is refusal of PT service without any sort of justification (e.g., telling the PT "God says its wrong, therefore you shouldn't get an abortion" does the practice of medicine a disservice).

Substitute "physician assisted suicide in places where this is legal" or "euthanasia of disabled infants in places where this is legal" for "abortion" and tell me that physicians must bow to patients (or patient's parents) wishes above their own moral code. Do we want to go down that road?

If these practices were legal, then the doctor's duty would still be diligent consideration of the specific scenario in which these are happening. I don't think one train of philosophical thought (e.g., humanitarian, utilitarian, libertarian, etc.) will be applicable to every scenario ever proposed, so we are still in ethical uncertainty.

Disclaimer: I am not condoning one course of action over another. My stance is merely saying that physicians need to stay as objective as possible while never hastily casting out a patient without first extensive consideration of the individual.

 

[Dral]

Substitute "physician assisted suicide in places where this is legal" or "euthanasia of disabled infants in places where this is legal" for "abortion" and tell me that physicians must bow to patients (or patient's parents) wishes above their own moral code. Do we want to go down that road?

Not to go off topic, but if people would actually learn about physician assisted suicide and watch some of the beautifully done documentaries out there, it might change their mind.

In the cases I've seen (in documentaries), it is wonderfully empowering for the patient when they have otherwise lost all control of everything else in their life (like even being able to use the restroom on their own). It also appears very therapeutic for loved ones as they know when to be there for final celebrations of life and final goodbyes.

Coming from someone who lost someone before being able to say goodbye, that's not that bad of a deal.

I'm sure it still goes against the beliefs of many to the point they can't accept it...which is fine.

Anyway, back on topic.

 

[Winged Scapula]

Thank you for the tip! This is my first post, and I just assumed I should be in this section since I'm technically still in highschool, and I didn't know if it would be inappropriate to post in other sections. Also, I totally welcome input from pro-choice individuals. I feel like that would help me get a better sense of the overall culture. If I only read comments from other pro-lifers, I'll be in for a rude awakening later on. I will try re-posting in the premedical form.

You were given inaccurate advice.

Since you are technically still a HS student, SDN policy is to post in the forum appropriate for your level of education. There are enough medical students, residents and attendings who post here. I will merge your Pre-Allo post into this one.

 

[Winged Scapula]

Moving back to hSDN since the OP is still a HS student.

Just to remind users: post are to be placed in the forum which meets the user's level of education, not where they think they will get the most responses. There are plenty of medical students, residents and attendings who respond in the HS forum, just as there are here.

 

[JustintheDoctor]

Moving back to hSDN since the OP is still a HS student.

Just to remind users: post are to be placed in the forum which meets the user's level of education, not where they think they will get the most responses. There are plenty of medical students, residents and attendings who respond in the HS forum, just as there are here.

ahh ok! Thanks for this I wasn't aware!

 

[Womb Raider]

You have different obligations if a patient is not competent to make decisions for themselves. Your examples are making it seem like you are comparing mothers who want abortions to mentally incompetent people.

Do you really not get why consent is taken out of the picture when someone is mentally ill or addicted?

Just because a patient wants to cut off a "perfectly functioning limb" does not automatically make them incompetent or mentally ill... They could be a completely rational, well educated person who has a legitimate reason (in their mind) for wanting to remove the limb. These things actually happen, by the way.

You should not get in the habit of hearing an opinion and immediately jumping to the conclusion that they're incompetent, irrational or mentally ill. You must listen to the patient and ascertain their rationale for their opinion before even considering incompetency.

Just because something disagrees with the common opinion of the health care team doesn't make it an incompetent decision.

 

[On Eagle's Wings]

Hello! I am an early college student strongly considering a career in medicine. Since I have such a long road ahead of me, I know I have time to change my mind, but right now, I'm strongly considering family medicine. I love how it seems to be the "jack of all trades." Family medicine seems to be exactly what I've been thinking of when I say I want to become a doctor. However, I have several concerns surrounding the field.
Firstly, I have had family members recommend I avoid family medicine because it does not pay well, and it will be impossible for me to set up my own practice. Is this really the way the healthcare market is headed? I think it would be nice to set up my own practice someday, and it's discouraging to hear people tell me it will be impossible by the time I get through my training; I'd love extra input (of course, I plan to do additional research as well). Also, what is the general pay and lifestyle of a family medicine physician, if there is one? I know lifestyle and pay rely a great deal on what you make them, but if anybody could give me some examples of what it might be like, that would be great. Additionally, could you tell me why family medicine seems to be such an unpopular specialty among medical students? I have heard that it is because the pay makes it difficult to pay of student loans.
Also, and perhaps most importantly, I am concerned about the moral implications of going into family medicine, or really becoming a doctor in general. I am a devout Catholic, and a major inspiration for becoming a doctor is so that I can do my part in pushing the medical world into a better direction. Family medicine is especially attractive to me because the general public seems totally unaware of the difference between abortive medication and contraception. I want to promote natural family planning, and I definitely want absolutely no part in abortions; however, I don't know how realistic that is for me if I want to become a doctor, especially a family medicine physician. I know sometimes kids like me have big dreams that don't match up to real life. If it is not possible for me to go into family medicine without participating in or promoting abortion, I would rather know now. Can you be a family physician who promotes natural family planning and never, ever condones and/or participates in abortions?
Before you tell me that my own morals should not interfere with patient care, I want to point out that I do not consider abortion to be a part of proper patient care. To me, abortion should not even be a part of the medical world because it goes against a doctor's duty to preserve life. I want this awful practice eliminated, and I feel that becoming a medical doctor would give me additional influence in the matter.
Also, please realize that the above stated matters are not my only motivation for going into the medical field. I have always felt called to become a doctor. Medicine fascinates me, and the thought of improving the quality of a life or possibly even saving one inspires me beyond anything else. I've shadowed doctors before, and from what I can tell, I really am in love with the profession. I'm a strong student who is more than willing to endure the hardships of medical school and residency; before I go through all of that, though, I do want to know what impact my personal values would have on a career as a medical doctor.
So, basically: can I remain a Catholic in good standing as a family medicine physician, and what would my lifestyle be like if I chose this profession? Remaining true to my faith is very important to me. If there are any Catholic doctors on this form, I would especially love to hear from them because I have yet to meet one, and I feel like they would be able to provide me with good insight.
Thank you, I'm looking forward to lots of advice, and I am expecting people to disagree; I only ask that those who disagree do so respectfully. Thank you guys for taking the time to read through this long post!

Okay, everyone, here is my take on this issue.

For the OP, I am an extreme pro-life, and I go to one of the few medical schools in the nation that are faith-based. I am not Catholic; I am a Christian.

I am also extremely concerned about the rise of abortion in medicine and the fact that doctors are often made to do it against their beliefs. Good news for the OP is that you can still do family practice without getting into the whole abortion disaster. At least you are not doing OBGYN, which also does a lot of birth control procedures and other morally questionable things.

The first thing is you need to carefully decide which medical school you go to. Many medical schools (the public ones especially) are public about their acceptance of abortion in their facilities, and the unfortunate med students get sucked into it. I would strongly encourage the OP to attend a medical school that is faith-based and does not condone abortion (Loma Linda or Saint Louis are two excellent schools). Training and indoctrinating doctors on abortion and birth control starts in medical school, so please pick a good school.

That said, I knew about the prevalence of abortion and birth control when I entered medicine. Like the OP, I am for natural family planning and want abortion eliminated. However, I still chose medicine for my career choice because I think that with the right navigation you can minimize or avoid the abortion issue altogether. You need to go to a Christian medical school, and hopefully enter residency and work at a Christian facility. If all else fails, and the US becomes more pro-abortion than it already is, the mission field is a great place for a career if you are called to it, and family medicine would be great for the mission field, and the abortion issue would be greatly minimized there.

If you feel called to medicine, by no means ditch it because of ethical issues. Sometimes, there are times when you need to abandon a career because of ethics (wedding cake bakers, for example). With medicine, it is broad enough of a field and there is enough opposition to abortion that going to the right school and picking a good specialty will go a long way towards avoiding the issue. Do what you feel called to, and I totally think that you can still keep your faith in medicine. This is one of the biggest reasons I turned down a scholarship from a top 20 medical school to go to a Christian medical school. My faith is the single most important thing in my life (more important than money and medicine), and I did not want to lose my faith or have it erode at a public medical school. Entering a Christian medical school with like-minded students will help you actually enhance your faith in medical school.

If OP has additional questions or wants to discuss this in more detail, please PM me and I will be happy to talk about it.

 

[efle]

Wow. If a patient came in telling you they wanted to hack off their perfectly function pain-free left arm, you honestly wouldn't immediately start to operate under the assumption that the person had a psychological disorder/illness? I would think "body integrity/identity disorder" and try to get them into mental health counseling immediately.

 

[efle]

Okay, everyone, here is my take on this issue.

For the OP, I am an extreme pro-life, and I go to one of the few medical schools in the nation that are faith-based. I am not Catholic; I am a Christian.

I am also extremely concerned about the rise of abortion in medicine and the fact that doctors are often made to do it against their beliefs. Good news for the OP is that you can still do family practice without getting into the whole abortion disaster. At least you are not doing OBGYN, which also does a lot of birth control procedures and other morally questionable things.

The first thing is you need to carefully decide which medical school you go to. Many medical schools (the public ones especially) are public about their acceptance of abortion in their facilities, and the unfortunate med students get sucked into it. I would strongly encourage the OP to attend a medical school that is faith-based and does not condone abortion (Loma Linda or Saint Louis are two excellent schools). Training and indoctrinating doctors on abortion and birth control starts in medical school, so please pick a good school.

That said, I knew about the prevalence of abortion and birth control when I entered medicine. Like the OP, I am for natural family planning and want abortion eliminated. However, I still chose medicine for my career choice because I think that with the right navigation you can minimize or avoid the abortion issue altogether. You need to go to a Christian medical school, and hopefully enter residency and work at a Christian facility. If all else fails, and the US becomes more pro-abortion than it already is, the mission field is a great place for a career if you are called to it, and family medicine would be great for the mission field, and the abortion issue would be greatly minimized there.

If you feel called to medicine, by no means ditch it because of ethical issues. Sometimes, there are times when you need to abandon a career because of ethics (wedding cake bakers, for example). With medicine, it is broad enough of a field and there is enough opposition to abortion that going to the right school and picking a good specialty will go a long way towards avoiding the issue. Do what you feel called to, and I totally think that you can still keep your faith in medicine. This is one of the biggest reasons I turned down a scholarship from a top 20 medical school to go to a Christian medical school. My faith is the single most important thing in my life (more important than money and medicine), and I did not want to lose my faith or have it erode at a public medical school. Entering a Christian medical school with like-minded students will help you actually enhance your faith in medical school.

If OP has additional questions or wants to discuss this in more detail, please PM me and I will be happy to talk about it.

Why is birth control immoral in your view? I could understand someone viewing abortion as murder, but how does stopping sperm from reaching egg qualify as murder?

 

[On Eagle's Wings]

Why is birth control immoral in your view? I could understand someone viewing abortion as murder, but how does stopping sperm from reaching egg qualify as murder?

Psalm 127:3. Children are a heritage from the Lord, offspring a reward from him.
Genesis 1:28. God blessed them and said to them, “Be fruitful and increase in number; fill the earth and subdue it.

Birth control is against my religious beliefs. I am from a very large family, and birth control goes against my beliefs that children are a blessing (not a curse).

 

[efle]

Psalm 127:3. Children are a heritage from the Lord, offspring a reward from him.
Genesis 1:28. God blessed them and said to them, “Be fruitful and increase in number; fill the earth and subdue it.

Birth control is against my religious beliefs. I am from a very large family, and birth control goes against my beliefs that children are a blessing (not a curse).

Does this reasoning not also condemn celibacy?

 

[Yojimbo_OGT]

Genesis 1:28. God blessed them and said to them, “Be fruitful and increase in number; fill the earth and subdue it.

Man, Bangladesh needs to put down the Bible once in awhile.

AM I RIGHT? ...GUYS?

 

[On Eagle's Wings]

Does this reasoning not also condemn celibacy?

Celibacy is nowhere the same as birth control. Celibacy is choosing to remain unmarried, and thus abstaining from participating in reproduction. There are multiple instances in the Bible where people remained celibate so that they could do other important work (Paul for example). If you are married, and you have s-- with your spouse, then you are choosing to participate in the reproductive process. Engaging in s-- but not wanting the children that result is not morally permissible in my view. S-- has always been for married couples to have children and be fruitful and multiply, not so we can have fun and use birth control to cover the natural results of our actions.

This is the same philosophy of the family in TLC's 19 Kids and Counting, so I am not alone here.

 

[Womb Raider]

Sometimes, there are times when you need to abandon a career because of ethics (wedding cake bakers, for example).

Ummmm please explain this in more detail - I'm intrigued.

Psalm 127:3. Children are a heritage from the Lord, offspring a reward from him.
Genesis 1:28. God blessed them and said to them, “Be fruitful and increase in number; fill the earth and subdue it.

Birth control is against my religious beliefs. I am from a very large family, and birth control goes against my beliefs that children are a blessing (not a curse).

The Catholic church is also having a very hard time internally surrounding this issue. Although the Catholics forbid birth control, it might not stay this way for too much longer. The problem is, some families are having an extremely difficult time because they keep having kids, don't have enough money to support them, and the entire family is negatively affected. Of course, the only true 100% effective way to stop this is to stop having sex, but what married family wants to do that? That's not even healthy.

Genesis tells us to increase in number, but it doesn't command us to do so constantly, having as many babies as humanly possible.

 

[On Eagle's Wings]

Man, Bangladesh needs to put down the Bible once in awhile.

AM I RIGHT? ...GUYS?

NO!!!

I would not put down the Bible for my profession. I would dump my profession if I had to choose between the Bible or my profession. My faith is the most important thing for me, not my medical career.

Another good reason to be at a Christian medical school, where we study the Bible once a week for religion class and discuss it. Integrating my faith and the Bible with my medical career, oh yea....

 

[On Eagle's Wings]

Ummmm please explain this in more detail - I'm intrigued.


The Catholic church is also having a very hard time internally surrounding this issue. Although the Catholics forbid birth control, it might not stay this way for too much longer. The problem is, some families are having an extremely difficult time because they keep having kids, don't have enough money to support them, and the entire family is negatively effected. Of course, the only true 100% effective way to stop this is to stop having sex, but what married family wants to do that? That's not even healthy.

Genesis tells us to increase in number, but it doesn't command us to do so constantly, having as many babies as humanly possible.

See my next post on sex and reproduction.

 

[efle]

Celibacy is nowhere the same as birth control. Celibacy is choosing to remain unmarried, and thus abstaining from participating in reproduction. There are multiple instances in the Bible where people remained celibate so that they could do other important work (Paul for example). If you are married, and you have s-- with your spouse, then you are choosing to participate in the reproductive process. Engaging in s-- but not wanting the children that result is not morally permissible in my view. S-- has always been for married couples to have children and be fruitful and multiply, not so we can have fun and use birth control to cover the natural results of our actions.

This is the same philosophy of the family in TLC's 19 Kids and Counting, so I am not alone here.

I chose wording poorly. Rather than celibate lets look at a married couple that chooses not to have sex (really happens!). Are they behaving immorally?

Alternatively , is attempting to naturally avoid pregnancy (timing sex by menstrual cycle) immoral?

 

[Yojimbo_OGT]

NO!!!

I would not put down the Bible for my profession.

Ughh now I have to explain my obviously awesome joke which will ruin its whole integrity...

Bangladesh is one of the fastest growing populations and most densely populated areas on this planet. I was merely playing the fact that the Genesis script is Bangladesh's mantra, or motto. Or whatever other funny m-word that conveys what I'm getting at.

Comedy equals tragedy plus time plus Bangladesh.

 

[On Eagle's Wings]

Neither of these is immoral because neither couple is using birth control!

 

[efle]

Neither of these is immoral because neither couple is using birth control!

But you said BC was bad because it prevented the blessing of children that sex is meant to produce. Timing sex with the cycle also prevents the blessing of children that sex is meant to produce. Can you clarify why only the one method of avoiding children is allowed?

 

[Womb Raider]

Neither of these is immoral because neither couple is using birth control!

I think you're missing his point. Birth control isn't inherently bad, it's bad because it prevents good things from happening (children) and because it violates a command by God (be fruitful and multiply). The point here is, why is abstaining from sex not also immoral, because it also prevents these things from happening. Clarify?

 

[Winged Scapula]

Ok guys...please remain on topic. The topic at hand is the OP's question about combining medicine and her moral beliefs. I'll close the thread as it appears the OP has received enough answers to her question. If you wish to further discuss the topic of whether birth control or abortion is immoral, then this can be moved to the Topics in Healthcare or SP forums.

 

[On Eagle's Wings]

But you said BC was bad because it prevented the blessing of children that sex is meant to produce. Timing sex with the cycle also prevents the blessing of children that sex is meant to produce. Can you clarify why only the one method of avoiding children is allowed?

I think you're missing his point. Birth control isn't inherently bad, it's bad because it prevents good things from happening (children) and because it violates a command by God (be fruitful and multiply). The point here is, why is abstaining from sex not also immoral, because it also prevents these things from happening. Clarify?

Timing sex with the cycle often naturally prevents reproduction, but it is by no means a sure thing (sometimes, fertilization still occurs). Using birth control is using a man-made invention to stop something naturally created.

The command to be fruitful and multiply was in response to trying to use birth control to stop reproduction from happening when people want to have sex all the time. People also use BC to try to have sex with people outside marriage, but they don't want kids from it.

Abstaining from sex is not immoral, but having sex and trying to use BC to stop the natural fertilization process is not fine. If sex during a period does not result in pregnancy, so be it. As long as men are mot using their methods to stop the process if it were to occur or as it occurs. Being fruitful and multiply is a command with a blessing, not an outright command like do not murder. And I can say from my experiences that having children is an incredible blessing for all people involved.