Lawyer in Medical School, having doubts!

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IMHO - If you don’t have a passion for medicine, you’re in for a lot of disappointment and a world of financial woes. Debt service on $500k with a relatively low paying specialty is problematic at best. I looked at going to med school at age 30. A pretty basic financial analysis put me in my mid-50s for a break even point. I think it’s time to be hard-core realistic about where you’re going. I get where you think your passions are, but you gotta pay the bills too.

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I don’t really have an answer for you as to should you stay or should you go, but I can let you in on my decision. I am an attorney currently finishing up my pre-reqs and applying to medical school in the Spring. Here are the conclusions I have made.

1.) there is no justification from financial perspective. There simply isn’t a break-even point. If you make the move, you will never have a theoretical point in your career where the decision was the financially correct move. So basically, you have to have other motivations than financial ones. If those motivations outweigh the financial ones, move on to step two. If not, go back to law.

2.) Medical school is going to be difficult, but you have a few advantages. First, you’ve been through a professional school before. You understand that as the content doesn’t get any easier, in fact it might get harder as you progress, your ability to process and utilize the content in a beneficial way will increase. Just like how taking constitutional law first or second semester helped you with taking criminal law or estates or something like that in later semesters, the foundations you’re building at the beginning will make things seem a little easier in the future. Not easy in terms of time strain, but at least in terms of mental ability. If you can deal with the fact that you are going to be incredibly stressed for the next 5-8 years, but you WILL be able to complete it, move on to three.

4) Next, there is the age component. You’re going to be older than most of the other starting doctors. This will have pros and cons, and they even themselves out. Ignore everyone who says it is too much of a con. I am older than you, and I have decided to make the leap, so you can too. If you made it this far, just trust me and move on to 4.

4) now that you’ve decided to go back, you have some abilities to mitigate the financial effects. First, you’re probably capable of taking the patent bar due to your undergrad. Becoming a patent lawyer can be benificial in a couple ways. First, it gives you a *relatively* low stress avenue to make money while attending school. You could take on just enough clients to cover bills while attending school. Since there are no imminent court proceedings with the work, if you need to take a week off to study, you can do it. Second, you can see about teaching a patent class at your school’s affiliated undergrad or law school if they have one. This would work to ease your student debt and bring in income while you attend school.

You can also join the military reserves. Since you are in the beginning of school, the vast majority of your original service commitment will be completed before you finish residency, possibly all of it. You can have them cover your tuition and give you a couple grand a month by tacking on more time.

Finally, there is the less likely, but not impossible option of pimping out your degrees. Depending on where you live, there are likely some competing personal injury firms. You can go to them and offer your services as an of-counsel. Their ability to use your degrees/future degree as an advertising chip, plus the possibility of having an extra hand if the need arises, might be enough to secure somewhat of a salary for doing not a whole lot. Like I said, not likely, but I have heard of more than 1 person having success at this route.

Good luck.
 
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I'm still a post-bacc student but I'm a career changer. I relate to a lot of what you are saying regarding feeling uneasy with your career choice. I want to offer a few thoughts. First, have you spoken with a therapist? It could be helpful to have a neutral third party help you work through your thought processes, particularly why you're feeling anxious and burned out. Second, be wary of debt. If you're interested in biomechanics, and you have the basic science classes done, you're honestly not that far off from a degree in biomedical engineering, which has a much higher return on its investment considering the amount of time you're putting in right now. Coupled with a JD, you'd be a very desirable employee given the ability to navigate patent law. If you already have $250,000 in debt, pulling out another $200,000 for medicine plus the opportunity cost of all those earning years as an attorney is unwise unless you have no doubt in your mind that medicine is the path for you. (I would argue that it's still financially unwise, but an MD/JD will open you up to lucrative positions that can help pay that down.) Your life will look much different in a few years, and being debt free will release a burden on other aspects of your life (and your potential family). Good luck on your decision, and I wish you the best.
 
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I wish that someone would write a few thousand pages in a textbook about mechanism, diagnosis, and management of spine pathology..

or what would be better- what if there were multiple specialties that all approach back pain in a holistic stepwise manner that may or may not even include spine surgery?

Guess we’ll never know..

Seriously- realize that as an MS1/2, you know NOTHING about medicine. You truly don’t grasp some of the most basic concepts of medicine unless you are the best MS2 in America. I don’t say this to condemn, this actually should be quite freeing to you. Realize that you will continue to learn and some concerns that you have now are insignificant and other things that you should be concerned about- you don’t even know exist yet.

Decide if you want to be a Doctor. Period. Don’t concern yourself with specialty or narrow visions yet. At very least, do some clinical rotations before you bounce out. I think you need to see more of the healthcare system from multiple perspectives
 
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You have a loan pay back dilemma. The issue is clinical medicine isn't going to get easier for you. If you finish med school you may be able to leverage your JD to be an admin or go into consulting and that will likely be better compensated than being a lawyer on average. I would explore the options you have and seriously consider that your debt level is limiting.
 
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I’ve learned that despite how much you enjoy something, the politics and bs involved can easily make it feel like “work”. If you are content with your profession as a lawyer, stick to that. Maybe focus on medical cases if they intrigue you. If you want to sacrifice three more years plus 3+ for residency to switch careers or compliment your existing one then more power to you but you will never get those years back and medicine is only fulfilling if you have a deep desire for providing that particular service. No amount of money will make up for the work and time you need to put in to get successful. Good luck with your decision!!!
 
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In looking over your posts here, I suggest that you either go back to law or get a degree in PT.

EDIT: I'll be blunt: you don't belong in Medicine.


I agree PT school and DPT route would be a better path to practice OP’s actual area of interest. Hands on rehab of sports injuries, especially back injuries is not really a reality for most MDs.
 
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How would one view a LOA favorably? I totally understand it not hurting you, but favorably, I don't know about that.


Many Stanford MDs take 5 yrs including a year to buff the residency app with research or service projects. It certainly doesn’t hurt them.
 
Recovery from LBP is highly correlated with job satisfaction and depression so it’s more than a mechanical problem. If you loved your job before sustaining a back injury, you’re much more likely to get better.
 
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Take a hard look at radiology. With MSK fellowship. I finished residency at 40 with $450k debt. 20 years later I work from home except 4 days a month I do flouro and US guided spine, hip, and shoulder injections. I love my clinic patients and I love my quiet private office. I am debt free and own my home , putting 4 kids through college. Every MD friend I have is jealous. I don’t know any unhappy radiologists.
 
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In looking over your posts here, I suggest that you either go back to law or get a degree in PT.

EDIT: I'll be blunt: you don't belong in Medicine.
omg. I have many physicians who were MD first then went to law school .... He seems passionate about helping people with low back injuries. Drugs and Surgery have their limits for sure. Physiatry would be perfect for him. 1 out of 4 microdiscectomy with laminotomy re-herniate. Bad stats. There are a multitude of treatments that could help but are not as profitable as drugs and surgery.
 
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It just means that fixing the mechanical issue will not necessarily make the back pain go away. They’re not always correlated. For example, many people have big disc herniations or spondylolisthesis found incidentally with no back pain. Back pain is a complex, multi factorial problem, it’s not just a mechanical problem.

Our spine surgeons will often tell their patients that the surgery has a 1/3 chance of making them better, 1/3 chance of making no difference, and 1/3 chance of making them worse.
 
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Take a hard look at radiology. With MSK fellowship. I finished residency at 40 with $450k debt. 20 years later I work from home except 4 days a month I do flouro and US guided spine, hip, and shoulder injections. I love my clinic patients and I love my quiet private office. I am debt free and own my home , putting 4 kids through college. Every MD friend I have is jealous. I don’t know any unhappy radiologists.


My med school classmate who did radiology works 1day/week. But he’s married to a peds ophtho who loves her job and still works a lot. He also did MSK fellowship and also a body fellowship while he was waiting for his wife to finish training.
 
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And there it is. Is this some troll thread in general? Supposed MS1 going on about low back pain with the only perspective as a patient calling doctors incompetent without any experience actually being a doctor or seeing patients clinically.
 
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There are a lot of different opportunities out there. I left Boston to work in rural Northern California, built a small practice and developed relationships where I could work from home and no one cared. I do live in front of a monitor for sure but have been able to raise my kids, own a restaurant, build a martial arts school and have a great life. That doesn’t mean I didn’t work my ass off for years to get here. I know plenty of rads who work nighthawk 10 hour shifts 7 days on 7 off and make $300 K. They hustle but work half time. Most important is to find something you love to do. I love making hardworking people feel better and get back to work pain free without narcotics. I have colleagues in orthopedic surgery and anesthesia who do the same job too. Occupational or rehabilitation medicine may suit you as well. Look at what Shriners is doing these days.
 
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I think you lack perspective and have emotional baggage with respect to the profession with your background of back pain that makes you biased. You also have no posts here except in this thread where you are waffling and keep promoting non invasive management and calling doctors incompetent at their job. Managing back pain is a cornerstone of multidisciplinary medicine.

I agree with Goro. You don’t sound like you belong in medicine. Besides having such a narrow focus so early on really is bizarre. It’s like the premeds that only want to do pediatric oncology. I honestly question if you are in med school.
 
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1. You have no idea what you are talking about. The sooner you can admit that, the better off you'll be.
2. If I were you I'd quit med school and go back to law. The additional time and loans that you're taking on are in no way worth it. Even if it's for something you're "passionate about":rolleyes:
 
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So the debt matters, but it doesn't matter that much. Depending on earning potential of the field you go into, paying down student loans can be a very fast process. Every field is different, so definitely keep that in mind. I went into dentistry and my wife went into medicine, we are both practicing full time. When I first graduated I was making around $100k, which was terrible considering how much schooling cost. I am currently 10 years out. Now my income is more per year than the total debt I incurred in obtaining my degree/license. My wife is in the same situation. If the major reason you want to stop is due to the debt then I would say keep going and you will be fine.
 
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Not trying to argue with a first-year med student but thinking that you are anywhere near knowledgeable enough to discuss causes and treatments of back pain is "bologne." It's just complete arrogance, and it's a problem. Having some humility is a nice thing to have
 
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The above two quotes is much more common in law, not medicine. For that reason, quit medical school and do law.

On the other hand, medicine is great for several reasons.
1. A JD and MD opens up some doors closed to MDs or JD's.
2. So many people make lousy medical decisions. Just look at the pandemic. If you are trained as a MD, you will have some insight that could save your life or the life of a relative. I have seen a family sign a DNR and want a Do Not Treat because they said "No Tubes!" and could not be convinced that an IV was not a tube prolonging life.
3. I sort of knew some one that was a MD and professor then started working for a Blue Cross insurance company, making big bucks. A JD/MD could do that. It might not be a goal now but definitely was not a goal for that professor.
4. I know of a lawyer earning $500,000 from one case of estate litigation. That estate is not huge, maybe $7 million. Much of the $500,000 is just hand holding the client and not filing motions.
 
Look into treatment modalities like neurokinetic therapy (NKT). I suspect that a lot of injury and pain is a result of movement dysfunction and faulty muscle recruitment patterns. You could be the guy or gal who helps athletes and your average Joe post-trauma or injury to get out of pain, and stay out of pain, get strong and stay strong. I know highly knowledgeable personal trainers certified in NKT that are charging $300 an hour cash. Is that enough?
 
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Non-traditional third-year US MD med student here. I know exactly what you are going through. First year was tough for me as well. I thought I was drinking from a fire hose the entire time. Unfortunately, I have some bad news for you. The journey will only get worse. Second year is way worse than first year. Third year depends on your clinical rotation sites and your school curriculum, but it can be just as tough or tougher than second year. With Step 1 going pass/fail, I have no doubt that third year will be much harder for new medical students. I have not gone through fourth year yet, but heard it's stressful until you are all done with interviews. Residency years are notorious, so I will save my words. Would it be possible to go through all this as a non-trad student? Absolutely. Would it be easy to do so if you have doubt in your decision? It certainly would not help you. It is ultimately your call. Compare your other exit plans and see what will make you the happiest in 10 years from now.
 
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Believe it or not, you are not the only person on this board who has personally experienced a back injury and back pain. I’m surprised you think it is simply a mechanical problem after all your research.


Sorry about threadjack.
 
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Reading your initial statement it really sounds like you want to be a PT with and MD salary. It also sounds like you want to be the best PM&R/PT/ortho ever. What you are looking to do is not realistic by any stand point and I highly recommend you stick to law. MDs (hopefully) aren’t just “passing patients off” to PT/surgeons. Research has shown time and time again that time improves acute back pain, and PT/surgery can improve acute/chronic LBP when it is applied correctly.

This whole post comes off wrong. Like you are saying current rehab specialist/surgeons/etc are incompetent instead of what it actually is, which is staying in a lane. MDs have their role to play in treatment, as do PTs, as do surgeons. It’s about being an IDT, not an autocrat. You don’t seem like you play well with others and that’s important in todays healthcare world.
 
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I’ve heard lawyers go to medical school to retire. When they commit medical malpractice, they can sue themselves.

I also heard that doctors go to law school to save money. When they are sued for committing medical malpractice, they can represent themselves.
 
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If OP stays in medical school they’re going to hear “expand your differential” a lot

I’m “just a PCP” and not a “back expert” but in the last few months I’ve seen lumbar pain turn out to be:

Pure MSK
Lumbar stenosis
Herniated disc
Compression fracture
Pylelonephritis
Kidney stones
Renal cell carcinoma
Shingles

I needed solid assessment skills to diagnose all of them. Only some of them could be treated with “comprehensive therapy plan.”

Edited: typos
 
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You’re contradicting yourself.

And, like I said: I’m a plain old PCP. My patients may be older and sicker than average, but that makes them more prone to mechanical issues in addition to the scary stuff, not less.
 
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Except they don't. This is the point a number of us are making. You don't seem to know who manages what. The majority of 'back pain' presentations end up in 1 of 2 places - the PCP and the ED (sometimes both when the PCP assesses the patient and refers them on due to acuity/concern). I have no idea why you think we need to do better. The job of most doctors is ruling out the things that are going kill you emergently, and then managing the risk factors for the things that will kill / harm you in the long run. You seem to garner some poor views about our profession if you think that we are all doing it wrong. I'm sorry you've had a rough go with your back pain. I pity the day if you actually graduate, magically find some niche position that only manages LBP and receives a referral for a 65yo male T2DM vasculopath smoker who never had any imaging has tearing back pain that just won't go away.

'Mechanical' causes by which you mean probably mean MSK related pain without concerning neurology or other features that is stable is a condition that is best managed by a multidisciplinary team. There's no magic pill.
 
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There are a lot of different opportunities out there. I left Boston to work in rural Northern California, built a small practice and developed relationships where I could work from home and no one cared. I do live in front of a monitor for sure but have been able to raise my kids, own a restaurant, build a martial arts school and have a great life. That doesn’t mean I didn’t work my ass off for years to get here. I know plenty of rads who work nighthawk 10 hour shifts 7 days on 7 off and make $300 K. They hustle but work half time. Most important is to find something you love to do. I love making hardworking people feel better and get back to work pain free without narcotics. I have colleagues in orthopedic surgery and anesthesia who do the same job too. Occupational or rehabilitation medicine may suit you as well. Look at what Shriners is doing these days.
people easily make 400k 7 on 14 off these days. just saying
 
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Yes, it is.

"Your back pain is caused by a mechanical cause". That is utterly worthless. What you're then describing is what us doctors actually do: figure out what's causing the pain specifically and then prescribing appropriate treatment which ranges from "give it time this will get better" up to "you need surgery" and plenty in between.

I've been a physician for over 10 years. I have never diagnosed someone with "idiopathic back pain".

Its becoming painfully clear that you don't actually understand what or how back pain is supposed to be approached. From your previous posts it sounds like this could be the result of a negative interaction you had with the medical profession in the past when dealing with back pain of your own combined with your inexperience with medicine (which as a first year medical student is to be expected).

I would suggest you have patience and get further along with your education before you castigate all of us.
 
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I’m not a physician but I know a great deal about LBP from personal experience. I also know a lot about diagnosis and treatment despite not being a “real doctor.”

What people are trying to explain to you is that every single case of LBP is different. EVERY. SINGLE. CASE. That’s analogous to me saying every patient complaining of a toothache is because of poor oral hygiene causing decay. This is untrue. People can have great oral hygiene and have tooth pain for any number of reasons.

The same goes for LBP. Patient walks into the exam room with LBP you absolutely cannot assume that it is most likely “mechanical.” It is a CC, not a dx. Even as a dentist I know that it can be MSK, degenerative, ankylosing spondylitis, pathology, malignancy, trauma, neurogenic pain, etc. I’m sure there are tons of other reasons that I am not educated enough on the topic to know about. And that’s the thing, neither are you. That’s what people here are trying to tell you. You have maybe 15 months of medical school training under your belt and are arguing with people way more knowledgeable and experienced than you. By years.

I recommend humbling yourself and being open to learning. These are people who could be your faculty. My wife is in law school so I get it, you have your argument and you stick to your guns. But You are fighting against the current of accurate knowledge being presented to you. Once again, I’m not a mental health professional either, but being so argumentative all the time with this information can be absolutely exhausting. This is why people on here are getting frustrated; they are not hanging up on you. This MAY be a contributing factor to your burnout in school, but again, I would confirm that with a trained provider. My advice is to take in ALL the information you can, all of it. As you gain more and more experience you can then decide what is relevant. You wouldn’t expect to pass the Bar and immediately become a Partner at a major firm would you?
 
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Your opinion is wrong. That is standard of care. You should understand that from a medicolegal perspective more than anyone here. Accurate diagnosis determines appropriate treatment.
 
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The number of insults being thrown around in this thread is not productive and the original intent of the thread has been all but lost at this point.

I'm not a mod, but can we get this argument about etiologic factors of lower pain behind us (no pun intended)?
 
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I would suggest just sticking to what you chose. There are people out there who can never really commit to one thing, and they keep thinking the grass is greener on the otherside. As you know, it isn't and the consequences to switching constantly is you get all the downsides and none of the benefits of everything you do. You really need to get it in your head that you will never be completely happy with your career and just enjoy the pros and cons of whatever you do.
 
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I would suggest just sticking to what you chose. There are people out there who can never really commit to one thing, and they keep thinking the grass is greener on the otherside. As you know, it isn't and the consequences to switching constantly is you get all the downsides and none of the benefits of everything you do. You really need to get it in your head that you will never be completely happy with your career and just enjoy the pros and cons of whatever you do.
I like that advice. I was that way. I even wrote my personal statement about it (having to deal with doors closing and deciding on a final career path to take). Sometimes one just has to take all the information they have and decide to just go with it and not look back.
 
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So I won't argue with you about your understanding of back pain.
reasons you should stop becoming a physician:

1. You have a clear bias and will have a hard time learning.
2. You want medicine mostly for the job security.
3. You believe you have an expertise you clearly do not. This leads to the scariest scenario in medicine to me; which is a intern or jr resident or fellow that won't ask or question themselves and has a belief they are correct. See Dr. Death.
4. You can not take criticism even if people are being helpful. You can not grow without this.
5. You can not take advice from experts in the field including a pm&r that is fellowship trained in pain, multiple seasoned primary care physicians, and now possibly from a fellowship trained primary care sports med physician--me
 
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I don’t know why this thread is 3 pages, but OP, it clearly looks like medicine is not for you, so consider leaving and doing something else whether it’s going back to law or doing PT. I don’t really care for your views on back pain management since the attendings covered this sufficiently well.
 
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It’s d

Yes it’s doable but it’s a grind pulling studies off a list at top speed with quotas and canned reports because individualizing complex cases takes too much time. There are less intense jobs for pretty great money. $500K with no overnight call and 6-12 weeks off is pretty easy to find, but you have to be good. It’s getting competitive and job security isn’t what it used to be with portable digital studies.
 
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Several users have been issued warnings for personal attacks. I'm going to clean up those personal attacks as much as possible, but if we can't have a courteous conversation this thread will be closed.
 
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Several users have been issued warnings for personal attacks. I'm going to clean up those personal attacks as much as possible, but if we can't have a courteous conversation this thread will be closed.
TBH, it may be worth closing, not sure what the OP's problem is, but he has bad-mouthed the profession, seems like he professes to be a know-it-all and has himself insulted others.
 
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Again, if you cannot be courteous especially after GoSpursGo post, he will issue you a formal warning and close the thread or kick you out of it.
We can continue the conversation as long as long as it is professional, otherwise it’s done.
 
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You can have a plausible theory but it’s not validated. A lot of medicine is not validated by RCTs but that’s what we strive for. If I had to guess, there are billions of humans walking this earth with “micromotions” (because that’s what the back does) and rounded posture who never have back pain. In fact, my own posture is often rounded and I haven’t had back pain in years. (Stopping CrossFit helped a lot.)

This is obviously a religious issue for you, a matter of faith, and no amount of evidence or reason will change your mind. That is not a good starting point to practice medicine.


When I had problems with my back, I went to a Feldenkrais structural integration practitioner because she was my friend. I felt pretty good after each session with subjectively less spasm and i believe somebody focusing their undivided attention to you has a strong placebo effect. Eventually my back pain completely went away. I suppose it could have been Feldenkrais or it could just have been time. Regardless, Feldenkrais is not medicine. It’s a single modality based on a guy’s theory of how the body works that has never been scientifically examined.
 
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Our society has a disease of hubris. I think this thread is a fascinating example, and in an attempt to remain on-topic, I think OP should practice law.
 
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Good point. Especially because patients are very compliant with instructions regarding behavior and activity etc.

The reason modern American medicine focuses on pills and surgeries is that they require the least amount of effort on the patients part. People are so eager to hear about diet, exercise and “natural” treatments but then never follow through.

You could probably find a niche somewhere with motivated athletes, but your average laborer won’t stop smoking, won’t lose weight, and won’t change how they lift. They’ll keep doing what they’re doing until they qualify for a surgery or disability coverage.
 
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