Why do some go from PharmD to MD/DO?

[lord999]

I don't know how you can in good conscience operate a fast food joint that ruins peoples' lives and health like Pop Eyes and then pretend to be a medical professional. This guy was literally killing tens of thousands a people a year and making hundreds of thousands more into bariatric indivudals. He definitely did more harm operating the soda/fast foot eateries than good as a surgeon. He should have just sold heroin on the street. He would have done less damage to society.

I guess you've never read Medical Nemesis, have you? Chapter 1 and the first part of Chapter 2 should give you an idea of how much we collectively are really worth around here.

http://soilandhealth.org/wp-content/uploads/0303critic/030313illich/Frame.Illich.Ch1.html

If you think about what your normal day-to-day practice really is, how much are you really "helping" others? Not to say that modern medicine is not useful, but it's far less useful beyond a certain baseline (there are incredible and obvious gains to be made from clean and wholesome food, clean water, immunizations, and public sanitation utilities of sewage and garbage, less so for the rest).

Once you figure this out, there are three possibilities:
1. Blue pill: Ignore the reality, and live out your days in your personal form of the Matrix where you will be "taken care of." (Most of us)

2. Red pill: Reject the reality, and actually seek to do your job which honestly will not make you a happy person and possibly a worse person. (A minority of us, rank and file workers in Criminal Investigation Departments or Provost Marshals)

3. White pill: Embrace the reality, and make the system your own. (Pharmacy school deans of for-profit institutions, Najarian (did I forget to mention that he got UMN on HHS suspension for two years?), your average I-banker).

And that choice not a contingent choice, I know people who have hold all three philosophical conclusions simultaneously (accept the reality while rejecting certain parts of it to take advantage of it in other ways). I'm definitely red pill for teaching and academic matters, but I'm also definitely white pill in the civil service where I want things done my way.

It's greed, but it's also, what do you do in a system that's fundamentally insane? I'm not looking askance at people who come to different conclusions based on those facts, I just don't want to be affected directly by them. In reference to another thread, it's not that I disagree with the fundamental gloom and doom of this forum given this reality, I don't necessarily think it has to end badly for any of us. The more one struggles with the reconciliation between the ideal and the reality of healthcare work is ultimately a personal concern to what extent you are willing to believe in the system.

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[PAtoPharm]

I guess you've never read Medical Nemesis, have you? Chapter 1 and the first part of Chapter 2 should give you an idea of how much we collectively are really worth around here.

http://soilandhealth.org/wp-content/uploads/0303critic/030313illich/Frame.Illich.Ch1.html

If you think about what your normal day-to-day practice really is, how much are you really "helping" others? Not to say that modern medicine is not useful, but it's far less useful beyond a certain baseline (there are incredible and obvious gains to be made from clean and wholesome food, clean water, immunizations, and public sanitation utilities of sewage and garbage, less so for the rest).

Once you figure this out, there are three possibilities:
1. Blue pill: Ignore the reality, and live out your days in your personal form of the Matrix where you will be "taken care of." (Most of us)

2. Red pill: Reject the reality, and actually seek to do your job which honestly will not make you a happy person and possibly a worse person. (A minority of us, rank and file workers in Criminal Investigation Departments or Provost Marshals)

3. White pill: Embrace the reality, and make the system your own. (Pharmacy school deans of for-profit institutions, Najarian (did I forget to mention that he got UMN on HHS suspension for two years?), your average I-banker).

And that choice not a contingent choice, I know people who have hold all three philosophical conclusions simultaneously (accept the reality while rejecting certain parts of it to take advantage of it in other ways). I'm definitely red pill for teaching and academic matters, but I'm also definitely white pill in the civil service where I want things done my way.

It's greed, but it's also, what do you do in a system that's fundamentally insane? I'm not looking askance at people who come to different conclusions based on those facts, I just don't want to be affected directly by them. In reference to another thread, it's not that I disagree with the fundamental gloom and doom of this forum given this reality, I don't necessarily think it has to end badly for any of us. The more one struggles with the reconciliation between the ideal and the reality of healthcare work is ultimately a personal concern to what extent you are willing to believe in the system.

The nice thing about going the MD/DO route and becoming a specialist physician is that even if the doc ends up hating their work, they only need to work FT for a few years, and once they've paid off their student loans and saved up some money, they can work PT for the rest of their careers, still earn a comfortable six-figure income, and not have to worry about working more than 1 or 1.5 days/week. I know of an orthopedic surgeon who is mostly retired who still earns $150k+ just by assisting other orthopedic surgeons in the OR (I'm assuming this is first assisting?) a couple mornings per week. I'm also familiar with an IM/FP doc who earns at least $120k by spending a couple hours per week looking over and signing off on the NP's/PA's medical charts. So I guess the silver lining to pursuing a career as a physician is that even if someone realizes (after it's too late to change directions and pursue something else) that they've made a life mistake, they only have to deal with the consequences of making that life mistake for, at most, 1-2 days per week, and at least they can count on earning a comfortable $120k+ income for their trouble.

I actually know of a PA who completed UAB's surgical PA program and who works for a local outpatient plastic surgeon who owns his own surgery center with a few other surgeons. I've seen a photo of the agreement the doc requires prospective patients to sign; in addition to his fee for the procedure itself, patients are also required to pay her an additional $250. This is in addition to her base salary, which is probably around $100k - $120k. So if he's in the OR 3 days/week and sees 3 patients/day, that's $250 * 9 = $2250, and that's in addition to her base salary (sure, maybe some weeks it's only $1900 additional earnings instead of $2250 -- whatever). So if the PA is earning $200k - $220k for a 40 hour workweek and no call, imagine what the surgeon has to be making?! He (and any other specialized surgeon who earns in that income range) could easily operate on a PT basis and still earn $200k+. Just unreal...

 

[gwarm01]

The nice thing about going the MD/DO route and becoming a specialist physician is that even if the doc ends up hating their work, they only need to work FT for a few years, and once they've paid off their student loans and saved up some money, they can work PT for the rest of their careers, still earn a comfortable six-figure income, and not have to worry about working more than 1 or 1.5 days/week. I know of an orthopedic surgeon who is mostly retired who still earns $150k+ just by assisting other orthopedic surgeons in the OR (I'm assuming this is first assisting?) a couple mornings per week. I'm also familiar with an IM/FP doc who earns at least $120k by spending a couple hours per week looking over and signing off on the NP's/PA's medical charts. So I guess the silver lining to pursuing a career as a physician is that even if someone realizes (after it's too late to change directions and pursue something else) that they've made a life mistake, they only have to deal with the consequences of making that life mistake for, at most, 1-2 days per week, and at least they can count on earning a comfortable $120k+ income for their trouble.

I actually know of a PA who completed UAB's surgical PA program and who works for a local outpatient plastic surgeon who owns his own surgery center with a few other surgeons. I've seen a photo of the agreement the doc requires prospective patients to sign; in addition to his fee for the procedure itself, patients are also required to pay her an additional $250. This is in addition to her base salary, which is probably around $100k - $120k. So if he's in the OR 3 days/week and sees 3 patients/day, that's $250 * 9 = $2250, and that's in addition to her base salary (sure, maybe some weeks it's only $1900 additional earnings instead of $2250 -- whatever). So if the PA is earning $200k - $220k for a 40 hour workweek and no call, imagine what the surgeon has to be making?! He (and any other specialized surgeon who earns in that income range) could easily operate on a PT basis and still earn $200k+. Just unreal...

You could easily work PT as a pharmacist and live very comfortably. It might not be a smart idea if you have 300k in student loans, unless you want to be on an income based payment for the rest of your life.

I think people lose perspective sometimes. As a pharmacist you can easily make nearly 3x the median household income in the US. Most people get by just fine on a whole lot less than we make.

 

[PAtoPharm]

You could easily work PT as a pharmacist and live very comfortably. It might not be a smart idea if you have 300k in student loans, unless you want to be on an income based payment for the rest of your life.

I think people lose perspective sometimes. As a pharmacist you can easily make nearly 3x the median household income in the US. Most people get by just fine on a whole lot less than we make.

I guess it just depends on what someone wants financially and in terms of lifestyle quality, regardless of whether they work full or part time. Even though a pharmacist might be able to work (even PT) and live comfortably, there is a relatively low "cap" on maximum earnings (at least compared to specialist docs); for example, there is a local spine surgeon whose house/estate was featured in Southern Living magazine. If someone's standards of achievement are on that high of a level, then being a pharmacist just isn't going to cut it. I think this has to be one of the reasons for why someone would be willing to spend another 8-10 years and $300k+ in debt to go back to medical school after graduating pharmacy school. They want to be in the extreme upper class, and not settle for being in the upper middle class. I remember that when I was an undergrad student, there were several students who wanted to undergo similar "rags to riches" transformations by going to medical school.

 

[gwarm01]

I guess it just depends on what someone wants financially and in terms of lifestyle quality, regardless of whether they work full or part time. Even though a pharmacist might be able to work (even PT) and live comfortably, there is a relatively low "cap" on maximum earnings (at least compared to specialist docs); for example, there is a local spine surgeon whose house/estate was featured in Southern Living magazine. If someone's standards of achievement are on that high of a level, then being a pharmacist just isn't going to cut it. I think this has to be one of the reasons for why someone would be willing to spend another 8-10 years and $300k+ in debt to go back to medical school after graduating pharmacy school. They want to be in the extreme upper class, and not settle for being in the upper middle class. I remember that when I was an undergrad student, there were several students who wanted to undergo similar "rags to riches" transformations by going to medical school.

That person could have saved themselves a lot of time and money by doing research then! I'll admit that I expected a 100k salary to go a lot further than it does because I come from a very poor family in rural Arkansas. If I was living in a run down house in the middle of the woods and driving a 20 year old clunker I would probably be pretty dang rich, but it turns out that a newer house, two cars, vacations, and actually leaving your house to enjoy life can really start to add up.

That said, I live very comfortably and enjoy many luxuries that I otherwise could not. For me it just wouldn't be worth it unless I had a true passion for medicine. I can understand why the people who are really clinically focused would want to do it if they were feeling unfulfilled in their jobs. You just have to weigh the sacrifices you will be making by pursuing that second career. At some point you should just fake your death, collect the insurance money, then go live on a nice island that doesn't extradite to the US.

 

[meister]

Doctors work extremely hard to make the higher numbers being thrown around here. The smartest ones either own a practice or multiple practices and/or have investments that earn them much more than being an employed physician ever could. It's not easy to do, if it was then many more would do it.