Would you do it again?

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Dermpath

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I'm curious to know if others out there would choose medicine again if they had the choice, given the recent changes in healthcare, the progressive encroachment by midlevels, etc?

Anyone out there think we are looking at a doctor-less healthcare system in the US, with midlevels progressively taking over more specialties-anesthesia, primary care, derm, etc?

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I'm curious to know if others out there would choose medicine again if they had the choice, given the recent changes in healthcare, the progressive encroachment by midlevels, etc?

Anyone out there think we are looking at a doctor-less healthcare system in the US, with midlevels progressively taking over more specialties-anesthesia, primary care, derm, etc?

I'm not 100% sure I would. I'm sick and tired of the continuing cuts, the demonization of drs and sanctification of nurses, the excessive nursing wages while we get cut, the excessive paperwork, etc. It makes no sense to be a dr in a large # of specialties already financially-IM/FM/peds/path/potentially rads. Low-mid 100's are attainable by nurses and PAs these days within a few years. Who wants to be in school for 10+ years to get paid the same as a nurse, while at the same time being told we are "greedy" and having nurses bill for the same $ to medicare and stuff? No one is doing anything-we have no power to unionize, to demand fair wages, to get paid for overtime, to even get compensated for call!!!, no hour restrictions, no fairness.
 
Anyone out there think we are looking at a doctor-less healthcare system in the US, with midlevels progressively taking over more specialties-anesthesia, primary care, derm, etc?

With all due respect, I've worked with nurse practiioners in my field for 27 years and there hasn't been the slightest movement for them to take over my field and I have no worries about that at all.

But, undoubtedly, I misunderstand the trends in the field I've worked in for my entire career.:rolleyes:
 
Well I honestly dont think I would. I owe over 1/3 of a million dollars, have been in school since I was twenty and wont be able to benefit from being a doctor until Im nearly 40. There is an interesting article that discusses this and the doctor who wrote it compares a doctor wage to that of a UPS truck driver and after averaging in hours and debt, we doctors make little more than a teacher or truck driver. I sure could have had a lot more fun in life if I hadnt studeied medicine.
 
Well I honestly dont think I would. I owe over 1/3 of a million dollars, have been in school since I was twenty and wont be able to benefit from being a doctor until Im nearly 40. There is an interesting article that discusses this and the doctor who wrote it compares a doctor wage to that of a UPS truck driver and after averaging in hours and debt, we doctors make little more than a teacher or truck driver. I sure could have had a lot more fun in life if I hadnt studeied medicine.

Why do you owe so much, and whats happened in those 20 years? I am not sure that's an accurate description, I think we make more than that, particularly for specialists.
 
I actually would do it all again. I ended up finding a field I love (psychiatry), and even in intern year I find what I am doing pretty fascinating and challenging enough to make the hours fly by. I owe in the low six figures (thanks to some generous scholarships and grants) but tend to be happy with pretty little in the way of material things and am not feeling that financially strained even as a resident. I will leave my training having achieved the highest level of training within my field, and I will keep working that way for probably the next forty years (rather than as an assistant or a 'second class' provider). I enjoy reading and learning more about mental illness and wellness, and there always seem to be fascinating new insights on the research horizon. And being in psychiatry, I can have all of this and still make time for family, friends, and hobbies. I haven't always been this sure, but I am pretty convinced I made the right choice by now.

Sorry if I just made anybody surfing SDN while finishing out a long call vomit!
 
I think everyone knows that there are better, easier, more efficient ways to make a good living. It is true that school isn't getting any cheaper and midlevels are expanding their scope in all directions. Fortunately, there will always be demand for people who are the best at what they do. For those of you doubting why you went into this, I recommend reading "purposes of medicine" by sir theodore fox.
 
No. I have been miserable since the first year of medical school and wish to God I had gotten out then. It has been one taxing endeavor after the next. Now I hate my life and regret going into medicine and if I didn't have this crushing debt, I would quit now.
 
Absolutely, no question, I would do it again. But I know a lot of good people who feel differently -- often those trapped by a mountain of debt who feel they have no choice but to continue down the path they're currently on.
 
Hmm..

This question often elicits answers of emphatic "NO!'s" for many of the reasons you and others have listed. My first reaction, was to also say... "No..probably not." but it was more reflex than anything and after mulling it over... I have to say that I would probably follow suit in my original trail of insanity.

Look, nothing is ever exactly how it seems in your ideological mind or from a merely subjective perspective. Many of us pursued medicine, even our specialty for that matter for specific reasons. It's after you arrive at your goal that you realize things were not exactly the way they appeared. Not only that, but I think our own personal goals and desires change over time and throughout life so it's impossible to project. Medicine is definitely not what I envisioned. Yes, there is mid-level encroachment, nurses have much more power than I thought they would, hospital policies and governmental agencies dictate my medical decision making more than I thought they would, the schedule isn't what I expected, my debt burden as I near 40...medicine being a second career...is a frightening and demoralizing challenge for me in the future as I will no doubt struggle to aggressively pay down on debt with a very late start on retirement savings/investing, delaying my ability to retire by a decade, the list goes on...ad nauseum.

That being said... My first career of a decade was chosen out of pursuit of a passionate hobby that had dominated most of my life growing up... computer technology. You would think that pursuing and even being very successful in your passion would make you happy..yes? Well, it doesn't. For all the reasons I mentioned. Nothing is exactly what it seems. I was disillusioned, dispirited, unsatisfied, and ultimately my hobby/passion was twisted into something I gained very little joy from.

I think most people need to realize that there is no panacea of career satisfaction. There will always be things you hate, and (hopefully)...always things you love about your job. Focus on the things you love, minimize the things you hate, and you've got a great formula for sustained psychological income from your career. Medicine is not perfect, but neither is anything else. Most of us are overachievers, hopefully have a dose of altruism and ideological philosophies that we want realized in our work, combined with a dash of genuine love for medicine and that's all you need really. What other job out there affords you the job security, continued need, earning potential, prestige, and personal satisfaction that medicine affords? Not many... So, yea.. I like to bitch and moan about how terrible the state of medicine and health care is in this country, but I'd be even more unhappy if I were robbed of the ability to continue working as a physician. I don't think you can make a spreadsheet with a weighted algorithm to decide if medicine is worth it or not. It truly is a higher calling in many respects.

Ok, I just channeled my dose of Zen for the day. Time to go run and bitch about the terrible the state of the economy and health care.
 
No, I should have gone into dentistry like my wife or stay in the field I was working in.
 
I tell med students to do dentistry as it's shorter and you can make way more money potentially, much faster. However, man... I just can't imagine staring at teeth for the rest of my life or the same calm, quiet, mellow orthodontic office I went to for braces as a kid with the elevator music playing in the background. Then again... I'm probably certifiable. You'd probably live longer as a dentist and might even avoid that CABG.
 
I am currently struggling very had between medicine and dental. I really feel torn. I love all of the options medicine has. However, I don't really have that "this is all I can see myself doing" type of feeling. Plus, the long, hard residency isn't very appealing, although I would work hard and definitely put my time in. On the other hand, I like dentistry as well. It seems like a great career with flexible hours, shorter school, good income etc. However, at the same time, I don't really know if I would want to look at teeth all day for 30 years (even though I know there is much more to it than that). Plus, you are restricted to the oral cavity. And one last thing, is I keep seeing articles about a vaccine called "Keep 32", which supposedly is going to prevent cavities. Should I even consider this into my decision equation? I would love for any advice/feedback with my dilemma. It has really been stressing me out, not to mention I am driving my parents + gf crazy!! Any advice ?

- Ar2
 
Ar,
nobody can make that decision for you. Maybe you need to shadow a few dentists and orthodontists to see the scope of what they do.
also, if you do medicine you are more likely than not going to end up "restricted to one or more areas of the body" (though not the oral cavity). That is unless you do family practice, internal medicine, or general surgery. Actually, a lot of people end up wanting to be "restricted" because knowing everything about everything in the body is just not really possible...and in fact can be very stressful trying to do so! It seems cool when you are 20 but may not seem so cool when you are 40 or even 30 in the middle of your 2nd year of residency on a 24 hour on call in the hospital.
 
In response to the OP's original question, my answer would be "I'm not sure". The reason is the godawful hours and stress of being a physician...I'm not talking about residency, I'm talking about what people need to do during practice as an attending. I would be better able to answer this question in a couple of years from now.

I do agree that one should think hard before choosing primary care over being a PA/NP. We have an NP in my department who makes 140k+ for a M-F basically 40 or so hour a week job. Maybe 45, tops. A pediatrician or fp is not going to do much better than that, and probably works much much more (? 60-65 hrs a week or even more if in private practice, plus some evening and/or night call and some weekends).

I am somewhat fearful for today's medical students who are borrowing 200k-400k at 6% interest, particularly the ones who can't get into the high paying fields even if they want to. I did not go to med school for the money, nor was it a primary motivating factor when I picked a specialty, but I am fortunate that I borrowed money at <3% and only 132k...even that is more challenging to pay off than what you would think. I've been paying while a resident/fellow for 8 years and I've still only paid off about 14k while paying >500/month...the reason is that half or more of what I'm paying is going to interest....if your loans are bigger then more of your payments will go to interest.
 
I am currently struggling very had between medicine and dental. I really feel torn. I love all of the options medicine has. However, I don't really have that "this is all I can see myself doing" type of feeling. Plus, the long, hard residency isn't very appealing, although I would work hard and definitely put my time in. On the other hand, I like dentistry as well. It seems like a great career with flexible hours, shorter school, good income etc. However, at the same time, I don't really know if I would want to look at teeth all day for 30 years (even though I know there is much more to it than that). Plus, you are restricted to the oral cavity. And one last thing, is I keep seeing articles about a vaccine called "Keep 32", which supposedly is going to prevent cavities. Should I even consider this into my decision equation? I would love for any advice/feedback with my dilemma. It has really been stressing me out, not to mention I am driving my parents + gf crazy!! Any advice ?

- Ar2
The thing about the hours is, if you like it, you're so busy during those hours that they just pass and you don't feel like you've been there *forever*. I'm sure there are rough days and better days, but generally it is ok.
 
In response to the OP's original question, my answer would be "I'm not sure". The reason is the godawful hours and stress of being a physician...I'm not talking about residency, I'm talking about what people need to do during practice as an attending. I would be better able to answer this question in a couple of years from now.

I do agree that one should think hard before choosing primary care over being a PA/NP. We have an NP in my department who makes 140k+ for a M-F basically 40 or so hour a week job. Maybe 45, tops. A pediatrician or fp is not going to do much better than that, and probably works much much more (? 60-65 hrs a week or even more if in private practice, plus some evening and/or night call and some weekends).

I am somewhat fearful for today's medical students who are borrowing 200k-400k at 6% interest, particularly the ones who can't get into the high paying fields even if they want to. I did not go to med school for the money, nor was it a primary motivating factor when I picked a specialty, but I am fortunate that I borrowed money at <3% and only 132k...even that is more challenging to pay off than what you would think. I've been paying while a resident/fellow for 8 years and I've still only paid off about 14k while paying >500/month...the reason is that half or more of what I'm paying is going to interest....if your loans are bigger then more of your payments will go to interest.

How does the NP in your dept make 140k for 40 hours of work??
 
I am currently struggling very had between medicine and dental. I really feel torn. I love all of the options medicine has. However, I don't really have that "this is all I can see myself doing" type of feeling. Plus, the long, hard residency isn't very appealing, although I would work hard and definitely put my time in. On the other hand, I like dentistry as well. It seems like a great career with flexible hours, shorter school, good income etc. However, at the same time, I don't really know if I would want to look at teeth all day for 30 years (even though I know there is much more to it than that). Plus, you are restricted to the oral cavity. And one last thing, is I keep seeing articles about a vaccine called "Keep 32", which supposedly is going to prevent cavities. Should I even consider this into my decision equation? I would love for any advice/feedback with my dilemma. It has really been stressing me out, not to mention I am driving my parents + gf crazy!! Any advice ?

- Ar2


Do dentistry.

What dent does right that med doesn't:

1. Dental school actually teaches you how to be a dentist, so you can start working after you graduate. Medicine teaches you how to be a suck-up, and that primary care is a garbage job.

2. No residency unless you want to specialize. In med, the non-specialists gave themselves a name, "Family medicine", and think they're a specialty that requires a long residency. Imagine if dent had to do three extra years after dental school to do general dentistry? Ha!

3. The hours in dent are far better. An 80 hour week is unheard of in dent. Weekends? Ha!

4. The people who go into dent are far more human. Docs are predominantly either save-the-world automatons, greedy gunners, or regretful sadomasochists whose only solace in life is making other the other, less miserable people feel horrible like them. The thing is, I don't think they were like this before they started. The training is dehumanizing and soul-crushing.

5. In dent there appears to be more professional autonomy though that may be changing with the rise of dent-corps like Aspen.

6. The gubmint controls your income in medicine. Dent is a bit more immune to this.

To put it in perspective, the most competitive field by a LONG shot is dermatology. It's not because skin is uber-cool, or because you have to be a genius to be good at it. It's because it has great pay, great hours, and lots of professional autonomy. Basically, its dent.

And don't listen to anyone who thinks dentists are second-rate doctors, or that they kill themselves all the time because they regret their failure to get into medicine, etc. It's a rewarding career. In fact its far more rewarding, professionally and financially, than "family medicine".

Do dent.
 
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Do dentistry.

What dent does right that med doesn't:

1. Dental school actually teaches you how to be a dentist, so you can start working after you graduate. Medicine teaches you how to be a suck-up, and that primary care is a garbage job.

2. No residency unless you want to specialize. In med, the non-specialists gave themselves a name, "Family medicine", and think they're a specialty that requires a long residency. Imagine if dent had to do three extra years after dental school to do general dentistry? Ha!

3. The hours in dent are far better. An 80 hour week is unheard of in dent. Weekends? Ha!

4. The people who go into dent are far more human. Docs are predominantly either save-the-world automatons, greedy gunners, or regretful sadomasochists whose only solace in life is making other the other, less miserable people feel horrible like them. The thing is, I don't think they were like this before they started. The training is dehumanizing and soul-crushing.

5. In dent there appears to be more professional autonomy though that may be changing with the rise of dent-corps like Aspen.

6. The gubmint controls your income in medicine. Dent is a bit more immune to this.

To put it in perspective, the most competitive field by a LONG shot is dermatology. It's not because skin is uber-cool, or because you have to be a genius to be good at it. It's because it has great pay, great hours, and lots of professional autonomy. Basically, its dent.

And don't listen to anyone who thinks dentists are second-rate doctors, or that they kill themselves all the time because they regret their failure to get into medicine, etc. It's a rewarding career. In fact its far more rewarding, professionally and financially, than "family medicine".

Do dent.

While I agree that dentistry is a cool gig, realize that general dentists don't make bank like people think. Gen dentists make roughly what primary care docs make or less. also with the serious need there is right now some places are offering 250k+ to start.
 
While I agree that dentistry is a cool gig, realize that general dentists don't make bank like people think. Gen dentists make roughly what primary care docs make or less. also with the serious need there is right now some places are offering 250k+ to start.

Dentists have more income-generating capability than family doctors, and can start generating this income earlier, which gives dentists the advantage of earlier compound interest.

All things considered, if a dentist's income equals a family doctor's income, you can be sure the family doctor is working more hours and taking on greater liability.
 
Dentists have more income-generating capability than family doctors, and can start generating this income earlier, which gives dentists the advantage of earlier compound interest.

All things considered, if a dentist's income equals a family doctor's income, you can be sure the family doctor is working more hours and taking on greater liability.

I am not so sure about that. If we are talking cosmetics or something like that, FP/IM can also generate extra income that way, just like a gen dentist can do some cosmetic work with stuff like teeth whitening. Yes obviously they do not have to do residency (which is kind of odd?) so at least they have 3 years of more work vs. FM/IMs. Taking more responsibility I agree, but working more hours not really. Currently you can work 40 hour week and make in excess of 200k.
 
Interesting points - Dent vs Med.

In general I believe that medicine downplays its positives and that dentistry is a little hyped. This is coming from someone who wants to go into dental school and has worked as an assistant. It's not as easy as people make it out. Yes, dentists most likely have better hours but I believe they're harder hours with less vacation. The work they do is very fine/small and requires alot of eye strain and at times awkward positioning. I have noticed this tends to get harder as dentists age. Also, the GP I work for spends ~40hrs of clinical practice and 10 hours managing his practice a week. This is not as little as suggested. Lastly, he is scared to death of DMO's [Dental Management Organizations] that are funded by private equity that are able to offer dentistry on the cheap and accept lots of bad insurance - all of which is directly effecting the revenue and leading to a feeling of over-saturation of dentistry in our area. Indeed, there is also a strong push in dentistry for a mid-level provider that can do many of the same functions as a dentist with only two years of education post-high-school (dental therapist). It is not hard to see that this is leading to a certain corporatization of dentistry.

Having said all that the average GP dentists makes ~200 grand who owns all of his practice but also must pay for their own health insurance, disability, and retirement. Associates start around 90-110k. Many dental schools cost ~300-400k. It's getting rough out there.

Are physician hours really that bad post residency? Are there not Hospitalist jobs where you work 7 10hr shifts then get 7 days off earning ~200-250k + befits + retirement vehicle? This is pretty much the upper average for dentistry after being the field for several years after building a practice.

lol. After writing this I question my decision to not go into medicine. Especially after looking over the MGMA spread - orthopedics @500k? Not bad.
 
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Interesting points - Dent vs Med.

In general I believe that medicine downplays its positives and that dentistry is a little hyped. This is coming from someone who wants to go into dental school and has worked as an assistant. It's not as easy as people make it out. Yes, dentists most likely have better hours but I believe they're harder hours with less vacation. The work they do is very fine/small and requires alot of eye strain and at times awkward positioning. I have noticed this tends to get harder as dentists age. Also, the GP I work for spends ~40hrs of clinical practice and 10 hours managing his practice a week. This is not as little as suggested. Lastly, he is scared to death of DMO's [Dental Management Organizations] that are funded by private equity that are able to offer dentistry on the cheap and accept lots of bad insurance - all of which is directly effecting the revenue and leading to a feeling of over-saturation of dentistry in our area. Indeed, there is also a strong push in dentistry for a mid-level provider that can do many of the same functions as a dentist with only two years of education post-high-school (dental therapist). It is not hard to see that this is leading to a certain corporatization of dentistry.

Having said all that the average GP dentists makes ~200 grand who owns all of his practice but also must pay for their own health insurance, disability, and retirement. Associates start around 90-110k. Many dental schools cost ~300-400k. It's getting rough out there.

Are physician hours really that bad post residency? Are there not Hospitalist jobs where you work 7 10hr shifts then get 7 days off earning ~200-250k + befits + retirement vehicle? This is pretty much the upper average for dentistry after being the field for several years after building a practice.

lol. After writing this I question my decision to not go into medicine. Especially after looking over the MGMA spread - orthopedics @500k? Not bad.

Yep, exactly. I mean sure some investment bankers make bank, no pun intended, but they can also lose their jobs at the drop of a hat. At the end of the day, making 200-250k+ after 3 years of residency starting at around 30 or so and having a job pretty much for the rest of one's life is not that bad. General dentists on avg as you point out don't make much more than GPs, and in order to make orthodontist $$, you have to be pretty darn competitive. It's sort of like the derm of dentistry!
But I guess grass is always greener on the other side! Until it's not.
 
Interesting points - Dent vs Med.

In general I believe that medicine downplays its positives and that dentistry is a little hyped. This is coming from someone who wants to go into dental school and has worked as an assistant. It's not as easy as people make it out. Yes, dentists most likely have better hours but I believe they're harder hours with less vacation. The work they do is very fine/small and requires alot of eye strain and at times awkward positioning. I have noticed this tends to get harder as dentists age. Also, the GP I work for spends ~40hrs of clinical practice and 10 hours managing his practice a week. This is not as little as suggested. Lastly, he is scared to death of DMO's [Dental Management Organizations] that are funded by private equity that are able to offer dentistry on the cheap and accept lots of bad insurance - all of which is directly effecting the revenue and leading to a feeling of over-saturation of dentistry in our area. Indeed, there is also a strong push in dentistry for a mid-level provider that can do many of the same functions as a dentist with only two years of education post-high-school (dental therapist). It is not hard to see that this is leading to a certain corporatization of dentistry.

Having said all that the average GP dentists makes ~200 grand who owns all of his practice but also must pay for their own health insurance, disability, and retirement. Associates start around 90-110k. Many dental schools cost ~300-400k. It's getting rough out there.

Are physician hours really that bad post residency? Are there not Hospitalist jobs where you work 7 10hr shifts then get 7 days off earning ~200-250k + befits + retirement vehicle? This is pretty much the upper average for dentistry after being the field for several years after building a practice.

lol. After writing this I question my decision to not go into medicine. Especially after looking over the MGMA spread - orthopedics @500k? Not bad.


Um my brother is a dentist and I am an internist (resident). there isnt a day that goes by that I dont wish I had listened to my brother and went to Dental school. seriously. Dental school is 4 years, and the last year is not bad at all. No residency. He never, ever takes call. He makes way WAY more than 200k. he works as much as he wants, when he wants. His stress level is nothing compared to medicine. He stopped taking HMOs and is only accepting medicaid/care and private payers only. Dentistry IS like derm only better because you dont have to do residency. oh and many dentists are over 50 and getting ready to retire so dont expect job saturation.
 
lol. After writing this I question my decision to not go into medicine. Especially after looking over the MGMA spread - orthopedics @500k? Not bad.

The part that they don't tell you about getting a sweet ortho job is the long, grueling hours trying to get a 250 on step I, followed by the suck-up charade of the clinical years, followed by potentially moving your ass halfway across the nation to work 130 hour weeks in some god-forsaken hospital away from your family and friends while making $3/hr, followed by another year or two of "fellowship" because you can't get a job without it. Ten years later, when you finally have that ortho job, you're still working 70 hr weeks and your wife has three lotharios on the side. That 500k doesn't seem all that great now, does it?

The ony fields in medicine worth a damn in my opinion are ROAD and rad onc and maybe urology(if you do scopes all day). Path would be if they weren't such obsequious losers (there's a job going for 110k/year in NY for path. LOL!)
 
The part that they don't tell you about getting a sweet ortho job is the long, grueling hours trying to get a 250 on step I, followed by the suck-up charade of the clinical years, followed by potentially moving your ass halfway across the nation to work 130 hour weeks in some god-forsaken hospital away from your family and friends while making $3/hr, followed by another year or two of "fellowship" because you can't get a job without it. Ten years later, when you finally have that ortho job, you're still working 70 hr weeks and your wife has three lotharios on the side. That 500k doesn't seem all that great now, does it?

The ony fields in medicine worth a damn in my opinion are ROAD and rad onc and maybe urology(if you do scopes all day). Path would be if they weren't such obsequious losers (there's a job going for 110k/year in NY for path. LOL!)

Well you're just a bundle of joy now aren't you...


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Um my brother is a dentist and I am an internist (resident). there isnt a day that goes by that I dont wish I had listened to my brother and went to Dental school. seriously. Dental school is 4 years, and the last year is not bad at all. No residency. He never, ever takes call. He makes way WAY more than 200k. he works as much as he wants, when he wants. His stress level is nothing compared to medicine. He stopped taking HMOs and is only accepting medicaid/care and private payers only. Dentistry IS like derm only better because you dont have to do residency. oh and many dentists are over 50 and getting ready to retire so dont expect job saturation.

How much does your brother realistically make and if he's just a general dentist, how is he making so much money? Because general dentists don't make that much more. And by making I mean taking home, of course I'm sure he collects more than 200k.
 
The part that they don't tell you about getting a sweet ortho job is the long, grueling hours trying to get a 250 on step I, followed by the suck-up charade of the clinical years, followed by potentially moving your ass halfway across the nation to work 130 hour weeks in some god-forsaken hospital away from your family and friends while making $3/hr, followed by another year or two of "fellowship" because you can't get a job without it. Ten years later, when you finally have that ortho job, you're still working 70 hr weeks and your wife has three lotharios on the side. That 500k doesn't seem all that great now, does it?

The ony fields in medicine worth a damn in my opinion are ROAD and rad onc and maybe urology(if you do scopes all day). Path would be if they weren't such obsequious losers (there's a job going for 110k/year in NY for path. LOL!)

You know, it's NOT just about the money. Yes, income is important, but I can tell you from my seeing the attendings in a pediatric oncology clinic, they all seem happy. Taking a child with a death sentence, diagnosing them properly and giving them good chemo/radiation/surgery and thus curing them and giving them a good chance at a somewhat normal life - that's amazing and gives these doctors a deep sense of purpose.

I've also worked with a missionary surgeon who works in the third-world and sees the fruits of his labor in 100s of saved and improved lives of some very destitute people.

And pathology is not a specialty for obsequious losers either, and people who make "only" 110k/year...what's wrong with them?
 
You know, it's NOT just about the money. Yes, income is important, but I can tell you from my seeing the attendings in a pediatric oncology clinic, they all seem happy. Taking a child with a death sentence, diagnosing them properly and giving them good chemo/radiation/surgery and thus curing them and giving them a good chance at a somewhat normal life - that's amazing and gives these doctors a deep sense of purpose.

I've also worked with a missionary surgeon who works in the third-world and sees the fruits of his labor in 100s of saved and improved lives of some very destitute people.

And pathology is not a specialty for obsequious losers either, and people who make "only" 110k/year...what's wrong with them?

Looks like the sanctimony train stopped at Substance station. Allow me to board...

The poster I had replied to mentioned ortho as being "worth it", and I politely gave him reasons why I think it is not.

The missionary surgeon takes pride in his work because he chooses to do it. His well-compensated domestic efforts give him the luxury of going to far-off lands to dispense his knowledge and expertise for the good of the unfortunate. Cut him down to 110k a year and steal his autonomy and I bet he'd be a lot less philanthropic.

If any medical specialty is making 110 a year, then it ain't going to attract great people. There are better options out there for people who have those options, and most do. And if someone accepts such a position (with an income that is in my opinion insultingly low) then they are an obsequious loser. And my comment about path being full of these people is true: pathologists are employees of large lab corps and other physician colleagues. What self-respecting physician group would even allow that to become the status-quo (radiology might, and if it does, watch it fill with questionably skilled people)?

You are right in asserting that it is not all about money. But it is partly about money. And in some cases, the parts that aren't money do not have benefits that outweigh the lack of money. Others, like my ortho example, have the opposite problem. That is why I believe doing dent gives you the best guaranteed income, professional autonomy and job satisfaction, and a sense of purpose, all things considered.

But hey, if you like to do oncology, then good for you. It's important and if you find it rewarding on a professional level then great! But to find this rewarding career is a big gamble and takes time to feel out (not everything in medicine fits all people), so you really can only go on the objective data when choosing something.
 
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If any medical specialty is making 110 a year, then it ain't going to attract great people. There are better options out there for people who have those options, and most do. And if someone accepts such a position (with an income that is in my opinion insultingly low) then they are an obsequious loser.

This is exaggeration and you know it, but for anyone else out there....note that pedi ID, pedi endo etc often have amongst the lowest salaries out there sometimes starting not much different from what you listed in many places. These fields are filled with very bright, non-losers who have willingly chosen to take a lower salary based on doing what they love. Instead of insulting them, consider commending them, especially if your family, or any child you care about, ever has need of their services.
 
This is exaggeration and you know it, but for anyone else out there....note that pedi ID, pedi endo etc often have amongst the lowest salaries out there sometimes starting not much different from what you listed in many places. These fields are filled with very bright, non-losers who have willingly chosen to take a lower salary based on doing what they love. Instead of insulting them, consider commending them, especially if your family, or any child you care about, ever has need of their services.

It is true that people who go into peds are different, in the sense that they are not particularly concerned about $$$. However, I think it's also true that there are many foreign docs in peds, and the low pay is probably one of the reasons many AMGs don't go into peds. Also, since we are at it, why is it that pay is so low in peds compared even to primary care and other specialties?
 
However, I think it's also true that there are many foreign docs in peds, and the low pay is probably one of the reasons many AMGs don't go into peds.

http://pediatrics.aappublications.org/content/116/1/e156.full

from 2005 - didn't look up current data but don't think it's changed much.

Approximately one third of practicing pediatricians attended medical schools outside of the United States and Canada, a proportion that has changed little during the past 10 years. US medical students generally fill residency positions first and constitute a higher proportion of pediatric residency positions than most other specialties. In 2003, 28.7% of offered first-year pediatric residency positions were filled by IMGs, a lower proportion than for internal medicine (44.8%) or family medicine (58%).48 IMGs remain an important and relatively stable part of the pediatrician workforce.
 
I have a hard time imagining him earning more than 200k unless he is a practice owner. Especially in today's market (very competitive). I think you're over stating dentistry's position and not looking at the opportunities in medicine. 50 hour weeks as an attending are not far off from what most dentists work. My understanding is that there are many flexible physician fields where you do not need to slave away 70hrs /wk once you've finished residency.

Starting out as a dentist can be very difficult. Even if you're at full production you are paying off your practice so your income is substantially lower than 200k for the fist decade. This combined with large student loans and buying your own health befits and retirement make things a lot more difficult.

Yes, dental school is 4 years however because of lab work I've heard it described as harder than medical school in some ways. You take similar basic sciences then have clinic and sim lab. It's not uncommon for students to start school at 8am then leave at 11pm then study for an exam the day on a regular basis as they have tests, patients, and lab projects. Is residency really that bad? As a paramedic intern I worked 72 hrs straight - over the course of that time I got ~5hrs of sleep. It wasn't that terrible of an experience. As residents dont most you guys work 12 hrs / day 5 days a week or so? I've even heard many describe it as "not bad".

I'm sure in the coming years your salary will match your brothers but you will not have to feel the pressures of running a practice if you don't want to - yet still have higher compensation, infinite job opportunities, and a steady stream of patients.



Um my brother is a dentist and I am an internist (resident). there isnt a day that goes by that I dont wish I had listened to my brother and went to Dental school. seriously. Dental school is 4 years, and the last year is not bad at all. No residency. He never, ever takes call. He makes way WAY more than 200k. he works as much as he wants, when he wants. His stress level is nothing compared to medicine. He stopped taking HMOs and is only accepting medicaid/care and private payers only. Dentistry IS like derm only better because you dont have to do residency. oh and many dentists are over 50 and getting ready to retire so dont expect job saturation.
 
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I have a hard time imagining him earning more than 200k unless he is a practice owner. Especially in today's market (very competitive). I think you're over stating dentistry's position and not looking at the opportunities in medicine. 50 hour weeks as an attending are not far off from what most dentists work. My understanding is that there are many flexible physician fields where you do not need to slave away 70hrs /wk once you've finished residency.

Starting out as a dentist can be very difficult. Even if you're at full production you are paying off your practice so your income is substantially lower than 200k for the fist decade. This combined with large student loans and buying your own health befits and retirement make things a lot more difficult.

Yes, dental school is 4 years however because of lab work I've heard it described as harder than medical school in some ways. You take similar basic sciences then have clinic and sim lab. It's not uncommon for students to start school at 8am then leave at 11pm then study for an exam the day on a regular basis as they have tests, patients, and lab projects. Is residency really that bad? As a paramedic intern I worked 72 hrs straight - over the course of that time I got ~5hrs of sleep. It wasn't that terrible of an experience. As residents dont most you guys work 12 hrs / day 5 days a week or so? I've even heard many describe it as "not bad".

I'm sure in the coming years your salary will match your brothers but you will not have to feel the pressures of running a practice if you don't want to - yet still have higher compensation, infinite job opportunities, and a steady stream of patients.

Agreed. Yes, medicine is stressful and difficult but it does not mean that is so terrible compared to everything else. I even asked in the dental forum-the statement was that associates start at 120-130 or so, median salary is 150k, and around 200kish +/- if owner, which is 5-15% of dentists. Medicine does not look so bad overall, and I think it gets better as an attending (hopefully!)
 
Looks like the sanctimony train stopped at Substance station. Allow me to board...

The poster I had replied to mentioned ortho as being "worth it", and I politely gave him reasons why I think it is not.

The missionary surgeon takes pride in his work because he chooses to do it. His well-compensated domestic efforts give him the luxury of going to far-off lands to dispense his knowledge and expertise for the good of the unfortunate. Cut him down to 110k a year and steal his autonomy and I bet he'd be a lot less philanthropic.

If any medical specialty is making 110 a year, then it ain't going to attract great people. There are better options out there for people who have those options, and most do. And if someone accepts such a position (with an income that is in my opinion insultingly low) then they are an obsequious loser. And my comment about path being full of these people is true: pathologists are employees of large lab corps and other physician colleagues. What self-respecting physician group would even allow that to become the status-quo (radiology might, and if it does, watch it fill with questionably skilled people)?

You are right in asserting that it is not all about money. But it is partly about money. And in some cases, the parts that aren't money do not have benefits that outweigh the lack of money. Others, like my ortho example, have the opposite problem. That is why I believe doing dent gives you the best guaranteed income, professional autonomy and job satisfaction, and a sense of purpose, all things considered.

But hey, if you like to do oncology, then good for you. It's important and if you find it rewarding on a professional level then great! But to find this rewarding career is a big gamble and takes time to feel out (not everything in medicine fits all people), so you really can only go on the objective data when choosing something.

OK, this just demonstrates your ignorance. The missionary surgeon does NOT work in the US. He lives fulltime in the Indian subcontinent (and isn't Indian heritage, and was trained in the US airforce) with his family and is supported 1.) by donations from churches and 2.) meager reimbursement from patients (and not all of them). There is no insurance, medicare, medicaid, half-million dollar salary, etc. There are no private schools for his children: they live in the rural third world and are home taught.

I understand that your $-obsessed head would probably find this really, really hard to comprehend.

Second, are you seriously saying that any human being who makes $110,000 or below is a loser?

The lowest salaries in medicine are going to be associated with two kinds of people: 1.) those who couldn't enter more competitive, higher-paying specialties; and 2.) those who have a passion for the job. A competent, intelligent physician who has passion for his work is not a loser, regardless of how much he is paid.
 
If pediatricians are getting paid this low why do they not figure out nice side gigs that generate cash. I know of so many parents that are trying to get their kids to lose weight - middle/upper middle class parents. Why not start a "Kids Wellness" center where parents pay a membership or for consults on how to get their kids to drop weight. Maybe expand it into some sort of day care where you offer good meals and have health standards - a physician running this with lip service to their professional training would be a huge selling feature. Once it's up and running they can spend more time doing pure clinical duties or start another one if it was successful at a new location.

I'm convinced the only reason some physician may make less than dentists is they have zero interest in business.



Second, are you seriously saying that any human being who makes $110,000 or below is a loser?

The lowest salaries in medicine are going to be associated with two kinds of people: 1.) those who couldn't enter more competitive, higher-paying specialties; and 2.) those who have a passion for the job. A competent, intelligent physician who has passion for his work is not a loser, regardless of how much he is paid.
 
OK, this just demonstrates your ignorance. The missionary surgeon does NOT work in the US. He lives fulltime in the Indian subcontinent (and isn't Indian heritage, and was trained in the US airforce) with his family and is supported 1.) by donations from churches and 2.) meager reimbursement from patients (and not all of them). There is no insurance, medicare, medicaid, half-million dollar salary, etc. There are no private schools for his children: they live in the rural third world and are home taught.

I understand that your $-obsessed head would probably find this really, really hard to comprehend.

Second, are you seriously saying that any human being who makes $110,000 or below is a loser?

The lowest salaries in medicine are going to be associated with two kinds of people: 1.) those who couldn't enter more competitive, higher-paying specialties; and 2.) those who have a passion for the job. A competent, intelligent physician who has passion for his work is not a loser, regardless of how much he is paid.

Again with the sanctimony. Be civil, now.

Good for that surgeon for finding what truly fulfills him in life. There are not enough people like that. Nonetheless, I had thought the discussion is centered around domestic medical careers, of which being a full-time surgeon in India is not one.

Why do pediatricians get paid so little? I'm really curious as to the logic for that policy. The people that go into peds tend to find fulfillment in dealing with children, to the point where they get underpaid to do so. I don't know whether this is due to some maternal/paternal instinct, some cynicism towards adult medicine, or a general sense of sanctimony? Or maybe they just like child physiology and medicine. Who knows? And for those that choose the even lower-paying peds subspecialties, then good for them too! They've found something they truly like, but that's after a lot of experience in the field. If I found a very rewarding sub-career I'd be willing to take a paycut to do it.

The issue is that when it comes to finding your niche in medicine, you have no time. Your experience is limited to only the objective data available, and one cannot really know what fulfills them due to this lack of experience.

Passion and money are not zero-sum games. Plenty of passionate people make good money, and plenty of burnt-out people make nothing. Same with competitiveness: there are family docs pulling in as much as some radiologists out there, and some opththalmologists who are lucky to make what a psychiatrist would make.

It's all about what you would accept as being fair reward for your efforts. As a physician I think 110 is far too little.

Loser is a harsh term, and I used it without a modicum of tact. Perhaps I should have said that such a person does not know the true value of their work. I pity these people actually, for they do not know the options truly available to them.
 
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Perhaps I should have said that such a person does not know the true value of their work. I pity these people actually, for they do not know the options truly available to them.

I know a lot of pedi subspecialists. Many hundreds of them actually since I work at a large children's hospital and am one of them. They/we have lives like other folks and most of them/us make $100,000-200,000/year. Some (including many neonatologists) make more in a few pedi fields or are more senior folks. A few do editing, consulting, moonlighting, etc to make additional funds. We're not financially ignorant because we are pediatricians. Surveys show, and my experience is, that pediatricians, especially academic specialists, are amongst the most content with their career folks in all of medicine. Most of them/us do pediatrics because we prefer caring for children relative to adults and are more than willing to accept the financial issues involved. I don't think that's sanctimonious, but to each their own. Again, when someday you or someone you know, needs one of us, perhaps you'll go slower on all of the negative comments about us.

In any case, although I appreciate the concern, I think, at my age, that I have a very good understanding of the value of my work and I'm absolutely certain that pediatricians and pediatric specialists do not need your pity or are unaware that there are and were higher paying options available to them.

I hope that as your career progresses, you make some real effort to understand what motivates people, including pediatricians, to be happy with their career.
 
I sounded harsh, and mean no disrespect towards practitioners in underpaid fields. If I did not think their services and skills were exceptional I would never be suggesting they are underpaid.

I guess what I meant to say is that it does not seem just that certain fields, certain very important fields, like pediatrics, have low remuneration, and it is seen as the status quo for them to be so undervalued.

This undervaluation surely scares away good people from the field that would have otherwise gone into it (hence the large number of unfilled spots). Though fulfillment is the most important thing, a wet-behind-the-ears medical student cannot know what truly fulfills him until he gets in too deep, hence the reliance on objective data such as income to decide one's career at such an early - dare I say premature - stage.

And to me there is a huge difference in working for 110 a year and doing pro bono work. In the first, an organization/CEO is profiting off of your labor, in the second, the only "profiteer" so to speak is the patient. Being underpaid does not equate to being altruistic.
 
I know a lot of pedi subspecialists. Many hundreds of them actually since I work at a large children's hospital and am one of them. They/we have lives like other folks and most of them/us make $100,000-200,000/year. Some (including many neonatologists) make more in a few pedi fields or are more senior folks. A few do editing, consulting, moonlighting, etc to make additional funds. We're not financially ignorant because we are pediatricians. Surveys show, and my experience is, that pediatricians, especially academic specialists, are amongst the most content with their career folks in all of medicine. Most of them/us do pediatrics because we prefer caring for children relative to adults and are more than willing to accept the financial issues involved. I don't think that's sanctimonious, but to each their own. Again, when someday you or someone you know, needs one of us, perhaps you'll go slower on all of the negative comments about us.

In any case, although I appreciate the concern, I think, at my age, that I have a very good understanding of the value of my work and I'm absolutely certain that pediatricians and pediatric specialists do not need your pity or are unaware that there are and were higher paying options available to them.

I hope that as your career progresses, you make some real effort to understand what motivates people, including pediatricians, to be happy with their career.

That was a great response, my hat off to you. I am however curious about why you guys are not compensated better? I guess I am ignorant on the matter other than knowing that there are a large # of peds patients that are on medicaid, but aren't there millions of other kids on regular insurance too?
 
i would not do it again.
one of my reasons for quitting was that clinical medicine is one of the only field where you can do 4 yrs of premed, 4 yrs of med school and 3-7 yrs of residency, totaling of more than at least 10 yrs being the expert in the clinical medicine specialty of your choice and then having people who never touched a bio book before telling you how you can practice medicine and how much your knowledge and service deserves to be paid (politician, insurance, pharm, etc).

I would never dare to dream to tell my plumber, electrician, contractor how to do their job or how much their job deserved to be paid (tho yes I may try to haggle a bit). Or I would never try to dictate what a lawyer can and should do in a court setting or demanding how much they can charge. Medicine is the only field where the experts in the field have no autonomous power at all.

If I would do it all over again, I would have listened to my childhood mentor and gone into bio/medical-informatics.
The 4 yrs in med school + yrs in residency, if you major in business or IT, or any of the computer related majors and worked the same amount of yrs as a friend who went to med school and residency and compared the debt and income and lifestyle, i think there is a huge difference.

in my opinion, with the decreasing reimbursements, increasing tuition and expenses and all the regulations and hurdles the doctors have to do now because of the HITECH/ ACA act, becoming a doctor in the US now is not worth it anymore, unless you truly have the passion for medicine and do not mind the sacrifices and all the BS and red tapes you will need to jump over to practice the way you want to practice.

Best of luck out there who are in training or in med school.
 
HIJay.

Thank you for your candor. It seems there are some common complaints - I wonder how much better physicians would be if they no longer accepted insurances and went cash based, opened their own physician lead hospitals and medical centers, and hired their own nurses and MA's. More responsibility but a lot more autonomy.
 
i would not do it again.
one of my reasons for quitting was that clinical medicine is one of the only field where you can do 4 yrs of premed, 4 yrs of med school and 3-7 yrs of residency, totaling of more than at least 10 yrs being the expert in the clinical medicine specialty of your choice and then having people who never touched a bio book before telling you how you can practice medicine and how much your knowledge and service deserves to be paid (politician, insurance, pharm, etc).

I would never dare to dream to tell my plumber, electrician, contractor how to do their job or how much their job deserved to be paid (tho yes I may try to haggle a bit). Or I would never try to dictate what a lawyer can and should do in a court setting or demanding how much they can charge. Medicine is the only field where the experts in the field have no autonomous power at all.

If I would do it all over again, I would have listened to my childhood mentor and gone into bio/medical-informatics.
The 4 yrs in med school + yrs in residency, if you major in business or IT, or any of the computer related majors and worked the same amount of yrs as a friend who went to med school and residency and compared the debt and income and lifestyle, i think there is a huge difference.

in my opinion, with the decreasing reimbursements, increasing tuition and expenses and all the regulations and hurdles the doctors have to do now because of the HITECH/ ACA act, becoming a doctor in the US now is not worth it anymore, unless you truly have the passion for medicine and do not mind the sacrifices and all the BS and red tapes you will need to jump over to practice the way you want to practice.

Best of luck out there who are in training or in med school.

At what point in your training did you quit? What did you end up doing instead? I'm actually very interested in informatics.
 
At what point in your training did you quit? What did you end up doing instead? I'm actually very interested in informatics.

Yeah me too....Give me some insight to get out of this god forsaken hell hole we call clinical medicine.....
 
becoming a doctor in the US now is not worth it anymore, unless you truly have the passion for medicine and do not mind the sacrifices

shouldn't this be the case anyway?
 
I have a hard time imagining him earning more than 200k unless he is a practice owner. Especially in today's market (very competitive). I think you're over stating dentistry's position and not looking at the opportunities in medicine. 50 hour weeks as an attending are not far off from what most dentists work. My understanding is that there are many flexible physician fields where you do not need to slave away 70hrs /wk once you've finished residency.

Starting out as a dentist can be very difficult. Even if you're at full production you are paying off your practice so your income is substantially lower than 200k for the fist decade. This combined with large student loans and buying your own health befits and retirement make things a lot more difficult.

Yes, dental school is 4 years however because of lab work I've heard it described as harder than medical school in some ways. You take similar basic sciences then have clinic and sim lab. It's not uncommon for students to start school at 8am then leave at 11pm then study for an exam the day on a regular basis as they have tests, patients, and lab projects. Is residency really that bad? As a paramedic intern I worked 72 hrs straight - over the course of that time I got ~5hrs of sleep. It wasn't that terrible of an experience. As residents dont most you guys work 12 hrs / day 5 days a week or so? I've even heard many describe it as "not bad".

I'm sure in the coming years your salary will match your brothers but you will not have to feel the pressures of running a practice if you don't want to - yet still have higher compensation, infinite job opportunities, and a steady stream of patients.

I lived with my bro while he was in the "basic sciences" portion of his dental education. He sat with the MD students for many of the classes such as biochem, pharm, general gross anatomy etc. but then he also had lab work he had to do. He did have some definite late nights. But it was no different for me in medical school. I can remember being in the anatomy lab in the middle of the night (and everybody else was there too) studying for a bell ringer in the morning. there is no question in my mind that dentistry is a far better route for combination of lucrative pay and FAR better Lifestyle.
 
I lived with my bro while he was in the "basic sciences" portion of his dental education. He sat with the MD students for many of the classes such as biochem, pharm, general gross anatomy etc. but then he also had lab work he had to do. He did have some definite late nights. But it was no different for me in medical school. I can remember being in the anatomy lab in the middle of the night (and everybody else was there too) studying for a bell ringer in the morning. there is no question in my mind that dentistry is a far better route for combination of lucrative pay and FAR better Lifestyle.

Look at how much dental school costs and starting incomes. Also look at the cost to buy a practice. Not all is as it seems. Entering dentistry 20 years ago would have been great because of low educational costs and low practice start-up costs. This is no longer true.

:cool:
 
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