Medicine going down the toilet

Im starting residency training next month and this article just put things in perspective!!

Man, that was depressing.

Cry me a freaking river. This quote pretty much says it all,

By the mid-nineties, circumstances had changed. "The general population decided we weren't worth all that much," says Schayes. Or, as he sometimes thinks of it, "people decided they wanted us to drive Acuras."

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Oh, you have to drive an Acura NSX instead of your Mercedes or BMW? Boo-freaking-hoo.

Most of this article is about old foagies missing the good old days. Personally, as a junior resident I could not be more excited about my profession. The glory days are finished, get over it.

I don't mean to sound insensetitive, but where is the news here? Unless you've started your medical education some time in the 1980s and then things turned out to be not what you expected them to be....Did I miss something? Over the years many industries went through a transformation, and some became absolete. All kinds of manual labour, assembly lines, messenger service. But hey, Do you guys remeber that in the 1990s you could have some "Socks R Us" joint on the corner, but if you put ".com" next to it the soap bubble would made you a milioner. So What? It has passed too. No ****, it's hard to make it in Manhattan in solo practice . Are these guys kidding me? NY has always been a welfare State, and now even more so with so many working ppl leaving, and able-budied bums sucking the system dry, and the illigal aliens invading the City, not paying the dime in tax revenues, and knocking out anchor babies, and using the social programs to the max. (Please don't call me a racist or some other crap. I'm an immigrant myself, but got in U.S without breaking the law, and not demanding everybody else to pay my way here. And I live in NYC, and i work in the health care field here, so I know exactly what I'm talking about). How many business we lost, and how many ppl moved out of NYC after 9/11. There is a huge migration from NY to the vibrant economy, low or no income tax States. You've got to go where the action is, and not maintain your "exclussivity", and think that you are just entitled to the way of life that's once was a reality. Just think about ppl who worked in IT, business etc. Their jobs are being shipped to India and China, and South of the Border by the craploads. If you entered medicine for money along, then you deserve to be screwed . Most sane ppl who go into medicine these days do so not because, but despite what it entails, IMHO.

Depressing article, for certain but the author did us no favors by writing this and publishing it in the NYT.

A bunch of Manhattan-based doctors complaining that they have to send their kids to public school and that they had to trade in their Jags for Acuras is NOT the way to get John Q. Public behind us and supporting our cause. This approach would be better suited for a physician-based publication--although I'm not sure bitching about the current situation solves anything; we all know how dire our situation is.

From what I have seen, the general lay public may be familiar with what it takes to become a physician but does not know the nitty-gritty, and in particular the financials required to get here. I am amazed at how many fairly well educated people think that since I'll now be a resident that I'm bringing in the "big bucks." They are surprised when they hear it's really only about $50,000/yr (which is on the high end for residents, I know)

We should put forth efforts to educating the public into the sacrifices--temporal and financial--it takes to get into and complete medical school and to obtain and complete a residency. Perhaps if they were a bit more attuned to the fact that many of us have put ourselves into $200,000+ debt and what that really means--it is easy to say that number, but when you then spell that out and let people know how much money that takes over thirty years to pay off they realize what that lump sum really means. I have seen people offer mild sympathy when they hear that number, but it takes on a whole new meaning when they realize that my student loan payment is high than the mortgage on their very well appointed home--that is when they really start to grasp what that student loan debt means. Try detailing what a residency really entails on a day-to-day and year-to-year basis, and relay how many of us have had to put off our personal lives (or see our personal lives fall apart) because this job has to come first. This is the life we have chosen, and I'm not complaining, but I really don't think the non-medical public really understands, and an article like this does us no good and makes us seem like a bunch of whiny brats who are sad b/c we can't afford a Mercedes AND a Jaguar.

Gfunk6 said:

Cry me a freaking river. This quote pretty much says it all,


Oh, you have to drive an Acura NSX instead of your Mercedes or BMW? Boo-freaking-hoo.

Most of this article is about old foagies missing the good old days. Personally, as a junior resident I could not be more excited about my profession. The glory days are finished, get over it.

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i absolutely agree...these ny docs are ridiculous and obnoxious...i am embarrassed to be associated with their same profession after having read that article. if i can't find sympathy for them, i can't imagine a single struggling new yorker that could or would. i would imagine that it would only inspire anger.

The article seemed insidiously anti-doctors (i.e. "I'm a DOCTOR" as a quote when being compared to part of the healthcare team ==> How many of you have or would say that?).

-Ice

ice_23 said:

The article seemed insidiously anti-doctors (i.e. "I'm a DOCTOR" as a quote when being compared to part of the healthcare team ==> How many of you have or would say that?).

-Ice

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I don't know if these doctors are real, but the whole thing is presented as an anti-doctor set up. They found some old hacks who are whining about good ole' days, and speak in such stereotypes that public believes. What a bunch of B.S. But then again NY mag sure cares more abiout their circulation and sales than the issues facing young docs. Anyway, may be some professional medical publication could do a better job. But then how do you reach enough lives to read it? A re-print in the lay-type of journal? I wish that flexible spending (or a medical saving) accounts would become more common in use by the general public. This will give ppl a choice of their doc, and will bite insurance industry as well. Until then it's all rubbish. We can complain all we want, but it will be falling on the deaf ears b/c ppl who they chose to speak for the docs are "poor souls" who are now "forced" to drive Accura instead of BMWs, and their "poor kids" now have to go to a public schools, just everybody else. Oh my, How terrible! . Ahhhh, forget it. To me the whole thing just stinks to High Heavens.

That article only made the general public LESS empathic with the *plight* of the physician rather than more so.

While there were some good points - the length of education only to, in many cases, make less than a junior law partner, the lack of assistants or the need to pay for multiple people to do the same job, etc. - the major complaints from the physicians seems to be as you guys note: "Boo hoo - I have to drive an Acura now, my wife has to go back to work, I have to send my kids to public school with all the unwashed masses."

The article was obviously not written for other physicians (hence its placement in a magazine) but it could have included some younger physicians, talk about the cost of education, the cost of starting a practice, malpractice etc. Instead they gave us oldies whining about how things aren't as good as they used to be - way to court sympathy and healthcare reform guys.

Robert Aldrich has been a cardiologist for 22 years in Morris County, New Jersey, an hour from Manhattan. Or at least he was. On July 1, in the midst of his prime earning years, he bought an inn in Vermont. It's not retirement, exactly. "We have to earn a living," he says.

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Right, because there's much more stability in the hotel business than in cardiology.

You can find this article published in every decade, only the names and dates are changed. The underlying themes are the same. The sky is falling. The good old days are gone. blah...blah...blah.

There was medicare hysteria. medicaid hysteria. HMO hysteria. Hillary hysteria. Big pharma hysteria. It never ends.

NewHope said:

I don't know if these doctors are real, but the whole thing is presented as an anti-doctor set up.

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Now that I think about it, the article almost seems like a parody. Some of the quotes are just so over the top that it makes you wonder.

This article is talking about doctor's experiences in the New York City area, which is one of the worst markets to be a doctor in the U.S. My Dad did his residency at SUNY Stony Brook, and a lot of the practicing doctors we knew worked for as little as $70,000-$90,000. It was a joke. The starting salaries my Dad was offered there were half what he was being offered in the Midwest.

Gfunk6 said:

Now that I think about it, the article almost seems like a parody. Some of the quotes are just so over the top that it makes you wonder.

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Exactly what I was thinking. All those phrases with exclamation points--and dashes!--kind of makes you think he's taking the pi$$ out of us.

"Where did we go wrong?" Well, we might have gotten a bit big for our britches a bit too soon. Back to reality. God forbid your children have to go to (in hushed tones) -- public school! --it's horrifying.

I'm just waiting for the lid to blow off the top of the legal profession...which will probably never happen because most of the people who make the laws are also lawyers.

Llenroc said:

This article is talking about doctor's experiences in the New York City area, which is one of the worst markets to be a doctor in the U.S. My Dad did his residency at SUNY Stony Brook, and a lot of the practicing doctors we knew worked for as little as $70,000-$90,000. It was a joke. The starting salaries my Dad was offered there were half what he was being offered in the Midwest.

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And to think... I recently signed a contract that has me starting out at twice that! I guess rural America doesn't know that doctors are only worth a buck or two.

Most med students and many residents don't realize that medicine has a unique job market. Because many specialties are very portable (meaning you can go anywhere and have a career) docs can choose where they want to go based on the lifestyle they want to have. Consequently, the most desirable places pay less because the supply of docs who want to be there is relatively high. Places that are less desirable have to pay more. I don't want to tick anyone off but over the past several years parts of the midwest such as Kansas and Oklahoma have gotten the reputation of paying more. This is because they don't have the big metro areas, skiing and beaches that other amenities that other places boast. Places like NYC, SF, LA, Denver, Boise, Reno (skiiers love Boise and Reno) can and do pay less. Other places like FL have issues like bad malpractice keeping them from getting "too" desirable.

Any resident who'll be on the job hunt ought to keep this in mind. In choosing where you want to go you will be affected by this phenomena.

but this is case for many professional fields....in "desirable" locals, the competition is fierce. so while you may be able to get a job there, you may have to work even harder to keep up with the competition.

in medicines favor, is that you CAN take a job in the sticks or mountains or flatlands (and some people would rather live in those kinda places for standard of living reasons, esp families or sometimes that's where they are from and they want to go back)...if you were in finance or consulting or marketing this may not be a possibilty when starting fresh outta b-school. you might be forced to live in major cities/expensive cities and quite frankly, their starting salaries (this is a rough estimate based on what some of my mba friends are making in these areas) are on par with an attending salary of 150-200k which still puts you no closer to easily owning a home in nyc or sf. or a mercedes AND a jaguar.


what medicine is and will always be at the very minimum (in comparison with other professional fields) is job SECURITY. not necessarily pay-scale security.


you can't turn out physicians in anything less than 7 years. and even in the worst of economic times, physicans will always be needed. that's about all we've got going for us and in comparison to other fields, it's not a bad deal.

that cardiologist that quit and went on to operate a B&B could easily have gone anywhere else in this freaking country to make a living as an MD.

i'm sorry but a B&B???? it certainly IS early retirement with potential for financial perks so that he doesn't have to tap into his fat investment/retirement accounts....which i'm sure he has given his years as a cardiologist during the golden years.

no sympathy for that guy what-so-ever.

sequela said:

but this is case for many professional fields....in "desirable" locals, the competition is fierce. so while you may be able to get a job there, you may have to work even harder to keep up with the competition.

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Yes, but in other major professional fields this "competition" translates into greater economic winnings. Attorneys and bankers in San Francisco and New York are paid a heavy, heavy premium over their peers in Kansas and Iowa.

This is probably because these other professionals are able to provide services to end-users thousands of miles away. Doctors, so far, are only treating patients able to reach their clinic. Until telemedicine becomes a reality, doctors will be paid less for working in desirable locations.

I guess we need to get better acquainted with something similar to http://mdvip.com

"The insurance industry has created a slave workforce out of the doctor," says Moshe Rubin

Maybe you need to be placed in the hold of a ship and carried thousands of miles from your home before you make that generalization, *****.

docB said:

Places that are less desirable have to pay more. I don't want to tick anyone off but over the past several years parts of the midwest such as Kansas and Oklahoma have gotten the reputation of paying more. This is because they don't have the big metro areas, skiing and beaches that other amenities that other places boast.
Any resident who'll be on the job hunt ought to keep this in mind. In choosing where you want to go you will be affected by this phenomena.

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And please keep thinking that!