'13 Things I Wish I Knew Before I Became an Ob-Gyn'

[W19]

http://news.yahoo.com/13-things-wish-knew-became-194253730.html

This article is for students who are thinking about going into OB-GYN... I don't know whether it's an accurate portrait of this specialty or not. I guess an OB-Gyn attending can chime in.

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[medicalstadent]

this popped up on my newsfeed lol .. good find

 

[zero0]

I guess an OB-Gyn attending can chime in.

I think they're too busy getting sued

 

[njtrimed]

I think it's amusing that she complains about how hard it is to have her own kids due to six weeks of lost income. If she's practicing in the U.S., few if any of her patients have true paid maternity leave; most are lucky if their jobs are protected while they're out. Her struggle isn't unique to medicine, and it certainly isn't unique to OB/GYN.

 

[22031 Alum]

Interesting read. The author's career really doesn't look anything like my own, since I don't have any experience in private practice. Most of her points aren't actually unique to Ob/Gyn at all, but could really be classified as "Things I wish I knew before I became a physician." My comments on the few points that are unique to the specialty:

Number 1: There are practices where you commit to always come in and deliver your own patients, or are incentivized to do so. However, many practices are moving away from that model and have some type of call system (nights, Q-whatever, using a laborist) in place. Much of the angst the author describes- guilt over missing a delivery, scheduling vacations a year out so as not to conflict with due dates- is entirely dependent on the practice model you decide on.

Number 6: Vaginas are amazing.

Number 7: Bedside manner is important in all specialties. However there aren't many fields where the most basic diagnostic procedure is not-infrequently equated to something as horrific as sexual assault. It can be tough and uncomfortable for most patients, especially those with a history of some sort of trauma. Bedside manner is especially crucial for those times when you'll need to be performing some sort of vaginal exam mere minutes after meeting a patient. It can be learned/taught, but it's easier for some people than others.

Number 8: There are practice options with little or no OR time, like consult-only MFM, but if you hate the OR, you're going to have a hard time in residency.

Number 11: Nobody should enter this field unprepared for the lows. The high points are great, but the low points can be very, very low. This isn't completely unique to Ob/Gyn, of course, but there is a good bit of discordance between the common perceptions of what OB is like and what it actually can be. To this day, the words "Dr. Alum, we can't find heart tones, can you come to the room?" gives me that sick feeling in the pit of my stomach. I've lost count of the number of times I've been really bummed out after delivering or diagnosing an IUFD, only to have some well-meaning person chirp "Why aren't you smiling? You get to deliver babies all day!" Ugh.

 

[Tenk]

If she's practicing in the U.S., few if any of her patients have true paid maternity leave

That's because few if any of her patients have jobs.

 

[psychMDhopefully]

Why do physicians always downplay how much they make? She seriously said shes not making 6 figures out of residency?

"While some doctors get paid six-figure salaries out of the gate to offset the cost of medical school, it can be difficult for ob-gyns to get reimbursed from insurance companies"

so is she getting paid 99k or something.

 

[Tenk]

Why do physicians always downplay how much they make?

Taxes, retirement, loans. They eat a lot of it, particularly the first.

 

[psychMDhopefully]

Taxes, retirement, loans. They eat a lot of it, particularly the first.

She worded it as if if she was making less than 6 figures gross. Everybody pays taxes and retirement and malpractice is usually paid by the hospital, and loans are income based.

 

[22031 Alum]

She worded it as if if she was making less than 6 figures gross. Everybody pays taxes and retirement and malpractice is usually paid by the hospital, and loans are income based.

If she set out to start her own practice, which it looks like she did, between overhead (paying for a facility and equipment, lab/ancillary services, staff salaries), and the time it takes to build up a decent patient load, she could have been coming in that low. It's less and less common for someone to leave residency and strike out on their own, though.

 

[W19]

Why do physicians always downplay how much they make? She seriously said shes not making 6 figures out of residency?

"While some doctors get paid six-figure salaries out of the gate to offset the cost of medical school, it can be difficult for ob-gyns to get reimbursed from insurance companies"

so is she getting paid 99k or something.

Physicians need to start downplaying their salaries more often. They also should stop living like celebrities... The public already think that they are a bunch of spoiled rich bastard...

 

[sliceofbread136]

Good, ob/gyn is an evil specialty

 

[psychMDhopefully]

Physicians need to start downplaying their salaries more often. They also should stop living like celebrities... The public already think that they are a bunch of spoiled rich bastard...

? The public thinks doctors are dead broke because we have so many loans we cant afford to pay back. Just read to comments on the article and every other article about doctors.

 

[FindMeOnTheLinks]

? The public thinks doctors are dead broke because we have so many loans we cant afford to pay back. Just read to comments on the article and every other article about doctors.

I think it depends where you look. In my experience most people think doctors make 500k+ and work 9-4, 4 days a week and are paid by the greedy pharmaceutical companies to prescribe you their most expensive drugs.

 

[Slack3r]

I think it depends where you look. In my experience most people think doctors make 500k+ and work 9-4, 4 days a week and are paid by the greedy pharmaceutical companies to prescribe you their most expensive drugs.

And they had to wait to be seen because you were too busy on the golf course.

 

[FindMeOnTheLinks]

And they had to wait to be seen because you were too busy on the golf course.

Lol yep

 

[mcloaf]

Good, ob/gyn is an evil specialty

That rotation was the only time so far I really wanted to drop out of med school. Shudder.

 

[22031 Alum]

Good, ob/gyn is an evil specialty

That rotation was the only time so far I really wanted to drop out of med school. Shudder.

Sorry it sucked for you guys. It's a great field and I'm glad I went into it.

 

[PSUtoMD]

? The public thinks doctors are dead broke because we have so many loans we cant afford to pay back. Just read to comments on the article and every other article about doctors.

You could not be more wrong if you tried.

The government is working hard to drive physicians' salaries down, and the public has zero sympathy for us. We are a bunch of overpaid, arrogant, lazy jerks who take all the glory while the real heroes (nurses) toil in obscurity. According to overall public perception.

 

[mcloaf]

Sorry it sucked for you guys. It's a great field and I'm glad I went into it.

I can see the appeal, but at my rotation site I spent most of my time getting the evil eye from L&D nurses every time I walked into a room.

 

[22031 Alum]

I can see the appeal, but at my rotation site I spent most of my time getting the evil eye from L&D nurses every time I walked into a room.

L&D nurses can be fiercely protective. I'm an attending and sometimes I still get the evil eye when I announce my intent to do something that goes against a nurse's plan - "Do you have to check her now??" I can imagine that's no fun when you're the powerless student.

 

[Mad Jack]

Why do physicians always downplay how much they make? She seriously said shes not making 6 figures out of residency?

"While some doctors get paid six-figure salaries out of the gate to offset the cost of medical school, it can be difficult for ob-gyns to get reimbursed from insurance companies"

so is she getting paid 99k or something.

If you jump right into private practice and bill your own patients, the lead-out time for insurance payments can be pretty extreme and you might very well not make anything close to six figures after taking into account your expenses.

 

[tiedyeddog]

I can see the appeal, but at my rotation site I spent most of my time getting the evil eye from L&D nurses every time I walked into a room.

Once you're a resident or attending the nurses treat you much differently, regardless of your field.

 

[njtrimed]

That's because few if any of her patients have jobs.

I don't know what kind of jobs your friends have, but the majority of women I know with full-time jobs (and most of whom have graduate or advanced degrees) do not have paid maternity leave. Less than 20% of companies in the U.S. offer any maternity benefits. We're lucky if our jobs our protected; they're not if there are any unforeseen complications in pregnancy that require us to be out of work longer.

 

[PL198]

? The public thinks doctors are dead broke because we have so many loans we cant afford to pay back. Just read to comments on the article and every other article about doctors.

no.

 

[Tenk]

I don't know what kind of jobs your friends have, but the majority of women I know with full-time jobs (and most of whom have graduate or advanced degrees) do not have paid maternity leave. Less than 20% of companies in the U.S. offer any maternity benefits. We're lucky if our jobs our protected; they're not if there are any unforeseen complications in pregnancy that require us to be out of work longer.

I wasn't talking about my friends. I was talking about the large amount of urban single mothers I saw having kids, unemployed on social service. It was a joke. Lighten up. I would never argue for our country's bogus maternity leave trends because you are right, they are bogus.

 

[Tenk]

She worded it as if if she was making less than 6 figures gross. Everybody pays taxes and retirement and malpractice is usually paid by the hospital, and loans are income based.

She might be. She's in private practice so she's got a big overhead. I don't know what her practice, payer base and hours are like.

You're right, everyone does pay taxes. Just wait until you start paying yours at physician brackets and suddenly you'll see the truth in my statement. That huge salary that gets quoted actually isn't that much to spend. Next, retirement: physicians are usually 10+ years late to the retirement game, therefore if you don't want to be working when you're 60 or 70, you need to invest a big portion of your pie into retirement which makes for even less disposable income. Next, loans: loans are not income based. Loans are loans. You take this much out you pay this much back. You may be talking about federal forgiveness but not everyone qualifies for that. Especially not private practice so that's not applicable in this thread. Lastly, malpractice is usually paid by your employer, not necessarily the hospital. If you're self employed, guess what? That's you!

You have a lot of misconceptions about what being a physician is really like financially (which is fine). Hell I was probably the same way as a premed and in med school. When you get to the other side though you realize the best major in undergrad is actually economics.

 

[tymont12]

She might be. She's in private practice so she's got a big overhead. I don't know what her practice, payer base and hours are like.

You're right, everyone does pay taxes. Just wait until you start paying yours at physician brackets and suddenly you'll see the truth in my statement. That huge salary that gets quoted actually isn't that much to spend. Next, retirement: physicians are usually 10+ years late to the retirement game, therefore if you don't want to be working when you're 60 or 70, you need to invest a big portion of your pie into retirement which makes for even less disposable income. Next, loans: loans are not income based. Loans are loans. You take this much out you pay this much back. You may be talking about federal forgiveness but not everyone qualifies for that. Especially not private practice so that's not applicable in this thread. Lastly, malpractice is usually paid by your employer, not necessarily the hospital. If you're self employed, guess what? That's you!

You have a lot of misconceptions about what being a physician is really like financially (which is fine). Hell I was probably the same way as a premed and in med school. When you get to the other side though you realize the best major in undergrad is actually economics.

It irks me that she complains of making a low salary because her staff 'doesn't have time' to follow up on claims. She needs a new biller or to outsource it then. If it's a new practice, then maybe 1 year of this at most. Most times that I hear physicians complain of low cash flow it is because they are unwilling to do what it takes to be a profitable business.

 

[Dave89]

She forgot to mention that Ob/Gyn gives one a front-row seat to the dysgenic trend of birthrates in America (well, the world over, to be frank).

 

[Psai]

She forgot to mention that Ob/Gyn gives one a front-row seat to the dysgenic trend of birthrates in America (well, the world over, to be frank).

Medicaid patient: 20 yo g10p5409
High powered lawyer: 39 yo g1p0 5x in vitro fertilization with 4 failures

 

[alpinism]

Medicaid patient: 20 yo g10p5409
High powered lawyer: 39 yo g1p0 5x in vitro fertilization with 4 failures

Heh.

So true.

Don't forget:

Medicaid - 2 PPD smoker
Lawyer - runs marathons for fun

 

[Okazaki Frag Grenade]

"I'm bound by HIPPA ..."

It's HIPAA dammit!

 

[Perrotfish]

She might be. She's in private practice so she's got a big overhead. I don't know what her practice, payer base and hours are like.

You're right, everyone does pay taxes. Just wait until you start paying yours at physician brackets and suddenly you'll see the truth in my statement. That huge salary that gets quoted actually isn't that much to spend. Next, retirement: physicians are usually 10+ years late to the retirement game, therefore if you don't want to be working when you're 60 or 70, you need to invest a big portion of your pie into retirement which makes for even less disposable income. Next, loans: loans are not income based. Loans are loans. You take this much out you pay this much back. You may be talking about federal forgiveness but not everyone qualifies for that. Especially not private practice so that's not applicable in this thread. Lastly, malpractice is usually paid by your employer, not necessarily the hospital. If you're self employed, guess what? That's you!

You have a lot of misconceptions about what being a physician is really like financially (which is fine). Hell I was probably the same way as a premed and in med school. When you get to the other side though you realize the best major in undergrad is actually economics.

The best way to think of physician salaries is to look at total lifetime earnings, after loans and business expenses (like malpractice). At the moment that number is 4-10 million for the majority of physicians, with another million being eaten up by loans (based on a pessimistic assessment of a student going to a private school on 100% loans and then repaying everything over 10 years without loan forgiveness). The average white collar worker in the country only earns 2 million, and the average person in the country only earns 1.2 million. Physicians do, in fact, do really well.

Also, physicians really aren't late to retirement game. 20 year olds are statistically unlikely to save any significant amount of money in any profession. The median 401K balance for a 30 year old who actually has a 401K (which is not a terrible way of singling out financially conservative white collar workers) is 15 grand. That's right, you can 'catch up' with a week of locums. The median person in this country, of course, has nothing for retirement at any age. The median near retirement household has saved less than 20K. Normal people pretty much rely on social security and, hopefully, some equity built up in their home, and even the median white collar worker doesn't start really saving until his late 30s.