academic medicine is lame

[50Cent]

attend what others would consider an elite school. I have met and worked in the labs of some very well known scientists. I have job shadowed/volunteered/researched w/ MDs, MD/Phds, Phds in both academic and private practice and I have come to one conclusion: people in academic medicine are completely clueless

I said this before on these boards: people in academic medicine are people who are yet to realize that medicine, like any other field, is a business. Afraid of the real world, they cloister themselves in the structure of a university and convince themselves they are interested in the pursuit and spread of knowledge. They complain endlessly about attaining grants completely clueless about how much harder it is to attain capital from VCs. The majority of them have little or no communication or leadership skills.

Knowing they have a s*&%y job, they also complain about other scientists, and doctors "who don't do research" and "make a lot of money." They also are afraid because they know the future of medicine is private industry driven by profit, not in academia.

What do you think?

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[5oProlene]

Originally posted by 50Cent
attend what others would consider an elite school. I have met and worked in the labs of some very well known scientists. I have job shadowed/volunteered/researched w/ MDs, MD/Phds, Phds in both academic and private practice and I have come to one conclusion: people in academic medicine are completely clueless

I said this before on these boards: people in academic medicine are people who are yet to realize that medicine, like any other field, is a business. Afraid of the real world, they cloister themselves in the structure of a university and convince themselves they are interested in the pursuit and spread of knowledge. They complain endlessly about attaining grants completely clueless about how much harder it is to attain capital from VCs. The majority of them have little or no communication or leadership skills.

Knowing they have a s*&%y job, they also complain about other scientists, and doctors "who don't do research" and "make a lot of money." They also are afraid because they know the future of medicine is private industry driven by profit, not in academia.

What do you think?

Great topic. I agree with you on some things but not others. I also feel that a lot of academic physicians chose the confines of academia because they didn't want to bother with or just knew they weren't saavy enough to deal with the business aspects of the private sector. I didn't appreciate this when I started med school, but have now come to realize that you have to have lots of business sense to efficiently run a private practice, ESPECIALLY if you are a solo practicioner (it's a bit easier if you are in a group practice with other surgeons). And this is the stuff they DON'T teach you in med school, it's stuff you have to learn on your own in addition to all the clinical stuff you learn during surgical residency. Maybe programs should let residents who want to go into private practice use their "1-2 years of mandatory research" learning about effectively managing a private practice instead of being in some lab trying to get publications which will be of no use to them in the private sector.

On the flip side, I think a lot of private surgeons chose the private sector either because they wanted to make more money than they would in academia or were just tired of the stuffy politics and requirements of academic surgery (i.e. the rat race to get grants, publishing requirements, teaching requirements, going from assistant prof to associate prof to full prof, etc), or a combination of wanting to make more money and not having to deal with the politics of academia. Some surgeons just want to operate and could care less about researching some esoteric protein receptor.

But I think it is wrong for you to claim that "people in academic medicine are completely clueless". Academic medicine is what ultimately advances medicine. Sure they may not be as business saavy as those working in the private sector, but they are absolutely essential to the progression of medicine. Think of where surgery would be today without its surgeon-scientists.

I guess it all comes down to what you want to do with your life after you get through residency. Medicine will always need both private and academic physicians.

 

[jmattwilson]

I once had a preceptorship with an older doctor (I believe he graduated medical school in the 50's) who said that when he was in school they had a course during fourth year on how to run a practice. I wish there was something comparable to that now days. My biggest peve about academists is their unwavering view that everyone must go on to grander things and do research. I sometimes feel looked down upon when I tell people I want to become an excellent hands on surgeon who will provide needed care to a rural population. I dont know I just feel they are looking at me thinking why would you waste yourself on that, sometimes they have even told me so.-

 

[cmz]

I'd have to refute the thread-starter's comment that academic physicians are clueless and have no business sense. I know a lot of geneticists/physicians who have done research and created a lot of valuable diagnostic tools that are used in the clincs everyday. They have patents for all sorts of diagnostic arrays and other molecular methods brought about by years of their hard research. They aren't hurting financially and are probably doing better than the avg. physician in private practice.

 

[quicksilver2000]

Surgeons in academic medicine are far from clueless. Sure a private practice surgeon may be able to do a case a little bit faster due to more reps. If you want to make tons of money and run an efficient business then go to business school, work in I-banking in NYC and then go get an MBA. I was a finance major in undergrad. Many of my buddies are now in I-banking. The one's that survived are making much more at the age of 26 than I can ever make being a physician.

Back to the topic at hand: without good surgical research we'd still be doing all our procedures open. Look at how far minimally invasive surgery has come! Could this have happened without dedicated individuals who put time and effort into developing this technology and then publishing reports so the rest of surgical community could benefit?

What about all the advances in surgical oncology. Twenty years ago if you had colon cancer with mets to the liver your five year survival was 0. Today with new technologies like cryo and RF your 5 year survival is closer to 30%. Would we have even known what the 5 year survival was without the effort to publish these results? No.

As far as monetary concerns, lets be honest, none of us are going to starve. The improvements in quality of life between someone earning $200,000 - $250,000 compared to someone earning $500,000 - $600,000 is minimal. The latter may own a house with one or two more rooms. Besides, if you really look at retirement, it's not how much you made or even saved but how wisely you invested. The power of monetary compounding is incredible.

Example A: You are an academic surgeon and save $30,000 a year for 25 years and your investments give you an annual return of 20%. After you account for inflation and taxes, your savings at the end of 25 years is:
$3,398,487.

Example B: You are a private surgeon and save $60,000 a year for 25 years but your investments give you an annual return of 10%. Again, after you account for inflation and taxes, your savings equal:
$2,740,243.

Sorry, I don't mean to preach or anything. I hope people find this informative. I just don't understand why med students are so consumed with how much they are going to make and not how wisely they should invest.

Peace.

 

[jmattwilson]

The fact of the matter is both sides of the field (academic or practitioner) need one another. Neither side is superior to the other so we should try to respect the ambitions of others. Not to sound like an earthy family practice type.

Common stereotypes.
Acedemist= Nerd with no social skills
Private sector= $$$ hungry oaf, you should be a d&*# lawyer

 

[50Cent]

My initial post was a bit harsh. I regret using the word 'clueless' - what i meant was many academics I encountered seem naive or close-minded about the business opportunities in medicine and the industry trend where research is shifting from purely academic to profit driven industry.

I appreciate the replies - this is an interesting topic indeed and one that directly interests us! I never believed successful business people in any field, especially medicine, do it just for the money but rather the thrill of risk and the competitive nature, the same reason many of you choose to do surgery. Otherwise, why do people like Buffett and Dell still head their companies?

Even in surgery, the future is a business-oriented approach. Congress resently passed a bill that restricted physician referalls to surgery centers - I don't think that will last more than a year. These specialty centers are much more efficient and profitable than hospitals and academic centers. It wont be long before these centers do their own research in minimally-invasive techniques to compete with academic centers for reputation. Take for example the Virginia Spine Institute (google it)

Overall, the future of academic surgery seems bleak and unappealing, (and I'm not simply speaking monetarily) though there seem to be exciting oppotunities in surgical business (and I'm not simply speaking monetarily)