Amount of hours to make 100k

[exsanguination]

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Im gonna say it. I'm on board with C.R.E.A.M.

LOL! You picked the wrong specialty if CREAM is your credo!

 

[The White Coat Investor]

Let me just say that your views are entirely opposed to medicine.

Agreeing to go through medical school and being given the privilege of being a doctor you fundamentally agree to the Hippocratic Oath.

By virtue of saying, "gosh, I could work 75% more but I choose not to for my personal lifestyle reasons" you are in essence telling the patients you should have seen, or the doctor who would have seen should you have chosen another path, that they can go to hell. You don't care about their concerns. You are trained to treat them, but your own personal reasons are more important than their needs.

The "market" has little role in medicine. We treat our patients the same whether they can afford our care or whether they are homeless.

No, I am not advocating you be a miser and abdicate personal privilege. Yes, I am saying if your goal is to make $100k/year and work minimum hours you should not have gone to medical school.

Who are you to define what medicine is or isn't?

I've been on a medical school admissions committee. I agree that someone who told me as a medical school interviewee that their goal was to work as little as possible while still making $100K would not get past my interview. But I also have a partner who works 64 hours a month in his 40s, and he's a darn good doc (actually recently chief of the medical staff.) He lives frugally, and spends lots of time with his kids, one of which has significant special needs, and backcountry skiing. I see nothing wrong with that.

Another doc I did residency with recently did a functional medicine fellowship for a year and has a 9-5 clinic. Was taking her into our residency a huge mistake? We certainly didn't think so at the time, as she was the chief and the one I would have most enjoyed working with my entire career. She was an incredible addition to the program.

People change. Career paths change. For some people in medical school medicine is a calling. For others, it's a job. And that's okay. Just carry your arguments to the extreme and you'll see why they're wrong.

 

[Birdstrike]

Let me just say that your views are entirely opposed to medicine.

Agreeing to go through medical school and being given the privilege of being a doctor you fundamentally agree to the Hippocratic Oath.

By virtue of saying, "gosh, I could work 75% more but I choose not to for my personal lifestyle reasons" you are in essence telling the patients you should have seen, or the doctor who would have seen should you have chosen another path, that they can go to hell. You don't care about their concerns. You are trained to treat them, but your own personal reasons are more important than their needs.

The "market" has little role in medicine. We treat our patients the same whether they can afford our care or whether they are homeless.

No, I am not advocating you be a miser and abdicate personal privilege. Yes, I am saying if your goal is to make $100k/year and work minimum hours you should not have gone to medical school.

Wow, where do I start?

#1 Most medical schools make the Hippocratic oath optional nowadays, and they have some altered and politically correct version you can opt in with. Part of the actual oath makes you vow you'll never perform abortions, which is a common medical practice nowadays: "I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses...I will not give to a woman an abortive remedy").

http://guides.library.jhu.edu/content_mobile.php?pid=23699&sid=190555#box_190555

#2 Most if not all physicians could work more hours, at cost to their family and personal lives. Doctors are human. If your goal is that you won't sleep until the last sick person is healed, you're in big trouble. Not recognizing your own needs is what leads to burnout, disillusionment, and depression amongst physicians.

#3 The "market" has a huge role in Medicine. Almost everything current physicians have to deal with nowadays has some basis in monetary forces (see Press Ganey; metrics; predatory ED contract loses; malpractice awards; HCAHPS; distorted drug-company funded research; I'm just getting started). Medicine is 95% business nowadays. Don't believe me? Just keep moving forward and learn the hard way.

#4 Most if not all physicians treat patients based on monetary/insurance factors. Almost no private practice specialists take Medicaid. Same goes for uninsured patients with no money. They will be turned away at most doctors offices, even primary care. Obamacare plans require that you buy insurance (it's not free) or you are fined.....that's right, money. Even many EDs now, screen non-emergency patients, charge them before completing treatment and if unable to pay a fee (around $100-150, they're turned away and given a list of local primary care doctors).

In private practice, you have to be a businessman to survive. As a group or hospital-based employee, you're basically a tool to generate facility fees for the hospital. Top to bottom, Medicine is 95% about business and money nowadays. I'm not saying I like it that way, because I don't. And if it's not that way for you, that's great, but you better at least have an understanding of the system you're entering, otherwise you'll be eaten alive.

 

[exsanguination]

Top to bottom, Medicine is 95% about business and money nowadays. I'm not saying I like it that way, because I don't. And if it's not that way for you, that's great, but you better at least have an understanding of the system you're entering, otherwise you'll be eaten alive.

Preach it brother - once I accepted this, my outlook has improved. It's still doom and gloom (in the sense that we're revenue-generating cogs first and foremost), but instead of getting angry all I had to do was simply own it. I'm not going to save the world, I'm not going to be the one that returns our profession to the true patient-doctor relationship days, and I'm definitely not going to change the public's perception of us.

Show up a little early, hold the patients hand and smile as you acquiesce to their whims, keep that press-ganey high as best as possible (thus keeping your job), grind out the shift, maybe help a few patients along the way, make your money, and go home. Work to live.

Honestly, I think we have one of the best gigs in medicine when one frames it that way.

 

[two guys]

Can I discuss the elephant in the room.

(sorry if it has already been broached, I did not read all of the comments)

You, in essence, wasted a position in medical school. This is a valuable resource. Certainly, you paid, or are paying, your tuition, went through the trials and tribulations of earning the degree. I will not deny you that. You also went through the hoops to get there as a pre-med. That being said. You don't deserve it. Someone else. Likely, someone else who was rejected from medical school and had to take a different career because of your decision, deserves your position in life. He or she actually wanted to practice medicine, actually could handle the day to day reality of what it takes. Be it Emergency Medicine or whatever he or she may have pursued. You gamed the system, took the spot, and now are cheating it.

The AAMC/AMA/ACGME does an analysis on the number of doctors needed based on the number of doctors in practice, and the number of doctors in training. While you, as an individual are likely accounted for within their calculations, I can not condone your choices.

Could not agree less with your sentiment.

You won't find many on here who would agree with accepting somebody into medical school who is already trying to figure out how minimally he can be involved to make a moderate amount of money. That sends huge red flags, not because he or she are "wasting a medical school spot" but because such a person would likely never make it through med school and residency. You need a little more incentive to get through the process and people already thinking of coasting are likely to fail. I'm also opposed to it just because someone fresh out of residency needs to work more than the minimum to achieve competence (let alone excellence).

That being said, no physician owes anybody ANYTHING. A ob/gyn can decide to do only gyn, a neurosurgeon can decide to not do spine, an ortho doc can decide to do only knees, a fam med doc can decide to only be in the clinic and not admit patients. Do you think any of them wasted a medical school spot?

Get off your high horse, I don't really see where you (or me, or anyone) can define what is a "waste" or not. By similar logic, we could call anyone who doesn't work in a rural health clinic for free 100 hrs a week a waste.

It looks like you're a neurosurgery resident, is that right? Do you see some of your attendings narrowing their scope of practice to spine or brain only? Do you think that's a waste since we have so few neurosurgeons they should do everything they are capable of, right? Or do you think they have the right to do whatever they choose? Have you worked outside of academic medicine ever? I think you'll find that in the community (where the majority of physicians work), people have a less high and mighty attitude about their profession and see it more as a job. A job should enhance ones personal life, but should never completely overshadow it (in my opnion).

I guess the main thing about your post that I disagree with is its judgmental nature. You've only walked in your shoes and it doesn't seem like you've even walked in them for very long. Best I can tell you aren't even done with residency. If you have spent time on admissions, it couldn't possibly have been in a significant capacity (ie full time for 5-10 years). I don't think I'd agree with your sentiment coming from someone who has spent 20 years in active practice, but at least I'd feel like it was a more qualified opinion.