Mar 8, 2012
55
3
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Pre-Medical
I'm a part-time undergrad student who has been bouncing back and forth between pursuing a healthcare career and pursuing a law/economics public service type career. In the process of trying to finally come to a decision, I decided to shadow a physician. He worked at a VA hospital. His residency had been in family med, but he was doing emergency medicine. I shadowed him for a total of about 20 hours, and his job seemed absolutely miserable. He spent more time sitting in an office shuffling paperwork than he spent seeing patients. It was simply one of the most mind-numbingly boring experiences of my life, and if I spent my life doing it, I'd cut my wrists before I hit 50.

So my question is this: are all patient care jobs like this? One of the career paths I've been considering is to be a primary care physician assistant and work in a VERY rural area. Seriously, the ideal job site for me would be one only accessible via off-road vehicle or horse. I want to treat patients who, without me and my supervising physician, wouldn't have access to. In fact, I've often fantasized about going off into the Andes mountains and treating the indigenous tribes out there! That would be perfect. :-D

Sorry, I kind of went off on a tangent there. So yeah...if this is the type of career I want, is that achievable? And if I do achieve it, am I still going to spend more time doing paperwork than actually treating patients?
 

LizzyM

the evil queen of numbers
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Mar 7, 2005
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I'm a part-time undergrad student who has been bouncing back and forth between pursuing a healthcare career and pursuing a law/economics public service type career. In the process of trying to finally come to a decision, I decided to shadow a physician. He worked at a VA hospital. His residency had been in family med, but he was doing emergency medicine. I shadowed him for a total of about 20 hours, and his job seemed absolutely miserable. He spent more time sitting in an office shuffling paperwork than he spent seeing patients. It was simply one of the most mind-numbingly boring experiences of my life, and if I spent my life doing it, I'd cut my wrists before I hit 50.

So my question is this: are all patient care jobs like this? One of the career paths I've been considering is to be a primary care physician assistant and work in a VERY rural area. Seriously, the ideal job site for me would be one only accessible via off-road vehicle or horse. I want to treat patients who, without me and my supervising physician, wouldn't have access to. In fact, I've often fantasized about going off into the Andes mountains and treating the indigenous tribes out there! That would be perfect. :-D

Sorry, I kind of went off on a tangent there. So yeah...if this is the type of career I want, is that achievable? And if I do achieve it, am I still going to spend more time doing paperwork than actually treating patients?
How do you expect to practice modern medicine in the wilderness (and I've lived in the Andes so I know wilderness.)

I met a public health nurse years ago who worked almost exclusively in rural villages in Alaska accessible only by airplane. She'd fly in, stay several days handling TB cases and vaccinating kids and fly out on the next plane.

Aside from that type of service, medicine as it is practiced these days in the US requires modern laboratories, diagnostic equipment, and electronic medical records (digital "paperwork"). There is more and more that is being made available as "portable equipment" but for anything beyond primary prevention, you really need to take the patient to the medical facility rather than bring the medical care to the patient.
 

Ruhroh

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Jun 4, 2012
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If you want to treat people in butt-**** nowhere like the Andes Mountains, you probably don't need to put yourself through all the stress, bullcrap, and hoops of doing medical training in the US.
 
Jul 18, 2012
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Flo Rida
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Physicians handle a lot of paperwork. Welcome to the real world. Did the ER doc you shadowed not have an ER scribe?
 

LizzyM

the evil queen of numbers
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Physicians handle a lot of paperwork. Welcome to the real world. Did the ER doc you shadowed not have an ER scribe?
A scribe in a VA hospital? :laugh:

And the emergency department of a VA hospital is usually a pretty dull place given that it can accept only veterans so it doesn't have the same action as a big city ED or even a community hospital.
 
OP
T
Mar 8, 2012
55
3
Status
Pre-Medical
How do you expect to practice modern medicine in the wilderness (and I've lived in the Andes so I know wilderness.)

I met a public health nurse years ago who worked almost exclusively in rural villages in Alaska accessible only by airplane. She'd fly in, stay several days handling TB cases and vaccinating kids and fly out on the next plane.

Aside from that type of service, medicine as it is practiced these days in the US requires modern laboratories, diagnostic equipment, and electronic medical records (digital "paperwork"). There is more and more that is being made available as "portable equipment" but for anything beyond primary prevention, you really need to take the patient to the medical facility rather than bring the medical care to the patient.
Thanks for the response, Lizzy. I had considered the fact that full MD/DO training would be more than was necessary in those types of settings, which is a big part of why I considered PA training instead. I guess it hadn't occurred to me that even THAT would be more than was necessary for the type of work I wanted to do. I mean, the idea of practicing in the Andes was a fantastical exaggeration. Really I'd be more interested in practicing in rural Maine or Alaska or something. I do love the idea of practicing in remote and/or isolated communities, though.

The question I was really hoping for an answer to was regarding the amount of actual patient contact/care you get to perform on a daily basis as a PA. Don't get me wrong, I don't mind doing paperwork and experiencing some idle time, but this MD I shadowed typically only saw 2 to 4 patients in a 5 hour span. This seemed absurd to me, and I wondered if it was the norm for healthcare professionals.
 
Oct 28, 2010
188
2
In Soviet Russia...MCAT take you!
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I'm a part-time undergrad student who has been bouncing back and forth between pursuing a healthcare career and pursuing a law/economics public service type career. In the process of trying to finally come to a decision, I decided to shadow a physician. He worked at a VA hospital. His residency had been in family med, but he was doing emergency medicine. I shadowed him for a total of about 20 hours, and his job seemed absolutely miserable. He spent more time sitting in an office shuffling paperwork than he spent seeing patients. It was simply one of the most mind-numbingly boring experiences of my life, and if I spent my life doing it, I'd cut my wrists before I hit 50.

So my question is this: are all patient care jobs like this? One of the career paths I've been considering is to be a primary care physician assistant and work in a VERY rural area. Seriously, the ideal job site for me would be one only accessible via off-road vehicle or horse. I want to treat patients who, without me and my supervising physician, wouldn't have access to. In fact, I've often fantasized about going off into the Andes mountains and treating the indigenous tribes out there! That would be perfect. :-D

Sorry, I kind of went off on a tangent there. So yeah...if this is the type of career I want, is that achievable? And if I do achieve it, am I still going to spend more time doing paperwork than actually treating patients?
Could this be because you didn't actually know what he was doing? When you look at a list of lab values, you see a bunch of meaningless numbers. When the doctor looks at that list, he sees real physiological processes, and he has to think about what every "off" value actually means to come up with his diagnosis. It could be very exciting for the doctor, and maybe it would have been more exciting for you if/when you have the training you need to appreciate this kind of work.
 

LizzyM

the evil queen of numbers
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Thanks for the response, Lizzy. I had considered the fact that full MD/DO training would be more than was necessary in those types of settings, which is a big part of why I considered PA training instead. I guess it hadn't occurred to me that even THAT would be more than was necessary for the type of work I wanted to do. I mean, the idea of practicing in the Andes was a fantastical exaggeration. Really I'd be more interested in practicing in rural Maine or Alaska or something. I do love the idea of practicing in remote and/or isolated communities, though.

The question I was really hoping for an answer to was regarding the amount of actual patient contact/care you get to perform on a daily basis as a PA. Don't get me wrong, I don't mind doing paperwork and experiencing some idle time, but this MD I shadowed typically only saw 2 to 4 patients in a 5 hour span. This seemed absurd to me, and I wondered if it was the norm for healthcare professionals.
This is because he was practicing emergency medicine in a VA facility. Go upstairs/down the hall at the VA to the psych department or the outpatient medicine clinic and you'll see plenty of busy doctors.

Your best bet is to find someone practicing in a rural area and shadow them for several days. It might mean being a house guest as well as a shadow but it will give you an idea of what it is really like.
 
OP
T
Mar 8, 2012
55
3
Status
Pre-Medical
How do you expect to practice modern medicine in the wilderness (and I've lived in the Andes so I know wilderness.)

I met a public health nurse years ago who worked almost exclusively in rural villages in Alaska accessible only by airplane. She'd fly in, stay several days handling TB cases and vaccinating kids and fly out on the next plane.

Aside from that type of service, medicine as it is practiced these days in the US requires modern laboratories, diagnostic equipment, and electronic medical records (digital "paperwork"). There is more and more that is being made available as "portable equipment" but for anything beyond primary prevention, you really need to take the patient to the medical facility rather than bring the medical care to the patient.
I have one more question about this: if physicians and mid-level practitioners don't have the resources to practice effectively in these remote locations, how is it that "wilderness medicine" is emerging as a distinct sub-specialty within the medical industry? I'm not trying to insinuate that what you're telling me is incorrect. I'm just trying to understand better.
 

lovesfall

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Jul 30, 2012
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[A]m I still going to spend more time doing paperwork than actually treating patients?
If you don't do anything to champion change and if you expect other people to construct a work utopia for you, you'll probably be spending a lot of quality time with paperwork. I think that if physicians/future generations of physicians were willing to become more active and open-minded participants in designing the systems in which they function, things could change for the better.
 
Last edited:
Dec 12, 2012
79
2
Status
I'm a part-time undergrad student who has been bouncing back and forth between pursuing a healthcare career and pursuing a law/economics public service type career. In the process of trying to finally come to a decision, I decided to shadow a physician. He worked at a VA hospital. His residency had been in family med, but he was doing emergency medicine. I shadowed him for a total of about 20 hours, and his job seemed absolutely miserable. He spent more time sitting in an office shuffling paperwork than he spent seeing patients. It was simply one of the most mind-numbingly boring experiences of my life, and if I spent my life doing it, I'd cut my wrists before I hit 50.
...And you think a legal career is going to be less paperwork?

Seriously, though, all service jobs are like that.
 

LizzyM

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Mar 7, 2005
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I have one more question about this: if physicians and mid-level practitioners don't have the resources to practice effectively in these remote locations, how is it that "wilderness medicine" is emerging as a distinct sub-specialty within the medical industry? I'm not trying to insinuate that what you're telling me is incorrect. I'm just trying to understand better.
Wilderness medicine is about search and rescue, treatment of injuries and illnesses that occur during mountaineering and other extreme sports. See:
http://wms.org/about/default.asp It seems to be an extension of emergency medicine that treats people in the field in remote locations. The point is to stabilize patients and bring them safely to a medical facility. It is somewhat related to ski patrol.

It is nothing like primary care of people who live the in the boonies.
 
Apr 7, 2012
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111
Hello, cold
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Wilderness medicine is about search and rescue, treatment of injuries and illnesses that occur during mountaineering and other extreme sports. See:
http://wms.org/about/default.asp It seems to be an extension of emergency medicine that treats people in the field in remote locations. The point is to stabilize patients and bring them safely to a medical facility. It is somewhat related to ski patrol.

It is nothing like primary care of people who live the in the boonies.
LizzyM,

I'm sorry I ask you so many questions but you're such a wealth of information and such a great resource. I have a question that's not really in the same ballpark as this but I didn't want to clog up the boards with a new thread. I'm wondering if you've heard anything about the doctors who work with the International Committee of the Red Cross. For several years now I've wanted to someday be able to donate my time to go to places where there is conflict or war and visit POWs and detainees to make sure that they are not being mistreated and provide medical care when needed. Do you know anything about the process to be able to do that? Would it be strange to bring this up in an interview because its a pretty lofty goal (I'm sure it's very hard to be able to volunteer for that position).
 
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LizzyM

the evil queen of numbers
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LizzyM,

I'm sorry I ask you so many questions but you're such a wealth of information and such a great resource. I have a question that's not really in the same ballpark as this but I didn't want to clog up the boards with a new thread. I'm wondering if you've heard anything about the doctors who work with the International Committee of the Red Cross. For several years now I've wanted to someday be able to donate my time to go to places where there is conflict or war and visit POWs and detainees to make sure that they are not being mistreated and provide medical care when needed. Do you know anything about the process to be able to do that? Would it be strange to bring this up in an interview because its a pretty lofty goal (I'm sure it's very hard to be able to volunteer for that position).
I don't know anything about those groups. You might want to look at
http://www.redcross.org/what-we-do/international-services
 

silleme

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Jan 2, 2012
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LizzyM,
I'm wondering if you've heard anything about the doctors who work with the International Committee of the Red Cross. For several years now I've wanted to someday be able to donate my time to go to places where there is conflict or war and visit POWs and detainees to make sure that they are not being mistreated and provide medical care when needed. Do you know anything about the process to be able to do that? Would it be strange to bring this up in an interview because its a pretty lofty goal (I'm sure it's very hard to be able to volunteer for that position).
You'd have better luck with Doctors Without Borders. American doctors and americans as a whole aren't exactly welcomed with open arms in the ICRC...or at least the ones who come out here. (*my opinion only) As someone who's spent more than my fair share of time where you want to go....don't believe the media in any outlet; it's all spun to the audience they want to rile up or placate.