Confessions of a Burnt Out Physician

[sloh]

Reading this just breaks my heart

http://www.kevinmd.com/blog/2014/12/confessions-burnt-physician.html

"I’ve wanted to be a physician for as long as I can remember. As a teen, the choice to become a doctor seemed to perfectly meld my affinity for science, academics, and helping others. Better yet, pediatrics offered the ability to work with families and children of all ages and developmental abilities.

For fifteen years, I lived, breathed, and worked toward my goal to become a pediatrician. In college, I studied the foundational cornerstones of science and humanities and focused on how health impacts the rest of our lives. In medical school, I learned about different aspects of each organ system and marveled at the miracles of the human body. During residency, I walked the halls of hospitals during the wee hours of the morning. I rubbed the sleep out of my eyes as I provided artificial breaths to a dying infant and smoothed the crinkles in my yellowing white coat as we brainstormed why another child was brought to us at death’s door.


When I finally achieved my goal to call myself a board-certified pediatrician, I beamed as I walked into my new office space that had my name posted on the wall outside exam room doors.

Despite my lofty dreams and expectations, practicing primary care pediatrics was nothing like I hoped it would be. My days were filled with opportunities to meet and grow with patients and families, but my tidbits of time were sliced into 15-minute increments. As my practice size increased, I was persistently pressured to add extra patients over my lunch hours, before the day started, and into time slots already booked with other patients. The need to move increasingly efficiently sparked anxiety within me — I was halfway through greeting one patient before I was also surreptitiously listening for the opening and closing of the next exam room door to signal that another patient was waiting.

The physical and emotional work of completing a visit every 15 minutes repeatedly refreshing my smile before I burst into the next room began to make me feel like a machine. As a robot in the factory of medicine, the demands of my job pulled at my greatest skills of empathy and compassion, two of the character traits that made me most suited for primary care. Try as I might, it was hard to feel compassionate for the mother of a child with a mild cold when I was already ignoring my raging headache, need to urinate, and fatigue. Despite my gut instinct to address the “one last thing” that patients often bring up at the end of a visit, the pressure of metrics that detailed my length of visit and wait time for patients coerced me to ignore their concerns, even if my actions translated into another office visit, another co-pay, another day.

When I did have time to sit down, I was crowded into the corner of a small office shared by two other physicians. When we all were present and trying to make phone calls, type office notes, and converse with staff, the cacophony rose. My brain and my inner self was desperate for peace, though I knew it would be only moments before the next patient was ready in a room to begin again.

By the time I got home each evening, I was a deflated emotional balloon, sucked of energy and ambition and left with little to share. When my own children rushed to greet me, I offered them a quick hug and kiss and then silently wished they would quiet down. After dinner and bedtime stories, I rested with them until it was time to open my laptop again and work through additional charts, emails, and work tasks. My husband personified my laptop as a bedfellow in our marriage. I struggled for the emotional energy to make my steadfast lifetime partner feel loved.

As a part of the middle management administration at my health care organization, I sat in meetings week after week where the physicians in the organization were referred to as “lazy, whiny, irresponsible, and unmotivated.” I gazed through the picturesque windows in the large administrative offices and chuckled at the irony that money is too tight to upgrade or expand space in clinics to improve the workplace environment. I seethed quietly as I listed to the mantra that we need to see more patients, more efficiently, and work longer hours as if I were listening to the drumbeat at a funeral march.

The articles on physician burnout cite the need for physicians to develop coping strategies to deal with the daily stressors incurred in the office. We are tasked to learn and practice mindfulness, meditation, and regular exercise. While I make exercise a priority, I simply can’t find the time to learn the other soul-saving techniques in my current work environment. I think it is not only a physician’s responsibility to take care of ourselves, but the scaffolding of the health care system needs allow for practices that will sustain those of us at its very core.

Last week, I submitted my resignation from medicine.

Many have asked me if I will ever come back, but I’m not sure. I am jaded by the push to provide efficient and effective health care for others while ignoring my own personal needs. I am saddened by the palpable wounds that I have left my children through lack of energy, lack of engagement, and inability to be there when they need me. I am discouraged that despite 15 years of focus and sacrifice, Dr. Google has become a smarter and more esteemed physician than I. I am worried that the advent and elevation of pseudoscience has led to increased vaccine resistance, re-emergence of previously eradicated diseases, and hours of time spent fruitlessly discussing why the opinions of thousand physician researchers should outweigh the thoughts of one or two dissenters.

I have heard that it costs up to $10,000 every time my organization hires and trains a new physician. It costs patients and insurance companies each time I ask a patient come back to discuss other concerns I didn’t have time to address. Every time I order a diagnostic test that is not medically warranted but desired by a patient that has Googled their symptoms, costs increase.

The United States spent approximately $8,895 per person for health care in 2012, which is higher than any other developed country but is among the worst health outcomes. If we want to decrease the cost of American health care, it will be imperative to make efforts to retain primary care physicians, decrease administrative costs and overhead spending, and put back some autonomy in physician’s hands so that customer satisfaction does not override the importance of good patient care.” In addition, health care companies and patients need to recognize that those of us who chose to study medicine are not merely well trained machines but humans who strive to deliver care with compassion, empathy, and expertise.

I don’t know what my next career will be, but for now I will work on regaining what made me chose medicine in the first place. As I cultivate the human that has been suppressed by the robot that provided medical care, I look forward to regaining the health and happiness that we seek for all.

The author is an anonymous pediatrician."

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[neusu]

Welcome to modern medicine.

This should be a wake-up call to everybody. In the current trend for care dynamics, physicians are no longer independent practicioners who are in charge of their own practice. We are simply revenue sources for management whose goal is to get as much money out of us and pay us as little as possible.

 

[Señor S]

BREAKING NEWS: A nation in shock after a female physician gets married, has kids and then decides she doesn't want to practice full-time

 

[PL198]

I feel like 99 % of the stories I hear about physicians being burnt out are people who went into it thinking they'd be god and have the best job in the world and life would be unicorns, candy and playing with puppies. If you go into any profession thinking it's going to be the second(third, fourth, whichever one we're on now) coming of jesus christ, you're probably going to be end up disappointed.

I still don't understand how primary care doctors don't see the chief issue behind chronic illness. If your patients don't listen to you, reducing overhead and administrative costs doesn't do anything because they're just going to have to keep coming back over and over and incurring costs. Instead of making a model where you're trying to minimize the cost of each visit, while assuming the patient is going to be coming back frequently for management of their issues, why not figure out how to make the patients actually take your suggestions(or if that is possible) so they only have to come back for checking up on their meds?

 

[Psai]

BREAKING NEWS: A nation is in shock after a female physician gets married, has kids and then decides she doesn't want to practice full-time

I'm guessing that you didn't read the article

 

[styphon]

Wow administration are heartless souls dressed in fancy suits who only care about the bottom line? Inform everyone!

You should learn in residency and/or medical shcool that people with NO medical training are making financial decisions and run the structures of hospitals and large physician groups. These people are focused on number of patients/hr, about metrics, about billing, about satisfication scores...

I also think sometimes pediatric residencies do not prepare the residents for the pace of the outpatient clinic. They focus more on inpt and specialites as opposed to building up the speed/efficiency needed in todays outpatient clinics.

 

[giantswing]

I also wonder how medicine vs surgeon types deal and differ with burnout. She seemed dissapointed that her clinic had to be so fast paced and she couldn't connect with patients where most surgeons can't get out of the room fast enough.

Also, along the lines of being a woman, i wonder how many house hold tasks she still had to take care of.

 

[Slack3r]

...decrease administrative costs and overhead spending...

Bwahahahahahahahahahahahahahahahahahahahha "gasp" Hahahahahahahhahahahahahahahahahahahahahaahahahahahahahahahahahh

Like that's going to happen.

 

[alpinism]

Reading this just breaks my heart

http://www.kevinmd.com/blog/2014/12/confessions-burnt-physician.html

"I’ve wanted to be a physician for as long as I can remember. As a teen, the choice to become a doctor seemed to perfectly meld my affinity for science, academics, and helping others. Better yet, pediatrics offered the ability to work with families and children of all ages and developmental abilities.

For fifteen years, I lived, breathed, and worked toward my goal to become a pediatrician. In college, I studied the foundational cornerstones of science and humanities and focused on how health impacts the rest of our lives. In medical school, I learned about different aspects of each organ system and marveled at the miracles of the human body. During residency, I walked the halls of hospitals during the wee hours of the morning. I rubbed the sleep out of my eyes as I provided artificial breaths to a dying infant and smoothed the crinkles in my yellowing white coat as we brainstormed why another child was brought to us at death’s door.


When I finally achieved my goal to call myself a board-certified pediatrician, I beamed as I walked into my new office space that had my name posted on the wall outside exam room doors.

Despite my lofty dreams and expectations, practicing primary care pediatrics was nothing like I hoped it would be. My days were filled with opportunities to meet and grow with patients and families, but my tidbits of time were sliced into 15-minute increments. As my practice size increased, I was persistently pressured to add extra patients over my lunch hours, before the day started, and into time slots already booked with other patients. The need to move increasingly efficiently sparked anxiety within me — I was halfway through greeting one patient before I was also surreptitiously listening for the opening and closing of the next exam room door to signal that another patient was waiting.

The physical and emotional work of completing a visit every 15 minutes repeatedly refreshing my smile before I burst into the next room began to make me feel like a machine. As a robot in the factory of medicine, the demands of my job pulled at my greatest skills of empathy and compassion, two of the character traits that made me most suited for primary care. Try as I might, it was hard to feel compassionate for the mother of a child with a mild cold when I was already ignoring my raging headache, need to urinate, and fatigue. Despite my gut instinct to address the “one last thing” that patients often bring up at the end of a visit, the pressure of metrics that detailed my length of visit and wait time for patients coerced me to ignore their concerns, even if my actions translated into another office visit, another co-pay, another day.

When I did have time to sit down, I was crowded into the corner of a small office shared by two other physicians. When we all were present and trying to make phone calls, type office notes, and converse with staff, the cacophony rose. My brain and my inner self was desperate for peace, though I knew it would be only moments before the next patient was ready in a room to begin again.

By the time I got home each evening, I was a deflated emotional balloon, sucked of energy and ambition and left with little to share. When my own children rushed to greet me, I offered them a quick hug and kiss and then silently wished they would quiet down. After dinner and bedtime stories, I rested with them until it was time to open my laptop again and work through additional charts, emails, and work tasks. My husband personified my laptop as a bedfellow in our marriage. I struggled for the emotional energy to make my steadfast lifetime partner feel loved.

As a part of the middle management administration at my health care organization, I sat in meetings week after week where the physicians in the organization were referred to as “lazy, whiny, irresponsible, and unmotivated.” I gazed through the picturesque windows in the large administrative offices and chuckled at the irony that money is too tight to upgrade or expand space in clinics to improve the workplace environment. I seethed quietly as I listed to the mantra that we need to see more patients, more efficiently, and work longer hours as if I were listening to the drumbeat at a funeral march.

The articles on physician burnout cite the need for physicians to develop coping strategies to deal with the daily stressors incurred in the office. We are tasked to learn and practice mindfulness, meditation, and regular exercise. While I make exercise a priority, I simply can’t find the time to learn the other soul-saving techniques in my current work environment. I think it is not only a physician’s responsibility to take care of ourselves, but the scaffolding of the health care system needs allow for practices that will sustain those of us at its very core.

Last week, I submitted my resignation from medicine.

Many have asked me if I will ever come back, but I’m not sure. I am jaded by the push to provide efficient and effective health care for others while ignoring my own personal needs. I am saddened by the palpable wounds that I have left my children through lack of energy, lack of engagement, and inability to be there when they need me. I am discouraged that despite 15 years of focus and sacrifice, Dr. Google has become a smarter and more esteemed physician than I. I am worried that the advent and elevation of pseudoscience has led to increased vaccine resistance, re-emergence of previously eradicated diseases, and hours of time spent fruitlessly discussing why the opinions of thousand physician researchers should outweigh the thoughts of one or two dissenters.

I have heard that it costs up to $10,000 every time my organization hires and trains a new physician. It costs patients and insurance companies each time I ask a patient come back to discuss other concerns I didn’t have time to address. Every time I order a diagnostic test that is not medically warranted but desired by a patient that has Googled their symptoms, costs increase.

The United States spent approximately $8,895 per person for health care in 2012, which is higher than any other developed country but is among the worst health outcomes. If we want to decrease the cost of American health care, it will be imperative to make efforts to retain primary care physicians, decrease administrative costs and overhead spending, and put back some autonomy in physician’s hands so that customer satisfaction does not override the importance of good patient care.” In addition, health care companies and patients need to recognize that those of us who chose to study medicine are not merely well trained machines but humans who strive to deliver care with compassion, empathy, and expertise.

I don’t know what my next career will be, but for now I will work on regaining what made me chose medicine in the first place. As I cultivate the human that has been suppressed by the robot that provided medical care, I look forward to regaining the health and happiness that we seek for all.

The author is an anonymous pediatrician."

The bolded is key.

However, the main problem isn't that primary care docs are overworked and undervalued.

It's that the majority of what they do on a daily basis is completely unnecessary and likely hurts patients more than it helps them.

Pediatrics is often the worst offender.

Useless general medical checkups and physicals
Unnecessary tests and procedures
Over-diagnosing and over-treating minor self limiting conditions
Prescribing inappropriate medications

and the list goes on...

Why?

Primary care in the US today is about making money above all else.

Patient satisfaction = money
seeing more patients = money
doing more paperwork = money
ordering more tests = money
doing more procedures = money

The bottom line is that you don't make money by telling patients they need to go home and drink lots of fluids for their minor cold symptoms.

You make money by ordering every lab and imaging test under the sun while also giving them a prescription for an antibiotic, narcotic, and sleep aid.

Not to mention you get sky high PG scores in the process...

 

[Sirach38]

I feel like 99 % of the stories I hear about physicians being burnt out are people who went into it thinking they'd be god and have the best job in the world and life would be unicorns, candy and playing with puppies. If you go into any profession thinking it's going to be the second(third, fourth, whichever one we're on now) coming of jesus christ, you're probably going to be end up disappointed.

I still don't understand how primary care doctors don't see the chief issue behind chronic illness. If your patients don't listen to you, reducing overhead and administrative costs doesn't do anything because they're just going to have to keep coming back over and over and incurring costs. Instead of making a model where you're trying to minimize the cost of each visit, while assuming the patient is going to be coming back frequently for management of their issues, why not figure out how to make the patients actually take your suggestions(or if that is possible) so they only have to come back for checking up on their meds?

This. Medicine is a job. Period. That is all. It won't make you the savior of the world, it won't make you rich (for most), it won't take away your inferiority complex, it won't take away your depression (in fact it is more likely to cause you depression), it won't make those around you love you more, it won't make you a badass in the eyes of society, it won't make you less lonely, and it won't make you happy and fulfilled.

Most people that go into it expecting these things will be very disappointed.

Happiness comes from within and from a balanced life with intimate and healthy relationships. An MD degree isn't some magic road to bliss. It's just a job. A hard job. Those who give up/neglect their health, hobbies, families, and friends for this job will deeply regret it. Don't let medicine take your soul.

 

[FIREitUP]

This article is pretty uninspired. It seems like the pediatrician who wrote it had unrealistic expectations of the realities of being a pediatrician, and her ability to cope with dealing with the inevitable poor outcomes and emotionally and physically damaged children. Perhaps she did not do enough introspection prior to entering the field to realize that in addition to dealing with the emotional stress of trainwreck patients, dealing with bread and butter pediatrics is essentially akin to working on an assembly line and requires zero thought. Maybe if she thought out her career choice a little better she would have realized that pediatrics was perhaps not the right field for her.

One lesson that y'all should take out of this is to make sure you choose the right field for you so you don't become like this doc. This will be the job you have for almost the rest of your life.

 

[sazerac]

Quitting the entire profession because you don't like one employer's environment is the kind of temper tantrum I would expect from a pediatric patient, not a pediatric practitioner.

 

[Psai]

Man ****ing lol at these med student perspectives. Fireitup, you're a 4th year.

"Perhaps she did not do enough introspection prior to entering the field to realize that in addition to dealing with the emotional stress of trainwreck patients, dealing with bread and butter pediatrics is essentially akin to working on an assembly line and requires zero thought. Maybe if she thought out her career choice a little better she would have realized that pediatrics was perhaps not the right field for her."

Jesus. Completely clueless

 

[redpanda]

BREAKING NEWS: A nation is in shock after a female physician gets married, has kids and then decides she doesn't want to practice full-time

BREAKING NEWS: Complaints from women must be caused by their ovaries!

 

[FIREitUP]

Man ******* lol at these med student perspectives. Fireitup, you're a 4th year.

"Perhaps she did not do enough introspection prior to entering the field to realize that in addition to dealing with the emotional stress of trainwreck patients, dealing with bread and butter pediatrics is essentially akin to working on an assembly line and requires zero thought. Maybe if she thought out her career choice a little better she would have realized that pediatrics was perhaps not the right field for her."

Jesus. Completely clueless

what's your point? pediatrics is one of the most difficult fields to emotionally deal with (due to the monotony of outpatient gen peds and the potential for terribleness in inpatient services) and most of the things she hates (that have led to her burnout) are easily seen when rotating on peds as a med student.

I'm not saying I don't feel for her, I'm just saying that we've heard this so many times before. I think what we should take away from this is that as med students we need to make sure we are choosing the path that is in line with our personal goals and our abilities.

 

[PL198]

The bolded is key.

However, the main problem isn't that primary care docs are overworked and undervalued.

It's that the majority of what they do on a daily basis is completely unnecessary and likely hurts patients more than it helps them.

Pediatrics is often the worst offender.

Useless general medical checkups and physicals
Unnecessary tests and procedures
Over-diagnosing and over-treating minor self limiting conditions
Prescribing inappropriate medications

and the list goes on...

Why?

Primary care in the US today is about making money above all else.

Patient satisfaction = money
seeing more patients = money
doing more paperwork = money
ordering more tests = money
doing more procedures = money

The bottom line is that you don't make money by telling patients they need to go home and drink lots of fluids for their minor cold symptoms.

You make money by ordering every lab and imaging test under the sun while also giving them a prescription for an antibiotic, narcotic, and sleep aid.

Not to mention you get sky high PG scores in the process...

I'll add you forgot the most important one

Not being sued for malpractice = money

Someone can't use their judgement and tell people to go home and drink lots of fluids and rest, when the 1/100000 they are wrong sues them and their insurance goes through the roof/ license has possibility of dings. Unnecessary tests and procedures will stop as soon as malpractice isn't held with this expectation for every physician to be 100 % correct, 100 % of the time. Simply being wrong isn't negligence.

 

[FIREitUP]

The bolded is key.

However, the main problem isn't that primary care docs are overworked and undervalued.

It's that the majority of what they do on a daily basis is completely unnecessary and likely hurts patients more than it helps them.

Pediatrics is often the worst offender.

Useless general medical checkups and physicals
Unnecessary tests and procedures
Over-diagnosing and over-treating minor self limiting conditions
Prescribing inappropriate medications

and the list goes on...

Why?

Primary care in the US today is about making money above all else.

Patient satisfaction = money
seeing more patients = money
doing more paperwork = money
ordering more tests = money
doing more procedures = money

The bottom line is that you don't make money by telling patients they need to go home and drink lots of fluids for their minor cold symptoms.

You make money by ordering every lab and imaging test under the sun while also giving them a prescription for an antibiotic, narcotic, and sleep aid.

Not to mention you get sky high PG scores in the process...

I'm not sure if I completely follow. Much of what peds does in the outpatient is preventative, and hardly is useless. Do you have data on your other claims? If it's true then it might be a result of over-bearing parents who push for their children to be over-tested/treated.

 

[PL198]

I'm not sure if I completely follow. Much of what peds does in the outpatient is preventative, and hardly is useless. Do you have data on your other claims? If it's true then it might be a result of over-bearing parents who push for their children to be over-tested/treated.

Not to mention someone's kid is a whole different level of insanity if someone screws up. You screw over a parent, they're ticked off. You screw over their kid, they'll tear your head off.

 

[Serous Demilune]

This. Medicine is a job. Period. That is all. It won't make you the savior of the world, it won't make you rich (for most), it won't take away your inferiority complex, it won't take away your depression (in fact it is more likely to cause you depression), it won't make those around you love you more, it won't make you a badass in the eyes of society, it won't make you less lonely, and it won't make you happy and fulfilled.

Most people that go into it expecting these things will be very disappointed.

Happiness comes from within and from a balanced life with intimate and healthy relationships. An MD degree isn't some magic road to bliss. It's just a job. A hard job. Those who give up/neglect their health, hobbies, families, and friends for this job will deeply regret it. Don't let medicine take your soul.

How do you know this as a medical student? Deep down I think most people going into this want everything you mentioned in the first paragraph, or at least I do. I'm not being facetious, I just think you can get some satisfaction out of practicing medicine if you don't let the bad parts drag you down and take over your whole perspective.

 

[Sirach38]

How do you know this as a medical student?

I have no study just observations and personal experience. One doesn't have to be an attending to realize life is so much more than medicine and that one needs so much more than prestige and money to be happy. Also over the course of medical school I have met many physicians and I make it a point to have a heart to heart with everyone. I ask every attending and resident that I meet about career/life satisfaction and happiness. Most seem pretty honest and willing to share their thoughts. I have asked all types of physicians from dermatologists to neurosurgeons and they all give me similar answers.

Deep down I think most people going into this want everything you mentioned in the first paragraph, or at least I do. I'm not being facetious, I just think you can get some satisfaction out of practicing medicine if you don't let the bad parts drag you down and take over your whole perspective.

I'm not saying practicing medicine can't be satisfying, what I am saying is the satisfaction depends much less on medicine itself and much more on the perspective, outlook, and expectations of the one who practices medicine.

It's like everything else that we aim for because we think it will make us happy. Then, we get what we wanted and realize that it wasn't what we expected and didn't make us fully happy like we thought it would. We as humans use external things to try to fill an internal void of unhappiness.

An undergrad student aims to get into med school and feels that once they do, they will be happy. Then they get in and they realize med school isn't all rainbows and unicorns so they decide that once they get their dream residency, then they'll be happy. They get the residency they want, then they realize how tough it is to be a resident and feel like once they become an attending they will be happy. They become an attending and then realize it isn't all rainbows and unicorns either and they aren't happy so they blame it on the system and their employer for not "making it possible for them to be happy". This just becomes a cycle and one day they look back and feel like they wasted all their life and sacrificed it all for medicine. Then the bitterness and depression sets in. The issue was never outside of them, it was inside.

There is a reason why doctors have much higher rates of suicide and depressin than the general populations. In many ways an MD is a lot like that fast car or hot girl that you want to get so bad because you feel like it will add so much to your life and make you whole. Then you get it and surprise! You're still unhappy. Only it takes much more effort, sacrifice, and time to get that MD than the car or the girl.

If you can't be happy and loving life now, don't expect an MD to ever change that.

 

[PL198]

To put it simply, it seems like a large amount of students put being a doctor on a pedestal. They think once they get there, everything will be all good, when it's really just another set of challenges. That doesn't mean medicine sucks, but again I don't understand why people have some strange exception for medicine. It seemed like throughout the entire spectrum of the job market, people are more commonly let down by their job compared to their expectations vs pleasantly surprised, so I'm not going to go into things thinking they're going to be perfect.

It's like when you're taking friends to a restaurant and you tell them it's the best (insert type of food) place ever, vs just saying " hey I found a new (type of food) place, let's check it out." When people have lower expectations of something, they tend to reflect higher on it. Conversely when you think you're going to cure cancer and figure out why mitochondria are so stubborn, it's easy to be discouraged.

 

[atomi]

I'm going to take a wild guess here and say that her husband is a physician who did NOT resign from medicine. For the life of me, I can't figure out why I have this hunch.

 

[Señor S]

I'm going to take a wild guess here and say that her husband is a physician who did NOT resign from medicine. For the life of me, I can't figure out why I have this hunch.

Hey now, he could also be an executive, corporate lawyer or investment banker (just kidding, no ban plz)

 

[tima]

I'm going to take a wild guess here and say that her husband is a physician who did NOT resign from medicine. For the life of me, I can't figure out why I have this hunch.

Some of the recent KevinMD articles have been whack.

There was another article how life was so hard being the spouse to a Dr.

 

[FIREitUP]

I have no study just observations and personal experience. One doesn't have to be an attending to realize life is so much more than medicine and that one needs so much more than prestige and money to be happy. Also over the course of medical school I have met many physicians and I make it a point to have a heart to heart with everyone. I ask every attending and resident that I meet about career/life satisfaction and happiness. Most seem pretty honest and willing to share their thoughts. I have asked all types of physicians from dermatologists to neurosurgeons and they all give me similar answers.



I'm not saying practicing medicine can't be satisfying, what I am saying is the satisfaction depends much less on medicine itself and much more on the perspective, outlook, and expectations of the one who practices medicine.

It's like everything else that we aim for because we think it will make us happy. Then, we get what we wanted and realize that it wasn't what we expected and didn't make us fully happy like we thought it would. We as humans use external things to try to fill an internal void of unhappiness.

An undergrad student aims to get into med school and feels that once they do, they will be happy. Then they get in and they realize med school isn't all rainbows and unicorns so they decide that once they get their dream residency, then they'll be happy. They get the residency they want, then they realize how tough it is to be a resident and feel like once they become an attending they will be happy. They become an attending and then realize it isn't all rainbows and unicorns either and they aren't happy so they blame it on the system and their employer for not "making it possible for them to be happy". This just becomes a cycle and one day they look back and feel like they wasted all their life and sacrificed it all for medicine. Then the bitterness and depression sets in. The issue was never outside of them, it was inside.

There is a reason why doctors have much higher rates of suicide and depressin than the general populations. In many ways an MD is a lot like that fast car or hot girl that you want to get so bad because you feel like it will add so much to your life and make you whole. Then you get it and surprise! You're still unhappy. Only it takes much more effort, sacrifice, and time to get that MD than the car or the girl.

If you can't be happy and loving life now, don't expect an MD to ever change that.

Well written and thought out post. I do take exception with the last sentence. I feel that as a medical student it is hard to feel fulfilled by your work. You are often in no man's land and have no real duty or responsibility, and yet concurrently you are being evaluated with little to no understanding on how or what you are being evaluated on. If you do, however, find joy in the small morsels of responsibility and interactions you have as a medical student, I think there is hope for a happy life as a physician. I think finding these small things that make you happy as a medical student is the key to finding what career will make you happy as a doctor.

 

[Sirach38]

Well written and thought out post. I do take exception with the last sentence. I feel that as a medical student it is hard to feel fulfilled by your work. You are often in no man's land and have no real duty or responsibility, and yet concurrently you are being evaluated with little to no understanding on how or what you are being evaluated on. If you do, however, find joy in the small morsels of responsibility and interactions you have as a medical student, I think there is hope for a happy life as a physician. I think finding these small things that make you happy as a medical student is the key to finding what career will make you happy as a doctor.

I agree. I would add that the key is to make sure that your happiness and worth in life is not dependent on what you do. Who you are is NOT what you do. If you're the type of person that inwardly says, "I'm a doctor therefore I am better (smarter, harder working, more successful, entitled to more, etc.) than others", be ready for a life of misery. If your self-worth comes from what you do and from your "rank" in society you will likely never be happy. If it doesn't, then there is nothing stopping you from being happy and loving life right now. No need to wait for that MD.

 

[FIREitUP]

I agree. I would add that the key is to make sure that your happiness and worth in life is not dependent on what you do. Who you are is NOT what you do. If you're the type of person that inwardly says, "I'm a doctor therefore I am better (smarter, harder working, more successful, entitled to more, etc.) than others", be ready for a life of misery. If your self-worth comes from what you do and from your "rank" in society you will likely never be happy. If it doesn't, then there is nothing stopping you from being happy and loving life right now. No need to wait for that MD.

what you do can change who you are or affirm/contradict the ideals you espouse. we spend so much time at work that it's hard not to make it part of who we are, especially in medicine.

 

[Sirach38]

what you do can change who you are or affirm/contradict the ideals you espouse. we spend so much time at work that it's hard not to make it part of who we are, especially in medicine.

Hard, yes. Impossible, not at all. This is what work/life balance is all about.

 

[sloh]

it's wise to find out for yourself how much you enjoy medicine. i'm quoting someone on the boards here from a while back but i think he said it most succinctly "there are some things i like in moderation that i hate in excess." someone may like peds but if they are forced to work as this anonymous writer depicts in her post, they could grow to despise their career. i enjoy pm&r but if it meant that i had to work countless weekends, nights, holidays at the expense of my own health, hobbies, and relationships with loved ones...forget it lol

 

[Entadus]

An undergrad student aims to get into med school and feels that once they do, they will be happy. Then they get in and they realize med school isn't all rainbows and unicorns so they decide that once they get their dream residency, then they'll be happy. They get the residency they want, then they realize how tough it is to be a resident and feel like once they become an attending they will be happy. They become an attending and then realize it isn't all rainbows and unicorns either and they aren't happy so they blame it on the system and their employer for not "making it possible for them to be happy". This just becomes a cycle and one day they look back and feel like they wasted all their life and sacrificed it all for medicine. Then the bitterness and depression sets in. The issue was never outside of them, it was inside.

There is a reason why doctors have much higher rates of suicide and depressin than the general populations. In many ways an MD is a lot like that fast car or hot girl that you want to get so bad because you feel like it will add so much to your life and make you whole. Then you get it and surprise! You're still unhappy. Only it takes much more effort, sacrifice, and time to get that MD than the car or the girl.

If you can't be happy and loving life now, don't expect an MD to ever change that.

Do people really think this way? If so I feel bad for them! I have never hoped that residency would bring me happiness (in fact quite the opposite). These sorts of expectations are foolhardy if you pay ANY attention at all to what residents say/think/experience.

Frankly, being in med school isn't about being happy, and I try my best to accept that. It's a means to an end. I'm not pursuing this path for any immediate gratification (it's all delayed...), but rather due to the belief in something greater than myself that is worth sacrificing for.

"Those who are too good for this world are adorning some other. So long as you breathe the free air of earth, you are under obligation to render grateful service." -Sri Yukteswar

 

[PL198]

Do people really think this way? If so I feel bad for them! I have never hoped that residency would bring me happiness (in fact quite the opposite). These sorts of expectations are foolhardy if you pay ANY attention at all to what residents say/think/experience.

Frankly, being in med school isn't about being happy, and I try my best to accept that. It's a means to an end. I'm not pursuing this path for any immediate gratification (it's all delayed...), but rather due to the belief in something greater than myself that is worth sacrificing for.

"Those who are too good for this world are adorning some other. So long as you breathe the free air of earth, you are under obligation to render grateful service." -Sri Yukteswar

everything you wrote, makes it seem like you're one of the people that think this way. A means to an end is what everyone says when they expect unicorns at the end. You acknowledge that it sucks now ( hence it has to be delayed gratification) and that it will be worth it in the end. You expect to feel some wholesome goodness for sacrificing yourself or whatever. So it's completely ironic you're saying " do people think this way," when you yourself think that way.

The people who say " I'm miserable in medical school but that will change when I'm a doctor" are the ones who get burnt out. That's the whole point. Your post is like the most ironic thing I've ever read.

 

[Entadus]

everything you wrote, makes it seem like you're one of the people that think this way. A means to an end is what everyone says when they expect unicorns at the end. You acknowledge that it sucks now ( hence it has to be delayed gratification) and that it will be worth it in the end. You expect to feel some wholesome goodness for sacrificing yourself or whatever. So it's completely ironic you're saying " do people think this way," when you yourself think that way.

The people who say " I'm miserable in medical school but that will change when I'm a doctor" are the ones who get burnt out. That's the whole point. Your post is like the most ironic thing I've ever read.

You are assuming that I care most about myself, perhaps because you do. Some people are able to expand their awareness and concern beyond the limits of their own ego/persona. I agree that it's ironic, but my belief is that it is possible to reach happiness by focusing on the well-being of others before oneself.

 

[PL198]

lol no. this isn't a psychology class. the people who pull the stuff you're pulling about serving are the most self serving type of people. eg the people who go on a mission trip and post 200 pics on facebook about it. the people that post about how they're so excited to serve xyz population.

if you want to get psychological, you're deflecting because the irony in your post is irrefutable. regardless of your motives, you're the exact thing you're critiquing, with a different reason behind it. therefore it's likely you will get burnt out because it's also likely that you will be disappointed by your capacity to illicit change.

 

[Entadus]

lol no. this isn't a psychology class. the people who pull the stuff you're pulling about serving are the most self serving type of people. eg the people who go on a mission trip and post 200 pics on facebook about it. the people that post about how they're so excited to serve xyz population.

if you want to get psychological, you're deflecting because the irony in your post is irrefutable. regardless of your motives, you're the exact thing you're critiquing, with a different reason behind it. therefore it's likely you will get burnt out because it's also likely that you will be disappointed by your capacity to illicit change.

There's no need to throw me into stereotypes or "kinds of people". I'm actually a pretty private person so the facebook photo thing is off base. And what is wrong with being excited to serve a specific population?

I see it's going to be tough to come to any agreement since our philosophies are so distinct. But suffice it to say, I think it's very likely for ALL of us that we're going to get burnt out, that part is evident. Is it a certainty? No, but we had best take note of the unhappiness traps everybody is pointing out.

I think it would be disappointing for anyone to see their life as a failure to create change... but I also see that everything in this world changes, slowly but surely. I don't see my own part as anything greater than an infinitesimal portion of that evolution.

 

[Sirach38]

You are assuming that I care most about myself, perhaps because you do. Some people are able to expand their awareness and concern beyond the limits of their own ego/persona. I agree that it's ironic, but my belief is that it is possible to reach happiness by focusing on the well-being of others before oneself.

Oh please. Look, I respect your altruism. But come on! Medicine doesn't need martyrs nor is it the place for martyrs. This is the unbalanced mentality that leads to burn out. You are not a super hero nor are you Mother Teresa. If you derive so much happiness from focusing on the well being of others then go to a third world country today and help those in need. Why wait for the MD? Whether you admit it or not, medicine is a business where we provide a service in exchange for an income. It's a job. Period. It may be a great job or a terrible job, you may be helping others, but in the end, you're getting paid to provide a service. It's this idealization of our profession and ourselves as some saviors of the world that leads many to sacrifice/neglect their families, friends, hobbies, and health only to write pathetic articles 5 years out of residency about how "the system is unfair" and how "it wasn't what I expected". Really?! Yes of course it wasn't what you expected because you expected to be some savior/super hero and never stopped to look at the reality of the situation. It's the same reason a young patriotic, optimistic soldier comes back from war with a very different mentality than what he went in with and many times is very sorry that he became a soldier.

Don't get me wrong, I love medicine! But do I love it more than my family, friends, faith, hobbies, or my own self? NO WAY IN HELL!

 

[Entadus]

Oh please. Look, I respect your altruism. But come on! Medicine doesn't need martyrs nor is it the place for martyrs. This is the unbalanced mentality that leads to burn out. You are not a super hero nor are you Mother Teresa. If you derive so much happiness from focusing on the well being of others then go to a third world country today and help those in need. Why wait for the MD? Whether you admit it or not, medicine is a business where we provide a service in exchange for an income. It's a job. Period. It may be a great job or a terrible job, you may be helping others, but in the end, you're getting paid to provide a service. It's this idealization of our profession and ourselves as some saviors of the world that leads many to sacrifice/neglect their families, friends, hobbies, and health only to write pathetic articles 5 years out of residency about how "the system is unfair" and how "it wasn't what I expected". Really?! Yes of course it wasn't what you expected because you expected to be some savior/super hero and never stopped to look at the reality of the situation. It's the same reason a young patriotic, optimistic soldier comes back from war with a very different mentality than what he went in with and many times is very sorry that he became a soldier.

Don't get me wrong, I love medicine! But do I love it more than my family, friends, faith, hobbies, or my own self? NO WAY IN HELL!

Dude, working at Hollister is a job. If you think treating someone's illness is comparable.... let me just say, it's not so black and white. This argument has been played out countless times before, so let me just point out that a spectrum of beliefs about the role physicians play is HEALTHY and a normal feature of the profession. We can talk economics or we can talk philosophy and spirituality, but the truth is that medicine straddles both realms. I see your point and I'm glad you see mine, too.

 

[PL198]

lol this reminds me of the people in high school who worked on hollister on on facebook it says " model- hollister" it's like no dude, you fold jeans

 

[Sirach38]

Dude, working at Hollister is a job. If you think treating someone's illness is comparable.... let me just say, it's not so black and white. This argument has been played out countless times before, so let me just point out that a spectrum of beliefs about the role physicians play is HEALTHY and a normal feature of the profession. We can talk economics or we can talk philosophy and spirituality, but the truth is that medicine straddles both realms. I see your point and I'm glad you see mine, too.

Yes, medicine is more work, pays better, requires more schooling, more hours, more emotional investment than working at Hollister. Not devating that. But at the end of the day, you still get paid for your services and in the majority of cases (more so now and in the future than ever before) you will be working for some large corporation similar to Hollister. You will make money for them and they will pay you a salary for your work. Then you go back to your family and friends at the end of the day and THEY are your true source of happiness. I don't care if you feel like the savior of the earth, if your family, friends, and self are not given proper priority and attention in life, you WILL be miserable and you WILL hate your job. Remember, at the end of the day ALL of your patients will die no matter what you did or how amazing of a doctor you were. The only legacy any of us will ever leave is our relationships. This is why medicine cannot provide happiness on it's own. All that we do is much too futile and temporay. It's a fart in the wind.

 

[josephpx]

Reality sets in and people realize it isn't like what they thought itd be.

 

[Physician Mom]

BREAKING NEWS: A nation in shock after a female physician gets married, has kids and then decides she doesn't want to practice full-time

@ Senor S: Your post indicates to me that you are:
A. Clueless about the practice of medicine as it exists today
B. At worst a misogynist, at best a chauvinist pig.
What this woman describes is unfortunately an excellent description of the practice of medicine at a large, corporate practice run by number crunching MBAs ( who probably make 3 to 4 times her salary). Her complaints and experiences have nothing to do with gender, or being a parent and I have seen many a physician, male and female, especially those in primary care, seriously consider leaving medicine for all the reasons cited by her.
I am a Mom of 4, an attending at a hospital that is affiliated with a medical school and residency program, in a small (7 physicians) surgical subspecialty practice. I have been in practice long enough to remember when the practice of medicine was a pleasure. My practice was recently romanced by executives of a large corporate behemoth promising to buy up our practice, with a nice payout for the founding partners (of which I am one). But a little bit of research revealed that each group that is bought out regrets their decision, because after a year, the big payout (which was never very large to begin with - or certainly not large enough to retire on) faded when the docs realized they were now on a corporate treadmill, seeing 50% more patients an hour than they did before, working longer hours to meet the corporate billing expectations and demands, keeping only a small percentage of their output. The big, bad,mega corporate medical practice trying to buy us out threatened to hire docs in our specialty if we did not join and we knew they were not kidding as we had watched small practice after practice bite the dust.
But, after much thought we decided we did not want to practice medicine that way and took our chances.
Instead, we kept our independent practice - which has done fine. Granted, big corporate practice tried to freeze us out, and we can't get the reimbursement rates that they do, because they blackmail the insurance companies, taking out newspapers ads threatening to leave insurance companies when they don't get their way & because we have no bargaining power. On top of that, big bad mega practice over orders tests, and refers patients within their group for nonsense just to generate more patient visits and generate income. But, we are the local antidote to the large corporate behemoth in our midst and constantly see patients who say they are tired of feeling like a number and so they turn to us. Did we lose patients? Yes. Did my income drop? Yes. But I am not the proverbial hamster on the wheel moving faster and faster trying to keep up to the expectations of someone who has never practiced medicine in their lives and does not care about patients, only profits.
Here is a little story I that illustrates the sad state of medicine today. An ophthalmologist friend practicing out in the midwest for one of the better known large corporate medical groups was called into the office of the big honcho number cruncher..."it takes you 15 - 17 minutes to do a cataract. Dr. X, your colleague, can do the same surgery in only 10-12 minutes. If you can't speed up, we will make sure that all the primary care doctors in the group only send their surgical patients to Dr. X. You will no longer be allowed to do surgery". My friends is an excellent surgeon, a compassionate physician, adored by all her patients. But corporate medicine sees that extra few minutes per case (multiplied by 10 or more cases a day) and has decided that a talented physician who spent years honing her surgical skills is expendable.
Sorry to say this, but that is the reality of the practice of medicine that many of you will be faced with.

 

[Sirach38]

@ Senor S: Your post indicates to me that you are:
A. Clueless about the practice of medicine as it exists today
B. At worst a misogynist, at best a chauvinist pig.
What this woman describes is unfortunately an excellent description of the practice of medicine at a large, corporate practice run by number crunching MBAs ( who probably make 3 to 4 times her salary). Her complaints and experiences have nothing to do with gender, or being a parent and I have seen many a physician, male and female, especially those in primary care, seriously consider leaving medicine for all the reasons cited by her.
I am a Mom of 4, an attending at a hospital that is affiliated with a medical school and residency program, in a small (7 physicians) surgical subspecialty practice. I have been in practice long enough to remember when the practice of medicine was a pleasure. My practice was recently romanced by executives of a large corporate behemoth promising to buy up our practice, with a nice payout for the founding partners (of which I am one). But a little bit of research revealed that each group that is bought out regrets their decision, because after a year, the big payout (which was never very large to begin with - or certainly not large enough to retire on) faded when the docs realized they were now on a corporate treadmill, seeing 50% more patients an hour than they did before, working longer hours to meet the corporate billing expectations and demands, keeping only a small percentage of their output. The big, bad,mega corporate medical practice trying to buy us out threatened to hire docs in our specialty if we did not join. And we had watched small practice after practice bite the dust.
But, after much thought we decided we did not want to practice medicine that way and took our chances.
Instead, we kept our independent practice - which has done fine. Granted, big corporate practice tried to freeze us out, and we can't get the reimbursement rates that they do, because they blackmail teh insurance companies, taking out newspapers ads threatening to leave insurance companies when they don't get their way & because we have no bargaining power. But, we are the local antidote to the large corporate behemoth in our midst and constantly get patients who say they are tired of feeling like a number. Did we lose patients ...yes. but I am not the proverbial hamster on the wheel moving faster and faster trying to keep up to the expectations of someone who has never practiced medicine in their lives and does not care about patients, only profits.
A little story I just heard that illustrates the sad state of medicine today. An ophthalmologist friend practicing out in the midwest for one of the better known corporate medical groups was called into the office of the big honcho number cruncher..."it takes you 15 - 17 minutes to do a cataract. Dr. X, your colleague, can do the same surgery in only 10-12 minutes. If you can't speed up, we will make sure that all the primary care doctors in the group only send their surgical patients to Dr. X. You will no longer be allowed to do surgery". My friends is an excellent surgeon, a compassionate physician, adored by all her patients. But corporate medicine sees that extra few minutes per case (multiplied by 10 or more cases a day) and has decided that a talented physician who spent years honing her surgical skills is expendable.
Sorry to say this, but that is the reality of the medical practice that many of you will be faced with.

This. Many of us will end up being just a numbered warm body for a large corporation. Still want to sacrifice your friends, family, faith, hobbies, and sanity for this nobel profession that we call "medicine"?

 

[Armadillos]

I think its good this physician quit (or more likely is taking a couple year sabbatical), maybe if more physicians in similar situations did similar it would force changes on the part of the corporate hospitals.

Google/Apple/etc all want to milk every ounce of productivity they can out of the workforce, but for them that means attracting and keeping happy the best employees because there is such a scarcity of people in the job market who will be amazing at those jobs.

Granted reimbursement models need to change, right now its equivalent to if these tech companies paid their software engineers based on how many words a minute they type

 

[PL198]

@ Senor S: Your post indicates to me that you are:
A. Clueless about the practice of medicine as it exists today
B. At worst a misogynist, at best a chauvinist pig.
What this woman describes is unfortunately an excellent description of the practice of medicine at a large, corporate practice run by number crunching MBAs ( who probably make 3 to 4 times her salary). Her complaints and experiences have nothing to do with gender, or being a parent and I have seen many a physician, male and female, especially those in primary care, seriously consider leaving medicine for all the reasons cited by her.
I am a Mom of 4, an attending at a hospital that is affiliated with a medical school and residency program, in a small (7 physicians) surgical subspecialty practice. I have been in practice long enough to remember when the practice of medicine was a pleasure. My practice was recently romanced by executives of a large corporate behemoth promising to buy up our practice, with a nice payout for the founding partners (of which I am one). But a little bit of research revealed that each group that is bought out regrets their decision, because after a year, the big payout (which was never very large to begin with - or certainly not large enough to retire on) faded when the docs realized they were now on a corporate treadmill, seeing 50% more patients an hour than they did before, working longer hours to meet the corporate billing expectations and demands, keeping only a small percentage of their output. The big, bad,mega corporate medical practice trying to buy us out threatened to hire docs in our specialty if we did not join and we knew they were not kidding as we had watched small practice after practice bite the dust.
But, after much thought we decided we did not want to practice medicine that way and took our chances.
Instead, we kept our independent practice - which has done fine. Granted, big corporate practice tried to freeze us out, and we can't get the reimbursement rates that they do, because they blackmail the insurance companies, taking out newspapers ads threatening to leave insurance companies when they don't get their way & because we have no bargaining power. On top of that, big bad mega practice over orders tests, and refers patients within their group for nonsense just to generate more patient visits and generate income. But, we are the local antidote to the large corporate behemoth in our midst and constantly see patients who say they are tired of feeling like a number and so they turn to us. Did we lose patients? Yes. Did my income drop? Yes. But I am not the proverbial hamster on the wheel moving faster and faster trying to keep up to the expectations of someone who has never practiced medicine in their lives and does not care about patients, only profits.
Here is a little story I that illustrates the sad state of medicine today. An ophthalmologist friend practicing out in the midwest for one of the better known large corporate medical groups was called into the office of the big honcho number cruncher..."it takes you 15 - 17 minutes to do a cataract. Dr. X, your colleague, can do the same surgery in only 10-12 minutes. If you can't speed up, we will make sure that all the primary care doctors in the group only send their surgical patients to Dr. X. You will no longer be allowed to do surgery". My friends is an excellent surgeon, a compassionate physician, adored by all her patients. But corporate medicine sees that extra few minutes per case (multiplied by 10 or more cases a day) and has decided that a talented physician who spent years honing her surgical skills is expendable.
Sorry to say this, but that is the reality of the practice of medicine that many of you will be faced with.

lol misogynist or chauvinist, get out of here. you realize multiple women agreed with him? yeah im sure they're all self-depreciating as well.

seriously I'm surprised to see this level of hamster from an actual physician. everything in your post in whining. sorry the economy works as it does and doing a procedure 50 % slower than a colleague isn't acceptable? just straight whining. show me another profession where someone who does their job 50 % slower than a counterpart doesn't face adverse consequences for doing so. if you can't figure out the revenue differences between someone who takes 10-12 minutes for a procedure vs 15-17 when they're doing 10 or more per day, then you're not good at math enough to even have this conversation.

 

[PL198]

but nah medicine is special, if you want to take 2 hours to do a surgery that billy joe can do in 20 minutes, be my guest because you're doing the lords work and who are we to apply market factors to medicine(which occurs in literally every other occupation)

 

[Greasy Pete]

Welcome to modern medicine.

This should be a wake-up call to everybody. In the current trend for care dynamics, physicians are no longer independent practicioners who are in charge of their own practice. We are simply revenue sources for management whose goal is to get as much money out of us and pay us as little as possible.

This should be pasted on every page of SDN.

 

[redpanda]

lol misogynist or chauvinist, get out of here. you realize multiple women agreed with him? yeah im sure they're all self-depreciating as well.

seriously I'm surprised to see this level of hamster from an actual physician. everything in your post in whining. sorry the economy works as it does and doing a procedure 50 % slower than a colleague isn't acceptable? just straight whining. show me another profession where someone who does their job 50 % slower than a counterpart doesn't face adverse consequences for doing so. if you can't figure out the revenue differences between someone who takes 10-12 minutes for a procedure vs 15-17 when they're doing 10 or more per day, then you're not good at math enough to even have this conversation.

Aaaaaand, we're back to using redpill terminology, discounting complaints of women as trite (clearly!), and insinuations that women are bad at math. Because math is the determinant of what is right and good in the world. Perhaps it should occur to one to consider that high numbers may not be the only determinant of good healthcare even if it might bring in extra cash.

Secondly, just because there are some women who hold an opinion that women being unhappy in whatever job must have to do with their ovaries/babiez/biotruths doesn't mean that they are actually right.

 

[PL198]

I didn't insinuate anything about women and math skills, stop looking for things that aren't there. If someone can't understand the economics behind 1 employee with a 50 % slower production rate than another, then they're not being rational enough for a productive conversation. And those women aren't misogynists or chauvinists right, because only men can be those things, right? Just like how only white people can be racist. I can't take someone seriously that uses buzzwords to lead off an argument, even if they have an MD after their name. It makes someone sound like a toddler when the first aspect of a point is attacking the character of the other person, which you succeeded in doing as well.

"Good health-care" is arbitrary and nonsensical. You have a job, with a supervisor. If you produce 50 % slower than your peer, you will face repercussions. Stop trying to spin medicine into a special snowflake where you get to do as you wish and play by a different set of rules than everyone else.

 

[redpanda]

I didn't insinuate anything about women and math skills, stop looking for things that aren't there. If someone can't understand the economics behind 1 employee with a 50 % slower production rate than another, then they're not being rational enough for a productive conversation. And those women aren't misogynists or chauvinists right, because only men can be those things, right? Just like how only white people can be racist. I can't take someone seriously that uses buzzwords to lead off an argument, even if they have an MD after their name. It makes someone sound like a toddler when the first aspect of a point is attacking the character of the other person, which you succeeded in doing as well.

"Good health-care" is arbitrary and nonsensical. You have a job, with a supervisor. If you produce 50 % slower than your peer, you will face repercussions. Stop trying to spin medicine into a special snowflake where you get to do as you wish and play by a different set of rules than everyone else.

Yay! Man has monopoly on rationality! He must have an impartial view of the world, because XY genotype. And yes, women can be misogynists and chauvinists too, in case you were wondering.

 

[jakeislove]

BREAKING NEWS: A nation in shock after a female physician gets married, has kids and then decides she doesn't want to practice full-time

I'm glad it was you who wrote that, LOL!

 

[alpinism]

I'm not sure if I completely follow. Much of what peds does in the outpatient is preventative, and hardly is useless. Do you have data on your other claims? If it's true then it might be a result of over-bearing parents who push for their children to be over-tested/treated.

Beyond vaccines and neonatal genetic screening (which don't require a doctor) there's no high quality (level A) evidence to support any other preventive measures in children.

Some other preventive measures such as obesity, tobacco use, and visual acuity screening have level B evidence, but don't require regularly scheduled doctors visits either.

http://www.uspreventiveservicestaskforce.org/Page/Name/recommendations

Slate has a good series of articles on the subject.

Primary care:

http://www.slate.com/articles/healt...ctor_when_you_re_not_sick_does_more_harm.html

Peds specific:

http://www.slate.com/articles/doubl...r_child_to_the_doctor_and_when_to_stay.2.html

http://www.slate.com/articles/doubl...ick_to_prescribe_antibiotics_for_toddler.html