"Devalued Doctors" Wash.Post 8-11 editorial

[schlrgirl]

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time out i have a question......concerning the original post, is it really possible to be THAT much in debt...i mean if you figure those monthly payments for 15 years!! thats almost $400,000!!!

yikes! am i figuring wrong!

they must have both gone to private school since undergrad w/o any financial aid. brilliant move...

somebody please tell me i figured this wrong!

 

[jay c]

Originally posted by schlrgirl
time out i have a question......concerning the original post, is it really possible to be THAT much in debt...i mean if you figure those monthly payments for 15 years!! thats almost $400,000!!!

yikes! am i figuring wrong!

they must have both gone to private school since undergrad w/o any financial aid. brilliant move...

somebody please tell me i figured this wrong!

before you comment on whether something is a "brilliant move," consider that some people may not have had a choice. They may have been accepted at a public school, but not their instate school. also, some state schools have fairly high tuitions as well

 

[Entei]

Originally posted by jay c
before you comment on whether something is a "brilliant move," consider that some people may not have had a choice. They may have been accepted at a public school, but not their instate school. also, some state schools have fairly high tuitions as well

For undergrad? Come on.

Originally posted by schlrgirl
yikes! am i figuring wrong!

they must have both gone to private school since undergrad w/o any financial aid. brilliant move...

somebody please tell me i figured this wrong!

 

[Lab-Rat21]

YET, with that trend there is also no way 90K a year is ridiculous...they need to move, and fast.

I think academic medicine still pays well though not as much as pure practice, but does anyone know if there is a way to do both? Must you choose one path or the other? I want to practice at a hospital and teach PART-TIME at the medical school or undergrad, maybe lil research. Is this something I must decide so soon, like residency time? I thought there was the dual career option, or is it only for MD/PHDs?

Anyways, I like this discussion, but it has turned into a money debate, my GREATER concern is are we being "devalued" not just moneywise, but in everyday life...? Are MDs still respected, I am more concerned with the everyday treatment of the doctor...I think we are not being devalued respectwise, anyone care to differ?😀

 

[TTSD]

Lab-Rat.. that's why God invented Associate Professors 🙂

I know a few, they mainly work in association with MD/PhD programs where they'll take a student or two under their wing and use them as monkey boys and come in for a guest lecture or two.

 

[Lab-Rat21]

Practice full time and teach part time? That sounds very cool and doable! I would love to do that...any more info is appreciated...is this topic discussed somewhere else before...

 

[MacGyver]

lab-rat,

its very possible to do both teaching and patient care.

HOWEVER, adding research to make it a triumvirate is just about impossible to do.

Research demands almost a full time committment. There are only a handful of people in the whole country who manage to serve as teh "triple threat" of teaching, research, AND patient care.

Its possible to do 2 of the 3, but unless you want to work 20 hour days its virtually impossible to do all 3.

 

[Lab-Rat21]

I guess one can always do collaborations of research, but teaching part time with full time practice sounds amazing.

Let me know of any links/websites...

I think I hijacked the thread, LOL, so who else wants this practice w/ teaching and WHERE can I learn more about this?

HIJACKED...🙄

 

[ckent]

Originally posted by MacGyver

Research demands almost a full time committment. There are only a handful of people in the whole country who manage to serve as teh "triple threat" of teaching, research, AND patient care.

Its possible to do 2 of the 3, but unless you want to work 20 hour days its virtually impossible to do all 3.

Once again (I think, don't remember who I was correcting before), I find your provided information completely out in left field. Only and handful of people? Try only a handful of people in private practice maybe, actually, not even that. The majority of physicians at academic hospitals do your "triple threat". I can't quote any completely accurate statistics, but I would imagine that half are involved in clinical and half are involved in clinical and basic science research. It's very, very possible to do all 3. Just work at a University as an academic physician after you finish your training and you will be doing all 3. Actually, I think that only "clinical instructors" publish no research, all people who have title professor at med schools have to publish. And there are only a few "clinical instructors" at my school. They are mainly the family practioners, but even with them, probably ~1/4-1/2 do clinical or epi research or find some way to publish, whether that be with review articles or case reports.

 

[WatchingWaiting]

Originally posted by ckent
Once again (I think, don't remember who I was correcting before), I find your provided information completely out in left field. Only and handful of people? Try only a handful of people in private practice maybe, actually, not even that. The majority of physicians at academic hospitals do your "triple threat". I can't quote any completely accurate statistics, but I would imagine that half are involved in clinical and half are involved in clinical and basic science research. It's very, very possible to do all 3. Just work at a University as an academic physician after you finish your training and you will be doing all 3. Actually, I think that only "clinical instructors" publish no research, all people who have title professor at med schools have to publish. And there are only a few "clinical instructors" at my school. They are mainly the family practioners, but even with them, probably ~1/4-1/2 do clinical or epi research or find some way to publish, whether that be with review articles or case reports.

Actually, you're in left-field. Yes, it's possible to be be an internist professor who sees patients one afternoon a week to keep up the semblance of being a doctor while teaching a class or two a year and doing research most of the time, but having a non-trivial practice and doing teaching and research is basically unheard of.

 

[MacGyver]

Originally posted by ckent
Once again (I think, don't remember who I was correcting before), I find your provided information completely out in left field. Only and handful of people? Try only a handful of people in private practice maybe, actually, not even that. The majority of physicians at academic hospitals do your "triple threat".

Let me rephrase then. Its virtually impossible to be excellent in ALL 3 AREAS of the "triple threat":


http://www.saem.org/facdev/fac_dev_handbook/afterword1.htm

Shortly after the second World War, and continuing for several decades thereafter, those academic medical faculty held up to students and house officers as role models were commonly described as "triple-threats", i.e., independently funded investigators, inspiring teachers, and stellar clinicians. In recent years, such individuals have become very nearly as extinct as bird's teeth. Although extinction is among the most natural of biological phenomena, when a highly venerated species becomes endangered because the cultural ecosystem that once supported it can no longer be sustained in an altered intellectual climate, there is a natural inclination to try and preserve the dying breed. Nowhere is such behavior more evident than in academic medicine, where the triple-threat seems to have attained the unique fictional status ordinarily reserved for myth.

Coming to terms with the realization that virtually no one can any longer juggle all three academic balls with equal agility for the duration of a career - is the first step toward moving beyond the myth of the triple-threat.

http://annals.edu.sg/pdf_nov98/edit276.pdf

In today?s world it may be unrealistic to expect the medical
academician to excel in all three areas of research, teaching and clinical service.

http://www.cordem.org/download/face.ppt

http://dukemednews.duke.edu/global/print.php?id=1742

It's difficult now for anyone to be supremely successful in research, clinical care, and teaching at the same time. What is possible is to be successful in all three sequentially, which is what I've tried to do. For the first 15 years I concentrated primarily on patient care, for the past 15 it was research. Now it's leading a medical school. I think my background will help me do that, because I know intimately what it takes to be successful in both cultures. I'm proud of my ability to drive balanced growth, to stimulate simultaneously the very best science and the very best patient care.

http://hopkins-id.edu/jobs/howto/careers_academic_positions.html

This "triple threat" -- excellence in science, patient care and teaching -- has been under siege for 10-20 years as summarized by Gordon Gill in the article entitled "The End of the Physician Scientist?" published in 1984 (Amer Scholar 1984;53:353). In essence, the concern is that science and patient care have become too complex for dual mastery by even the most accomplished scholar.

This ongoing debate has reached a more fevered pitch with the increasing emphasis on managed care, which requires a more consistent commitment to patient care responsibilities and carries with it the assumption that attending 1-2 months/year or a clinic one half-day/week is not compatible with high quality care.

The result is that faculty are now asked to do more clinical work, take salary cuts or both. The results is that the institutional demands of clinical faculty are increasing and the ability to provide protected time for the physician-scientist is more difficult.

http://www.saem.org/facdev/fac_dev_handbook/1-1_what_is_faculty_development1.htm

The "triple threat" existence of research, service and teaching is difficult, if not impossible, to maintain without considerable sacrifice of one?s youth and family. In addition, administrative and interpersonal skills must be added to that triple threat capability to make it fully effective. There are few, if any, individuals who can carry it all for a sustained time period.

http://www.chestjournal.org/cgi/content/full/115/2/311

There is little or no room for the "triple threat" academician who can teach, research, and provide excellent clinical care.

http://www.medschool.com/futuretense_cs/MedSchool/faq/forums/research.html

There used to be a concept called the "triple threat" in medicine. This term referred to someone who could do research, clinical medicine, and teach. Most doctors today say that the triple threat no longer exists. Many people who do both clinical medicine and basic research seem to focus on one or the other because both require large time commitments in order to be done well.

http://www.meddean.luc.edu/lumen/deptwebs/surgery/n_fwisit.htm

It has been said for many years that the triple threat no longer exists in academic medicine.

http://www.scripps.edu/research/sr99/memgen0.html

Academic medicine, it used to be said, was like a 3-legged stool. The legs were research, teaching, and clinical care. The "triple threat" academic physician performed all 3 tasks and did them well. In the past 2 decades, clinically competent and active physicians who also do laboratory research have become increasingly scarce. Clearly, we cannot depend on this model in the future as we did in the past.

http://conferences.mc.duke.edu/privatesector/dpsc1995/era.htm

The combination of pressures forces a dichotomization of the clinical faculty into minimally or non- overlapping research and clinical camps, thereby rendering the fabric of academic clinical medicine that has been intricately woven from the threads of education, research, and patient care. This situation raises many troubling issues but perhaps the most pressing concerns the fate of clinical research and the future of the clinical investigator who perhaps most distinctively in the contemporary AMC has strived to retain some of the substance as well as the image of the academic "triple threat."

 

[ItsGavinC]

Originally posted by evescadeceus
Are there ways to avoid this fate?

.

Yes, it's called "moving to a city where there isn't saturation".

If the author would move 200 miles away she could probably double her income.

And by the way, 90 a year is twice what most people make. What a sob story.

 

[ckent]

Those are a lot of articles you have cited, but to me, it seems like someone telling everyone that the world is flat and citing a lot of literature saying that the world is flat while I am looking at a picture of the world from space and seeing that it is round. Once you people get into med school (if you aren't already there already), you will see that practically all of your professors do the "triple threat". Some focus more on one area more then others. A lot really do only have clinic 1-2 per week, and remember that "teaching" doesn't take all that much time in med school as teaching during the 1st 2 yrs is just giving one to a few lectures per year and teaching during the clinical years is just showing up to work and working with the med students on your service. Whether people do all 3 sucessfully is arguable I suppose, but reputations of physicians are largely built on research, not clinical skills. Therefore when people refer the zebras to academic physician specialists in hopes that they will be able to treat them based on their clinical skills, they are doing so largely based on their specialty in research.

 

[kito]

I think I know one triple threat. But she's unbelievably remarkable.