Before someone calls out troll, check my previous posts to know that I am definitely not one. Additionally, I just graduated medical school and therefore
have no vested interest in dissuading others from applying b/c I surely am not competing with you. Now to the topic, why is not worth it? Well, let me give
you a little background info. I worked hard in med school, did well, and this year I matched into a competitively field that is amongst the best paid specialties in medicine, and one that I find to be very fascinating and intellectually challenging. I am glad it worked out. However, it will LONG time before I will be 'rolling in the dough' especially with reimbursements being cut every year. Although I was excited when I got accepted, the exicetement has been fading away every year as I learn more and more how frustrating it has become to practice medicine. Let me outline some of the reasons why it ain't worth it IMO.
1) High debt. The avg. student's debt at the end of state funded med. school is about $150,000. If I recall correctly, that of a private school is ~$170,000. Interest rates start at 6.9% for subsidized loans and go up for private loans. Your med school loan cannot be discharged for life! i.e. this is not credit card debt which you can wipe out by claiming bankruptcy. Read the thread in the General residency forum about the MD who didn't pay his loans for about 20 years and how his license was suspended without him realizing it. Then he was arrested for prescribing medicines without a license.
2) Government takeover of healthcare. The medical system is going broke. Costs will continue to spiral out of control because docs will keep on ordering
every single test under the sun to "CYA" (cover your @$$). That just means that Medicare and private insurers will keep finding new ways to refuse
reimbursement to docs. Do some reading about the SGR and DRA (look it up on google/wiki). Did you know that just three days ago, a 21% reimbursement cut went into play? Yes, congress has been playing this game with the docs since the 90's. They would like nothing more than to have doctors working as govt. peons. Don't believe it? Ask any physician what they think about govt. run healthcare.
3) Lack of tort reform. Meaningful reform is probably not going to happen because the trial lawyers lobby is one of the biggest contributors to Democrats (and they take care of the Repubs too!). Politicians know better than to bite the hand that feeds them. That just means that docs will continue to get sued for the most frivolous reasons. Have some time on your hand? Read about the frivolous lawsuits and their outcomes
http://www.jvra.com/ Even if docs win these suits, they still lose b/c of all the years invested in fighting these suits. And countersuing the patient and the lawyer is know to be a waste of time. Not to mention the ridiculous premiums that can go upwards of $250,000 per year in the most litigous parts of the country. The intellectual part about medicine dissapears when you are ordering shotgun tests for every patient, b/c even though 99 out 100 times your judgement may be correct, the one time you miss that intra-cranial bleed b/c you didn't think the patient needed a CT will come back to bite you with vengeance.
4) The dumbing down of healthcare. Nurse Practitioners and Physician's Assistants are gaining more and more independence every day. NPs are transitioning to DNPs which means they are going to Dr. Nurse and can call themselves Dr. XYZ in many states. NPs can also practice independently in many states. Many of them are arrogant and spread misinformation about how they know as much primary care physicians. The nurse's union is also VERY strong and B.O. loves them and has gone to bat for them. Everyone in the hospital wears a long white coat, except the medical student. Many hospital patients can't tell the doctor apart from the technician apart from the janitor (not to knock on janitors). Lets face it, NPs and PAs are the future of primary care. And all of you certainly can't be specialists b/c there aren't enough spots. Which means that you will be a 'Primary care Provider', not a 'Primary care Physician'.
5) Many patients are not appreciative of the care we provide. Many are abusive of the free care they receive. For example, spend one night working in the E.D. and you will see tons of repeat customers who complain of back/chest/stomach pain, then get the million dollar work up, get their opiod fix and leave, only to come back few days later. ER cannot turn away these patients without a proper workup. Lot of these patients do have several co-morbidities thus you cannot just blow them off b/c 1 out of 100 times, they actually might have some serious pathology that needs to be addressed. Thus the docs are stuck in a catch 22. Lot of these patients are self-pay (i.e. no pay). Sending them to collections isn't helpful b/c their credit histor is already mucked up to begin with. Patients think you are overpaid but they don't know all the hard work you have done and all the debt you have accumulated to be where you are.
6) The red tape is ridiculous. Ever try to get an MRI or CT for your clinic patient? Insurance companies will do everything they can to preven that from happening. You may have to argue on the phone with some punk who has been trained by the company to DENY BABY DENY anything that will cut into the companies bottom line: their profits! When working in the E.D., I'd see many patients who were told by their primary doc to go to the ER to get a CT scan b/c it was more convenient than to hassle with the insurance companies. NOt to mention, all the ridiculous forms that docs have to fill out every day to C.Y.A.
These are just some of the things that I've experienced or learned from other physicians during my last 4 years. I still have a lot of doubt in my mind about the future of Medicine. Even though I have matched in one of the 'nicer' fields, it won't be so nice when I am out practicing. Money isn't everything and I wouldn't even mind working for less money, but I cannot put up with the bureaucracy that has permeated medicine. Everyone wants to be the Monday morning quarter back that judges physicians but none of those chumps know what it is like to practice Medicine. Nonetheless, I do find Medicine to very interesting but unfortunately, for many docs, practicing 'real medicine' makes up only a fraction of their day. With that said, I implore you to talk to as many physicians as you can, in private practice and in the hospital setting.
Shadow them, ask them whether they would recommend medicine to their children, whether they are happy with the current state of their field, whether they would quit if they could. If after that, you still want to practice medicine, then who am I to stop you? I wish someone had made a thread like this when I was applying. Maybe they did and I never paid attention. But if you are reading this, you have no excuse. Good luck to you!
Where do you live that all chest pains get a CT angio?
