Disillusioned With Medicine

[WingedOx]

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#1 I can't remember the last patient that I couldn't treat exactly the way that I wanted to treat because of financial issues. Granted it helps to be in a specialty and area with an essentially single payer healthcare system, but 30%? I'd like to see some data on that before throwing around a huge number like that. I mean every once in a while some insurance won't let me put someone on Eliquis, but it isn't like we don't have other options.

I'm in a little different boat being in mental health. I haven't really had a problem doing the type of psychiatry I need to do in the office, but where the financial problems start to come in is getting patients the ancillary services they need. State cuts have been BRUTAL to those with severe mental illnesses in my state. I can only do so much in my office, and inpatient isn't a long-term solution to anything. The gap between the two types of services is massive for those who aren't of means.

I'd love to have the resources that Massachusetts has for community mental health...just without all the Massholes and those horrible accents.

 

[Finette]

Someone mentioned that doctors should all be practical/pragmatic types of people. While I'm not entirely disagreeing, TBH there's nothing really practical or pragmatic about going massively in debt and giving up years of your life for a profession that those who are in continuously complaim about in terms of finances and overall satisfaction. With that in mind, there has to be at least a little necessary idealism to get through it, no? I kind of feel like the super pragmatic people of the world who don't care very much about the grander notion of things would just go into finance or something.

 

[zeppelinpage4]

Trophy husband seems like a profession without any suck. Can't be said about being a trophy wife though.

Well, there might be a small amount of sucking, but not the bad kind. 😉

 

[sloop]

Someone mentioned that doctors should all be practical/pragmatic types of people. While I'm not entirely disagreeing, TBH there's nothing really practical or pragmatic about going massively in debt and giving up years of your life for a profession that those who are in continuously complaim about in terms of finances and overall satisfaction. With that in mind, there has to be at least a little necessary idealism to get through it, no? I kind of feel like the super pragmatic people of the world who don't care very much about the grander notion of things would just go into finance or something.

It is very pragmatic to go into medicine. It is a field with impeccable job security. The education, while long and expensive, still has a great return in terms of total lifetime earnings. There is good variety in terms of specialties you can choose. If you want to go balls to the wall for a few decades and retire early, you can do that. If you want to work decent hours and cut back to part time as you get older instead of retire, there are specialties where that's possible too. Med school is intense, but it's not unlivable.

People complain because the amount of delayed gratification involved is tremendous and sometimes they are sold the dream without the information about the business/bureaucracy/social work aspects of medicine. Still, it's about the most pragmatic long term career path there is.

I am not an idealist. I'm in medicine to make money and earn a living. I want to be comfortable and I want my future family to not have to deal with the stress of financial or job insecurity. I also love the science and patient interaction involved with medicine but I would not have done it if the job prospects were poor. So far, overall, I've loved medical school and have enjoyed most parts of it—even things I thought I'd hate.

It is a lot of school, though. If you hate school, I can see how you might have to have an idealistic vision to get through it and then promptly peace the **** out of academia as soon as you graduate.

If you like school, the process is fine. If you like the pragmatic aspects of the job and it seems like something you'd like, medicine can be a great decision.

 

[jl lin]

Someone mentioned that doctors should all be practical/pragmatic types of people. While I'm not entirely disagreeing, TBH there's nothing really practical or pragmatic about going massively in debt and giving up years of your life for a profession that those who are in continuously complaim about in terms of finances and overall satisfaction. With that in mind, there has to be at least a little necessary idealism to get through it, no? I kind of feel like the super pragmatic people of the world who don't care very much about the grander notion of things would just go into finance or something.

The pragmatic part is the realization that you will not be able to optimally help everyone. The idealistic part is that you accept it as a blessing to help one person or one family at a time. You may help 5 patients a lot in a day, but you may lose 2, and then you may have 4 that you know aren't going to follow through--or have a couple of kids that you know darn well the parents are not going to put their children's health needs where they belong on the priority list--and in a number of situations, that's me writing in a euphemistic fashion. It doesn't stop you from trying. When you don't want to try anymore--and there will be moments when you may really wrestle with this thought--and when it lasts longer than a matter of moments, that's when you need to see someone or take a break from the field.

 

[Planes2Doc]

Yet again, another thread that needs to get exposed to pre-allo in order to wake some people up. Too many premeds are eager to tell med students and physicians how terrible they are for having attitudes about medicine other than unconditional altruism. I didn't even enter with that level of naive idealism, and it's amazing how different my attitude is now.

Yes!!! Maybe I'll finally stop getting crap from all the pre-allopathic pre-meds about my volunteering views if that happens, even though it's pretty much representative of everyone I've ever talked to OUTSIDE of SDN.

 

[pd1112]

#1 I can't remember the last patient that I couldn't treat exactly the way that I wanted to treat because of financial issues. Granted it helps to be in a specialty and area with an essentially single payer healthcare system, but 30%? I'd like to see some data on that before throwing around a huge number like that. I mean every once in a while some insurance won't let me put someone on Eliquis, but it isn't like we don't have other options.

#2 In 6 years of clinical medicine I've run into a fair bit of annoying administrative/policy issues. But, I've yet to see one that impacted my ability or another physician's ability to care for a patient effectively. Does it happen? I'm sure. But commonly? Kinda doubt it.

#3 Compliance is an issue. Does it diminish the effectiveness of your care? Yes, sometimes drastically. Are you still helping them, even if they aren't compliant? Yes.

Every single person that I know who burned out/quit/did something else should not have gone to medical school in the first place. They had unrealistic expectations of something. None of them went into medicine to "help people". They went into it for the money, the prestige, the job security, the "science", the "tech" etc. Is there a lot of bureaucratic nonsense in medicine? Absolutely, just like any other job. But, medicine offers unparalleled opportunity to make a direct impact on people's health and lives. It certainly doesn't have to be the only motivator, but if it isn't one of main ones, there is no reason to go into medicine.

Agree with a lot of this. The hypothetical numbers were based on the areas of medicine, region & practice settings I've been exposed to so far, not any actual data, so I can see how they would be highly variable for everyone else. Also, I was intending to look at a more big-picture definition of "helping people" including social/emotional/financial aspects beyond the physical/therapeutic effects (which on a fundamental level, as you mentioned, have to be one of the motivators for any provider). As you and others have mentioned and I tried to convey, it really all boils down to your expectations of "helping" & ability to manage the nonsense.

 

[dienekes88]

Which is basically what I left for interpretation in my next post but ok

Slight difference. You say anything can be a "right reason."

My point is that the reason changes as you mature. It is what you need it to be for the time. The reason will be different for a pre-med than for a senior resident, and anecdotally people seem to change in similar ways.

 

[cbrons]

The med students who went into it thinking they were gunna save the world (ignorant leftist children) get hit the hardest come disillusionment.

 

[WingedOx]

The med students who went into it thinking they were gunna save the world (ignorant leftist children) get hit the hardest come disillusionment.

Perhaps you should actually be in practice for more than (negative) a few years before deciding who is or isn't going to burn out.

 

[ohioguy]

OP, I was so much more motivated before med school. Hoping to find a specialty where I won't feel like some very qualified drug Pez dispenser.

 

[cbrons]

Perhaps you should actually be in practice for more than (negative) a few years before deciding who is or isn't going to burn out.

Well we're talking about med school right now.

 

[Psai]

Perhaps you should actually be in practice for more than (negative) a few years before deciding who is or isn't going to burn out.

Bro this is the allopathic section, most of us here have been in practice for negative a few years