Disliked primary care shadowing - stay away from medicine?

[jb94mg]

I finally got some shadowing experience this summer, after having already taken most of the pre-reqs for medical school; and to be honest, I was not that excited about it. I guess as a pre-med, you have this abstract, idealized version of medicine, and then, once you get into the real world and get a sense of what it's really like, you realize the two are pretty disparate.

I guess a saw a lot of routine stuff, a lot of aches and pains being complained about, people who were overweight, wanting pain meds/medicine refills, or who had strange back pain, and so on. It wasn't really all that exciting to be around and it made me think, "Man, is this really what I want to do? Is this work sacrificing years and tons of time?" And the doctors I shadowed were basically on their EMR nonstop. I thought that that seemed like a huge nuisance; it was all day and even continued through patient visits. Both claimed they worked 60 hours per week, which is way more than I'd prefer to work. If that's what a career in medicine takes, I'd rather be a physical therapist or pharmacist or something more relaxed. Also, most of what they did seemed like piecemeal medicine, aimed at improving people's pain in small ways, or at keeping pain at bay, rather than fixing what the cause of the pain probably actually is (e.g. being weak and overweight). Helping people, knowing a fascinating subject well, and being respected for your knowledge is nice, but that's about all that seemed nice about it.

This, on top of already having a few worries about my suitability for medical school/being a doctor, pretty much put the nail in the coffin for me. Is that silly? Should I shadow specialists? Psychiatry and radiology seem like they'd at least be more abstract and not involve as much poking and prodding of people who're complaining about this or that problem, but I don't know that it makes sense to go to medical school with only two specialties in mind as good options. And I know very little about pathology. I find the sciences very interesting, but the clinical side seems like it would be a drag possibly. The bad part about it is that no other career seems as interesting to me subject-wise.

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[Toutie]

This is exactly why they want you to shadow...especially a primary care doctor....to see what their day is really like. It's not exciting and glamorous. You might want to shadow a few specialists and see if you feel the same about what they do on a day to day basis. You might also want to shadow a physical therapist and a pharmacist while you're at it.

 

[theonlytycrane]

Maybe not "stay away", but strongly consider pharm or PT?

 

[Eagleye2]

I felt similar to the way you are feeling. Its ok to question your career path because as a doctor, you will be sacrificing years and alot of money to do it. I still sometimes question it. Its okay. In my case, shadowing specialists (surgeons and cardiologist) were more interesting to me which made me feel better about the profession. I would give a specialist a shot then reevaluate.

 

[emkayveedee]

Shadowing is a relatively dull experience in general, IMO. Lots of medical students and physicians did not enjoy primary care. Shadow specialists and if you don't enjoy it then re-evaluate.

 

[efle]

Medicine is pretty vast in the different kinds of day-to-day work different people end up doing. General practice vs specialist can look very different, some people do procedures all day and some never do procedures, some people even spend lots of time on research or teaching. I'd try shadowing some other kinds of MDs and see how you feel about those.

 

[The Knife & Gun Club]

My $0.02 is that if you go into medicine you need to be OK with the idea of going into PC. You don't have to love it, but you need to understand it's a possible outcome. Most students are able to specialize if they want, but not 100%.

Maybe try to get some shadowing with an anesthesiologist, ER doc, or even just a hospitalist (inpatient IM). See if there's other areas of medicine you like.

Personally I despise primary care, but I went to med school anyway because I'm OK with taking that risk if it means having a shot at some of the other specialties I really liked.

 

[Mad Jack]

I finally got some shadowing experience this summer, after having already taken most of the pre-reqs for medical school; and to be honest, I was not that excited about it. I guess as a pre-med, you have this abstract, idealized version of medicine, and then, once you get into the real world and get a sense of what it's really like, you realize the two are pretty disparate.

I guess a saw a lot of routine stuff, a lot of aches and pains being complained about, people who were overweight, wanting pain meds/medicine refills, or who had strange back pain, and so on. It wasn't really all that exciting to be around and it made me think, "Man, is this really what I want to do? Is this work sacrificing years and tons of time?" And the doctors I shadowed were basically on their EMR nonstop. I thought that that seemed like a huge nuisance; it was all day and even continued through patient visits. Both claimed they worked 60 hours per week, which is way more than I'd prefer to work. If that's what a career medicine takes, I'd rather be a physical therapist or pharmacist or something more relaxed. Also, most of what they did seemed like piecemeal medicine, aimed at improving people's pain in small ways, or at keeping pain at bay, rather than fixing what the cause of the pain probably actually is (e.g. being weak and overweight). Helping people, knowing a fascinating subject well, and being respected for your knowledge is nice, but that's about all that seemed nice about it.

This, on top of already having a few worries about my suitability for medical school/being a doctor, pretty much put the nail in the coffin for me. Is that silly? Should I shadow specialists? Psychiatry and radiology seem like they'd at least be more abstract and not involve as much poking and prodding of people who're complaining about this or that problem, but I don't know that it makes sense to go to medical school with only two specialties in mind as good options. And I know very little about pathology. I find the sciences very interesting, but the clinical side seems like it would be a drag possibly. The bad part about it is that no other career seems as interesting to me subject-wise.

The day to day in medicine generally sucks regardless of specialty. There are different things that can bring enjoyment to your day that different specialties provide, but 30-50% of your day is going to be paperwork and reviewing labs/charts, 10-20% will be seeing patients, and 30-40% will be coordinating tests and care and the like, with maybe a procedure thrown in here and there. In procedure-heavy specialties, you're looking at more procedure time, but even many of the surgeons I rotated with on surgery spend maybe 15-25 hours actually operating, the rest is consults, waiting for rooms to turn over, paperwork, outpatient workups, etc...

 

[The Knife & Gun Club]

The day to day in medicine generally sucks regardless of specialty. There are different things that can bring enjoyment to your day that different specialties provide, but 30-50% of your day is going to be paperwork and reviewing labs/charts, 10-20% will be seeing patients, and 30-40% will be coordinating tests and care and the like, with maybe a procedure thrown in here and there. In procedure-heavy specialties, you're looking at more procedure time, but even many of the surgeons I rotated with on surgery spend maybe 15-25 hours actually operating, the rest is consults, waiting for rooms to turn over, paperwork, outpatient workups, etc...

Would point out though most well paying jobs involve doing stuff you hate for 50-100% of the work day.

Only person I know who both makes bank and loves 100% of his job is a guy Who runs a big cat dentistry practice. Turns out that's actually a super in demand field

 

[efle]

The day to day in medicine generally sucks regardless of specialty. There are different things that can bring enjoyment to your day that different specialties provide, but 30-50% of your day is going to be paperwork and reviewing labs/charts, 10-20% will be seeing patients, and 30-40% will be coordinating tests and care and the like, with maybe a procedure thrown in here and there. In procedure-heavy specialties, you're looking at more procedure time, but even many of the surgeons I rotated with on surgery spend maybe 15-25 hours actually operating, the rest is consults, waiting for rooms to turn over, paperwork, outpatient workups, etc...

The interventional gastro guys I worked for would be solidly back-to-back ERCPs/EGDs/colons all throughout the day when they were in the procedure room, like majority of the time a scope was in their hands. They had academic days and non-procedure office days too but at least a few days per week were all about procedures.

Maybe GI is outlying there though, I haven't seen what a week looks like for something like ENT or ortho or ophtho

 

[jb94mg]

The day to day in medicine generally sucks regardless of specialty. There are different things that can bring enjoyment to your day that different specialties provide, but 30-50% of your day is going to be paperwork and reviewing labs/charts, 10-20% will be seeing patients, and 30-40% will be coordinating tests and care and the like, with maybe a procedure thrown in here and there. In procedure-heavy specialties, you're looking at more procedure time, but even many of the surgeons I rotated with on surgery spend maybe 15-25 hours actually operating, the rest is consults, waiting for rooms to turn over, paperwork, outpatient workups, etc...

Can you at least work regular hours?? If you combine the mundanity with having to work 50+ hours per week, stay on call, work on holidays, etc., it seems really stressful. Not interested in dentistry at all, though. Way too procedural and mouth based.

 

[Mad Jack]

Would point out though most well paying jobs involve doing stuff you hate for 50-100% of the work day.

Only person I know who both makes bank and loves 100% of his job is a guy Who runs a big cat dentistry practice. Turns out that's actually a super in demand field

My girlfriend loves what she does. She works at a freaking paint bar, gets paid to teach happy drunks how to make things on canvas like she's Bob Ross. Totally jelly of her career satisfaction, but I'm hoping to have a carefully built practice that makes me happy 80% of the time down the line.

 

[Mad Jack]

The interventional gastro guys I worked for would be solidly back-to-back ERCPs/EGDs/colons all throughout the day when they were in the procedure room, like majority of the time a scope was in their hands. They had academic days and non-procedure office days too but at least a few days per week were all about procedures.

Maybe GI is outlying there though, I haven't seen what a week looks like for something like ENT or ortho or ophtho

But that's the thing- the GI guys I know spend 5 out of 10 days in the procedure room, and even during those days, there's charting to be done and room turnover time. That's still probably only 35% procedure time overall.

 

[Mad Jack]

Can you at least work regular hours?? If you combine the mundanity with having to work 50+ hours per week, stay on call, work on holidays, etc., it seems really stressful. Not interested in dentistry at all, though. Way too procedural and mouth based.

Depends on your field. Most of the people I know in primary care work 4 days a week, 10-12 hours per day, plus a little charting here and there, probably 45-50 hours a week with three days in a row off every week, no weekends, and no holidays. In outpatient medicine, that is very doable.

 

[bannie22]

Can you at least work regular hours?? If you combine the mundanity with having to work 50+ hours per week, stay on call, work on holidays, etc., it seems really stressful. Not interested in dentistry at all, though. Way too procedural and mouth based.

Dang. How disassociated I have been from reality.

When I glanced 50 I thought. Wow such great hours. And took a step back and recognized that 50hours is way over the average.

Lol. You would be lucky to work 50 hours. I hope I work 60...

 

[Dandine]

@jb94mg When you say no other field is more interesting subject-wise, what are you thinking of, just curious? Is it the healthcare aspect of things or the sciences involved that you're interested in?

Reaction aside, it's a good thing you shadowed this now rather than later. Definitely would recommend shadowing in other specialties you're interested in now that you have some primary care down, as well as PT and pharm.

The "piecemeal medicine" idea is actually a pretty common reason why people decide not to go into medicine (hence why some people prefer to go into medical research so they can find cures based on known mechanisms). I'd argue though that medicine is as much about understanding the best way to treat someone from multiple levels rather than just from a mechanistic level (for example, if a patient can't take this treatment for X reason, what is the next best thing to do or recommend and how can I work with a patient and his/her family if they are confused about how to manage the condition and what treatment options are available).

Basically, it is expected that while there are known cures for things, there are not always easy cures, or easy ways of providing the cures, or managing the best that can be done if there isn't a cure at all. And it's the physician's job to take into account all that. Just giving some perspective as that, I think, is what a lot of people go into medicine for: not necessarily for just cures (although there are many fields that work with very known cures, infectious disease is one of them) but for taking the time to help someone in that way. Obviously it's not for everyone and it's a really long path for this sort of career, so it's good that you're being mindful of what works and doesn't work for you in terms of the medical field.

Also, it's almost guaranteed that you will find another specialty interesting once in medical school, so even if you have ideas now, that's fine; the exposure is what will help you decide on specialty.

 

[jb94mg]

@jb94mg When you say no other field is more interesting subject-wise, what are you thinking of, just curious? Is it the healthcare aspect of things or the sciences involved that you're interested in?

Reaction aside, it's a good thing you shadowed this now rather than later. Definitely would recommend shadowing in other specialties you're interested in now that you have some primary care down, as well as PT and pharm.

The "piecemeal medicine" idea is actually a pretty common reason why people decide not to go into medicine (hence why some people prefer to go into medical research so they can find cures based on known mechanisms). I'd argue though that medicine is as much about understanding the best way to treat someone from multiple levels rather than just from a mechanistic level (for example, if a patient can't take this treatment for X reason, what is the next best thing to do or recommend and how can I work with a patient and his/her family if they are confused about how to manage the condition and what treatment options are available).

Basically, it is expected that while there are known cures for things, there are not always easy cures, or easy ways of providing the cures, or managing the best that can be done if there isn't a cure at all. And it's the physician's job to take into account all that. Just giving some perspective as that, I think, is what a lot of people go into medicine for: not necessarily for just cures (although there are many fields that work with very known cures, infectious disease is one of them) but for taking the time to help someone in that way. Obviously it's not for everyone and it's a really long path for this sort of career, so it's good that you're being mindful of what works and doesn't work for you in terms of the medical field.

Also, it's almost guaranteed that you will find another specialty interesting once in medical school, so even if you have ideas now, that's fine; the exposure is what will help you decide on specialty.

By other fields I meant careers like accounting and law. Accounting seems particularly dreadful. Law might be good if I could do well enough on the LSAT to get a full-tuition scholarship from a T14. The material would be less interesting, and perhaps I would end up hating my colleagues, but at least I wouldn't be a doctor in a specialty they hate. Physical therapy seems to require a lot of small talk and group interaction, which I don't like; and debt would be a concern given the average salary of a PT. Pharmacy seems like it could be a good choice, but I'm not sure what the job market's like.

I see what you're saying. I agree with that. Often it's a matter of doing what you can to help rather than thinking there's a panacea for anyone's situation. Also, because people have free will there is no way to just make someone's health perfect. Their own free choices can sabotage their health, making perfection impossible.

 

[raiderette]

If you were not so averse to long hours, I would recommend computer work. There is not the security, but you rely on your skills, earn for your worth and it isn't routine. All medicine will be fairly routine, whether in primary care or as a specialist. I guess the trick is to find a patient base that you prefer, choose inpatient, outpatient or a mix and dedicate the next 7-12 years to it.

 

[TypeADissection]

It's OK not to like primary care. I spent zero time in primary care before med school as all my mentors were cardiac or vascular surgeons. Didn't play the game and lie about it either during my interviews when I clearly stated that I never knew that there was anything outside of medicine other than surgery. The reality is, medicine kind of blows as a whole. It's not glamorous and there's a lot of work to be done. Do a thorough self-assessment and see if the journey is worth the price because there will be profound costs to the prime years of your life slaving away in a library or hospital while your non-medical peers have BBQs and play golf. This isn't in any way to dissuade you from medicine at all, but rather to really weigh out whether or not it's worth it to you. I love what I do and wouldn't do anything else and I'd like to think that some admissions committee members many years ago could see that even though I wasn't primary care oriented, I was definitely determined and committed to become the best I could be.