Doubts about medicine; need help with considering other healthcare fields. All opinions appreciated

Kurk

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I'll try to get my points across quickly as I tend to ramble.

I think I'm being deterred from medicine mainly because of the rise of socialized healthcare. I know for a fact from healthcare workers in my family and from the outside that primary care physicians are being forced to see more patients in a smaller amount of time because of low medicaid payouts.

To me, one-on-one time with the patient is probably the most important aspect of being a physician.
I watch a few medical channels on YouTube in my free-time, one of which is Auburn Medical Group. It gives me a warm feeling to see the physician-patient interaction (yes I know it is a little falsified on Youtube) at play. This is probably one of the most, if not, the most rewarding aspect of practicing medicine in my opinion.

If it gets to the point where doctors are treating patients more like numbers and are concerned about red tape more than the personal needs of patients, I don't think I should seriously continue down this path as it would probably lead to great misery in the future for me.

This leads me to my next point concerning the future of private-practice.

I really enjoy the idea of eventually having the opportunity to open up your own clinic as a physician in whichever specialty you choose. I consider myself to be somewhat of a "natural businessman" in a way and believe that small-businesses are imperative in shaping positive communities on the local level. It would be great to also be able to give back to the community within the realm of business. Again, it is to my understanding that low payouts are making it difficult for private-practitioners to stay in business.

My third concern is the loss of respect and status for physicians in general.

I sometimes read older American like plays. It humbles me to see how doctors were portrayed in literature from a different era. Docs were greatly respected for what they did and were treated with respect for being intelligent and hard-working. Today I rarely see this outside of smaller, conservative, mid-west communities. I think it's ridiculous that people are trying to put physicians on the same level as your average 9-5 worker in terms of "at the end of the day it's still a job" because it isn't. Literally no other profession requires the same amount of financial, emotional, physical, and time sacrifice as a physician. There is no way in hell that I'm going into this with my self-confidence intact if in the end I'm going to be treated like some pawn by a hospital administrator with a B.A in business. No amount of personal altruism will supersede this.

Phew! that was long enough. Unfortunately there is some more to read.

I am considering a career in another health-care field like:

Dentistry
Optometry
Podiatry
Pharmacy

I have not ruled out medicine, and I will not until I shadow a doctor, but in the meantime I'd like to get a preliminary feeling for what I think best fits me.

Here is what I'm looking for in a career:

- It needs to be mentally stimulating
It's always nice to have periods of repetition when you need it, but I don't like being on auto-pilot all the time if you know what I mean. In a way, it needs to be stressful. I actually like stress; but I know my body doesn't. It scares me to think that I could develop health problems due to being constantly stressed so a good mix is a plus.

- It needs to provide a good income per hour
I need 6 figures; preferably 120k+ at the least by mid 30s. What's more important is having a decent amount of time for hobbies and investing the capital I've earned.

- Lifestyle
This is where the problems lie. I don't mind working 80+ hours a week and having short-term sleep-deprivation if I know a desirable future in achievable. If the future means constantly work all the time and make a lot of money to give to your family, I'm not interested. I know some physicians are in the mindset of being extremely family orientated and don't mind not having a life in the name of giving their family money. This is not me at all. I'm focused around my person in my free-time. I love to work and would never retire. In order to do this I have to stay in great physical shape. This means being able to go to the gym and having enough time to do some food shopping. Don't take this like I'm saying I'm lazy or want to to work 9-5 because I don't. I would honestly love to work on holidays and overnight when needed. An inconsistent schedule is not a problem—I just need time to myself for my few, but important hobbies.

- Other things
I am very good with my hands; (forgive me if this is irrelevant) I played with Legos A LOT as a kid, like working on cars, and was pretty good with manual work in my Anatomy class (I know it's fodder in the grand scheme of things). This is why I am especially interested in dentistry and surgical specialties.

That's all I can remember right now.


Wow, you truly are someone for reading this entire post if you did. If not, you're still awesome for caring enough to leave an opinion. It doesn't matter if you're an adcom or highschool student; let me know what you think on some of the other healthcare options.

Thank you so much.
 

The Wobblie

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It needs to provide a good income per hour
I need 6 figures; preferably 120k+ at the least by mid 30s. What's more important is having a decent amount of time for hobbies and investing the capital I've earned.
Please stay as far away from health care as a career as you can.
 
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Kurk

Kurk

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Please stay as far away from health care as a career as you can.
So even pharmacists, optometrists, general dentists with essentially 9-5 job hours have no life too?
 

efle

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Please stay as far away from health care as a career as you can.
Oh come on. If medicine paid below 100k per year, do you think it would be hard to get into medical school? If things like engineering and basic science PhDs guaranteed a comparable income to medicine, most of your classmates probably wouldn't have been your classmates.

I'll try to get my points across quickly as I tend to ramble.

I think I'm being deterred from medicine mainly because of the rise of socialized healthcare. I know for a fact from healthcare workers in my family and from the outside that primary care physicians are being forced to see more patients in a smaller amount of time because of low medicaid payouts.

To me, one-on-one time with the patient is probably the most important aspect of being a physician.
I watch a few medical channels on YouTube in my free-time, one of which is Auburn Medical Group. It gives me a warm feeling to see the physician-patient interaction (yes I know it is a little falsified on Youtube) at play. This is probably one of the most, if not, the most rewarding aspect of practicing medicine in my opinion.

If it gets to the point where doctors are treating patients more like numbers and are concerned about red tape more than the personal needs of patients, I don't think I should seriously continue down this path as it would probably lead to great misery in the future for me.

This leads me to my next point concerning the future of private-practice.

I really enjoy the idea of eventually having the opportunity to open up your own clinic as a physician in whichever specialty you choose. I consider myself to be somewhat of a "natural businessman" in a way and believe that small-businesses are imperative in shaping positive communities on the local level. It would be great to also be able to give back to the community within the realm of business. Again, it is to my understanding that low payouts are making it difficult for private-practitioners to stay in business.

My third concern is the loss of respect and status for physicians in general.

I sometimes read older American like plays. It humbles me to see how doctors were portrayed in literature from a different era. Docs were greatly respected for what they did and were treated with respect for being intelligent and hard-working. Today I rarely see this outside of smaller, conservative, mid-west communities. I think it's ridiculous that people are trying to put physicians on the same level as your average 9-5 worker in terms of "at the end of the day it's still a job" because it isn't. Literally no other profession requires the same amount of financial, emotional, physical, and time sacrifice as a physician. There is no way in hell that I'm going into this with my self-confidence intact if in the end I'm going to be treated like some pawn by a hospital administrator with a B.A in business. No amount of personal altruism will supersede this.

Phew! that was long enough. Unfortunately there is some more to read.

I am considering a career in another health-care field like:

Dentistry
Optometry
Podiatry
Pharmacy

I have not ruled out medicine, and I will not until I shadow a doctor, but in the meantime I'd like to get a preliminary feeling for what I think best fits me.

Here is what I'm looking for in a career:

- It needs to be mentally stimulating
It's always nice to have periods of repetition when you need it, but I don't like being on auto-pilot all the time if you know what I mean. In a way, it needs to be stressful. I actually like stress; but I know my body doesn't. It scares me to think that I could develop health problems due to being constantly stressed so a good mix is a plus.

- It needs to provide a good income per hour
I need 6 figures; preferably 120k+ at the least by mid 30s. What's more important is having a decent amount of time for hobbies and investing the capital I've earned.

- Lifestyle
This is where the problems lie. I don't mind working 80+ hours a week and having short-term sleep-deprivation if I know a desirable future in achievable. If the future means constantly work all the time and make a lot of money to give to your family, I'm not interested. I know some physicians are in the mindset of being extremely family orientated and don't mind not having a life in the name of giving their family money. This is not me at all. I'm focused around my person in my free-time. I love to work and would never retire. In order to do this I have to stay in great physical shape. This means being able to go to the gym and having enough time to do some food shopping. Don't take this like I'm saying I'm lazy or want to to work 9-5 because I don't. I would honestly love to work on holidays and overnight when needed. An inconsistent schedule is not a problem—I just need time to myself for my few, but important hobbies.

- Other things
I am very good with my hands; (forgive me if this is irrelevant) I played with Legos A LOT as a kid, like working on cars, and was pretty good with manual work in my Anatomy class (I know it's fodder in the grand scheme of things). This is why I am especially interested in dentistry and surgical specialties.

That's all I can remember right now.


Wow, you truly are someone for reading this entire post if you did. If not, you're still awesome for caring enough to leave an opinion. It doesn't matter if you're an adcom or highschool student; let me know what you think on some of the other healthcare options.

Thank you so much.
The people complaining about the end of private practice, and everyone working for big hospitals, aren't out in small towns in the midwest. If you're willing to live in that setting, there will be a need for private practice GPs in small communities for longer than the next decade before you'd get to practicing. Medicine is mentally stimulating compared to most careers. It pays well. It doesn't require 80+ hours outside of residency; the most common bracket is 40-50 hours per week. Surgery doesn't fit well with small midwestern USA private practice, so if you're really interested in specializing in that direction, best make peace with big city hospital bureaucracy.
 

The Wobblie

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So even pharmacists, optometrists, general dentists with essentially 9-5 job hours have no life too?
I'm merely addressing the "need" in your post. It reeks of entitlement. You don't "need" 100k per year. You want 100k per year.

Because you're just a high school student, I'll give you the benefit of the doubt. As you get older, you'll realize many things, and I hope that you realize this: You are entitled to NOTHING.

It does not matter how hard you think you work or how much you sacrifice. There are many things outside of your control. If you think that if you pursue medicine you are owed a certain income or lifestyle, you are in for a rude awakening.

I think it's better for you (and us) if you choose to pursue some other venture where it would be easier for you to earn a decent living with less work.

Oh come on. If medicine paid below 100k per year, do you think it would be hard to get into medical school? If things like engineering and basic science PhDs guaranteed a comparable income to medicine, most of your classmates probably wouldn't have been your classmates.


The people complaining about the end of private practice, and everyone working for big hospitals, aren't out in small towns in the midwest. If you're willing to live in that setting, there will be a need for private practice GPs in small communities for longer than the next decade before you'd get to practicing. Medicine is mentally stimulating compared to most careers. It pays well. It doesn't require 80+ hours outside of residency; the most common bracket is 40-50 hours per week. Surgery doesn't fit well with small midwestern USA private practice, so if you're really interested in specializing in that direction, best make peace with big city hospital bureaucracy.
Thank you for your input on the state of the health care industry, Mr. Premed.

I'm a resident, farther along the pipeline than you are (and possible will ever be, if you even make it that far) and even I can't make the predictions or prognostications that you're making.

Come back if you make to college, medical school, residency, and practice.
 
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efle

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I'm merely addressing the "need" in your post. It reeks of entitlement. You don't "need" 100k per year. You want 100k per year.

Because you're just a high school student, I'll give you the benefit of the doubt. As you get older, you'll realize many things, and I hope that you realize this: You are entitled to NOTHING.

It does not matter how hard you think you work or how much you sacrifice. There are many things outside of your control. If you think that if you pursue medicine you are owed a certain income or lifestyle, you are in for a rude awakening.

I think it's better for you (and us) if you choose to pursue some other venture where it would be easier for you to earn a decent living with less work.



Thank you for your input on the state of the health care industry, Mr. Premed.

I'm a resident, farther along the pipeline than you are (and possible will ever be, if you even make it that far) and even I can't make the predictions or prognostications that you're making.

Come back if you make to college, medical school, residency, and practice.
At what point in the medical education did they teach you the motives of all your classmates? Several good friends of mine went straight in instead of gapping. Maybe I have a weird sample set, but almost all of them would not have done it for income only meeting the "need" level.

There are programs trying to get people to go out and provide primary care to small communities no? Again I don't think getting accepted is going to change the existence of underserved areas, but I guess I'll keep you posted.

If I can find some posts by attendings more in line with my reasoning than yours, are you auto-refuted until at least finishing reasidency?
 
OP
Kurk

Kurk

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I'm merely addressing the "need" in your post. It reeks of entitlement. You don't "need" 100k per year. You want 100k per year.

Because you're just a high school student, I'll give you the benefit of the doubt. As you get older, you'll realize many things, and I hope that you realize this: You are entitled to NOTHING.

It does not matter how hard you think you work or how much you sacrifice. There are many things outside of your control. If you think that if you pursue medicine you are owed a certain income or lifestyle, you are in for a rude awakening.

I think it's better for you (and us) if you choose to pursue some other venture where it would be easier for you to earn a decent living with less work.



Thank you for your input on the state of the health care industry, Mr. Premed.

I'm a resident, farther along the pipeline than you are (and possible will ever be, if you even make it that far) and even I can't make the predictions or prognostications that you're making.

Come back if you make to college, medical school, residency, and practice.
I was hoping that we could focus on the big picture here rather than semantics but since you bring it up I will say that I would rather go into research or academics if I knew I would be making less than six figures a year. It doesn't make sense to invest so much and get very little in return and honestly I could make a bigger impact on a community with money at a certain point than purely one-on-one interaction. You are correct; I want 100,000 a year. I am not entitled to anything and things are outside of my control. I'm a skinflint right now and don't have a problem with living like one for the future if necessary; I have a problem with being taken advantage of.
 

efle

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I would rather go into research or academics
But...this still requires 6+ years of PhD and post-doc work to struggle to find a tenure track opportunity and clear the 100k mark anyways. What makes it preferable?

And anyways, you've already posted threads asking about what would happen if we saw physician income decline to say 80k and had relevant responses from other docs:

Let's say the average pay for primary care physicians was cut down to $80,000 (this is about the median salary in Europe for PCPs).
There is no physician shortage. There is a distribution issue with two few doctors in some parts of the country and gluts in the big popular cities.
Market forces have already dictated what doctors need to earn to get some of the best and brightest go through all the required training, and we are in fact finding that it's probably actually not enough to get people to move to certain underserved parts of the country as is.
80k is less than I made with my Associate's degree- why the hell would I have cost myself one million dollars in tuition and opportunity cost to make the same amount after 8 years of hell?
Someone even expressed the "don't consider money" ideal there:
If you wouldn't become a physician if the healthcare system changed, don't become a physician with the current system. Become a doctor if this is what you want to do.
That's a rather shortsighted thing to say. People should do what fits the three big vectors in regard to employment- what gets them the best balance of what they can stand or enjoy doing, what they're good at, and what makes them enough money to suit their needs.
I mean, if physician pay were to theoretically decline to 80k, I'd be making 50k post-tax. Professional dues eat up another 3k/year. My minimum loan payments are $31,608/year (unless I go with IBR, in which case I'll have a multi-million dollar tax bomb at the end which will wipe out my life's savings right before retirement). That leaves me with just over 15k a year post-tax to live on- I wouldn't do ANY job for that low of pay, let alone one that involves the stress, training time, and liability of being a physician. Wanting to take care of others doesn't mean one should be willing to financially ruin themselves for the rest of their lives to do so.
I mean, perhaps a premed quoting other docs comes in somewhere below a resident on the infallibility hierarchy, I dunno. This has already been discussed enough on the boards to judge with some searching!
 
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Kurk

Kurk

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But...this still requires 6+ years of PhD and post-doc work to struggle to find a tenure track opportunity and clear the 100k mark anyways. What makes it preferable?
I was thinking along the lines of medical researcher. Yes it's not amazing money but provides better schedules for the most part and less stress.
 

efle

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I was thinking along the lines of medical researcher. Yes it's not amazing money but provides better schedules for the most part and less stress.
Is this your impression from a parent that works the job or something? The PIs I've worked with/for have generally described the researcher track as quite stressful, pressure to get out something big and important when you're young to be competitive for PI positions or else be stranded as a staff scientist for decades, pressure to fight constantly for grant money to keep your funding safe once you're there. Working on weekends or past 5 is very common still.

Many of the alternative careers people mention are not as much greener as they sound at first. Law school - high unemployment rates, terrible workload in your junior years when you do land a job. Consulting or finance - again, insane work hours, easily dropping 60 hour weeks for ~80k at the beginning. Startups/business, yeah you might be able to get rich and retire at 35, or you might spend years on a series of failed ventures despite being smart and hardworking.

I think you have a pretty skewed view of the medical workload, if you're the same person that often talks about 70-80 hour workweeks. There are some specialties that will make you work a lot (still rarely 70+ hours) but the range is absolutely huge. Some of the less intense specialties are notoriously hard to get into (Derm the famous lifestyle example) but there are also more accessible things like emergency medicine, or very accessible things like psychiatry, where working 45 hours/week doesn't make you some low outlier.
 
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jeffk805dent

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Some of the less intense specialties are notoriously hard to get into (Derm the famous lifestyle example) but there are also more accessible things like emergency medicine, or very accessible things like psychiatry, where working 45 hours/week doesn't make you some low outlier.
but dont EM docs working 32-36 hours be the equivalent to working 52-60 hours in a regular schedule? While psychiatry has the best overall balance of pay and hours imo, a person really needs to like dealing with mental health patients.
 

efle

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What about dentistry?
What about it? If teeth interest you and you'd feel it was fulfilling work, go for it. Hell, you can make great money in all sorts of non-MD roles. Nurse anesthetists make north of 6 figures last I checked, as do most podiatrists and a good number of veterinarians.
 

efle

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I guess, I've never been in an EM's shoes. But some EM docs I've talked to say the shift work of an EM is the equivalent of a family/internal medicine physician working 60 hours
I guess it depends what they mean, like number of patients seen per week? Compared to FM they work something like 4-8 hours less per week in terms of time
 
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The Wobblie

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If I can find some posts by attendings more in line with my reasoning than yours, are you auto-refuted until at least finishing reasidency?
No.

My experiences will always trump what you can "quote" someone else saying. Until you have experienced it for yourself, your argument is meaningless. Again, once you get to college, medical school, residency, and being an attending (because if you make that far, my post graduate training will have long ended), then we can have a discussion on where health care is going. Until then, it's best to just listen.

OP, I realize I have in the past given you a lot of heartache and you've still remained polite. I commend you for that.

Part of the reason, and this isn't an excuse, is that I feel you and I come from different parts of the political spectrum. I just get annoyed when you post videos about Mike Huckabee, or complain about "socialized medicine" (many attendings on SDN are unable to define let alone discern the difference between the different types of health care systems, so at least we know that that's one thing they don't teach you in med school, residency, or practice). I feel a little more research on health care policy is necessary. You don't get that in med school and if you do, it can be very biased. I know: this was my experience in medical school. I had a background in research and public health and public policy before medical school so I knew what resources were better on the subject of health care reform.

I am of the opinion that most of what's written about health care reform and universal health care from the conservative side of the political spectrum is fear-mongering propaganda that is devoid of facts.

It's one thing to say that you want get the best education that you can and earn a decent living. I can't blame you for that; hell, that's what I want. It's quite another to say you "need" an income above an arbitrary amount. You shouldn't pick a career based upon an income you don't know you'll have. Rather, you should pick one where you can get the most personal satisfaction from your day-to-day activities.

If it's an income and a lifestyle you're looking for, then medicine (or dentistry) isn't for you. Health care professions are a lot of work where the "payoff" is very much delayed. Even if you start early. And the money is good, but it's not the profession you want if you want to get rich. Getting rich is for hedge fund managers and investment bankers.
 

efle

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My experiences will always trump what you can "quote" someone else saying. Until you have experienced it for yourself, your argument is meaningless.
But, it's not my argument. It's another physician describing what 80k would mean in their own words. I was joking above with my comment about the infallibility hierarchy, but I guess it really works that way in your head.

I'm not a highschooler like OP. I have experienced working full time under student debt that is massive relative to my income. You could say I don't need to make more than I do, I suppose, but only in the sense that I don't need to own my own home or a car or have money for a family to live comfortably, kids attend college, pay off my debt at a reasonable rate with something left over etc. I really enjoy the day-to-day of my job in a clinic right now, but it's not conducive to moving past a frugal existence splitting rent in a small apartment. Telling a highschool kid the only thing to consider is "personal satisfaction from day-to-day" or that they can't know they'll be paid well with an MD is just bad advice. Even in the lower paying states and lower paying specialties, you can "know" far better than other career options that you'll be breaking six figures if you're anywhere near the average.

Happy to back that up with BLS data, btw, though I'm sure being delivered by a premed would invalidate it.
 

Mad Jack

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In terms of what, stress?
Stress and output. You're constantly moving and seeing patients in EM, so you'll deal with more patients and do more procedures in 36 hours than most physicians do in 54 hours. Yeah, you're working less hours, but you're working way harder unless you're in some backwater place in the sticks.
 

Mad Jack

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In respect to medicine...
I stand by my statement. When you're fighting for funding dollars, every day you have to work under the stress of potentially losing your job if you can't produce results. And once you're out of a funded position, the longer you go until you pick up another one, the harder it becomes to get funding. Constantly breaking new scientific ground isn't easy, and knowing that, if you fail to do so, you're going to take a serious hit to your income is a tough burden to bear. Most researchers that are not tenured put in 60-80 hour weeks to try and fight for a tenure-track position, and those that aren't tenured often make very little until they can prove to be productive (which requires long hours and a lot of hoping and praying). Never in my life would I want the existence of a researcher, it is objectively awful unless you love it.
 
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Kurk

Kurk

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Responses so far:
- Don't do dentistry or medicine b/c I said so


...and that's it. :/
 
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Mongoosie

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Alright,
Dentistry - It's a fine career, but do you really see yourself saying "the reason for why your gums are bleeding is because you aren't flossing" for the rest of your life? If so fine.
Podiatry - You can make good money, it just seems like an incredibly limiting career. However someone like @Foot Fetish might truly enjoy it.
Pharmacy - Again you can make good money, not anything too grand though. Also can't help feeling that it would get incredibly tedious after a while(your opinion may differ)
Optometry - Idk man, kind of like podiatry in that it's kind of limiting but with less money. Maybe you'd like doing eye exams and all that though?
 
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Goro

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You are so woefully ignorant about this, that it's hard to know where to begin. However, I'll take a stab at it: try lab technician.

I was thinking along the lines of medical researcher. Yes it's not amazing money but provides better schedules for the most part and less stress.
 

jeffk805dent

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Responses so far:
- Don't do dentistry or medicine b/c I said so


...and that's it. :/

fine, lets review dentistry

Whats to like

1. unlike medicine where your path isnt really determined until your 3rd/4th year, in dental school you will know what you be doing (spoiler alert its working on teeth)

2. 4 years (or 3 years if you're at UOP) and boom you're done

3. if you want to be a general dentist, grades dont matter (other than to pass to get your DMD/DDS), this puts less stress on the desire to do well to get the career (now if we're talking about being an oral surgeon, then your stress goes up by a factor of 4

4. assuming you do a good job, you get immediate satisfaction seeing your patient feel much better and thank you for it

5. owning your own business, I can determine what my hours can be like and hire office managers/dentist assistants/hygienists that I feel comfortable working with

6. For the hours worked, you get a good paycheck. Heck if I went back to CA, I could still make a an average living in a saturated area without having to burn myself out (good luck buying a house though)

7. Some diversity in the dental field itself, if you don’t want to be general dentist, no problem, if you can get good grades and test scores, oral surgery, endodontics pediatric dentistry, etc may be an option for you. There are currently 9 different specialties recognized by the ADA. http://www.ada.org/en/education-careers/careers-in-dentistry/dental-specialties/specialty-definitions


Whats not to like

1. If you go into dental school and you figure that working with patient’s dental care was not your thing, well you better suck it up or switch to another profession before the debt really piles up

2. Its hard to open up a dental school (though recent openings suggest otherwise), hence dental school why the dental school tuition is outrageously expensive. Dental school can range anywhere from $250k - $550k, so with interest rates its possible you can owe a total of $1 million over the course of your career.

3. Dental salaries are great but not that great. That becomes a big time factor, if you are married or have children that removes a significant chunk from your post-tax salary. This is complicated even more so when your ever increasing student loans take a chunk out of your post-tax paycheck. Long story short, after all the taxes and student loan payments, you don’t have as much as you would think to live a lifestyle like those folks on the Wolf of Wall Street. You could go to a rural area to fix that though.

4. Now about rural areas, a popular topic on SDN is that rural areas are the be all and end all prescription to handle student loan debt and earn a killing. Yes and No. While a dentist in some rural areas can make a killing ($350k for a general dentist), other areas the patient population is simply too poor and too careless with their dental hygiene to really check into a dentist’s office. This hurts both the dentist’s business and more importantly, hurts the patient’s being as well.

5. The public notion that a dentist is a greedy scum. Reading a dental board’s announcements on some probations and revocations due to shady practices and procedures, I can say to a tiny extent this is true. The funny part is, it’s not just the corporate dental offices but also some private practice dentists as well, despite a lot of complaints of corporate dental offices coming from private practice dentists. A patient gets mad when they go to the dentist’s office but they seem to be meh when it comes to visiting a family medicine practitioner (wait times might suck though).

6. Speaking of corporate dentistry, you’ll most likely be working for a corporate dental office unless you are one lucky soul that is taken by a private practice as an associate dentist. What’s not to like about a corporate dentistry, long story short – they make you work like a slave so bad that you wish you were back in dental school working on patients supported by faculty instead. I worked for Western Dental in Los Angeles once, lets just say I did some stuff that I wasn’t happy with and quit within a year (common to leave after a year of corporate dentistry btw)

7. Patient to dentistry ratio, whereas some physicians in a variety of specialties will always have patients coming regardless of the city, there might be cases depending where you live where patients may not come that often. I know of an orthodontist who had no patients come in a certain time period to the point where he simply just played on his computer while waiting for a patient to come in. This is more significant in cities where there are dental offices on every corner. Not everyone is going to have a root canal and cavity to fix.

8. In some of the more desirable places, a 1-year dental residency maybe required in order to work as a general dentist in those places. Considering a family medicine residency is 3 years, going to a residency for another 2 years is not a bad investment taking into account there is a lot more demand for family medicine physicians than a general dentist, in say New York City.

9. Back, neck and wrist pain. You are working on an area of the body no bigger than a tea cup which calls for excellent hand-eye coordination. You also need to work on this patient in a timely manner because 1.) the patient will hate you for keeping him/her forever and 2.) You got other patients waiting in the office needing to have their care dealt with. You may need braces for your wrist due to carpal tunnel syndrome. This condition occurs when repetitive motions and/or sustained postures damage tissues and cause swelling. There is a particular reason why dentists work no more than 32-40 hours and pain in these areas over time is a major reason.


I am sure there are other stuff that I failed to mention that other dentists will go over.
 
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Martian1

5+ Year Member
Sep 13, 2010
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You are so woefully ignorant about this, that it's hard to know where to begin. However, I'll take a stab at it: try lab technician.
OK, so let ME take a stab at this. I'll agree with Goro here, you are woefully ignorant. BUT I come from a different perspective. I'm a practicing internal medicine physician with almost 30 years in healthcare (almost 15 has an RN and the rest as a physician). So let me speak from EXPERIENCE and less data and conjecture: get out there and SHADOW!!! Shadow a LOT! Shadow pharmacists and RN's and CRNA's and podiatrists and dentists and ophthalmologists and physicians of all specialties...and not just during the DAY from 9-5...ask them about THEIR day and stay with them for the length of THEIR day, whether that's 0500- MN or 0800- 2300. And not just ONE day with each person but SEVERAL days with each person! When are you going to do this??? On the weekends, in the evenings, during your holiday breaks, in the summer. If you are really committed to figuring out what you want to do, you need to INVEST the TIME. Make some cold calls, show up, be diligent, interested, take notes, learn some medical terminology before you go and at the end of each day take a few minutes to write down your impressions of the day. NO ONE ELSE can tell you what is the right fit for YOU!!! YOU have to figure it out...and better to figure it out NOW before you rack up $$$ of debt and time chasing someone else's dream.
 

Goro

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Now that I'm finished cooking, I can better illuminate you.

To be a "medical researcher", you get a PhD. These take, on average five years. You get paid a stipend, and you had better work 50-60 hrs/week, including weekends and holidays if you really want to be good at your craft. More time than that means there's something wrong with your science. And you definitely can't work banker's hours.

Then you do a post-doctoral fellowship. The pay is better, maybe up to double what a grad student gets. These are about 3-4 year positions, but many post-docs do two of these before landing a full time permanent job. A post-doc is analogous to being a resident.

Then you try to get a faculty position. If you want that at any MD medical school in this country, or research facility, like Scripps, or major UG university, like Vandy or U WI, you better already have a grant. AND publications. Good ones.

Then you have six years to earn tenure. That means getting another grant, a major one, like an R01 (100K+) or two smaller ones, like R21s each (~50K+) +/- foundation grants, which are just as hard to get.

Fail to get tenure? Then you're out on your ass after one more year.

The odds of anyone getting a grant these days are from 5-20%. To get a grant, you gotta publish. Ever hear the term "publish or perish"? It's real.



I was thinking along the lines of medical researcher. Yes it's not amazing money but provides better schedules for the most part and less stress.
 
D

da8s0859q

I guess it depends what they mean, like number of patients seen per week? Compared to FM they work something like 4-8 hours less per week in terms of time
Stress and output. You're constantly moving and seeing patients in EM, so you'll deal with more patients and do more procedures in 36 hours than most physicians do in 54 hours. Yeah, you're working less hours, but you're working way harder unless you're in some backwater place in the sticks.
This.

We work, on average, fewer hours than most of the house of medicine. But the hours we work, save for low-volume departments, are not the same as others' hours. This isn't being elitist -- it's just that they are different.

And they are different.

There's an SDN aphorism of sorts which says that one hour of EM is like 1.5 hours in most other specialties (hat tip to you, @Birdstrike).

True.

- exi, friendly local neighborhood new EM attending who will now leave this thread to its original purpose
 
OP
Kurk

Kurk

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Feb 18, 2016
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Ever hear the term "publish or perish"? It's real.
And it's because of this quote that some will publish—how do I say this?—misleading/wrong materials. It's unfortunate but people need to survive.
 

Goro

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It happens, but thankfully it's still rare. The beautiful thing about Science is that it's self-correcting. You publish BS, and it will catch up with you, sooner or later.

And it's because of this quote that some will publish—how do I say this?—misleading/wrong materials. It's unfortunate but people need to survive.
 
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Kurk

Kurk

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Alright,
Dentistry - It's a fine career, but do you really see yourself saying "the reason for why your gums are bleeding is because you aren't flossing" for the rest of your life? If so fine.
Podiatry - You can make good money, it just seems like an incredibly limiting career. However someone like @Foot Fetish might truly enjoy it.
Pharmacy - Again you can make good money, not anything too grand though. Also can't help feeling that it would get incredibly tedious after a while(your opinion may differ)
Optometry - Idk man, kind of like podiatry in that it's kind of limiting but with less money. Maybe you'd like doing eye exams and all that though?
Thanks for your opinion. I don't like repetition if I'm doing all day everyday; I mean I really like the idea of working in an ER doing night-shifts and working on Christmas Eve. It sounds exciting and would keep me motivated, yet at the same time I don't like thinking about the long-term effects it will have on my physical health. Also, I don't think I like the idea of having to treat anyone who walks into the ER like convicts and gang members off the street—what if they are dangerous? Maybe I watch untold stories of the ER too much.

Dentistry seems appealing too because of the opportunity to run your own business. I don't mind slaving away for a few years working for corporate dentistry (I remember going in there as a kid and man did it look miserable! We switched right away to private practice!) to gain some experience. The flexible hours and better work/life balance is a huge plus too because while I don't like repetition, having time for extracurricular activities makes up for it.

I don't know a whole lot about Podiatry other than...well...feet. I'm not sure if private practice is practical here.

Pharmacy is really saturated from what I hear. It seems a little brain-numbing as well, but I'm open to it.

Optometry is cool; I like eyes more than feet and teeth, but it puts bit too much emphasis on retail for my liking and it seems owning your own business might be a bit more difficult though I might be wrong.
fine, lets review dentistry

Whats to like

1. unlike medicine where your path isnt really determined until your 3rd/4th year, in dental school you will know what you be doing (spoiler alert its working on teeth)

2. 4 years (or 3 years if you're at UOP) and boom you're done

3. if you want to be a general dentist, grades dont matter (other than to pass to get your DMD/DDS), this puts less stress on the desire to do well to get the career (now if we're talking about being an oral surgeon, then your stress goes up by a factor of 4

4. assuming you do a good job, you get immediate satisfaction seeing your patient feel much better and thank you for it

5. owning your own business, I can determine what my hours can be like and hire office managers/dentist assistants/hygienists that I feel comfortable working with

6. For the hours worked, you get a good paycheck. Heck if I went back to CA, I could still make a an average living in a saturated area without having to burn myself out (good luck buying a house though)

7. Some diversity in the dental field itself, if you don’t want to be general dentist, no problem, if you can get good grades and test scores, oral surgery, endodontics pediatric dentistry, etc may be an option for you. There are currently 9 different specialties recognized by the ADA. http://www.ada.org/en/education-careers/careers-in-dentistry/dental-specialties/specialty-definitions


Whats not to like

1. If you go into dental school and you figure that working with patient’s dental care was not your thing, well you better suck it up or switch to another profession before the debt really piles up

2. Its hard to open up a dental school (though recent openings suggest otherwise), hence dental school why the dental school tuition is outrageously expensive. Dental school can range anywhere from $250k - $550k, so with interest rates its possible you can owe a total of $1 million dollars over the course of your career.

3. Dental salaries are great but not that great. That becomes a big time factor, if you are married or have children that removes a significant chunk from your post-tax salary. This is complicated even more so when your ever increasing student loans take a chunk out of your post-tax paycheck. Long story short, after all the taxes and student loan payments, you don’t have as much as you would think to live a lifestyle like those folks on the Wolf of Wall Street. You could go to a rural area to fix that though.

4. Now about rural areas, a popular topic on SDN is that rural areas are the be all and end all prescription to handle student loan debt and earn a killing. Yes and No. While a dentist in some rural areas can make a killing ($350k for a general dentist), other areas the patient population is simply too poor and too careless with their dental hygiene to really check into a dentist’s office. This hurts both the dentist’s business and more importantly, hurts the patient’s being as well.

5. The public notion that a dentist is a greedy scum. Reading a dental board’s announcements on some probations and revocations due to shady practices and procedures, I can say to a tiny extent this is true. The funny part is, it’s not just the corporate dental offices but also some private practice dentists as well, despite a lot of complaints of corporate dental offices coming from private practice dentists. A patient gets mad when they go to the dentist’s office but they seem to be meh when it comes to visiting a family medicine practitioner (wait times might suck though).

6. Speaking of corporate dentistry, you’ll most likely be working for a corporate dental office unless you are one lucky soul that is taken by a private practice as an associate dentist. What’s not to like about a corporate dentistry, long story short – they make you work like a slave so bad that you wish you were back in dental school working on patients supported by faculty instead. I worked for Western Dental in Los Angeles once, lets just say I did some stuff that I wasn’t happy with and quit within a year (common to leave after a year of corporate dentistry btw)

7. Patient to dentistry ratio, whereas some physicians in a variety of specialties will always have patients coming regardless of the city, there might be cases depending where you live where patients may not come that often. I know of an orthodontist who had no patients come in a certain time period to the point where he simply just played on his computer while waiting for a patient to come in. This is more significant in cities where there are dental offices on every corner. Not everyone is going to have a root canal and cavity to fix.

8. In some of the more desirable places, a 1-year dental residency maybe required in order to work as a general dentist in those places. Considering a family medicine residency is 3 years, going to a residency for another 2 years is not a bad investment taking into account there is a lot more demand for family medicine physicians than a general dentist, in say New York City.

9. Back, neck and wrist pain. You are working on an area of the body no bigger than a tea cup which calls for excellent hand-eye coordination. You also need to work on this patient in a timely manner because 1.) the patient will hate you for keeping him/her forever and 2.) You got other patients waiting in the office needing to have their care dealt with. You may need braces for your wrist due to carpal tunnel syndrome. This condition occurs when repetitive motions and/or sustained postures damage tissues and cause swelling. There is a particular reason why dentists work no more than 32-40 hours and pain in these areas over time is a major reason.


I am sure there are other stuff that I failed to mention that other dentists will go over.
Now that's more like it!

Let's look at the not to like points:

1. N/A
2. Parents want to help me with that; even if not, I understand
3. Not a huge problem. I don't want to have kids and am iffy on marrying
4. I wouldn't mind living somewhere rural—I already live in a suburb with rural parts close by. I could not imagine living/practicing in a city. Yuck!
5. Meh. It's unfortunate but there. Anyone hear of the cardiologist who was arrested for hiring a hitman to kill his competition so more patients would go to him? His basement had a secret room full of all sorts of weapons.
6. I don't mind doing it for the experience.
7. It's a business. Price and demand.
8. Something to consider
9. Definitely something to consider, though I would like to think that those with the pain do not follow proper ergonomics.

OK, so let ME take a stab at this. I'll agree with Goro here, you are woefully ignorant. BUT I come from a different perspective. I'm a practicing internal medicine physician with almost 30 years in healthcare (almost 15 has an RN and the rest as a physician). So let me speak from EXPERIENCE and less data and conjecture: get out there and SHADOW!!! Shadow a LOT! Shadow pharmacists and RN's and CRNA's and podiatrists and dentists and ophthalmologists and physicians of all specialties...and not just during the DAY from 9-5...ask them about THEIR day and stay with them for the length of THEIR day, whether that's 0500- MN or 0800- 2300. And not just ONE day with each person but SEVERAL days with each person! When are you going to do this??? On the weekends, in the evenings, during your holiday breaks, in the summer. If you are really committed to figuring out what you want to do, you need to INVEST the TIME. Make some cold calls, show up, be diligent, interested, take notes, learn some medical terminology before you go and at the end of each day take a few minutes to write down your impressions of the day. NO ONE ELSE can tell you what is the right fit for YOU!!! YOU have to figure it out...and better to figure it out NOW before you rack up $$$ of debt and time chasing someone else's dream.
Absolutely. Nothing can replace shadowing. Right now, however, I'm very limited as I have transportation issues. I hope to shadow as soon as my situation corrects itself. On a side note, do they get annoyed if you constantly shadow them? I mean I am a liability aren't I?
 

hamstergang

may or may not contain hamsters
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May 6, 2012
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My experiences will always trump what you can "quote" someone else saying. Until you have experienced it for yourself, your argument is meaningless. Again, once you get to college, medical school, residency, and being an attending (because if you make that far, my post graduate training will have long ended), then we can have a discussion on where health care is going. Until then, it's best to just listen.
Well I'm an attending now, and since you're just a resident I suggest you stop posting and just listen to what I have to say. Your opinion on healthcare is useless once I post my opinions based on my experience.

That's how this works, right?

You shouldn't pick a career based upon an income you don't know you'll have. Rather, you should pick one where you can get the most personal satisfaction from your day-to-day activities.
Who are you to tell OP what he should do? People pick careers for different reasons, and it's not so easy to say that one person's reasoning is 'better' than another.

I think I'm being deterred from medicine mainly because of the rise of socialized healthcare. I know for a fact from healthcare workers in my family and from the outside that primary care physicians are being forced to see more patients in a smaller amount of time because of low medicaid payouts.

To me, one-on-one time with the patient is probably the most important aspect of being a physician.
I watch a few medical channels on YouTube in my free-time, one of which is Auburn Medical Group. It gives me a warm feeling to see the physician-patient interaction (yes I know it is a little falsified on Youtube) at play. This is probably one of the most, if not, the most rewarding aspect of practicing medicine in my opinion.

If it gets to the point where doctors are treating patients more like numbers and are concerned about red tape more than the personal needs of patients, I don't think I should seriously continue down this path as it would probably lead to great misery in the future for me.

This leads me to my next point concerning the future of private-practice.

I really enjoy the idea of eventually having the opportunity to open up your own clinic as a physician in whichever specialty you choose. I consider myself to be somewhat of a "natural businessman" in a way and believe that small-businesses are imperative in shaping positive communities on the local level. It would be great to also be able to give back to the community within the realm of business. Again, it is to my understanding that low payouts are making it difficult for private-practitioners to stay in business.

My third concern is the loss of respect and status for physicians in general.

I sometimes read older American like plays. It humbles me to see how doctors were portrayed in literature from a different era. Docs were greatly respected for what they did and were treated with respect for being intelligent and hard-working. Today I rarely see this outside of smaller, conservative, mid-west communities. I think it's ridiculous that people are trying to put physicians on the same level as your average 9-5 worker in terms of "at the end of the day it's still a job" because it isn't. Literally no other profession requires the same amount of financial, emotional, physical, and time sacrifice as a physician. There is no way in hell that I'm going into this with my self-confidence intact if in the end I'm going to be treated like some pawn by a hospital administrator with a B.A in business. No amount of personal altruism will supersede this.
How much these concerns matter depends a lot on the field of medicine you ultimately choose. For instance, in my field of psychiatry (specifically child/adolescent), pay is going up and opening a private practice is almost too easy. Everyone's been very respectful to my face, at least.

Medicine is a very broad field, so it's hard to generalize about it. As someone else said, you should do lots of shadowing to see different doctors in different fields in order to get a better feel for this.