How do you have a positive outlook on becoming a physician when the medical space constantly describes it as depressing and draining?

[guytakingboards]

From the time I started scribing to eventually being accepted to Medical school, I have been constantly told that medicine will be mentally challenging and draining with a possible chance that I will regret it. How can I continue on this path with so much negativity tied to it? Why are so many people becoming physicians when the end game is that you will be miserable? I don't get it. Why am I doing this? Why are "WE" doing this? Are all physicians truly miserable? Is working in medicine accepting that it is miserable and continuing onward? If so, then why do it in the first place lol? Why are we all becoming martyrs when we only have one life?

How can we as physicians work together to change this? I want to be in a space where we are flourishing and enjoying ourselves, all while helping others. I don't want to be miserable. Medicine is a passion of mine and I am devastated to know that it will be a horrible experience. What have I gotten into? How do yall (present physicians, pre-meds, current medical students, etc.) process this and justify it? Have we all come to suffer together?

Let me know your thoughts.

It's tough to put into words an adequate response to your post. The stuff you've heard is real and the feelings/concern you describe are valid.

I think my 20's (spent in college, grad school, medical school, training) were as or more formative than my teenage years or earlier. My 20's strongly shaped how I see the world now. College was about learning to see and understand the bigger world. Everything afterwards was actually functioning in the real world.

The goal of medical training (and the practice of medicine itself) is not individual happiness. Not to say people can't be happy or that everyone is just plum miserable, but understand that the primary goal is the benefit of the sick. It is a mighty privilege to be able to provide care to the ill. Some people call medicine a calling, I don't personally believe that. But I do believe there has to be implicit understanding that to the individual physician there will be sacrifice on behalf of the patient. That may be staying up late studying, working a 24hr shifts or doing a 12 hr surgery.

In the real world, there is the head smacking realization that there are many actors in the healthcare realm but few if any prioritize the well being of the physician. In some order it goes: patient, hospital rules, profits, other professions (e.g. nursing) >>>>>>>> doctors. It's only natural to become a little negative and/or jaded. Some would argue that's a natural response.

The tough thing to get across to someone at your level is that medicine while tough, isn't exactly unique regarding a lot of things. Most jobs are jobs. You do your work. You get paid. Rinse, wash, repeat. Passion can only take you so far. First year law students pound their chests talking about passion for the law; talk to them 15 years later. New teachers talk about passion for teaching the next generation of the world.... see how they feel after a few years.

Call it world weariness, jadedness, cynicism, whatever. The world just looks different at 32 than it did at 22.

To actually answer your question though, I would say don't expect medicine to be the thing that fulfills you personally. It isn't meant to. You aren't meant to flourish personally within healthcare. Find other things: family, friends, hobbies, etc...

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[ChordaEpiphany]

People like to vent...

I actually think it's easy to make money in medicine and the job itself is not that bad. You could be at the bottom 10% in term of competency as a physician and still make 300-500k/yr.

I volunteered for habitat for humanity in 2013 to beef up my application for med school and It was when I realized what it's like to work hard.

Don't get me wrong! I complain a lot so admin can make my job easier but my job is not that bad as a hospitalist.

I got to work ~7:15 am; get my free Starbucks coffee at the hospital Starbucks. Vent a little while doing chart review until 7:45 am. See patient from 7:45am to 10 am. Then write some notes and then take ~45 mins lunch. Finish all the notes and tight some loose end around 2-3pm and watch CNBC until 4:15pm and then go home. I got 350k/yr working 7 days on/off doing that.

Made 405k last year without breaking my back. Never thought a day in my life I would be able to afford $700+/night hotel vacation stay.

I have a colleague who just transitioned for outpatient PCP to do hospital medicine in my group. He found other hospitalists covering his every other weekend. He is basically working M-F every other week from 7am-4:15p making ~260yr (brilliant from his part). How many jobs out there one can have that kind of flexibility while making 250k+/yr? Not that many.

If you put things into perspective, medicine is not that bad. It's called work, meaning you have to spend some energy to do it.

This post puts something into perspective that is often forgotten in SDN-land. Medicine is an amazing deal for the less ambitious members of the profession. If you don't want to change the world, and you just want local influence and a comfortable life, medicine is basically a cheat code.

Put aside your ego. Stop trying to be top of the class, match a competitive specialty, train at a top institution, or rise to department chair. Decide to be a community PCP, hospitalist, psychiatrist, anesthesiologist, etc... Do right by your patients, but stop trying to impress attendings. Suddenly, much of the stress of medical training vanishes while the job security and pay of being an attending remain.

This is why the general public often has disdain for physicians, because they would approach medicine with the attitude above. The average American is stuck in their home town/suburb, and their idea of success is a McMansion one county over. They don't care about prestige, and they've never tried to be top of the class. In their mind, going to med school means going to the closest school to their hometown and then practicing in a strip mall or a community hospital in the suburbs to the tune of $300-500K/year.

Most physicians obviously don't approach the profession this way. Even if eventually most do wind up practicing in the community, they spent anywhere from 7-11 years allowing medicine to consume their life so they could stay at least middle-of-the-pack and get high quality training in a good residency program. At the very top, physicians turn down far more lucrative career options and add many years to their training. They rise to the top 0.1% of society in achievement while earning top ~5% wages. All that work comes with no extra money unless you match a high-paying specialty and prioritize pay.

Approach medicine like a job instead of a calling and you'll likely have extremely high QOL.

 

[Splenda88]

This post puts something into perspective that is often forgotten in SDN-land. Medicine is an amazing deal for the less ambitious members of the profession. If you don't want to change the world, and you just want local influence and a comfortable life, medicine is basically a cheat code.

Put aside your ego. Stop trying to be top of the class, match a competitive specialty, train at a top institution, or rise to department chair. Decide to be a community PCP, hospitalist, psychiatrist, anesthesiologist, etc... Do right by your patients, but stop trying to impress attendings. Suddenly, much of the stress of medical training vanishes while the job security and pay of being an attending remain.

This is why the general public often has disdain for physicians, because they would approach medicine with the attitude above. The average American is stuck in their home town/suburb, and their idea of success is a McMansion one county over. They don't care about prestige, and they've never tried to be top of the class. In their mind, going to med school means going to the closest school to their hometown and then practicing in a strip mall or a community hospital in the suburbs to the tune of $300-500K/year.

Most physicians obviously don't approach the profession this way. Even if eventually most do wind up practicing in the community, they spent anywhere from 7-11 years allowing medicine to consume their life so they could stay at least middle-of-the-pack and get high quality training in a good residency program. At the very top, physicians turn down far more lucrative career options and add many years to their training. They rise to the top 0.1% of society in achievement while earning top ~5% wages. All that work comes with no extra money unless you match a high-paying specialty and prioritize pay.

Approach medicine like a job instead of a calling and you'll likely have extremely high QOL.

I think many tend to look at medicine in isolation and forget to compare it with the alternative.

Someone in this thresd talked about something that I noticed anecdotally. I am an AMG and I noticed the FMG at my job are less "whiny" and the same thing was true during residency.

Again, medicine is not great but it's good compared to the alternative.

People who are not in medicine that make 500k+/yr are either working crazy # of hours or have some exceptional talent. On the other hand, most of us don't have exceptional talent; we are people with just above average IQ.

Just to give some examples. There was a GI locum doc at my shop who was getting paid ~5k/day (confirmed). A hospitalist acquaintance made 700k+ (3k/day) last year working ~20 days/month in Wyoming.

 

[PikminOC]

Okay. So I’m a little confused. You made a post saying that a job might not be good just because FM has a good job market. As an example, you listed a specialists job description and salary which I thought was an example of a bad job the way you described it but you’re defending it saying it’s actually a good job (or at least good salary). I disagree, but I don’t care.

I’m not sure what any of this has to do with me saying FM has the best job market.

I was saying my endo friend is a specialist and only makes 350, she also works a lot and is charting at night. It's not in a good place to work.

That's why I'm surprised y'all are saying PCP makes more than that at a hospital.

 

[PikminOC]

I think many tend to look at medicine in isolation and forget to compare it with the alternative.

Someone in this thresd talked about something that I noticed anecdotally. I am an AMG and I noticed the FMG at my job are less "whiny" and the same thing was true during residency.

Again, medicine is not great but it's good compared to the alternative.

People who are not in medicine that make 500k+/yr are either working crazy # of hours or have some exceptional talent. On the other hand, most of us don't have exceptional talent; we are people with just above average IQ.

Just to give some examples. There was a GI locum doc at my shop who was getting paid ~5k/day (confirmed). A hospitalist acquaintance made 700k+ (3k/day) last year working ~20 days/month in Wyoming.

I'm still trying to wrap my head around the numbers you guys are talking about with the physicians you quote. Those are anecdotal and aren't the majority of PCP.

The level of responsibility is much higher in medicine than in any other field. The life long dedication doesn't end after residency.

The loans now are much higher than we had to deal with.

 

[Splenda88]

I'm still trying to wrap my head around the numbers you guys are talking about with the physicians you quote. Those are anecdotal and aren't the majority of PCP.

The level of responsibility is much higher in medicine than in any other field. The life long dedication doesn't end after residency.

The loans now are much higher than we had to deal with.

No one is saying this is typical. But the money is there if you want to make it as a physician.

 

[PikminOC]

No one is saying this is typical. But the money is there if you want to make it as a physician.

I just don't want to set unrealistic expectations for the op

 

[Ho0v-man]

I was saying my endo friend is a specialist and only makes 350, she also works a lot and is charting at night. It's not in a good place to work.

That's why I'm surprised y'all are saying PCP makes more than that at a hospital.

I just don't want to set unrealistic expectations for the op

Ah okay. I get your point now. I’ve only got a few anecdotes for endo for salary. All of them rural areas outpatient only for $300k and no midlevel oversight. One of them did inpatient consults which were mostly for DM management a couple times a week. So I’m surprised to see so much added responsibility for what I perceive as a relatively small increase, but my sample is admittedly pretty small.

I am however very familiar with FM salaries and $300k is not at all unrealistic outside of the super large cities. Maybe not the first year out though.

 

[VA Hopeful Dr]

Thanks for brining this up! Yeah I have read a decent amount of the blog posts and bough the book as well. I was considering doing PSLF but if I only do a 3 year residency it might make more sense to just aggressively pay it off. Definitely living like a resident though

Do you mean how hard have I worked towards a career in primary care? I have done a lot of research in health disparities stuff since its a passion of mine and worked at the school free clinic. As it stands im thinking of doing IM and figuring out where to go from there. But I really enjoyed my FM and geriatrics rotations. The culture at our school is for most people to either sub specialize in IM or to go into surgical subspec since we have so many strong programs. That being said I definitely am not concerned about trying to go pound for pound salary wise lol. I also didnt do this to be rich or anything like that. Though I would like to be able to save enough to pay for my kids college and retire without having to worry about if SS will be there to help me when I am older. It seems thats still the case no matter what specialty. Why would you say primary care has a better job market than specialities?

ah gotcha that makes sense! When you say find a hospital system that prioritizes primary care does that essentially mean finding a practice where the salary is high relative to the average? Or are there other markers to be aware of? Appreciate the insight!

By valued I mean an administration that realizes that value having a solid primary care network brings in. Our billing isn't all that impressive, but think about all the labs/imaging/referrals a busy PCP will order. If you have those all staying within the system, that's a huge amount of money.

You can usually tell if a place values primary care if they 1) have a large number of primary care practices compared to everything else and 2) the PCP turnover is fairly low. Its rare to have both of those without pretty good income as well.

Primary care has a better job market because we can find jobs literally everywhere in the county.

 

[VA Hopeful Dr]

I'm still trying to wrap my head around the numbers you guys are talking about with the physicians you quote. Those are anecdotal and aren't the majority of PCP.

The level of responsibility is much higher in medicine than in any other field. The life long dedication doesn't end after residency.

The loans now are much higher than we had to deal with.

Loans are a big problem, I don't see anyone saying otherwise.

Good PCP money isn't all that hard to find. Pulling the 400k+ the my partners and I do is tricky but doable. Getting above 300k is pretty easy most places. We don't start out that high, but once your practice gets established (1-2 years max) it shouldn't be hard.

Plus, as has been stated, you have to put it in perspective. My IM PCP wife makes right at 300k. She works 4 days a week, sees at most 20 patients/day, and takes the same 5-6 weeks off per year that I do. No nights, no weekends, no holidays. Sure we aren't making as much as most of the high earning specialties, but we also work banker's hours.

 

[ChordaEpiphany]

I think many tend to look at medicine in isolation and forget to compare it with the alternative.

People who are not in medicine that make 500k+/yr are either working crazy # of hours or have some exceptional talent. On the other hand, most of us don't have exceptional talent; we are people with just above average IQ.

As someone who came to medicine from an industry background, I strongly disagree. I think you haven't looked closely enough at the alternatives, and you are giving far too much credit to top 1% earners in other fields.

In general, there are a few paths to $500K+: medicine, (big) law, FAANG+, finance (IB, HF, PE, +/- VC), management consulting, corporate management/strategy, and business ownership. You could also make an argument for sales and real estate.

In terms of hours, only big law, IB, and business ownership come close. However, big law and IB also pay more far earlier in life and have a much, much higher ceiling than medicine. In terms of talent, I think medicine, even at the DO and community medicine level, hangs with most of these professions at the $300-500K level. Obviously partners at big law, consulting firms, and big banks, C-suite execs, and top-level SWEs have demonstrated more raw talent (be it technical prowess or cockroach-like ability to thrive), but they also make way more. As I said before, there's an argument that the bottom 25% or so of physicians are getting a sweet deal, but if I had to advise a college kid who was a bit dull or lazy, I'd definitely push them towards management consulting, finance, or corporate management before telling them to pursue medicine.

In general, in medicine you have to be smarter and work harder to make your money, and regardless of how smart or hardworking you are, the ceiling is much lower than these other paths. The difference is that medicine historically comes with exceptionally low risk, though I'm not sure that will hold in the future.

 

[PikminOC]

Loans are a big problem, I don't see anyone saying otherwise.

Good PCP money isn't all that hard to find. Pulling the 400k+ the my partners and I do is tricky but doable. Getting above 300k is pretty easy most places. We don't start out that high, but once your practice gets established (1-2 years max) it shouldn't be hard.

Plus, as has been stated, you have to put it in perspective. My IM PCP wife makes right at 300k. She works 4 days a week, sees at most 20 patients/day, and takes the same 5-6 weeks off per year that I do. No nights, no weekends, no holidays. Sure we aren't making as much as most of the high earning specialties, but we also work banker's hours.

I've seen a lot of mergers between hospitals that then low-ball the physicians and they leave, including PCP. How much are hospitals paying PCP? They use mgma data, not how much you are ordering. Not the initial guarantee, but thereafter rvu based payment.

 

[PikminOC]

As someone who came to medicine from an industry background, I strongly disagree. I think you haven't looked closely enough at the alternatives, and you are giving far too much credit to top 1% earners in other fields.

In general, there are a few paths to $500K+: medicine, (big) law, FAANG+, finance (IB, HF, PE, +/- VC), management consulting, corporate management/strategy, and business ownership. You could also make an argument for sales and real estate.

In terms of hours, only big law, IB, and business ownership come close. However, big law and IB also pay more far earlier in life and have a much, much higher ceiling than medicine. In terms of talent, I think medicine, even at the DO and community medicine level, hangs with most of these professions at the $300-500K level. Obviously partners at big law, consulting firms, and big banks, C-suite execs, and top-level SWEs have demonstrated more raw talent (be it technical prowess or cockroach-like ability to thrive), but they also make way more. As I said before, there's an argument that the bottom 25% or so of physicians are getting a sweet deal, but if I had to advise a college kid who was a bit dull or lazy, I'd definitely push them towards management consulting, finance, or corporate management before telling them to pursue medicine.

In general, in medicine you have to be smarter and work harder to make your money, and regardless of how smart or hardworking you are, the ceiling is much lower than these other paths. The difference is that medicine historically comes with exceptionally low risk, though I'm not sure that will hold in the future.

Medicine comes with high personal risk.

 

[VA Hopeful Dr]

I've seen a lot of mergers between hospitals that then low-ball the physicians and they leave, including PCP. How much are hospitals paying PCP? They use mgma data, not how much you are ordering. Not the initial guarantee, but thereafter rvu based payment.

My original employer got bought out. The new one increased my income by around 30%.

MGMA is used to determine our RVU conversion factor. Given how unproductive the median FP is (median RVU for FP amounts to 17 patients/day for a 4.5 day week and 6 weeks off per year assuming an equal mix of 99213 and 99214). Between my schedule of 26 patients per day, my mostly 99214 visits, and my nurses doing the Medicare Wellness Visits on anyone who needs one, I basically earn double the median which means double the money. And that doesn't take into account quality bonuses.

 

[PikminOC]

My original employer got bought out. The new one increased my income by around 30%.

MGMA is used to determine our RVU conversion factor. Given how unproductive the median FP is (median RVU for FP amounts to 17 patients/day for a 4.5 day week and 6 weeks off per year assuming an equal mix of 99213 and 99214). Between my schedule of 26 patients per day, my mostly 99214 visits, and my nurses doing the Medicare Wellness Visits on anyone who needs one, I basically earn double the median which means double the money. And that doesn't take into account quality bonuses.

Ok thanks for saying you earn double the median. That's important.
When lvhn bought up more hospitals they decreased salaries as they bought struggling hospitals which is what may happen in a merger

 

[voxveritatisetlucis]

How is medicine a stable path to 500k? Many of the specialties that pay that much are extremely difficult to match. Doesn’t the median physician earn like 300k and that is total comp not salary alone

 

[VA Hopeful Dr]

How is medicine a stable path to 500k? Many of the specialties that pay that much are extremely difficult to match. Doesn’t the median physician earn like 300k and that is total comp not salary alone

I could swing that if I worked 40 hours a week, took fewer vacations, and did some moonlighting.

 

[ChordaEpiphany]

Ok thanks for saying you earn double the median. That's important.
When lvhn bought up more hospitals they decreased salaries as they bought struggling hospitals which is what may happen in a merger

My understanding is that the greater Philadelphia area has some of the worst payer mix in the country (I think BCBS runs the whole show), and it causes a lot of wage suppression. About 5 years ago I spoke to some physicians from that area who were complaining they couldn't even find docs to hire for their practices because everyone wanted to go to NJ where pay was instantly higher. If the same is true for the Lehigh Valley area, it could explain your experience with physician income.

How is medicine a stable path to 500k? Many of the specialties that pay that much are extremely difficult to match. Doesn’t the median physician earn like 300k and that is total comp not salary alone

I don't think people appreciate just how much physicians willingly take pay cuts to do things they enjoy. The result of this is that if money is the priority, you can probably get there. There's a correlation between salary and competitiveness, but it's nothing like other industries. In the corporate world, everyone is shoveling s*** just to work their way up the ladder. Very few people are making career moves based on anything other than money. In medicine, every year people willingly subject themselves to 2-3 years of additional work at low pay so they can earn less than a hospitalist as a specialist in rheum, ID, endo, nephro, etc... People work at academic centers and take huge pay cuts so they can see higher acuity patients, teach, and do research. If you want to make $500K+ and you aren't particularly competitive, you can be a general surgeon, psychiatrist, anesthesiologist, or oncologist. Just pick your location and employer correctly, rack up RVUs, and you'll earn $500K+ easily.

 

[Neopolymath]

My understanding is that the greater Philadelphia area has some of the worst payer mix in the country (I think BCBS runs the whole show), and it causes a lot of wage suppression. About 5 years ago I spoke to some physicians from that area who were complaining they couldn't even find docs to hire for their practices because everyone wanted to go to NJ where pay was instantly higher. If the same is true for the Lehigh Valley area, it could explain your experience with physician income.

I don't think people appreciate just how much physicians willingly take pay cuts to do things they enjoy. The result of this is that if money is the priority, you can probably get there. There's a correlation between salary and competitiveness, but it's nothing like other industries. In the corporate world, everyone is shoveling s*** just to work their way up the ladder. Very few people are making career moves based on anything other than money. In medicine, every year people willingly subject themselves to 2-3 years of additional work at low pay so they can earn less than a hospitalist as a specialist in rheum, ID, endo, nephro, etc... People work at academic centers and take huge pay cuts so they can see higher acuity patients, teach, and do research. If you want to make $500K+ and you aren't particularly competitive, you can be a general surgeon, psychiatrist, anesthesiologist, or oncologist. Just pick your location and employer correctly, rack up RVUs, and you'll earn $500K+ easily.

Too many people without any real job experience outside of medicine. Medicine is a hell-hole in several aspects but it's still a great profession overall with either the same issues as industry or less severe issues.

 

[Splenda88]

As someone who came to medicine from an industry background, I strongly disagree. I think you haven't looked closely enough at the alternatives, and you are giving far too much credit to top 1% earners in other fields.

In general, there are a few paths to $500K+: medicine, (big) law, FAANG+, finance (IB, HF, PE, +/- VC), management consulting, corporate management/strategy, and business ownership. You could also make an argument for sales and real estate.

In terms of hours, only big law, IB, and business ownership come close. However, big law and IB also pay more far earlier in life and have a much, much higher ceiling than medicine. In terms of talent, I think medicine, even at the DO and community medicine level, hangs with most of these professions at the $300-500K level. Obviously partners at big law, consulting firms, and big banks, C-suite execs, and top-level SWEs have demonstrated more raw talent (be it technical prowess or cockroach-like ability to thrive), but they also make way more. As I said before, there's an argument that the bottom 25% or so of physicians are getting a sweet deal, but if I had to advise a college kid who was a bit dull or lazy, I'd definitely push them towards management consulting, finance, or corporate management before telling them to pursue medicine.

In general, in medicine you have to be smarter and work harder to make your money, and regardless of how smart or hardworking you are, the ceiling is much lower than these other paths. The difference is that medicine historically comes with exceptionally low risk, though I'm not sure that will hold in the future.

The Top 1 Percent: What Jobs Do They Have?

Explore the occupations and industries of the nation's wealthiest households.

archive.nytimes.com

 

[PikminOC]

The Top 1 Percent: What Jobs Do They Have?

Explore the occupations and industries of the nation's wealthiest households.

archive.nytimes.com

The point is that people who works that hard in med school, undergrad, residency and beyond, can do better financially in other fields as the ceiling is higher

 

[PikminOC]

My understanding is that the greater Philadelphia area has some of the worst payer mix in the country (I think BCBS runs the whole show), and it causes a lot of wage suppression. About 5 years ago I spoke to some physicians from that area who were complaining they couldn't even find docs to hire for their practices because everyone wanted to go to NJ where pay was instantly higher. If the same is true for the Lehigh Valley area, it could explain your experience with physician income.

I don't think people appreciate just how much physicians willingly take pay cuts to do things they enjoy. The result of this is that if money is the priority, you can probably get there. There's a correlation between salary and competitiveness, but it's nothing like other industries. In the corporate world, everyone is shoveling s*** just to work their way up the ladder. Very few people are making career moves based on anything other than money. In medicine, every year people willingly subject themselves to 2-3 years of additional work at low pay so they can earn less than a hospitalist as a specialist in rheum, ID, endo, nephro, etc... People work at academic centers and take huge pay cuts so they can see higher acuity patients, teach, and do research. If you want to make $500K+ and you aren't particularly competitive, you can be a general surgeon, psychiatrist, anesthesiologist, or oncologist. Just pick your location and employer correctly, rack up RVUs, and you'll earn $500K+ easily.

Show me. The rvus, the places, and the 500 k
And everything in med school is competitive

 

[Splenda88]

The point is that people who works that hard in med school, undergrad, residency and beyond, can do better financially in other fields as the ceiling is higher

That is the mistakes most of us make in medicine. We think our skills are transferable.

 

[PikminOC]

That is the mistakes most of us make in medicine. We think our skills are transferable.

The amount of work we put in if we put it into anything else, yes for many of us, would work.

Doesn't require this much intellect and work to do many other jobs.

It's not about transferable. It's the sheer amount of work we put into medicine. Putting that much work into another field may be better.

 

[voxveritatisetlucis]

I think that most medical students would be able to tech but probably not investment banking or PE where the real money is made. These industries require a level of charisma and family connections that many med students don’t seem to have

 

[PikminOC]

I think that most medical students would be able to tech but probably not investment banking or PE where the real money is made. These industries require a level of charisma and family connections that many med students don’t seem to have

Plenty of investment bankers and pe out there that's aren't charismatic or have family connections.

 

[whoknows2012]

I think a lot of the perspectives and the things being said so far in this thread are fair and somewhat true.

I would also say as having been in medicine for 10 years and having started medical school at a time (2009) when for a lot of reasons there was a fair bit of negativity towards the field, I don’t believe that doom and gloom (nor the current crop I see here) is completely fair or matches the reality. Medicine is hard work, no one should be disillusioned on that front; we are a self selected bunch that have worked incredibly hard at least since medical school many going back further than that…

Of course the real issues of administrative and bureaucratic bs, EMR meant to literally drive you crazy, and compensation that could be better are recipe for some to be unhappy. Burnout is high, job satisfaction is too low and yet all the above being true I constantly interact either professionally or personally/socially with other physicians and for the most part, however anecdotal it is, people are happy with their job and work. Surveys are helpful and I don’t mean to suggest that things your read or see are untrue, I would however suggest that each generation of physicians has its trouble and the millennial crop (those that graduated med school between 2006-2020) actually have it pretty good.

A couple things I have learned in my time training and 3+ years in sub speciality practice;
1) the importance of hard introspection and knowing the kind of job you want.
2) to the best of your ability keep doors open while training bc you never know how things will work out
3) be a good colleague-this goes a long way
4) alternate sources of income are there if you’re motivated and interested ( consulting, market research especially in the “in demand” specialties) expert witness etc etc
5) even as early as med school, prioritize your work life balance (and personal life outside medicine) I did and I don’t have a single regret. I’ve kept college and high school friends and built meaningful relationships throughout the last 15 yrs. I have a family, 2 kids, and didn’t postpone my life for medicine-my 20’s and early 30’s much like many of you, were consumed with med school and training. I lived my life in parallel and I’m very content with where I’m at.

Hope this helps

 

[Med Ed]

Thread in a nutshell:
Q: How to you keep a positive outlook on a career in medicine?
A: $$$

 

[PikminOC]

I think a lot of the perspectives and the things being said so far in this thread are fair and somewhat true.

I would also say as having been in medicine for 10 years and having started medical school at a time (2009) when for a lot of reasons there was a fair bit of negativity towards the field, I don’t believe that doom and gloom (nor the current crop I see here) is completely fair or matches the reality. Medicine is hard work, no one should be disillusioned on that front; we are a self selected bunch that have worked incredibly hard at least since medical school many going back further than that…

Of course the real issues of administrative and bureaucratic bs, EMR meant to literally drive you crazy, and compensation that could be better are recipe for some to be unhappy. Burnout is high, job satisfaction is too low and yet all the above being true I constantly interact either professionally or personally/socially with other physicians and for the most part, however anecdotal it is, people are happy with their job and work. Surveys are helpful and I don’t mean to suggest that things your read or see are untrue, I would however suggest that each generation of physicians has its trouble and the millennial crop (those that graduated med school between 2006-2020) actually have it pretty good.

A couple things I have learned in my time training and 3+ years in sub speciality practice;
1) the importance of hard introspection and knowing the kind of job you want.
2) to the best of your ability keep doors open while training bc you never know how things will work out
3) be a good colleague-this goes a long way
4) alternate sources of income are there if you’re motivated and interested ( consulting, market research especially in the “in demand” specialties) expert witness etc etc
5) even as early as med school, prioritize your work life balance (and personal life outside medicine) I did and I don’t have a single regret. I’ve kept college and high school friends and built meaningful relationships throughout the last 15 yrs. I have a family, 2 kids, and didn’t postpone my life for medicine-my 20’s and early 30’s much like many of you, were consumed with med school and training. I lived my life in parallel and I’m very content with where I’m at.

Hope this helps

So you are male? Because it's very difficult to not postpone having kids during the rigors of med school and residency

And just to get into med school requires a lot of hard work. So the work starts much sooner.

 

[PikminOC]

Thread in a nutshell:
Q: How to you keep a positive outlook on a career in medicine?
A: $$$

I think with the amount of work, money can be made in any nonmedical field also.

 

[whoknows2012]

So you are male? Because it's very difficult to not postpone having kids during the rigors of med school and residency

And just to get into med school requires a lot of hard work. So the work starts much sooner.

I am male but would give the same advice to female colleagues. I’ve mentored and worked with and underneath many female colleagues and students/trainees. I get that it’s way harder being female than male in this context but the advice remains

 

[PikminOC]

I am male but would give the same advice to female colleagues. I’ve mentored and worked with and underneath many female colleagues and students/trainees. I get that it’s way harder being female than male in this context but the advice remains

Men and women are different. It's very hard to not push off life while grinding for over ten years with med school, undergrad, and residency.

I have seen many female colleagues end up needing IVF etc to have kids because they had to wait too long for the education.

 

[whoknows2012]

Men and women are different. It's very hard to not push off life while grinding for over ten years with med school, undergrad, and residency.

I have seen many female colleagues end up needing IVF etc to have kids because they had to wait too long for the education.

Many of my colleagues postponed as you suggest but my advice doesn’t change-the few that had children during training were quite happy that they did. I don’t want to speak for them though and welcome our female posters thoughts here…

 

[PikminOC]

Many of my colleagues postponed as you suggest but my advice doesn’t change-the few that had children during training were quite happy that they did. I don’t want to speak for them though and welcome our female posters thoughts here…

Med school and residency are so hard I can't imagine also having a baby during that time. I'm female.

 

[VA Hopeful Dr]

Med school and residency are so hard I can't imagine also having a baby during that time. I'm female.

Plenty of people do it.

 

[LunaOri]

Med school and residency are so hard I can't imagine also having a baby during that time. I'm female.

It is hard, for sure. Whether you have a baby during med school or residency depends on a lot of factors: priorities, your age, how much support you have from family and spouse, finances, whether you pass your classes easily or struggle, whether you are aiming for a very competitive specialty.
All that being said, several of my classmates had babies during medical school and residency. A friend in general surgery took a research year after she gave birth, but everyone else kept their original timeline. I waited until my final year of residency, and banked most of my vacation for the first 4 years to use as maternity leave.

 

[Putkernerinthehall]

Plenty of investment bankers and pe out there that's aren't charismatic or have family connections.

I get the sense you are unhappy as a physician. Or maybe just sour on certain annoying aspects of your particular situation. I'd love to understand if you are truly miserable or just bitching.

 

[PikminOC]

Plenty of people do it.

Plenty of people don't. It puts a lot of strain on the other residents and themselves.

Just devils advocate. And what I've seen with my friends. They've gone thru multiple rounds of ivf and had a miscarriage. I've seen physicians lose their licenses. There's just a lot.

 

[PikminOC]

From the time I started scribing to eventually being accepted to Medical school, I have been constantly told that medicine will be mentally challenging and draining with a possible chance that I will regret it. How can I continue on this path with so much negativity tied to it? Why are so many people becoming physicians when the end game is that you will be miserable? I don't get it. Why am I doing this? Why are "WE" doing this? Are all physicians truly miserable? Is working in medicine accepting that it is miserable and continuing onward? If so, then why do it in the first place lol? Why are we all becoming martyrs when we only have one life?

How can we as physicians work together to change this? I want to be in a space where we are flourishing and enjoying ourselves, all while helping others. I don't want to be miserable. Medicine is a passion of mine and I am devastated to know that it will be a horrible experience. What have I gotten into? How do yall (present physicians, pre-meds, current medical students, etc.) process this and justify it? Have we all come to suffer together?

Let me know your thoughts.

Who has told you these things about medicine?

 

[PikminOC]

This post puts something into perspective that is often forgotten in SDN-land. Medicine is an amazing deal for the less ambitious members of the profession. If you don't want to change the world, and you just want local influence and a comfortable life, medicine is basically a cheat code.

Put aside your ego. Stop trying to be top of the class, match a competitive specialty, train at a top institution, or rise to department chair. Decide to be a community PCP, hospitalist, psychiatrist, anesthesiologist, etc... Do right by your patients, but stop trying to impress attendings. Suddenly, much of the stress of medical training vanishes while the job security and pay of being an attending remain.

This is why the general public often has disdain for physicians, because they would approach medicine with the attitude above. The average American is stuck in their home town/suburb, and their idea of success is a McMansion one county over. They don't care about prestige, and they've never tried to be top of the class. In their mind, going to med school means going to the closest school to their hometown and then practicing in a strip mall or a community hospital in the suburbs to the tune of $300-500K/year.

Most physicians obviously don't approach the profession this way. Even if eventually most do wind up practicing in the community, they spent anywhere from 7-11 years allowing medicine to consume their life so they could stay at least middle-of-the-pack and get high quality training in a good residency program. At the very top, physicians turn down far more lucrative career options and add many years to their training. They rise to the top 0.1% of society in achievement while earning top ~5% wages. All that work comes with no extra money unless you match a high-paying specialty and prioritize pay.

Approach medicine like a job instead of a calling and you'll likely have extremely high QOL.

That's a lot of work and finances, and time for a "cheat code"

 

[operaman]

Thread in a nutshell:
Q: How to you keep a positive outlook on a career in medicine?
A: $$$

Yeah you’re not wrong! It definitely helps dealing with the suckage if you’re getting paid very well. Much harder if you feel your work isn’t valued. There are other factors of course, but compensation is a big one.

Hard to think of another field where the work is so meaningful and the compensation so good.

I’m also fairly bullish on AI helping reduce a lot of the documentation and admin burden in the next 5-10 years. I’m sure a GPT derivative will be able to screen the inbox (though I already have it set up so my nurse handles this) and write replies. It will also surely be able to skim the massive chart and give good summaries. And the biggest will be when it can also act as a scribe. It can basically do these things already, and it’s just a matter of time before there are products aimed at the healthcare market.

 

[PikminOC]

Yeah you’re not wrong! It definitely helps dealing with the suckage if you’re getting paid very well. Much harder if you feel your work isn’t valued. There are other factors of course, but compensation is a big one.

Hard to think of another field where the work is so meaningful and the compensation so good.

I’m also fairly bullish on AI helping reduce a lot of the documentation and admin burden in the next 5-10 years. I’m sure a GPT derivative will be able to screen the inbox (though I already have it set up so my nurse handles this) and write replies. It will also surely be able to skim the massive chart and give good summaries. And the biggest will be when it can also act as a scribe. It can basically do these things already, and it’s just a matter of time before there are products aimed at the healthcare market.

Is value derived from money only?

 

[operaman]

Is value derived from money only?

I would refer you to the third sentence of my quoted post.

But the fact is that money is how we as a society have decided to assign value to things.

 

[PikminOC]

I would refer you to the third sentence of my quoted post.

But the fact is that money is how we as a society have decided to assign value to things.

I think lots of other things determine value.

 

[VA Hopeful Dr]

I think lots of other things determine value.

So does he, hence the last sentence of the first paragraph.

 

[ChordaEpiphany]

That's a lot of work and finances, and time for a "cheat code"

It depends on your other options. I'd argue the Ivy League grad is getting a raw deal. That kid could weasel their way into plenty of circles where just breathing the air gets massive compensation. Rank-and-file employees at the big firms are paid like physicians (but without the debt or years of training), and the ceiling is just absurd.

On the other hand, if you're just some guy with a 3.6 GPA from State University, getting into a new MD or a DO program is probably the best shot you have at a guaranteed upper middle class life. It won't be easy, but how many other pathways could get you to that level of compensation. Even if we apply the 60% rule (multiply income by 0.6 to account for opportunity cost of training/debt), a hospitalist in a community hospital is likely making the equivalent of ~$200-250K. Outside of the industries I listed above, which are hard to break into unless you run in those elite circles, that's not easy to come by. You're relying on getting promoted to senior management positions, which is a whole lot of luck and subjectivity.

The best argument I can make against my points above is that if you worked equivalently to a physician in training, you'd likely be able to establish enough side income streams to match that $200-250K income assuming you could rise to middle management and make ~$150K or so.

 

[PikminOC]

It depends on your other options. I'd argue the Ivy League grad is getting a raw deal. That kid could weasel their way into plenty of circles where just breathing the air gets massive compensation. Rank-and-file employees at the big firms are paid like physicians (but without the debt or years of training), and the ceiling is just absurd.

On the other hand, if you're just some guy with a 3.6 GPA from State University, getting into a new MD or a DO program is probably the best shot you have at a guaranteed upper middle class life. It won't be easy, but how many other pathways could get you to that level of compensation. Even if we apply the 60% rule (multiply income by 0.6 to account for opportunity cost of training/debt), a hospitalist in a community hospital is likely making the equivalent of ~$200-250K. Outside of the industries I listed above, which are hard to break into unless you run in those elite circles, that's not easy to come by. You're relying on getting promoted to senior management positions, which is a whole lot of luck and subjectivity.

The best argument I can make against my points above is that if you worked equivalently to a physician in training, you'd likely be able to establish enough side income streams to match that $200-250K income assuming you could rise to middle management and make ~$150K or so.

Pls explain the 60 percent rule and how it came to be in this environment of increasing medical school costs, esp private do schools which are very expensive.

And if you look at the early threads we discuss that medicine has a ceiling whereas some other fields don't.

And nothing else has this level of responsibility. Another physician was just murdered by his patient too. A 42 yo orthopedic surgeon.

 

[razortrunks]

Pls explain the 60 percent rule and how it came to be in this environment of increasing medical school costs, esp private do schools which are very expensive.

And if you look at the early threads we discuss that medicine has a ceiling whereas some other fields don't.

And nothing else has this level of responsibility. Another physician was just murdered by his patient too. A 42 yo orthopedic surgeon.

From looking through this thread, almost all of your posts unfailingly highlight the negatives of being a physician. I think its safe that you may be the population that I referred to when I talked about those constantly making medicine seem so depressing. Lol, my question is why do you do this? Do you regret your job? What other career would you have followed?

 

[PikminOC]

From looking through this thread, almost all of your posts unfailingly highlight the negatives of being a physician. I think its safe that you may be the population that I referred to when I talked about those constantly making medicine seem so depressing. Lol, my question is why do you do this? Do you regret your job? What other career would you have followed?

I'm just stating the facts as I see them for someone who will be going thru it now. You will get through truth online. Not in person. You have had a lot of into here given to you so you won't be going into it blind. Pls keep posting as u go thru school and residency too.