Idealistic Contrast Between Pre-Meds and Physicians

[MRSAful Fate]

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The pre-meds that I have been personally exposed to are mostly liberal and idealistic. They generally support health care reform, view health care as a right, and give lip service to working in free clinics as a physician and working with underserved populations, et cetera. This stands in contrast to the physicians that I have worked and shadowed who are mostly conservative and somewhat jaded. They don't support health care reform, are less than enthused about taking patients with bad or no insurance and none of them volunteer their time.

Granted that this is all anecdotal, but I postulate two possible reasons for this ideological contrast. It could be a generational phenomenon, most of the pre-meds I know are in their early 20's and the doctors I know are all 45+. Or, and more likely I think, it is a result of the process of medical education and the realities of working as a physician. It seems to me that most pre-med idealism exists in a vacuum. It is easy to say that you will take a pay cut/work for free to better society when you aren't actually going to be getting that pay check either way for a number of years. But when you wake up in the morning as a physician and have the choice to volunteer/take on uninsured patients or earn a large amount of money, and your massive medical school debt/mortgage/clinic overhead/car payments/children's college funds are now a looming reality, it must be very hard to be altruistic. Likewise, after seeing your 100th angry, malingering patient demanding Dilaudid every two hours for their dubious ailments while threatening to sue you for malpractice and calling you an incompetent quack it has got to be very hard to maintain a glowing idealism about humanity.

Are these observations similar to your own? Do you agree/disagree with my conjecturing? And if you are a liberal and idealistic pre-med (like me) do you see your ideology shifting by the time you are working as a physician?

 

[apumic]

The pre-meds that I have been personally exposed to are mostly liberal and idealistic. They generally support health care reform, view health care as a right, and give lip service to working in free clinics as a physician and working with underserved populations, et cetera. This stands in contrast to the physicians that I have worked and shadowed who are mostly conservative and somewhat jaded. They don’t support health care reform, are less than enthused about taking patients with bad or no insurance and none of them volunteer their time.

There are actually quite a few docs who volunteer their time once they have time to do so. However, volunteering your time while you are working 50-60 hrs/wk probably isn't going to be particularly attractive sounding to most people. Many of the docs that volunteer have cut back on their clinical hours.

As for pre-meds seeing healthcare as a right and supporting healthcare reform (at least in its current form)... I think that's probably most among those who haven't been out in the real world. Most physicians I've met strongly agree we need healthcare reform; they simply don't agree with what Washington has proposed. Many of the reforms are backwards, so expensive as to be absolutely unsustainable, and take responsibility for people's health even further away from them (instead of placing that responsibility where it belongs -- on them).

Granted that this is all anecdotal, but I postulate two possible reasons for this ideological contrast. It could be a generational phenomenon, most of the pre-meds I know are in their early 20’s and the doctors I know are all 45+. Or, and more likely I think, it is a result of the process of medical education and the realities of working as a physician. It seems to me that most pre-med idealism exists in a vacuum. It is easy to say that you will take a pay cut/work for free to better society when you aren’t actually going to be getting that pay check either way for a number of years. But when you wake up in the morning as a physician and have the choice to volunteer/take on uninsured patients or earn a large amount of money, and your massive medical school debt/mortgage/clinic overhead/car payments/children’s college funds are now a looming reality, it must be very hard to be altruistic. Likewise, after seeing your 100th angry, malingering patient demanding Dilaudid every two hours for their dubious ailments while threatening to sue you for malpractice and calling you an incompetent quack it has got to be very hard to maintain a glowing idealism about humanity.

While some of this seems tenable, it's also noteworthy that people simply tend to become more conservative over time. As people (at least here in the US) gain experience and see the real world for themselves, they tend to embrace conservative values (or at least that's what the sociological and psychological research I recall seeing awhile back showed).

Are these observations similar to your own? Do you agree/disagree with my conjecturing? And if you are a liberal and idealistic pre-med (like me) do you see your ideology shifting by the time you are working as a physician?

Personally, I'd say my idealism has worn off. I had it before I started working full time (i.e., during UG) but after graduating and working for a few years, paying your own bills, etc., the idealism wears thin. At least for me, the desire to make a difference and so forth has not grown old, but I can say confidently that I now understand the difference between the idealism and optimism of youth and the determined realism of adulthood. The latter is a calmer, more focused approach and, in my experience and that of my mentors, the one that tends to get things done over time. Idealism will fade, but at the same time, you'll maintain excitement over things.

 

[JeetKuneDo]

The pre-meds that I have been personally exposed to are mostly liberal and idealistic. They generally support health care reform, view health care as a right, and give lip service to working in free clinics as a physician and working with underserved populations, et cetera. This stands in contrast to the physicians that I have worked and shadowed who are mostly conservative and somewhat jaded. They don’t support health care reform, are less than enthused about taking patients with bad or no insurance and none of them volunteer their time.

Granted that this is all anecdotal, but I postulate two possible reasons for this ideological contrast. It could be a generational phenomenon, most of the pre-meds I know are in their early 20’s and the doctors I know are all 45+. Or, and more likely I think, it is a result of the process of medical education and the realities of working as a physician. It seems to me that most pre-med idealism exists in a vacuum. It is easy to say that you will take a pay cut/work for free to better society when you aren’t actually going to be getting that pay check either way for a number of years. But when you wake up in the morning as a physician and have the choice to volunteer/take on uninsured patients or earn a large amount of money, and your massive medical school debt/mortgage/clinic overhead/car payments/children’s college funds are now a looming reality, it must be very hard to be altruistic. Likewise, after seeing your 100th angry, malingering patient demanding Dilaudid every two hours for their dubious ailments while threatening to sue you for malpractice and calling you an incompetent quack it has got to be very hard to maintain a glowing idealism about humanity.

Are these observations similar to your own? Do you agree/disagree with my conjecturing? And if you are a liberal and idealistic pre-med (like me) do you see your ideology shifting by the time you are working as a physician?

I have also observed the same thing as you. Most pre-meds I have been in contact with are very very liberal. In fact, most people in the 18-25 group I have been around are like that as well. They are in enormous favor of healthcare reform and view healthcare as a right. I cannot say I agree with them. For me, I have never believed in free healthcare. I just don't think it will ever be possible to make it happen.

 

[jd1031]

From my experience, I've seen a mix of physicians. The ones that are completely against current health care reform are either a) motivated by greed or b) afraid of change of any sort (it's their personality type).The vast majority of physicians I've seen are, like you said above, aware of the need of reform, but disagree with the current healthcare reform (HINT you can't just blame Obama or the Dems/GOP for the current bill...it's a result of complicated interactions between health care insurance corporate interests, watch groups, politicians, and the rules of the political process).

If you want to learn about some of the darker truths of the health insurance cartels, then read "Deadly Spin" by Wendell Potter. He was a former executive at CIGNA.

The reason that I've seen more people become more "conservative" over the years is out of personal necessity and obligations. i.e. An idealist has a family, and now has a obligation to take care of the family. A young doc is now at the mercy of the health insurance system. The idealist can no longer risk him/herself for idealistic causes, since it involves risking the entire family - even if the cause, if implemented - leaves society better off in the long run. Also, I've seen idealistic people become caught up in materialism and greed. They end up giving up their idealistic goals because they are (superficially) rewarded by the current system. It's not necessarily a good thing, especially of more conservative = more jaded by the system/less open-minded. (Not to say that unrealistic idealists are any better) Through that process, idealism wears off for most - but not for some. People are starting to wake up.

Let's change the kinds of foods we subsidize and we won't need as much health care. Boom.

Amen to that

 

[painmd87]

Not all attendings are jaded, but true, many are. You'll hear a lot complain that they aren't practicing medicine, they're practicing protocols. Others complain about frequent flyers, noncompliant patients, the "entitlement generation" and more.

Pre-meds, especially those who haven't worked in healthcare, have a more idealistic view, in general. You've likely cherry-picked your shadowing opportunities or at least remember the extreme (best/worst) moments.

Physicians have faced a career filled with doing what they can get reimbursed for without getting sued. Navigating the perils of insurance/Medicare rules and regulations can be extraordinarily painful. Recent Medicare changes have really screwed up a lot of patients in the practice where I work. Doctors who are wary of government interference already feel they are being told what to do way too much.

And then from a financial standpoint, you are watching half your paycheck go back to federal/state/local governments because you were audacious enough to use your skills and talents to earn more than most people in the world. How dare you apply yourself! Half the country pays a total of $0 in taxes for the year, yet your work ethic means you must give back half of what you've earned.

It's hard to fathom before you get into the world of hospital work; private practice may not be so bad (fewer people in general telling you what to do, but not always). See signature.

 

[sonofva]

During first semester of my M1 year they gave us a journal article showing that physician empathy and idealism generally go down the tubes starting during the M3 year... so. things to look forward to.

 

[apumic]

During first semester of my M1 year they gave us a journal article showing that physician empathy and idealism generally go down the tubes starting during the M3 year... so. things to look forward to.

Hahahaha... the moment you start working w/ real pts regularly, in other words. That's kind of sad really, but it makes sense.

 

[jmin]

During first semester of my M1 year they gave us a journal article showing that physician empathy and idealism generally go down the tubes starting during the M3 year... so. things to look forward to.

I wonder why..
Is it the grueling training process itself, with the insane hours and ******* attendings?

Or is it the patients themselves?

A mix of both? Something else?

Huummm ho...

 

[Eobrien]

I wonder why..
Is it the grueling training process itself, with the insane hours and ******* attendings?

Or is it the patients themselves?

A mix of both? Something else?

Huummm ho...

Id say the combination of grueling hours + pissed off un-appreciative patients are the main reasons why most doctors to turn from any altruistic ways, or at least it makes them put a guard up when it comes to wanting to help all of humanity.

Granted there are patients that are amazing and you feel like superman when you can help them and you will do anything for them, but you have to take the good patients with the bad patients who will try to take advantage of you/sue you/poo on you (literally and figuratively) and you have to protect yourself.

When you spend years and years of training wanting to help and then you get poo'ed on by patients no matter how much effort you give its going to get old and your going to become more conservative.

But its not going to matter anyway because we are all going to die in 2012. the end.

 

[NurWollen]

So only people who are jaded and overworked are conservatives?

Idealistic conservative here.

 

[BOOYA18]

isnt there a saying that goes something like "if youre a republican at 20 you dont have a heart, if youre a democrat by 40 you dont have a brain"
just kinda exemplifies the idea of obtaining hard earned money and seeing lottttts of it taken away basically.

 

[NurWollen]

isnt there a saying that goes something like "if youre a republican at 20 you dont have a heart, if youre a democrat by 40 you dont have a brain"
just kinda exemplifies the idea of obtaining hard earned money and seeing lottttts of it taken away basically.

Haha... there is a lot of truth to that. At least I hope there is. If the 40 year olds running the country in 20 years are half as liberal as the 20 year olds of today, there won't be any wealth in this country to redistribute.

Actually, I consider myself a social and economic conservative, but I am all for pro bono medical work, donating to charity, using my skills to help poor immigrants regardless of their legal status etc.