Internal medicine, why it's not hot

[dank204]

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Would some of you become internists if it paid more? I think if we had a lot of really good internists who educated the people, people would take more care of themselves and not have to see the specialists. Unfortunately with lots of undergrad/med school debt, internal medicine doesn't seem to be a worthwhile option. If all specialties paid the same, would you become an internist?

 

[ACSurgeon]

Would some of you become internists if it paid more? I think if we had a lot of really good internists who educated the people, people would take more care of themselves and not have to see the specialists. Unfortunately with lots of undergrad/med school debt, internal medicine doesn't seem to be a worthwhile option. If all specialties paid the same, would you become an internist?

While I'm sure pay is a component that pushes students into other specialties (or to pursue a fellowship), I think another thing to consider is the perception of being fellowship/specialty trained. Also, the type of work that internists do is not for everyone.

Remember, some folks spend additional training time to become an ID specialist or nephrologist which don't pay that much more than general medicine (if at all). the nature of work and prestige seem to make the additional time in fellowship worthwhile.

 

[Pons Asinorum]

You're starting waaayyy too many new, pointless threads, my man. Head back over to pre-allo with the rest of us non-MS1's and chill out a bit.

 

[2012mdc]

Would some of you become internists if it paid more? I think if we had a lot of really good internists who educated the people, people would take more care of themselves and not have to see the specialists. Unfortunately with lots of undergrad/med school debt, internal medicine doesn't seem to be a worthwhile option. If all specialties paid the same, would you become an internist?

No, just not for me. I love the diagnostic challenge as well as the broad scope but too much of general IM like ACS, pneumonia, DKA can be cookbook.

Also I don't think it's procedural enough for me

 

[Yope]

Would some of you become internists if it paid more? I think if we had a lot of really good internists who educated the people, people would take more care of themselves and not have to see the specialists. Unfortunately with lots of undergrad/med school debt, internal medicine doesn't seem to be a worthwhile option. If all specialties paid the same, would you become an internist?

Of course.

 

[dank204]

You're starting waaayyy too many new, pointless threads, my man. Head back over to pre-allo with the rest of us non-MS1's and chill out a bit.

The only thing you will need to be studying for my friend is how to say "paper or plastic."

Keep it real OK?

 

[Yope]

The only thing you will need to be studying for my friend is how to say "paper or plastic."

Keep it real OK?

Returning to topic, IM is totally boss. Even though the majority of practice is probably boring and routine problems, this is the specialty in which all systems are considered and the coordination of procedures occurs. I think if you're into the science behind it, IM and its subspecialties are great options (among others).

In addition, it's a very stable field. The highest paying specialties are based on what is best reimbursed, and who can predict how technology will be in the future? Orthopedic surgeons might make tons based on hip replacement surgeries, but suppose a cheaper and better pharmaceutical alternative is developed that obviates the problem. In contrast, the role of IM (perhaps not all subspecialties) has been fairly consistent and not dependent on a particular therapy. Additionally, there's the primary care aspect, applicable anywhere in the country.

 

[Pons Asinorum]

The only thing you will need to be studying for my friend is how to say "paper or plastic."

Keep it real OK?

Just trying to help you. Carry on.

 

[DrBowtie]

Heck no. I don't want to be a dumping ground doctor.

 

[JaggerPlate]

IM -> Hospitalist -> working every other week -> 250k + a year ...

Sounds pretty decent to me.

Granted, I know that there are far, far more variables to consider with the above statement (which was just for generalization - calm down in advance), but I don't know if all IM is awful.

 

[xanthomondo]

IM -> Hospitalist -> working every other week -> 250k + a year ...

Sounds pretty decent to me.

Granted, I know that there are far, far more variables to consider with the above statement (which was just for generalization - calm down in advance), but I don't know if all IM is awful.

Working 7 12's on and then 7 off? No thanks

 

[Lokhtar]

Working 7 12's on and then 7 off? No thanks

Actually I'd LOVE that over working 9-5. Different strokes I suppose.

 

[dank204]

IM -> Hospitalist -> working every other week -> 250k + a year ...

Sounds pretty decent to me.

Granted, I know that there are far, far more variables to consider with the above statement (which was just for generalization - calm down in advance), but I don't know if all IM is awful.

I had no idea Hospitalist's were doing that well. I shadowed a family practice doc and he told me that his best year was $140k.

I also knew an internist who had to close shop here in Jersey and move to Michigan because it was just so expensive.

Hospitalists seem to be at the hospital like all the time. It almost seems like they are working 7 days a week.

 

[thepoopologist]

Actually I'd LOVE that over working 9-5. Different strokes I suppose.

Same here. I'd use the week off to fly to Europe or South America or Asia and come back. Or I'd spend it out on the beach. Or whatever I want I suppose, because it's 7 FULL DAYS OFF.

 

[Residual]

Same here. I'd use the week off to fly to Europe or South America or Asia and come back. Or I'd spend it out on the beach. Or whatever I want I suppose, because it's 7 FULL DAYS OFF.

good god yes.

 

[DrBowtie]

Same here. I'd use the week off to fly to Europe or South America or Asia and come back. Or I'd spend it out on the beach. Or whatever I want I suppose, because it's 7 FULL DAYS OFF.

Except you spend two of those days recovering from the fatigue, and the last two days dreading going back.

 

[whouse]

Hospitalists seem to be at the hospital like all the time.

Funniest thing I've read all day.

 

[Handsome88]

I had no idea Hospitalist's were doing that well. I shadowed a family practice doc and he told me that his best year was $140k.

Hospitalists seem to be at the hospital like all the time. It almost seems like they are working 7 days a week.

😕😕😕😕😕

Internists are considered specialists in the rest of the world man, even Canada (250-350K for a general IM)! They are only given a bad rep in the US because they do primary care jobs.

Internal medicine is the most stable, largest, most diverse specialty with lots of flexibility. It is very mentally demanding and so only the most competent would be able to do this job (don't go with competitiveness of specialties to determine who's doctor is "smarter"). Sure it is on the low end of compensation (RELATIVELY SPEAKING). But they are still payed well IMO (200K+ will make your next door neighbor drool, unless of course he's a Rad Onc). Also, a rad onc, anesthesiologist, or a pathologist are not what come's to people's minds when you say "Doctor"...It's the doctor who they have most contact with...the one who actually treats them (not merely diagnose them, study their disease, or puts them to sleep). So internists have their respect also. In terms of lifestyle, working as an hospitalist puts you up there with EM in terms of lifestyle (which may not be the best but it's pretty damn good, ask my dad who works 8-7 at age 57 with a lower pay), also you could subspecialize to endocrinology/allergy/pulm..etc and have a better life style. Pulm/CC is now also shift work (or so I heard), which is frikin awesome.

 

[Law2Doc]

...
Hospitalists seem to be at the hospital like all the time. ...

Wait until you are a resident and you need to speak to one about his/her critically ill patients. When there's nobody around to return your page, you will get a much better appreciation.

 

[JaggerPlate]

Actually I'd LOVE that over working 9-5. Different strokes I suppose.

Agreed.

 

[xanthomondo]

Except you spend two of those days recovering from the fatigue, and the last two days dreading going back.

Yeah I agree. I worked a mini shift schedule (where every weekend was either a 3 day weekend or 4 day weekend) and it wasn't fun at all. You spend those days at work wishing you could do things with your friends/family at night who have normal schedules. I constantly missed sports games (even had to pass up playoff tickets that were offered to me). And then when you have all of your time off you get bored because everyone else has something to do.

Would you work a full month on, then a full month off? Hell, why not a full year?

 

[Law2Doc]

😕😕😕😕😕

Internists are considered specialists in the rest of the world man, even Canada (250-350K for a general IM)! They are only given a bad rep in the US because they do primary care jobs....

Let's not use internist and hospitalist interchangeably. It will only make for confusion.

 

[Handsome88]

Let's not use internist and hospitalist interchangeably. It will only make for confusion.

I wasn't using them interchangebly...General Internists are specialists (and you cannot see them without a referal) in Canada, Europe, Middle East, and I think India. The GP there is a family doctor, and a family doctor does the work of the hospitalist there, the GIM is a specialist.

 

[sideways]

Except you spend two of those days recovering from the fatigue, and the last two days dreading going back.

And the two in-between taking care of all the **** you couldn't take care of during the work week because you were constantly working.

 

[Handsome88]

And the two in-between taking care of all the **** you couldn't take care of during the work week because you were constantly working.

seriously...Med students are a bunch of whiny p******, most of the population works their butts off, in an unstable job, in little cubicles looking at computer screens...and they don't complain as much even though they are getting payed MUCH MUCH LESS!

 

[DrBowtie]

seriously...Med students are a bunch of whiny p******, most of the population works their butts off, in an unstable job, in little cubicles looking at computer screens...and they don't complain as much even though they are getting payed MUCH MUCH LESS!

Technically, they are getting paid MUCH MUCH MORE than medical students.

 

[sideways]

seriously...Med students are a bunch of whiny p******, most of the population works their butts off, in an unstable job, in little cubicles looking at computer screens...and they don't complain as much even though they are getting payed MUCH MUCH LESS!

Uh, most people don't work their butts off. Most people get paid to work 2 hours a day, and update their Facebook statuses for the other 6. Also, when most people **** up at work, the biggest consequence is someone gets their power bill 3 days late.

 

[SeekerOfTheTree]

Actually I'd LOVE that over working 9-5. Different strokes I suppose.

I second that one dude! I'm all about having seven days off. I had to work 5 12s 5 days a week and 4 hours on sat and sunday while checking e-mails in the corporate world so doing this ain't half bad. It's like a vacation every other week!

 

[SeekerOfTheTree]

Uh, most people don't work their butts off. Most people get paid to work 2 hours a day, and update their Facebook statuses for the other 6. Also, when most people **** up at work, the biggest consequence is someone gets their power bill 3 days late.

Lol true for a lot of fields of work in the business, IT, and engineering world.

 

[JaggerPlate]

seriously...Med students are a bunch of whiny p******, most of the population works their butts off, in an unstable job, in little cubicles looking at computer screens...and they don't complain as much even though they are getting payed MUCH MUCH LESS!

Actually, most peeps graduate with a BA in 'business' from a state school, sit in a little cube all day, input some numbers into a computer, take a 45 minute lunch break, spend 2 hours on facebook after lunch, then go home at 5 PM satisfied with the 45k a year they are making. Not to mention, they aren't 200k in debt and can start working at 21.

 

[Handsome88]

Actually, most peeps graduate with a BA in 'business' from a state school, sit in a little cube all day, input some numbers into a computer, take a 45 minute lunch break, spend 2 hours on facebook after lunch, then go home at 5 PM satisfied with the 45k a year they are making. Not to mention, they aren't 200k in debt and can start working at 21.

That's true. But they do not get the respect/prestige that any doctor gets (regardless of type), they have stingy bosses most of the time, may be fired anytime (especially during todays economy), and even though they don't have 200k debt, they have a harder time finding jobs when they graduate (my friend spent a whole year to try and find a job which now only pays him 40k), and if you do get fired or you resign for some personal reason (which is almost inevitable during your life time) then you will have the same problem again. Also the pay is 1/3 of what a family doctor gets.
I'd rather be busy during my 10hr/day job (where time can pass by quickly, especially when you get complex interesting cases) than input numbers (VERY BORING) for 2 hours feeling like my life is meaningless and then be bored out of my mind for 6 hours and pretend to work when my boss passes by.

 

[Lokhtar]

Yeah I agree. I worked a mini shift schedule (where every weekend was either a 3 day weekend or 4 day weekend) and it wasn't fun at all. You spend those days at work wishing you could do things with your friends/family at night who have normal schedules. I constantly missed sports games (even had to pass up playoff tickets that were offered to me). And then when you have all of your time off you get bored because everyone else has something to do.

Would you work a full month on, then a full month off? Hell, why not a full year?

A month? Maybe, though that's pushing it - you'd be too tired mentally. 14 on, 14 off? Yea, I think I could manage that. It's an argument to absurdity...obviously there is a limit. I've worked shifts before...actual manual labor work not cubicle facebook check work. For me, it's preferable to 9-5. Consecutive days off are such a huge plus for me.

It's inane to argue about it anyway, I don't know how you can possibly disagree with another person's preference. Some prefer 9-5, others prefer 7 on 7 off....it's not a concrete choice.

I love it, you obviously don't. So you shouldn't do it, and I probably should 😛.

 

[Handsome88]

Heck no. I don't want to be a dumping ground doctor.

Dumping ground doctor? That is very insulting. Didn't your school teach you not to speak badly about other doctors? They are saving more lives than a lot of other specialties and one of the most hard working specialties. I hope you take that back, that was not very professional of you...I hope doctors in the US don't think the way you do.

 

[samuraiR]

Uh, most people don't work their butts off. Most people get paid to work 2 hours a day, and update their Facebook statuses for the other 6. Also, when most people **** up at work, the biggest consequence is someone gets their power bill 3 days late.

you really hate corporate america don't you...

 

[DrBowtie]

Dumping ground doctor? That is very insulting. Didn't your school teach you not to speak badly about other doctors? They are saving more lives than a lot of other specialties and one of the most hard working specialties. I hope you take that back, that was not very professional of you...I hope doctors in the US don't think the way you do.

Fact remains that EVERY service turfs to medicine. The medicine folks would agree that everyone tries to turf to them. It isn't insulting because they know this before going into IM residency.

 

[2012mdc]

Except you spend two of those days recovering from the fatigue, and the last two days dreading going back.

I wouldn't mind recovering on the beach. I would spend the 2nd last to day traveling back and the last day sleeping.

7 on, 7 off is a lot better than what they did to us on Surgery. Spare me the lecture on differences in responsibility etc. Just comparing the overall hours

 

[Handsome88]

I wouldn't mind recovering on the beach. I would spend the 2nd last to day traveling back and the last day sleeping.

7 on, 7 off is a lot better than what they did to us on Surgery. Spare me the lecture on differences in responsibility etc. Just comparing the overall hours

What did they do to you on surgery? I am considering surgery vs IM...but I hear that surgery is 3x worse in lifestyle...even though it has better pay, this does not compensate to its horrendous lifestyle. Is that true?

Also, how much does the average surgeon take home at the end of the year, would the higher overhead/insurance...etc balance out the pay/hour to that of an IM.

 

[sideways]

you really hate corporate america don't you...

I love capitalism, so I guess by definition, I love corporate America.

I hate you though.

 

[DrBowtie]

I wouldn't mind recovering on the beach. I would spend the 2nd last to day traveling back and the last day sleeping.

7 on, 7 off is a lot better than what they did to us on Surgery. Spare me the lecture on differences in responsibility etc. Just comparing the overall hours

Youd like some of these sick telereadiology gigs I heard about. 7on/7off from home.

 

[Slack3r]

I had no idea Hospitalist's were doing that well. I shadowed a family practice doc and he told me that his best year was $140k.

I also knew an internist who had to close shop here in Jersey and move to Michigan because it was just so expensive.

Hospitalists seem to be at the hospital like all the time. It almost seems like they are working 7 days a week.

This explains SOOO much about you.

 

[MossPoh]

Docs are also notoriously bad at business, so some of them don't do as well as they could.

To say you can't get fired and finding a job is easy with medicine is a bit naive as well. It depends on specialty, location, practice type, etc. Someone in the boondocks will alway stake you, but not many people want to make the sacrifice for that. Also, if you join a very large practice or are employed by the hospital, the job may be secure but if they want you out, they will find a way. I've seen it happen multiple times. Group hires doctor. Group discovers they don't like doctor. Group makes doctor's life a living hell and/or get them to buy into the practice and then retire, leaving them with old equipment, staff he or she doesn't know and usually awful wall paper.

There are also plenty of people who are miserable in medicine and probably would be better fit for clock punching cubicle work. Depending on your skillset, it isn't always that hard to find a job. I was offered multiple at a very good salary with benefits and paid graduate school after a few years of working there.

 

[xanthomondo]

This explains SOOO much about you.

pshhh don't be hatin on the jerz

 

[dank204]

This explains SOOO much about you.

What? That I'm smart? That I know this and you don't? That I'm from Jersey and you're not?

 

[TheCatalyst]

Sadly, the impression I'm stating to get (from talking to Primary care Docs) is that many ppl, sometimes even the majority, arent willing to do what it takes to get better.

So a lot of the physician's work is often futile.

I would prefer to be in a practice that has a defined, often definite outcome...i.e., surgery.

 

[dank204]

Sadly, the impression I'm stating to get (from talking to Primary care Docs) is that many ppl, sometimes even the majority, arent willing to do what it takes to get better.

So a lot of the physician's work is often futile.

I would prefer to be in a practice that has a defined, often definite outcome...i.e., surgery.

You know what, I agree with you on that. If they were compensated more though, I'm sure they would be more willing. That is wishful thinking though.

 

[HealingSenses]

Working 7 12's on and then 7 off? No thanks

From what i heard, those 7 working days are BUSY. I mean it's you-work-your-arse-off-busy.

 

[johnmendes]

From what i heard, those 7 working days are BUSY. I mean it's you-work-your-arse-off-busy.

with the exception of some specialties, medicine is usually like that... work your arse off busy.

 

[DoctwoB]

Theres no law that says hospitalists have to work 7 on 7 off 12 hour shifts. that is a common arrangement, but different groups negotiate different hours with their hospitals. Some have a typical 8 hours a day, 40 hours a week every week type arrangement. Others pick up X number of shifts per month. Some work 7 on, and then cover more shifts during their off week. Its entirely variable. Obviously the more you work, the more you make.

 

[Handsome88]

with the exception of some specialties, medicine is usually like that... work your arse off busy.

lol exactly..if you dont want to work your arse off then don`t do medicine in the first place. The only specialties that allows you to go on facebook during office hours are Dermatology, ophthalmology, pathology, and anesthesia (if you have a smartphone). But they are hella boring.

 

[VoiceofReason]

you would have to pay me literally 1 mil per year to do internal medicine. It is functionally the same as an office cubicle job with piles of paperwork and boredom. All you do is write notes and fill out forms, or make phonecalls. You are the custodian of medical records. Your primary concern is the chart, not the patient. Truly an awful job.