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- Nov 3, 2013
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Aspiring medical students need to know some things. Mostly, regarding specialties, and how Hospitals (i.e., your employer) treats them. Bottom line: It doesn't matter if you are the smartest medical student in your class. If you choose any Non-Surgical, or Non-interventional procedural field, you are the bottom of the food chain. Your life, and consequently your family's life will be unstable. Corporate medicine is a real thing. It's now a very big thing. Most of you will never know true academic practice or true private practice. Most specialties are not respected, or valued. For instance, as an Anesthesiologist, you will often hear Nurses say to the patient, "The Doctor will be by shortly to see you and talk to you." This implies many things. But, here is the order of what you should choose if you wish to have a successful and stable occupation as a Physician. After all, considering the loans you will take and the time and grit you will put forth, you must reap its benefits to the fullest.
#1. Interventional Cardiology. Most people will have heart disease. Most people prefer to eat what they want and get heart attacks, rather than follow a healthy lifestyle. You will have tons of patients, tons of devices and procedures to perform. Hospitals love interventional cardiologists because of billing capture. So, you will be coddled, sucked up to and paid. I know this interventional cardiologist who managed to keep his job even though he grabbed a surgical tech by the neck and threw him up against the wall. He brought the hospital a lot of money. He still does, and he makes a lot of money. Close to $1M a year!
#2. Orthopedic Surgery. Most joint surgeries don't need to be done. The US is one of the highest performers of joint replacements. Cash cow in many ways. Sure, CMS doesn't reimburse much for the surgery portion itself. But there's facility fees (you make a ton of $ on facility fees), Physical Therapy reimbursements, and basic contracts with hospitals. You make over $1M a year!
#3. Spine Surgery.
#4. Vascular Surgery.
Fields NOT to go into.
#1. Anesthesiology. Very political. Stressful in ways you don't expect.
#2. Primary Care. Same as above. This includes Internal Medicine, Pediatrics, Family Practice. CRNAs make more than either of these specialties. They make as much as Anesthesiologists in many places. CMS reimburses NPs and Physicians the same.
Salaries in above specialties are well below $400 in most places. Not a bad income whatsoever. But, most people underestimate Hospitals' greed. They don't care about how smart you are, or were, your commitment, your skills etc. Cheapest is all that's needed. Consequently, there's a lot of career threats and instability and very little incentive (aside from the fact that you're doing the right thing) to stand up for the right things (patient advocate). It'll wreck your career.
If you're going to do Medicine, choose wisely.
Politicians and Congress, as you already know, are not working for public welfare. They are representatives of a very small minority, which wants to have two classes (the haves and the have nots). You are an expense, at the end of medical school. The incentive of you going to medical school financially, is for others unless you choose the top 4 specialties above. People make money off of your loans. That's really what it's all about. The rest is made up glory. You can do good in any and many professions.
Country and Medicare is going broke. No one will want to pay you. And to do that, they will stoop to many new lows including devaluing your training, dehumanizing you as a Physician (treating you as a commodity) and catering to different Physicians of different specialties in vastly different ways. Justice, is also, biased.
I'm sorry to post a cynical and bleak thread. Most of you lived through the Financial crisis as teenagers I presume. But you must have made observations.
It will be okay in about 20+ years, but the next 20 years, Medicare expenses are going to go up (Boomers) and to maintain Corporate profit (egregious profit), they will cut you down to pieces. So think this through.
No faculty member in Medical School will tell you these things, because they want you to have an open mind. Which you should.
#1. Interventional Cardiology. Most people will have heart disease. Most people prefer to eat what they want and get heart attacks, rather than follow a healthy lifestyle. You will have tons of patients, tons of devices and procedures to perform. Hospitals love interventional cardiologists because of billing capture. So, you will be coddled, sucked up to and paid. I know this interventional cardiologist who managed to keep his job even though he grabbed a surgical tech by the neck and threw him up against the wall. He brought the hospital a lot of money. He still does, and he makes a lot of money. Close to $1M a year!
#2. Orthopedic Surgery. Most joint surgeries don't need to be done. The US is one of the highest performers of joint replacements. Cash cow in many ways. Sure, CMS doesn't reimburse much for the surgery portion itself. But there's facility fees (you make a ton of $ on facility fees), Physical Therapy reimbursements, and basic contracts with hospitals. You make over $1M a year!
#3. Spine Surgery.
#4. Vascular Surgery.
Fields NOT to go into.
#1. Anesthesiology. Very political. Stressful in ways you don't expect.
#2. Primary Care. Same as above. This includes Internal Medicine, Pediatrics, Family Practice. CRNAs make more than either of these specialties. They make as much as Anesthesiologists in many places. CMS reimburses NPs and Physicians the same.
Salaries in above specialties are well below $400 in most places. Not a bad income whatsoever. But, most people underestimate Hospitals' greed. They don't care about how smart you are, or were, your commitment, your skills etc. Cheapest is all that's needed. Consequently, there's a lot of career threats and instability and very little incentive (aside from the fact that you're doing the right thing) to stand up for the right things (patient advocate). It'll wreck your career.
If you're going to do Medicine, choose wisely.
Politicians and Congress, as you already know, are not working for public welfare. They are representatives of a very small minority, which wants to have two classes (the haves and the have nots). You are an expense, at the end of medical school. The incentive of you going to medical school financially, is for others unless you choose the top 4 specialties above. People make money off of your loans. That's really what it's all about. The rest is made up glory. You can do good in any and many professions.
Country and Medicare is going broke. No one will want to pay you. And to do that, they will stoop to many new lows including devaluing your training, dehumanizing you as a Physician (treating you as a commodity) and catering to different Physicians of different specialties in vastly different ways. Justice, is also, biased.
I'm sorry to post a cynical and bleak thread. Most of you lived through the Financial crisis as teenagers I presume. But you must have made observations.
It will be okay in about 20+ years, but the next 20 years, Medicare expenses are going to go up (Boomers) and to maintain Corporate profit (egregious profit), they will cut you down to pieces. So think this through.
No faculty member in Medical School will tell you these things, because they want you to have an open mind. Which you should.
