"Medicine is my calling"

[chocomorsel]

Why is it that I read this quite frequently on this forum? I mean to me, medicine is going to be a job. I'm gonna handle it like a job, 8-5, M-F, call no more than twice monthly and no weekends hopefully, if all goes as planned. Why can't being let's say, a police officer, fireman, teacher, salesperson, technician be a "calling"? Why are these types of jobs looked at as just "jobs" and not a "calling"?

I don't get it. Is it because it takes such a long time and is so difficult, that only ones who get "called" to do it, fare thru? Is it because of the immense expense that only the "called" can sacrifice for?

And for those who get "called" is it a little voice you hear inside your head calling you to medicine? I mean, how am I supposed to know that being a physician is a "calling" vs a "job" that I've wanted to do since I was a kid? I don't know, but this whole "calling" thing sounds a little snooty.

Any thoughts?

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[Ultimator]

I think there are several reasons why medicine is generally considered a calling as opposed to just being a job. However, I would also argue that any of a number of different professions (including teaching) could be considered a calling.

First, a historical reason for the "calling" of a physician could be the mystery that has always surrounded the medical profession even to this day. In this way it's akin to the "jobs" within religion. Not to mention the fact that it's also a field where you are serving people when they are at their most vulnerable which (in my opinion) requires a special sort of person.

Second, the nature of the field of medicine is intimidating to many people. They cannot understand how others can stand the sight of blood, wounds, trauma, children with cancer, etc. There are so many things in medicine that are "disgusting", tragic, heartbreaking, and sometimes even downright scary. Working in a burn unit patient families are constantly commenting "I don't know how you do what you do" or "How can you stand working here?". I find in a lot of cases I don't even know how to respond, the burns and wounds hardly even bother me (in fact in most cases I find them fascinating and interesting) but they cannot even understand that viewpoint. As a result, many people would consider it a calling.

I'm sure there are loads of other reasons but I think those are the most important ones (especially the second one I listed). Any other ideas?


On another note, I would hope that you have a little more dedication to your patients than only wanting to work M-F 8-5 or any other similar arrangement. Now this is just my personal opinion, but I believe our patients deserve better than that, I mean seriously we are dealing with their wellbeing, in many cases their very lives. I believe that a doctor should be willing to work longer hours, be called in, stay and talk to a patient even if you have other plans. I believe there are doctors out there that aren't "called" to the field of medicine, and I know for a fact that there are those that were definetely "called". The doctors that go the extra mile for their patients regardless of the cost to them, that love what they do and can't imagine doing anything else are definetely called. Working in the Burn Unit, I see doctors like this all the time, but I also see the other kind too. The ones that are always in a foul mood, dislike being called with significant lab results (even when it's their patient), having to come in to perform an emergency procedure (surgery, bronchoscopy, etc.), these doctors are not called to the field (if there like this all the time, cause everyone has a bad day once in awhile).

 

[ocean11]

On another note, I would hope that you have a little more dedication to your patients than only wanting to work M-F 8-5 or any other similar arrangement.

ARE YOU SERIOUS?!?!?

what's wrong with working 8-5pm... and for me that is LONG hours! I plan on working 10-3 in my future. I think it all depends on the VOLUME of patients you have! you don't need to spend 15 hours a day at the hospital to show dedication to your patients. Remember, you also have to have a balanced life, otherwise you'll be miserable and your patients will feel it too!!

 

[Law2Doc]

what's wrong with working 8-5pm... and for me that is LONG hours!

Honestly 45 hours a week is not realistic for most professionals, and is pretty much below the average work hours for all but a handful of specialties.
Even in law, at some firms 40 hours/week was considered part-time, and prohibitive for career advancement.

 

[Tired]

Remember, you also have to have a balanced life, otherwise you'll be miserable and your patients will feel it too!!

Bleah. This is the new wave of medicine, don't present this opinion as some sort of tried-and-true fact. The doctors in every generation before us worked killer hours throughout their entire career and carried gigantic patient loads. We can debate the relative goodness/badness of such a lifestyle, but understand that the notion of a "part-time doctor" is incredibly new, and runs counter to the traditions of our profession.

Also, I would suggest that you will never ever ever be able to cover your overhead working a 10-3 schedule.

 

[deleted87716]

Also, I would suggest that you will never ever ever be able to cover your overhead working a 10-3 schedule.

It's doable, depending on how your practice is structured. We have a married couple in our group who each work half-time in their practice. In essence, they're job-sharing. We also have a couple of people who work, on average, around 20 hours/week. Their partners have agreed that they only need to pay a half-share of the site overhead. These are all primary care folks, BTW (IM and FM).

 

[Law2Doc]

It's doable, depending on how your practice is structured. We have a married couple in our group who each work half-time in their practice. In essence, they're job-sharing. We also have a couple of people who work, on average, around 20 hours/week. Their partners have agreed that they only need to pay a half-share of the site overhead. These are all primary care folks, BTW (IM and FM).

Well, the catch is that you can't split medmal insurance, licensing fees and other fixed costs in half for each of them, so in all such situations, a company is better off having one full time employee than two half time ones, because many of the fixed administrative costs are per head, not hour. And as reimbursement amounts decline, folks need to work more hours, not fewer, just to stand pat. So expect to see fewer and fewer of these "job sharing" arrangements every year, unless there are massive changes in the industry.

 

[deleted87716]

Well, the catch is that you can't split medmal insurance, licensing fees and other fixed costs in half for each of them, so in all such situations, a company is better off having one full time employee than two half time ones, because many of the fixed administrative costs are per head, not hour.

Again, it depends entirely on how your practice is structured. In our group, each individual covers their own malpractice (although we have a group policy) and any physician-specific expenses (licensing fees, etc.) Group expenses are shared equally, whether you're full-time or part-time. Each doctor is, in essence, their own profit center, as is each practice site. Individual docs can work as much or as little as they want, provided they and their partners are happy with the results (income, availability, cross-coverage, etc.) It's not easy to work part-time, but it can be done.

 

[jdh71]

Personally, I don't think there is any sort of reason I should work myself to the bone for what? I also see medicine as being more of a job. I know I didn't enter medical school to "help people" - if that happens along the way - BONUS! I'm here because I wanted a cool job, intellectually challenging job, and personally fufilling job. The hours are just merely the part of the package. But I think the idea that just because I am a doctor that I need to work all these hours is crazy. I'm like a plumber or an electrician or more properly a mechanic - you pay me for a service. I will work and do my best for those I am taking care of and if that means 100 hours one week, then so be it, but I do not "owe" any patient above and beyound that. You may argue that that a doctor should do more, and I won't disuade you of that opinion, but it's nothing more than your own personal preference. It is possible to create practices with pretty regular hours, little to no weekends, and little to no call, especially with certain specialties. You may not find high compensation with these hours, but like I said you do not owe anyone slave hours. I'm personally looking at hospitalist work in the future it's an 80+ week on, and then one off. Seems like a fair trade. Should I, just because I am doctor, work more hours? When did these ideas infiltrate medicine?

 

[Law2Doc]

Should I, just because I am doctor, work more hours? When did these ideas infiltrate medicine?

I think historically the long hour notions largely infiltrated medicine back in the heyday when cocaine was legal by prescription and physicians were thus able to self prescribe and work 20 hour days. (All the greats did it). We are in part stuck with that legacy.

But today people are working longer and longer hours because we are under a reimbursement system where more throughput/procedures equals more income. And as reimbursement amounts decline, and costs of insurance and other expenses increase the hours/procedures have to increase to keep at the same income level. And when someone is looking to fill a position, and he can get 1 person to work 80 hrs/wk and fill the spot of two people working 40 hrs/wk yet costs half the overhead, the 80 hr/wk person gets the job. (Assuming the practice doesn't use the pay your own way system Kent described, which I suspect is less common).

 

[jdh71]

I think historically the long hour notions largely infiltrated medicine back in the heyday when cocaine was legal by prescription and physicians were thus able to self prescribe and work 20 hour days. (All the greats did it). We are in part stuck with that legacy.

I'm not saying you are wrong, and I know of a few back-in-the-day docs who used cocaine, but I have a hard time thinking this is the best explanation. As an aside, could you imagine coke-rounds? HA!

But today people are working longer and longer hours because we are under a reimbursement system where more throughput/procedures equals more income. And as reimbursement amounts decline, and costs of insurance and other expenses increase the hours/procedures have to increase to keep at the same income level. And when someone is looking to fill a position, and he can get 1 person to work 80 hrs/wk and fill the spot of two people working 40 hrs/wk yet costs half the overhead, the 80 hr/wk person gets the job. (Assuming the practice doesn't use the pay your own way system Kent described, which I suspect is less common).

Yes, I do understand this, and genreally agree, but I would also point out that as a physician you should be able to moderate your hours. Yes, you may take a pay cut, but there is no reason we should all be expected it work so much. Although working as much as the work requires is another thing altogether. For instance, if I work as as a hospitalist when I'm done, I'll work as much as there is work to do when I'm on and this might mean 100 weeks sometimes, but that's just hospital medicine . . . I guess my point is where does this workaholism come from. I even notice some resentment aginst folks who have the audacity to suggest normal working hours. I don't know. It just seems like after all the school and training if a doc wants to work "normal" hours the he or she should.

 

[Law2Doc]

I even notice some resentment aginst folks who have the audacity to suggest normal working hours. I don't know. It just seems like after all the school and training if a doc wants to work "normal" hours the he or she should.

Part and parcel of being a professional is being a workaholic -- partly because that's who is willing to jump through all the hoops and schooling to get here. I certainly have no resentment against folks who want to work normal hours, but having worked as a professional before and knowing pretty well the demands, overhead costs and the like in a practice, I just don't think it a very realistic expectation to have a < 45hr/wk job as a physician.

It's tough to line up something like that now in the couple of specialties where it's even possible, and getting tougher annually. I truly suspect part time job options will largely go by the wayside in a few years, as reimbursements continue to go down and patient loads go up.

 

[oldbearprofessor]

And for those who get "called" is it a little voice you hear inside your head calling you to medicine? I mean, how am I supposed to know that being a physician is a "calling" vs a "job" that I've wanted to do since I was a kid? I don't know, but this whole "calling" thing sounds a little snooty.

Any thoughts?

Unfortunately, the term "calling" can get interpreted in a religious way that makes many people uncomfortable and provokes images of a Supreme Being using a cell phone to guide ones med school or residency application.

An alternative idea is that some people find (a bit/a lot/immense) personal satisfaction in medicine, or any career that they've chosen and come to understand, and feel that this is due to them having found a life's task that "fits" them. This can be in a religious context (without the cell phone call) or not. Others don't have that sense. Neither is right or wrong and certainly no one should be looked down upon or take excessive credit for having this feeling or belief.

For me, I value what I do very much. I find satisfaction in it and I believe that working with my wife and with the support of my children have found a way to come up with a life balance even though I work well over 40 hours/week including several 30 hour in-house night-call shifts each month. I travel a lot as well related to my work. There is an option of shift work as an attending in my field, but no real 8-5 option. Babies like to be born and become ill at night and on weekends and holidays.

I am grateful for the opportunity (actually I am grateful to a Supreme Being whom I believe in, but again, the religious aspect is a turn-off to some and not needed for my point) to have the career I have. If someone else chooses a career emphasizing more regular work hours, that's great for them, but not my choice.

Regards

OBP

 

[deleted87716]

Unfortunately, the term "calling" can get interpreted in a religious way that makes many people uncomfortable and provokes images of a Supreme Being using a cell phone to guide ones med school or residency application.

Agreed. I think most people use the term "calling" to simply mean that they're particularly well-suited for medicine as a vocation. I imagine those who are using it in a religious sense are in the minority.

 

[LurkNoMore]

Derm if he has the scores....... or Psych both will easily fulfill these requirements without "cutting corners"