Medicine

[R3D2P1]

Hey...I was researching the field of medicine and spoke to a quite a few physicians for their perspectives on the profession. However, I did receive some negative responses. A common statement was that "medicine is not what it used to be" and how they are really sick of dealing with HMOs, malpractice insurance and enourmous amout of paper work. I even asked if they would recommend going into the field...and many answered "no".

I was just wondering if many of you have been told this or even heard of this? What are your views on this topic?

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[lf777]

Hi

Very common to hear that people would not have chosen Medicine if they could go back. But it is still very gratifying to see patients that you are able to help. Sure, it is a lot of work. But there are specialties that have a better lifestyle.

lf

 

[HamSandwich]

four years ago, a few days before i started med school, i went for my physical. the doc doing the PE basically told me i was an idiot to leave business for medicine and if she could do it all over again, she would get her MBA instead. i am v. happy that i chose medicine and if you are sure that is what you want to do, do what 311 says and F the naysayers.

remember too that you are going into it now and have no idea of "how it used to be". this will be all you know and hopefully things will get better from here.

 

[lowbudget]

Well, grass is always greener... Most people who lament whether or not they would've gone to law school or b-school forget that everything they have now is the result of having gone through med school and that life would've been different if not worse had they chosen a different path. The paper work is truly a pain, but that's part of the job and you have to think of it like that. There is no job out there that doesn't have paper work and dealing with difficult people and organizations. Imagine the amount of paper work in fields requiring MBA and law? Everything you do requires a report or a powerpoint presentation or a model. Worse yet, in some fields your hours are just as bad as medicine. No need lamenting. Everything is just as bad.

 

[Lonestar]

Medicine is just not what it used to be. Really, I wouldn't do it over again. Do something else. Maybe optometry, pharmacy, dentistry. To me these are better options with much less schooling. Just my two cents.

 

[R3D2P1]

Hey...

Thank you for all of your responses. I was wondering, for those who are in the profession...do you have any regrets? Would you opt to go into another field if given the opportunity? Also, have any of you ever considered going into dentistry?

Medicine is just not what it used to be. Really, I wouldn't do it over again. Do something else. Maybe optometry, pharmacy, dentistry. To me these are better options with much less schooling. Just my two cents.

Lonestar...exactly why wouldn't you do it over again? What are your reasons, if you don't mind me asking? (aren't both medicine and dentistry four years of school)

RDP

 

[shag]

In general, medicine is moving toward trade status like auto mechanics or plumbing. The days of super respect for docs and big $$$ are pretty much gone. Lots of folks are self diagnosing based on internet articles, ordering prescription meds from overseas, and then busting you chops in the ED for being "incompetent" when they screw themselves up.

The rewards of medicine still include satisfaction gained from helping people, the ability to route phone calls from friends and family at all hours of the day and night, and having 2 letters after your name.

Seriously, life is a journey as is medicine. I would be doing much better financially if had continued in business, but I don't think that life is a rush to having the biggest bank account. When I'm 70 and reflecting back on my life as a surgeon, I think that I will satisfied with my life's course. Of course, that reflecting will have to happen between cases since I'll still be scrambling to finally finish paying off school loans.

R3P2D1: FYI, MD's have 3-11 yrs of training (i.e. residency, research, and/or fellowship) to complete after getting the letters; Dentists can go straight to work, make 3X what a PCP makes working half the hours, and retire at 40.

 

[Lonestar]

R3D2P1,
here are reasons I wouldnot go into medicine. #1 NOT as gratifying as people think it is. You are rarely saving lives. For the most part, you will be doing TONS of paperwork/scutwork and not to mention tons of buttkissing. Many (majority) of the patients don't really care about their health or you. #2 You will be practicing medicine for the lawyers. Forget evidence-based medicine. You need to order every test under the sun (no thinking involved here). You will always be aware of legal ramifications. #3 Most of your colleagues/attendings are not NORMAL. This is a big factor for me. Lots of backstabing and simply ****ed up personalities. Now many may start out normal but they change after years of mistreatment (from superiors). YOU will be the victim. Very few genuinely care about your happiness. We have a saying about the hospital staff "they are not your friends" (referring to being honest about your career plans with the attendings and residents). #4 As I have mentioned before, the time it takes to get to private practice is just waaaaay tooooo much. 4 yrs medschool + 3-7 yrs residency. Being a specialist takes more time. For some reason, some idiots keep increasing the years in some residencies (as I have said lots of screwed up personalities). Passive-aggressive type people seem to be prevalent in this field. #5 Waaay tooo much debt. 100-200K. If you become a generalist, good luck trying to pay this off. You will be broke during the years of your life that you should be enjoying. When you do make some money, about half of it will go to uncle sam. Damn, Life is a vicious circle. #6 The hours are UNGODLY. You will NOT have a family life. Medicine defines a full time job as 60 hours a week minimum (again this can be due to the LOTS OF MESSED UP PERSONALITIES in this field). Now there are many NORMAL personalities in the field, BUT they get overshadowed by the malignant ones. During your residency years, you will work anywhere from 60-90 hours/wk. Basically you will get paid less that $7/hr. Vacation time is practically non-existent. The moral of the story: its a game of survival. Hope this helps.

 

[DrQuinn]

R3D2P1,
here are reasons I wouldnot go into medicine. #1 NOT as gratifying as people think it is. You are rarely saving lives. For the most part, you will be doing TONS of paperwork/scutwork and not to mention tons of buttkissing. Many (majority) of the patients don't really care about their health or you. #2 You will be practicing medicine for the lawyers. Forget evidence-based medicine. You need to order every test under the sun (no thinking involved here). #3 Most of your colleagues/attendings are not NORMAL. This is a big factor for me. Lots of backstabing and simply ****ed up personalities. #4 As I have mentioned before, the time it takes to get to private practice is just waaaaay tooooo much. #5 Waaay tooo much debt. 100-200K. #6 The hours are UNGODLY. .

1) Actually, I think what I do is very gratifying! I'm only an intern but I really enjoy what I do and I leave work knowing I made a difference (unlike when I was a paralegal). 2) Incorrect. You are practicing medicine for the PATIENT. If you do what is right for the patient, the lawyers have nothing on you. EBM is what is "right" to do. 3) Nope. I enjoy all my attendings and colleagues... we had a happy hour a few days ago and it was an absolute blast, just like back in college. 4) Four years of medical school, I am a full time resident, get paid 40k, and in two more years will be out making 200k+... I think that's fine! I've had so much fun these past 5 years... 5) I owe 180k. I'll be paying 700 a month for 30 years. Considering i'll be makign 200k+, that's not that big a deal, really, for a 40 hour work week. 6) Hours aren't THAT bad. I enjoy work, I enjoy the nurses, the other residents, and the patients.

If you go in with a negative attitude, you will hate absolutely everything.

Check out the EM Forums. See how much fun we have in what we do. You HAVE to like what you do otherwise you'll be one disgruntled mofo.

I love what I do!

Q, DO

 

[Lonestar]

well, I guess I am a disgruntled mofo. But in all honesty, there are many positive aspects of medicine that I didn't mention. In my opinion, they just happen to be overshadowed by the negative ones. Good luck with your decision.

P.S. This will be me during my residency years

 

[hndrx1a]

Hey Quinn, I understood Lonestar as griping about medicine (Int.Med/Gen.Med ) where salary is no where near ER's, and paperwork seems endless...

 

[R3D2P1]

Hey guys...

I was just wondering...why did you all decide to go into medicine? Were you always interested in going into the profession? Have any of you ever considered going into dentistry?

 

[Hudson]

I think most of us went into medicine b/c of a mixture of the following: $$$/financial security, scientific curiosity/intellectual challenge, desire to contribute/help others, autonomy(being one's own boss). You could make the same argument for dentistry except for the intellectually challenging factor. I think a lot of people in med school would say they would be bored with dentistry. That is why I did not go to dental school. Oral/maxillofacial surg is cool stuff though.

It used to be that Docs made more money than dentist. This may still be true with some specialties, but if you break it down by hourly wage then I bet dentist make more per/hr than all docs except rads/anesth/optho/derm. I bet orthodontist make more per hour than any doc. Most of us probably did not forsee this finalcial discrepancy when we applied to medical school. If you already know that you want to balance lifestyle and work then dentistry may be a better option than medicine. Even if you go to med school, once there it is hard to guarantee yourself a spot in a "lifestyle" specialty. However, medicine is fun and challenging, but it also has huge drawbacks already discussed.

On another note: Lonestar why are you so bitter as a medical student? Its not nearly as bad as you make it out. Are you even going to practice medicine? If you hate it that much do yourself and your future patients a favor and do something else.

 

[Foxxy Cleopatra]

I admire people, actually, I ENVY people that have graduated from medical school and have truly found what they loved.

I heard the same warnings when I applied to medical school, "stay away, bad choice, etc." I turned the proverbial deaf ear to those comments and thought, "it won't be like that for me." Yeah, famous last words.

IMO it is good thing if you have a passion for medicine outside of the "I want to help people" one. I never got into the prestige, role, money and I think that is why I have struggled with my choice since graduating from medical school. I even hate white coats- I think they are dirty, nasty germ vectors and I hate washing and ironing them.

What motivated me as a student is that I truly DID like taking care of patients- all of the bad things seemed worthwhile as long as I got the chance to help people.

A year later my tune has nearly done a 180. Granted, I am a surgery resident (which is not the kindest way to spend a year of your life) and after the lawsuit threats, practicing medicine for the lawyers/business, having to fight against the system to provide halfway decent patient care, putting my own health in jeopardy, being strapped to a job with my >$10OK of debt, working, let's just say, many hours a week... l wonder if I was insane at the age of 21 to sign myself up for this career.

ANYWAYS, choose wisely should you decide to go to medical school. Realize that it is a HUGE committment and have some of your reasons for wanting to be in medicine be not-so-idealistic ones.

good luck

 

[kinetic]

I admire people, actually, I ENVY people that have graduated from medical school and have truly found what they loved.

I heard the same warnings when I applied to medical school, "stay away, bad choice, etc." I turned the proverbial deaf ear to those comments and thought, "it won't be like that for me." Yeah, famous last words.

I hear that. I always see the people who are so into what they are doing that they won't shut up about the latest journal article and they know every paper that was generated in their field for the last 20 years. Who are you people?!?! YEARGH!!

 

[kinetic]

well, I guess I am a disgruntled mofo.

No, THIS is being a disgruntled mofo.

Kinetic being a disgruntled mofo as he explains Medicine to an unsuspecting victim.

 

[aphistis]

Have any of you ever considered going into dentistry?

I've heard the question a million times, but never this direction. Let's hear it for equity!

 

[Lonestar]

I am not as bitter as the original post I made. This person asked for the drawbacks and I gave them to him/her. If that person had asked for the positives of going into the field of medicine, than I would have done so. My original post was to make R3D2P1 aware of the negatives of medicine. I mean you can't sugarcoat it at all. Being a generalist just sux nowdays, and many/majority of the docs are generalists (i.e. peds, family docs, general internists, etc.). BTW I have graduated from med school. The way I looked at it in 3rd year is that if I can tolerate the negatives of a particular field than I can be happy with it. Now, it would be great if I find one that I am truly passionate about, but if I didn't then I knew I had suitable backups.

On the contrary, I am pretty happy that i got into anesthesiology. In my opinion, there certainly are some fields worth doing, but to get to them is about survival, sacrifice, and self-discipline. Some of the good fields are ROAD specialties, ENT, PM&R, ER, etc. A person may start out trying to be generous, but end up just helping himself in the end. And I saw this more and more among my classmates. I know that many of us thought of docs as having the respect, the nice house, nice cars, etc. when we started, but never once thought of what it takes to get there. We all started out saying we will be the best med studs that we can be, but as most of us finish we end up doing enough to get by. We end up studying for the sake of passing tests, and NOT for the sake of truly learning something. I hope my point is getting through: its a game of survival. AND nowdays there are many other fields with comparable income to that of a generalist with much less hassle to finish. Many pharmacists make above a 100K in many states with much less hours. I know because my pharmacist cousin in Texas tells me so. Same thing with optometry, dentistry, hell even Anesthesiology Assistant. These are all fields where you help people, but don't give up your family life. If we end up helping ourselves anyway, why not make a smart decision and go into one of these fields. Just my 2 cents.

 

[Lonestar]

Oh yeah, I just wanted to Add:

KINETIC, YOU ROCK MAN!!!!!!!

Here's another tidbit from my life: During my third year psychiatry rotation, I had this patient who would not talk to me unless he got his disability check. Well, I convey this to my psych attending, and he is all cool about it. Well, six weeks later I find out that the reason I passed and didnot get a high pass was that I was not able to communicate effectively with my patients and he cited this incident. The patient ended up being discharged without care, because 3 psych attendings weren't able to get a single bit of info out of him. The patient kept saying, "I gots to get my disability check or I ain't talkin'." Seriously, this is the only thing the psych attendings wrote in his history part. I guess it didn't really matter that I scored 80th percentile on my psych shelf test. There are lots of messed up personalities in medicine even in laid back fields.

 

[Mirror Form]

A lot of the stuff people have said here is 100% accurate. But one thing a lot of medical students (and even many residents) don't realize is that once you're an attending you can choose not to work in certain areas. For instance, some people complain about their patients (I'm on of them). Well, believe it or not, the majority of the population isn't IV drug users and once we're attendings we can join nice suburban private practices that only see normal people if that's more our speed. Also, Foxxy chose a field WELL KNOWN to be malignant; big surprise she's not lovin residency! You won't see me doing gen surg b/c I don't feel like putting up with that crap, and there are plenty of routes in medicine that don't require you to. There are lots of options available once you get your MD, it's a great investment.

 

[avendesora]

As I get ready to graduate and start residency, I'm trying to reconcile what I really want to do (IM for now, Cardiology eventually) with the fact that I want to have a meaningful family life, have outside interests, and occasionally go on vacations. It's tough when I look at people I know working at the F'in Kroger pharmacy making $70-90K for 40 hours per week. Yeah, I could someday make $400k as an interventionalist, but at what price? Working 90 hours a week and being on call all the time? Is 200 thou a year really better than 100 if you're working twice as much?

Still, I love what I'm doing. I've been doing a consult month with 90% responsible, grateful patients in the clinic and it is SO nice to be able to interact like a human being with them. Like someone said previously, it's all about where you end up practicing -- real life is not like your inner-city academic hospital.

Also, I've been practicing signing my name with 'MD' -- kind of nice!

I think if I knew what I know now 4 years ago, I might have gone the route of pharmacy or even PA school. Still, in the end, I'm glad it happened the way it did. In the short term I might have been happier, but at the end of a career I will be able to say I was a PHYSICIAN and I think it will be worth it.

 

[medique]

One big reason why want to do medicine is because of the sdupposed intellectual change. Every body is different and must be solved accordingly, and the leaps in technology and advances in biology are exciting. Also you'll b able to collaborate with smart people.

What do you think about this at this stage in your med education? And is there any room for creativity in medicine?

Thanks.

 

[Square Pants]

Yeah, go ahead and try to be creative. You'll get labeled a cowboy or slapped with a lawsuit so fast your head will spin.
Medicine in general is all about following protocol. Treatment algorithms, standard of care, standard orders, and other very non-creative stuff.
Can you read a list and follow a flow chart? Great! You just mastered the fine art of covering your ass! Do it for 3 years, take a standardized test for board certification, and (lucky you) you get to do it forever.

Anyway, as a previous poster noted, what really irks me is that most patients don't even care about themselves enough to attempt to get better. I figure about 75% of admissions to IM are secondary to imminently preventable dz. Think about it. What percentage of your patients right now are in the hospital because they 1) Don't eat right 2) Smoke or 3) don't exercise.
The good any doctor can do pales in comparison to the damage patients inflict upon themselves. Very frustrating

 

[Mirror Form]

Yeah, go ahead and try to be creative. You'll get labeled a cowboy or slapped with a lawsuit so fast your head will spin.
Medicine in general is all about following protocol. Treatment algorithms, standard of care, standard orders, and other very non-creative stuff.
Can you read a list and follow a flow chart? Great! You just mastered the fine art of covering your ass! Do it for 3 years, take a standardized test for board certification, and (lucky you) you get to do it forever.

This is true to some extent, but a good percentage of the patients you'll see don't fall into the neat little categories and the physician must use their own clinical experience and judgement to decide the best course of action.

Anyway, as a previous poster noted, what really irks me is that most patients don't even care about themselves enough to attempt to get better. I figure about 75% of admissions to IM are secondary to imminently preventable dz. Think about it. What percentage of your patients right now are in the hospital because they 1) Don't eat right 2) Smoke or 3) don't exercise.
The good any doctor can do pales in comparison to the damage patients inflict upon themselves. Very frustrating

It's tough to argue with that. Last month we had a patient who had just had a BKA (below the knee amputation) b/c of diabetes and non-compliance with tx. What was she doing on the day of d/c? Naturally her friend had brought her in a huge bad of candy and potatoe chips and she was pigging out. Most patients are at least compliant with tx for a week after getting their foot amputated! Sometimes you do start asking yourself why we even bother!