Hi there,
I am a senior surgical resident who loves everything about what I do. I cannot wait to get to work in the morning and I love all of the challenges that surgery had presented me and presents to me on a daily basis. This residency has been long, physically and mentally demanding but it has been great fun too.
I am not going to blow smoke and sunshine up your a-- but medicine has loads of drawbacks. It is not the lucrative profession that it once was. Gone are the days of instant ticket to the country club. Reimbursments are down and going down every year; malpractice premiums are going up and high for surgical specialties and some physicians are going bankrupt because of huge overhead costs and the changing face of private practice. Few medical school applicants understand the business of medical practice and practice building. Even fewer understand the seriousness of some issues facing practicing physicans today.
Medicine is a very difficult profession in that it takes years of expensive preparation with little guarantees at the other end. One is often forced to make life and professional decisions within medicine with huge life-changing implications and often on very short notice.
Reimbursements are at the hands of Congress. The AMA is a very poor lobbying agency in terms of representing the interests of practicing and student physicians. This past year we (I am part of that physician lobby) lobbied for studying ways to decrease the debt load for physicians who enter primary care. Currently there is the HSP program and armed forces but that is about it. We also lobbied to study reducing the debt load on students coming out of medical school in terms of making and keeping interest rates very low. (Medical students carry some of the highest loans of any profession). We also lobbied for changing the reimbursement formula (currently tied to the GNP which has nothing to do with cost of practice) to reflect increased costs of practice. The amount that a general surgeon is paid for doing a hernia is much less today than even three years ago. Much of our lobbying efforts fell on deaf ears in terms of Congress.
Medicine is very, very difficult to do well. The hours are very long and patients are very sick. For many physicians, in order to make a living, they have to see a huge volume of patients with complicated pathology in a very short period of time. Many HMOs and insurance companies have replaced primary care physicians with mid-level practicioners as a cost-cutting measure.
Still, I love to operate and I would choose medicine/surgery if I had it to do over. There is nothing more satisfying for me than operating the entire day. It's instant gratification even when things do not go routine. There is always a challenge and I love it. I also work very hard and very long to hone my skills and knowledge.
If you are entering medicine for prestige, respect and money, you are likely to be disappointed. If you are entering medicine because you love the work and enjoy the challenge, you are likely to love your profession.
njbmd
