talking about why people are in med school and how they got there

[Arista.MD]

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I am halfway through 1st year at top 10 med school, and I already see about half of my class admitting some a little more timidly some more courajously that they could not care less about anything else, and that they are in for the money. 90% of my class is going to match in a highly competitive residency. Of these 50% are in for the money. Where is healthcare going?

Most of my colleagues probably lied in their application, "I want to be a doctor because I care about people" says the standard application phrase. But how many of us continue to volunteer after they get in? maybe 5%. And interestingly enough of those who volunteer at free clinic why do they do it? Because it is practice time! I think most of us really love medicine because it is intriguing, that's why we self inflict pain on ourselves by essentially frying our brains for 4 years, learning a million things we might or might not use later on. I think we like it because we are used to work hard, and because at the end of the day the pay is high. But honestly, they should eliminate the whole "volunteering" and "I care about people" thing from the application. As long as you don't come across as a total jerk in your interview I don't think you need to volunteer anywhere. We should really get the best people in medicine, at the end of the day is the people who are working harder, have the highest endurance, and are the brightest who are going to succed. Do you really care if your cardiologist is nice or not, if he is going to kill you cause he forgot how to put a stent in? And also, they teach you people skills in the first year of medical school, they teach you how to talk to patients, how to interact with them, what kind of questions to ask, and what kind of questions not to ask, and what to do so you are not going to get sued.

So my question is What kind of people are we selecting, and why are we making people lie in their application when the whole "I care about people" phrase has no value when you are on the other side of the fence. This is just for reflexion... don't get all angry about it.

 

[typeB-md]

they played the game and did it very well. the problem is that you are judging them based on your own ideals. there is nothing wrong with wanting a nice paying profession, but also keep in mind that any doctor, no matter how rich, is going to help other people which is more than can be said for many other professions.

yes i agree that they were probably 'misleading' during their interview, but when you see half of stanforod match in derm, then you know something was up. the reality of it is, the top schools want the top people so that they can brag... the top scores, the top matches, etc.

it's a game and the more you think about how others may have been disingenuous you are just going to make yourself angry.

 

[tigershark]

Making money and "helping people" are not mutually exclusive. It's rather sad how med students are brainwashed by med schools to believe that money shouldnt even be considered. Whoever controls the money has all the power, and this sissified crap being pushed by med schools is a major reason why doctors are losing alot of power over patient care.

I plan on maximizing profit and making as much money as I possibly can, there's no reason why I shouldn't do that as long it doesnt compromise patient care, you would be stupid not to.

I agree with you that "volunteering" should be removed from applications. I find it disgusting that people "volunteer" and then try and get all the credit they can for it. People that volunteer just to pad their application are just as bad as the people that lie about "helping people." If you are volunteering for good reasons then there is no need claim credit anywhere.

 

[Brickhouse]

Perhaps if you look at schools that aren't competing for the US News #1 ranking you will see a better reflection of where "healthcare is going". Maybe I'm naive, but at my "modest" med school, most of the students are hard working and honest, enjoy learning medicine and have gone into medicine with the expectation that they might be able to have a positive impact in the lives of the people they serve. I don't think you necessarily have to be literally volunteering to have the same effect in the world that volunteering produces. It doesn't presuppose a defect of character to want to earn a living in your lifetime. To support myself and help others with my knowledge - I think that is a very admirable goal to have.
There will always be those people who just want a lot of money. Keep your own intentions honorable, that's the best thing you can do.

 

[dancinjenn]

I think it really depends on where you go to school. Wayne is a huge medical school. There are over 1000 students MS1 - 4 combined. We have the largest number of student organizations out of ANY medical school in the country, which do an enormous amount of volunteering. We also do community projects like cleaning up playgrounds, Habitat for Humanity, soup kitchens, donating time/items to shelters, blood drives, etc. I would say that 75% of my class does some type of volunteering.

Being commited to the community is one of our greatest prides. We have an obligation to the city and surrounding area because we are going to be the future physicians and leaders of the area and I believe that most of us (myself included)wish to stay in the area to practice, and it is to our benefit to learn how the city and surrounding areas are put together to better serve our future patients.

I'm not saying that we all are these altruistic wonders. Part of my reasons for choosing medicine included the job security and the compensation factor, and I think most of us would be lying if we said it never crossed our minds. I think it depends on how close to the top of your list the money factor is. For some it is a deal maker/breaker, for myself and others...more of a perk.

 

[donvicious]

Premedical volunteering may not be altruistic but it is one way to "color" the application. It is a tool that admissions committees use to better understand the real person behind the MCAT score and GPA.

 

[Fantasy Sports]

I am halfway through 1st year at top 10 med school, and I already see about half of my class admitting some a little more timidly some more courajously that they could not care less about anything else, and that they are in for the money. 90% of my class is going to match in a highly competitive residency. Of these 50% are in for the money. Where is healthcare going?

That's the problem with top 10 schools. I think the average med school isnt going to have as big a problem in this regard.

 

[Brickhouse]

That's the problem with top 10 schools. I think the average med school isnt going to have as big a problem in this regard.

That's what I said! 😀

 

[Iwy Em Hotep]

That's the problem with top 10 schools. I think the average med school isnt going to have as big a problem in this regard.

Curious...I'm at a top 10 school too, and I think the student body leans far towards the altruistic end. Informal survey showed about 1/3 of the class wanting to do family med. Lots of neuro, med. Only a handful interested in ortho or rads.

Probably just depends on the school.

 

[cytoborg]

Curious...I'm at a top 10 school too, and I think the student body leans far towards the altruistic end.

Same here. Many if not most have done signficiant volunteer work over the 4 yrs (not me - can't imagine how I would have found the time - guess my classmates are brilliant enough to keep up and have time for outside stuff...I am not! 🙁 ) and are vociferous advocates for patients. When I got jaded and discouraged and was just trying to make it through the day, these people were still superhumanly motivated and enthusiastic about caring for people. (Annoying, aren't they? 😀 ) Of course there are a few colorful personalities whom I don't consider friends of mine necessarily...but they will still probably make excellent physicians, as I've seen them care for their patients and they too are outstanding...also annoying. 😀 Overall my classmates have truly humbled me. I frankly don't know how I ever made it into that school... 😕

Informal survey showed about 1/3 of the class wanting to do family med. Lots of neuro, med. Only a handful interested in ortho or rads.

Just because someone chooses family med, neuro or IM doesn't make them a better or more altruistic person. One might argue that in those particular fields, there is actually little opportunity to definitively cure people or change their lives in a dramatic way, which is something many medical students (wanting to help people) find sad and frustrating. We all need physicians to manage our HTN, DM, UTIs and CVAs, and I'm very glad someone enjoys doing that, but let's not suggest that fields like ortho and rads don't make a HUGE impact on patient's lives.

 

[Fantasy Sports]

That's what I said! 😀

Im just agreeing with ya, Mrs. Bloom 😎

 

[Fantasy Sports]

Just because someone chooses family med, neuro or IM doesn't make them a better or more altruistic person. One might argue that in those particular fields, there is actually little opportunity to definitively cure people or change their lives in a dramatic way, which is something many medical students (wanting to help people) find sad and frustrating. We all need physicians to manage our HTN, DM, UTIs and CVAs, and I'm very glad someone enjoys doing that, but let's not suggest that fields like ortho and rads don't make a HUGE impact on patient's lives.

While what you say is true, when you hear about students matching into derm, plastics, gas, rads, and radonc just for money/lifestyle, it jades your view of a)those people and b)those specialties. Getting paid and helping people arent mutually exclusive. But what does differ is the REASON you are in a specific specialty, which determines how your classmates behave. I think this is what the OP was referring to.

 

[DCM]

Some people think about other high-paying jobs like business or law and then feel like they need something more tangible or rewarding and medicine is a natural choice. So for them a high paying specialty makes a lot of sense. Still contributing to noble medical field and getting paid. Being kind is very important, but being technically competent is the most important. Being altruistic is needed in some percentage of the class but not everyone.

Also the enormous debt combined with length of residency and other delayed gratification probably makes people want more of a reward at the end than working so many hours for a salary that they could have gotten much more easily by another path without the debt and sacrifice.

As a physics major I thought rads or rad onc would be a great way to pursue my interests but now I am somewhat dissuaded because I don't want to feel like a sell-out. Maybe if I'm in academics...

 

[typeB-md]

While what you say is true, when you hear about students matching into derm, plastics, gas, rads, and radonc just for money/lifestyle, it jades your view of a)those people and b)those specialties. Getting paid and helping people arent mutually exclusive. But what does differ is the REASON you are in a specific specialty, which determines how your classmates behave. I think this is what the OP was referring to.

well it must be taken into relative perspective.... if the guy playing basketball is making $25 million, then the guy who's actually saving lives and making them better can settle for $600K.

i hate how everyone is like "oh no... he is doing it for the money" like that's denigrating. The guy who's doing it for the money is making just as much of an impact as the guy who is doing it for the love. And it's not always like these guys are doing it because they hate it.. maybe they like medicine a little but don't want to make it the focus of their life. Or maybe they want to retire at 50 and enjoy their life.

students put away much of their youth to ensure that the rest of their life will be taken care of... this is not right or wrong... just different strokes.

 

[typeB-md]

Some people think about other high-paying jobs like business or law and then feel like they need something more tangible or rewarding and medicine is a natural choice. So for them a high paying specialty makes a lot of sense. Still contributing to noble medical field and getting paid. Being kind is very important, but being technically competent is the most important. Being altruistic is needed in some percentage of the class but not everyone.

Also the enormous debt combined with length of residency and other delayed gratification probably makes people want more of a reward at the end than working so many hours for a salary that they could have gotten much more easily by another path without the debt and sacrifice.

As a physics major I thought rads or rad onc would be a great way to pursue my interests but now I am somewhat dissuaded because I don't want to feel like a sell-out. Maybe if I'm in academics...

don't get sucked into a guilt trip because you feel like making some $$

listen.. the reality of it is, surgeons and rads and the likes (save for maybe derm, which i think really is a good student reward) really outshine any other form of medicine if you want to talk about who patients really give their kudos to. all of these other doctors are great in how they do their deal, but i hate how others bash surgeons.

a surgeon who saves someones life or does a bypass is much more 'helpful' in the sense that without them, they would be left to die.

no doctor is better or worse but c'mon family practice isn't for everyone.

 

[cytoborg]

While what you say is true, when you hear about students matching into derm, plastics, gas, rads, and radonc just for money/lifestyle, it jades your view of a)those people and b)those specialties. Getting paid and helping people arent mutually exclusive. But what does differ is the REASON you are in a specific specialty, which determines how your classmates behave. I think this is what the OP was referring to.

I guess I've been fortunate in that I haven't ever witnessed those motives or behaviors in any classmates (or residents, or attendings for that matter) even though plenty of them do choose competetive specialties. There seems to be a perception on SDN that top schools attract money-hungry selfish bastards, and this thread is feeding into that a bit...no offense to the OP as she's simply stating her personal observations (sad ones, I might add...I can't imagine remotely enjoying med school without some other motivation in addition to $). There's also a perception that competitive fields attract the same said bastards...perhaps that's true of some places, just doesn't seem to be true here. Just my $.02.

 

[cytoborg]

As a physics major I thought rads or rad onc would be a great way to pursue my interests but now I am somewhat dissuaded because I don't want to feel like a sell-out. Maybe if I'm in academics...

Do what you love. Period. No one was ever accused of "selling out" for pursuing their passion. Plus, rads and rad-onc help patients in a HUGE way and can be extremely satisfying.

 

[prmd4555]

wow I really disagree with this. I feel like medical school has really opened my eyes to the fact that we have a two tiered system of health care - that health care is a privelege in this country and not a right.

When someone with no health insurance, who has worked all her life, has kids, goes to church each sunday, comes into the office after not seeing a doctor for years with a health complaint that will probably kill her and put her in enormous debt if she goes to the hospital - it just makes me so angry that we have all the technology in the world and that yet so many people are languishing with poor health. I get frustrated that there is so little I can do in the system as it is as a doctor. I guess that is why I volunteer at a free health clinic and with other organizations. Has anyone not experienced this frustration? As doctors how can we just accept this?

The real reason medicine is going down the tubes is that people who are entering into the profession are focused on and perfectly complacent with simply providing a commodity for the rich.

 

[Paws]

Has anyone not experienced this frustration? As doctors how can we just accept this?

1) Yes 👍

2) We can't and we shouldn't 👎

 

[tupac_don]

well it must be taken into relative perspective.... if the guy playing basketball is making $25 million, then the guy who's actually saving lives and making them better can settle for $600K.

i hate how everyone is like "oh no... he is doing it for the money" like that's denigrating. The guy who's doing it for the money is making just as much of an impact as the guy who is doing it for the love. And it's not always like these guys are doing it because they hate it.. maybe they like medicine a little but don't want to make it the focus of their life. Or maybe they want to retire at 50 and enjoy their life.

students put away much of their youth to ensure that the rest of their life will be taken care of... this is not right or wrong... just different strokes.

I agree if you are not getting paid someone else is. Also actually making money is much easier to do something else if money is what you seek. But I think that it is perfectly natural that someone who works hard wants to get rewarded for his work. However, money is really the only tangible way of getting a reward. Going to a specialty that pays well and being successful at it is not selling out at all. It's not like the guy who goes to a lifestyle specialty is working very little getting to where they are. Just my two cents.

 

[Bo Hurley]

Oh geez this is pathetic. Try to live in the real world guys and not this idealistic med school fantasy realm. Premeds/med students/doctors are still like other 'normal' people who didn't choose to go into medicine. Maybe a lot more anal and hard-working but they still want the things others want. That includes job security, a good income to allow them to do what they want in life, etc.

My personal opinion is that EVERY SINGLE extracurricular activity premeds and med students perform is in some way to pad their resume and get them to their next career stepping block so to speak (except if it's a hobby they've been doing for a while and didn't just happen to conveniently pick-up a few days before application time). As premeds they did the token volunteer work like everybody else (read: fear of nonconformity) so they could put it on their application and get them to the med school stepping block. Then in med school they did some more token volunteer work (i.e. inner-city health clinic, blood drive, etc.) so they could put it on their residency applications to get them to their next career stepping block---residency. Some even did 'research' even though they hated research just because they knew most other people trying to get into the competitive specialty they wanted to match into had done some reasearch.

You'll rarely (if ever) find a premed/med student who did some meaningful volunteer work who DIDN'T PUT IT ON THEIR RESUME/APPLICATION or didn't try to sell it during interviews. That says a lot about just why they do volunteer work/research. It's the same reason politicians go around shaking the hands of potential voters and kissing their asses---they don't really want to do it but they know it looks good and will get them the votes they need to advance their careers to the next stepping block.

 

[matthew45]

I find it ironic when people go into medicine for the money....

a) a JD or and MBA or even a real estate license is probably a better ticket the the country club

b) said professions seldom involve blood, urine, feces, or body odor.

 

[daria]

Oh geez this is pathetic. Try to live in the real world guys and not this idealistic med school fantasy realm.
...

My personal opinion is that EVERY SINGLE extracurricular activity premeds and med students perform is in some way to pad their resume and get them to their next career stepping block so to speak (except if it's a hobby they've been doing for a while and didn't just happen to conveniently pick-up a few days before application time).

That's a HUUUUUGE "except" clause there... like saying "EVERY SINGLE doctor out there is a money-grubbing bastard - except for those that aren't".

You'll rarely (if ever) find a premed/med student who did some meaningful volunteer work who DIDN'T PUT IT ON THEIR RESUME/APPLICATION or didn't try to sell it during interviews. That says a lot about just why they do volunteer work/research. It's the same reason politicians go around shaking the hands of potential voters and kissing their asses---they don't really want to do it but they know it looks good and will get them the votes they need to advance their careers to the next stepping block.

On the contrary, cross-referencing your comment about trying to live in the real world and not "some idealistic med school fantasy realm" -- I suspect in a substantial minority of cases, you're seeing idealistic premeds accepting reality by doing the self-marketing they have to do in order to become a physician. We're idealistic, not stupid. 🙄

Alas, I think it's a minority who come at it from this direction, but I'm hoping the percentage is increasing. It's a hefty percentage at my school, I believe.

 

[daria]

wow I really disagree with this. I feel like medical school has really opened my eyes to the fact that we have a two tiered system of health care - that health care is a privelege in this country and not a right.

When someone with no health insurance, who has worked all her life, has kids, goes to church each sunday, comes into the office after not seeing a doctor for years with a health complaint that will probably kill her and put her in enormous debt if she goes to the hospital - it just makes me so angry that we have all the technology in the world and that yet so many people are languishing with poor health. I get frustrated that there is so little I can do in the system as it is as a doctor. I guess that is why I volunteer at a free health clinic and with other organizations. Has anyone not experienced this frustration? As doctors how can we just accept this?

The real reason medicine is going down the tubes is that people who are entering into the profession are focused on and perfectly complacent with simply providing a commodity for the rich.

prmd4555, I definitely share your frustration. However, a word of hope; I think medicine is perhaps going down the tubes LESS now than it was in the 60s and 70s, the days when physician incomes were at their maximums. That's when we REALLY had droves of people wanting to get into it for the $. As others have pointed out, definitely law school and perhaps business school (depending on the tier) are FAR better returns on investment of time and $ if $ is all you're concerned about. Medicine's generally less of a cash cow than it used to be.

People going into med for the sole purpose of earning high salaries, in my opinion, are indeed bad for medicine. Making $ is not what it's all about. It can be PART of what it's about, and I suppose it's fair enough that that should be a partial motivator for some. It's a lot of work, and hard work should be rewarded (many other things - grade school teaching, for example, are also a lot of work but not adequately rewarded, but that's another topic entirely). When it becomes the primary motivator, it scares me a little; I have no confidence at all that such people will prioritize the welfare of patients as highly as their own pocketbooks. What would stop docs with a primary motivation of $ from rushing through visits ridiculously to cram in a few more patients, performing unnecessary but highly-reimbursed procedures, etc. Only the fear of being found out? Scary... Medicine is a helping profession AND a business; I hope it admits mainly doctors who recognize both. For those who just want the $, go sell widgets and gadgets or something.

 

[typeB-md]

wow I really disagree with this. I feel like medical school has really opened my eyes to the fact that we have a two tiered system of health care - that health care is a privelege in this country and not a right.

When someone with no health insurance, who has worked all her life, has kids, goes to church each sunday, comes into the office after not seeing a doctor for years with a health complaint that will probably kill her and put her in enormous debt if she goes to the hospital - it just makes me so angry that we have all the technology in the world and that yet so many people are languishing with poor health. I get frustrated that there is so little I can do in the system as it is as a doctor. I guess that is why I volunteer at a free health clinic and with other organizations. Has anyone not experienced this frustration? As doctors how can we just accept this?

The real reason medicine is going down the tubes is that people who are entering into the profession are focused on and perfectly complacent with simply providing a commodity for the rich.

while i can see what you're saying, there is no "real" reason to go into medicine. every folk has a different stroke.

and if you don't care about money, that's awesome. But, there are people who care a great deal about money, and just because they do, does not make them bad people. The money grubbing doctors is equally as helpful as the probono clinic doctor, maybe they are different patient tiers, but in the end each person has to sleep at night with the decisions they've made.

 

[typeB-md]

I find it ironic when people go into medicine for the money....

a) a JD or and MBA or even a real estate license is probably a better ticket the the country club

b) said professions seldom involve blood, urine, feces, or body odor.

this is a common misconception about the 'medicine for the money'

jd and MBA are boring and many students of science have an interest in medicine... they just do not want to spend 24/7 doing it.

also, jd and mba are fickle paying fields with no job security

finally, the md is the best degree that a single individual can have. when you have a family or even just for yourself, you are the most knowledgeable person about the human body and can fix/identify many problems on your own without relying on someone else.

 

[azzarah]

I like to help people and I see nothing wrong with wanting to make a good living doing so.

I am halfway through 1st year at top 10 med school, and I already see about half of my class admitting some a little more timidly some more courajously that they could not care less about anything else, and that they are in for the money. 90% of my class is going to match in a highly competitive residency. Of these 50% are in for the money. Where is healthcare going?

Most of my colleagues probably lied in their application, "I want to be a doctor because I care about people" says the standard application phrase. But how many of us continue to volunteer after they get in? maybe 5%. And interestingly enough of those who volunteer at free clinic why do they do it? Because it is practice time! I think most of us really love medicine because it is intriguing, that's why we self inflict pain on ourselves by essentially frying our brains for 4 years, learning a million things we might or might not use later on. I think we like it because we are used to work hard, and because at the end of the day the pay is high. But honestly, they should eliminate the whole "volunteering" and "I care about people" thing from the application. As long as you don't come across as a total jerk in your interview I don't think you need to volunteer anywhere. We should really get the best people in medicine, at the end of the day is the people who are working harder, have the highest endurance, and are the brightest who are going to succed. Do you really care if your cardiologist is nice or not, if he is going to kill you cause he forgot how to put a stent in? And also, they teach you people skills in the first year of medical school, they teach you how to talk to patients, how to interact with them, what kind of questions to ask, and what kind of questions not to ask, and what to do so you are not going to get sued.

So my question is What kind of people are we selecting, and why are we making people lie in their application when the whole "I care about people" phrase has no value when you are on the other side of the fence. This is just for reflexion... don't get all angry about it.

 

[azzarah]

well it must be taken into relative perspective.... if the guy playing basketball is making $25 million, then the guy who's actually saving lives and making them better can settle for $600K.

i hate how everyone is like "oh no... he is doing it for the money" like that's denigrating. The guy who's doing it for the money is making just as much of an impact as the guy who is doing it for the love. And it's not always like these guys are doing it because they hate it.. maybe they like medicine a little but don't want to make it the focus of their life. Or maybe they want to retire at 50 and enjoy their life.

students put away much of their youth to ensure that the rest of their life will be taken care of... this is not right or wrong... just different strokes.

👍 👍

 

[MichiMO]

I think a lot of the debate about whether or not doctors should get a lot of money or even want a lot of money comes from the fact that so many people in our country do not have health care. Because of the disparity in health care access, a lot of people (misinformed people by the way) believe that doctors should be altruistic and take less return for their services because they went into medicine "to help people" so they shouldn't care about making a lot of money.
I absolutly disagree with this. There are plenty of people making tons of money off health care in this country and it is not the physicians. It is the insurance companies, the hospitals, and the drug companies.
If you want to start cutting medical costs start at these places. I known it is like a sin to say this on SDN, but it is called a single payer system people. 36% of medical costs in this country are administrative (vs. the 2-7% that you get in a... oh my lord....SOCIALIZED...medical system). (on a quick side note...malpractice costs only represent 2% of our nations health care costs...so much for the crisis needing emergency tort reform)
If you try to cut costs at the level of doctor's saleries, what happens is you lose the best and brightest who have their pick of careers and chose medicine because it affords the unique ability to make a valuable contribution to society and provide a good living for one's family. Canada is the prime example of why it is dangerous to do this...they lose several hundred medical graduates to the US every year because they have tried to cut costs in their system by cutting doctor's saleries.
Doctors do deserve a good salery. Besides the issue of the large debt most students incure, you are asking someone to not only make personal sacrifices while they are in school, but for the rest of their lives...in terms of time, sleep, stress load, personal relationships. Part of the reason people are willing to do this today IS because they can make a good living. It would hardly be worth it if they couldn't. I would personally go become a school teacher or a social worker or do international aid work....I could think of a million alternatives. I don't think it is amoral that medicine currently ranks higher than those fields in part because of the higher salery. I also don't think it is amoral that certain specialties rank higher because they pay more. I mean, I will make the same life sacrifices if I am in Peds or FP as I would in a higher paying specialty, so if I enjoy that higher paying specialty as much, why wouldn't I go for that? I mean really, people do this everyday in the real world. You are offered two jobs you like equally well...how do you make your decision...which one pays better and offers better benifits....it is only natural. You might even chose the job you liked less well if the pay was substantially better. People do it every day. That is not the definition of being in it "just for the money."
Okay, done with the rant if anyone bothered to read this far.

 

[Gerota]

when you are a pre-med/1st or 2nd year med student, being altruistic sounds nice, but when you are working 80 - 100 hours a week during residency and are sleep deprived, your view point changes. Plus you have to do what interests you- sure learning about diabetes and htn sound fun but actually treating that crap is not for everyone- if it was everyone would be a Primary care doc. Also There is nothing wrong with picking a field with a better lifestyle- one with less call or healthier patients. There are many ways to "help the sick." . there is nothing wrong with wanting to see you your family or to make money to support them.
I consider my 6 year residency altruistic as i work in 2 public hospitals and one VA and make $40 grand. You forget that if it were not for cheap resident labor (i.e abuse) in these facilities, those individuals would have higher expenses or would be denies services.

 

[ptolemy]

What would stop docs with a primary motivation of $ from rushing through visits ridiculously to cram in a few more patients, performing unnecessary but highly-reimbursed procedures, etc. Only the fear of being found out? Scary... Medicine is a helping profession AND a business; I hope it admits mainly doctors who recognize both. For those who just want the $, go sell widgets and gadgets or something.

heh.. have you been to a primary care clinic.. or almost any clinic recently... or better yet, have you picked up the current magazine(us news or newsweek, can't remember) that talks about lack of time doctors spend with patients because of reimbursements? (somewhere on here there's a thread if you want to search) . I don't know how many times I've heard an attending say "I just made $X,000 to do that 5 minute procedure, ain't it great" I will bet you that most of these people did not get into medicine for the money, but they learn to do this to get by. yes, it is disgusting, but there are a lot of other people in medicine for $$$ too. how many plastic surgeons really do burn reconstruction, etc?

sorry, but most of medicine ends up being "this is more cost effective" (which isn't nec. bad esp. from a societal view, but sh|tty from a personal view) or I'm going to ask about this so I can bill at a higher level, etc. yes, it sucks. it sucks royally, but if the system is the way it is, and I'm not about to try to fight the system (which is another entire issue), people learn how to get by in the system. The problem though is, what do you change the system to? socialism? sorry, i really don't want that.

 

[pyranose]

They (those in it for the money) might be in for a rude awakening when socialized medicine is passed.

The study linking bankruptcies and medicine in my opinion is the beginning of something bad.

The general public is almost screaming for it.

Physician's wages keep loosing to other fields such as engineering and law.

I hope I'm wrong.

 

[typeB-md]

They (those in it for the money) might be in for a rude awakening when socialized medicine is passed.

The study linking bankruptcies and medicine in my opinion is the beginning of something bad.

The general public is almost screaming for it.

Physician's wages keep loosing to other fields such as engineering and law.

I hope I'm wrong.

it'll be even funnier when half of the doctors quit and people are still left without healthcare.

and those people are claiming bankruptcy on $12,000 debts.

the solution is to eliminate the middlemen (i.e. why do you need to send forms out when 99% of the time the procedure is OKed?)

socialize medicine and you will immediately see a decline in the quality of healthcare. I will become TypeB-md/banker, realtor, or lawyer

 

[Fantasy Sports]

They (those in it for the money) might be in for a rude awakening when socialized medicine is passed.

And unfortunately so will the American economy and way of life be gone before we switch to socialized medicine. Socialized medicine is contingent on the assumption that those with money will be willing to have the SAME healthcare in a rationed form. Can you imagine telling Bill Gates that "Im sorry, but your wife cannot have BMT since we were only allocated 5,000 units and have already used them up by June?" Its not going to happen.

When it comes down to it, people will spend everything to save their life, and when you tell middle class and upper class individuals that they arent allowed to spend their money to get better care, they will flip out (and to those saying there should be baseline coverage and then you can buy into more, well Europe tried that and it doesnt work, and the EU is about to prevent anyone from buying into more care than anyone else).

And also, look at the unholy alliance of people that would oppose socialized healthcare:

1. rich people
2. HMOs (replaced by govt)
3. insurance companies (also replaced by govt)
4. pharma (no more profits)
5. trial lawyers (govt will make medmal weak so they dont have to pay lawyers)
6. doctors

And that doesnt even take into account the increased tax burden the US will have to take (which we wont, we keep CUTTING taxes in wartime) or the fact that Americans demand SOME choice in their doctors (why PPOs are becoming more popular). In socialized healthcare you're assigned a doctor, and that's that. And that doesnt even get into the fact that no one will specialize anymore, or that doctors will unionize, etc.

Unless we become a MORE socialistic country (like European countries) in terms of our culture, we wont have socialized medicine. And from the way the country looks, socialized healthcare wont happen in our lifetime.

 

[Ross434]

And also, look at the unholy alliance of people that would oppose socialized healthcare:

1. rich people
2. HMOs (replaced by govt)
3. insurance companies (also replaced by govt)
4. pharma (no more profits)
5. trial lawyers (govt will make medmal weak so they dont have to pay lawyers)
6. doctors

Hahaha. The beauty of massive concentrations of power in extremely influential lobbying groups.....Priceless.

 

[Trismegistus4]

There are plenty of people making tons of money off health care in this country and it is not the physicians. It is the insurance companies, the hospitals, and the drug companies.
If you want to start cutting medical costs start at these places. I known it is like a sin to say this on SDN, but it is called a single payer system people. 36% of medical costs in this country are administrative (vs. the 2-7% that you get in a... oh my lord....SOCIALIZED...medical system). (on a quick side note...malpractice costs only represent 2% of our nations health care costs...so much for the crisis needing emergency tort reform)
If you try to cut costs at the level of doctor's saleries, what happens is you lose the best and brightest who have their pick of careers and chose medicine because it affords the unique ability to make a valuable contribution to society and provide a good living for one's family. Canada is the prime example of why it is dangerous to do this...they lose several hundred medical graduates to the US every year because they have tried to cut costs in their system by cutting doctor's saleries.
Doctors do deserve a good salery. Besides the issue of the large debt most students incure, you are asking someone to not only make personal sacrifices while they are in school, but for the rest of their lives...in terms of time, sleep, stress load, personal relationships. Part of the reason people are willing to do this today IS because they can make a good living. It would hardly be worth it if they couldn't. I would personally go become a school teacher or a social worker or do international aid work....I could think of a million alternatives. I don't think it is amoral that medicine currently ranks higher than those fields in part because of the higher salery. I also don't think it is amoral that certain specialties rank higher because they pay more. I mean, I will make the same life sacrifices if I am in Peds or FP as I would in a higher paying specialty, so if I enjoy that higher paying specialty as much, why wouldn't I go for that? I mean really, people do this everyday in the real world. You are offered two jobs you like equally well...how do you make your decision...which one pays better and offers better benifits....it is only natural. You might even chose the job you liked less well if the pay was substantially better. People do it every day. That is not the definition of being in it "just for the money."
Okay, done with the rant if anyone bothered to read this far.

You know, I don't think I have ever seen anyone advocating both socialized medicine and high incomes for doctors before. It's a very interesting idea, but it will never happen. The government will cut costs wherever it can. If socialized medicine happens, doctors' six-figure incomes will be the first things to go. Goverment jobs typically pay less than their private-sector counterparts, and medicine will be no different. Can you imagine the government paying a CT surgeon $350k/year or an FP $150k/year? The public perceives doctors as arrogant, country-club-belonging, Benz-driving, upper-crust snobs, and resents them for it enough already; they'd never stand for doctors having high incomes if those incomes came at taxpayer expense.

I agree with what you say about there being nothing wrong with doctors being well compensated for such a valuable service, though. I'm always puzzled when I see presumed future doctors here on SDN and elsewhere attacking people who actually care somewhat about money. Altruism is great, but practically speaking, I'm not going through all of med school and residency only to come out the other end making $60k. It just wouldn't be worth it. And I'm the least worthy example: in general, intelligent hardworking people who would make the best doctors aren't going to go into medicine if you don't make it worth their while.

it'll be even funnier when half of the doctors quit and people are still left without healthcare.

Another excellent and oft-forgotten point. I was unable to find a cite with brief Googling, but one reason Hillary Clinton's health care plan failed was that they surveyed doctors and found that more than half said they'd retire early or quit medicine if it went through.

 

[Seashelley]

Oh geez this is pathetic. Try to live in the real world guys and not this idealistic med school fantasy realm. Premeds/med students/doctors are still like other 'normal' people who didn't choose to go into medicine. Maybe a lot more anal and hard-working but they still want the things others want. That includes job security, a good income to allow them to do what they want in life, etc.

My personal opinion is that EVERY SINGLE extracurricular activity premeds and med students perform is in some way to pad their resume and get them to their next career stepping block so to speak (except if it's a hobby they've been doing for a while and didn't just happen to conveniently pick-up a few days before application time). As premeds they did the token volunteer work like everybody else (read: fear of nonconformity) so they could put it on their application and get them to the med school stepping block. Then in med school they did some more token volunteer work (i.e. inner-city health clinic, blood drive, etc.) so they could put it on their residency applications to get them to their next career stepping block---residency. Some even did 'research' even though they hated research just because they knew most other people trying to get into the competitive specialty they wanted to match into had done some reasearch.

,...

My opinion closely matches yours...and not just for medical school. Anyone who wants to get accepted into any institution of higher learning where they can get an advanced degree that will enable them to do more things and make more money will pay their dues through things like volunteering. Doesn't mean they're not sincere about it though, you've got to sell the job to yourself as well as sell yourself to any admissions committee out there.

 

[Ross434]

Can you imagine the government paying a CT surgeon $350k/year or an FP $150k/year? The public perceives doctors as arrogant, country-club-belonging, Benz-driving, upper-crust snobs, and resents them for it enough already; they'd never stand for doctors having high incomes if those incomes came at taxpayer expense.

Dont foreign governments (third world) pay ridiculous amounts to physicians?? I've heard they get free cars and mansions and stuff.. I agree though, the US would never stand for it.

 

[Benzo4every1]

I am halfway through 1st year at top 10 med school, and I already see about half of my class admitting some a little more timidly some more courajously that they could not care less about anything else, and that they are in for the money. 90% of my class is going to match in a highly competitive residency. Of these 50% are in for the money. Where is healthcare going?

Most of my colleagues probably lied in their application, "I want to be a doctor because I care about people" says the standard application phrase. But how many of us continue to volunteer after they get in? maybe 5%. And interestingly enough of those who volunteer at free clinic why do they do it? Because it is practice time! I think most of us really love medicine because it is intriguing, that's why we self inflict pain on ourselves by essentially frying our brains for 4 years, learning a million things we might or might not use later on. I think we like it because we are used to work hard, and because at the end of the day the pay is high. But honestly, they should eliminate the whole "volunteering" and "I care about people" thing from the application. As long as you don't come across as a total jerk in your interview I don't think you need to volunteer anywhere. We should really get the best people in medicine, at the end of the day is the people who are working harder, have the highest endurance, and are the brightest who are going to succed. Do you really care if your cardiologist is nice or not, if he is going to kill you cause he forgot how to put a stent in? And also, they teach you people skills in the first year of medical school, they teach you how to talk to patients, how to interact with them, what kind of questions to ask, and what kind of questions not to ask, and what to do so you are not going to get sued.

So my question is What kind of people are we selecting, and why are we making people lie in their application when the whole "I care about people" phrase has no value when you are on the other side of the fence. This is just for reflexion... don't get all angry about it.

How can you honestly say they are lying when they wrote that on their applications? maybe then they did it because they wanted to, or maybe for both reasons, shameful or not. Maybe, after they finish the wards, they decided that patient interactions are not for them and that they are now doing it for the money. It happens: people change and they become jaded. You maybe one of the the lucky few who didn't let what happened bother you. I don't think the med school required volunteer work as a prerequisite for entrance. However, I think it is to show the committee that you have done some research in the medical field, like what you see, and want to give med school a try and maybe just maybe, do it for the rest of your life. There are many aspects of medicine and even if you are doing it for the money, you still in the end are helping your patients, regardless of your true reasons.