Warning from my Internist: Please specialize

[Bigz]

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I saw my Dentist whose brother is also my Internist two weeks ago and he said not to do what his brother is doing.

Then I saw my Internist today to get some Pre matriculation health forms filled and he almost pleaded with me to specialize. He says he loves what he is doing and can see himself doing it till he is 80 yrs old but the money and the pain of dealing with insurance is not worth it.

He wanted to do GI fellowship after residency but he was on the other side of 35 and wanted to add to his one child. He said luckily for him his wife also works and so things are not that bad

Question do some of you guys get similar advice from your general practitioners?

 

[jw123]

yeah i've gotten the same thing when talking to my family doctor. he told me to first do internal medicine instead of family practice, then told me to specialize if i can. although almost every doctor i've talked to regardless of the specialty tell me to go into dentistry!

 

[DoctwoB]

yeah i've gotten the same thing when talking to my family doctor. he told me to first do internal medicine instead of family practice, then told me to specialize if i can. although almost every doctor i've talked to regardless of the specialty tell me to go into dentistry!

Theres a dentist's practice right under my apartment that seems rather prosperous.

Hours: M-Th, 9-3, Friday 9-12. We're in the wrong field.

 

[shaggy alfresco]

Then again, you get to work inside people's mouths all day. No thanks.

 

[jw123]

yeah for me there's no way i could do what a dentist does day in and day out, i personally think its just way too boring.

 

[jdh71]

I tend to agree. Sadly the current system is straggling primary care. Too much bull**** for too little money, which is all the more frustrating when you know that there is plenty of money floating around the system when anesthesia and radiology can pull the salaries they do. I'm all about people making as much money as they possibly can so I'm not hating. Bottom line, the peeps that went into rads and gas, even if it only was for the money and lifestyle made the smart decision.

So, unless you have a hard on to "save the world" one primary care patient at a time, or you know you want to do an IM subspecialty (2-4 more years of training after three years of IM), don't go into IM. Go into something else if you like it.

<--- IM resident, done in 3 days (going to fellowship)

 

[DoctwoB]

I tend to agree. Sadly the current system is straggling primary care. Too much bull**** for too little money, which is all the more frustrating when you know that there is plenty of money floating around the system when anesthesia and radiology can pull the salaries they do. I'm all about people making as much money as they possibly can so I'm not hating. Bottom line, the peeps that went into rads and gas, even if it only was for the money and lifestyle made the smart decision.

So, unless you have a hard on to "save the world" one primary care patient at a time, or you know you want to do an IM subspecialty (2-4 more years of training after three years of IM), don't go into IM. Go into something else if you like it.

<--- IM resident, done in 3 days (going to fellowship)

Congrats on finishing. What specialty are you going into?

 

[jdh71]

Congrats on finishing. What specialty are you going into?

Pulmonary and Critical Care

 

[shaggy alfresco]

The problem is specialists. Primary Care physicians are trained to handle much more complex cases than they currently handle but in many cases, they basically refer anything remotely complicated (or anything that pays $$ remotely well). This allows NP and other midlevels to encroach in PC because they too can handle most bread and butter. Eventually the same encroachment will happen with specialists. It hurts everyone. A strong independent primary care provider helps everyone - the patients, health of the society, the bottom line in healthcare spending, and specialists too (though you'd need fewer of them). But it's not going to happen. Unless you live in a very rural area or do a lot of overseas work, I don't see the fundamental issues with primary care getting better. And it's not about the $$. Sure, the money is a part of it, but it's also about what we allow them to do based on their training and education, and how they are valued in general.

 

[soeagerun2or]

Guys. Seriously.

Regardless of the source, an internist makes >$100,000/year. If that is not enough for you then you have your priorities wrong.

Cry me a river about the sacrifice of school, debt, long hours. That is life. If you are entering medicine expecting nothing but roses and lavish pay for minimal work you are in for a rude awakening.

 

[danzman]

The problem is specialists. Primary Care physicians are trained to handle much more complex cases than they currently handle but in many cases, they basically refer anything remotely complicated (or anything that pays $$ remotely well). This allows NP and other midlevels to encroach in PC because they too can handle most bread and butter. Eventually the same encroachment will happen with specialists. It hurts everyone. A strong independent primary care provider helps everyone - the patients, health of the society, the bottom line in healthcare spending, and specialists too (though you'd need fewer of them). But it's not going to happen. Unless you live in a very rural area or do a lot of overseas work, I don't see the fundamental issues with primary care getting better. And it's not about the $$. Sure, the money is a part of it, but it's also about what we allow them to do based on their training and education, and how they are valued in general.

I disagree with the first part of this statement. Medicine is a different game today than 40yrs ago. Treatments are different and require a specialist. Part of this is because of the way insurance companies will pay, part of it is just the nature of the field, part is due to liability. PCPs do a great job of managing chronic health problems and the everyday complaints (UTI/OM/LBP etc) but we are getting older, and old people get sick. I am all for a strong PCP system, not because I think they should do more, rather I think there is a lack of access. Medicine costs so much because we can do so much more.

 

[sineapse]

Then again, you get to work inside people's mouths all day. No thanks.

And OB/GYN...?

 

[mfrizzo3]

Guys. Seriously.

Regardless of the source, an internist makes >$100,000/year. If that is not enough for you then you have your priorities wrong.

Cry me a river about the sacrifice of school, debt, long hours. That is life. If you are entering medicine expecting nothing but roses and lavish pay for minimal work you are in for a rude awakening.

Who are you to tell people what there priorities should be?

 

[Jolie South]

Who are you to tell people what there priorities should be?

This ^^^^

 

[inspirationmd]

Guys. Seriously.

Regardless of the source, an internist makes >$100,000/year. If that is not enough for you then you have your priorities wrong.

Cry me a river about the sacrifice of school, debt, long hours. That is life. If you are entering medicine expecting nothing but roses and lavish pay for minimal work you are in for a rude awakening.

Soeager,

What do you say to the guy with >$200K in debt who shuns a Primary Care specialty because of $140K starting salary (thats generous from what I hear)? A new traditional IM, FM, or Peds grad at 29 presumably would like to think about starting a family at some point. Exactly how would they afford to make $3000 a month loan payments, live, save for retirement , etc with $95K in disposable income after taxes?

EDIT: And don't give me the IBR, and loan repayment for underserved arguement. No one knows if IBR will last the 10 years and the loan repayment locations are often undesireable positions (which is why they must offer loan repayment). I am actually for the service to the underserved but it should be a choice not something you feel like you have to do to survive. That makes for unhappy physicians and potential burnout.

 

[sanityonleave]

Who are you to tell people what there priorities should be?

You're my hero. Thank you.

 

[sanityonleave]

Soeager,

What do you say to the guy with >$200K in debt who shuns a Primary Care specialty because of $140K starting salary (thats generous from what I hear)? A new traditional IM, FM, or Peds grad at 29 presumably would like to think about starting a family at some point. Exactly how would they afford to make $3000 a month loan payments, live, save for retirement , etc with $95K in disposable income after taxes?

 

[boggvir]

And OB/GYN...?

Well I wouldn't pick that either. You generally have more choices regarding what you do or do not want to work with than you would in dentistry.

 

[NickNaylor]

Who are you to tell people what there priorities should be?

I'm eagerly awaiting a response to this.

 

[soeagerun2or]

Soeager,

What do you say to the guy with >$200K in debt who shuns a Primary Care specialty because of $140K starting salary (thats generous from what I hear)? A new traditional IM, FM, or Peds grad at 29 presumably would like to think about starting a family at some point. Exactly how would they afford to make $3000 a month loan payments, live, save for retirement , etc with $95K in disposable income after taxes?

First of all, as students you do not understand how debt is structured and repaid. I agree, the debt obligation seems egregious. Nonetheless, it is no reason to deter you from pursuing a primary care field.

That being said, the majority of students now enter medical school with the desire to pursue a "competitive" specialty and use debt obligation as a justification for this desire. It is entirely unfounded. With even a $250,000 debt load, $200,000 in government backed and $50,000 in private loans, the maximum monthly payment would be $2,500. If the loans are consolidated in the direct loan program they are both income based and forgiven after 10 years of employment for a non-profit. The majority of physicians in practice either work for a hospital or clinical group which are non-profit, or, incorporate as a non-profit personal corporation.

No one is denying that it is hard or expensive. That is not a reason to ignore the reason you were allowed to train as a medical doctor which is to provide care for those who need it.

 

[MossPoh]

Yea and? I've had EM docs tell me never to go into emergency medicine. I've had surgeons tell me to never go into surgery. I've had radiologists tell me never to go into that. Nearly every specialty, I've had someone tell me to NOT go into it.

If anything, the unifying thought process between them is that the grass is always greener. There is crap to deal with in EVERY field. There will always be a group of people who just aren't happy and never focus on the positive side. You could give them their fellowship and then they'd say they wished they did another one.

Go into what you friggin want to go into. I followed plenty of primary care docs who are perfectly content with their life and their job. While they admit there is b.s. involved, they took the gig understanding that and just get through it to do the things they do enjoy.

Whether one acknowledges are not, we are being told what our priorities should be from day 1. Sure, lip service may be paid to primary care but the income discrepancy and relative respect from other non-primary care specialties speaks volumes to what we REALLY think. We see what our priorities should be on TV, hear them on the radio and read them in our magazines. I'm not some paranoid media controls us type person, but you are ignorant to a lot of things if you think that the personal value we place on income is one's own value and priority. Once you get above 150-200k, the whole cliche "money can't buy happiness" thing is true. (Yes, studies have looked at this) Admittedly, if I had to choose between two specialties where I liked one only SLIGHTLY less and made double or triple the amount of money, I'd go with it....I like my expensive toys too. I also realize that medicine is not going to make me rich and wise investments are a better idea with the capital I have than thinking I can get it directly from working.

The major exception to money not buying happiness is a jetski. Go ahead, try to NOT smile on one of those things. (Plagiarized from Daniel Tosh)

 

[soeagerun2or]

Who are you to tell people what there priorities should be?

Who are you to piss on more than half the country?

The median family income is $50,233.00.

Imagine those that earn much, much less than that. Which do they have a greater need for, a dermatologist or a PCP?

 

[inspirationmd]

First of all, as students you do not understand how debt is structured and repaid. I agree, the debt obligation seems egregious. Nonetheless, it is no reason to deter you from pursuing a primary care field.

That being said, the majority of students now enter medical school with the desire to pursue a "competitive" specialty and use debt obligation as a justification for this desire. It is entirely unfounded. With even a $250,000 debt load, $200,000 in government backed and $50,000 in private loans, the maximum monthly payment would be $2,500. If the loans are consolidated in the direct loan program they are both income based and forgiven after 10 years of employment for a non-profit. The majority of physicians in practice either work for a hospital or clinical group which are non-profit, or, incorporate as a non-profit personal corporation.

No one is denying that it is hard or expensive. That is not a reason to ignore the reason you were allowed to train as a medical doctor which is to provide care for those who need it.

1) That $2500 absolutely assumes you want to be paying loans off into your 50s on the 25 year plan. I absolutely have a problem with this as I want to be paying for my children's school (or at least helping) not paying my loans off.

2)As I mentioned in my EDIT no one knows if IBR will continue to be in existence in 10 years. My guess is that it will vanish when senators realize that doctors are taking advantage of this en masse. Think economic deferment option dissapearance and now only forbearance with interest accrual available.

If that 10 year forgiveness continues to exist then maybe it won't be such an issue but a lot is up in the air. After all this education and post poning gradification people want some guarantees.

3) The average American does not go through doctoral education and give up their 20s. So the $50K argument is a little thin.

 

[Jolie South]

First of all, as students you do not understand how debt is structured and repaid. I agree, the debt obligation seems egregious. Nonetheless, it is no reason to deter you from pursuing a primary care field.

That being said, the majority of students now enter medical school with the desire to pursue a "competitive" specialty and use debt obligation as a justification for this desire. It is entirely unfounded. With even a $250,000 debt load, $200,000 in government backed and $50,000 in private loans, the maximum monthly payment would be $2,500. If the loans are consolidated in the direct loan program they are both income based and forgiven after 10 years of employment for a non-profit. The majority of physicians in practice either work for a hospital or clinical group which are non-profit, or, incorporate as a non-profit personal corporation.

No one is denying that it is hard or expensive. That is not a reason to ignore the reason you were allowed to train as a medical doctor which is to provide care for those who need it.

People need ENTs, dermatologists, radiologists, anesthesiologists, ophthalmologists, plastic surgeons, and urologists, too. By virtue of entering medical school, we're going to help people regardless of the specialty. Saying that everyone should want to do primary care is ludicrous. Not everyone is best suited to becoming a PCP from a skill-set and interest stand point.

Frankly, if I'm committing this much of my life to a career (12+ years of training and 60-80 hour work weeks for life), I'm sure as hell going to do something that I like to do, am better equipped to do, and has a better lifestyle/compensation. Even if all things were equal in terms of lifestyle and compensation, I still wouldn't do primary care.

 

[coldweatherblue]

this thread is going to the crapper, and fast..

no one can judge a man for accepting his due. As long as you earn your money through hard, just work, and are responsible with the income you have, you don't have to justify accepting what society deems to be your compensation. The idea that a hard-working, responsible citizen should accept *less* than society is willing to compensate him is absurd. Why? Because (listen closely liberals) the government WILL NOT be more responsible with that money than you. If you make good financial decisions, invest wisely, raise well-educated, adjusted children, etc, you should fight for every dollar you can, because as a well-read, responsible citizen, you will do more good with every dollar you earn than the gov ever could. By accepting less than your due, you are NOT necessarily doing anything "moral". If you are financially responsible, you do society a disservice by NOT fighting for fair compensation for your hard-work.

 

[soeagerun2or]

People need ENTs, dermatologists, radiologists, anesthesiologists, ophthalmologists, plastic surgeons, and urologists, too. By virtue of entering medical school, we're going to help people regardless of the specialty. Saying that everyone should want to do primary care is ludicrous. Not everyone is best suited to becoming a PCP from a skill-set and interest stand point.

I agree with you entirely. We need specialists and we need well educated people to pursue these fields.

Frankly, if I'm committing this much of my life to a career (12+ years of training and 60-80 hour work weeks for life), I'm sure as hell going to do something that I like to do, am better equipped to do, and has a better lifestyle/compensation. Even if all things were equal in terms of lifestyle and compensation, I still wouldn't do primary care.

Frankly, I have to disagree with you.

You pursue the field you are interested in for the monetary and lifestyle gain. If primary care paid $750,000/year and you worked 20 hours/week you surely would do that. It is sad that you can not see through your lust.


And to address the other thought that the median income does not include that, as an MD, you have an advanced degree. It does not matter. There are PhDs earning $40,000 and Bill Gates college drop outs earning millions. It is a median for a reason. It reflects that you are earning much, much more than your AVERAGE patient. Much more than the average American family. Get over it. You will be able to pay off your loans, send your kids to college, and still have nice vacations. Stop being so selfish.

 

[IwannabeDrP]

You pursue the field you are interested in for the monetary and lifestyle gain. If primary care paid $750,000/year and you worked 20 hours/week you surely would do that. It is sad that you can not see through your lust.

Really? You just went there? Really?

I resonate with Jolie South. I like the excitement of an emergency room, or performing surgery, and don't mind the extra dolla dolla bills.

 

[VoiceofReason]

all 4th year medical students interested in primary care need a stat CT head

 

[DrYoda]

I agree with you entirely. We need specialists and we need well educated people to pursue these fields.



Frankly, I have to disagree with you.

You pursue the field you are interested in for the monetary and lifestyle gain. If primary care paid $750,000/year and you worked 20 hours/week you surely would do that. It is sad that you can not see through your lust.


And to address the other thought that the median income does not include that, as an MD, you have an advanced degree. It does not matter. There are PhDs earning $40,000 and Bill Gates college drop outs earning millions. It is a median for a reason. It reflects that you are earning much, much more than your AVERAGE patient. Much more than the average American family. Get over it. You will be able to pay off your loans, send your kids to college, and still have nice vacations. Stop being so selfish.

It must be hard for you, living amongst the sinners...🙄

 

[Jolie South]

I agree with you entirely. We need specialists and we need well educated people to pursue these fields.



Frankly, I have to disagree with you.

You pursue the field you are interested in for the monetary and lifestyle gain. If primary care paid $750,000/year and you worked 20 hours/week you surely would do that. It is sad that you can not see through your lust.

How much surgery is the average PCP doing these days? I'm pretty sure it's zero. 🙄

I like the OR so I'm going into a surgical subspecialty. If I wasn't competitive enough for a subspecialty, I would go into gen surg. I wouldn't be going into a surgical field at all if I had no desire to do surgery. That just doesn't happen.

You could not pay me enough to be an internist. I would rather drop out completely and be a chef than do a medicine residency. It took everything I had just to make it out of the rotation while being 100% SIGECAPS positive the entire time. So really your in depth analysis on my life and "lust" doesn't hold up.

 

[inspirationmd]

I agree with you entirely. We need specialists and we need well educated people to pursue these fields.



Frankly, I have to disagree with you.

You pursue the field you are interested in for the monetary and lifestyle gain. If primary care paid $750,000/year and you worked 20 hours/week you surely would do that. It is sad that you can not see through your lust.


And to address the other thought that the median income does not include that, as an MD, you have an advanced degree. It does not matter. There are PhDs earning $40,000 and Bill Gates college drop outs earning millions. It is a median for a reason. It reflects that you are earning much, much more than your AVERAGE patient. Much more than the average American family. Get over it. You will be able to pay off your loans, send your kids to college, and still have nice vacations. Stop being so selfish.

You do realize your name is "so eager to run to the OR" right? Fact is that the numbers do not lie. New graduates are running in droves to specialties. My med school is well known for primary care entry but what they hide from you is the fact that 67% of people that enter IM do so with a plan to specialize. Many (including you) do not want to do primary care for various reasons including relatively poor compensation. It's not a question of selfishness but interest, societal influences and Financial remuneration.

 

[soeagerun2or]

General surgery is considered primary care.

Emergency Medicine should not be a subspecialty but, instead, be what it was where both surgery and medicine covered the department.

I have no issue with medical or surgical subspecialties, per se. They are, indeed needed. However, going in to medical school thinking you want to do radiology, dermatology, rheumatology, etc. is problematic.

We need more PCPs. We can afford it on the current reimbursement level, we just don't want to.

 

[Jolie South]

General surgery is considered primary care.

Emergency Medicine should not be a subspecialty but, instead, be what it was where both surgery and medicine covered the department.

I have no issue with medical or surgical subspecialties, per se. They are, indeed needed. However, going in to medical school thinking you want to do radiology, dermatology, rheumatology, etc. is problematic.

We need more PCPs. We can afford it on the current reimbursement level, we just don't want to.

Umm, general surgery is not primary care. People see a surgeon once for a particular issue that is fixed by a surgical procedure and never see them again.

EM should be its own specialty. Neither surgery nor medicine like to cover the ER and the focus of their daily practice is much different from the way the ER should be run.

 

[soeagerun2or]

Umm, general surgery is not primary care. People see a surgeon once for a particular issue that is fixed by a surgical procedure and never see them again.

For billing and general purposes, yes, general surgery is primary care.

EM should be its own specialty. Neither surgery nor medicine like to cover the ER and the focus of their daily practice is much different from the way the ER should be run.

You are very mistaken. All an ER doc is there to do is to decide whether the patient should be admitted to surgery or medicine. In the end, they decide between themselves. Obviously, taking the concierge doctor out of the loop would be a cost saving measure.

IF ANYTHING it should be a fellowship of medicine (IM, FM, Peds) and surgery. LIKE IT USED TO BE

 

[danzman]

For billing and general purposes, yes, general surgery is primary care.



You are very mistaken. All an ER doc is there to do is to decide whether the patient should be admitted to surgery or medicine. In the end, they decide between themselves. Obviously, taking the concierge doctor out of the loop would be a cost saving measure.

IF ANYTHING it should be a fellowship of medicine (IM, FM, Peds) and surgery. LIKE IT USED TO BE

I will spare you the insults that are coming to you for this one, but I would recommend you educate yourself on the role of the EM doc. As I said before, the kind of medicine you are talking about was practiced 40yrs ago. Modern medicine is a different beast entirely.

 

[Jolie South]

For billing and general purposes, yes, general surgery is primary care.



You are very mistaken. All an ER doc is there to do is to decide whether the patient should be admitted to surgery or medicine. In the end, they decide between themselves. Obviously, taking the concierge doctor out of the loop would be a cost saving measure.

IF ANYTHING it should be a fellowship of medicine (IM, FM, Peds) and surgery. LIKE IT USED TO BE

I have never heard of general surgery being defined as primary care. The term primary care connotes comprehensive, longitudinal care, which is not the nature of general surgery practice.

EM is focused on ruling out the most dangerous stuff on the differential and if they can't, sending the patients on to the most appropriate inpatient service.
-Does a surgeon need to come down and see every patient with abdominal pain? I don't think so.
-Is a surgeon necessary for every minor lac? Probably not. Will medicine take care of said lac? Nope.
-Is medicine ever expedient in their diagnostic process? Not really.
-Who gets the vag bleeders? Neither medicine nor surgery touch that.

In all seriousness, EM is there for a reason. My school's Level 1 trauma ED was run the way you described above and it was nothing short of a disaster. Now, we're staffed fully with EM trained faculty and I think the patients are getting much better care. EM physicians just think differently and are trained to do so.

 

[coldweatherblue]

You are very mistaken. All an ER doc is there to do is to decide whether the patient should be admitted to surgery or medicine.

This is consistent with your other posts.

 

[NickNaylor]

First of all, as students you do not understand how debt is structured and repaid. I agree, the debt obligation seems egregious. Nonetheless, it is no reason to deter you from pursuing a primary care field.

That being said, the majority of students now enter medical school with the desire to pursue a "competitive" specialty and use debt obligation as a justification for this desire. It is entirely unfounded. With even a $250,000 debt load, $200,000 in government backed and $50,000 in private loans, the maximum monthly payment would be $2,500. If the loans are consolidated in the direct loan program they are both income based and forgiven after 10 years of employment for a non-profit. The majority of physicians in practice either work for a hospital or clinical group which are non-profit, or, incorporate as a non-profit personal corporation.

No one is denying that it is hard or expensive. That is not a reason to ignore the reason you were allowed to train as a medical doctor which is to provide care for those who need it.

Who are you to piss on more than half the country?

The median family income is $50,233.00.

Imagine those that earn much, much less than that. Which do they have a greater need for, a dermatologist or a PCP?

Who are you to piss on everyone and tell them what the "right" salary is and when they should be happy with how much money they make? What gives you that right? Why should I be fine with paying $2,500 a month for 25 years to pay back student loans just because you are? You're completely blind to the fact that not everyone shares your worldview. I believe they call people with that sort of reasoning "children."

It doesn't matter what is needed and what isn't - as a HUMAN BEING, I have the right to pursue whatever career I want and attempt to make whatever income I want. I have the right to enter IM and refuse to work for anything less than a $500,000 salary. Of course I would be a ***** and never get a job, but nevertheless I have that right. I also have the right to enter derm and demand a $300,000 salary. And if someone is going to give me a job doing that, what's wrong with that? As long as I don't harm my patients and am providing a service that people want, what's wrong with going into the field just for money? Other than that you may disagree with my priorities and my values, please tell me what is fundamentally wrong with this situation.

And since we're on the subject, why shouldn't I care about my work hours and attempt to have as much time to spend with my family or do whatever I want with as possible? What if I went into general surgery and worked for 30 hours a week for a $60,000 salary because I value my personal time so much? Would you have a problem with that? Obviously that situation isn't realistic, but would you object to it if it was possible?

By the way, I'm not at all intending to follow through with the first hypothetical situation. I'm the kind of person that needs to be stimulated on some level by the work I'm doing. I couldn't go into a field that I absolutely hated or have no interest in regardless of the salary. But the fact that you feel as if you're capable of telling people how much is too much and what they should or should not prioritize when choosing WHAT TO DO WITH THE REST OF THEIR LIVES is downright *****ic. And the fact that you would scold me for going into a "lifestyle" specialty because the hours and salary are desirable - even if my primary motivation is because of an intellectual interest - is stupid.

 

[username456789]

For billing and general purposes, yes, general surgery is primary care.

For virtually every purpose on Earth, general surgery is NOT primary care. Someone planning on going into surgery, more than anyone else, should realize that.

 

[jdh71]

all 4th year medical students interested in primary care need a stat CT head

That's not fair. Some people want to do that kind of medicine - they are "people" people, and they enjoy primary care. My point earlier was that unless that is you, don't do it.

 

[soeagerun2or]

It doesn't matter what is needed and what isn't - as a HUMAN BEING, I have the right to pursue whatever career I want and attempt to make whatever income I want.

This is the problem. No you do not. By taking on a medical career you have the right to care for patients. Your personal gains are an exception, not the rule.

And since we're on the subject, why shouldn't I care about my work hours and attempt to have as much time to spend with my family or do whatever I want with as possible?

I am the first to promote family time. Yet if it distracts from your purpose, you are misguided.

I couldn't go into a field that I absolutely hated or have no interest in regardless of the salary. But the fact that you feel as if you're capable of telling people how much is too much and what they should or should not prioritize when choosing WHAT TO DO WITH THE REST OF THEIR LIVES is downright *****ic.

You might get lucky and you might do well on Step 1. If you don't, primary care is a great field and needs people like you to fill in for the spots that your ego long ago evacuated.

 

[soeagerun2or]

Who are you to piss on everyone and tell them what the "right" salary is and when they should be happy with how much money they make? What gives you that right? Why should I be fine with paying $2,500 a month for 25 years to pay back student loans just because you are? You're completely blind to the fact that not everyone shares your worldview. I believe they call people with that sort of reasoning "children."

It doesn't matter what is needed and what isn't - as a HUMAN BEING, I have the right to pursue whatever career I want and attempt to make whatever income I want. I have the right to enter IM and refuse to work for anything less than a $500,000 salary. Of course I would be a ***** and never get a job, but nevertheless I have that right. I also have the right to enter derm and demand a $300,000 salary. And if someone is going to give me a job doing that, what's wrong with that? As long as I don't harm my patients and am providing a service that people want, what's wrong with going into the field just for money? Other than that you may disagree with my priorities and my values, please tell me what is fundamentally wrong with this situation.

And since we're on the subject, why shouldn't I care about my work hours and attempt to have as much time to spend with my family or do whatever I want with as possible? What if I went into general surgery and worked for 30 hours a week for a $60,000 salary because I value my personal time so much? Would you have a problem with that? Obviously that situation isn't realistic, but would you object to it if it was possible?

By the way, I'm not at all intending to follow through with the first hypothetical situation. I'm the kind of person that needs to be stimulated on some level by the work I'm doing. I couldn't go into a field that I absolutely hated or have no interest in regardless of the salary. But the fact that you feel as if you're capable of telling people how much is too much and what they should or should not prioritize when choosing WHAT TO DO WITH THE REST OF THEIR LIVES is downright *****ic. And the fact that you would scold me for going into a "lifestyle" specialty because the hours and salary are desirable - even if my primary motivation is because of an intellectual interest - is stupid.

BTW I entirely agree with you, if you feel called to a subspecialty and are son incline then do it. I have no fault with that. It just seems the majority of people here pick something like derm, anesthesia, radar that have no real purpose.

 

[IwannabeDrP]

You might get lucky and you might do well on Step 1. If you don't, primary care is a great field and needs people like you to fill in for the spots that your ego long ago evacuated.

 

[Jolie South]

BTW I entirely agree with you, if you feel called to a subspecialty and are son incline then do it. I have no fault with that. It just seems the majority of people here pick something like derm, anesthesia, radar that have no real purpose.

How do you know what anyone's purpose is?

You don't know any of us in real life.

 

[username456789]

This is the problem. No you do not. By taking on a medical career you have the right to care for patients. Your personal gains are an exception, not the rule.

I'm really not sure even you know what you're trying to say here. None of it makes any real sense.

 

[drturkleton]

This is the problem. No you do not. By taking on a medical career you have the right to care for patients. Your personal gains are an exception, not the rule.
...
I am the first to promote family time. Yet if it distracts from your purpose, you are misguided.

Friend, you are living in your own world. I respect your idealism, but at the end of the day we're all just anonymous posters whose words mean nothing. Maybe NickNaylor will turn out to be Mother Theresa. Maybe you will turn out to be Dr. 90210.

 

[soeagerun2or]

How do you know what anyone's purpose is?

You don't know any of us in real life.

Honestly. Who in medical school goes in to dermatology, these days, because they want to "help the poor, unattended people?"

You all need to look deep inside and ask yourselves why I make you so upset.

If its because I'm hitting you where it hurts most, that you want a great income and great lifestyle.. Get with it, ALL physicians are going to pay the price in the future. We need to stand by primary care where it currently stands and keep it within medicine.

I myself am a surgical sub specialty resident with an MBA, PhD, and MPH. I see the writing on the wall. You can bet your ass that I am going to lobby for increased PCP compensation at my own expense and at the expense of anesthesia, radiology, and every other specialty. This is a necessity.

 

[carolinablue]

boo hoo quit crying,
no matter how little you think a primary care doctor makes, you will still be wayyy over the national income average...and wayyyyyyy over the world income average....if debt was such a big deal for you then why didn't you just go to your in-state school?
My in-state school is about 10k a year tuition...i didnt get in because i didnt have high enough scores, so im going to another school that i did get into which is 37k a year. I accept the responsibility of having more debt because i know that someone worked harder for the school seat that costs 10k.
nobody in life is entitled to making bank....it all comes from god...i know that sounds difficult to hear but its true...it all comes from god...he gives, he takes...you could be a radiologist and get sued for everything...you could be a family doctor and make millions just by being in a good location and knowing how to do buisness....
meh.....maybe im just over the whole >150k salary lusting...i get that you wanna make alot, but when you want to make money so much it won't happen....focus on perfecting your craft and people will give you the money that you deserve.

 

[Jolie South]

Honestly. Who in medical school goes in to dermatology, these days, because they want to "help the poor, unattended people?"

You all need to look deep inside and ask yourselves why I make you so upset.

If its because I'm hitting you where it hurts most, that you want a great income and great lifestyle.. Get with it, ALL physicians are going to pay the price in the future. We need to stand by primary care where it currently stands and keep it within medicine.

I myself am a surgical sub specialty resident with an MBA, PhD, and MPH. I see the writing on the wall. You can bet your ass that I am going to lobby for increased PCP compensation at my own expense and at the expense of anesthesia, radiology, and every other specialty. This is a necessity.

So you yourself weren't even willing to go into primary care?

Is the pot calling the kettle black?

 

[drturkleton]

Honestly. Who in medical school goes in to dermatology, these days, because they want to "help the poor, unattended people?"

You all need to look deep inside and ask yourselves why I make you so upset.

No, it's just silly to suggest that doctors have a moral duty to help indigent patients to the detriment of their own lives.

I used to be an investment banker. I would do more good for people as a cosmetic dermatologist than as a banker. I would do even more good as a family doctor in the middle of South Dakota. What you're advocating is admirable... but unfortunately unrealistic for most doctors. At the end of the day, doctors in every field, at every income and work hours level, are doing good things for their patients - regardless of whether you approve.