What are the main challenges you expect to face as a doctor?

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sirus_virus

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I was just curious what specific challenges you guys expect to face as a practicing physician.

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decreasing reimbursements and liability

:sleep:

the ****ing sky is falling, doctors are going to make less than nurses one day!

skyfalling.jpg
 
decreasing reimbursements and liability

:sleep:

the ****ing sky is falling, doctors are going to make less than nurses one day!

skyfalling.jpg

why the negativity? I am trying to put together a postive thread here.
 
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Having this conversation at cocktail parties...

Stranger: So, what kind of work do you do?
Me: I'm a physician.
Stranger: Oh, you're a doc. Good. Hey, I got this weird rash on my back- mind taking a look at that?

I was just curious what specific challenges you guys expect to face as a practicing physician.
 
Patients that want to self-diagnose...

"I was reading WebMD/wiki and I think I have X"

Me: "No You don't"

"If you don't treat me for X i'll sue"

Wah Wah Wah.

Not the biggest challenge but something that would annoy me to no end.
 
Having this conversation at cocktail parties...

Stranger: So, what kind of work do you do?
Me: I'm a physician.
Stranger: Oh, you're a doc. Good. Hey, I got this weird rash on my back- mind taking a look at that?

become a surgeon; that way you won't have time to go to cocktail parties.
 
Thinking of my own original answers to interview questions.... Now that I've gotten that out of my system, I think balancing family and work will be a challenge (specialty dependant). I think handling ambiguity as far as clinical outcomes; eg how do you define success as a doctor if you're just mitigating the symptoms of some chronic disease?
 
Patients that want to self-diagnose...

"I was reading WebMD/wiki and I think I have X"

Me: "No You don't"

"If you don't treat me for X i'll sue"

Wah Wah Wah.

Not the biggest challenge but something that would annoy me to no end.

:laugh: :laugh: I think the part about noticing signs and symptoms of a particular disease isn't a bad thing because it alerts you to get it checked out. However, I agree that if they assume they have it even after proper tests are done to prove they don't have those problems and continue to threaten to sue then that's just plain pathetic.
 
I was just curious what specific challenges you guys expect to face as a practicing physician.

Going to the bathroom when you've accidently tied too tight a knot in your scrubs drawstring.

Actually the hardest thing is going to be convincing folks you actually know what you are doing half the time. The amount of stuff you need to know is voluminous.
 
The fact that you'll never know enough to be able to give the right diagnosis to every patient.

Being faithful to my wife when their are so many attractive nurses/ health workers around.:D :p

The long hours and the stress of knowing that the decisions you make could mean life or death for those you treat.
 
Making a fatal mistake, especially if it is downright negligent.
 
While decreasing compensation for the amount of work and time we put in and the amount of debt we incur to get there unless we are one of the few fortunate ones who got a full scholarship is at the top of the list, I'd also say there are a few other things equally as big of a deal.

Let's see, there is insurance companies and/or govt role in healthcare that will increase the problems not decrease them because they put restrictions on what tests and procedures can be done sometimes hindering patient care because critical tests and diagnoses may not be able to be performed. Furthermore, if the govt does try to create socialized medicine then we'll have increased amount of patients without being able to give adequate time to each and every single one of them to treat them as a patient rather then just some object to be passed in and out.

Then there's the issue of money hungry lawyers and malpractice laws that are causing a lot of people to not go in certain fields coupled with the long call hours in some of those same fields (i.e. surgery, ob/gyn) which cause a shortage of physicians in those areas. Hence, this uneven distribution of physicians being trained in certain fields will probably lead to a shortage of physicians in certain fields when they are critically needed. The same can apply to people who go in these fields but don't perform certain procedures due to fear of malpractice lawsuits and/or long call hours if they add certain services. That again will affect patients in the long term.

These are what I'd consider some of the biggest problems facing healthcare today.
 
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The fact that you'll never know enough to be able to give the right diagnosis to every patient.

Being faithful to my wife when their are so many attractive nurses/ health workers around.:D :p

The long hours and the stress of knowing that the decisions you make could mean life or death for those you treat.

Most the nurses I know are older and married and far from being the most attractive human beings on earth. I'd say a lot of them are overweight and the ones who are skinny are older and married with kids. I wouldn't count on finding many model looking girls as nurses if I were you.
 
Going to the bathroom when you've accidently tied too tight a knot in your scrubs drawstring.

Actually the hardest thing is going to be convincing folks you actually know what you are doing half the time. The amount of stuff you need to know is voluminous.

Yeah that would suck if you had to pee during the middle of a surgery or procedure that takes a long time.
 
Being faithful to my wife when their are so many attractive nurses/ health workers around.:D :p

Funny you mention this, my gf to be wife always has this fear :laugh:

Most of the challenges doctors face, unfortunately, will be negative things. However there may be a few positives here and there. They are:

Learning how to use new and emerging technology and putting in the hours to train and learn how to use it.

The aspect of the healthcare system in the future is a tossup in that we can still have a terribly disorganized system, we have can a more organized one, but with unhappy doctors, we can have one with government involvement, but with unhappy doctors. Whatever it is, something has to give way, and judging by the responses of many across SDN and the chief complaints given by doctors now, doctors will most likely have the short end of the stick.

Unless the law starts changing, or physicians start taking CMEs that deal strictly with malpractice laws, I think there will probably be some rise in lawsuits, but this is pure conjecture.

Treating patients with more complicated illnesses with rising obesity, cancer, etc..etc..

Balancing family and work. I have a strong feeling that a large chunk of physicians in the future will work longer hours to make money. Physicians may also resort to boutique/concierge type services.

Politics- so many issues, so little time.
 
I think handling ambiguity as far as clinical outcomes; eg how do you define success as a doctor if you're just mitigating the symptoms of some chronic disease?

The patient is the one with the disease. End of story.

Making a fatal mistake, especially if it is downright negligent.

You will eventually make a mistake that will kill a patient or cause a less serious negative outcome. Learn to deal with that idea now.

Decreasing compensation rates.

That is a real concern.
 
Being on call... studying all the time to keep up on new treatments and for recertification tests... dealing with pharm reps... dictating at the end of the day... raising a family... and somehow keeping a healthy marriage. All at the same time. Thats the challenge. I can't wait. :D
 
Deciding whether to buy the Bentley or the Maybach on my 1mil/yr salary!

Oh wait, I'll just get both!
 
this was actually one of the questions on the uconn secondary
 
become a surgeon; that way you won't have time to go to cocktail parties.

Or you could go to cocktail parties and answer with, "Well, let's heat up this butter knife and get you on the table! We'll have that rash out in no time."

No doubt they'd stop pestering you after that!
 
The patient is the one with the disease. End of story.



That is a real concern.

I always wondered which one of us was the patient. Do you mean something like, let the patient determine when they've been successfully treated? what exactly are you saying ? How would you define success in the case of a chronic illness?
 
I always wondered which one of us was the patient. Do you mean something like, let the patient determine when they've been successfully treated? what exactly are you saying ? How would you define success in the case of a chronic illness?

Reduction of pain and symptoms is all a physician can do. Whether the petient lets the illness run their life is out of the physician's hands.
 
I always wondered which one of us was the patient. Do you mean something like, let the patient determine when they've been successfully treated? what exactly are you saying ? How would you define success in the case of a chronic illness?
It isn't going to kill you if the patient dies. Do your best to prevent suffering and alleviate pain, but remember to check your emotions at the door.
 
What about whether or not to get an MD license plate? Big decision there.
 
Or you could go to cocktail parties and answer with, "Well, let's heat up this butter knife and get you on the table! We'll have that rash out in no time."

No doubt they'd stop pestering you after that!

Tried it. Works like a charm! :D
 
I was just curious what specific challenges you guys expect to face as a practicing physician.

settling for treating patients empirically or based or anecdotal evidence/data...
 
Deciding whether to buy the Bentley or the Maybach on my 1mil/yr salary!

Oh wait, I'll just get both!

You beat me to it, but my choice will be more sensible, Choosing between a new Lexus, or a new Range Rover!
 
Here's one: Being a resident and having patients doubt your credibility. I work in a dermatology clinic and patients come in all the time throwing a fit because they've figured that residents are not actual doctors. Granted they're in training, but it's usually un-called for, considering the idea that the residents never see patients without an experienced physician present. But, patients are always like "I don't want to see a young doctor". So all you 21 year olds starting medical school, beware of the disgruntled patient who figures that you're incompetant because you don't have wrinkles. :)
 
Most the nurses I know are older and married and far from being the most attractive human beings on earth. I'd say a lot of them are overweight and the ones who are skinny are older and married with kids. I wouldn't count on finding many model looking girls as nurses if I were you.
This is where young good looking female techs/phlebotomists come in
 
Most the nurses I know are older and married and far from being the most attractive human beings on earth. I'd say a lot of them are overweight and the ones who are skinny are older and married with kids. I wouldn't count on finding many model looking girls as nurses if I were you.

This is so true. In all honesty, most of the nurses I've come in contact with are overweight, chain smoke, and have painfully poor taste in scrubs.

That said, they are great nurses ad care a lot about their patients. However, they definitely ain't where it's at in terms of general babe-a-liciousness. :D
 
Most the nurses I know are older and married and far from being the most attractive human beings on earth. I'd say a lot of them are overweight and the ones who are skinny are older and married with kids. I wouldn't count on finding many model looking girls as nurses if I were you.


You could say this about American women in general when they get older...
 
You could say this about American women in general when they get older...

Well see that's precisely my point. Most nurses you run into at at any given hospital or clinic are older nurses not people who are fresh out of college model looking kind of types mostly because the rate of production of new nurses is not as high as the rate of more experienced nurses who aren't retiring due to the shortage that's already in existence. Not saying you can't find pretty nurses just as I'm not saying you can't find hot male nurses or hot male doctors, but the general population of them is going to be smaller as is true even outside of medicine.
 
Here's one: Being a resident and having patients doubt your credibility. I work in a dermatology clinic and patients come in all the time throwing a fit because they've figured that residents are not actual doctors. Granted they're in training, but it's usually un-called for, considering the idea that the residents never see patients without an experienced physician present. But, patients are always like "I don't want to see a young doctor". So all you 21 year olds starting medical school, beware of the disgruntled patient who figures that you're incompetant because you don't have wrinkles. :)

If those same patients feel that way they should go to a hospital that isn't a primary teaching hospital. Generally you can avoid coming in contact with students by going to a typical county hospital that has no teaching affiliations. You are liable to choose your own physicians based on the options presented by your insurance company, provided you have insurance. Granted there are cases where this cannot be avoided, i.e. VA hospitals, in a lot of cases it can be avoided.

But how do people expect people to become experienced physicians if they don't have the training first? Besides residents are physicians because they'e completed their MD degree. But yeah they need the training. If they are unsure hey ask the attending in charge or senior resident who's gained more experience.
 
Patients that want to self-diagnose...

"I was reading WebMD/wiki and I think I have X"

Me: "No You don't"

"If you don't treat me for X i'll sue"

Wah Wah Wah.

Not the biggest challenge but something that would annoy me to no end.

If they do that, then you can tell them to get a second opinion from a physician in the same field of expertise because that option is often there for patients. sometimes a physician may overlook something that is caught by another physician. so it is possible that a patient who has done their research may be right and often times the patients I saw when observing, who did research something, were often people who really looked to see the possibilities and weren't there saying things out of ignorance. If they sue even after a second opinion showing no evidence of the fact then that's plain sad. But don't assume the patient has no understanding of what may or may not affect them. Not all patients are uneducated people with no real understanding of anything.
 
Being on call... studying all the time to keep up on new treatments and for recertification tests... dealing with pharm reps... dictating at the end of the day... raising a family... and somehow keeping a healthy marriage. All at the same time. Thats the challenge. I can't wait. :D

You don't have any obligation to deal with pharm reps. Just tell them politely that you don't take calls from reps. You have no obligation to listen to their schpiel. Did you know that pharm companies get back 10 dollars for every 1 dollar they invest in direct-to-physician marketing? That free lunch is NOTHING so don't feel guilty about telling them you don't take calls.
 
It isn't going to kill you if the patient dies. Do your best to prevent suffering and alleviate pain, but remember to check your emotions at the door.

That is ridiculous. You are a human being, not an automaton. Empathy and compassion are things med schools look for for a reason.
 
You don't have any obligation to deal with pharm reps. Just tell them politely that you don't take calls from reps. You have no obligation to listen to their schpiel. Did you know that pharm companies get back 10 dollars for every 1 dollar they invest in direct-to-physician marketing? That free lunch is NOTHING so don't feel guilty about telling them you don't take calls.

Yes but you make thousands of dollars if you take them up on their offer.
 
You don't have any obligation to deal with pharm reps. Just tell them politely that you don't take calls from reps. You have no obligation to listen to their schpiel. Did you know that pharm companies get back 10 dollars for every 1 dollar they invest in direct-to-physician marketing? That free lunch is NOTHING so don't feel guilty about telling them you don't take calls.

important to keep in mind :idea: :
1) many, many felllowship positions in academic medical centers are financed if not entirely, then in large part by the pharmaceutical industry

2) with the fledgling NIH budget for clinical and basic science research, industry-sponsored research (meaning not developing industry drugs solely, but getting the industry to finance one's OWN studies as they relate to a mutual field of interest) is becoming more and more attractive.

academic medicine's relation to the industry must remain strong, and dealing with big pharma is bound to become only more and more a "requisite" part of the life of academic physicians. the challenge of balancing or otherwise circumventing conflicts of interest is one for the present and future generation...and erasure of "perceived" conflict of interest is nigh impossible as it is.
 
That is ridiculous. You are a human being, not an automaton. Empathy and compassion are things med schools look for for a reason.

I interpreted DKM's post (DKM, correct me if I'm wrong:) ) to mean that you can't let your emotions interfere with your obligation to perform your job to the best of your ability. This doesn't mean being an automaton, but without maintaining that professional distance your medical judgment can easily be compromised. Your role is to provide the best medical care you possibly can, not to be the patient's friend.
 
I interpreted DKM's post (DKM, correct me if I'm wrong:) ) to mean that you can't let your emotions interfere with your obligation to perform your job to the best of your ability. This doesn't mean being an automaton, but without maintaining that professional distance your medical judgment can easily be compromised. Your role is to provide the best medical care you possibly can, not to be the patient's friend.

Oh I fully agree with you. I think there should be a level of distance - to keep a clear head and make the best decisions possible. But completely checking one's emotions is not giving the best care to the patient either. Bedside manner is important. Its definetly not a black and white issue, there is grey area.
 
In all my med school and residency interviews, I never once had an interviewer ask me a question designed to test my "empathy and compassion". Research, grades, test scores, future plans, coping strategies, ethics, all those involved long discussions. But the cutesy emotional stuff you're going on about, well, the only people I talk to about that kind of stuff is my mom. Not sure who you've been talking to, but I'll go ahead and second DKMs comment.

I didn't go on about anything cutesy or emotional. I just said that compassion and empathy are important qualities for a doctor to have. A doctor will need to be able to talk about serious issues with their patients, nothing cutesy, but emotions will be part of the equation when youre breaking bad news.

I have been asked questions during two of my interviews that touched on emotional subjects, like end of life care and how best to handle sensitive situations. Maybe you just didnt get those kind of questions on your interviews.
 
Most the nurses I know are older and married and far from being the most attractive human beings on earth. I'd say a lot of them are overweight and the ones who are skinny are older and married with kids. I wouldn't count on finding many model looking girls as nurses if I were you.

Haha... ya my sister who goes to Baylor was telling me that one of the biggest problems with Grey's is that they don't have enough middle-aged vietnamese nurses in the show. Apparently that's all there is in the TMC.
 
I interpreted DKM's post (DKM, correct me if I'm wrong:) ) to mean that you can't let your emotions interfere with your obligation to perform your job to the best of your ability. This doesn't mean being an automaton, but without maintaining that professional distance your medical judgment can easily be compromised. Your role is to provide the best medical care you possibly can, not to be the patient's friend.
Nope....you hit the nail squarely on the head.

It was intended to be an expression that you don't let your emotions cloud your judgment and you don't let your patients' conditions or outcomes damage you as a person. Learning to shed the baggage that comes along with dealing with others' problems is a vital skill to learn.
 
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