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Where will medicine be in 20 years?

Discussion in 'Pre-Medical - MD' started by Climberak, Jan 7, 2009.

  1. Climberak

    Climberak Senior Member
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    Nurse practitioners, physician assistants, universal coverage, and a shortage of care. All of the time we hear of these factors and how they will influence the face of medicine in the years ahead. As in any career, I believe it is wise to know just what exactly the field will be like in the coming years. So I am asking you all, where do you believe medicine will be in 20 years? I am hoping to get some residents' and attendings' (people who are actually practicing medicine) input in this matter, in addition to all of you premeds :).
     
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  3. Pedsbro

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    It will be in many current SDNer's hands...:scared:
     
  4. 236116

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    Unless we man up, FP/GIM will be the province of NP/PAs. CRNA/AA's will be screwing up anesthesia. DNP's will think they're real doctors and kill people. Specialisation will continue until everyone is limited to one procedure. Training hours will be cut, we'll still whine, and we'll start killing people b/c signout didn't remind us about xyz.

    Stupid legislation will require malpractice insurance that makes today's look like pennies in your pocket. Doctors will be afraid to undertest anyone, even the obvious crack ***** on a jones coming in with the dt's.

    The insurance system will be dead. Reimbursements will be negative. God willing, universal health insurance will never be inacted.

    Patients will continue to be idiots.

    No one will want to be a doctor, it'll be like residency for the entirety of your working years.
     
  5. Forthegood

    Forthegood ProcrastinationAficionado
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    Jurrasicpark girl... why medicine?
     
  6. savant

    savant XIII
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    Apparently s/he's a machochist
     
  7. 236116

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    Masochistic proclivity unrelieved by sexual experimentation.

    --------

    Because I'm still an idealist and I think that there are people who are worth it. I still believe in medicine and that healing bullsh it. I want to be a surgeon, at this point probably peds-- there's just something about taking someone so terribly broken like some of those kids are and putting them back together.

    (Holy shi t, savant. Didn't see your post.)
     
  8. tnig469

    tnig469 No more Kryptonite!
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    December 21, 2012!!!!!!!!!!!!!!!!

    :)
     
  9. luctoretemergo

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    NP/PAs putting MD's out of jobs is what made me procrasinate so long in making the decision for med school. That is a great fear of mine, to be limited in the field you have worked so hard to excel in because of government and enomonic factors out of your control.
     
  10. DrYoda

    DrYoda Space Cowboy
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  11. TheElement

    TheElement Being Lazzy
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    We will be replaced by robots.

    (I'm just going with the trend here :)).
     
  12. DrYoda

    DrYoda Space Cowboy
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    and then they will revolt.
     
  13. emttim

    emttim Addicted to SCUBA
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    And then they will take over our military defense system, launch our nukes at their targets in Russia, Russia returns fire, and then we got thousands of the little bastards crawling over the remains with laser guns hunting down the survivors. Bwahahaha!
     
  14. angrypremed

    angrypremed Membership Revoked
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    I think it'll be impossible to get in by then (too competitive) and for the jobs, people will always be sick :thumbup: so there'll always be a need
     
  15. Climberak

    Climberak Senior Member
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    :eyebrow: Maybe I should've asked somewhere else...
     
  16. JackInTheBox

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    I, for one, welcome our new robot overlords.
     
  17. rama kandra

    rama kandra Actual Psychiatrist jk
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    rights for robots.
     
  18. Retsage

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    About the same as today, including the same Chicken Little Syndrome from premeds.
     
  19. mfrizzo3

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    Um.. As more and more modalities for radiology come to fruition we will see more and more minimally invasive procedures. Those procedures will then be adapted by the other specialties. Molecular genetics may start playing a larger role in treatment options and will we develop a revolutionary cure for cancer using the smallpox virus, which will work by the same mechanism as the Po-Po......Police :cool:, inciting praise around the globe. 28 Days Later we will be a bunch of zombies running around a mall in Racoon City trying to captured by some Col. Legend dude who is accompanied by a genetic experiment gone wry from some Umbrella Corp. who is trying to kill us instead of capturing us like the Col. fella. 28 Weeks after that there will be another beef scare. IDK:xf:
     
  20. RoyBasch

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  21. ejay286

    ejay286 Member
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  22. Retsage

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    This one's still my favorite by them.

    [YOUTUBE]http://ca.youtube.com/watch?v=mlYkIJVguCU[/YOUTUBE]
     
  23. Narmerguy

    Moderator Emeritus 10+ Year Member

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    Probably. You are asking a significant population to think ahead more years than they've lived themselves.

    :clap: :clap:

    I plan to walk naked through the streets on this day.
     
  24. cbrons

    cbrons Ratatoskr! *Roar*
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    Nurses will never be doctors, that doesn't worry me at all. If there ever comes a day when a CRNA is allowed to serve in the place of an Anesthesiologist during surgery on a pheochromocytoma, then you just know that medicine is dead and America has really lost its head. In all seriousness, how do these people get away with practicing medicine? Doctor of nurse practice? LOL...

    anyway, the problem is going to be the money. People want to make a lot of money. Hell I know I do. Sure I like to help people and it gives me happiness to see that my skills have improved their lives. Would I do it for free or for an average income? Not a snowballs chance in hell. If I'm going to do 8 years of training, I'm going to ensure I make a lot of money, go on vacations, buy my kids nice stuff, drink top shelf liquor, golf a lot, etc. The problem is that we have idiot politicians who won't acknowledge that people are motivated by their own self-interests. Hopefully universal health care will never become a reality because it will most certainly ensure that a lot of talented people will utilize their talents elsewhere- in a more lucrative profession.
     
  25. Gut Shot

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    "Blasting across the alkali flats in a jet powered, monkey navigated..." and it goes on like this...

    Short answer: nobody knows.

    Long answer: nobody has any idea.
     
  26. swamprat

    Physician Classifieds Approved 10+ Year Member

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    I was at the doctor the other day and when he found out I want to be a doctor he said - "i would advise you to change your mind." and when i said "well we need doctors, someone has to do it" he said "yes good thing we have a lot of naive boys and girls like you going into the field, theres a lot better and more healthy things you can do" This is not the first doctor that has told me to not go into the field.
     
  27. cubssox2000

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    I was talking to my genetics teacher one day, and I asked him what the state of health care would be in 20 years. He said that within 15 years everyone will have either a credit card or a digital implant with their genome on it that would be swiped at the doctor's office. The implications of this are that a person could find out about their genetic diseases as well as their possibilities of getting disease like cancer, diabetes, etc.

    Of course, this raises many questions about identity theft, insurance issues and how people would react to the information. For instance, if a person was told they had a 30% chance that within the next 50 years they would get colon cancer, what would they do? They could wait and see, or they can start removing colon tissue, or they can set up oncology treatments years in advance to protect themselves. There are many options. However, once the insurance companies have this information, they may decide the increase his rates by a couple thousand because of his increased risk.

    In 20 years, anything can happen - cure cancer, anti-bacterial overload and old diseases like polio and smallpox come back, influenza pandemic that kills millions of people like in 1918. The only thing to do is try and keep up.
     
  28. Kaustikos

    Kaustikos Archerize It
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    I just like to see people smile and I can only ask them so many times with a smile on my face to get that sort of response (Great experiment, btw)

    But seriously, stop copying me :laugh:
    Are you being serious? You would be eating your own words if you had a time machine, flew back to the 50s/60s and asked a Nurse if he/she ever thought they would have the same prescribing powers as a Physician. Guess what? SURPRISE! I, for one, would gladly welcome NPs taking over the primary care field since no one wants to properly reimburse physicians for taking that sort of "****".
     
  29. ngkats

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    According to everyone on this thread: up sh#t creek
     
  30. 236116

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    Wait, what?
     
  31. andexterouss

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    Interesting. I think increase specialization is a certainty. It's also a negative since that may turn off applicants due to the fact it takes one LONGER to train(residency-->fellowship-->super fellowship -->super duper fellowship!!!).

    Also lets not forget tuition. Med school tuition is increasing yearly(~7 percent) while salaries remain stagnant. In 20 years, the average med school grad ( DOs in particular)will probably owe 500K upon graduation. Can the government afford to lend that amount? Can students afford to pay back? We may be looking at another bubble bursting.
     
  32. savant

    savant XIII
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    One result of increasing specialization could be the growth of these auxiliary fields (i.e. NP, PA, etc). While I was shadowing a cardiologist, there was a person there training as an echocardiogram technician (they apparently have certification routes for those).

    Doctors are trained in integrating various types of information and to look at the patient as a whole entity. It's just that the bodies of information that all doctors used to know now have grown so large that it takes a specialist to master it. However, the specialist is still responsible for information integration from his specific field.

    Given that my assertions are true, that would mean so long as the bodies of information grow as they have been, specialization will continue. However, I think this trend (i.e. information growing) is more readily apparent for some fields (e.g. neurology, psych) than others (e.g. i would suggest ortho but don't know enough to make that assertion) ./
     
  33. because

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    When you treat you physicians like Dilbert (a cartonist), it’s Dilbert medicine you’ll get. As 3rd party payers and HMOs continue to divorce expertise from judgment, so results Dr. Dilbert: the highly specialized and well-educated yet ineffective nebbish masochist. American medicine sucks? The problem isn’t a lack of health care management. Insurance and health management organizations do not provide medicine; they “manage” it. You do not stagger into the swanky Blue Cross Blue Shield office lobby so that the receptionist will buzz down a squad of underwriters to stymie your hemorrhaging which you have tracked across their polished floor. You go… to a hospital. You can’t just magically create “medicine” on a spreadsheet.

    For example: in the Helix BRCA CliniCast, Dr. Barbara Ward describes how she recommends a treatment as medically necessary, but her judgment is overridden by the insurance company, and without funding, the treatment is not feasible.

    So what will medicine be in 20 years?

    Primary care: run by mostly Ph.D. nurses and PAs. That is reality! Deal with it. Genetics will become a big part of primary care. Deal with it! A community with a strong primary care can lead to a healthy community. Access to primary care has shown a community to be healthier than a community without access to primary care. Since medical school is so expensive and doctors demand a salary higher than 100,000 a year, insert the Ph.D. nurses (NPs included) and PAs. Result? A healthier community.
    Surgery: More robot intense. Fewer "hands on" procedures. Faster recovery time for patients. Some types of surgery, when more invasive, will be adopted by other specialites.

    Internal medicine: High patient demand for over a decade to come. Then a decrease in patient load. Result? Too many internal medicine doctors....decrease in salary.

    Peds? With improvement of vacines, tests, procodures and the like, less demand. However, here is what most pre-meds don't know. Peds will actually become a popular field because of the toxic waste dump that mothers now carry in their blood stream? Don't know WTF I'm talking about? Learn about cancer rates in children since 2000. What is the leading cause of death among children 1-14 years of age? Think about all of the medication that kids are now on because of the toxic waste dump in mothers bloodstream. 1-6 children are now born with a mental disability. Geee, what does that mean for a certain other field?

    Psych: read the above paragraph and hopefully you are the ability to figure out the trend.

    Neruology: increase in neruological conditions because of a better understanding of the conditions (nervous sytem, etc).
    More professional expertise among doctors-----equals longer training, more debt, and a demand for higher salaries===== equals increase penetration among the other healthcare providers.
    As science improves, the role of the doctor diminishes. That is reality.
    Medical Genetics: will become the forefront of medicine----with being intigrated into primary care.

    Result? Too many doctors will enter a certain field ***Caugh media generated***** and there won't be much demand for them once a certain population group dies off...result? Low salaries, low demand, and you get the rest.

    Going into medicine without your ass being exposed to the sun is going to cause your ass to burn the second you step foot in the desert when your ass is exposed.

    Really get to know what you are getting yourself into. Doctors are NOT immune to their skills becoming outdated.


     
  34. Kaustikos

    Kaustikos Archerize It
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    I don't know. You're posting what I want to say and so I have to say something else entirely now. :laugh:

    But seriously, medicine will cease to exist but instead become vending machines outside of walmart
     
  35. 236116

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    Ok i gotcha. :love:
     
  36. vokey588

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    A few years ago I relayed essentially the same story to Atul Gawande and asked what he though of that and this was his response: "I'd ignore them. There are difficulties in every field. And medicine is one of
    the great ones from which you can push a career forward in almost any
    direction--pure patient care, organizational leadership, business, research,
    arts. AG"

    This is coming from a very respected figure in healthcare, so I try to just look towards the vast benefits of being a physician.
     

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