why are endocrinologists unhappy?

[mxns]

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Endo seems like a really fascinating field, but it seems to have high rates of dissatisfaction from what I've read (unscientific, but: http://www.kevinmd.com/blog/2015/06/where-are-you-on-the-physician-pain-scale.html). Why is that? I imagine that in practice, most patients are being managed for diabetes, but isn't it possible to get into other diseases during fellowship?

 

[bashwell]

I don't know about "high rates of dissatisfaction." All the endocrinologists I know seem pretty happy. They don't get paid as much as other specialties, but who cares? They enjoy what they do, and they have a pretty good lifestyle.

 

[Raryn]

Endo seems like a really fascinating field, but it seems to have high rates of dissatisfaction from what I've read (unscientific, but: http://www.kevinmd.com/blog/2015/06/where-are-you-on-the-physician-pain-scale.html). Why is that? I imagine that in practice, most patients are being managed for diabetes, but isn't it possible to get into other diseases during fellowship?

Look at the actual data underlying the graphic:
http://www.medscape.com/features/slideshow/compensation/2015/public/overview#page=17

Except for a few outliers, there's *really* tight clustering overall. You have practically everyone in the 50-55% overall satisfied range. I doubt the sample size is high enough to make meaningful statements based on this data.

 

[rokshana]

the pay is about the same as IM (not hospitalist) and in the private practice is limited by the number of patients you see.
i think most endocrinologists are pretty happy with the medicine they practice, but are frustrated by the vast amount of (at time incredibly stupid) paperwork there is in the outpt setting....but this isn't unique to endocrinology.

 

[runnergal]

I don't know about "high rates of dissatisfaction." All the endocrinologists I know seem pretty happy. They don't get paid as much as other specialties, but who cares? They enjoy what they do, and they have a pretty good lifestyle.

"Don't get paid as much as ...." Try infectious disease .... Bottom of totem pole but probably the real a$$ savers 🙁((((

But you're right - who cares. It's still my goal anyway

 

[jdh71]

Endo seems like a really fascinating field, but it seems to have high rates of dissatisfaction from what I've read (unscientific, but: http://www.kevinmd.com/blog/2015/06/where-are-you-on-the-physician-pain-scale.html). Why is that? I imagine that in practice, most patients are being managed for diabetes, but isn't it possible to get into other diseases during fellowship?

Lots of diabetics who are diabetic because they suck as human beings. That would be my guess.

 

[jdh71]

"Don't get paid as much as ...." Try infectious disease .... Bottom of totem pole but probably the real a$$ savers 🙁((((

But you're right - who cares. It's still my goal anyway

ID doesn't save anyone's ass. Ever. Lol.

 

[Gastrapathy]

ID doesn't save anyone's ass. Ever. Lol.

Orthopods. They save ortho's ass.

My first reaction to the OP "Duh hormones"

 

[jdh71]

Orthopods. They save ortho's ass.

My first reaction to the OP "Duh hormones"

Curing disease.

 

[rokshana]

Lots of diabetics who are diabetic because they suck as human beings. That would be my guess.

you don't have to see diabetes...that's what PCPs are for 🙂 ....i plan to see as little diabetes as possible (and yes it can be done).

 

[jdh71]

you don't have to see diabetes...that's what PCPs are for 🙂 ....i plan to see as little diabetes as possible (and yes it can be done).

Don't have too? I don't know about you but I see what I'm consulted to see. If I don't people will stop sending me patients and I like seeing new patients. Most PCPs manage basic COPD fine too. I still see plenty of it. The bad and or harder to treat variety.

Maybe you'll get to pick and choose but I doubt it.

 

[rokshana]

Don't have too? I don't know about you but I see what I'm consulted to see. If I don't people will stop sending me patients and I like seeing new patients. Most PCPs manage basic COPD fine too. I still see plenty of it. The bad and or harder to treat variety.

Maybe you'll get to pick and choose but I doubt it.

depends on where you are and what type of setting...here there are separate divisions of diabetes and endocrinology...so if you are in the endocrinology division you see everything but diabetes...sure in the inpt setting, there will be diabetes (the majority of those consults are for diabetes), but that amount probably makes up <10% of what those in the endocrinology division see.

really the most common thing is thyroid...those get referred from the PCPs much more than diabetes...and there are people out there that see only thyroid...esp if they are heavy into biopsies.

in private practice, it will be different...with a mix, but even then thyroid and diabetes are probably even, unless you bill yourself as a diabetologist...then of course you can be 100% diabetes.

 

[VA Hopeful Dr]

depends on where you are and what type of setting...here there are separate divisions of diabetes and endocrinology...so if you are in the endocrinology division you see everything but diabetes...sure in the inpt setting, there will be diabetes (the majority of those consults are for diabetes), but that amount probably makes up <10% of what those in the endocrinology division see.

really the most common thing is thyroid...those get referred from the PCPs much more than diabetes...and there are people out there that see only thyroid...esp if they are heavy into biopsies.

in private practice, it will be different...with a mix, but even then thyroid and diabetes are probably even, unless you bill yourself as a diabetologist...then of course you can be 100% diabetes.

Yeah, as an outpatient PCP let me tell you how this works. Unless you are the only endocrinologist in town, if you refuse to see my diabetics you sure as hell won't be getting my thyroid patients. And my experience is that I have many more diabetics that I have trouble with than I have thyroid patients that I can't handle.

Obviously this doesn't apply if you're in an academic setting.

jdh is exactly right here.

 

[rokshana]

Yeah, as an outpatient PCP let me tell you how this works. Unless you are the only endocrinologist in town, if you refuse to see my diabetics you sure as hell won't be getting my thyroid patients. And my experience is that I have many more diabetics that I have trouble with than I have thyroid patients that I can't handle.

Obviously this doesn't apply if you're in an academic setting.

jdh is exactly right here.

*raise hand* academic setting!!

but for example....

http://www.thyroidflorida.com

they are not going to take diabetes patients...not equipped for it...but probably still get an awful lot of thyroid referrals...

and they are very specific about what pts the accept for referral

http://www.thyroidflorida.com/for-physicians.html

but thank you for telling me how it works in my own field...

 

[jdh71]

*raise hand* academic setting!!

but for example....

http://www.thyroidflorida.com

they are not going to take diabetes patients...not equipped for it...but probably still get an awful lot of thyroid referrals...

and they are very specific about what pts the accept for referral

http://www.thyroidflorida.com/for-physicians.html

but thank you for telling me how it works in my own field...

I think you're overly optimistic about your lack of diabetic patients. Unless you are telling us you are going to be working at a special thyroid only gig.

I've heard of a general surgeon that makes over a million dollars a year doing cash pay only too . . . just because it "exists" somewhere, is no reason to have expectation you will be able to practice that way.

 

[rokshana]

I think you're overly optimistic about your lack of diabetic patients. Unless you are telling us you are going to be working at a special thyroid only gig.

I've heard of a general surgeon that makes over a million dollars a year doing cash pay only too . . . just because it "exists" somewhere, is no reason to have expectation you will be able to practice that way.

again, thank you for telling me what to expect in my own field....

my fellowship program has SEPARATE divisions for endocrinology and diabetes...the endocrinology attending see...endocrinology patients...not diabetes...or very little...can you have a pt with hypothyroidism and diabetes? sure...and will that person manage both? sure...

and again it DEPENDS on where you are...is it realistic to think you can be an endocrinologist in some rural town in the sugar belt and think you won't see diabetes? of course not, but could you be at an academic center that is known to be THE place for thyroid or pituitary or GID and become focused in that sub-specialty of endocrinology...yes, yes you can...

one of my co-fellows is starting an endocrine oncology fellowship this year...you think she's gonna see a lot of diabetes after she's done? i doubt it...

 

[jdh71]

again, thank you for telling me what to expect in my own field....

my fellowship program has SEPARATE divisions for endocrinology and diabetes...the endocrinology attending see...endocrinology patients...not diabetes...or very little...can you have a pt with hypothyroidism and diabetes? sure...and will that person manage both? sure...

and again it DEPENDS on where you are...is it realistic to think you can be an endocrinologist in some rural town in the sugar belt and think you won't see diabetes? of course not, but could you be at an academic center that is known to be THE place for thyroid or pituitary or GID and become focused in that sub-specialty of endocrinology...yes, yes you can...

one of my co-fellows is starting an endocrine oncology fellowship this year...you think she's gonna see a lot of diabetes after she's done? i doubt it...

Hope it works out.