Why I Chose Against Being a Physician

[polly-o]

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this is a nice scenario, but... you're patient is NOT going to be able to run out and get her genome sequenced (and as a genetic counselor you are not going to be able to order this test and insurance cover it). it does NOT cost about $1K for a clinic patient to get their genome sequenced right now. not even close. there is a contest right now for scientists to develop a technology that will allow sequencing of a genome for $1000K. No one has done it yet. And even once someone comes up with the technology, that doesn't mean that it costs $1K to the patient. Someone has to produce the kit, deal with getting it FDA approved, figure out a way to do it on a LARGE scale production, how to deliver the results, how to store them, accuracy-what about false positives and negatives and the liability this entails? etc., etc. while it is true that genetic testing will in our lifetimes become a reality there are a lot of hurdles: scientifically, economically and ethically that will come into play before the genetic counselor is writing orders for every patient who walks through the door to have their genome sequenced. while i think there is a need for genetic counselors, especially in taking the time-which many doctors don't have, to explain the risk of transmission for parents with risk alleles who are trying to conceive, the scenario isn't quite as peaches and cream as you suggest. you seem to knock on pre-meds for glamorizing medicine, but you might want to do some reality check as well about your chosen career.

There is a lot of responsibility and a lot of emotions that can take place during a genetic counseling session. For instance, let’s look at the following example.

A 35 year old female calls on the phone wanting to know if she inherited her breast cancer from her mother and if she can pass it on to a child. So the counselor recommends that the person come into the clinic to have a counseling session done. An assessment has to be done regarding if a test for BRCA1 and 2 should be done (will insurance cover the cost) and if the patient is psychological stable enough to handle a positive test. Maybe the BRCA gene is not the cause of her breast cancer. Maybe it was the ATM gene leading to her breast cancer. So after a family history is done, the counselor finds out that the patient has an increased risk of breast cancer because of her ethnicity.

It turns out that the 35 year old female is single but wants to marry but has had her breast removed to help prevent her breast cancer from coming back. So now the patient finds out that she is positive for a mutation in the BRCA1 gene that can leads to breast cancer and the counselor describes how the mutation can lead to developing breast cancer and explains that there is a 50 percent chance of her passing on the gene to a child for developing breast cancer. However, even if her child was to develop breast cancer it might not actually be a result of the mutation she inherited. Since there are several ways a person can develop breast cancer, the counselor can explain that even if the child was to be tested and found positive to have the mutation that the mother passed on, does not mean that the child will develop breast cancer. Even though the risk of developing breast cancer is higher. Therefore, when the child gets to be around 35 or so years old, the child should be getting checked for breast cancer. So now comes into play personalized medicine. Let’s say the child was found positive for the mutation leading to breast cancer and latter develops is at age 37, the child already has her genome screened because the counselor recommend that the parents child have her genome screened so effective therapy can be done if her child were to develop breast cancer. Thus, if the breast cancer is found early, then there is a better chance of the child not getting to ill because of better therapy that COULD result from her genome being sequenced (only cost $1,000 these days and will only get cheaper) and cancer being found early and already have a positive test for the mutation.

So now comes the emotions of the parent because she has had her breast removed and still wants to have a family and having a 50 percent chance her children developing breast cancer as well.

This is only a small portion of what the counseling session will entail.

I really enjoy this type of work. That is why I’m becoming a genetic counselor. I’m not interested in the other type of medical care (i.e., repairing a broken bone, doing heart surgery, putting a balloon in, and so forth…I’m not interested in doing that type of work). I would rather have a role in helping the clinical geneticist in the management of the genetic disease and do counseling. I really enjoy this and I am really excited for having the chance to do it.


My advice is to have someone start a RT forum and spend your time there. There is no need to keep bashing me for what I like.

 

[sejin8642]

I think the OP is trying to deceive premed students to reduce competitiveness.

 

[Tired]

Most people in America don't really trust doctors. I have not had one single family member be happy with their doctor. Most of the reasons why they have not been happy with their medical care is that the doctors are not taking the time to explain why they are doing what they are doing and don't take the time to explain the disease process or try to figure out why they got this cancer, and just treat instead of trying to manage the disease.

Anyone know if I would get in trouble for starting a "Why I Chose Not To Be a Genetic Counselor" thread?

 

[DropkickMurphy]

I think so long as you don't post any PM's you get because of it, you'll be fine.

 

[Mayday]

Even worse, the people at interviews who try to diagnose while walking by patient rooms during the hospital tour. FREAKIN TOOLS!

Actually, I bet most people do this - and there's no problem with that. The problem is when they mistake thier out loud voice for their inside the head voice 😉

 

[DropkickMurphy]

Actually, I bet most people do this - and there's no problem with that. The problem is when they mistake thier out loud voice for their inside the head voice 😉

True, I think we all test ourselves. It's just that many premeds tend to forget how little they actually know that is directly clinically applicable.

 

[MWillie]

Yup.

 

[Ouroboros]

I was once given some advice: "If you can think of anything that will make you happy besides medicine... do that."

I personally have no problem with people doing what they love. Seems that you've (Genetics) found something; more power to you. As for myself (and apparently others), medicine is a passion, a calling, and something we just can't resist pursuing. Good for us... we who both found careers instead of jobs.

<shrug> just my two cents. 🙄​

 

[Haemulon]

I have seen this thread here for several days but for some reason never opened it. After finally reading what the OP's original message was, I came away with a very different impression than some of the others that responded. I agree with Quix in that I can see the value in posting a thread here about why someone chose not to be a physician. Unfortunately, there will be some pre-allo's that arn't successful and ultimately decide to go in a different direction. The sort of reasoning that the OP posted my help somebody else think through their own situation. While I can say that I do not share the same priorities and work ethic as the OP, I can respect that he recognizes the importance he places on activities such as regularly watching football and that a career as a physician is incompatable with that.

Genetic counseling is a great field to be in and I actually considered it once. My wife has thought about it as well. But I never seriously pursued it since I was much more facinated by the medical and diagnostic aspects of clinical practice. Perhaps I will go into Clinical Genetics as a fellowship? We'll have to see. I do really love many aspects of that specialty.

 

[mshheaddoc]

I have seen this thread here for several days but for some reason never opened it. After finally reading what the OP's original message was, I came away with a very different impression than some of the others that responded. I agree with Quix in that I can see the value in posting a thread here about why someone chose not to be a physician. Unfortunately, there will be some pre-allo's that arn't successful and ultimately decide to go in a different direction. The sort of reasoning that the OP posted my help somebody else think through their own situation. While I can say that I do not share the same priorities and work ethic as the OP, I can respect that he recognizes the importance he places on activities such as regularly watching football and that a career as a physician is incompatable with that.

Genetic counseling is a great field to be in and I actually considered it once. My wife has thought about it as well. But I never seriously pursued it since I was much more facinated by the medical and diagnostic aspects of clinical practice. Perhaps I will go into Clinical Genetics as a fellowship? We'll have to see. I do really love many aspects of that specialty.

I 100% support this post (minus the last paragraph - I don't want to be in genetics and my wife hasn't thought about it either! I think my husband would be pissed if I had a wife ). Some of you need to settle down for jumping on the OP with your sarcastic remarks. Talking out your career options can be a sense of clarity and I'm sure many of you have done it at one point. 🙄 Maybe not here, but you've talked with someone about it. That's why you have these forums to explore career choices. Don't belittle someone with immature remarks, talk about it in a professional manner! 🙂

 

[Genetics]

There has been a small scale personalized medicine project that has been done. I don't know the exact number of people who participated in the project, but Marshfield Clinic in Marshfield, Wisconsin, offered every person in a certain age group in a certain zipcode to have a chance to have their genome sequenced for the purpose of their medical care (for drug treatments mostly).

I know that a person needs funding and to build a work group to get this done and FDA approval and all that stuff is needed. I'm studying how the Marshfield Clinic did their project and I would like to follow their model. But I would like to offer predispositional testing as well.

The best way to go is by starting small (start in your own community) and then work out from there. The price for genome sequence is not as expensive as it use to. I remember reading recently that a research group did a sequence for only $3,000 dollars. So the $1,000 genome sequence is no far off. I'm sure the price of doing a genome sequence will go even below $1,000 in the near future.

As far as what can be tested for will vary from state to state. In the state I live in, genetic testing is mostly only done for genetic disorders that can be treated. The cost for a genetic test will vary from test to test.

Everything that I am typing about this topic is nothing new. Everything that I'm typing about this topic is stuff that people are already trying to get done. I'm really excited about this stuff.

David Schwartz, a professor of genetics at the University of Wisconsin, Madison, decribed recently at the Human Genome meeting in Helsinki that within three years, he believes his lab will have a test capable of reading an entire genome within an hour for less than $100.

To read a whole genome, Dr Schwartz plucks strands of DNA from a cell and stretches them out on a sheet. He then squirts on an enzyme that cuts the DNA whenever it encounters a specific sequence of letters. Studying the barcode-like pattern produced by the cuts helps identify which letters, or DNA bases, are where.

Have a good day!

this is a nice scenario, but... you're patient is NOT going to be able to run out and get her genome sequenced (and as a genetic counselor you are not going to be able to order this test and insurance cover it). it does NOT cost about $1K for a clinic patient to get their genome sequenced right now. not even close. there is a contest right now for scientists to develop a technology that will allow sequencing of a genome for $1000K. No one has done it yet. And even once someone comes up with the technology, that doesn't mean that it costs $1K to the patient. Someone has to produce the kit, deal with getting it FDA approved, figure out a way to do it on a LARGE scale production, how to deliver the results, how to store them, accuracy-what about false positives and negatives and the liability this entails? etc., etc. while it is true that genetic testing will in our lifetimes become a reality there are a lot of hurdles: scientifically, economically and ethically that will come into play before the genetic counselor is writing orders for every patient who walks through the door to have their genome sequenced. while i think there is a need for genetic counselors, especially in taking the time-which many doctors don't have, to explain the risk of transmission for parents with risk alleles who are trying to conceive, the scenario isn't quite as peaches and cream as you suggest. you seem to knock on pre-meds for glamorizing medicine, but you might want to do some reality check as well about your chosen career.

 

[Haemulon]

Wow. I am all about genetics man, but your posts just always seem to be so huge. Almost blog style. More people may read them if they were more concise, just a suggestion. 😉

 

[Genetics]

LOL, Yup! But there so much to say, 😀

 

[Wackie]

Some of the replies to the OP are so full of immaturity it shocks me.

Unbelievable.


Genetics,

I applaud your decision. I'm glad you researched exactly what it is you want to do instead of looking to an MD as the only way to accomplish your goals, the only thing "worthy" of your time. Hopefully, physicians won't ever look down their noses at you as some here have done.
Good luck in your quest.

 

[MonkeyNuts!]

I'm no longer in dispair for trying to decide what I want to do. I simply looked at what options I had for careers in the field of genetics and had to spend some time looking into all of the careers so I could find one that I am intersted in and allows me to do what I want outside of work. Just because I love football is not a reason to bash me for not wanting a certain career because it will take away my time from watching football on the fall weekends (I like to keep my intersts......having a career taking away my intersts is not worth it. Life is to short, why not enjoy it?).

Playing football for a team? Maybe. Coaching a kids' football team? Maybe. But WATCHING football? Sitting there with your pals drinking beer and eating chips? That's what you will factor in to your decision not to pursue a career???

Please. And if you REALLY considered your options, you might have discovered there are such things as torrents, TiVO, and this nifty little device that made a huge impact in the late 1980s and 1990s - a VCR.

I gurantee you that better then 80 percent of the pre-meds on here have not taken the time to look at careers outisde of being a doctor. Just because I'm not one of the arrogant ass pre-med doctor wanabee, does not give anyone the right to bash me for making a post. So what if most people didn't like it. Big deal!

I will guarantee you that your percentage is wrong. The amount of non trads on this site is enough to offset it.

Every single one of the friends I have that want to be doctors keep saying the only reason why they want to be doctors is because it seems interesting and they want to help people. LOL. I find this to be so funny because when you ask them if they can help you with a homework assignment, they run the other way. If they wanted to help people, they would help people who ask for help on an assignment. Also, most pre-meds don't know what it is like working 80 hours a week and not having a single day off in 4 months, and having 250K debt sitting on their shoulders, caring for an ailing family, and so forth. Most pre-meds just want to be rich, have the ability to say they are a doctor to make themselves feel better and so forth.

You're making rampant generalizations about premeds without any proof whatsoever. The only thing concrete you can draw from this little anecdote is that you need to find better friends.

Most people in America don't really trust doctors. I have not had one single family member be happy with their doctor. Most of the reasons why they have not been happy with their medical care is that the doctors are not taking the time to explain why they are doing what they are doing and don't take the time to explain the disease process or try to figure out why they got this cancer, and just treat instead of trying to manage the disease.

Again, rampant generalization. But to an extent, this is true, but what is more important is WHY this is happening. Take the time to stop and research the reason for lack of communication. So easy to just blame the doctor.