Why would anyone go into primary care nowadays?

[Blue Cohosh]

---

Members do not see this ad.

I'm a student strongly interested in primary care. Potential reasons for choosing primary care (not exhaustive, and not all fit me):

1. Attraction to the field. (My #1)
2. Flexibility in practice style.
3. Flexibility in practice location.
4. Pay might not reflect the maximum possible ROI when compared to specializing, but a guaranteed 6 figure salary in one 's first real job is nice. Coupled with the ability to make that salary anywhere and it's very nice.
5. Shorter length of residency - not as significant a factor as the above but settling into a real job sooner is desirable to some.
6. Path of least resistance (IM and FM residencies less selective than others)

We do have subforums full of people that have actually chosen this career path. Why not head over to those and ask those people this question?

 

[DermViser]

This is from you....

In general, my feeling is if you are aiming for primary care - General IM/General Peds/Family Med, then NP or PA is a much better investment, esp. from a student loan standpoint. You can have a very good lifestyle, with good pay being a PA and doing primary care, and if you ever get bored you can always switch over to a specialty field. That's what is so great about PA is its flexibility

How is that "attacking" primary care physicians? What part of that is wrong? With respect to primary care: NP or PA is a much better both in terms of # of educational years invested AND amount of money to pay for the education.

Part of the reason many people do the PA route is bc it is 2 years after which you are not required to do a residency and which you can do both primary care or specialty medicine. PAs are able to switch between specialties and have done so. None of that is wrong.

The goal of the govt. is to have primary care physicians head the PCMH (Primary Care Medical Home) and serve more as administrators/managers, which is the opposite of why most people who want to go into IM/Peds/FM go to 4 years of medical school. They want to actually practice medicine not be administrators/managers.

 

[Bulbasaur]

There are some people in here who look down on PCPs, but the relentless attacks on PCPs have been coming from one person-- @DermViser

I don't think people necessarily look down on PCP but view it as something that isn't worth it if you've paid your dues to finish medical school. Especially if you're like me and have undergraduate loans from an expensive private college and are taking all loans for medical school (about 300k total as stated in first post), primary care's 200k salary simply isn't lucrative enough for me to pay my student loans, pay my bills, support my family, take care of my parents, AND live a comfortable life at the same time. Eventually, I will get there but the time it takes to become financially stable from PCP takes way longer than those doing certain specialties.

Everyone knows doctors are rich, and everyone going into medicine expects to live a top 1-5%tile lifestyle. I really don't understand why people on here say "if you want to be rich, go into finance or engineering." That is absolutely absurd. The ceiling for those professions may be higher but only few make it to te top. The ceiling in medicine is not that high but the basement is already pretty damn high in medicine.
At the end of the day, It comes down to lifestyle and money and almost all specialties out there have a better combination of both than primary care. A PCP and a dermatologist are both doctors: you're still helping patients deal with medically related issues. So why get paid $200k when you have a chance to earn more and love a better lifestyle as a specialist? Is the answer simply board scores?


Posted using SDN Mobile

 

[BestDoctorEver]

@DermViser... You said you were not talking about money and I show you one of your posts in which you are telling someone to go PA/NP because PCPs don't make enough money to justify loan/length of training etc... I don't see you criticize people who go in general surgery that much in here... These surveys show they have a low overall satisfaction rate as well. I guess it comes down to money and prestige for you...

 

[DermViser]

I don't think people necessarily look down on PCP but view it as something that isn't worth it if you've paid your dues to finish medical school. Especially if you're like me and have undergraduate loans from an expensive private college and are taking all loans for medical school (about 300k total as stated in first post), primary care's 200k salary simply isn't lucrative enough for me to pay my student loans, pay my bills, support my family, take care of my parents, AND live a comfortable life at the same time. Eventually, I will get there but the time it takes to become financially stable from PCP takes way longer than those doing certain specialties.

Everyone knows doctors are rich, and everyone going into medicine expects to live a top 1-5%tile lifestyle. I really don't understand why people on here say "if you want to be rich, go into finance or engineering." That is absolutely absurd. The ceiling for those professions may be higher but only few make it to te top. The ceiling in medicine is not that high but the basement is already pretty damn high in medicine.
At the end of the day, It comes down to lifestyle and money and almost all specialties out there have a better combination of both than primary care. A PCP and a dermatologist are both doctors: you're still helping patients deal with medically related issues. So why get paid $200k when you have a chance to earn more and love a better lifestyle as a specialist? Is the answer simply board scores?

Posted using SDN Mobile

If you talk to most PCPs, it isn't their salary that frustrates them as much as the non-medical stuff they have to do: filling out disability forms, having to call in prior authorizations, etc. For some reason, the bureaucratic BS happens to be the highest in primary care vs. specialty medicine which can largely avoid this. This is why many of the people who enter IM, for example, tend to specialize.

The millenial medical student is also more willing to give up some level of income for a better lifestyle. Hence why certain specialties that aren't paid gobs of money, i.e. PM&R, are getting to gain popularity. This is more a generational trait, which wasn't present in past generation of medical students. For example, decades ago, the so called, "top" medical students in the class went for IM and General Surgery. This was also a time when all of medicine paid well. This is no longer the case now, where medical students are attracted to fields with a better lifestyle. Is one better than the other? I don't think so. What has changed is how people value their time.

 

[BestDoctorEver]

Everyone knows doctors are rich, and everyone going into medicine expects to live a top 1-5%tile lifestyle. I really don't understand why people on here say "if you want to be rich, go into finance or engineering." That is absolutely absurd. The ceiling for those professions may be higher but only few make it to te top. The ceiling in medicine is not that high but the basement is already pretty damn high in medicine.



Posted using SDN Mobile

To be honest with you when I see people post stuff like that about business/engineering/law, I said to myself they probably don't understand that most people in these field start with an average salary and will never see 200k+/ year until they retire...

Edit... Also another thing that most fail to realize is that: resentment about physician's salary is not coming from the masses... It's mostly coming from these people who have college degree and are stuck in jobs making 40k-70k/year...

 

[DermViser]

@DermViser... You said you were not talking about money and I show you one of your posts in which you are telling someone to go PA/NP because PCPs don't make enough money to justify loan/length of training etc... I don't see you criticize people who go in general surgery that much in here... These surveys show they have a low overall satisfaction rate as well. I guess it comes down to money and prestige for you...

It's obvious your sole goal is to argue, although quite inartfully. Try to understand what the words, "return on investment" (not just money) mean. I'll wait while you research and educate yourself on the topic.

You realize that General Surgery isn't primary care and PAs and NPs aren't actively trying to do Surgery, right?
You realize that most General Surgery residents pursue subspecialty fellowships, right?

As I said, if you want to pursue primary care, there is more than one avenue to achieve this. The PA/NP pathway is a much easier pathway than the physician pathway. For Surgery, the only pathway is the physician pathway.

 

[NontradCA]

If you talk to most PCPs, it isn't their salary that frustrates them as much as the non-medical stuff they have to do: filling out disability forms, having to call in prior authorizations, etc. For some reason, the bureaucratic BS happens to be the highest in primary care vs. specialty medicine which can largely avoid this. This is why many of the people who enter IM, for example, tend to specialize.

The millenial medical student is also more willing to give up some level of income for a better lifestyle. Hence why certain specialties that aren't paid gobs of money, i.e. PM&R, are getting to gain popularity. This is more a generational trait, which wasn't present in past generation of medical students. For example, decades ago, the so called, "top" medical students in the class went for IM and General Surgery. This was also a time when all of medicine paid well. This is no longer the case now, where medical students are attracted to fields with a better lifestyle. Is one better than the other? I don't think so. What has changed is how people value their time.

I agree with what you said about PC and the increasing bureaucratic BS. However, I don't think my (our?) generation values time anymore than the older folks. I just think the time spent in medicine in the past was more enjoyable and was in turn a good lifestyle in itself.

 

[BestDoctorEver]

It's obvious your sole goal is to argue, although quite inartfully. Try to understand what the words, "return on investment" (not just money) mean. I'll wait while you research and educate yourself on the topic.

You realize that General Surgery isn't primary care and PAs and NPs aren't actively trying to do Surgery, right?
You realize that most General Surgery residents pursue subspecialty fellowships, right?

As I said, if you want to pursue primary care, there is more than one avenue to achieve this. The PA/NP pathway is a much easier pathway than the physician pathway. For Surgery, the only pathway is the physician pathway.

Yeah... I know your mastery of business and the English language is quite impressive 🙄

 

[DermViser]

I agree with what you said about PC and the increasing bureaucratic BS. However, I don't think my (our?) generation values time anymore than the older folks. I just think the time spent in medicine in the past was more enjoyable and was in turn a good lifestyle in itself.

I should be a little more clear. Medical students now value their time outside of medicine more. This is supported by the literature.

 

[DermViser]

Yeah... I know your mastery of the English language is quite impressive 🙄

I can see, again, you didn't actually refute any of the facts I laid out, but thought (wrongly) that I was remarking about your English. I was talking about your ability to make solid arguments.

 

[BestDoctorEver]

I can see, again, you didn't actually refute any of the facts I laid out, but thought (wrongly) that I was remarking about your English. I was talking about your ability to make solid arguments.

Why so many PA/nurses are going back to school for MD/DO then? Are they just misinformed? I suggest you check the non trad forum... They don't think they have it that good as you do...

 

[DermViser]

Why so many PA/nurses are going back to school for MD/DO then? Are they just misinformed? I suggest you check the non trad forum... They don't think they have it that good as you do...

Really? SO MANY PAs and NPs are going back to medical school? News to me. You have an actual paper showing that or are you just going based off of anecdotal evidence?

 

[BestDoctorEver]

Really? SO MANY PAs and NPs are going back to medical school? News to me. You have an actual paper showing that or are you just going based off of anecdotal evidence?

Anecdotes from the nontrad forum. I have seen many posts from PA/RN (not NP)/ Lawyers/Engineers trying to go med school...

 

[DermViser]

Anecdotes from the nontrad forum. I have seen many posts from PA/RN (not NP)/ Lawyers/Engineers trying to go med school...

Right, like I said, anecdotes. I prefer to go based on actual evidence, not anecdotes, as you're making it seem like it's some type of huge upheaving trend. And who brought up Lawyers, Engineers, Nurses (not NPs)? I surely didn't.

 

[BestDoctorEver]

@DermViser ... This is the title of one of your threads about some PhD blogger making a bogus argument going to nursing school is better than med school.

Why you should become a nurse or physicians assistant instead of a doctor
http://jseliger.wordpress.com/2012/...ctor-the-underrated-perils-of-medical-school/

What you have to understand that there are for some no matter how you glorify nurses, they won't leave med school so they can go to nursing school... Becoming a nurse/truck driver/engineer or whatever might make more sense financially for you, but don't try to shove it down people's throat... Not everyone will be a dermatologist.

 

[DermViser]

@DermViser ... This is the title of one of your threads about some PhD blogger making a bogus argument going to nursing school is better than med school.

Why you should become a nurse or physicians assistant instead of a doctor

What you have to understand that there are for some no matter how you glorify nurses, they won't leave med school so they can go to nursing school... Becoming a nurse/truck driver/engineer or whatever might make more sense financially for you, but don't try to shove it down people's throat... Not everyone will be a dermatologist.

You have officially lost the argument @BestDoctorEver. What does the title of this blog article, read?
http://jseliger.wordpress.com/2012/...ctor-the-underrated-perils-of-medical-school/

The title of the blog article is: "Why you should become a nurse or physicians assistant instead of a doctor: the underrated perils of medical school" hence why I titled the thread accordingly. No one is talking about becoming a "nurse/truck driver/engineer" if you don't like it. In this thread I was specifically talking about primary care, and the ROI (both monetary and non-monetary) of doing primary care as a physician, vs. doing primary care as a PA or NP.

Keep going at it though. I'm having fun having you trip over yourself trying to argue and not actually refuting any of the points I've made.

 

[BestDoctorEver]

@DermViser... Where is the monetary argument you made? Did you put them side by side and calculate how much both will earn when they reach 65... I have not seen that... Non-monetary ROI is such subjective measure and it's frankly weird you would even try to compare that...

 

[DermViser]

@DermViser... Where is the monetary argument you made? Did you put them side by side and calculate how much both will earn when they reach 65... I have not seen that... Non-monetary ROI is such subjective measure and it's frankly weird you would even try to compare that...

Your investment is in 2 forms: money (paid in tuition) and time (number of years of education + training), which includes the opportunity cost. I consider non-monetary investment to be the amount of time you have to invest. For PA school (and it's PA school tuition) it is 2 years of education and for med school (and it's medical school tuition) it is 4 years of education + 3 years of residency training.

I'm not going to do the calculations for you, something you can do on your own since you're that interested in seeing for yourself. I am not your *****. I'll let you have the last word on this, as I've entertained you enough, and your sole purpose seems to be to derail this thread.

 

[fuzzytoad]

No offense taken. You are right, I don't have what it takes to really earn as a banker or stockbroker, etc. I don't have the necessary ruthlessness. I worry that the other side of a deal might be disavantageous to my trading partner. I would fail to maximize profits.

Yup. I do. That doesn't mean that I didn't graduate from an Ivy with a decent GPA and score better on the MCAT than anybody giving me crap in this thread.

I want to go to a DO school because I think there will be fewer stat obsessed douchebags there. I think that as a DO, I won't get ragged on for actively choosing a primary care specialty without concern about the financial implications of that choice. I work with some exceptional doctors who are DOs, and I have seen that they are not any less than their MD colleagues in the eyes of the people who really matter, that is our patients and their families.

One day you will look back on this and laugh as hard as I'm laughing now.

 

[BestDoctorEver]

Your investment is in 2 forms: money (paid in tuition) and time (number of years of education + training), which includes the opportunity cost. I consider non-monetary investment to be the amount of time you have to invest. For PA school (and it's PA school tuition) it is 2 years of education and for med school (and it's medical school tuition) it is 4 years of education + 3 years of residency training.

I'm not going to do the calculations for you, something you can do on your own since you're that interested in seeing for yourself. I am not your *****. I'll let you have the last word on this, as I've entertained you enough, and your sole purpose seems to be to derail this thread.

Ok... BLS puts PA salary at 91k (average) and PCPs at 220k...

Let say PA school overall COA is 80k and medical school is 250k...

A PA that finishes school at 25 year old (most PA programs are a little bit over 2 years) will work for 40 years until he/she retires... Earn $ 3,640,000.00

MD (PCPs) finish med school at 30 year old, work 35 years will make $ 7,700,000.00

Can you tell me how that PA will make up that $3 millions difference? Are you serious?

 

[fuzzytoad]

Oh the wonders of compound interest and opportunity cost. How often are you forgotten by highly educated idiots.

 

[DermViser]

Oh the wonders of compound interest and opportunity cost. How often are you forgotten by highly educated idiots.

 

[BestDoctorEver]

Yeah... Once the PA finishes school, s/he starts investing to make up the $3 millions difference in lifetime earning between him/herself and a PCP on a 80k+/year salary... Ideal world.. I know!🙄

 

[username456789]

Yeah... Once the PA finishes school, s/he starts investing to make up the $3 millions difference in lifetime earning between him/herself and a PCP on a 80k+/year salary... Ideal world.. I know!🙄

I literally don't know how someone can be so naive. Unless you're choosing willful ignorance. A lot of people do that.

 

[DermViser]

I literally don't know how someone can be so naive. Unless you're choosing willful ignorance. A lot of people do that.

You didn't know? The moment you graduate from residency the ONLY expenses you'll have then are your student loans, and only the original principal too. Just put your entire salary towards your student loan debt and you'll pay it off in 2 years.

 

[Frazier]

Couple things:

1) From my perspective it doesn't sound like Dermviser is attacking primary care at all really. Rather, just painting a picture (via threads/posts) of themes which others are welcome to walk right by therein ignoring it, stop and ponder the meaning, or criticize.

2) Continuing on with the paint analogy, some of you guys are looking at Dermviser's painting and criticizing, of all things, the brush stroke technique. (i.e. criticizing titling a thread "Why you should become a nurse or physician assistant instead of a doctor"). Even if it is the exact title of the blog article linked in the thread, this is marketing 101. Get your audience's attention. It is an attention-grabbing title that grabs the reader's attention by speaking directly to them with a product that might offer more utility to their lives. Who is going to get more readers: the original title of the blog post, or a thread title like "A blog post comparing NP/PAs with Doctors."? Yawn.

3) If you want to read a thread where the OP used similar tactics, but perhaps eventually was a little too persistent read the "Why make 150k when 450k is out there?" (http://forums.studentdoctor.net/threads/why-make-150k-when-450k-is-out-there.509725/)

4) I imagine you see a lot of posts from Dermviser about primary care (as some of you point out with different phrasing) because A) the person is passionate about the politics of medicine, B) the person feels that the current positioning of the field is unfortunate, C) the person has a lot of free time to post on SDN (which is an awesome thing to have available -- time -- as a resident. No hate.)

Now that's a burn.

 

[Bulbasaur]

Yeah... Once the PA finishes school, s/he starts investing to make up the $3 millions difference in lifetime earning between him/herself and a PCP on a 80k+/year salary... Ideal world.. I know!🙄

How do you make $3mil by investing with a $80k/yet salary?


Posted using SDN Mobile

 

[DermViser]

2) Continuing on with the paint analogy, some of you guys are looking at Dermviser's painting and criticizing, of all things, the brush stroke technique. (i.e. criticizing titling a thread "Why you should become a nurse or physician assistant instead of a doctor"). This is marketing 101. Get your audience's attention. It is an attention-grabbing title that grabs the reader's attention by speaking directly to them with a product that might offer more utility to their lives.

The thread post title is the title of the blog I was referencing: http://jseliger.wordpress.com/2012/...ctor-the-underrated-perils-of-medical-school/, I didn't come up with it by myself.

 

[Frazier]

The thread post title is the title of the blog I was referencing: http://jseliger.wordpress.com/2012/...ctor-the-underrated-perils-of-medical-school/, I didn't come up with it by myself.

Noted and edited.

 

[BestDoctorEver]

@Bulbasaur... I don't know! I just presented the two situations (post #171) to a financial advisor and she told me 'there is no way in hell the PA is better off financially' (her quote)... Maybe I am very ignorant when it comes to financial matters...

 

[sinombre]

I think he responded to criticism about this somewhere, but I can't find it. The 2 first things that come to mind:

1) It's funny when he asks another physics professor to verify his observation, considering he was criticizing seeking the opinions of those 'trained in the same system.' It's not perfectly ironic, but there is obviously some irony there.
2) To the professor who shouted that he's failed more pre-meds than pre-law students... lol. I'm sure students seeking both professions take physics classes in equal numbers.

I still love Neil deGrasse Tyson for being a tremendous role model for kids, and for being a huge science advocate.

 

[Frazier]

I think he responded to criticism about this somewhere, but I can't find it. The 2 first things that come to mind:

1) It's funny when he asks another physics professor to verify his observation, considering he was criticizing seeking the opinions of those 'trained in the same system.' It's not perfectly ironic, but there is obviously some irony there.
2) To the professor who shouted that he's failed more pre-meds than pre-law students... lol. I'm sure students seeking both professions take physics classes in equal numbers.

I still love Neil deGrasse Tyson for being a tremendous role model for kids, and for being a huge science advocate.

Dude, English literature majors are the best physics students. period. I have failed exactly zero English literature majors in my time. I've failed hundreds of pre-meds. English literature majors are hundreds of times more intelligent than our practicing physicians.

 

[michaelrack]

No offense taken. You are right, I don't have what it takes to really earn as a banker or stockbroker, etc. I don't have the necessary ruthlessness. I worry that the other side of a deal might be disavantageous to my trading partner. I would fail to maximize profits.

Although a stockbroker is in the financial field, I wouldn't consider that position to be a top financial job- it's not what most SDN members mean when they talk of finance as an alternative to being a doctor.

 

[DermViser]

I think he responded to criticism about this somewhere, but I can't find it. The 2 first things that come to mind:

1) It's funny when he asks another physics professor to verify his observation, considering he was criticizing seeking the opinions of those 'trained in the same system.' It's not perfectly ironic, but there is obviously some irony there.
2) To the professor who shouted that he's failed more pre-meds than pre-law students... lol. I'm sure students seeking both professions take physics classes in equal numbers.

I still love Neil deGrasse Tyson for being a tremendous role model for kids, and for being a huge science advocate.

It was more in reference to the highly educated idiots remark above by @fuzzytoad. Apparently one can make it to med school without knowing what compound interest and opportunity cost are.

 

[Psai]

It was more in reference to the highly educated idiots remark above. Apparently one can make it to med school without knowing what compound interest and opportunity cost are.

Well standards are lower for DO schools

 

[demayette]

Financially savvy med students and residents... Lol . I love SDN.

 

[circulus vitios]

I literally don't know how someone can be so naive. Unless you're choosing willful ignorance. A lot of people do that.

You're two sides of the same coin. Both of you need to post an earnings analysis based on realistic assumptions or shut up.

 

[username456789]

You're two sides of the same coin. Both of you need to post an earnings analysis based on realistic assumptions or shut up.

How cute!

 

[circulus vitios]

How cute!

A six year head start on investing doesn't necessarily mean a greater end value, even with the magic of compounding interest, when a PA or NP can put away $10-20k a year versus a physician putting away $50-100k a year.

 

[username456789]

A six year head start on investing doesn't necessarily mean a greater end value, even with the magic of compounding interest, when a PA or NP can put away $10-20k a year versus a physician putting away $50-100k a year.

I'm not sure why you think I'm the one harping on money here. It's only part of the equation, and I think DV is working hard to make that clear to a lot of people. Spending the better part of a decade in medical education takes its toll on you: physically, emotionally, and yes financially. It involves a lot of sacrifice. And yes, so do many other fields. But the point (I think) that DV has been trying to convey is that when you see someone whizzing on by in ~2 years while you're still practicing delayed gratification, it can be pretty demoralizing.

This isn't just a race to retirement to see who accumulated the most money.

 

[Promethean]

I'm not sure why you think I'm the one harping on money here. It's only part of the equation, and I think DV is working hard to make that clear to a lot of people. Spending the better part of a decade in medical education takes its toll on you: physically, emotionally, and yes financially. It involves a lot of sacrifice. And yes, so do many other fields. But the point (I think) that DV has been trying to convey is that when you see someone whizzing on by in ~2 years while you're still practicing delayed gratification, it can be pretty demoralizing.

This isn't just a race to retirement to see who accumulated the most money.

I think this idea of the education component as being something that one has to get through in order to reach a finish line is part of the problem.

I am looking forward to the time I spend in school and residency. That isn't an onerous burden that I have to slog my way through to get to something better... it is something that, in itself, I have wanted to experience my whole life long. People who skip over it aren't getting ahead of me, and I don't envy the way that they are missing out on the training that I am going to such trouble to experience.

Don't delay gratification. Find gratification in what you are doing right now, in the process. This is life, today.

 

[BestDoctorEver]

I'm not sure why you think I'm the one harping on money here. It's only part of the equation, and I think DV is working hard to make that clear to a lot of people. Spending the better part of a decade in medical education takes its toll on you: physically, emotionally, and yes financially. It involves a lot of sacrifice. And yes, so do many other fields. But the point (I think) that DV has been trying to convey is that when you see someone whizzing on by in ~2 years while you're still practicing delayed gratification, it can be pretty demoralizing.

This isn't just a race to retirement to see who accumulated the most money.

Maybe you should read his posts... A financial advisor thinks he, Psai are delusional.....

No one is arguing about physician vs. PA training here since it is obvious....

 

[CherryRedDracul]

Don't delay gratification. Find gratification in what you are doing right now, in the process. This is life, today.

I have a feeling that DermViser is actually advocating that by telling us to avoid primary care through the physician pathway.

 

[Roxas]

I think he responded to criticism about this somewhere, but I can't find it. The 2 first things that come to mind:

1) It's funny when he asks another physics professor to verify his observation, considering he was criticizing seeking the opinions of those 'trained in the same system.' It's not perfectly ironic, but there is obviously some irony there.
2) To the professor who shouted that he's failed more pre-meds than pre-law students... lol. I'm sure students seeking both professions take physics classes in equal numbers.

I still love Neil deGrasse Tyson for being a tremendous role model for kids, and for being a huge science advocate.

I also take issue with the manner in which he criticized the medical "system," as it makes it sound as if he's a small step away from saying that physicians intentionally keep people sick. And although as a humble MS-0 I haven't been through the training process yet, I would imagine when giving a terminal diagnosis, erring on the side of telling them less time when they may have more is common practice, is it not? Better to have someone happy they lived longer, rather than a family pissed because they died earlier.

 

[DermViser]

I'm not sure why you think I'm the one harping on money here. It's only part of the equation, and I think DV is working hard to make that clear to a lot of people. Spending the better part of a decade in medical education takes its toll on you: physically, emotionally, and yes financially. It involves a lot of sacrifice. And yes, so do many other fields. But the point (I think) that DV has been trying to convey is that when you see someone whizzing on by in ~2 years while you're still practicing delayed gratification, it can be pretty demoralizing.

This isn't just a race to retirement to see who accumulated the most money.

Thank you. Thank you. Thank you. I don't see how this is so difficult for certain people to understand. The delayed gratification is in so many areas.

 

[sinombre]

I also take issue with the manner in which he criticized the medical "system," as it makes it sound as if he's a small step away from saying that physicians intentionally keep people sick. And although as a humble MS-0 I haven't been through the training process yet, I would imagine when giving a terminal diagnosis, erring on the side of telling them less time when they may have more is common practice, is it not? Better to have someone happy they lived longer, rather than a family pissed because they died earlier.

Although I can't find it, I do remember him responding that what he said in that video clip was supposed to be a critique of the irrationality of that kind of religious assumption, not a critique of physicians per se. I think he could have used any other profession and made the same point (that people are fallible). But yeah, I don't think many people would disagree with you about being conservative with life expectancy estimates.

 

[DermViser]

I have a feeling that DermViser is actually advocating that by telling us to avoid primary care through the physician pathway.

Correct, as Primary care has several pathways to do it in -- Physician, NP, or PA.

 

[Roxas]

Although I can't find it, I do remember him responding that what he said in that video clip was supposed to be a critique of the irrationality of that kind of religious assumption, not a critique of physicians per se. I think he could have used any other profession and made the same point (that people are fallible). But yeah, I don't think many people would disagree with you about being conservative with life expectancy estimates.

From his point of view, that religious assumption seems irrational. Fine. But is the alternative of people constantly questioning each one of your medical decisions much better? Because that seems like what he's advocating. Once someone is out of the hospital and back home, it shouldn't matter to the professionals what they believe. I would argue it's better for the profession (or at least less obstructive) to have that trust, as long as the physician isn't intentionally lying to the patient.

 

[demayette]

I have seen many PA/NP in Derm, EM, psych etc... Yes there are a lot more in primary care, but it appears they are starting to invade the non-surgical specialties as well.. Lets face it, everyone is after the $...