Worst/ Most Boring Specialty?

[latinfridley]

Making money is important. Anyone who says otherwise is just fooling themselves.

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[deleted87716]

Making money is important. Anyone who says otherwise is just fooling themselves.

"Money's only important when you don't have any." - Sting

 

[YouDontKnowJack]

the worst specialty is one that overworks you and doesn't pay enough for what you do.

I demand to be paid an amount that is equivalent to what your health is worth. If you think your health is worth only $20, I will give you $20 service (tell you to get out of my face and take some aspirin). simple as that. doctors deserve to make big bucks.

 

[deleted87716]

the worst specialty is one that overworks you and doesn't pay enough for what you do.

And the less you enjoy what you do, the more you expect to be paid to do it.

 

[8744]

Your post wasn't simply about money. It was about making money in order to impress one's spouse/significant other.

Good luck with that.

No. Not to impress. To give her the lifestyle which she deserves and to reduce her stress level by securing her (and your) future. Once you have the carcass of a mammoth or two safely cached in the permafrost then you can go on long meaningful walks on the tundra.

 

[DoctorFunk]

Your post wasn't simply about money. It was about making money in order to impress one's spouse/significant other.

Good luck with that.

Are you married? I would guess not, with a reply like that. Ensuring that you are maximizing your income potential for your spouse's sake isn't about impressing anyone, it is an effort to ensure that your children will be properly cared for, that life's ups and downs will not be life-shattering events financially, and that you and your spouse can enjoy retirement without worrying about whether or not medicare will cover your latest doctor's appt. In short, just as you may believe that you will be practicing medicine for the "love" of your patients, I will be practicing knowing full-well that it is my opportunity to really provide and ensure the safety of the love of my life and our family. Ethically, it's a wash.

In the end, there is absolutely nothing wrong with choosing a specialty that you love. However, only a fool would walk away from a specialty that pays better and would be just as interesting and rewarding because of some sense of guilt over being well-paid.

 

[deleted87716]

Are you married?

Happily, for 18 years. Thanks for asking.

only a fool would walk away from a specialty that pays better and would be just as interesting and rewarding because of some sense of guilt over being well-paid.

Nice straw man.

To borrow a phrase from our friends in the legal biz, your post assumes facts not in evidence.

 

[QofQuimica]

Dude. You are so going to change your tune as you get a little older. I guarantee it. Save this post. Print it out. Put it in a safe place and read it five years from now. You are going to cringe in shame the same way your AMCAS essay will make you wince if you read it when you graduate medical school.

When your wife is worrying herself sick over sending your four children to some crappy local public school and the only option is home schooling or shelling out 40,000 bucks to send them to private school she's not going to be impressed by your desire to go for a late night walk with an old friend.

My wife has put up with a lot in the last five years and we are barely half way through with making an income which pretty much limits our discretionary spending to on-line scrabble or reading. To call her a gold-digger (although she is a very, very easy on the eyes) is to not understand what motivates women. They do not want their mates to be the low neandrathal in the clan who submissively cowers to the the other males or forages for beetles and rodents while the mighty hunters are bagging the mammoth.

Can you trust yer' Uncle Panda on this?

But not everyone has these goals, expectations, and responsibilities in life, so not everyone is going to feel this same pressure that you feel, Panda. Callogician may never even get married, let alone have children. If he doesn't, will he give a flying rip about the cost of private schools or the quality of public ones? Will he worry about the nonexistent sacrifices of his imaginary wife? Of course not. Having children takes a huge bite out of one's disposable income, and those who choose not to have them are going to be in very different financial straits compared to those who do have them, even at the same income level. Even if Cal does get married, his wife may not be a stay-at-home mom. Their combined incomes are likely to exceed a six figure salary if she is also some type of professional.

I definitely agree with Cal for these reasons. Seeing as I'm never going to have a wife (I'm not into girls, and it's not legal in my state anyway), nor kids, that gives me more freedom to adopt a career that pays me less if I choose to do so. BTW, you (and your wife, assuming she agrees with you) neither speak for nor understand the motivations of all women. There's a reason why Neanderthals and mammoths both went extinct several millenia ago.

 

[DoctorFunk]

Nice straw man.

To borrow a phrase from our friends in the legal biz, your post assumes facts not in evidence.

That may be, but our capitalist economy would likely fall apart if every employee were like you, Q, and Call-awhozits and failed to demand that they be paid their maximum possible renumeration. But hey, that's cool, I hope that I am able to find midlevel clinicians to hire in my future practice that enjoy walks on the beach and their rewarding career choice more than their paycheck.

Speaking personally, and assuming only that which I hold to be personal "evidence", I am NOT throwing away 10-15 years of my life to endless learning and scutting to enjoy the mac&cheese, board-game playing on Friday, drinking malt liquor because I can't afford real wine existence that my wife and I are enduring currently. This might seem to be a situation that will be remedied naturally no matter what specialty/pay level I end up choosing, but when you take into account the quarter-MILLION dollars in debt I will have upon graduating, future mortgage payments, and the non-professional salary my wife pulls in, suddenly I'm left with little more expendable income than I have now.

 

[Rafa]

That may be, but our capitalist economy would likely fall apart if every employee were like you, Q, and Call-awhozits and failed to demand that they be paid their maximum possible renumeration.

Our "capitalist economy" is already falling apart, with very little help from the non-greedy.

 

[deleted87716]

our capitalist economy would likely fall apart if every employee were like you...and failed to demand that they be paid their maximum possible renumeration.

And where, exactly, did I say or imply anything like that? (Hint: I didn't.)

I have no interest in defending comments that I haven't made. Have a nice day.

 

[1Path]

Kent and Q, GREAT posts!

 

[QofQuimica]

That may be, but our capitalist economy would likely fall apart if every employee were like you, Q, and Call-awhozits and failed to demand that they be paid their maximum possible renumeration. But hey, that's cool, I hope that I am able to find midlevel clinicians to hire in my future practice that enjoy walks on the beach and their rewarding career choice more than their paycheck.

I never said I would not demand the maximum possible renumeration for my work, and I don't think you could have missed my point any more thoroughly had you purposely tried to do so. I am trying to say that I am not choosing my JOB based on how much it pays, not that I wouldn't want to be paid as much as my employer were willing to pay me.

I am going into medicine knowing that my future career (as an MD/PhD in academia) is NOT going to pay me as well as the majority of you who go into private practice, particularly the uberspecialists. I am ok with this. I do not (and will not ever) have a spouse or children to support financially, and I therefore have more flexibility to choose a career in academia that will almost certainly pay me less than a career in private practice. However, I will almost certainly not be working for you, my friend, unless you aspire to be the department head of the university that ultimately hires me.

 

[DoctorFunk]

And where, exactly, did I say or imply anything like that? (Hint: I didn't.)

I have no interest in defending comments that I haven't made. Have a nice day.

I apologize if I misquoted you. I admit, it's hard to refute your d@mning condemnation of Panda and my points when you refuse to write more than 1 or 2 lines per post and delineate none of your viewpoints. It's like debating a fortune cookie.

 

[8744]

Our "capitalist economy" is already falling apart, with very little help from the non-greedy.

Dude. Shut up. It is no more falling apart then it has been since I can remember. While I am not ancient, I remember very well the seventies, inflation, stagflation, the rust-belt, Bruce Springstein singing about jobs he would never actually want to do himself, the rise of Japan, the fall of Japan, various oil shocks, the tech bubble, and every other calamity that was finally going to prove that capitalism doesn't work.

As to making money, I want KentW who claims on the Family Medicine forum to make a good income to take a pay cut before he, or anybody, seeks the moral high ground.

I am reminded of the people who buy million dollar homes in Aspen to get away from the materialism of modern life.

 

[DoctorFunk]

I never said I would not demand the maximum possible renumeration for my work, and I don't think you could have missed my point any more thoroughly had you purposely tried to do so. I am trying to say that I am not choosing my JOB based on how much it pays, not that I wouldn't want to be paid as much as my employer were willing to pay me.

Don't get me wrong Q, I find nothing wrong with your choosing your field of medicine based on what interests you rather than economic pressures. Where I draw the line (and I don't think you made this point, but it has been hinted at in posts here by others) is when one makes the financial concerns of those of us interested in private practice in potentially mid to high-level paying specialties seem superfluous and ridiculous. For example, Callogician painted the black and white picture that you can either be a romantic, intellectual uninterested in wordly pursuits of luxury, or you can be the small-penised, sports-car driving man interested only in wealth and extravagance.

As with most subjects on messageboards, real life is nowhere near this simple. People choose specialties (as with career choices in any other field) due to their personal preferences. I prefer not to worry about my retirement, whether I will have choices in how my children are educated, whether my wife can afford to pursue the career she would enjoy (or even be a stay-at-home mother), or whether I can afford to pay my student loans AND eat out with my friends this weekend. I do not find these concerns to be outrageous, and I fully intend to make career choices with them (and my hefty debt load) in mind.

 

[8744]

But not everyone has these goals, expectations, and responsibilities in life, so not everyone is going to feel this same pressure that you feel, Panda. Callogician may never even get married, let alone have children. If he doesn't, will he give a flying rip about the cost of private schools or the quality of public ones? Will he worry about the nonexistent sacrifices of his imaginary wife? Of course not. Having children takes a huge bite out of one's disposable income, and those who choose not to have them are going to be in very different financial straits compared to those who do have them, even at the same income level. Even if Cal does get married, his wife may not be a stay-at-home mom. Their combined incomes are likely to exceed a six figure salary if she is also some type of professional.

I definitely agree with Cal for these reasons. Seeing as I'm never going to have a wife (I'm not into girls, and it's not legal in my state anyway), nor kids, that gives me more freedom to adopt a career that pays me less if I choose to do so. BTW, you (and your wife, assuming she agrees with you) neither speak for nor understand the motivations of all women. There's a reason why Neanderthals and mammoths both went extinct several millenia ago.

The primal instinct to provide for the family persists.

 

[8744]

The only real difference between me and many of you "idealists" is that you will pay a lot of lip service to the notion of the simple life but still take the money.

Let me throw out a challenge which, of course, will be impossible to resolve. Based on lifestyle, possesions, and hobbies I bet I am the least materialistic person here. I don't even own an iPod.

 

[deleted87716]

I want KentW who claims on the Family Medicine forum to make a good income to take a pay cut before he, or anybody, seeks the moral high ground.

How would that help your argument?

 

[MN81]

Don't most (99%) doctors make enough money to support a more-than-modest lifestyle?

 

[deleted87716]

Where I draw the line (and I don't think you made this point, but it has been hinted at in posts here by others) is when one makes the financial concerns of those of us interested in private practice in potentially mid to high-level paying specialties seem superfluous and ridiculous.

Why do you persist in arguing with people about things they haven't said?

I don't care if you make a zillion dollars a year. The question is, why do you care that I don't care?

 

[deleted87716]

Let me throw out a challenge which, of course, will be impossible to resolve. Based on lifestyle, possesions, and hobbies I bet I am the least materialistic person here. I don't even own an iPod.

You win. I have a second-generation iPod. It has a bad battery, and I really need to send it in to Apple. Thanks for reminding me.

 

[QofQuimica]

Don't get me wrong Q, I find nothing wrong with your choosing your field of medicine based on what interests you rather than economic pressures. Where I draw the line (and I don't think you made this point, but it has been hinted at in posts here by others) is when one makes the financial concerns of those of us interested in private practice in potentially mid to high-level paying specialties seem superfluous and ridiculous. For example, Callogician painted the black and white picture that you can either be a romantic, intellectual uninterested in wordly pursuits of luxury, or you can be the small-penised, sports-car driving man interested only in wealth and extravagance.

As with most subjects on messageboards, real life is nowhere near this simple. People choose specialties (as with career choices in any other field) due to their personal preferences. I prefer not to worry about my retirement, whether I will have choices in how my children are educated, whether my wife can afford to pursue the career she would enjoy (or even be a stay-at-home mother), or whether I can afford to pay my student loans AND eat out with my friends this weekend. I do not find these concerns to be outrageous, and I fully intend to make career choices with them (and my hefty debt load) in mind.

Hmm, I guess I didn't interpret Cal's post as harshly as you did, but I can see your point. For the record, if it was unclear whether I was mocking people for taking economics into consideration, I'm not. Hell, I am doing the same thing myself. Since I know that I will earn a smaller income during my career, the cost of each medical school has been a major factor for me; I can't afford to have a quarter of a million dollar debt load, because I won't be able to pay it back. So you better believe that I am going to minimize my educational debt, even if it means giving up my top choice school to go to another school that is my second choice but significantly cheaper. I've argued this point in pre-allo a zillion times with people, but most of them still want to take out as many loans as are necessary to go to the biggest name school they can.

You sound like a sensible person who is planning for the future. I certainly can't criticize you for that. I guess what prompted me to write in the first place is that I had the impression that you and Panda (and really Panda more than you) seem to assume that everyone must share the same ultimate goals in life, such as providing for a family. Caring for children is an immensely important job, and not a responsibility to take lightly. However, I am not completing a PhD and now an MD so that I can stay home and change diapers. I also do not think it is fair to either my hypothetical kids or to my future employer for me to try to balance two such all-consuming jobs, although there are some women who manage to do it. But I don't think that *I* personally can do both. I respect and support any women (and men too) who do choose to stay home and care for their children, but it's not a life that will work for me. That's really where I am coming from here.

 

[QofQuimica]

The only real difference between me and many of you "idealists" is that you will pay a lot of lip service to the notion of the simple life but still take the money.

Let me throw out a challenge which, of course, will be impossible to resolve. Based on lifestyle, possesions, and hobbies I bet I am the least materialistic person here. I don't even own an iPod.

Sorry, but I'm going to have to disappoint you, dude. I don't even own a TELEVISION, let alone an ipod, although I did listen to a friend's ipod once. No VCR, no TIVO, no stereo system, no home telephone. I do have a $20 CD player from Wal-Mart, a cell phone, and a computer, which I need for school/work. Let's see, I have an old microwave that I got as a gift when I first started college in 1993. Oh, and a six-year-old car that I plan to keep at least until I make it out of med school. I concede that I do have running water, indoor toilets, and electricity, but the weather here in FL is pretty similar to what y'all have in LA, so I hope you'll pardon my extravagence.

 

[1Path]

I guess what prompted me to write in the first place is that I had the impression that you and Panda (and really Panda more than you) seem to assume that everyone must share the same ultimate goals in life, such as providing for a family

This entire thread is very interesting to me personally because I could choose to not take the MCAT for the umpteenth time and apply MD/PhD. I could easily choose to rest on the hard work of others and chill until death I do part.
But since I'm neither a gold digger or lazy, I guess I'll reapply to med school to become a pathologist at some point in the future!

So it would appear that most people are picking specialties based on interest (happiness?) or earning potential (time share in Aspen?). IMHO, with the current status of healthcare, basing a career on earning potential could be a HUGE mistake. A "broke" dermatologist would be a sad sight to see!

 

[1Path]

Sorry, but I'm going to have to disappoint you, dude. I don't even own a TELEVISION, let alone an ipod, although I did listen to a friend's ipod once. No VCR, no TIVO, no stereo system, no home telephone. I do have a $20 CD player from Wal-Mart, a cell phone, and a computer, which I need for school/work. Let's see, I have an old microwave that I got as a gift when I first started college in 1993. Oh, and a six-year-old car that I plan to keep at least until I make it out of med school. I concede that I do have running water, indoor toilets, and electricity, but the weather here in FL is pretty similar to what y'all have in LA, so I hope you'll pardon my extravagence.

Here's an interesting coorelation. People who don't get off on "stuff" (I won't have an Ipod until they're priced under 50 bucks )are more likely to pick specialties based in personal interest. Hmmmmmmmmmmm

 

[8744]

...seem to assume that everyone must share the same ultimate goals in life, such as providing for a family...

And yet most people (with apologies to our gay friends) end up with a family just the same.

It's a primal urge. You won't be able to help yourself.

So sorry.

 

[MollyMalone]

6.2% of American women of childbearing age choose not to have children (this does not include women who are infertile and unable to have children). (Source:NHCS)

That's almost 4 million women able to control themselves and their reproductive destinies.

So sorry.

(Edited to clarify statistic)

 

[happydays]

6.2% of American women of childbearing age choose not to have children (this does not include women who are infertile and unable to have children). (Source:NHCS)

That's almost 4 million women able to control themselves and their reproductive destinies.

So sorry.

(Edited to clarify statistic)

And those are the ones whom evolution will select against.

 

[MarzMD]

This thread is slowly turning into a reverse pissig contest. "Im better than you because I am more frugal". Medical school is an investment. I dont get why people look down on doctors that expect to come out far ahead on that investment. Many of you are making it seem like people are declining their dream specialty for another specialty simply because it pays more money. I really doubt this is actually how it plays out. If I were interested in derm and peds, which one do you think I will pick at the end of the day? Like Panda has been saying, if you have a family and are interested in both and pick peds over derm, I think you are doing your family a disservice.

 

[MollyMalone]

And those are the ones whom evolution will select against.

Not relevant to the discussion at hand; the statistic merely demonstrates that not all women can't help themselves but to become mothers, as Panda was suggesting.

But since you brought it up, I happen to think that I am more than just the collection of my genes, so that doesn't bother me too much. And even if I cared, the rest of my family is reproducing at a rate which leaves me few worries on that score.

 

[MN81]

6.2% of American women of childbearing age choose not to have children (this does not include women who are infertile and unable to have children). (Source:NHCS)

Citing Sources is hot.

 

[OSUdoc08]

6.2% of American women of childbearing age choose not to have children (this does not include women who are infertile and unable to have children). (Source:NHCS)

That's almost 4 million women able to control themselves and their reproductive destinies.

So sorry.

(Edited to clarify statistic)

"Able to contol" = Can't get laid

 

[DoctorFunk]

6.2% of American women of childbearing age choose not to have children (this does not include women who are infertile and unable to have children). (Source:NHCS)

That's almost 4 million women able to control themselves and their reproductive destinies.

So sorry.

(Edited to clarify statistic)

I'm not sure that statistic does much to support your case at all. 6.2% is only 1.2% away from falling into an accepted p-value of .05 if we were to hypothesize that ALL women would prefer to have children.

 

[1Path]

Medical school is an investment. I dont get why people look down on doctors that expect to come out far ahead on that investment.

Because when a doctor who picked a specialty primarly based on pay has an "investment" that failed, someone ends up dead or disabled.

 

[MarzMD]

Because when a doctor who picked a specialty primarly based on pay has an "investment" that failed, someone ends up dead or disabled.

I dont think anyone in this thread was advocating picking a specialty primarily based on pay. I think most are saying that it can be irresponsible to not consider pay when picking a specialty(especially when one has a family to consider). If this is not what they are saying, then I am saying it.

 

[LanceArmstrong]

I think people with skin cancer would disagree with that.

I don't think skin cancer goes to derm per se... usually GS cuts those things out, PATHOLOGY determines what the hell it is (acrochordon vs. infiltrating melanoma), then when the melanoma spreads RADIOLOGY determines the extent of tumor spread, and HEME/ONC treats the patient.

 

[LanceArmstrong]

I don't think skin cancer goes to derm per se... usually GS cuts those things out, PATHOLOGY determines what the hell it is (acrochordon vs. infiltrating melanoma), then when the melanoma spreads RADIOLOGY determines the extent of tumor spread, and HEME/ONC treats the patient.

also...I dont see why a FAMILY doc can't do 80% of derm, and just refer the obscure stuff. "Here's your prescription for hydrocortisone/topical antifungal." "Let me take off that wart" I wonder how much a family doc charges to take of a wart/mole vs. a DERM.

 

[cdql]

I don't think skin cancer goes to derm per se... usually GS cuts those things out, PATHOLOGY determines what the hell it is (acrochordon vs. infiltrating melanoma), then when the melanoma spreads RADIOLOGY determines the extent of tumor spread, and HEME/ONC treats the patient.

Not according to the place I shadowed though.

The dermatologist took one glance at some innocuous looking bump and immediately diagnosed it as basal cell carcinoma (and then insisted it was a cancer that needed to be removed right away)

The procedure was also done within the derm office.

I think that kind of expertise can only be achieved if you are looking at skin bumps all day long. I think FP's would be hard-pressed to just identify a spot on the skin and immediately and confidently diagnose it as a skin cancer.

 

[MollyMalone]

I'm not sure that statistic does much to support your case at all. 6.2% is only 1.2% away from falling into an accepted p-value of .05 if we were to hypothesize that ALL women would prefer to have children.

I'm not sure I understand what you're trying to argue here.

 

[MarzMD]

I'm not sure I understand what you're trying to argue here.

I think he is saying that your quoted percentage is close to being insignificant statistically. In which case, you can argue that all women want children.

 

[cdql]

I dont think anyone in this thread was advocating picking a specialty primarily based on pay. I think most are saying that it can be irresponsible to not consider pay when picking a specialty(especially when one has a family to consider). If this is not what they are saying, then I am saying it.

Well put!

I think many people start off with the idea of picking a job based on pay. But the clinical rotations probably change a lot of peoples' perspectives. For instance, Plastics pays a lot and it seems so glamorous but after spending a week in a surgery rotation, some people may decide that it is just too strenuous. Or the people there just don't click with them, etc... etc...

Or if someone who was initially interested in derm does a derm rotation (another seemingly lucrative field) and they just find themselves bored to tears doing it.

 

[8744]

6.2% of American women of childbearing age choose not to have children (this does not include women who are infertile and unable to have children). (Source:NHCS)

That's almost 4 million women able to control themselves and their reproductive destinies.

So sorry.

(Edited to clarify statistic)

So 93.8 percent of American women of childbearing age choose to have children?

I rest my case.

"Reproductive Destinies." Har har.

 

[8744]

And yet most people (with apologies to our gay friends) end up with a family just the same.

It's a primal urge. You won't be able to help yourself.

So sorry.

Primal urge of men and women.

 

[latinfridley]

This thread has gotten ridiculous.
#1 Money is important, though for most not the overiding consideration when choosing a specialty.
#2 Career satisfaction has numerous facets, not just money
#3 You need to be realistic about choosing a career in terms of balancing needs/wants in life with the ability of that career to meet those needs/wants
#4 To each his own.

 

[MN81]

...#4 To each his own.

Second that.

 

[QofQuimica]

And yet most people (with apologies to our gay friends) end up with a family just the same.

It's a primal urge. You won't be able to help yourself.

So sorry.

In a few more years (I'm already in my early thirties), there won't be much of an issue any more of whether I can "help it" or not. Time is on my side, not yours, on this one.

I agree that this thread got totally off track. And idiotic. So, how about we go back to pissing on various specialties that we don't like instead???

 

[deleted87716]

I think FP's would be hard-pressed to just identify a spot on the skin and immediately and confidently diagnose it as a skin cancer.

I do it all the time, including the excision. It's bread-and-butter family medicine.

 

[deleted87716]

Second that.

Motion carried.

 

[Mr. Freeze]

I had a big diatribe typed, but in the end it is all personal preference...

Is EM really the "glorified triage nurse" that everyone seems to make it out to be? I have a buddy that is at UMich now that was gung-ho EM before he went to school and changed to plastics that said "I guarantee you'll pick surg of some sort..."