The Medical Profession - Would You Recommend It?

[jyl]

General question - meant to invite discussion -

What do you think about becoming a MD today? Still a good profession? What are realistic expectations? How does this differ among the specialities and with primary care? Is the future physician-owned practice or employment? How can one become a MD without incurring crippling debt? What are the reasons to pursue an MD/PhD, and what are the reasons not to?

I have several doctor friends. One started a primary care group, then was hired as a top dog at OHSU. One is a pathologist and combines being head of pathology at a local hospital with a three day a week work schedule. One is a neurosurgeon who is struggling to maintain his private practice and thinking about bailing to become an employee somewhere. One was a Harvard researcher in endocrinology with practice at Mass General, who left academia and now works in clinical development for large pharma. One is a geneticist who has spent her career at small biotech companies in the Bay Area, managing drug development and works four days a week. One was a practicing doctor in New Zealand and the UK, then became chief medical officer at a small biotech company. A range of careers, all successful - the neurologist might be on the bubble - but they started decades ago, not today.

[dw1]

I don't have any input on this, but I really want to see the responses from those in the profession. I work with MD's (mostly very experienced research-oriented ones) and have long admired the profession, but I know it's a lot harder these days.

[Hugh R]

I was at my GP for a physical a few months ago, and he runs his own practice. We didn't talk actual $ but between office rent, staff, insurance, and equipment, I got the impression that I probably net more income annually than he does.

[HardDrive]

My wife is a pediatric anesthesiologist. She's the director of her program. What I say below are my impressions as her spouse, so take it with a grain of salt. I'll ask her about this and chime in later (when she gets home after a 14 hour day).

She is in a good position, with a good boss, at a great hospital. And she talks about leaving medicine all the time. Tired of endless, inane paper work. Tire of getting nickeled and dimed. Tired of 80 hour weeks. Tired of idiotic rules clearly made up to satisfy the legal department as opposed to what is good for patients.

What I say next may seem mean, but she's also tired seeing grossly obese, non compliant patients. 400lbs dad and 300lbs mom show up with their 200lbs 12 year old, and (with a straight face) want to know why their child had issues with joint pain. Or worse, big pharma pill junkie mom who is showing up with her kid at every clinic in town just to score pills. A couple months ago, a mom got arrested because her kid was lying in a hospital bed with an opioid drip, and she took the needle out of her kids arm, and stuck it in her own.

Don't get me wrong, my wife loves her job in its pure form. Loves it when she can help a child and their family through a rough patch. She goes on medical missions to India and Africa, and will work 12 hours a day for a week straight, and is overjoyed at what she is doing. She comes home, it grinds on her how little of her time is spent in a room with a patient. And it grinds on her to see people wasting the systems time because of their poor life choices, choices that they are passing on to their kids. Imagine being 12 hours into your day, at the end of an 80 hours week, and having some junkie who's dragged her poor kid into your clinic trying to score pills, getting in your face and calling you names because you don't to be her drug dealer. Yeah, thats frustrating.

[Moses]

I can't imagine any other career. Having said that, I actively discouraged my children from following my path. Here are some of the reasons...

1) Loss of autonomy.
2) Cost based treatments favored over outcome based treatments.
3) 80 hour workweeks. Forever.
4) Good doctors care deeply about their patients. This comes with a steep price. Stress, insomnia and long, long hours.
4) Rapidly declining reimbursement.
5) Average medical school debt about $300,000.

Bottom line? If you commit the time and energy and absolute focus required by medicine into any other profession you will be better rewarded. And even perhaps have a more positive impact on your community.

[sc_rufctr]

I talked to a doctor once about what it was like working those long hours for average money. (I was a nurse at the time)
He said it was a "Calling" and there's nothing else he wanted to do with his life.

He also said that "Calling" is what keeps you working those 14-16 hour shifts.

So for some, maybe a lot there is no choice.

[masraum]

My daughter is a PA (Physicians Assistant). It seems like a pretty good route. You get the benefits of being in medicine without the headaches that the Dr has to deal with.

[Moses]

Originally Posted by sc_rufctr

I talked to a doctor once about what it was like working those long hours for average money. (I was a nurse at the time)
He said it was a "Calling" and there's nothing else he wanted to do with his life.

He also said that "Calling" is what keeps you working those 14-16 hour shifts.

So for some, maybe a lot there is no choice.

I think that's exactly right. I always hoped for a more "balanced" life for my children.

Originally Posted by masraum

My daughter is a PA (Physicians Assistant). It seems like a pretty good route. You get the benefits of being in medicine without the headaches that the Dr has to deal with.

Excellent point. Nurse Practitioners and PA's get to make a positive professional impact on peoples lives without all the liability, excessive hours, debt and stress. It's a very good choice for someone who might have chosen medical school a few decades ago. If my daughter chose that route I would be very proud and supportive.

[Targa Me]

I don't want this thread to go to PARF, but the way things are going I"m willing to bet that at some point in the future medical professionals will be government employees and reap those benefits.

And along the lines of what Hugh was saying; I have talked to my GP and to keep her practice in the black she leads a modest life, with a modest home and an average car.

[livi]

To me it was never about the money, working hours, benefits, status or what have you. If those are the goals in life, there are better lines of work, because in many aspects those criteria sucks being a doc.
No, to me it was always a matter of passion. A passion that grows with experience. To me there is not much that gives me a better feeling than feeling secure in my knowledge meeting and treating children every day. Its not even about the grateful Words, looks and thankfulness from my patients and there parents. Its primarily a very fulfilling sense of doing good for other human beings in distress.

Just yesterday I got a painting from a 6 year old girl with severe asthma with me standing next to here and the text "Thank you for being my doctor, Markus". That kind sums up the whole experience.

There must be a whole lot of jobs creating the same sense. Being a doctor is just one of them.

BTW, I am not encouraging my children neither to follow this path, unless they are truly sure they do it for the right reasons.

[gatotom]

All I know is that after doing my job as a Chiropractor for the last 32 yrs, I would not do anything else that I love more than anything.

I have had ample opportunities to get that MD degree but everytime refused.

Everything has changed in the last 32 yrs, first I was only 22K in debt when I graduated, now 150K is about normal.

I feel fortunate, I am in a small town 2500 population, I don't work long hours but as I have told my patients for many yrs, retire, no my truck doesn't need to be re-tired.
Insurance is the thorn in my keester, we charge more than when I first started but get to keep far less.

Now with computers controlling everything, my per hour rate at the office has pummeled to eating beans and hotdogs, EHR is a total pain in you know what.

Can I see why every provider is now going to massive clinics and leaving private practice, yupe.

We raised 3 children, no one followed my footsteps. Taking care of humans is a noble and honorable thing to do and is unbelievably rewarding just not is the financial part. I truly believe that all of medicine should be socialized and pay docs on performance and yearly service with a pension at the end of career.

oh, to have pursued a career is sports or learned how to play cards better or be a movie star.

[vash]

i think it would be best to encourage one (or both) of your parents to go this way..

[flipper35]

Our daughter wants to be a pediatric endocrinologist. She has wanted to do this since she was 10. I am hoping that specialization will help more than hurt. That said, she loves to travel and would do great as a traveling nurse.

[dennis in se pa]

You can still get your MD paid for by the armed forces. That seems to me to be the smart way to get the degree without crippling debt. I know one guy who worked on an Indian reservation for awhile as part of his deal for them to pay for his education. Yeah, sort of like Northern Exposure.

[Hugh R]

Originally Posted by flipper35

Our daughter wants to be a pediatric endocrinologist. She has wanted to do this since she was 10. I am hoping that specialization will help more than hurt. That said, she loves to travel and would do great as a traveling nurse.

Tell her to look into IATSE 767 as a Studio Medic. They are like nurses and you can travel and the pay is pretty good, but uneven. A good 767 medic can earn $200,000/year, but long and uncertain work hours.

[jyl]

Any thoughts on income data surveys such as

Medscape: Medscape Access

Note "For employed physicians, compensation includes salary, bonus, and profit-sharing contributions. For partners, compensation includes earnings after tax-deductible business expenses but before income tax. Compensation excludes non-patient-related activities (eg, expert witness fees, speaking engagements, and product sales)."

Also, any thoughts about the MD/PhD, pharma/biotech company route?

[Tobra]

Moses has summed it up well.

I have not read any recent studies that put the percentage of doctors that would recommend it as a career being reported as greater than 10%.

Originally Posted by Hugh R

I was at my GP for a physical a few months ago, and he runs his own practice. We didn't talk actual $ but between office rent, staff, insurance, and equipment, I got the impression that I probably net more income annually than he does.

I am quite confident in guaranteeing that this is the case.

Markus never had to deal with the transition to government healthcare, which is where this is all headed, so his experience , while valid, perhaps is not as applicable as someone more local.

If I were doing this for the money, I would be doing something else.

[gatotom]

As all have said money is not the motivation, thou I really groove on the fresh farm eggs all the time, elk, venison, moose and salmon steaks now and then.

[Tilikum Turbo]

My advice: don't pursue ANY profession such as law/engineering/medicine for money...that would be 40-50 years of enslavement in a Golden-Cage.

If any of the above is a real PASSION...then everything else will fall into place.

Good luck!

[flipper35]

Our daughter has always been wanting to do something medical. When she was 5 she had some friends over and took their doll and told them it died and it might be lime disease and she needed to do an autopsy. She watches Mystery Diagnosis and every other show like it.