A reader asks -
So I'm curious, since so many doctors I've talked to (both young and old) say "don't do it, it's not worth it” can you point to something you'd say makes it worth it? Is there something different about the path you've chosen, or is it more about your attitude? I realize that it's difficult to compare yourself to my hypothetical doctors, but I'm assuming you might know some of these naysayers.
Why do I love medicine? I can describe multiple aspects of medicine that I love.
- Problem solving
- Interpersonal interaction
- The need for continuing education – I love learning and love the ability to take new knowledge and adapt it to my patients
- My goals – I really enjoy helping patients. When I think about medicine, I think about how I can help patients achieve better quality of life
- The doctor side of the doctor patient relationship – the way patients respond to their physician; the default respect that we receive (unless our actions forfeit that respect)
- The intellectual challenge
My list does not include money (although I must admit that I have done very well financially). I tend to view the glass as 3/4 full. The annoyances of current medical practice – insurers, time constraints, the business aspect – are not a major part of my daily life. Perhaps my extremely positive attitude comes from my enjoyment of academic medicine. I love to teach – especially that moment when the student's, intern's or resident's eyes lose the glaze and gain the sparkle. I love rounds. Describing why I am so happy (while others are not as happy) is a challenge. But I do not believe that I am the only happy physician. I see happy physicians every day. I see many unhappy adults. Most adults my age (56) do not love their jobs. Fortunately for me medicine represents both a vocation and an avocation. Medicine allows one to help people in many ways. Too many have not found their best fit. Some enter medicine for the wrong reasons. But here I speculate – and I may certainly be wrong.
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Do you think the desire to help people is necessary for having a fulfilling career in medicine? I’m a young person considering that path. I’m motivated more by the intellectual stimulation and challenge than anything else though. I see this as a difference between myself and many other young people entering the field — most seem motivated (at least in part) by a genuine desire to help people. For me, this is happy byproduct of my work, but not the main motivator or source of satisfaction. Is this uncommon among physicians? I don’t want to be one of those persons entering medicine for the wrong reason.s
Though never in academic medicine, I cannot think of anything different from what Dr. Centor mentions on why he loves the profession of medicine. Of the reasons he cites, the professional and personal satisfacion – along with the intellectual challenges – would top my own list. Money, of course, counts but that was incidental and I never thought of myself as a businessman.
Way before I decided on medicine as a career, I had opportunities to consider other callings, consistent with my academic aptitudes, observations of what doctors and their non-medical brethen do, the potential for fulfillment, and of course my family’s finances (back home, medical education is quite expensive, with scholarships we have here largely unknown there.) Law, accounting and journalism all crossed my mind, but in the end I chose medicine. I never had any regret.
In contrast to Dr. Centor, I practiced on the frontlines of medicine, spending 33 years as a busy general internist. The hours were long, the work hard, but the satisfaction was profound. I realize a number of things came about in the last 10 years of my practice – managed care, bureaucratic hassles, malpractice insurance woes and decreasing reimbursements – that marred somewhat an otherwise rewarding career, and which today pose a challenge to those still in practice and to those young men and women thinking of going into medicine.
I must have set a good example for my son to follow my footsetps and to become an orthopedist(he’s as happy as his father was.) But apart from this family influence, I had opportunities, away from my practice, to do things for my county and state medical organizations. I founded and edited the quarterly publication of my medical society, and later devoted 10 years in helping edit the two major publications of my state medical society. Those were some of the best years of my life.
Looking back more than three years after I retired, I see older colleagues still in practice, some fulltime, and I get the same answer every time I ask why they continue to hang on: STILL IN LOVE WITH MEDICINE.
That may be simplifying things at a time when a lot of people, including some doctors, are starting to question the worth of spending so many years on a profession that
does not sound as alluring as it used to be. But barring financial considerations, with reports that dentists now earn more than doctors for working less, I see no let-up in top young men and women of America looking towards medicine as their career of choice. My guess is it will remain that way for years to come.
Yes, medicine is still worth it.
Most docs still love medicine, but spend so little time and energy doing the real stuff of medicine and so much time and energy putting up with crap that it’s just not worth it anymore. I can’t imagine anything more fulfilling than meeting a complete stranger in terrible pain and spending a few hours with him in pre-op, the OR, and in post-op care, completely, totally, and forever relieving him of this, so he can return to being productive. My medical/pediatric/psychiatric and other colleagues have their different pleasures and ideally their personalities are better matched for the less dramatic but no less important endeavors that they engage in with patients. The problem is that for every hour, and unit of intellectual effort, that we spend on the good stuff, there is a greater amount wasted on dealing with the parasites, hangers-on, wannabes, meddlers, and other assorted conterproductive folks who have latched onto the health professions over the last half century. It is axiomatic that what is documented in teh chart is as important as what is actually done in medicine; we get paid for what we enter into the chart, not what we have done with the patient. Why? Because it’s not the patient who pays, it’s a 3rd party. A typical patient would be quite satisfied with a 3 line paragraph explaining that I removed his gallbladder/colon cancer/repaired his hernia/don’t think he needs surgery for that lesion, but the documentation required is 10 to 100 times that amount to satisfy the other parties now involved. Medicine in 1960 was a lot simpler than it is now, but it still took 5-10 years of postgraduate training for a very smart person to become competent to begin practice. It still takes that long, and since then the US Congress has generated 120,000 pages of Medicare/Medicaid rules and regulations to guide us in medical practice, every private insurance company has its own set of rules, everything that we do in the hospital is compared to guidelines and practice parameters, and don’t get me started on what the trial bar has done to medical practice.
The reason that people go into medicine is that it’s a terrific way to do well by doing good. The reason that people get out of medicine is because of all the help that we get from the folks I discuss above. The ratio continues to go the wrong way.
Is it at all possbile to keep a balance in a life of medicine? can you have the best of both worlds? having time to travel and spend with friends and family and also have a rewarding, medically driven career?
So, When becoming a doctor, did you ever wish that you would of chose a profession that is less life consuming?
It is definitely interesting to see this conversation that has taken place on this forum. Though, what I find even more intriguing is the fact that the very people who initially chose the profession now, oppose it. Regardless, some might think I am crazy for thinking the following I am about to share and I can only imagine my family's reaction. I recently graduated completing my bachelors degree in International Relations and Middle Eastern Studies with a focus in International Law & Organizations. I am thinking of switching careers and wanted to know is there any hope for someone like me to pursue a career in Medicine, but never taken the science requirements? In college, I took one biology course with a lab and a Statistics course, apart from that I haven't taken any Science courses. Is it too late to change course and pursue Medicine? How can you become a doctor if you have not taken a "Pre-Med" curriculum?
This isn't exactly a decision I made overnight and I am aware of the difficulties that are entailed in pursuing a medical profession. However, for a while, I have given it some serious thought and believe it is my calling in life; however, I've been to afraid to consider such a huge career change because I always though, "Oh I'm not good at Scienc or math. As I used to work with the undergrad pre-law office and we always had initial pre-med students who switched tracks and decided they want to go to Law School, but I guess it's the other way around for me.
I appreciate all the help I can get.
Sincerely,
JD Amused MD confused.
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