In which I respond to the curmudgeon comments

Your appeal to consider medicine as a profession rather than a job is noted. I believe that you are right to make the appeal, and that the appeal should be heard. However, the response to that appeal will, and must be, highly individual. Many after completing residencies, feel that they have fulfilled their obligation to the profession. To saddle them with obligations not of their choosing is, I believe, wrong. You must know several who have dedicated themselves, body and soul, to the practice of medicine, forsaking all others. Their zeal is admirable, but not everyone is a zealot.

For those with families, there must be a competing interest with medicine. I would hesitate to equate golf with family, at least when considering whether to respond to that off-call page while at dinner with my spouse, or while holding a screaming child while my spouse is away.

I utterly fail to see what would make you shudder at the thought of some-one considering their profession (or job) being a part of their life, but not their entire life. Some of us play multiple roles: physician, parent, advisor, consoler. One could legitimately argue that those other roles can take primacy over the role of physician.

In response to DB’s comments on resident work hours and training, I think it’s more the exception than the rule to be within the 80 hour guidelines. And even at 80 hours, resident salary is at the 40-50k range so that works out to about 11$/hour. So essentially, we pay the guy at Fry’s the same amount to service your computer as we would a third year resident to treat your mother’s CHF or lead a code when your grandpa goes into shock. We’re not indentured servants (speaking now as a fam med resident), but we do it anyways. What else are we supposed to do? We come out of school with debt up to our ears, so we need to work. We have to accept the conditions of the residency programs – the call schedule, the salary, the working environment. For 11$ an hour, we have to stay up every third to fourth night, essentially treating patients with the same mental capacity as if we were drunk. But, again, what can we do? Engage in collective bargaining? Go on strike? While I think such actions are entirely appropriate – and I’m sure any other worker would feel the same – our label as “professional” essentially hobbles us. We can’t take such a drastic action. Professionals can’t strike, otherwise we would’ve ended this nonsense of q3 call and 11$hour pay long ago.

BTW – I still love medicine and genuinely enjoy helping my patients. It’s just that rent is coming due, and I’m feeling the pinch. =)

I am well aware of the 80-hour week. I happen to have been in programs where it was observed even though I know that many other programs use it as just a guideline. I was just saying that if the Old Guard had their way there would be no restrictions at all on how much a resident could be made to work.

The salary is not reasonable. Medicare pays hospitals three times my salary per year so, even taking into account overhead, residents are a huge profit-center for hospitals even without considering the usefiul work we do.

For most of my training my salary has hovered around nine to ten bucks an hour. I know of a MacDonalds that pays eight bucks an hour. As for moonlighting, sure, it’s great, but it’s not free money. Essentially you have to work a job on top of your job…and my program does not allow outside moonlighting and only pays about 40 bucks an hour for picking up “gaps” in the call schedule at one of our hospitals. A tough way to make a few hundred bucks.