Reasons to become a doctor
Medical Rants May 7th. 2008, 7:57am
Tara Weiss, writing in Forbes, argues against becoming a doctor - Reasons Not To Become A Doctor
She paints a negative picture of the business of medicine. Her arguments include:
- Costs Of Practice Rise, Reimbursements Drop
- Rising Malpractice Costs And Frivolous Lawsuits
- School Debt
- Salary
- Decreased Autonomy
- On-Call Responsibilities
All of these issues have some merit, but I believe she overestimates the negatives, and assumes that we will have no counter reaction to these problems.
I do believe we will have a payment revolution within 5 to 10 years. Our current system of payment makes little sense. Many writers and influence leaders now understand the problem. More physicians are leaving insurance dependence, and I predict that this trend will only increase.
As a medical educator, I am distressed about the school debt issue. At some point we (medical schools) must address this problem.
The case for becoming a doctor is a straightforward one. Given what I know about medicine, I would do it again and I would encourage my children to do so.
Medicine remains the greatest profession. Every day that I round on the wards, I know that my goal is to help people. I make a nice salary, which helps, but the main goal when you are with the patient is the patient. Patients sense that, and appreciate our doctoring. Medicine satisfies my intellectual nature and my desire to help.
We have many financial issues to address in medicine, but many physicians still love the patient interaction. My understanding of economics tells me that when demand exceeds supply sufficiently, the system will have to change. I believe we are seeing many positive signs. We have many states addressing the malpractice issues.
We have increasing numbers of internists and family physicians refusing to take new Medicare patients. Now you are probably scratching your head - how is that a positive action? I would argue that as Medicare patients have a more difficult time finding a physician, they will put more pressure on Congress to fix our payment system. More physicians and patients now understand that our payment system is bizarre and creates perverse incentives. Change does not happen quickly, but eventually we will get change here.
So the economics need fixing, but the profession remains desirable. I see primary care graduates making acceptable salaries. I see other specialties making incredible salaries. I do not understand the teeth gnashing and general wailing about medicine. We must address many issues, but not forget that we belong to the greatest profession.
I see medical students and residents every day who love what they do. The "job" is rewarding.
I will agree that if your goal is to get Rich (rather then just very well off) you should choose another career. But if you want to have the opportunity to positively impact people daily, become a physician.
May 7th, 2008 at 1:48 pm
It is unfortunate that in today’s world, it appears that many physicians have gone “into” medicine to make a lot of money. (Actually, I think that is a poor reason to enter any profession.) When I go to a doctor, I want to see someone who is curious, loves dealing with people and untangling mysteries and above all, wants their clients to be healthy! Otherwise all you get is the physician bean-counter….
May 7th, 2008 at 5:29 pm
Re: JPB
I don’t think the pay disatisfaction stems so much from not making enough money. I think it more closely resembles “the sacrifices I made (and continue to make!) to get here are not worth the cost.”
Why go through all the training and sacrifice to be an MD making 120k/year on a 70 hour work week when you could have a similar career as a PA at 70k/year on a 32 hour work week?
May 7th, 2008 at 5:30 pm
“not worth the cost” should read “not worth the pay”.
Hmm DB, maybe a preview button could add to the site?
May 7th, 2008 at 10:11 pm
I think many of us docs like the practice of medicine. It’s the business of medicine that drives us nuts. The hassles are increasing too much, making docs more unhapphy, so therefore they want more pay. If the hassle factor was diminished, I don’t think there would be so much harping about the pay. How can you not get by on a six figure income? There are no starving docs out there and pretty close to 0% unemployment. The loans are getting too big, but there are still health shortage area loans. Those who leave the insurance system are usually very happy.
May 8th, 2008 at 11:12 am
The reason why pay is so important to new graduates is because it determines how much you have to work. Yes, 180K sounds like a good amount of money, but it is not a good amount when are having to work 60-80 hours per week to get it. We want higher pay so that we can make 180K working 45 hours a week. That is why pay is important. It is a function of time. Whoever looks at physician salaries and sees that they are very high and thinks “Wow” is naive. You must look at income made per hour. When you consider what a pharmacist would make by working 60-80 hours with overtime each week you start to see that the extra schooling really does not pay.
May 8th, 2008 at 3:09 pm
Physician salaries and income are high relative to most other occupations. I don’t think there are many doctors who really work just 45 hours per week, and there are alot of people in other walks of life who work greater hours also. My Dad worked 50-60 hours per week for decades as an engineer for Boeing. Maybe cosmetic surgeons can do that, or anyone doing elective and cash-and-carry stuff, but a job that is just 45 hours, and 180,000k per year, would be hard to come by, in my view. I wonder what the Canadian and British docs do? My guess is that they put in less hours than us Americans, but likely make less money too.
If it’s all and only about the money, I agree that “the extra schooling really does not pay”.
May 8th, 2008 at 5:25 pm
So, while the Medicare beneficiaries without physicians are putting pressure on Congress, what are they supposed to do about healthcare? I don’t think that the pressure they’ll bring to bear on Congress will be enough to override the pressure from insurance companies to maintain the status quo.