my life, my pace

This post is in response to a question from a reader about med students’ motivations for pursuing medicine.

You/I would hope that the people that we trust our lives to when we are sick and most vulnerable are saints–people who are in it because they truly desire to help people and not because they are greedy and power-hungry. Well, we all know (or at least I think we do) that not all doctors are saints. And I’ve wondered more than once how the “rigorous” screening process that is the medical school admissions process allows some of these less-than-saintly people to slip through the cracks. So how many of my classmates would I say are in it for less-than-saintly reasons? Maybe I have a skewed view because my ex-boyfriend was one of these people (don’t even ask why I subjected myself to such a person in the first place) and was forever bashing my more altruistic motivations for medicine and searching for the holy grail of medical specialties (one that involves the least amount of training while allowing for the best lifestyle and the most money), but I would say that about 10% of my class had less-than-saintly motives for being there. Who knows how many others were just very good at hiding their less-than-saintly ways.

Sure, I think that people who pursue medicine based on less-than-altruistic motivations do the profession and their patients a huge disservice. But at the same time, I don’t understand how they came to the conclusion that being a doctor is the ideal way of achieving money, power, and respect. Because I think that it simply isn’t true.

1. Money. What money? Unless you’re already rich and can pay for med school yourself or you have rich parents who can pay for med school for you, you’ll graduate with well over $100,000 in debt. Then you’ll spend at least three years being a resident being worked to death only to be paid peanuts. And just when you thought you would finally make the big bucks, you become a full-fledged doctor just to get screwed over by insurance companies. Insurance companies make the big bucks. Not doctors. The only exception here is probably plastic surgery, which rich people can afford to pay out-of-pocket for and insurance usually doesn’t cover anyway. Not only that, but several states (CT, CA) have been toying with universal healthcare-type initiatives that involve taxing physicians an extra 2-3% of their income to fund. No need to panic yet because they’re not getting very far with this doctor tax, but who knows what will happen in coming years. So that idea that doctors own Ferraris and vacation homes in exotic places is just not really true. Except for plastic surgeons, of course.

2. Power. What power? If you choose to be a part of an HMO, you’re at their mercy. They decide what you can and cannot do. Then there’s also the whole bureaucracy involved in being in a hospital or practice. Guidelines to follow for every little thing. People to answer to. Thinking about academics? You’ll still be just as powerless because there’s bureaucracy everywhere (not to mention the pay cut you’ll be taking). You’ll probably only wield power over med students and residents. Whoo-hoo.

3. Respect. Seriously?  Nobody respects MDs anymore these days.  You have your chiropractors, your optometrists, your dentists, and even your pharmacists all calling themselves “doctors” and getting that instant respect that should be yours.  And patients don’t respect you.  They think you exist to serve them.  They come to see you because they need help with their illness and then they argue against what you tell them if they don’t like what they hear.  Or they just plain don’t listen.  Then, when everything goes to hell, they slap you with a malpractice lawsuit.  They think you should be taxed 3% of your salary to fund their universal healthcare because you already make way too much money.  The only respect you’ll be getting…maybe…is from your peers if you happen to be better than them or from your family and friends (and even I can’t get any respect from my totally uneducated in-laws).  So, yeah, good luck with that.

So there you have it.  Even though I secretly despise my not-so-saintly classmates, I feel sorry for them because they sure made the wrong call based on their motivations.

Well, now that I’ve gone over how medicine isn’t quite the place to be if you’re motivated by the quest for money, power, and respect, I bet you’re wondering what you should go into to obtain these things.  Of course, I have some theories so tune in tomorrow to read all about them.

Related posts:

1. so you want money, power, and respect? (part 2)As promised, here is the conclusion to the search for the Coveted Career Trifecta. Coveted Career Trifecta Contender #3: LAW Money: Lawyers make lots of money.  A friend of mine just graduated from law school and is making $190,000 just starting out.  But all this money comes at a cost because they tend to work long hours and weekends.  Wait.  Don't physicians do that too?  They sure do, except they get paid peanuts.   Score: 8/10. Power: There's plenty of power to be had if you climb the ranks of your law firm.  Or you could go into politics and run for president!  The sky's the limit if you have the charisma.  Score: 9.5/10. Respect: Many people think lawyers are sleazy, money-hungry, and selfish bastards.  I'm sure these same people think physicians own Ferraris and private islands, so who can say whether this conception is true.  True or not, it's what people think.  So you probably won't be getting so much as respect as you are feared.  And I'll take fear in place of respect any day.  But that's just me, of course.  Don't forget that many of our politicians who hold highly esteemed offices are/were lawyers and are highly respected for the most part.  Not to mention that lawyers can make so many people's lives miserable.  *cough cough* Malpractice, anyone?  Score: 8/10. Final Coveted Career Trifecta score: 25.5 So there you have it.  Being a dentist is best, followed by lawyer, and finally by optometrist if you're looking for money,...
2. so you want money, power, and respect?Then don't become a doctor. But if I shouldn't become a doctor, then what should I do if I want to achieve my much Coveted Career Trifecta? Well, honestly, I don't know because I'm not motivated by this trifecta. But that's not going to stop me from making some guesses and sweeping generalizations. Because I just might not really know what I'm talking about, I urge you to not take just my word when it comes to your career choice and do some exploring of your own if anything I mention interests you. First off, let's set some ground rules. What we need is a totally arbitrary rating system. So let's say that each of the three components of the coveted career trifecta is worth a total of ten points, making the highest possible Coveted Career Trifecta score 30. The higher the Coveted Career Trifecta score, the more likely a career is going to help you achieve money, power, and respect. Make sense? Okay. Here we go. Coveted Career Trifecta Contender #1: DENTISTRY Money: Dentistry is definitely the way to go if you're looking to make tons of money for minimal education and/or effort. Dental school is just four years long and after you're all done, you can practice. No need for residency unless you want to further specialize, which you would do if you want to make even more money! Orthodontics anyone? There are supposedly two-day seminars on dental implants, a hot new procedure that rakes in the money...
3. who needs a doctor anymore……when all I have to do is use Google? I’m just waiting for my mother-in-law and/or sister-in-law to tell me that and insinuate that it means even less to them now that I’m going to be a doctor since Google can do my job. I can just see my sister-in-law sticking her nose up in the air at me now. My job’s better than yours because Google can’t do it for me (oh, but it can—Google can do everything). It’s already bad enough that patients like my mother-in-law don’t trust doctors—do we have to really make it worse by making it widely known that sometimes, we need to use Google? Really, I’m fine with using Google to look up stuff, even medical stuff, which I was guilty of from time to time during my first two years of med school. But does everyone have to know? I know, I know—patients these days are more informed than ever before. And I’m fine with that. Really, I am. That is, if these patients have enough sense to realize that their internet searches cannot replace all the years of medical training that doctors have received as well as all their years of experience. And my mother-in-law is not one of those people. People like her will turn this study into leverage against doctors when they don’t tell them what they want to hear and every argument otherwise (like the fact that Google wasn’t very good at getting the diagnoses if the symptoms were...

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