I came across this article on KevinMD.com that had an encouraging perspective on the current and expected state of medicine for those now entering the field. I know that I have certainly been “warned off” this pursuit of mine by disillusioned MDs, but continue to be drawn to it nonetheless. See what you think:
http://www.kevinmd.com/blog/2012/04/future-m edicin…
That’s a great article, and I certainly agree with most of it. The business end of medicine is a huge part of it and it’s one that VERY few students consider. I personally foresee very few primary care folk owning private practices in the future. Too much overhead, not enough reimbursement. I think many will end up back in the hospital or part of a much larger group. Really, that’s kind of sad. I personally remember my family physician owning his practice when I was growing up.
Whatever a person’s idealism may be, you’ve gotta be able to pay the bills. At some point there has to be a better balance between medicare reimbursement, malpractice, medical education cost, etc. Until we solve these problems Amercian med school graduates aren’t gonna fill the primary care slots at nearly the needed rates.
- In reply to:
After a physician in practice pays his family’s health care insurance, his retirement, disability, malpractice, license fees, professional organization fees, mortgage, car payments and all the rest (since he or she is typically responsible for his or her own benefit package), each month’s salary leaves about $600 of free money.
My wife and I found this rather comical. Some of you may be coming from a more financially sound background, but that ain't me folks.
I would LOVE to have $600 of "free" money each month after ALL my bills were paid. This is a weak apologetic, and should have been excluded.
The remainder of his points are certainly valid. More emphasis should be placed on the human factor of medicine. There are too many stoic physicians in the field. I firmly believe that a provider can supply emotional support as well as medicinal. There should not be a dichotomy.
After all, isn't the lack of emotion itself, an emotion?
We're not Vulcans here people!
- radardenny Said:
Fascinating.
Dammit jim...er radardenny, I'm doctor not an oldpremeds website director.... oh wait, never mind
Thanks for posting that! I just read it myself as I subscribe to kevinmd and thought it was great, too. Now, where to find a scribe apprenticeship? Oh gosh, like I (We) don’t have enough on my plate! Between lab assisting, volunteering, working off campus, being a single mom, taking 12 science and math credits, maintaining a 3.9 gpa, I cannot even think about finding a scribe position yet, too! Sounds like excellent experience, though. There is an element of the premed journey oft forgotten: Being human! Aspiring physicians, while motivated and hard working, are not super humans. It’s time we give credit to those of us who know when enough is enough. Who know when we have done enough to impress “them”, to know that our life experience speaks volumes and to know that that experience will translate into dedication and compassion as we become practicing physicians. Those of us who understand the real world, who did not pass go and collect $200 and went naturally on to the next step, but went back around for another go at it have a tremendous amount to offer to this profession. It would behoove others to take notice of “us” and to put into practice some of these suggestions. Especially loan forgiveness and scholarship programs. Medical school debt is hard on anyone, but those of us nontrads, many of whom will end up in, and desire to be in, primary care, need assistance. We already have the drive. And it takes a lot of it to pursue this career path at a later age, when second and third chances are all used up. But those of us with that ambition, that calling, that aptitude deserve to be given a chance to practice and make a difference. Addressing medical education debt more seriously and proactively must be done for us nontrads and our younger counterparts. There is so much talk about it, but I have yet to really see any solid programs in action. National Health Service Corps notwithstanding, but that system has flaws and limitations, too.
Well, I will get off my soap box and go study for my chemistry and calculus exams tomorrow, but I felt the need to vent tonight!
Thanks again for posting that article. Food for thought, indeed.
The outlook obviously isn’t reducing the number wanting to go to school to become doctors, or the competitiveness. One rejection letter I got from a school mentioned that they had the most competitive class in the schools history.
As for the lack of emotion in the field. Say you have cancer, and you have two doctors you can go to. One is a warm and fuzzy doctor who is of average skill. The other is a cold as ice doctor, but you know from reputation is has excellent skills. Who would you go to?
While I think compassion is a wonderful trait for a doctor to have, I don’t think it’s the most important for him to do his job. Ideally, you have both, but that doesn’t always happen.
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I don't think it's the most important for him to do his job
Hmmm...I have to respectfully disagree. A well designed algorithm can diagnose a patient. It takes more than that to heal.
Compassion is absolutely necessary to interact with a living, breathing human being. As you mentioned, ideally, both compassion and competence would go hand-in-hand.
It is NOT unreasonable to expect both. I think a paradigm is in order.
I have to agree with denny on this one. Some of you may know that my wife has been suffering from some health issues the past year. After a trip to Mayo we have finally discovered what she has but the process to get there was a pretty rough path and it was filled with many doctors. I can think of two who she saw who were “well respected” in their specialties who were total douches. They basically brushed her off in fifteen minutes without even talking to her. They seemed more concerned with the “science” of medicine, (ie tests, imaging, ect) rather than the art of medicine. If you as a doctor can’t get information out of a patient because you are to busy being a “ice cold scientist” you are basically nothing more than that computer on Jeopardy.
Also, if you are a jerk to the patients referred to you by the GP you pretty soon loose referrels, as now my wife’s GP won’t refer to either of these two.
- radardenny Said:
- In reply to:
There are too many stoic physicians in the field. I firmly believe that a provider can supply emotional support as well as medicinal. There should not be a dichotomy.
After all, isn't the lack of emotion itself, an emotion?
We're not Vulcans here people!
After all, isn't the lack of emotion itself, an emotion?
We're not Vulcans here people!
I really agree with your assertion that there are too many stoic physicians in practice. Doctors forget that they are dealing with PEOPLE and not just symptoms. My primary care physician is like this and I avoid seeing her at all costs.
(I can think of two who she saw who were “well respected” in their specialties who were total douches. They basically brushed her off in fifteen minutes without even talking to her. They seemed more concerned with the “science” of medicine, (ie tests, imaging, ect) rather than the art of medicine.)
This is why I cannot figure out why so many med schools don’t use the 3.0 GPA minimum as their baseline and THEN figure out who has a personality via the interview. I saw this in nursing school and on the job; so many of the 3.5+ GPA’s (they tend to let people know their GPA status more often than not) lacked the ability to break things down into layman’s terms and listen to the people they care for. I work with one that LOVES those medical terms (eye rolling included) and uses them freely in front of patients. Problem ~ patients don’t understand them and can hear the word ‘syncope’ or ‘hypertension’ and think they’re near death.
I honestly don’t think I’ll make it into med school since my GPA is around 3.3, not the stellar 3.7. I have taught patients about diabetes, their diets, how often to test their sugar, etc., all using layman’s terms. Yes, I know the medical terms but why…who am I impressing?? Yes, depending on whom I’m dealing with, I’ll give the medical term and THEN the layman’s term and make it applicable to the individual.
Medical school admissions seem to have forgotten about the art of medicine. Yes, knowing the sciences is key, which is why a minimum 3.0 GPA is essential along with a 25+ MCAT. However, they shouldn’t discount the person (like myself) who can take the hand of a patient and explain what the doctor had just said and reassure them that following up with their PCP, specialist or that their hospitalist will see to it their care will be fantastic and they’re in goood hands.
Sometimes people need someone who will sit down and listen to them and explain the plan of action to them in a way that the patient will take action. Otherwise, some may feel as if it’s optional.
Just an FYI Leush, your 3.3 will be more than adequate if you have a decent MCAT. This guy right here got accepted to 5 DO schools with a pretty sad undergrad GPA. I also have an allopathic waitlist and got another allopathic interview.
Inspiring to say the least. I hope one day I can tell a similar story.