Another guy in his late 40s

Hello, I guess I’m hoping to be be read by somebody who already went through med school. I’ve taught biology for 10 years. I have all the pre-requisites for med school. After teaching for 10 years I’m burned out. I’m really thinking about med school but I’m going to be 47 this month, which means I won’t be able to start until sept 2011 when I’ll be 49, since it’s too late to apply for sept 2010. I understand the philosophy of Old Premeds, and I understand that the sky’s the limit, still, should I go for this. If I want to be a PCP it’s going to take me 7 years and I’ll be 56! Isn’t it pushing it a little bit? What do you think?


Do I want to do that to myself?


The prospect to stay without income for 4 years is not that scary, I have savings, but what is my life going to be in med school? As an older student, will I have a life? Is the pace going to destroy me? I’m in extremely good shape, I’ve run three marathons and I think I’m “younger” than most 47 years old, still, I just can’t help thinking that I might have missed the coach!


Tell me frankly


Thanks


Phil



I’m only slightly behind you… don’t focus on the age, focus on the pursuit.


When I have focused on my age, I get all wrapped up in ageism rather than focusing on classes, prep, and letting the chips fall where they will.


I’m feeling pretty good about my chances and I’ll be 46 when I app in 2010.

Sure, but are you in line with what people on this forum think or with what people on admission boards think? You know what I mean?


Yes, since I’ll turn 55 no matter what, whether I become a FCP or not, why not become one!

Medical school is an ALL consuming event if you are okay with giving up many things that you now may enjoy, then I say go for it. OTOH with the way HC is going right now…I would be very hesitant to pursue this path but this is just my personal feelings. Primary care is not the most attractive career choice for many reasons and you may find out that you despise it when you start this path…so buyer beware. Good luck though on whatever path you decide on!

efex 101, why do you think HC is not going into the right direction? What if we have a single payer fund in 10 years from now?


Why do you think primary care is not the most attractive career choice? I understand that it’s not the most lucrative, but I’m not after money, so what are your arguments?


Thanks


Phil

Forlan,


I’ve talked to many adcoms now over the past 1.5 years. The schools I’m primarily interested in, allopathic, don’t care about my age: grades, MCAT, LORs, extras… seems that is pretty similar to what they want in ANY applicant.


Efex, I shadow a rural family prac. I’ve made more money than God at times… I don’t care about it anymore. Never made me happy.

Phil,


I’m new to this forum, and I really like the mentality here. After working in other fields, I spent years in the medical field before deciding that I wanted to pursue a degree in medicine.


Though I’m “relatively” young, I’ve worked with medical students and residents ranging in age from 20-mid 50’s. In my experience, those who chose medicine after the age of 30 have been truly committed. I have seen younger students and residents give up medicine/surgery and transition to a new career.


My only advice is that you should do what is meaningful to you. If you enjoy medicine, go for it!

efex 101, why do you think HC is not going into the right direction? If Obama continues with trying to haphazardly push this new reform without putting into it EXTENSIVE thinking, getting more people (specially physicians) than the those that will just go with whatever he wants, and not realizing that defensive medicine NEEDS to be addressed, HC will be a dream that will never come to fruition. Just because you have the “potential” to cover ALL does not mean ALL will be covered if there are NO physicians that will take this type of HC. Physicians will leave en masse or not take this government run nightmare.


What if we have a single payer fund in 10 years from now? I think this would be a bad idea. There has to be a LOT of competition for new ideas/procedures/pharmace uticals to be designed/invented/impleme nted. Capitalism is what runs the way we practice now. Should there be changes? yes, but going about it so quickly is insane.


Why do you think primary care is not the most attractive career choice? I understand that it’s not the most lucrative, but I’m not after money, so what are your arguments? It is not “just” about the money, it is about taking care of patients the “right way”. There is some component regarding money though, it is really nice to think you can run a practice with low funds but realities are different. You have a TON of overhead and you have to pay your employees. You have to make GOOD money to be able to run a PC practice and with Medicare cutting the $$$ this is not a possibility. Physicians in the front lines are leaving in droves and becoming hospitalists because they cannot afford their practice anymore. Patients are more and more demanding and they KNOW and DEMAND what and how you do things and many want a quick fix for everything to the common cold to low back pain without putting INTO IT common measures like losing weight, exercising, and the simple fact of letting some things run their course. I see it everyday but until you get there you as a lay person will not be able to fathom any of it. Most of the folks entering medicine are NOT doing primary care and hence as the years go by and if Obama passes through his nightmare of a HC plan those that do remain will be inundated! and although know you think “great” that is what I came in to do,…you also have a LIFE and need time for YOU. Sorry to be the bearer of bluntness but it is what it is. Also, seeing patients is not just the pretty office visits, it is the HUGE amount of paperwork and bullshit surrounding patient care. I go through more time dealing with “phone calls”, dictating, signing insurance forms, answering e-mails than ACTUALLY seeing patients. Also, you just get tired at some point patients wondering "wow, how come my kidneys/heart/lung/liver are shot doc? when they smoke 2 ppd, have BS in the 300 range, are morbidly obese, and drink a pint of vodka a day. The degree of self entitlement also gets to me…“well, although grandma is 95 we still want EVERYTHING done for her”, “yes, we know there is NO chance she will recover, but that is what Medicare is for” and yes, you then get ready to spend over 30K on grandma to do NOTHING for her, but by God let us try anyways. Pathetic but true.


I love what I do but there is NO way you could pay me enough to do PC.


Thanks


Phil

Also, taking care of patient entails TIME, not office visits that are 15 minutes long and patients coming in with a laundry list of 20 medical problems and over 15 medications.

Thanks for the good feedback and answers. What you describe is typical of US doctors. I was born and raised in France, over there too doctors are not starving, they can afford better than average houses, if they want a flashy car they can too.


My point? I disagree with you about single payer fund. With a single payer fund you don’t need support staff. There’s no need to have those desk people working on insurance paper because there’s no insurance paper to fill out. Everybody has the same insurance it it never deny coverage.


Come on, we spend 17% on health care and the rest of the industrialized world is around 10% and some less and offer better coverage and provide better lives to the HC professionals.

I lived in Spain for over 20 years and have first hand knowledge of that type of healthcare and it sucks period. IF you are healthy, young with no significant medical problems it IS a good system for preventive type of office visits, acute but minor health problems, etc. IT IS horrible if you are over 60 and have serious medical problems or need something done NOW be it imaging or an intervention. There is a waiting list, there is certain things (procures, imaging, pharmacotherapy) that are never EVEN brought up because whenever you provide HC for ALL at the expense of taxation things have to be RATIONED. Also, there is just NO COMPARISON among the European and other socialized HC systems population and the US population! we are massively overweight, we do not WALK (to be honest unless you live in a large city there is no freaking way to walk to buy a bagette here so you have to drive), there is no personal responsibility either here, folks want things done NOW and fix me now. Over there they do RATION THINGS, NO DIALYSIS FOR GRANDMA IF SHE IS OVER X (HERE WE DO IT EVEN UP TO 100 OR MORE), no CABG for grandpa if he is over X, etc…IF you like that system why not practice there? also, all or most of the new advancements in medicine for the most part are undertaken HERE, why? because $$$ runs the show, there is “that” incentive, take that away and we will not come up with so many new techniques, pharma, surgical interventions. Another point, I have lived there and worked there (during medical school) with physicians there and guess what? most do not give a shit about how much they work for the government run HC, if they see 2 patients vs 10 so be it. The patients can come back tomorrow who cares, it is free. Then they run to their evening private practice. Also, France had a huge number of elderly dying during one summer why? all the docs, nurses, whatever were on vacation. Same in Spain, everything comes to a screaching halt during the summer months. Can you imagine that here? they do not get sued there, here we do, until ALL those things change there is no freaking way American docs will roll over and let themselves get anal sphincterized.

The statement about “it never denies coverage” is just plain wrong IMHO. There IS coverage denied, there are patients that due to multiple comorbidities do not get what they would typically get here. That IS denying coverage. I am not saying that our system is flawless because it is not, but to say that those systems would work here is asinine. The American people are for the most part more of a capitalist bent (although now with MoronObama I am starting to doubt this) and want immediate satisfaction. They have no freaking clue about “rationing” HC and personal responsibility. Many of those countries are having a hell of a time keeping physicians there and are filling their ranks with folks from Egypt, Rumania, Russia and other countries due to low reimbursement. Medical school is for the most part FREE or at a very low price there, here it is 200K or more. Until you walk in our shoes you truly will not understand everything I describe. Most folks in those HC systems that can afford “private” insurance get it, why I ask would they do this if that HC system is SO great? there are flaws to both systems and to assume that we can change ours at the blink of an eye is irresponsible and plain stupid. First, they should cap malpractice, make medical school less expensive, open up state lines for HC insurance, put some responsibility at the feet of the patients (ok, you do not want to take your Plavix and you are still smoking 2 ppd, are morbidly obese and drink a 6 pack a day? well medicare will NOT cover your next CABG you need to pay yourself), start turning people away from the ER that come for pregnancy tests, the common 4 hours viral URI, etc…once all this is in place and done THEN they can talk about providing care for a select slice of the population like children, pregnant females, the mentally and physically disabled gratis. I do not agree with providing HC for free at my taxation for everyone! because there are a large amount of folks that choose to NOT work and get $$$ from the government and pop kids out at an alarming rate for more $$$. Why do I have to pay for those? I busted my ass, was in the military, went to war, have a husband missing a limb that he lost fighting for this country, went to medical school, busting my ass to pay for them? screw that.

As a side note, if international healthcare is so incredibly awesome and so incredibly perfect, WHY do internationals come HERE to the US for healthcare?


Oh yeah, because this country, is known for being top-notch in diagnosis, treatment, and care of patients.


Sadly, many have abused the system (including healthcare and insurance company CEOs, lawyers, …) and now it is overly costly.


To those that think the 10% cost is great and you get the same care, then I say, go back!


(I’m on a crabby roll… been about 3 years coming… sorry folks)


Efex & hubby… /salute!

I hear ya! there are so many folks (not necessarily here but everywhere) that LOVE socialized/nationalized HC YET come here to practive WTF? I truly do not understand it.


Thanks jkp!

BTW, I am just browsing at our inpatient list…93 yo with 10 MMP involving EVERY organ system, whom is DNR/DNI YET DEMANDS the 50K work-up to see what is causing the syncopal event although regarldess they will NOT pursue radical interventions…WTH? see what I am talking about…Also, a freaking ANKLE SPRAIN IS GETTING ADMITTED!!! because if this less than 40 yo F falls at home…“well, your hospital will be sued” so there, take that and wrap it up.

12 years ago I went to NYC having excruciating abdominal pain, lower right quadrant. Worst pain ever - including the birth of 10#4oz baby in 1.5 hours. On a scale of 1 - 10, it was a 15.


Rolling pain… bursting insides … more rolling pain…


Had just started my new job, literally had not even spent one day on site as officially my start date was July 1 but due to July 4th… you get the idea.


I started having the pain on 7/3 in middle of night. Lasted through 7/4 but drove home to my house 3 hours away, got packed, and on 7/5 jumped a flight to White Plains.


Monday came and went and I was in pain, thinking bad gas. Tuesday came and I was thinking bad gas, maybe onset diarhhea. Weds came and I was starting to vomit. Thursday came and I couldn’t eat and chills were setting in. Friday came and during the morning annual report meeting, I couldn’t stand the cold so I sat out in the bright sunshine in sunny Stamford, CT and still had the chills.


My boss saw fit to fly me home in 1st class so that at least I’d be comfy. A young man so excited about his new life yacked for the 3 hour flight home.


Back then, people could meet you at the gates. My parents met me at the gates with my then 5 year old son and immediately wanted to get me a cart. I, being somewhat stubborn, said no way. Walked the entire length of the longest gate chain… to baggage claim… to the car… and then respectfully hauled in my own suitcase.


Saturday came and something changed. I barfed up blood. I called the triage nurse. She suggested I get an ambulance. I suggested she not be so dramatic. I said I’d find care for my young son and be in when I could. She said matter of factly, “If you make it that long.”


My ruptured appendix had been so for what they suspected 4 - 5 days. I was so full of poison they could not:

  1. find a vein to draw blood

  2. operate for worry about the infection spreading


    So for 24 hours I was on $500/hr meds in an IV and then the 45 minute operation lasted 2 hours. Surgeon came out to my waiting father and said he didn’t know how I survived, I was a mess inside. Then added I was his “race horse” the one who would not quit.


    Next day, being new to the company, my insurance was denied.


    I was kicked out of the hospital immediately. Within a few hours I was discharged the surgeon stating hospital policy said anyone without health insurance could not stay.


    I was not on clear liquids yet. In fact, I wasn’t even given ice chips yet.


    A few days later, I received a phone call from a very nice woman who asked if I’d like to be readmitted. Respectfully, I said no.


    There was no lawsuit. There was no charity care or goodwill or anything like that. I didn’t demand pain and suffering monies, I didn’t demand a lawyer.


    I simply healed, moved on with my life, saw Garth in Central Park that August, worked my life and am now hopefully headed to med school with the knowledge of what CAN happen to those who are under-insured.


    BTW, my insurance company did pay the bill in full… eventually. It was just a simple the system at insurance company had not caught the paperwork from my employer yet.

This does not happen at ALL hospitals. We do not KICK out folks because they have no insurance EVER.

Seen both worlds, their cons and pros. When we discuss health care here, we also discuss health insurance like the two were one and the same subject. If we can discuss one at the time, lets first state that health care in US is great (I do not buy “best in the world” political slogan). Second, the health insurance business is less great. And third, the idea that health care and employment somehow are mutually inclusive is even less great of an idea.


Health care is important for those who need it which in general are expected mothers, newborn, chronically sick, and old people (applies to all of us). All we others can go about our lives without so much as thinking about it (does no apply to US). This is the greatest difference between having health care paid by insurance companies versus with your tax money (taxes by the way are not THAT high if you consider that 30% before reduactions pays for your health care, part of child care, your childrens’ education= med school, etc.) and even worse, intimately connected to your employment. When or if you get sick and need health care, there is still no need to THINK about the insurance, it will be there for you regardless. Dutch people are right now experiencing health insurance make over where private businesses are involved but where laws prevent anyone’s access to health care, and premiers to be affected due to age, health status, “per-existing conditions”, etc.


By the way, I have never heard of anyone to come to US for care from Northern Europe where I’m from. If someone does go abroad, they more often fly to Great Britain for cardiac surgery. Alongside the public health care with its waiting lists for the most common ailments (hip replacements as an example) there is a private system available for anyone to use, with or without an additional private insurance that are offered to children and adults.


What I really wanted to say is that lets not generalize when we discuss this super important issue, there are many countries with health care system that works. In all those countries the nurses and docs know what to do, freely roaming insurance companies are the sticks in the wheels.

Again, comparing what works in some countries to here is another issue…what works in Denmark will not work here UNLESS there is a radical change in the way American people think and what they expect. MoronObama has NOT addressed yet the need to RATION either which is done in all countries with socialized/nationalized HC. Just the other day, we had a 90+ yo F that although was DNR/DNI with a plethora of medical problems DEMANDED and RECEIVED a FULL WORK-UP FOR SOME MINOR AILMENT that was liking finding a needle in a hay stack. Again, this person was on MEDICARE and yet demanded everything for nothing, because her symptoms were minimal and even if she had a cardiac condition (example) there were be NO USE in any type of intervention even if she wanted it which she did not! So until the “President” addresses these issues (along with malpractice cap, decreasing the huge amount of debt for medical school) there is NO way most physicians will be happy with this.

may i ask what you mean by “President”???