discouraging doctors

I was wondering if anyone else has had doctors discourage you from going to medical school? I decided last year that I wanted to go back to school to become a doctor. I first wanted to make sure that I wasn’t just picking something because i hate my current job but that I really liked it and wanted to pursue it. I asked my ortho if I could shadow him. First day was awesome! I came home thinking what a great job and i actually learned something from him. I ended up doing it for 1 week and at the end of every day he would have a talk with me trying to discourage me from going. At first I just thought he was trying to find out how serious I was but after a while it became apparent that this was not the case. I then asked my obgyn who has been practicing for almost 30 years if i could shadow him. He declined but answered alot of my questions. He also tried to discourage me from going into medecine. His line was about how it has changed so much and that we are heading for socialized medecine…etc,etc. These are just 2 examples of docs but i also had a PA tell me the same thing. I love it but when I hear from the doc’s themselves how bad it is and how bad it is getting I am a little concerned. Anyone have any comments or similar experience? I would love to hear it.

Similar Thread Elsewhere

I thought it easier to post the link to a discussion very similar to this from December.

Honestly, I have been told by doctors to go for PA and to skip med school. They keep telling me that the pay, respect, and satisfaction have all decreased for them.

Apparently, they didn’t do a good enough job trying to talk me out of it.


You have to do what you want to do, not what others feel is a better course for them if they were in your shoes. Obviously, doctoring is not what it used to be, but then neither is computer programming, lawyering, homemaking, or car repair. The world changes constantly and you have to stay centered on your goals and ideals and not be swayed by the disappointments and frustrations of others.

In many ways doctoring today is better than it ever was. We have superior tools and technologies compared to even five years ago, and the promise of even better ones soon. It’s a very exciting time to be in the medical field.

In terms of job security, don’t even worry about it. They’re predicting massive shortages of primary care providers (docs, RNs, other midlevels) over the next few years.

Just do your “due diligence” and know what you’re getting into, and be prepared to enjoy every minute of it.

I’m personally in the midst of what they call “Black January” at my school–a 19 week stretch of relentless grinding coursework relieved only by one week of vacation. People are starting to drag. Yet, I come home at the end of the day feeling more knowledgeable than the day before. This is just the beginning, too; medical school is an onslaught of information, tests, and experiences, and then you start to really learn medicine in residency!

It’s a long, tough slog, but is it worth it? Not a week goes by that I don’t question my decisions to go this direction, but I would not trade it for anything right now.

Go for it and just let those docs vent, but do listen to them and be prepared to learn from their mistakes. But keep in mind… it’s your life, not theirs that you’re talking about here.

To get some perspective, go read Po Bronson’s What Should I Do with My Life? which is a wonderful set of interviews in the Studs Terkel style that all of us can find some commonality with. Best of luck,

It always amazes me when I hear of “Docs” discouraging others from their chosen profession.

I, for one will be the most fulfilled feeling person once I have finished. I can’t imagine others not feeling the same way? I just don’t get it, at all.

For you that are currently employed as doctors, why do you think that there is such negativity from other doctors when upon hearing of others choices of pursuing med school?

I am starting to understand it now that I am out.

Officially I work a 4 day week - but unofficially it more like 6 and 1/2 days a week. The charting and paperwork goes on and on.

6 months in and I keep telling my self it will get better, and I suppose it will. But at the moment I am putting in 12 - 14 hour days wondering if I can keep it up.

Still - I have to pause now and again in the midst of the craziness and think about the bigger picture.

I really don’t mean to be discouraging. offer a reality check – yes - but not be overly discouraging. Over all its good work, and despite the derision of patients who don’t get the pain meds they want from me, most seem to appreciate the help I offer. -

Ask me again in a year, but over all I still say I would not change what I have done. Yes - there are a lot of times when I say “good god- what was I thinking” but then I will get a real heart felt “thanks doc” and I’m good again…

I know of a physician, some 20 years into FP now and he loves the work.

He starts every morning at 6 AM, showers, gets his coffee, to the hospital by 7 AM for rounds, walks across the parking lot to clinic for patients remainder of day until about 5:30 or so, then back to hospital if he has admits, then back to clinic to finish up charts, and home by 8 (if he’s lucky). More often than not, it’s closer to 9 or 10, and if he has night plans it means he’s doing dictation while driving home from said plans.

He is on call once every other week for one night and one weekend a month. Those calls come anytime, anywhere and he must be close enough to get to hospital if required. Those calls can be anything from Aunt Susie’s knee hurts to Uncle Sam collapsed on the floor.

He bugged me incessantly about why I never finished up my pre-med education and became a doc myself. He never, ever bemoaned what he did although he did pause to wonder how other docs in clinic got home to their families by 6 and he was never able to (I am guessing it had something to do with his OCD tendency which is GREAT for patient follow-up and care, but needs to be managed and balanced).

I believe, he would say the hardest part of being a practicing physician is not the hours, is not the patient care, and is not even the balance - it’s the paperwork now required for the Fed gov’t, the state gov’t, the lawyers, the insurance companies, etc. Despite all of that, however, he’d tell you - after 20 years - he LOVES his job and would never wish to do anything else.

If any of you were to ask him, he’d be the first one to say if it’s an itch you have, go for it and don’t worry about what might, could, should happen or why some people are unhappy in the profession.

Personally, I worked with CEO’s who made millions - maybe in the upward trend of $50M a year… and they are and will always be, miserable. Would imagine every profession has that; including docs.

That is grea, both of you… Thanks for some great respectives!

This has been discussed many times before and one point that always comes out is that last one from jkp - the practice environment is different now, more demanding and less rewarding. A couple of vignettes from my day will demonstrate:

I will spend 25 minutes with a patient talking her in off the ledge (figuratively speaking) and getting her set up with antidepressants, therapist, etc. If I am so stupid as to diagnose this with the ICD-9 code 311, “Major Depression unspecified,” the insurance company won’t pay me at all. I have to code it as “Fatigue and Malaise,” or “Insomnia.” (Why? Because only psychiatrists, who are hard to find and harder to schedule, and who as a group tend not to take insurance, are supposed to diagnose depression . It’s at least 20% of my day.] Furthermore, I have to bill the visit by the time spent in order to charge it appropriately. On my books, the encounter code will be 99214, or $190. The insurance company will then reimburse me some negotiated percentage of that $190. Depending on what my practice has negotiated with a particular carrier, it could be $45.

There are insurance companies now who are instituting “pay for performance.” They are monitoring the medications I prescribe and the tests I perform on patients. If I have a patient with diabetes, for example, I should be checking not only fasting glucose, but several other tests at certain time intervals. Furthermore, they would like to look at the results of those tests to see if I am doing a good enough job. I can order the tests and prescribe the medications, but it is up to the individual to follow through. However, the insurance company would like to make ME responsible for the jelly doughnuts consumed, and doses of diabetes medication skipped…

Or I see a 60-year-old with enlarged lymph nodes in their groin and a worrisome cough that has gone on for months. This is Badness until proven otherwise. When I order the CT scan of chest and abdomen, I may be pulled out of patient care to speak with an insurance company representative (last time this happened, it was an extremely rude physician) to plead the patient’s case for what I see as a medically necessary test. I may not win.

Lest I blame everything on the insurance companies, there are patients who are pretty damn irritating too. In some cases, they are mad at the insurance company too but they take it out on me and my staff because we are in front of them, and the insurance company is this amorphous nonentity that they can’t see or contact. (Have you ever tried to phone the 800-number on the back of your insurance card???) I have healthy 30-year-olds who INSIST that I run every blood test that might be part of a physical “because it’s covered by my insurance.” When I point out that the United States Preventive Health Services Task Force recommends that lipid screening start at age 35, and that their parents and grandparents and GREAT grandparents are still living, so it would seem that they are not exactly in a high-risk category for heart disease, they are incensed! “But my insurance pays for this!” “But My Insurance Pays For It” is one way we increase health care costs.

Or someone comes in with a looooong list of “demands.” I want this for my insomnia, and I want this for my restless legs, and I want to see a dermatologist for a skin check, and I want to see a cardiologist because my great-uncle just had a heart attack and he is 78… etc. etc. etc. Often the underlying condition is Worried Well and I can help them figure out what is actually going on and what they really need. But sometimes I feel like I am taking an order at the McDonald’s drive-up window. I have warned my office manager that there will come a day when someone is going to complain about me, because I may just crack and ask someone if they would like fries with that.

Doctors are alpha-type personalities who like to call the shots and be in charge. If we were shrinking violets, we’d be in a different line of work. And so this practice environment where we are NOT in charge much of the time is irritating and infuriating much of the time.

And I gotta say that as much as I love being a family doc, it is not supposed to be my life or consume every waking hour of my day. I want to do a good job and enjoy my free time. But right now I don’t know what “free time” is. I am looking forward to a vacation in a few weeks and my main thought now is that I have to be even MORE driven than usual to get all my work done before I leave…

So yeah, it is even harder than I thought and at age 53 I would like to have more free time than I do. Fortunately on most days, the rewarding patient interactions far outweigh the irritations of the job. I have a LOT of patients who come back, or bring family members or friends - that means a lot to me and definitely spurs me to do my best. But it is hard. It is why I will tell people that if you have a “Plan B” for a career, you should seriously explore that one and rule it out categorically before going with medicine. If there is something else you think you’d like to do, you should do it.

Wow I have given myself quite the pep talk for a day of charting…


Mary, I chuckled when I read your account of a day with patients. (Good luck with your dictation and charting today!)

This doc I speak of was on call one weekend. We were watching golf on tv (insert rolling eyes but it was for him that I did), almost asleep his pager went off and then his cell phone. It was the call nurse.

As I listened to “this” side of the phone conversation it went something like:

“Hmmm hmmm… okay… did she … okay well, I’m not inclined to prescribe her Oxycontin as she knows… well, I’m not inclined to prescribe her morphine either… , well OF COURSE, her leg hurts, that’s why she’s in the hospital!”

Basically, patient was in pain thought it was life ending and wanted highly addictive narcotics to help.

I’m guessing all of you, get those types of patients too and then they complain that you aren’t doing a good enough job to help them proactively manage said pain.

Thanks, Mary. Very insightful.