IS this the right choice?

unsure.gif Hi Everyone, I 've been thinking a lot lately about the medical profession in general and the future of doctors in particular. I thought I might get some feedback or comments from all of you about this topic. Right now, I'm confused and afraid and am not sure what to think anymore.
Here's my issue. I think about all that I am putting myself through in order to pursue medicine--working part time to finish pre-reqs (which has financial implications obviously), attemtping to deal with my organic nightmare (I have to take it over--which pushed me back one year), dealing with bouts of anxiety and depression (thinking medical school will NEVER COME), the MCAT yada yada. These are all things we ALL have to deal with to some degree. Then I start thinking about med school---wanting the NHSC scholarship, the hours, the low pay at first. And THEN......I start to think about all of the liability insurance issues that are invading the profession. The doctor I work with took me with her to the capitol (west virginia) for White Coat day and I listened to the doctors stories of making little money, inability to take care of their patients, having to leave the state, lawsuits etc...(OB-GYNs especially). I watched 60 minutes last night--only to hear about the issue pervading other states the same as WV.
I don't know about anyone else....but all of this is scaring me. It's a long haul to become a doctor...and we all are sacrificing a great deal. That's part of it. But when I start thinking of the pros and cons---what we will go through and give up to then enter a profession that seems to be in serious trouble, then I start to question my decision. I have friends who considered medicine and opted to go to Pharm.D programs. They say "you're still in the medical field, your well respected, and field is booming, and the pay is great." I don't think I'd like to be a pharmacist, but they do have a point. Does anyone else worry about this stuff???? Anyone else aftraid of the future of medicine and contemplate whether or not it's worth it to go through all of this??? Sorry this is so long...but I thought it was an important topic to bring up. Frankly, I'm scared!!
Any thoughts??? Anna

There is nothing that would satisfy me right now aside from medicine. Yes, I do think about all the pros and cons, but the pros outweigh the cons by a ton. You are doing the right thing and thinking about these issues, and we all have to make the decision about if it is worth it or not. Regardless, you have to do what is right for you, and maybe at this point it is not right, but you never have to give up completely on your dream. Maybe ten years from now it may be the right time…food for thought nonetheless.

Ugh, I just wrote a huge post and went to preview it and was told I wasn't logged on!!! Anyway, I will try to recreate what I wrote.
Anna, reading your post made me feel like I could have been the one writing it. I have made the decision to become a doctor so many times just to freak myself out and change my mind. But it always boils down to me thinking about what I could do as an alternative career and knowing that whatever that will be might meet the quicker/easier/cheaper criteria, but that in the end I won't actually be happy doing it. So right now my philosophy is to take baby steps. If I find that what I'm doing is too much, then I'll adjust accordingly, but at least I'll know that I'm taking the steps towards my goal. My situation in life may change, but I'll cross that bridge when I come to it.
It sounds like you've already put in a lot of work to meet your goal and perhaps you should consider how you'll feel if you change your mind. One thought is to shadow people in related professions whether it be pharmacists, NPs, PAs, etc. and try to get an objective view of what really goes on in their day-to-day lives. Every job has it's downsides (and upsides), and maybe after seeing what your options are you'll feel better about making a choice. The only other advice I have is what I'm doing right now… keeping my eye on the prize and not dwelling on the negatives too much. Of course, that isn't to say ignore them completely, just acknowledge them and keep on truckin'. You've worked really hard. There will always be negatives, but don't let them diminish what you've accomplished already.
Oh, and in terms of the recent situation in WV and some other states, I think that this is going to be a wake-up call for the federal and state governments to create some sort of legislation so that we don't continue to lose these valuable physicians from their specialties or from the field altogether. Start a letter-writing campaign to your representatives and congressmen… sometimes taking a proactive step can squelch some of that fear you are feeling. And of course, feel free to vent here whenever you want. I think we can all relate!

It seems to me that the insurance issues are cyclical. Ten years from now, things will be different. There will be a new crisis du jour. But we’ll get by. I know we’ll get by. And we’ll even thrive.
Every profession has its issues, its crises. This isn’t such a hot time to be a librarian, either, with journal price increases, budget cuts, and the “graying of the profession”. Just follow your heart and plan ahead for the medium-term. The long-term is too far ahead and the picture will have changed by the time we get there.

Absolutely, all of these issues must be weighed & evaluated within each individual’s personal context. This weighing & eval process shoulg also be repeated periodically to ensure that we stay a true & vakid course…and life breeds changes in perspective. For me, with each repetition of the weigh & eval cycle, physician won out. But, that will not be true for everone here.
However, and this is my personal choice, I do not merely see a profession in crisis on a downward spiral to oblivion or disaster. I chose to see a magnificent & noble profession in a state of metamorphosis. In my eyes, this “crisis” is truly a era of rapid evolution. Such times are ripe opportunities, for those who are inclined accept the challenge, to jump in & influence the process & potentially aid in facilitating changes that could yield a vastly improved healthcare system for everyone. I choose to take ownership in the problems that exist & endeavor to make things better.
It is purely all in what perspective YOU permit yourself to buy into. No, I am not denying that there is significant risk for me & my family, but that would be true to a greater or lesser degree no matter what profession I chose to pursue.

So, physicians are telling students they shouldn’t go into medicine because of liability issues… but rarely tell students that they shouldn’t go into medicine because of the deep moral qualms they may experience while practicing within a system in which the working poor are denied healthcare insurance and access to quality care, and clear differences in healthcare outcomes result. ( http://www.iom.edu/IOM/IOMHome.nsf/Pages/C…Uninsurance#HCS )
Along those lines, it’s worth considering why providers in areas like West Virginia have decided to strike most actively at the right of patients to take action against negligent care, while more or less passively enduring or even endorsing the system that daily denies millions of patients the ability to pay reasonable compensation, via insurance, for good care. Of course, it’s the right of any citizen to get worked up about whatever he or she wants to get worked up about, and ignore more or less whatever he or she wants to ignore, but it’s worth pointing out that not everyone, even within medicine, frames these problems in the same way.
If I were you–which of course I’m not, so do with my advice what you will-- I’d spend more time worrying about your soul than your pocketbook; that is, what the process of becoming and then being a doctor might do to your time, your connections to other people, and your relationship to your community. Consider this in light of, first, a training system that restricts the amount of time you have with family and loved ones; and second, a healthcare system that restricts your time with patients. I find that wrestling with those questions is harder than questions about things like liability. Nonetheless, I answer each with a continued wish to be a doctor. If you enjoy the process of becoming a doctor, you will probably find a way to enjoy being a doctor.
OK, now, hopefully less righteously, and more personally, I’d suggest to you that although issues like liability and time are easy and sometimes even valid things to hang anxiety on, it is just as often questions about ourselves–can we do it? and if we can, will we be good at it? will we enjoy it?–that plague us most deeply. Sometimes the external issues really become metaphors for these internal concerns, which are harder to admit to. Not always. But it’s worth considering. If someone told me that she’d stopped trying to be a doctor because of liability issues, I’d wonder what else was going on. You might ask yourself the same.
best regards
boston joe

Thank you everyone for your thoughts and reponses…especially you Joe. What you said really did hit home and I do know that deep down inside I have a few insecurities about my getting into med school, making it, and eventually becoming a doctor. I suppose we all do at one point or another. It's really nice to have people to talk to and discuss these things with. I'm so thankful for OPM.
Anna

QUOTE (joewright @ Mar 10 2003, 10:10 PM)
So, physicians are telling students they shouldn't go into medicine because of liability issues... but rarely tell students that they shouldn't go into medicine because of the deep moral qualms they may experience while practicing within a system in which the working poor are denied healthcare insurance and access to quality care, and clear differences in healthcare outcomes result. ( http://www.iom.edu/IOM/IOMHome.nsf/Pages/C...Uninsurance#HCS )

joe,
I agree that the poor have unequal access to healthcare, but there is no healtcare system on this planet which gives the poor truly equal access as the rich people have. Thats something that will always be built into any system, whether its totally privatized or a government single payer model.
If you look at England, Germany, France, Canada, Cuba, etc you will find that poor people STILL dont get the same access to health care as the rich people get.

I read Joe’s comments to speak of “good care” “quality care” and “not receiving negligent care” == those to me are way below the standard you mention of “same access as rich people” - and I think the former should be somehow achievable in this society where “equal access” may never be.

What Lisa said. (Whassup, Lisa?)
I'll spare y'all my continued righteousness on this topic, or at least, I'll take it to that ethical debates corner if I get further inspired.
Anna–I'm so glad that what I wrote was helpful to you. I hope you're already figuring out that all of us get scared, at every stage along the way. Join the beautiful brave freaked-out club.
warmly
boston joe

I think it’s natural to second guess your self when making a decision this big. It is a huge committment of time, money, and effort. Talking to my classmates this week, it seems like we’ve all been wrestling with the issue- not because of the liability or insurance issues, or the pay issue, or any of those things, but just the “wow, this is really hard, and I’m really tired, and I’m giving up a lot of stuff, will I really enjoy practicing medicine after 7 years of training?” (Last night I was seriously considering the qualifications needed to switch to Lion Taming. However, since I don’t seem to be able to even handle one small cat, I guess I’d better stick with medicine). Truthfully, when I get right down to it, there is nothing I’d really rather be doing. But I think you will continue to question the decision. It’s normal to have those moments of anxiety (and downright fear!), and I think it helps to know that others are going through the same thing. At least, it’s saved my sanity this week.
Now, after this brief interlude of waxing philosophical, I’ll go back to studying for a Bacteriology exam tomorrow morning that I suspect is going to be extremely ugly. So many things inhibit cell wall synthesis, in such a variety of ways…(sigh).

QUOTE
(Last night I was seriously considering the qualifications needed to switch to Lion Taming. However, since I don't seem to be able to even handle one small cat, I guess I'd better stick with medicine).

LOL Epidoc. In my stressful moments I used to say that for my next career change, I was going to be a shepherd. Nice grassy hillside somewhere, some sheep....doesn't it sound peaceful?
wink.gif Beth

Oh, that does sound nice!
In one of my loopier moments a friend and I were joking about starting a business where we own the flocks, and let people rent them for a week at a time, so they could go enjoy being shephards for a short period. (This rather odd thought had occured after seeing- and I'm not kidding- a sheep with a mark spray painted on its side, apparently to identify which flock it belonged to. But admittedly, we were in 130F heat at the time, so I'm not sure we weren't hallucinating).

Epidoc, I think you’re onto something there! Or on something, or…er, never mind. biggrin.gif

QUOTE (AnnaB @ Mar 10 2003, 11:08 AM)
unsure.gif Hi Everyone, I 've been thinking a lot lately about the medical profession in general and the future of doctors in particular. I thought I might get some feedback or comments from all of you about this topic. Right now, I'm confused and afraid and am not sure what to think anymore.
Here's my issue. I think about all that I am putting myself through in order to pursue medicine--working part time to finish pre-reqs (which has financial implications obviously), attemtping to deal with my organic nightmare (I have to take it over--which pushed me back one year), dealing with bouts of anxiety and depression (thinking medical school will NEVER COME), the MCAT yada yada. These are all things we ALL have to deal with to some degree. Then I start thinking about med school---wanting the NHSC scholarship, the hours, the low pay at first. And THEN......I start to think about all of the liability insurance issues that are invading the profession. The doctor I work with took me with her to the capitol (west virginia) for White Coat day and I listened to the doctors stories of making little money, inability to take care of their patients, having to leave the state, lawsuits etc...(OB-GYNs especially). I watched 60 minutes last night--only to hear about the issue pervading other states the same as WV.
I don't know about anyone else....but all of this is scaring me. It's a long haul to become a doctor...and we all are sacrificing a great deal. That's part of it. But when I start thinking of the pros and cons---what we will go through and give up to then enter a profession that seems to be in serious trouble, then I start to question my decision. I have friends who considered medicine and opted to go to Pharm.D programs. They say "you're still in the medical field, your well respected, and field is booming, and the pay is great." I don't think I'd like to be a pharmacist, but they do have a point. Does anyone else worry about this stuff???? Anyone else aftraid of the future of medicine and contemplate whether or not it's worth it to go through all of this??? Sorry this is so long...but I thought it was an important topic to bring up. Frankly, I'm scared!!
Any thoughts??? Anna

Hi there,
Since I am sitting here with an MD and practicing in the scope of residency, I have a closer perspective on what's out there and what it is like to practice medicine albeit within the confines of a residency program. First of all, I totally love every second of what I do. Yesterday, I spent most of the morning helping to repair a T-E fistula on a young patient who is just days old. This patient is totally fixed and will lead a totally normal childhood and life in terms of their condition. Even twenty years ago, this patient would have died shortly after birth because we would not have been able to maintain the tiny child long enough to get them through surgery. I have another child who was born with a diaphragmatic hernia. This child is off mechanical ventilation; only days old (a small premie) and will sail through rapair on Monday. We know what the anatomy is, thanks to the innovative and wonderful folks in pediatric radiology here at UVA and we will be able to repair the defect on Monday after this child has been medically stabilized.
No other job in the world will allow me to hold the tiny pylorus of a 27 day old infant in my hand and totally fix the problem so that it goes home with Mom to resume development. We also detected an ASD (atrial septal defect) and got this infant into the pipeline of the pediatric cardiology department where this infant will be closely monitored until it gets fixed or grows out of the condition. Some children have ASDs that go un-noticed until young adulthood when they find that their exercise tolerance during sports becomes compromised. By that time, they may have life-long effects from this condition that was picked up, not by the local pediatricians who examined this child after birth, but by the pediatric surgery resident because this child had the good fortune to be living close enough to be transferred a complete pediatric medical center.
I worked hard during graduate school and even harder during medical school. The intensity that you have come accustomed to dealing with is second to none in any profession. You literally hold life in your hands on a daily basis. This profession is not for everyone. It is not for those who are looking for easy money and a wealthy lifestyle. You are not going to achieve this with medicine. You will achieve a wealthy lifestyle far easier and quicker if you enter the world of business. This profession is not for those who cannot work on the edge at times. My mentors have had me totally redo suture by suture because it wasn't perfect. I was happy to do this even though I could feel my professor pushing me to get every suture perfectly placed(in a timely manner as OR time is very, very expensive). This is the job of a junior resident, to learn perfection with every patient. From the manner in which you make the first incision to every suture of the closure, you have to get the job perfect time and time again.
Medicine is a long-term goal at best. You have to win the little battles along the way because the battles get bigger and more numerous once you graduate and actually get into practice. Everytime I step into the operating theatre, I encounter new anatomy, new physiology and learn something new. One day, in the next six years, I will step into that operating theatre without my attending physician to tell me to redo that suture or where to place a stitch for best results. I will be the only person in the room that can make that decision. The years of honing my skills in residency will come down to the day to day decisions that I will make as a practicing physician.
I look at my junior attending physicians and how they have stepped up to the plate as the surgeon in charge of the case. I look at their lifestyles because they are my most reliable litmus test of what life as a surgeon will be like for me. They don't live in the huge estates and drive the Jags. They do live comfortably and drive the Buicks. They have to spend some time learning how to correctly bill for their cases and time spent so that they get paid. Even the more established surgeons have to do this so what had changed? The surgeons coming out of residency today, do far more cases than my my cousin who finished residency twenty years ago but they love what they are doing. She does three major cases per week compared to an average of ten to fifteen major cases per week for the junior attending surgeons.
Only you can decide what is the proper course for your life. I can tell you with total assurance, that I have met not one surgeon at the University of Virginia who has any regret about their career choice. From the junior residents to the junior attendings to the department chairs and chiefs of staff, they all totally love their choice of vocation. They are all driven and they have all sacrificed something be it time with family or being home at 5pm everyday or being able to jet off to the south Pacific when the urge moves them. My attending range in income from the chairman of the department who is a cardiothoracic surgeon earning well into the multiple seven-figure range to the junior attending who is fresh out of residency earning six figures to the junior resident who earns just over $36,000. We all love our work and would do it over and over again.
No Pharm.D.can ever have this much fun day in

and day out. There are so many options in medicine that you can't count them all. I can work anywhere in the world and affect thousands of lives on a yearly basis. Just getting to this point was worth every sacrifice that I made in terms of those countless hours pouring over the thousands and thousands of things that I had to learn both before medical school and during medical school. My compensation at this point and for several year to follow will be pretty much the same in spite of the more complex cases that I will be performing. Still, I would do this job even if I didn't get paid. I would work another job so that I could do this job. It's just that much fun and that much of a rush. Surgery is total gratification on a daily basis. There is nothing better than spending a whole day in the OR doing cases.
Natalie