All,
Please help me as I am at a bit of a crossroads in my life. I graduated almost 10 years ago with pre-med and was accepted to medical school, but decided not to pursue. Essentially, I had shadowed a couple of physicians who discouraged me (they were GPs) due to the insurance environment leading to decreasing pay. I have since made my employment and educational decisions completely based upon how much money I could make (I have an MBA) and am pretty much miserable in my life and constantly regret not going back to medical school.
Anyway, I am studying for the April MCAT now to reapply and recently received an email from my father-in-laws physician friend who is once again saying that he doesn’t recommend medicine due to insurances, etc. I am about to turn 30 and am a bit of a worrier so I am constantly thinking about the ramifications of my decision if it is wrong. I will have to make my wife sacrifice and then I’ll have loads of debt that was completely unnecessary.
Can any physicians out there tell me if it’s really that bad? Are insurances that much of a drag if I plan on specializing? How do you guys deal with all the debt? Please let me know when you can as this is, once again, really affecting my dream. I keep telling myself that this shouldn’t matter, that I constantly keep coming back to being a physician b/c it it what I am truly supposed to do. But, I still worry nonetheless.
Thanks,
Dan
In my experience there are physicians who haven’t adapted well to the current health care model. It’s not what they “grew up with” and they resent the changes. Many if not most physicians (except for those in cash-based practices) are probably making LESS money now than they were ten years ago. That stings.
Physicians resent having to justify clinical decisions to bureaucrats and others in managed care corporations. They don’t like having to spend money on extra staff in order to deal with insurance issues. Primary care doctors like me are VERY angry about the number of people we need to see each day in order to keep our staffs paid and our lights on… BEFORE we get paid.
But I do think that those of us who’ve recently come to medicine didn’t have any illusions about how it was going to be. The ones who are telling people to stay away are those who experienced the change - they feel like they had the rug swept out from under them. I never had a rug under me to begin with 
As far as the money: As a family doctor 18 months out of residency, I am making in the low six figures. I have a loan payment (original loan size about $155K) of about $600 per month. This is certainly enough to live on comfortably… although it is not going to let you feel confident that you can pay for your kids to go to private school, or go on expensive vacations regularly. There are any number of ways to reduce or eliminate your debt burden and lots of ways to configure your work so that you make more than I am currently making. (note I am an employee; when I make partner I will have substantially more risk and likely more reward as well)
Those doctors discouraging you are saying, “The job isn’t what it used to be,” but since YOU have not ever been in medicine, that is not an issue for you. For you, the question is whether your future job in medicine would be better than your current job, which you clearly don’t find rewarding.
So ignore them. Their perspective really isn’t relevant; you absolutely should consider whether the switch to medicine is Worth It for you and your family, but not because of their perceptions - rather, you need to consider what’s important to you. Good luck!
Mary
Mary,
Thank you so much for your insight. I have pretty much come to the same opinion as you have in your response. I am not going into medicine because I want to make loads of money - I would just do what I am doing if that were the case. I am going into medicine because this is truly what I want to do. I agree that I need to stop listening to others and just go with what is going to make me happy, but it is hard.
Do you have any feel for how insurances really affect those who specialize? For instance, I’m considering going into radiology since I’ve always really enjoyed the structure of the human body. Thanks again for your words of wisdom and your consistent posts on this website.
I think specialists are having to invest more overhead in their relationships with insurance companies (e.g. staff members working to gain authorization for studies, or working to get more appropriate compensation after a study has been done). Medicare has cut reimbursement rates for many radiology studies, even as the population ages and more of these studies (such as bone scans) are performed.
So yeah, although I don’t know the details, I am sure that radiologists feel the heat of insurance companies breathing down their necks. I presume they have increasing malpractice premiums, too, although I don’t know that for a fact - I’m just speculating.
Mary
My friend, let me tell you - there will be no shortage of people who will discourage you for reasons that may or may not apply to you. And, there will be no shortage of reasons/excuses to make you decide not to pursue becoming a physician. In fact, you have already allowed yourself to be heavily influenced by this mindset, which you admit having been turnkey in your original exit from medicine. So, if you are looking for reasons to not do this…or, for that matter, anything else that is remarkably challenging or involves substantial risks…you will never lack for a rationale to not do it. If reasons ‘not to’ were in short supply, many more folks would be engaged in careers that challenged & satisfied them professionally & personally.
On the flipside, money, power, prestige and so on are shallow justifications for even attempting to pursue medicine. To be perfectly frank, it is too damned hard, the risks too high and the sacrifices in excess for a rational balance sheet to come up stating - Yes, go be a physician.
However, the preponderance of us are not becoming/did not become physicians for those reasons. We did it because it is our calling - it is what we were meant to do (as corny & sycophantic as that sounds). It is about that itch that cannot be scratched any other way…
Dave (purposely left out “Old Man” here b/c you’re only as old as you feel!),
Thanks for your response, and I could not agree with you more. Like I said in my response to Mary, I know this is what I want to do and I am finally making the decision not to listen to anyone but myself. I honestly believe that even the physicians that complain about the profession would still never have done anything else. I’ve been kicking myself for giving up on this dream for too long now and I know that if I don’t follow through, I will continue to regret my decision. There is truly (corny as well) nothing else that I want to do and I honestly feel that this is my true calling. My wife says that whenever I discuss going back to medical school I get a huge smile on my face. Now, if that doesn’t say it all then I don’t know what does. Thank you all for your support - I am sure I will require it again in the future.
Dan
I’ve encountered this too, physicians saying I shouldn’t do this; that they aren’t happy with the work (insert reason here).
I think that another factor not yet mentioned is that we tend to choose our profession at a very young age, and therefor not for the best reasons. There are many mid-career professionals that are unhappy with their choices made at 24 years old. (I know I could add myself to that list) - However, not many are crazy enough to change their minds and do it all over - so, stay crazy!
Campkel,
“Stay Crazy!” I love it and boy do we hear that more often than not. This was the initial reaction I received from many of my wife’s friends (not mine, they have been supportive from teh beginning), but they have come around too! Many of them are now starting to have kids and increasing their family and responsibilities so they think we should as well and that medical school puts an obvious crimp in those plans. Well, we weren’t planning on having kids anytime soon anyway (we’re only 29!), so this hasn’t really hurt our plans. Besides, many of them are horribly unhappy with their jobs and only see it as a means to an end. I don’t want to live the next 30+ years of my life that way. There is nothing I’d rather do than to “be crazy” and go back to school so that I can enjoy the rest of my professional and personal life. Anyway, thought your comment was incredibly appropriate - I now only listen to my heart and will continue to follow the path that is right for me, not everyone else.
Dan
dcathell,
Your situation sounds amazingly familiar. I am 28 and my husband is 30 and all of our friends give us the oddest looks when we let them know that we are waiting on kids and I am planning on going back to school. Truth is, I wouldn’t trade places with them for anything.
It sounds like you have given this a lot of thought and I hope the other posts have been encouraging. You’re the only one that can know if this is the right direction for you. If it is, best of luck!
I agree, the insurance companies are frustrating, pay ain’t what it used to be; bureaucracy will boggle the mind. There are days when I feel like I spend more time fighting computers then disease.
I deal with drug seekers and general whiners on a daily basis. But parents bring me their children and children bring me their parents, in both cases trusting me to take care of the most precious things they have. For good or ill I touch lives in ways I would never have dreamed 10 years ago. It is hard to explain how the days leave me both drained and uplifted at once, but I suspect Mary and the others who do it will understand.
Yes, the hours are long, the work is both intellectually, emotionally, and physically demanding, and sometimes it seems to be run by people who don’t give a Sh#T - but it is still the best job I can imagine.
This Physician says GO FOR IT!
(ps radiology? really? do you want to hide in the dark and read mammograms all day?)
We absolutely get the same reactions, especially with those of our friends who have kids. I am actually turning 30 tomorrow (my mom says she never thought I’d make it to this age based on all the stuff I got into when I was a kid - I walked at 7 months and she said it was all downhill after that), and realize that we’re putting off kids at this point, but we didn’t want to have them now anyway, so what’s the hurry. I am pretty sure my child(ren) will thank me when they have a much happier father coming home to them than I would be if I kept going the way I’m going now. Sure, we may have more money if I do this, but how much do you really need? All I can say is listen to your heart (pretty syncophantic, but very true) and just do what makes you happy - it will make everyone else around you better to have a truly happy friend.
I have always enjoyed the structure of the human body, so I think radiology would be amazing - the other option is orthopedic surgeon, so I guess I’ll have to see how everything goes. I’m also considering pediatric oncology. I know, it has to be excruciating for the ones you can’t help, but for the ones you can has to be amazing. I have always loved kids and would love to be in a position to help those that are in serious need. I’m sure my medical school experience will continue to shape my plans and I am looking forward to the adventure/journey. Thanks for the insight and encouragement.
I have also been where you have been…I was initially a pre-med major, hated chem and transferred to nursing. I always knew I wanted more, I tried specialization in Emergency nursing, joined groups and then started a NP program. I never found a good NP mentor. I have always worked in Emergency Departments with residency programs…one day I was talking to the residency director and the next day I was looking into medical school pre-req’s. The next thing I know I am 1 1/2 years out of residency. I am an Emergency physician and love it.
Re: radiology…I can only speculate…but if you work for a hospital, I am not sure you are salaried. Now there are radiologists that do interventions, but usually they are referred by another physician…I would think that would be paid.
Good luck, you have a long rewarding future in front of you.
Rachel
You know… I have not only the physicians but the whole department where I work either trying to discourage me or making fun of me. Who cares!? I have practiced 13 years as an OT and absolutely loved it until now (the itch I have to scratch), but I have seen many colleagues trying to talk students out of pursuing OT as a profession. Look, I believe that the fact is that not everybody is happy with their choices, it doesn’t have to be your case. In the end of the day, the only one you have to report to is yourself. Do what your heart tells you is best FOR YOU.
In the words of Judy Colwell, “Does the thought of this make your eyes dance?”. If so, you already KNOW that this is what you ARE going to do. Kick ass, take names, and become an outstanding physician. You won’t regret it.
Many folks find it quite threatening for a peer to openly express desire, let alone make steps towards betterment. I do not think it is envy, jealously anything malicious. I attribute it to many folks having unmet dreams that for an infinite number of reasons they are unable or have chosen not to pursue. Seeing someone they consider a peer step out of that rut and aspire to their dreams can be unsettling to them. Some will react as you have described. Others will rally in support.
For you though, you have accept that you cannot control external influences nor can you dictate to them how they will respond to you. This is only one of many tests of the strength of your commitment.
I wanted to take a second to thank everyone for their unwaivering support. I ABSOLUTELY KNOW this is what I want to do and nothing is going to stop me this time. I haven’t posted in a while b/c I was studying my butt off for the MCAT and volunteering at a local hospital. Exam is over (thankfully) and I think I did pretty well (knock on wood). So, on to my personal statement and preparing everything else. thanks again.
Boy do I know how you feel, Dan. While it hasn’t been any physicians, it has been some people close to me. I’m 44 now and will be 46 when I get into medical school, God willing. I’ve a friend who is just a year older and believes that it is too late…well, I guess if I were him and thought that when I’m 65 that’s it, I’m a goner…maybe…but I’ve a long line of women who have a long life span, and an active one at that. One thing I can never imagine is fully retiring, maybe just semi-retiring with reduced hours when I’m in my mid-to-late 70s. I’m going to go, kicking and screaming and doing what I want to do.
Smile and nod…then do what you want to do! There will always be naysayers…don’t let yourself become their receiving board.
Good luck!
I have not had any physicians say not to do it. One said that Physicians Assistant was the way to go. Less insurance, and excellent pay. The same one called it a long and arduous journey. I have received discouragement from the strangest people. When I called a hospital for volunteer paperwork, she told me that “I would change my mind. Everyone does. They become P.A.'s or RN’s.” First of all, I didn’t ask for their opinion, second of all, you don’t even know me in order to give one. My inlaws are weird about it. I am of the thought that if the shoe doesn’t fit, don’t wear it. If it’s what you want, you have to go for it. Their experience is not yours.
No physicians have told me not to do it, they all tell me there is nothing like it. My future FIL repeats Dr. Hartman over and over, and says he loves the way it sounds, he’s thrilled. Then he asks my SO why he doesn’t go to medical school too. My whole family is all on board, they’re very supportive. I just had a that one guy at the PA advising thing basically tell me I’d never make it to be a doctor and I should give up now.