<p>Missypie--my H was, and is, a total proponent of single payer, national health. Absolutely. He may have stayed in medicine wit that, though the other aspect, the life or deathness of it, was wearing him to bits, too. At least in teaching, no matter what else, you don't get those scary midnight phone calls, or the level of heartbreak that goes with the worst things a pediatrician sees.</p>
<p>I am not sure how reliable that survey was. They mailed 270,000 questionnaires and got back 12,000 responses. Wouldn't the most dissatisfied docs be more likely to respond?</p>
<p>I'm not sure it's all the red-tape. I've often thought that the repetitive nature of family medicine must get really depressing. It's like a conveyor belt. They must see it all over and over and over again.</p>
<p>I agree that living well within your means gives doctors the ability to maintain a satisfying career. My husband feels more entitled to a better lifestyle than I do (a physician also, but he did the Ivy thing while I did an HBCU), but we are not as extravagant as our neighbors. For me, this meant leaving a staff job with good pay and benefits, because I can't stand how psychopharmacology dominates the practice of mental health in "managed care" models. So my income dropped a lot.... and my "taxes" increased... oh well... I don't hate it, and even at these rates, the income would be hard to replace.</p>
<p>S1 wanted to be a doctor, did his premed and now has decided against it after shadowing physicians and many conversations with MD relatives both young and old. S2 wants to be a lawyer, a good friend our ours who happens to be a successful lawyer, spent a two hours talking with him about what the reality of it really is, so he is not under any false pretenses. Last summer he enrolled in a very intensive college credit course in law and litigation taught by a faculty member of one the top law schools. He came away loving it. I asked why he felt that way given the pyramid and long hours of major firms and the anxieties of having one's own practice, he said it was simple, law, he said, was one of the only professions where one can win, and he likes to win. He said that all kinds of law had that attribute not only winning cases, writing a better contract, finding a new way to do something given a certain statute, etc. In his mock court he and his partner were prosecutors trying to prove a weak case against an almost surely innocent defendant, and came within one juror of successfully sending the guy to jail, they were exhilarated.</p>
<p>I still like being a lawyer, after 23+ years. I always say that if you have to have a job, it's a good one. But I certainly chose my firm carefully. As an equity partner, I probably make about 20-30% of what my counterparts at the big New York firms make. I probably make about half of what my counterparts at more "intense" local firms make. But compared to most of the rest of the world, I make great money but still rarely miss a kid's event. That's what I tell my kids a good education gives you: the opportunity to make choices.</p>
<p>Not a doctor. Not a lawyer. In my experience, at least 50% of everyone hates his or her job, at some time or another, or all of the time, in some cases. If I mailed out 27,000surveys to the general population and received 12,000 them back, I would not be surprised if 50% said they would rather be doing something else. Doctors and lawyers have plenty of choices, if they don't want to practice standard medicine or law, if they want more flexible schedules, if they want to live in a different community, etc. They also have a lot more power to change their work environments them most people. Yes, they may have to take lower salaries, but it's really difficult for me to empathize with the complaints I hear at a cocktail party, while standing in a million dollar home, knowing that the food was catered and just one car in driveway cost more than most people will be able to spend on their child's college education.</p>
<p>^Well, my former physician H lives in a shoebox in a downscale neighborhood, driving a Civic, raising his own vegetables in the back yard.</p>
<p>Yeah, there are people like the above, but that's not all docs. And the limitations on being a good doc because of the present state of medicine hamper good docs at all pay scales.</p>
<p>In my area, the doctors struggle. My friend who is a doctor was told by the realtor who thought her H was also a physician, that there was little in their price range. This was a surprise to me having come from the midwest where doctors were truly kings in terms of socio economics. Many doctors I know here do drive civics and live in small houses. I would not call the neighborhoods down scale, and because of that, they struggle to make their household budgets. A lot of the kids at my S's school are physicians, and I would hardly call their lifestyles and homes "rich" and neither would most people I know. I'm talking about living in a small ranch or split level house with little property. Here the investment bankers and other finance folks rule the financial roosts. Now things are getting very scary for them. The doctors are in much better shape with their smaller houses and budgets and jobs being stable. When bonuses are revealed at year end, I fear what is going to happen to the NYC area economy. Alot of people sneer when those big spenders are in trouble, but the problem is that a lot of jobs and wages are dependent on that spending. The big guys have room to pull back.</p>
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I guess it's the "life or death" aspect that makes it easier to deal with those kind of issues as a lawyer rather than a doctor. We (those of us in private practice) can't really help folks with small matters....no one wants to spend $5000 to collect $5000. Most of these people aren't anyone you'd take on a pro bono basis...they're normal middle class people who can't afford the legal system. But if no one will discount their rates to help them, they're just out the $5000; they don't die or become disabled.
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<p>Unfortunately, when you are on call in the ER (or even in your own office), you can acquire a duty to care for a patient regardless of ability to pay. Doctors everywhere know and accept this risk. What kills private practice is the marginal reimbursement from Medicare and Medicaid. Many docs would like to opt out of Medicare and Medicaid, but hospital call duties require participation on the major insurance panels.</p>
<p>Definitely agree with cptofthehouse that in the NYC area, those in IB rule the roost financially. It's always amazing to me when I'm even a few hrs outside of NYC metro, people view MDs and JDs as the keys to financial stability.</p>
<p>I'm an associate at an NYC law firm, and I'm keenly aware of the fact that I need to save everything I can to give myself options -- the associate yrs (and paycheck) don't last forever, partnership is next to impossible, and the hours are brutal enough that you may not want to work that way forever. So far I love practice and already know that I'm not going to want to leave in a few yrs. However, you'd be shocked as to how many of my associate co-workers see it the other way; they already hate being lawyers and know they don't want to do it (even though they've only practiced for 1-5 yrs) but they live in the fanciest apartments, go to the best restaurants/bars, and take the most expensive vacations etc. now -- taking advantage of the money now because who knows what it'll be like in the future. I understand the living in the moment attitude, but I think it's a bit extreme.</p>