What do you think... is med school worth it for the kids?

Parents Forum
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<p>Do any of the physicians (or family members or friends thereof) have any idea of what the future will hold in so far as universal care and its impact on the medical profession? Will it be better or worse in terms of the various topics discussed here (e.g. individual freedom, management from above, debt, salary... ) </p>

<p>It may not happen in the next year or two, but in all likelihood it seems that some sort of big changes must be in store down the line. Just curious what others think will happen career wise.</p>

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<p>And garland, you did a good job of explaining your H's story. I listened this time as I have listened before. Intently. I'm glad you posted it .</p>

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<p>Me, too, Garland. Thank you for contributing! :)

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It's really, really misguided, in my opinion, to dismiss any misgivings because, hey, you'll be rich and riddled with prestige, what's your problem, anyhoo?

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I agree with this, too. Kids should do their due diligence before making any decisions, and this would be a good thread for them to read. But I believe this thread is overly negative about medicine, and when I visualize the world of "all jobs", and place "medical doctor" in there, it's not in the bottom of the hierarchy, it's not in the middle, and it's pert near the top in terms of many, many characteristics (salary, respect, prestige, stability, working environment, and the ability to help fellow humans and make the world a better place for them). And, sorry, just have to insert this in here, it beats working in a hog processing plant aspirating pig brains all day! ;)</p>

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<p>
[quote]
Do any of the physicians (or family members or friends thereof) have any idea of what the future will hold in so far as universal care and its impact on the medical profession? Will it be better or worse in terms of the various topics discussed here (e.g. individual freedom, management from above, debt, salary...)

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</p>

<p>I think the short answer is that nobody knows. It seems quite clear that something will happen but what that something is is unclear.</p>

<p>Some general thoughts:</p>

<p>Individual Freedom / Management from Above
In a universal system it's likely there will still be a strong sense of controlling management from above, although instead of an HMO or insurance company it will be a government run (or backed) management board. If, as I would like to see happen, physicians are allowed to have a lot of influence on these boards then the situation would likely be better than now but that's a big if. </p>

<p>I have some experience with the UK's National Health Service (NHS) and there is still a lot of anger and complaints over management and lesser educated 'managers' controlling physicians from above so I don't think that problem will necessarily just go away if we get rid of the HMOs. </p>

<p>Debt
If we go to a universal (nationalized) system then one potential very positive outcome would be the use of government subsides to pay for medical school in the same way that the government backs and pays for most of the costs for a science PhD. This would certainly help people out debt wise, although in the shorter term (e.g. for those currently thinking about med school) this won't help. </p>

<p>Salaries
Physicians would still be very well paid (relative to the general workforce) but there will be some strong limiting pressures on salaries if the bulk of that money is coming from the taxpayer. Any physician that has Medicare patients will tell you that if a government backed healthcare plan is footing the bill for someone the focus is on getting the absolute maximum amount of healthcare for the absolute minimum amount of money. Some could, as is the case in countries with universal care, refuse to accept patients unless they pay their own way (and thus higher rates) for care but personally I think this practice runs into serious ethical issues (see below).</p>

<p>It's unfortunate that some politicians seem to be of the mindset that if we just ignore this whole universal healthcare issue the problem will go away... but of course it's not going away and it's only getting worse. A lot of people, including myself, are weary of a lot of 'entitlement programs' but when it comes to universal access to healthcare this is something that everyone should be entitled to regardless of their income. Getting to that point won't be easy, won't be cheap and will require some compromises and sacrifices (including from those in the medical profession) but it's the right thing to do and, in my opinion, any physician that truly believes the Hypocratic Oath should be amongst those fighting to see that it gets done. </p>

<p>"I will treat without exception all who seek my ministrations, so long as the treatment of others is not compromised thereby, and I will seek the counsel of particularly skilled physicians where indicated for the benefit of my patient."</p>

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<p>me, too anxiousmom.</p>

<p>rocket, IMO that post did a good job setting it out. Government or insurance companies and HMO's. Boy what a choice.

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A lot of people, including myself, are weary of a lot of 'entitlement programs' but when it comes to universal access to healthcare this is something that everyone should be entitled to regardless of their income. Getting to that point won't be easy, won't be cheap and will require some compromises and sacrifices (including from those in the medical profession) but it's the right thing to do and, in my opinion, any physician that truly believes the Hypocratic Oath should be amongst those fighting to see that it gets done.

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That may be more of a consensus than I would have originally believed.</p>

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<p>
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That may be more of a consensus than I would have originally believed.

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</p>

<p>Agreed... there's not a consensus but there should be (in my opinion).</p>

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<p>Negativity - </p>

<p>There's been a lot of negativity towards the medical profession on this thread but of course, the OP wanted feedback so that's fine. But, I couldn't help comparing it to other professions and similar negativity posted in threads about those -</p>

<ul>
<li>Computer Science (job ends after a few years, it's all being oursourced to India)</li>
<li>Teaching (low pay, budget cuts, lack of appreciation by students/parents, rote teaching the same subject for 20-30 years)</li>
<li>College Professor (low pay, few openings - must wait until someone retires/dies, math/science are all from other than USA)</li>
<li>Investment Banking (long hours, cutthroat, have to live in NYC)</li>
<li>Lawyer (most are in non-high-pay, drudgery government positions, must be from the top of the class of the top schools to get anywhere)</li>
<li>Biology (need a PHD to do anything and then there's a glut of bio PHDs)</li>
<li>Chemistry (jobs on the decline, people out of work)</li>
<li>PoliSci, History, gender/race studies, other social science and humanities (no jobs to be had equating directly to the major, some low paying jobs related to major, might be able to get an unrelated job since some prowess for reading/writing was demonstrated in obtaining the degree, many grads working at the local mall)</li>
<li>Music (no one gets a reasonably paying job in music)</li>
<li>Dance/Acting (ditto with music)</li>
<li>etc.</li>
</ul>

<p>Now, I don't want to derail the thread, especially since the OP is so keen on keeping it exactly on topic, but we seem to see similar negativity in these kinds of discussions on many other potential careers. Of course, most of us realize that the reality for many is generally not exactly the negativism posted in this forum. Some of the negativity comes from people outside the profession and therefore they don't really know much about it and some of it comes from people in the profession who, perhaps because their choice didn't fit whatever picture they imagined up front or because the field has morphed over time (medical field, CS, others), seem down on it to the point of discouraging others from entering the field. </p>

<p>The general negativity voiced towards many professions is a factor that should be considered when one reads the small sample size and skewed sample of people posting in this forum. It doesn't mean that data isn't valid, it just means that it's data from a small sample of a skewed audience. When one considers the constantly changing aspects of some fields, who's to say what it'll be like in 5, 10, 15, 20 years from now? Who's to really say what it'll be like as various laws have their impact (socialized medicine, perhaps laws protecting OB/Gyn docs due to flight from the field, trade laws, etc.)?</p>

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<p>Amen to the above post.</p>

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<p>Curm, your attacks on VC's are irrational and frankly, beneath you. I recently had a long airplane flight next to an MD, former oncologist, now working for a mid-sized VC fund. His job is to help "the money guys" evaluate early clinical trials or just early bench research to help determine which protocols, medications, procedures to bankroll. He was a pretty passionate, high energy guy, and when he was done describing what he does and why there is such a void in the markets for investments in new drugs, you yourself would have signed on to join his firm.</p>

<p>Bottom line- if you think the government is adequately funding cancer research you are wrong. If you think that private foundations are eager to take on the stem cell/right to life lobby by aggressively increasing their investment in genetics and stem cell research you are wrong. That leaves Big Pharma and the little guy working in his garage. How does the little guy in the garage bankroll a hugely expensive clinical trial on real live cancer patients who are going to die anyway without an experimental treatment??? VC's, that's how.</p>

<p>You are fun sometimes but the combination of your defense of your daughter (this thread is not about her.... remember?) and your ranting about souls and who has them and who doesn't is getting tiresome.</p>

<p>And for the record, my seatmate claimed he was doing just fine financially as an oncologist. It was the last lawsuit which sucked up all his time and attention which drove him out.... it's only malpractice when a terminally ill member of YOUR family dies; it's called God's Will when it's someone else's family member.</p>

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<p>Waaay off topic and unfortunate. </p>

<p>Sorry you feel that way, blossom. I really am. But I'm not sorry for anything I posted. Again, I was not defending my D. It is tiresome for me to have to post that (it seems so often). Unfortunately I have only one student data point that I know well enough to post about. </p>

<p>I do admit that I use her as a "prop" in too many postings and that I will try to curtail that use so that people like you won't assume facts and motivations that are simply not true. </p>

<p>As far as my disdain for VC (I'm kinda liking that abb.;)) I have had more than one instance in my practice where companies (or officers in companies) I know had dealings with VC's that were IMO pirates and IMO nothing more than loansharks in Brooks Brothers suits. What they want from the company in return for their services can be quite a steep price indeed. My opinion is not based on a casual meeting on a plane. I view them quite reluctantly as a necessary evil. I wish medical R+D was handled differently.</p>

<p>But be that as it may, you are entitled to your opinion , however it was formed. </p>

<p>I also have no use for some HMO's, and most insurance companies and I'm sure you've had a seatmate in those industries , too. My opinions are based on my dealings with them over a number of years. I also have no use for bananas, Walmart and Michael Bolton music. 1 and 3 are disgusting and 2 may very well be evil incarnate, or the velociraptor of retail.</p>

<p>So go ahead and pin my ears back about them, too. It won't change anything but it'll sure look good to any crowd you are playing to with your ridiculous attack post. Now go cluck and cackle all you want that you backed me down. If that's a big thing to you...I give. Enjoy your victory. </p>

<p>To anyone who feels the need to defend me, please..... I'm begging you....don't do it. It just goes on forever and I am tired of it. Way too tired of it. I just want it to end.</p>

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<p>"Do any of the physicians (or family members or friends thereof) have any idea of what the future will hold in so far as universal care and its impact on the medical profession? Will it be better or worse in terms of the various topics discussed here (e.g. individual freedom, management from above, debt, salary... )"</p>

<p>In one word: Ghettoization
Medicine is becoming an ethnic ghetto.</p>

<p>I can see evidence of "white flight" as incoming classes are increasingly composed of Indians, Chinese and other minorities. In addition, medicine is becoming a largely female career area as the number of female physicians increases.</p>

<p>I applaud the increasing career opportunities for non-Caucasians that this represents; I am from a non-Caucasian minority myself . However this is likely to further marginalise medicine. Historically becoming a racial and gender ghetto has had very unfortunate effects on working conditions, relative pay and work satisfaction. School teaching and nursing are good examples of this process.</p>

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<p>This is quite the post! H is of the MD persuasion. I can tell you that the lifestyle is not great. The family life in certain specialties is non-existent. If H worked in an automobile factory as many hours as he works (with far less stress) with overtime for all hours after 40 per week he would be making much more money and have vacation time and a pension to boot!</p>

<p>Most MDs whose practices include the ever larger aging population (Medicare - Medicaid there is no rest for the weary and lots of work for zero pay. Examples - no pay for those telephone calls in the middle of the night about mom or from the hospitals to give orders or arrange tests or just the follow up visit fee for a 10 hour visit and transfers to other facilities which cancels the entire next day of office patients, who incidentally get really crabby. Or how about the drug seekers. Come to the office, supposedly in pain and are trying to get narcotics from all of their physicians. Oodles of forms to fill out for next to nothing or subsidizing attorneys who insist that you have to photocopy a 200 page medical record for 1/10th of what your office staff's time or a photocopy service costs because the government has not increased the allowable charges for 10 years.</p>

<p>Ethical doctors who continue to practice Medicine vs. Medicare/Medicaid/PPO work their tails off for very little compared to what they would earn in another field. H has discovered that he earns 5x more reviewing medical records for Med Mal Ins companies than he does practicing traditional medicine... This should scare you. It is the reason that he has encouraged our daughter to go into anything but medicine. (Incidentally, she is going into Biomedical Engineering and will probably go to medical school as part of an MD/PhD program :D).</p>

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<p>I haven't read every post on this thread, but get the general idea of what the OP is asking and some of the responses received. Thought I would try to relate our story as briefly as possible.</p>

<p>H is a general internist of close to 30 years. Went 4 years undergrad, 3 years post grad - decided research wasn't for him, he really wanted to be a physician, packed up and left campus without finishing his "paper". His mother nearly had the vapors. Put on the alternate list for his first choice med school and attended his second choice. Did a 1 year internship, 3 year residency, and stayed on an extra 6 months for some extra (unpaid) training in GI, cardiology, and pulmonary. H is at this point close to 32 years old and ready to practice! Returned to his hometown in a solo practice (where I was his only employee) for 3 years. Asked to join an internal med group in town in 1985 - and fast forward to today. </p>

<p>We have a senior in the honors program at our stateU who (if she keeps up her sterling record) will graduate with a 4.0, with honors from both her department and the U at large. She started out as a bio major with med aspirations, but decided midstream that really wasn't what she wanted. Completely changed course and will graduate with a communications degree. H still laments, "She would have been a great doctor". I have to remind him that she will be a great something else, though I really do think it broke his heart.</p>

<p>Freshman D is a science "of some type" major, taking the premed prereqs, and seems (at this point) to be heading straight on towards that goal. She attends a top 12 private school and is challenged to the max. We ask her repeatedly if she is sure this is what SHE wants and she adamently says YES!</p>

<p>I think that simply, that is the key. Is it what your student wants? If it is a passion that burns in them - not for the money, not for the prestige, not even because "they want to help people", then they are on the right path. My husband gets up at 5 am every day and is at the hospital by 5:40, then off to the office. Every day is a 12 hour day (at least) and he loves every minute of it. He loves the problem solving aspect of medicine, he loves that he continues to learn something new daily, he loves the challenge of trying to use all the resources at hand (his own and those of other people in the medical field) to assist someone in obtaining optimum health. If a bank or insurance provider asks on a form how much his income was the previous year, he has to ask me to look it up - he really has no idea! That is not to say that he doesn't enjoy the fruits of what his passion provide him.</p>

<p>As I read through the posts on this thread, I related some of the information to him. I asked, "Do you think we should try to dissuade younger D from persuing medicine?" In his ever calm and well thought out manner he replied, "First of all, if it is someone's passion, there is no way you could dissuade them. I think there will always be a good living to be made in medicine, but saying that, money should be the last reason you go into medicine. I wouldn't change my choice for a second - I love what I do".</p>

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<p>Good one!.</p>

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<p>"Is it what your student wants? If it is a passion that burns in them ...... then they are on the right path."</p>

<p>Well said. Still waiting to see what S's passion is, I do hope he finds one.</p>

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<p>MidwestParent, my neighbor could be just like your H in about 15 years. They think a lot alike and he has two very bright daughters ....and a big ol dumb roundfaced boy. ;)</p>

<p>Thanks for posting. I know at least some kids who think that way, too.</p>

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<p>rocketman:</p>

<p>While universal health care has been discussed on different threads, I'd like to respond to your thoughts about less med school debt: perhaps, but I've never seen any proposal from universal health care supporters that say then intend for the Govt to pay to send kids to med school. Anything is possible, but that one I kinda doubt. </p>

<p>If the Feds/States really wanted to reduce debt, instead they could offer free/massively reduced tuition at state med schools, but that prolly ain't gonna happen since all trends are in the opposite direction. And, of course, if they did try to reduce tuition (or otherwise reduce costs) to attend med schools, the other health care schools will jump right in line (nursing, dental, pharm, etc.). :rolleyes:</p>

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<p>There is no way out of risk, boredom, anger, frustration, and tedium in life, no matter which profession we pursue.</p>

<p>I'm a college professor and my colleagues complain about grading papers all the time, especially the English professors. (Come to think of it, so do I!)</p>

<p>We also bemoan our low salaries, which actually are pretty good when amortized across the hours we actually are required to work.</p>

<p>It's the nature of the beast. Working is annoying sometimes, and often very rewarding. And sometimes others make it more annoying by introducing rules and practices that make our jobs harder. (Exit exams in English classes are like this IMO.)</p>

<p>I admire my doctors and am glad they're there.</p>

<p>I have a harder time with business, but it's just my personality. I am not an entrepreneurial kind of person. H owns a business, not a venture capital type business, a modest business, and if he didn't love it his life would be miserable. He works six or seven days a week, has no benefits at all. Some weeks he has a lot of money to throw around. Some weeks I'm VERY grateful I did not give up on tenured teaching job when the kids were born.</p>

<p>I think a kid knows if s/he is a doctor or not, just as a kid who wants to be an actor will probably not be dissuaded by having to bus tables.</p>

<p>And I was not detoured by the dissertation I had to write without knowing if I would ever get a job.</p>

<p>I could tell my D that there are too many lawyers already, until I am blue in the face, but it's the only thing she's ever wanted to do. I say, "go for it," even if she never works as a lawyer.</p>

<p>Long post, sorry, to say, fit is mysterious. Each has to decide for himself.</p>

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<p>Thanks Curm - I've followed your D's story on here for a couple of years and have been cheering for her just as long! She's headed in the direction her heart is leading her and for all the right reasons.</p>

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<p>
[quote]
While universal health care has been discussed on different threads, I'd like to respond to your thoughts about less med school debt: perhaps, but I've never seen any proposal from universal health care supporters that say then intend for the Govt to pay to send kids to med school. Anything is possible, but that one I kinda doubt.

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<p>I was trying to offer the most optimistic situations possible, but I agree that it's a long shot. </p>

<p>Realistically the current probability of sorting out all the current problems is probably quite slim... it very well may take a self destruction of the industry to get something done... hopefully the politicians will stop fighting and get something done before then, but don't hold your breath.</p>