<p>A recently resurrected ( by Rocketman08 ) thread.</p>
<p><a href=“http://talk.collegeconfidential.com/careers-medicine/74417-career-medicine-really-worth.html[/url]”>http://talk.collegeconfidential.com/careers-medicine/74417-career-medicine-really-worth.html</a></p>
<p>I think it would also be interesting to poll younger docs. It is very clear that medicine is harder to practice in today’s climate than 20 or 30 years ago. It doesn’t surprise me that older physicians are becoming more disillusioned. However, I imagine the lower salaries, higher malpractice premiums, etc. will be easier for younger residents and physicians to stomache because, presumably, they would have been aware of these difficulties upon entering med school.</p>
<p>Despite everything, we are reaching a record high in the number of medical school applicants and the average GPA/MCAT score continues to rise (it’s at about 3.7/32 for ORM’s).</p>
<p>I don’t think managed care is the same as having a boss in a job. Presumably in most jobs, your boss actually knows more than you or has somehow paid his/her dues to have that position. Assuming it’s not an unfortunate situation, he/she knows enough to supervise you. That is not the case in managed care as the person making the decisions has nowhere near the training that the physician has. Neither are they actually seeing the patient. They are thirdhand making decisions. MDs have a license to practice medicine but then have someone who is unlicensed micromanaging their practice – it is not the same thing as having a boss. In what other profession does someone less qualified than the professional get to tell the professional how to do his/her job?</p>
<p>“I can do the above without having to go to med school which requires lots of effort and hardwork than my career. Not to say one has to graduate with a lot of debt too. I would say no.”</p>
<p>Well, everybody makes choices, and choices have good and bad. I’d rather be an unhappy md, than a guy getting laid off at 50 cause of corp downsizing.</p>
<p>“all these ‘21st century corporations’ that are scooping up today’s PhDs, paying them very decent salaries and putting them in a ‘Google’ style corporate world”</p>
<p>I guess I would ask are there that many? and remember for every start up success about 50 others failed… But I understand your point. Had I applied to work at as a janitor at microsoft when it opened up back in the day, I would have already been retired prior to 40 as a multi-millionaire, no phd required. 
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<p>“It FEELS like nobody else has to carry 3 million plus dollars worth of insurance coverage ( cheap for a doctor, but hey, I just mess with peoples minds!).What do other professions carry? Tell me more…”</p>
<p>I carry that much too. E&O coverage for insurance and securities business. </p>
<p>"I don’t think we’re talking about average jobs we’re talking about jobs for folks with extensive education and doctorate degrees… so these sorts of folks are usually in positions with a lot of independence over what they do. "</p>
<p>ever talk with a teacher? 
Ask em about their prinicpal or school board sometime… </p>
<p>"Presumably in most jobs, your boss actually knows more than you or has somehow paid his/her dues to have that position. "</p>
<p>I’m guessing you’re still pretty young. </p>
<p>“MDs have a license to practice medicine but then have someone who is unlicensed micromanaging their practice – it is not the same thing as having a boss.” </p>
<p>yes, it actually is because the feeling is exactly the same. </p>
<p>Folks, my point all along is be happy in what you do, look around long and hard and realize that others have it much worse and much better, no sense worrying about what your neighbor has or hasn’t. Be glad if you’ve got a spouse who loves you or kids who still enjoy you and aren’t either hooked on drugs or pregnant without a relationship. </p>
<p>And for crying out loud try camping sometime in eastern WA. It cures what ails ya. Have your “happy place” where you bake in the sunshine, the sky is blue, the water warm and the lake is huge…</p>
<p>"Presumably in most jobs, your boss actually knows more than you or has somehow paid his/her dues to have that position. "</p>
<p>“I’m guessing you’re still pretty young.”</p>
<p>Your guess is incorrect. I’m old enough to have a kid out of college and in the work force.</p>
<p>Man, Opie! I guess I know why your kids aren’t going into the securities business. I don’t even know what that is but it doesn’t sound good.</p>
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<p>I wasn’t specifically referring to startups, but you’re right in pointing out that working for one, in any sense, can be a risky venture. However, I was trying to make the more general point that most companies treat their highly educated employees (e.g. those with a doctorate) in a much more trustworthy manner than the average MD is treated by their ‘boss’ be that a hospital or HMO. Not every company is Google (and not everyone would like working there) but on average I think it’s safe to say that you’re average PhD working for a company would say they’re far more valued (in terms of their input taken at face value and implemented because they’re the expert) than the average MD in managed care (where the MD may have initial input but someone with far less training gets to make the final call). </p>
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<p>There aren’t that many teachers with doctorates (although I did have one in elementary school). Again, I think the discussion points are in regards to those that have extensive higher education in a particular specialty. You can’t really say that well the average office worker with a Bachelors degree is quite miserable so that’s no different than the MDs. The comparison is between those that have a similar amount of highly specialized advanced training and how they view their career situation. </p>
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<p>I agree with some of the others in thinking that no it’s really not the same at all. Again, we’re talking about those with highly advanced training (not just an average job where someone has an idiot incompetent boss). In most other cases that I can think of with careers for advanced degree holders the person with the degree has a lot of independence and their expertise is taken at face value. Yes, they might have a superior or ‘boss’ but that ‘boss’ would almost certainly be able to do the job of those that they’re in charge of overseeing (e.g. a the ‘boss’ of a PhD at a scientific company may be a research team leader who has the same degree but more experience or the ‘boss’ of a PhD administrator is likely a more senior executive who very well may have previously held the same post). As mentioned by mimk6 the ‘boss’ of most MDs is someone with far less training and expert ability and thus having decisions, micromanagement and policy directives coming down from those much less qualified than you is a very different situation.</p>
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<p>That would be very consistent with the sort of responses we were hearing as one of the leading causes of discontent. The “why did I bother to go to school for so long and endure the hardships of med school and residency only to let someone else without any of that training tell me what happens to my patients” complaint.</p>
<p>And while I have learned something about securities, I don’t believe any managed care “bosses” have to carry 3 mil med mal and deal with what a suit, or even a complaint, can do to a career. BTW, one nice thing about Kaiser is that many of the decision makers are in fact physicians.</p>
<p>It’s been my observation that most professionals aren’t happy with their career choice. I hear my lawyer friend’s tell me not to advise my son to go to law school. It’s just the nature of the beast.</p>
<p>I think it’s very common for practicioners in a prestigious field such as medicine to try to discourage people from entering their field. I encountered this myself. It’s funny. Practically all my friends were the children of professionals, and most of them were told by their parents that it “wasn’t that great” to do what they do. A lot of them chose a different professional career (instead of medicine, they became a scientist or went on Wall Street, for instance.) It was almost like the next generation was playing musical chairs. Their parents were a doctor, so they became a lawyer because their parents complained about being a doctor.</p>
<p>Nothing is that great. As a professor, you have to write grants every day and the future of your lab is always in question. In Wall Street, people can be pretty cut-throat I’ve heard. In straight business, all people care about is making money. I think since medicine is idolized by a lot of people, practicing physicians seem to need to puncture the bubble for aspiring doctors. I think they overdo it a little.</p>
<p>And there are many things you can do with an MD besides just be the family doctor. (In fact, this has become enough a problem that a med school I work at did a study on how many people go onto careers other than the practice of medicine.) You can make just as much consulting. You can do research in biology without any extra degrees. Some people get a law degree afterwards instead of doing that residency and go into patent law or do law related to HMOs. Some people go into business–hospital administration and business related to medical products. In fact, Harvard has a joint MBA–MD program to encourage this.</p>
<p>In some fields, I think it is legitimate to think long and hard whether you have the right temperament for it. Social work comes to mind. You work hard for little pay, and often the very people you help are at odds with you. And if anything goes wrong, you get sued. You really have to be altruistic to do it. But with medicine, if you are interested in biology and enjoy personal interaction, what more is there to think about? Unless you have an equal interest in something else, you should just go for it.</p>
<p>“I think it’s very common for practicioners in a prestigious field such as medicine to try to discourage people from entering their field. I encountered this myself.”</p>
<p>It is a recent phenomenon.
We have two generations of physicians and four generations of lawyers in our family.
My family did not try to discourage me from doing medicine; I on the other hand have semi-actively discouraged my son from doing medicine. And this has been happening across our family. As a result, virtually nobody from our extended family are going into medicine.</p>
<p>On the other hand, I don’t see the lawyers in our family discouraging prospective lawyers. As a result several of the younger generation are going into law.</p>
<p>OP: Make sure your son talks to young doctors before making any decisions. </p>
<p>My friends, who are doctors in their late 40s, say that they were trained in the old, pre-HMO system, and adapting to the new rules is one of the reasons they are unhappy. Younger docs never knew the “old” way and so may have a different perspective on the profession.</p>
<p>Also, there are lots of careers in health care – it is a growing field. One doesn’t have to spend years on education to be a doctor to work in health care.</p>
<p>The MD/PhDs in all Pharma companies I have worked with generally get starting salaries of $170-180,k/year…which is way more than PhDs will ever get paid in these positions. I am speaking from experience having worked in 3 of the top Fortune 500 Pharma companies in the last 18 years.</p>
<p>It’s no small change IMO.</p>
<p>I am purplegirls mom, my husband saw this and posted earlier. I am an OB/Gyn, my husband an internist and my brother-in-law a pediatrician. I think anyone thinking of going into medicine should see there are no posts yet on how great it is, only how bad it is right now. We doctors who have been in medicine for more than 20 yrs are really upset how things have turned out because we know how things were in the past and are very concerned about the future of medicine. Students today won’t have that knowledge and we don’t know what the future of medicine will be. The current model isn’t working and is near collapse, so the future is scary. In our defense, we studied hard, worked 100 hrs work week, took out loans, and gave up our youth to be physicians. When we entered the work force at age 31, we were paid fairly, able to pay back our 100,000$ loans, save money, buy a house, raise our families, etc. In addition to financial security, we had the respect of our patients, neighbors and friends. Well just about all of that has changed. In my field, my malpractice insurance is currently 172,000$, projected to go over 200,000$ in July, my overhead for the office is 70%. Reimbursements from the insurers are 30% of what they were in 1990! when my malpractice was 88,000$ a year. Right now, here in NY, young physicians are leaving the area, forced to work in less desirable areas, because we cannot afford to hire anyone. Two of my male partners, one much older than me has to moonlight to pay his bills. I’ve seen many collegues already lose their homes, and get divorced over the financial woes. In addition to that, patients have become more demanding and have lost respect for us. They believe what they read on the internet as gospel rather than respecting the advice we give them, despite our years of experience. They demand expensive MRI’s, hormone tests, sonograms, etc. but nobody wants to pay for this. Medical care costs are rediculous but why do you expect to get our service for free or at little cost but you have no problem paying someone 50 to 100$ to cut your hair, or $300 for your Coach pocketbook, but fight us on your $15 copay that we need in order to keep our business open because your HMO isn’t paying us enough! We are disgruntled because, the doctors have been forced to subsidize your healthcare for years, not the insurers. We’ve taken a big hit, and until now no one cared because we are still seeing patients, trying to give first class care at bargain rates. I love what I do, and there are patients who appreciate us and care, but it is coming close to the point where we won’t be able to keep our business going at these rates despite our busy practice. So not everything is what it seems on the outside. Things will have to change, because you can’t expect our brightess children to graduate with over 250,000$ in loans, no way to pay it back. The way things are now, young doctors will have more hard decisions to make than we had, regarding where they can live and still make a living paying back the loans. Unless they do plastic surgery or dermatology, they will most likely not be their own boss and won’t be as happy as we and our patients once were. My children will need to follow their own path and maybe practicing medicine in this country will again become a great profession but for now they will have to think long and hard if it’s worth it. I hope things do improve in my lifetime. It is in the hands of the goverment now. Sorry, but your children need to know what they are headed for.</p>
<p>S1 was set on medical school, but after speaking with a cousin (Chief Resident at a prestigious hospital) he is having second thoughts. Cousin graduated from a top Ivy (felt it gave him no edge in med school), worked hard and now is faced with almost all that purplegirls mom described. He says he would not do it again, he would like to go into research and wishes he would have gotten a Ph.D. instead, and have much less debt.</p>
<p>Purplegirl’s mom, thanks for your post.</p>
<p>Do doctors make $150,000 net a year and more?</p>
<p>With all the costs and headaches, do OB/GYN’s make over $200,000 + a year after expenses?</p>
<p>I see costs and problems for doctors exploding. I am trying to get an idea how doctors do after these problems are taken into account.</p>
<p>If medical school cost half as much would you change your mind?</p>
<p>purplegirls mom, Thanks for that insight. I truly think the public is on the side of the physicians. I think the average American thinks a physican should be highly paid and live a decent life free of financial concerns in compensation for the truly essential services provided to the local community. However, I think the problem is that the average person on the street really doesn’t know what the current situation is in the sense that the physicians are getting screwed over just as much (if not more) by the HMOs as the patients are. The average person sees ‘TV doctors’ being portrayed as being worry free, having lots of money and lots of free time. They also see something in the press saying the salary for such and such a position is $200k and they think hey they must be rolling in dough. Of course they don’t realize that the difference between the physician’s ‘salary’ and what actually gets deposited into their checking account, their ‘actual salary’, can be quite drastic. All this is in part I think why you still see young naive folks saying ‘yeah I gonna be a doctor and make the big bucks and have a lavish lifesytle’ like many seem to often say over on the pre-med forums. There’s clearly a lot of discontent behind the scenes on behalf of the physicians, but in public the only real complaints and lobbying seem to be coming from the patient side of things. Perhaps if the physicians got the word out a bit better more people would understand what’s really going on. At the moment, the HMOs have a chokehold on the system but perhaps if serious public pressure comes from both sides (patients and physicans) will finally convince enough people that the ‘corporate middleman’ model we have now must go. </p>
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<p>Well yes, but you’re comparing apples to oranges. I don’t think it should come as a shock that someone with both an MD and PhD who is working in a, at least partially, clinical environment for Pharma (e.g. testing and development) is going to make more than someone with only the PhD working on purely laboratory based research. And there are certainly PhDs (or MD/PhD), e.g. those that move onto a management track and are one of the executives at the Pharam company, that could still make more than that. The same is true of a science PhD working in the Pharma arena via consulting where, after a few years, making those amounts or more would be quite normal (that is often the starting point for some that go onto be the execs in Pharma since they then have both the biz and scientific expertise). </p>
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<p>Well yes, all that is certainly true but again I just don’t see why one would go to med school if, before starting, they knew they didn’t want to practice medicine (given, for one, the extreme cost). Those are all decent ‘exit options’ after the fact if a med school graduate doesn’t want to practice medicine but I can’t see those being decent ‘entry options.’ Take the consulting example… every firm I’ve ever known about hires MDs at the same level as PhDs (except the MD likely has six figures of debt from their degree but the PhD, especially if they were a science PhD, likely has none). And a law degree after med school? Well law school ain’t cheap either so taking on another 130+k or more of debt on top of everything else is a bit insane. So yeah, you can do all those things but if the intent up front is to enter law, consulting, research or admin then there are much better, and less expensive, paths to take.</p>
<p>Some other physician feedback I found in an old thread on the Pre-Med forum…</p>
<p>From rds248:
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<p>From OldPerson:
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<p>It’s likely even worse than that. Consider if both the folks are running a private practice the plumber gets that whole $325 minus the costs of running his business which would include a truck, some insurance and his equipment… and last time I checked (which admittedly was never) state-of-the-art plumbing equipment costs a heck of a lot less than state-of-the-art medical equipment. </p>
<p>The physician gets that $125 and, before taking a salary out of that, has to pay all the costs of his practice including a staff and their costs, cost of his building (which is more than a truck) and malpractice insurance (the liability of a bad plumbing job is a lot less than a botched medical procedure). So in that case the actual income difference, in terms of amount of take home pay per X time worked, is likely even much more drastic than 125 vs 325.</p>