Saturday, November 5, 2011

Is now the best time to be a doctor? I think not.

Those of you who are physicians will be interested to learn that according to Dr. Bryan Vartabedian, who blogs at “33 Charts,” there’s never been a better time to be a doctor.

I won’t quote the post. It’s not very long and you can read it yourself.

I will admit that there are some things about being a doctor that are good today. Access to information has never been better. Communication is easier. New treatments are emerging.

But to say that there’s never been a better time to be a doctor than right now is ludicrous.

Where shall I begin? Let’s start with government and third-party interference, regulations, inspections, unfunded mandates, cutbacks, rollbacks and so on. Reimbursements for services are declining while the amount of non-clinical work is increasing.

How about the malpractice insurance situation? Neurosurgeons in parts of New York are paying premiums of over $300,000 per year.[See what any MD pays in NY here.]

Many are predicting the imminent demise of private practice.

Medical education is under fire with ratcheting down of work hours. Yesterday, I heard a Congressman speak at a surgical conference. He is sympathetic to physicians but predicts a 30% to 50% reduction in graduate medical education funding this year.

A shortage of physicians is on the horizon. Will anyone want to become a doctor?

I would like to see a poll of doctors on the subject of whether they think there’s never been a better time to be a doctor than right now.

I can think of a better time—the early 1970s. Doctors were respected. The cost for malpractice insurance for general surgeons was under $500 per year. Most people had medical insurance and the payments were based on fee-for-service. Charity care was undertaken willingly with because doctors were satisfied with what their incomes from insured patients. Was it perfect? Of course not. Are patients better off now? I don’t know. The news is full of stories about how doctors and hospitals are killing people every day. Medical errors are occurring in record numbers. Panic in the streets.

You tell me; is now the best time to be a doctor?


XOXO Dr. Kay Elizabeth said...

Maybe it's because I'm not in medical school yet, but I think it is the best time to be a doctor. Even if I had to do it for free, I would. Of course I cannot do it for free because I need to pay for the cost of living. I would donate my time and resources to help a lot of people if I could and was a doctor! So I know you're only talking to people who actually are doctors and have the opportunity to practice medicine but I felt compelled to respond. :)

drinkingfromthefirehose said...

Two separate questions here:

#1: Was it better (easier, more lucrative, more fun) to be a physician in the 1970s vs 2011 - yes, maybe, I dont know (I'm just a med student).

#2: Why do people in 2011 want to become physicians? Answer: because the alternatives are worse. Consider the employment market, then consider having a guaranteed salary of >100k (and in many specialties >200k), essentially guaranteed employment as long as you are diligent and conscientious (thanks to the physician shortage this will only get better). If I could hop in my time machine and travel back to 1970, maybe I would, but I can't - when I decided to go to medical school I was choosing between investment banking, management consulting, law school, academic economics, and a few other ideas. Okay, which of these careers is more attractive than medicine - Banking? Law school? Academia?

Being a physician-entrepreneur is much harder than it was 30 or 40 years ago - but being a physician trainees is easier (though still not a cake walk at 80hrs/wk). And frankly, if I wanted to run a small business, then I would have done that instead of going to medical school.

But, honestly, I didn't go into medicine based on some hyper-rational process wherein I weighed the risks and benefits of becoming a physician vs. working on wall street. I went to medical school because I fell in love with solving medical problems. I'm learning more and more during my surgery clerkship that I enjoy operating (read: cutting sutures, tieing knots and closing if I'm lucky). I work more, stay later, and read more, because I fell in love with medicine. Isn't that enough?

Skeptical Scalpel said...

Thanks for commenting.

@Dr. Kay

I admire your idealism and hope that you can sustain it.


Yes, it was better in the 70s. It wasn't easier. It was probably more lucrative. It was definitely more fun.

The problem with choosing medicine because the alternatives are limited is that you may end up with a lot of uncommitted people as doctors. Please see the blog I just posted today

Chris Porter MD said...

The best time for me is right now. I finished training in 2002, went through a burnout rut about two years ago and am back on track. I expect too, that I will enjoy watching medicine evolve over the next twenty years.

Blog post on my burnout:

Skeptical Scalpel said...


Thanks for the comment. Glad you made it through the rough patch. Good post.

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