tag:blogger.com,1999:blog-4968787219619380438.post1864338676683227639..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Choosing a Medical Specialty Is DifficultSkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger49125tag:blogger.com,1999:blog-4968787219619380438.post-91037825724595417912015-12-28T11:39:16.859-05:002015-12-28T11:39:16.859-05:00What would lead you to return to corporate nursing...What would lead you to return to corporate nursing?Hhttps://www.blogger.com/profile/01596213501702795592noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-10015688010965801332014-12-21T15:34:16.441-05:002014-12-21T15:34:16.441-05:00I don't think anyone is spending 24/7 at the h...I don't think anyone is spending 24/7 at the hospital these days, nor did they in the past. I think the concept of shift work has gradually taken over for attending physicians too. By the time you finish med school and residency, you should be OK. Private practice will be a distant memory by then.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-54012637246327418052014-12-20T20:58:19.071-05:002014-12-20T20:58:19.071-05:00Very intereting discussion happening here! I am a ...Very intereting discussion happening here! I am a gymnasium (last year) engineering student who's got many possibilities ahead, and one of them is medical university (if I can pass Biology- and chemistry classes after the Gymnasium). Since my knowlegde in math is very VERY low, I'm starting to find some interest in the medical branch. To me, passion is very important, and working at a place that you consider more a a hobby than a job is a big thing. What's the point of being an engineering student if you don't like math? So what's the point of going for medicine if you don't enjoy helping people? Is it because of the title? Well, you're NOT going to enjoy the rest of your life stuck in one place. If you find it amaing helping people and earning decent amount of money and STILL wanting to go back there and help more, than you've come to the right place, nothing else! <br /><br />I also have a question or two about the job as a physician: Is it REALLY this way, as the people say, about the fact that you either choose your career or your family? In that case, what's the point of really existing if you spend 24/7 in a hospital, tired and having your bank filled with money?I understand that while there are people who don't care about money, you must be realistic about the fact that most of us want to live in a decent place and acctually enjoy life once or so. Helping people IS my passion, but sometimes I need my batteries re- charged, and if I can't even do that, than what's the point of even having a name or even have a girl/boyfriend of even a family for that matter? I find this whole "family/career"- dilemma really stupid, and if you really don't get any free time to spend with people who acctually care for you, that why even bother worrying about other peoples problems, when youve got your own at hand?<br /><br />Sorry for this useless post, I'm just a really confused student who's got 6 more months to study at the engineering- preperation before I decide to either switch to medical or go along with engineering.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-85512505086660090932014-10-30T08:08:22.588-04:002014-10-30T08:08:22.588-04:00"Abolish the patient's right to sue"..."Abolish the patient's right to sue"? Good luck with that. With 80-90% of state legislators and Congress being lawyers, I don't think that's going to happen.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-15122569424238449002014-10-30T01:43:12.504-04:002014-10-30T01:43:12.504-04:00Ya know, the following line that I keep reading is...Ya know, the following line that I keep reading is really starting to grate on me: "you should have figured that out before you even applied to medical school". <br />So I won't bother to even address it. <br /><br />What I WOULD like to address is where exactly is this field going? What will the surgical profession resemble in the next hundred years? Will it go back to simply being overworked, jaded, harsh barbers with sharp knives? Because that's pretty much where it seems to be now. <br />Don't get me wrong; I love the field. But, I also love macaroni and cheese and motorcycles, both of which would kill me given similar excess which is required for this career. The suicide rate is real, and it scares me. The question isn't just whether my family is more important than my career or my patients...it is whether I am. I am the only me that I get to be. And, death is coming whether I'm a surgeon or not. <br /><br />As far as fixing modern health care that the "old timers" screwed up...well, it's pretty simple. Abolish the patient's right to sue. Place the emphasis back on actually being a good physician and a good person (shocker, I know) that patients can trust, and let the capitalist fundamentals work their magic. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-46100823083936628952014-09-16T09:07:34.468-04:002014-09-16T09:07:34.468-04:00Thank you for commenting and for the kind words. I...Thank you for commenting and for the kind words. If this post helped you, I'm glad. I'm sure you will be just fine. Let me know how it all works out. Good luck.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-90137141670288976402014-09-15T12:11:16.614-04:002014-09-15T12:11:16.614-04:00Thank you so much for this blog, it really opened ...Thank you so much for this blog, it really opened my eyes in choosing a specialty. I went into medical school mostly because there wasn't a lot of opportunities for my pre-med course. ( I know, it wasn't a very good reason, but there you have it.) However, along the way, I learned to really love my new "job", sure clerkship and internship were sucking my social life out but just that one heartfelt thank you from a mom whose child you were able to revive beats all the exhaustion away. ( I worked in a government hospital so when I say 36 hr duty, I really do mean a 36-hour duty). After internship,I was all set to become the greatest internist (neurologist) out there! <br /><br />But after passing the board exam, I became confused. Now, i'm not so sure about it because i think even after residency, i wouldn't be able to have much of a life outside of the hospital..am i getting this right? <br /><br />So now I have read all the comments here and one thing really stood out for me. Choosing medicine will dictate my life. Scary thought. But thank you for it. I am a female physician who wishes to have a family someday but i think until that day comes, i shouldn't plan my chosen specialty around it. I'll try to see how my life will be doing something i'm good at, really love doing and train to become better if not the best at it. If and when I doget around to having a family, i'll cross that bridge when I get there. <br /><br />Thanks again, i'll continue to follow your blogs, they are truly very helpful. anne_mdnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-2524584417207470972013-11-20T09:41:42.565-05:002013-11-20T09:41:42.565-05:00Michele, thanks for commenting and for reading my ...Michele, thanks for commenting and for reading my blog. You are right about specialties changing over the years.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-26497041492736662192013-11-19T14:01:42.948-05:002013-11-19T14:01:42.948-05:00Lots of great comments, I am having fun reading th...Lots of great comments, I am having fun reading this blog. <br />I chose plastic surgery because I found it fascinating. I set my practice up in St Louis because it was the best place for my family at the time. With that being said I think your specialty chooses you as much as you choose it. specialties have changed over the years and I think they will continue to do so. Anonymoushttps://www.blogger.com/profile/11767464975058939187noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-4857163872254156822013-09-12T11:26:30.742-04:002013-09-12T11:26:30.742-04:00Darrell, thanks for commenting. I read your post. ...Darrell, thanks for commenting. I read your post. Interesting, as were the comments.<br /><br />You make a good point about respect and recognition. They are no longer factors. Everyone is queuing up to bash us.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-20675936741351012832013-09-12T11:11:33.487-04:002013-09-12T11:11:33.487-04:00Greetings,
My response to the article in the WSJ ...Greetings,<br /><br />My response to the article in the WSJ in 2011 and the comment it elicited. http://drdarrellwhite.com/tanstaafl-and-mommy-track-docs/ <br /><br />The bilious responses on KevinMD.com when it was reprinted were of the same kind. The facts are the facts. Every physician makes a choice and every choice has consequences. Once upon a time there was an additional type of compensation showered upon us: respect and recognition for both our knowledge and the significant sacrifices we'd made and continued to make. By and large this "compensation" is no longer a part of the equation, and thus the calculus of whether our sacrifices at all points of the journey is dramatically different. <br /><br />Even for dinosaurs like us it really DOES feel more like a job now, doesn't it? <br /><br />The entire healthcare system, in all respects, is being bourn on the backs of mid-career docs of both genders who continue to behave in their practice lives as if we still live in a world that treats us like it is 1982. As we retire, cut back our hours (as I admit I've done), reduce the amount of work we do per hour (ditto), the true cost of the work/life balance compromise will be dramatically exposed. <br /><br />I wonder how everyone will feel about that...Darrell White, M.D.http://www.drdarrellwhite.comnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-23408327921458585462013-09-12T10:19:56.166-04:002013-09-12T10:19:56.166-04:00Anon, I agree you are fortunate to have found what...Anon, I agree you are fortunate to have found what you don't like about EM before you committed to it as a career. Thanks for giving us a different perspective on the life of an ED MD.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-11351686778976019382013-09-11T22:15:42.605-04:002013-09-11T22:15:42.605-04:00As an Australian intern, I found that working an 8...As an Australian intern, I found that working an 8 hour shift in the EM was far more exhausting than working a regular 12 hour shift on the surgical ward. EMs are MUCH busier than they used to be. In Australia, the pressure to get patients up into a (bedblocked) ward before the 4 hour time limit imposed by bureaucrats is enormous. Juggling four undifferentiated patients at once is a completely different prospect to juggling 12 or 13 mostly stable surgical patients whose problems you have a good handle on. Towards the end of shift, I simply feel as though I don't have the concentration span left to adequately get a fix on a complex patient's problem.<br /><br />This is probably more of a junior doc issue, as I see terrific EM consultants handling 6-7 patients at once with ease - but they still experience extraordinary stress and pressure, even if they do get to leave it all behind at the end of their shift...<br /> <br />I think the problem in EM is that there is only so much new information in relation to a totally unknown patient that you can process in a certain period of time, and still perform well. That is the fundamental difference between EM and ward work, at a junior level at least. <br /><br />I used to think that I wanted to specialise in EM, given it seemed relatively flexible, but after my intern rotation I realised I simply hadn't comprehended the toll it took on me. I still work a day a week in EM and really enjoy it, but I doubt I'll specialise in the field. I think I am just lucky that I realised all these things before I chose it as a specialty, perhaps unlike the author of the post.<br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-24927526791412321902013-09-10T08:43:35.135-04:002013-09-10T08:43:35.135-04:00Anon, good points, but as you can see from the abo...Anon, good points, but as you can see from the above, not everyone has figured it out. And I'm about to post yet another Q and A on this subject on my other blog "Ask Skeptical Scalpel."Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-10978690904582413312013-09-09T16:59:32.764-04:002013-09-09T16:59:32.764-04:00Medicine is not a job that you go into for money. ...Medicine is not a job that you go into for money. Medicine is a passion. You have to want the best for you patients. If you choose medicine it is a choice that will dictate not accommodate your life. You should have figured that out before you even applied for medical school. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-70705223020260151702012-12-05T07:19:54.894-05:002012-12-05T07:19:54.894-05:00It is difficult to choose medical specificity. Kno...It is difficult to choose medical specificity. Know the details from here<br />Plastic Surgeryhttp://www.laderma.com/noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-36947466198669184572012-11-25T10:08:38.412-05:002012-11-25T10:08:38.412-05:00As some one that has an undiagnosed medical proble...As some one that has an undiagnosed medical problem I have to look at the question as what ever Medical Specialty one choses then need to put many hours kepping up with all the new studies related to that specialty. As to a Dr having a 9 to 5 job if that is all the time they are spending then they just are not doing there job.<br /><br />frankbillhttps://www.blogger.com/profile/05592389641852861124noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-19098660886655719522012-08-22T12:04:45.358-04:002012-08-22T12:04:45.358-04:00I am so touched by your anguish. My heart goes out...I am so touched by your anguish. My heart goes out to you. Your last paragraph sums it up. I wish everyone could read it.<br /><br />It was easier for us. There were far fewer women in medical school. My class of 180 had 20. Our chances of marrying another doctor were much lower.<br /><br />I have no way to contact you but feel free to email me if you want to discuss this further. I am thinking of using your comments as the basis for another blog on this subject.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-46391983718667663642012-08-22T10:29:08.116-04:002012-08-22T10:29:08.116-04:00Since you are so senior to me, let me ask you for ...Since you are so senior to me, let me ask you for your thoughts. I got into medical school, studied ,worked hard, got into residency and learnt, spent hours and hours in hospital, loved critical care and got into fellowship. Along the way met a guy ( both were residents at that time) ,fell in love and we both dreamt and read and learnt and discussed cases. He decided on cardiology and I decided on critical card. Both got into fellowships ....worked hard, spent long hours into fellowship...we were committed. We ARE committed but divided.... We had kids and now everyday i I feel divided. I have a feeling that all "old timers " like you who worked formlongerbhours and did frequent niight calls , had " spouse" who take care of your kids and you did not have to worry as much. Times were different. Times were not so dangerous and kids safety outside of the house was not so concerning. <br />In my situation, me and my spouse are both physicians in fields that requires us to spend lots and lots of hours in hospital. If I were to find a traditional practice and work every 3 rd might" who will raise my kids. Who will teach them right from wrong. Everything is on rise- drug abuse, physical abuse, drop out rates. I WANT to raise my kids and be there to guide them . So yes I want a practice where call frequency is lesser, where I can spent evening with my kids ( not because I want to have fun but I want to be there) . <br />We do not think about all this when we get into medical school and I did not think about this when i married my husband and we did not think about this when we chose our subspecialities. Perhaps that was a mistake.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-11772752697079048822012-08-21T22:36:55.773-04:002012-08-21T22:36:55.773-04:00I appreciate your comment. I appreciate your comment. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-67294858488892891042012-08-20T21:45:29.584-04:002012-08-20T21:45:29.584-04:00While I am not a physician I worked closely with g...While I am not a physician I worked closely with general surgeons for many years and agree with Dr. Eastwood, The work of (good) surgeons is close to heroic...And they do it every day! <br />Grace under pressure. . that describes surgeons.<br />DDAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-16102913238399589372012-07-14T23:05:37.801-04:002012-07-14T23:05:37.801-04:00Eastwood, thanks fr the great comments. You make s...Eastwood, thanks fr the great comments. You make some very god points. Yes, I was exaggerating about working Navy hours. Many thought I was serious though. It must be difficult being a med student now, especially if you are a woman. I wish you all the best of luck.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-85888563109781202182012-07-14T21:31:56.852-04:002012-07-14T21:31:56.852-04:00First off, as an M2 I disagree with Anon #1 about ...First off, as an M2 I disagree with Anon #1 about stricter screening of med students. This woman’s problem was in her chosen specialty, that doesn’t mean she can’t be a good physician. It seems to me that she just chose poorly and while I do think it’s bit ridiculous that she didn’t know better, we students also only get a couple months in a specialty before we are supposed to decide what we want to do for the rest of our lives. Some know before they ever enter school, but I also know people who said they were absolutely positive they didn’t want to do a certain specialty and a couple years later ended up choosing that same specialty. And one must realize, many of us (not myself) are roughly 26 years old making these decisions, before we have any idea of what it takes to have a successful marriage and family. <br />Women that choose to go into medicine do have a lot more things to consider; fair or unfair, biology has dictated that. Which brings me to another point to those that think my generation’s doctors (particularly surgeons) are “soft” or “weak”. Society and the economy is different today, most families that are fortunate enough to still have both parents under the same roof can’t financially afford NOT to have both those parents working. My generation doesn’t have the luxury of previous generations that were the traditional make-up where the man goes to work, the woman stays home, and that was that.<br />On the navy work hours, I’m assuming you’re being sarcastic. Those hours are set for a very specific niche, one that needs to be constantly watchful of someone trying to harm them and everyone is confined on a ship with nothing else to do anyway. Those hours are not conducive to a “normal” life (e.g. they don’t have to consider families, there aren’t any around), nor are they kept for any length of time close to a lifetime, hence deployments tend to be 6 months. But work hours do need to be addressed (see below).<br />To the Anon that mentioned “tours of duty”, not only is that comparable to a draft in which we would actually be paying hundreds of thousands of dollars to be a part of, I really don’t think you want every med student to be in the ED. I know many classmates that just couldn’t handle the gore or stress that EM provides.<br />And I don’t think you “old docs” destroyed medicine, in fact, medicine today is what its is because of you, good and bad yes, but one should remember that we also have the best healthcare in the world. But I truly do hope the days of working for what amounts to a couple dollars an hour are gone for good. It was completely unfair to your generation that you were compensated in such a way for what is one of the most demanding jobs ever. In just one year of med school I have realized many sacrifices that I have had to make in my life to get here, and I realize that there are going to be a lot more. And while yes, it is also one the noblest professions, I don’t think it’s right to ask of us to sacrifice the best years of our lives, our families, even our health, and saddle us with hundreds of thousands of dollars debt just for the privilege of saving lives or so we can go on to not have a good family life.<br />And to whomever thinks being a doctor is no more noble than an engineer, you obviously have never worked as both (see above paragraph). I personally feel being a physician, a good one, is the most noble AND the most stressful job in the world, but I am biased for sure. To comment on something I know Dr. Scalpel has mentioned before, I believe being a surgeon is even more stressful than an airline pilot, the commonly reported most stressful job. A more proper comparison would be more like the pilot magically finding himself beamed into a plane at 30,000 feet and the plane has some kind of mechanical malfunction; oh and the pilot has to go out on the wing and fix it himself, or everyone dies. Again, I’m probably biased.Dr. EastwoodCJhttps://www.blogger.com/profile/11926779570067114584noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-59694552526771829782012-04-24T20:07:51.917-04:002012-04-24T20:07:51.917-04:00Jakob, thank you fr commenting. I hope you achieve...Jakob, thank you fr commenting. I hope you achieve your goal.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-29465707261806818352012-04-24T18:41:25.467-04:002012-04-24T18:41:25.467-04:00im 12 and i want to be a cardiothoracic surgeon so...im 12 and i want to be a cardiothoracic surgeon so your kind of a role model.Anonymousnoreply@blogger.com