Tell me being a doctor is still a good profession after hearing so much negativity?

Hi all,
I have a high school senior who is determined she wants to be a doctor in the future. Obviously she could change her mind through undergrad and go a different route but she is one brilliant and determined girl who has always dreamed of being a doctor so just may end up there. My question is in regards to the amount of people who say to her “why the heck would you want to be a doctor when doctors seem so miserable right now” and then talk about all the negatives physicians face. She recently shadowed a Hospitalist at our local hospital who said “just don’t be a hospitalist” but did not give much for the reasons he doesn’t like that. We know a few nurses who have said “every doctor they know hates their job, being a nurse is a much better choice”… SO I am just wondering if someone can restore my faith in the profession (not the process to get there, I know that is incredibly hard and lots of debt, etc.) and that there really are happy/fulfilled physicians out there who do not regret their choice?

I know plenty of happy physicians of all ages. Some specialists in hospitals, others who forged their own way in private practice. Sure there are challenges and lots of changes with payment and the trickle down impact to patient care, but every career has it’s own set of issues.

There are much easier ways to earn a living but if this is your daughter’s passion, support her and let her follow her dreams.

She does need to be realistic that (1) being a doctor isn’t just about caring for patients — there is a lot of paperwork, occasional insurance wrangling, and ongoing training. (2) Don’t see it as a way to make a lot of money. She might, she might not. (3) It can be repetitive. You may see the same types of illnesses all day long. I wouldn’t discourage my kid, but I’d make sure they know the pros and cons.

There is a lot to unpack, I work in healthcare (business side) and also have a senior daughter who has always wanted to become a physician. I know some happy physicians and others who aren’t, and MANY who have left private practice to work in the business world—e.g., drug development or hospital/practice operations consultants, at pharma companies, at insurance companies as medical directors. There are high rates of suicide, alcohol and drug abuse among physicians.

We all know it is a long road to become a physician and expensive, with a more uncertain financial payoff than before (among other considerations). Physician business models are changing and will continue to change, it’s not just more paperwork and needing to hire employees to deal with said paperwork, regulations, and insurance companies. It’s also that more and more physicians and their practices have become either employees of hospitals, or their practice is owned by hospitals/larger companies. For example, oncology used to be a very lucrative area, partly due to the fact that oncologists could make significant profit on drug treatments they administered in their offices. Private and government insurance changed reimbursement models so that there are lower margins on drug admin. As a result, many oncology practices have sold to hospitals/other larger healthcare companies because it became harder to make $.

Most physicians are in primary care (FP/GP/IM, pediatricians) and the financial payoff is not what it used to be…especially if one lives in a high cost of living area and/or has student debt (most do now, it was different 30 years ago). It is very competitive to become a specialist, which is where the higher salaries are and/or greater potential for business profit. Physicians will never be solely in charge of their practices and businesses, their are so many variables and ways for the government, private insurers and other companies to directly impact how physicians can structure their days and how they can make money.

Women physicians have the additional issue of figuring out when (and if) to start a family. It is very difficult to have children when you are in med school and residency. But, it’s also difficult to have children when one is just starting out (finally) as a physician, in early to mid 30’s.

For your daughter, I would have her continue to get healthcare delivery experience, and shadow where she can. Hopefully she will gain exposure to physicians with different viewpoints than the hospitalist. I would also have her read physician blogs (in her spare time!) to get a sense for what physicians’ lives are like, their concerns, and how things might be different by specialty and gender. There are many physician blogs, but as a start have her take a look at KevinMD.com, Life of a med student.com, futureproofmd.com. For the business/money side: whitecoatinvestor.com, for medical/globalhealth/economics: incidentaleconomist.com

Good luck to her with her college decision and beyond.

I think the hardest part is the rush with patients. And the uncertainty of some diagnoses and treatments. They aren’t the omnipotent healers we see on tv. I have involvement with a large number in a context where practicing doctors educate/mentor and every one of them found their niche, is happy to work with the next generation. And financially doing well.

I dont think shadowing is an accurate view. It’s watching. Has she done more?

I can understand your concern. My son is studying to be a veterinarian and his girlfriend to be a doctor. They hear many of the same things. They are in college and have worked with vets and doctors and have seen the good and the bad. They both have told us that you have to realize it isn’t all unicorns and rainbows. It is VERY hard work, can be emotionally exhausting and frustrating, but can also be very rewarding. My son was told “If you can see yourself doing ANYTHING else do it. If not go for it with your eyes open.” Money isn’t there like it was. Reward vs. the amount of time you put into it probably isn’t where it should be. Then again neither is becoming a teacher. Where is your passion and are you going in with your eyes open? My friends mom told me just the other day to tell S’s gf not to become a doctor. She said her daughter had no time while she was working and is a totally different person since she retired. Then I talk to my friend and she says that overall it was worth it. Different perspectives.

Bottom line is if she is passionate go for it. In college continue to work with physicians, continue to look at the career and at other options. Then she can make the best decision for her.

Both of my daughters are physicians. It’s a career that both choose, but one that I (not so secretly) wished they hadn’t pursued. (They both had math degrees so they could have pursued careers in a variety of industries. And both had very viable Plan B careers they would have been happy --and well paid-- doing had they not gotten a med school acceptance.)

Becoming a physician requires jumping through very many hoops and a very lengthy training process. Minimum of 7 years. For D1 it’ll be 9 years and for D2, 11 or 12 years. That’s a long time to put your life on hold. Plus the process is expensive at every step of the way and puts most young physicians into substantial debt for many years after they finish training.

D1 who is in the process of finding her first “real” job after residency/fellowship says that the one thing she wished she had known before starting this very long process was that she was going to be treated as an interchangeable commodity by employers once she started her work career–a body to fill X shifts/months for $Y/hour. She also wishes she had known about PPH put-through minimums, and bonuses tied to the number of hospital admissions and extra tests she orders each year. That’s not what she signed up for when she chose medicine.

Despite all this, she still loves what she does and is still glad she’s chose this path.

I would suggest your D shadow some physicians–but to remember that people seldom air job complaints to students. If she can get some clinical volunteering–even better. Try a local nursing home so she gets a chance to see close up what it’s like to deal with the chronically ill and demented on a daily basis. It takes a special kind of person to be able to deal with the elderly & demented, the chronically ill, the mentally ill. the disabled, and the other disadvantaged among us–and these are who her future patients will be. Patients aren’t clean, healthy, happy people–even in mostly “happy” specialties like pediatrics, OB/GY, derm.

Things I worry about as the mother of female physicians:
Doctors have higher rates of depression and suicide than any other profession
Doctors have high rates of burn-out
Female doctors still face institutionalized gender discrimination in most specialties
Doctors see all the seamy side of life and its effects on my daughters’ empathy, emotional well being and idealism
Finding a healthy work-life balance, esp during residency

[Medscape Physician Lifestyle & Happiness Report 2018

[url=<a href=“https://www.medscape.com/slideshow/2018-compensation-overview-6009667%5DMedscape”>https://www.medscape.com/slideshow/2018-compensation-overview-6009667]Medscape Physician Compensation Report 2018](https://www.medscape.com/slideshow/2018-lifestyle-happiness-6009320)

[Medscape Residents Lifestyle & Happiness Report 2018](https://www.medscape.com/slideshow/2018-residents-lifestyle-report-6010110)

Yes, have heard the same from a number of physicians. So many metrics measuring everything, comp tied to achievement of these metrics.

Adding that many patients perceive physicians as just another service provider, which is a relatively new phenomenon. There seems to be an overall lower level of respect for the profession… it is a more transaction based relationship for many…“I need my prescription refilled” (without wanting to do another visit), “I need my kids’ school/athletic forms signed”, etc, etc.

I think those transactional needs have been there for a long time. As an adult, I’ve always been annoyed at needing an appointment for those things, and that goes back to the 80s. Taking time out of a busy work and parenting life is annoying. Just saying, that isn’t new.

I wouldn’t say nursing is better. In the hospital setting, they deal with what the docs don’t. Their satisfaction also depends on the workplace, pay, and sort of patient issues in that setting.

I agree about working in a clinic. Or having some responsibilities in a specific hospital dept. It’s not just the elderly or dementia patients that challenge. It’s also the needy, the frazzled and scared.

And a Physician’s Assistant program is also an option. Does she even know what sort of medicine interests her?

^^^Yes, true, but the ‘just another service provider’ is new, at least as heard from some long time docs. The transaction based nature, flexibility and convenience are reasons the pharmacy based (CVS, Walgreens, etc) in-store clinics and non-urgent care centers are doing so well…it’s easy to get appointments, longer hours, etc. For physicians, today there is greater liability in not seeing a patient as required for refills, along with a more rules and regulations from public and private payers and institutions governing these behaviors.

I just finished reading Andrew Yang’s book “The War on Normal People”.

It’s about the next reat disruption, when AI (artificial intelligence) takes over and dramatically changes many, many, many jobs.

Before reading the book, I could definitely picture AI muscling its way into lower skilled jobs (fast food), call centers, and manufacturing.

But after reading some of the scenarios in the book? Oh boy. I suppose there are BIG changes coming our way, that are simply difficult to wrap one’s head around. For example, in 1994 could we picture how different the world is in 2018?? with not only personal computers, but smart phones and social media, etc.?

Yang argues that big changes are coming our way, and not just for low skill jobs. He gives an example of AI doing a more efficient and more accurate job of reading X-rays and MRIs and CT scans. An example of AI performing the first tooth implant in a human patient, unassisted by a human.

I just don’t know what certain jobs are going to look like, in the not so distant future. You know, being a physician (or anything else) might look really, really different 10-20 years from now.

My wife is an NP who works in family practice. She does 99% of the work of the physicians for half the pay. I do not agree that the PA/NP path is going to be lower stress or lead to a happier life, just two years less school. It is all about the job she would get.

We have a lot of part-time MDs here in the Seattle area. The full-time general surgeons at our local hospital work 3 1/2 days per week and make above $400k. They are among the happiest people I know.

thanks to all of you …and to @WayOutWestMom your worries:

Things I worry about as the mother of female physicians:
Doctors have higher rates of depression and suicide than any other profession
Doctors have high rates of burn-out
Female doctors still face institutionalized gender discrimination in most specialties
Doctors see all the seamy side of life and its effects on my daughters’ empathy, emotional well being and idealism
Finding a healthy work-life balance, esp during residency

certainly make me worry too…ugh

I think a number of us agree it’s not just the title that a kid should be interested in.

I know happy PAs and NPs. Mine have more time to interact with patients. There are so many specialties. But so many kids choose this path without knowing much about what it is, xx hours/week, all year, for years.

Just within the last 72 hours we bumped into an MD friend of ours at the gym who spontaneously spoke with my 9th grade son for 20 minutes telling him why he should go to med school and how much she loved being a doctor and what a great future there is in medicine. I’m pretty positive myself but this was amazing.

@Midwest67 that’s really interesting! I had a knee X ray recently and it was in this room with this huge, robotic machine. There was a tech person there, but the machine did everything…moved around, aligned itself, took the picture…I think the tech was just there for my mental comfort and to make sure I didn’t get up and get knocked out by the machine! I was totally laying there thinking that there wasn’t much need for her to be there as the machine did everything.

@TS0104

The book says just wait until 2-3 million semi-truck drivers are out of work.

The examples & scenarios in the book gave me a lot to think about!

I just got a pop-up on QuickBooks this week encouraging me to run a trial of AutoEntry. Hmmm… that would be AI coming for MY job, thank you very much.

AI and robotics are going to change many professions, including the medical profession. Even skilled surgeons are not immune. However, nurses are still needed. I don’t think I ever want to be “manhandled” by a machine at a hospital.

I think the discussion went all over the map here. For some reason I thought this was a financial discussion. Just back of the envelope.

The single biggest incremental cost of med school is the 4-year med school (say around $300K). Everyone goes to 4 year college, and mostly everyone does a few years of low paid starting job (in medicine we call this residency)

After that even at places like Kaiser, a GP does rise very quickly to $400K/$500K annual. This can continue for 30 years with no impact during recessions. Plus there is a potential to make more in private …

From a financial perspective this is an easy call - unless of course you compare this against becoming a VP in Google or Facebook (or winning the lottery).

What am I missing here… as far as hard work goes, better to work hard for good money than to work less for crappy income