To the MDs out there: are you happy?

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<p>In my husband’s academic practice, 4 physicians had full clinical responsibilities (i.e., patient care) in their subspecialty for a large patient population, as their employer, a teaching hospital, was a regional referral center. They are the only physicians in their specialty in an approximate 150 mile radius. They also had teaching responsibilities as assistant, associate, or full professors of the medical school. In addition, since all are accredited pediatricians, they rotated with other subspecialists in covering the inpatient care of pediatric clinic patients (i.e., patients without private physicians, of whom there are many). Additionally, they had research responsibilities, which were heavily weighted in determining their annual salaries, paid by the teaching hospital and the supporting state medical foundation. Someone has to be responsible for patient care outside of office hours, which means the docs take turns on call - my husband and his colleagues are on call one week night each week and one weekend each month (unless someone’s on vacation or sick leave, in which case it’s more often).</p>

<p>This academic practice was somewhat unique in that the clinical responsibilities were especially heavy - most academic physicians probably do not spend so many hours per week in actual patient care. </p>

<p>Accurate and comprehensive record keeping is an important and time-consuming physician responsibility. Charts and letters on each patient must be dictated in a timely fashion. By paperwork, I also meant red tape. There are also letters and phone calls to insurers, begging permission to prescribe a more expensive treatment or procedure, or explaining why such were necessary. There are letters to the power company explaining why the power shouldn’t be shut off in an apartment where a sick baby requires round-the-clock monitoring, letters to a parent explaining why their child can’t be cleared for full-contact sports, meetings with HMOs or hospital administrators to formulate office protocols, phone calls at 8 PM on a Sunday night asking a pharmacist to open up so a parent can refill a child’s prescription that should have been filled on Friday but the family was out of town - stuff like that. Lots of stuff like that.</p>

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<p>Both my H and I are physicians, and I have always worked fulltime (as has he)except the 6 weeks I took off 18 and 14 years ago to have my 2 kids.
We are both in separate private practices, internal medicine.</p>

<p>We love many things about our work- in a nutshell, these things all revolve around treating complex cases, diagnosing difficult problems, and relationships with our patients. It is enormously rewarding work, and we use our skills to the “nth” degree on a daily basis.</p>

<p>As others have said, it is also very difficult, grueling work at times due to fatigue with long hours (much easier physically in our 30s and 40s than 50s and too-soon-to-come 60s!), middle of the night emergencies (no case seems intersting at 3AM!), and working many weekends sacrificing family time. We also Hate with a capital H the insurance companies and paperwork. Luckily, never a lawsuit, but the risk is always there in this litiginous world.
A small percentage of patients can be ridiculously demanding and unreasonable, and dealing with an increasing load of mental illness co-morbitities can be frustrating at best.
But that is primary care, and one CAN choose easier paths in medicine.</p>

<p>Our children have neither been encouraged or discouraged from our professions directly, but neither have chosen to consider medicine. It has been considerably intrusive to their lives given 2 parent doctors, yet they respect and are proud of our work. They think it is simply too difficult, and they are not lazy kids.</p>

<p>They were in excellent home daycares from around age 1, prior to that we had one-on-one grandmotherly, doting women care for them their first year.
I cut my hours as much as I could until they started school- I consider a 40hour work week (not counting night call and weekends!)very light, and I made sure to get home by 5:30 ish to get dinner, spend lots of face time, and play! The beeper was the dreaded sound. My H and I worked out sharing everything. He is a gem, and the funniest man I have ever known. You MUST laugh.</p>

<p>It can be done, happily. It is very difficult. We don’t make much money compared to many friends- private practice overhead is ridiculous, and our incomes have been ratcheted down yearly by insurance companies.
Would we do it over? Yes. Will we last physically until the usual retirement age of 65? No.
We will likely change from this grueling schedule to clinic-type work with regular hours and no night call (but sacrificing case complexity and challenge) by age 58 or so. We’ll make more $$ to fund a retirement as well.</p>

<p>Follow your heart- are you a bright, compassionate person with high energy? Those are the requirements of the job. Good luck!</p>

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<p>Both wife and I are subspecialists. Love our work, and have avoided suits, barely. Work has involved teaching, practice, myself surgery, and research.
We live comfortably and two children are in medical school of three. One in JHS.
We did not encourage them. It is a calling. It is a stressful life, but worth it for the most dedicated. We try to limit call, worse in some specialties,wife’s is one. My advice to my children; choose a profession that will benefit your fellow man.</p>

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<p>As I said before, my H. loves his actual practice of medicine, but some days…</p>

<p>Yesterday, he came home and said one of his partners is being sued by a patient who stopped a medication because a friend told him that his doctor said he shouldn’t take it (who knows what friend’s problem was or his other medications?). Anyway, there were medical consequence to stopping med and guess what? the doctor is being blamed for the patient being noncompliant.</p>

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<p>mkm56, that’s just horrible!</p>

<p>Surely no judge is going to side with the patient in a case like that, though?</p>

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<p>Hopefully, it will never go to trial. But if it does one never know what a jury will do. Even if verdict is favorable there are many, many hours of missed patient care time due to meetings with lawyers, depositions, the trial itself, etc. I wish congress would pass something that made it criminal to file a frivolous suit—I know one can countersue but then that is more time and money tied up in the legal system.</p>

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<p>Best thing to do if you can stand medicine is…</p>

<p>Go shadow a physician or resident for a SOLID month. Not like an afternoon here and there. I mean real shadowing where you get to hear the bad and good. Mostly bad these days.</p>

<p>It’s not a noble calling because it’s not perceived as noble anymore. People think you steal their money like somehow I should walk in there and treat their failure attitudes for free. Americans are lazy POSs today. They cry like a bunch of b#tches about everything including blood draws. I had to actually draw my own blood in front of an irrational 40 some year old lady because she was THAT scared. WHAT!? The idea of people meeting you halfway, which is essential to medicine, is GONE.</p>

<p>Go be a lawyer and be part of the problem because that’s what people value these days.</p>

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<p>I probably have no business posting on this thread so take this with a grain of salt ;)</p>

<p>There are no doctors in my family or my H’s family. And I don’t really know too many doctors very well personally. I do know a few pharmacists and most of them seem to like their work. I know not the same as pre-med but maybe something you could explore</p>

<p>Also, my S’s best friend and roommate at college is pre-med and the son of an eye doctor (I can’t remember if optometrist or opthalmologst). His older brother is/was also premed and starting med school later this year. So perhaps it’s possible that what kind of medicine you go into makes a difference in quality of family life.</p>

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<p>

It sounds like you should do yourself and the rest of us a favor and find another profession.</p>

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<p>My sister is a physician and says that she loves her job. She works for a hospital based practice and has nothing to do with insurance companies, malpractice costs, etc. She has a job and is paid by the hospital. The hours are long but she finds her job intellectually interesting. She studied medicine later in life and says that she feels lucky to have found her profession. She seems to have job security with no worries about the economy, corporate politics or losing clients. Even though her hours are long they are no worse than the hours that most lawyers or business executives work. She does have periodic nights when she is on call. Overall, she is very satisfied with her decision to work in medicine.</p>

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<p>My husband’s cousin works as an emergency room physician. She has been able to arrange a 30 hours a week schedule and has no patient follow up.</p>

<p>She is the mother of two and her husband has his own practice in orthopedics.</p>

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<p>There is a new and burgeoning field in medicine called “hospitalists”. These Drs. do inpatient work only, and are usually hospital employees, so don’t have to do all the battles the private prctitioners do with insurance companies, staffing/turnover issues, etc. It sounds great!</p>

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<p>One huge advantage is job security. After being employed by 9 different organizations in past 24 years I highly encouraged my D. to go to medicine for this reason in addition to all other reasons that she had. And I feel lucky to be able to find all these professional jobs , not everybody can say that, including people in my profession.</p>

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<p>Ren–</p>

<p>I think you are very wise to seek out the wisdom of so many!</p>

<p>This is probably going to be a terribly unpopular thing to say, but I wanted to bring up another issue. One of my hobbies is that I am a breastfeeding mother’s support and education group leader. I am finding that a huge number of young mothers I am seeing are very unhappy. They had planned for a professional career, had carefully planned a good daycare for the baby to come, but had a great big student loan debt. Then, when they actually held that little one - looked at the person that was a tangible expression of their love for their mate - they fell in love. They didn’t want to go back to work. They wanted to stay home. Lots of times these were moms who when they came to our preparation meetings pregnant, despised stay-at-home moms and said, “I love my career!” They often say afterwards, “Why didn’t anyone tell me I’d feel this way???” When they have a load of debt, they often don’t have any choice but to go back to work. </p>

<p>I have friends who are stay-at-home homeschooling moms who are physicians, attorneys, former judges, have PhDs in chemical engineering, and are former professors. None of them ever thought being at home was what they wanted out of life, but it is! Some of them are living in extremely frugal circumstances due to ongoing student loans.</p>

<p>I do absolutely understand that there are lots of women who are working mothers who love their jobs. I just think it is important for young women to hear that you really won’t know how you feel about motherhood until you have a child. For that reason, I would strongly encourage my daughter not to pursue <em>any</em> career that would leave her in deep debt. I want her to be able to follow her dreams, whatever they are, and debt makes you a slave to what your dreams used to be.</p>

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<p>^ Not everybody feels that way. I was breasfeeding for 2.5 years and I was working full time. I was happy to be at home with the baby for several weeks but at the same time I felt very lonely and disconnected from the rest of the world, meeting just with stay at home moms and their kids. It is nice to have a professional job to go back to, it feels very fulfilling. I was always very busy with my D., taking her to all her activities after work (at one point of time she was engaged in 5 different after school activities, some of them required several practices per week). She was always a straight A student and that also required my input. We were able to go to nice vacations every year taking her with us (would not be possible without my salary). And we can pay for her college, including helping her in graduate school when time comes. Multifaceted life was much more rewarding for me. In addition, I know some women who do not know what to do when kids leave for college. It is hard to start or go back to profesional carrier after being disconnected from it for close to 20 years. I even had hard time looking for a hobby to fill my time after work. So, everybody needs to follow their own path.</p>

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<p>Seems like this sound advice would hold true for men, women, those who have children, and those who do not.</p>

<p>The advice could be extended to any financial decision that could trap one in a job that one would prefer to leave – taking on a large mortgage, for example.</p>

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<p>I agree, Fendrock. When I think how hard we struggled to pay off the piddling amount of student debt we had and how blithely kids on this forum talk about taking on 10 or 20 times that (without 10 to 20 times the starting salaries! starting salaries are maybe 2-3 times what they were)… well, it makes me feel sick for them!</p>

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<p>Haven’t read the whole thread in detail so my opinion may have been stated better by others.</p>

<p>DH is a public health doc.I am a retired public health nurse. Loves his patients - HATES the system he works under. Tries to talk anyone considering med school OUT of it.</p>

<p>Too many missed birthdays,piano recitals,parent-teacher conferences, too many sleepless nights.</p>

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<p>Ren - I posted this on another thread awhile back. I thought it answered your question, so I am repeating it here with some updates!</p>

<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 will graduate Sunday with a 4.0, with honors from both her department and the U at large, and was named one of only 10 Chancellor’s Scholars out of the 3,500+ seniors graduating. 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 you want? Is it a passion that burns in you - not for the money, not for the prestige, not even because “you want to help people”, then you 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>I have 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. By the same token, if it is not someone’s passion, they shouldn’t head down this road. I wouldn’t change my choice for a second - I love what I do”.</p>

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<p>If my mother had time to post on message boards, she’d say that she loves being a doctor and would make the same choices again. I can’t imagine her without the MD; it’s like a part of her body.</p>