Is It Time To Rethink Your Pre-Med Major?
Many students who dream of going to medical school often choose to major in the sciences: Biology, chemistry, biochemistry, physics, or any other related field of study. After all, you will be better prepared for medical school, right?
Not necessarily.
Actually, medical school admission committees are now looking to fill their classes with well-rounded students.
Even as breakthroughs in science and advances in technology make the practice of medicine increasingly complex, medical educators are looking beyond biology and chemistry majors in the search for more well-rounded students who can be molded into caring and analytic doctors.
This is great news, particularly for students who don’t exactly enjoy the sciences to the degree that they do other fields of study. It reinforces the fact that you can major in anything and still get into medical school. The odds are actually in your favor now.
The number of science majors applying to medical school has been steady for the past decade—about 65 percent of applicants major in biology or another physical science. What’s changing is who gets in.
Medical educators are favoring students who major in the arts, humanities, or related areas. In principle, this makes sense. The science that you learned as an undergraduate student is rarely used in medical school at best. Does it make practical sense, though?
Reinforcing The Generalist
You don’t necessarily have to be good at anything, as long as you are average in everything. This is the basic premise of the well-rounded student — as they adcoms would have us believe, anyway. It’s never this cut and dry, but the argument holds true.
In other words, students who are mediocre scientists but have great social skills should make better physicians than those with excellent science skills and mediocre social skills. This can’t be further from the truth, but is the basis for the change in admission preferences.
During my medical school experience, I saw students both with excellent grades and superb social skills. These were likely the same students who majored in chemistry and studied night and day during college. Along the same lines, I saw students in the top 3% of my class who absolutely sucked with patients. You cannot make generalizations, but that is exactly what the adcoms are doing.
Medicine is an age of specialists. The best physicians are extremely specialized while the general family practice physicians are considered a “jack of all trades, master of none.” This is not to say that generalists are bad physicians, but who would you want treating your hyperthyroidism — your family physician or an endocrinologist?
Consider the pediatric cardiac surgeon who specializes in congenital heart defects. Is this person well-rounded? Maybe in the social realm, but as a medical professional he is about as specialized as you can get.
Whether or not your child’s cardiac surgeon plays the oboe in the city symphony orchestra matters very little to you. What does matter is the fact that he has a firm grasp on the pathophysiology of congenital heart defects and knows how to diagnose, treat and cure them.
Good social skills are required for successful physicians. But, they should not be a substitute for excellence in one particular field.
What I Think
1. If you enjoy it, do it.
If you truly enjoy the sciences and can’t see yourself majoring in anything else, go for it. Being a science major doesn’t automatically make you poor applicant choice.
2. English majors perform better on the verbal reasoning section of the MCAT.
It’s been known for awhile that students who practice verbal reasoning and deduction throughout college outperform other students on the verbal reasoning section of the MCAT — often the most difficult section for students.
3. If you enjoy a wide variety of activities, you are not automatically well-rounded.
Likewise, if you study every waking minute, this does not mean you’re socially inept.
4. Students will adapt.
If changes to the selection process of medical schools change, so will the students applying. Just like many students shadow physicians or do some volunteer hospital work to pad their application, they’ll start to adapt and make themselves more “well-rounded” on paper.
5. It’s just a game.
Any changes to the admissions process is just another new rule in the ever-changing game of gaining a spot in medical school. Play the game well and you will be rewarded. This is your first set of hoops that you’ll jump through over the next four years. Put your shoes on because there will be many, many more.
Email In Your Practice – Thinking Outside Of The Box
Adaptation.
All businesses that want to survive do it. Medicine is no different — and medicine is adapting by allowing patient email access to their physician.
If new technologies or practices immediately cause you to think of increased workloads and decreased compensation, you need to start thinking outside the box.
For example, let’s take a look at a recent article published at AMNews entitled e-mail means fewer patient calls and visits.
A Kaiser Permanente study showing that physicians who e-mailed with patients saw a drop in visits raises the specter that online communication might reduce revenue.
The article headline might sway you into thinking that you’ll take a paycut. We all know that’s the last thing you want. However, the article actually shows that allowing email access to physicians offers greater practice flexibility, time efficiencies and marketing power. This is a very good thing.
Positive Work Hour Control and Easy Documentation
Remember, the key is to find ways to adapt to changing business practices, but to make them work for you in a positive way. Naysayers will see an inbox full of patient complaints, decreased patient visits and an overall drop in revenue. I see positive benefits across the board.
- You’ll have better time control.
Instead of answering the phone and turning a 3 minute explanation into a 25 minute conversation, with email you’ll be able to deliver the relevant information to the patient and save loads of time. Physicians would be better off to phase out phone consults altogether. Times are a changin’.“It’s like taking a phone call at your leisure. I almost never talk to patients on the phone. I find when I do, it’s like an office visit, it’s like 20 minutes,” she said. “I will do the e-mail with them because I can control how much time I spend on it, and I can control when.”
- Documentation will be on easy mode.
A phone call is difficult to log. Physicians still have to manually write notes and keep track of the conversation. With email, physicians can either a) print out the entire conversation and place it in the patient’s chart or b) save the email and place it on the patient’s electronic chart. More time saved.
Seizing Opportunity
So far, physicians have been reluctant to begin offering email to patients across the board due to the lack of reimbursement. There are some payment models currently being tested.
Medem, whose owners include the AMA and other medical societies, allows patients to e-mail doctors’ offices free of charge. But to e-mail a doctor directly, a patient has to enter a credit card number and is charged for an e-consultation. There are about 10,000 doctors using the system. Dr. Fotsch said the charge for e-consults is typically the same as a co-pay, which makes the insurer’s involvement in the process unnecessary.
This is a beautiful system. Free access to email the office, but a charge for direct-to-physician contact all covered by insurance.
The Targeted Consumer
Patient’s who prefer to email physicians are targeted consumers. They have health concerns and are looking for a solution. Whether you charge for direct email access or not, you can collect email addresses and offer a free newsletter about health maintenance, deliver lab results to patients electronically, send appointment reminders, and best of all — stay in constant contact.
Contact Means More Revenue
If you change practice locations, how many of your patients will follow? More if you contact them on the regular basis. To make this worth your while, you’ll need to draft up a series of email messages that are sent to your entire patient list. Using some email list management software, these messages are personalized just like you wrote them one-by-one, but they are actually done in bulk. To the patient, you are staying in constant contact. To you, it means a few extra hours of work one time that can pay off for years to come.
Here are some additional ideas of content you can send to your patients on a regular basis:
- Health news, highlights, and videos
- Healthy cooking, recipes, and shopping advice
- Skin and beauty tips
- Sleep remedies and tips
- Dieting and tips for weight loss
- General health and wellness information
Hopefully you’ll be able to apply some of this to your own practice one day. Remember the importance of thinking outside of the box — it can pay off for years.
Opportunity Costs & Why Lifestyle Specialties Are So Popular
The amount of money that you earn in life depends on managing your opportunity costs. In principle, this is somewhat simple: Focus your time where returns are the greatest.
Choosing a medical specialty is difficult for many students, since there are numerous factors that come into play.
First you’ll need to evaluate your commitments: How long is the residency? How much time do I have to work each week? What’s the call schedule like?
It’s also important to try and get an idea of your returns for completing residency: What’s the average salary? How much vacation time do I get? Are there bonuses for patient, case, or specimen volume?
Let’s step out of the residency realm for a bit. Did you know that you could earn $1 Million by not watching TV?
A recent study found that it would take $1 million for someone to be willing to give up TV for the rest of their lives. People rarely consider the cost of watching TV, and when they do, they usually focus on the cost of their monthly cable bill. The truth is that there are a wide variety of costs associated directly and indirectly with having a TV.
The costs associated with watching TV go far beyond the cost of the television and cable. Additions such as pay-per-view, DVD players, gaming consoles, entertainment cabinets, movie rentals, and games help to run up the bill.
More importantly are the opportunity costs associated with not watching TV and the hidden costs of commercials.
Another cost often overlooked when considering the price of watching TV is the opportunities forfeited when you choose viewing over something else. Assuming that your time is worth at least the minimum wage of $5.85 per hour, your opportunity cost is $737 a month if you view the average amount of TV.
In 2005, Nielsen Media Research reported that the average person watched approximately 4.5 hours of TV a day, or 31.5 hours a week. At $200 in extra spending for each hour watched, that means that the average person spends an extra $6,300 a year due to TV commercials that they wouldn’t have spent if they didn’t watch TV.
You Need To Measure The Opportunity Costs For Medical Training
This case study on TV looks at costs many people have never thought of. You need to take the same approach when selecting a specialty in medicine.
It basically boils down to this: Where can you make the most amount of money with equal time and monetary commitments?
Here are some things to consider:
- Are increased costs associated with a “prestigious” residency or medical school worth it in the long run?
- Will you dilute your time value of money with more hours worked on the job?
- If you plan to go into private practice, is it really necessary to train at an academic center?
- Could you do something now that surpasses your future earning potential as a physician?
- Is a 5-year residency financially sound when you could potentially match those earnings in a three or four year specialty?
Lifestyle specialties are so popular because either the commitments, returns, or both are favorable. Similarly, the opportunity cost of not choosing a lifestyle specialty is extremely high.
Honestly, why work 60 hour weeks for $120,000 per year if you can work the same amount of time and pull in $300,000?
It’s something to think about.
Bend Over – Medicare Is Fluffed And Ready
Medicare is “a program under the U.S. Social Security Administration that reimburses hospitals and physicians for medical care provided to qualifying people over 65 years old.”
Everybody pays into the Medicare bucket — if you pay taxes that is. In other words, you’re paying for those non-compliant diabetics who have to undergo dialysis and lower extremity amputations.
“I can’t be bothered to stick my finger every flippin’ day, take those damn blue pills, or not eat sugar. Hell, I’ve been drinking sweet tea every day for fitty years!”
“But Mr. Robertson, you could suffer from some very serious complications if you don’t manage your diabetes.”
“Naw. Ma pa had da sugar disease and he did OK. Lived to be 95 and ate biscuits n’ gravy every mornin’. That sugar disease don’t affect me or my family.”
You’re paying for these incompetent idiots. Doesn’t that piss you off? It certainly gets under my skin.
Medicare Likes Games
Take a look at this recent article from the Association of American Physicians and Surgeons:
If the provision survives, physicians would get a 0.5% pay increase in 2008 and 2009, instead of projected cuts of 9.9% and 5.0%.
Before you get too excited:
The tiny physician payment increases would be offset by 11% cuts in 2010 and 2011. Specialty societies report that the various cost-control schemes will pit physicians against each other—for example, it sets up an advisory panel to re-do Relative Value Units (RVUs) for “over-valued” services.
Let’s take a look at some basic math. Pay increases of 0.5% per year for two years instead of projected cuts of 9.9% and 5.0% This is a net increase of 15.9% However, cuts in 2010 and 2011 add up to 22%, leaving physicians with a net pay decrease of 6.1% Factor in inflationary costs and docs are pedaling backwards.
Other changes include abolishing “Health Opportunity Acounts,” the provision that allows HSA-programs in Medicaid; repealing a provision of the Medicare Modernization Act that restricts the use of general revenues to fund Medicare; and raises fees of certified nurse midwives to equal those of obstetricians. There is a plethora of new requirements that enrich some interest groups and kill off others.
Democrats plan to pay for the bill by boosting federal tobacco taxes and hiking taxes on insurance companies by $2 per person.
On the whole, the bill contains “the most sweeping changes in decades” to American medicine—changes that will affect every American, stated Rep. John Shadegg (R-AZ). It marks a sharp turn away from a re-invigorated private market and toward government-run medicine.
Watch out. Physicians are poised to be the next government employee. Ask any government worker: The paychecks suck.