The Medicine Work Ethic
This is a reply to a comment made by Johnny Youngblood. I’m not calling Johnny out personally, but I think his comment exemplifies the way an average medical student thinks.
I really don’t want to hear another medical student, resident, or physician complain about the money. Lots of people work overtime. Lots of people work 2 jobs. Very few make 6 figures by the time they’re 30.
He makes some very valid points with his comment, and it’s absolutely true that few people are pulling in six-figure incomes by 30 years of age.
Having a strong work ethic is important, but you need to realize that working hard does not equal working smart. Many who have graduated from the school of medical training think that if you’re not working every waking minute that you’re slacking. I absolutely know some of you feel this way now — I used to feel that way myself, especially early during my medical training.
Working two jobs, excessive hours, or any combination of the two is just plain inefficient. Sure, many people do it. It’s not wrong, per se, but it’s also not right for many people. Working like this leads to faster burnout rates, decreased productivity, and overall decreased well-being.
Do you really love your job as a medical professional? Not just happy doing it, but I mean really love it. My guess is that most people will probably — deep down inside — say no. Whether you want to admit it or not, for most of you I bet that medicine is a decent job with lots of status and above average pay. Nothing more, nothing less.
What I Did
As most of you probably know by now, I got enough of medicine during medical school. I didn’t want to pull the ridiculous hours doing something that I wasn’t too excited about to begin with. Somewhere around the beginning of my junior year, I started pondering exactly what I wanted out of life. For me, medicine didn’t fill any of my expectations. I could care less about status, but I wanted to make a comfortable living and be able to do so with more free time that I could get out of a lifetime of call and pagers.
Some called me a slacker, others thought I was lazy. I’m actually the exact opposite.
You see, my work ethic is stronger than most of the students that I went to school with. We just think differently. My classmates — and countless medical students like them — have been brainwashed into thinking that you must work your entire life doing something that you may or may not like. My brain was once programmed along the same frequency.
During my junior year after I started having second thoughts of medicine, I used to sit and daydream about what life would be like to not have to go to a job that you hated. I wanted to be excited about what I did for a living. I wanted to love it.
Daydreams soon turned into a burning desire and obsession to find the meaning of life for me. My parents told me I was crazy. My wife didn’t support me at first. My grandma began to worry about me. They were all preaching ‘a house, a wife, a job, a white picket fence, and 2.5 kids.’ After all, that’s the American Dream right?
Medicine could give me a nice house with a white picket fence, and I could afford 2.5 kids and sail off into the sunset pulling the same routine until I’m 65 and become one of those old docs who are too senile to really practice anymore, but still show up to grand rounds for the free meal and CME credit. But hell no, I didn’t want that. That’s what everybody didn’t understand. They didn’t understand that I needed to do this for me.
Leap Of Faith
I wanted the ability to work from wherever I choose. I wanted to be able to go to the gym at 11:00 am or midnight. I wanted to be able to take as long as I wanted for lunch, and not to have to ask permission to take a piss. I wanted to call all of the shots without the political bullshit that accompanies most positions of power. I wanted to be able to take a two-week vacation at the drop of a hat and then extend it to four weeks when I realize what a fun damn time I’m having. I wanted to stay up until 3 am if I felt like it or sleep in until noon. I wanted freedom. After all, these are the best years of my life and I sure as hell was not getting any younger.
I soon realized that being an entrepreneur was what I wanted. I wanted it more than anything. I worked my ass off, but I was finally enjoying my work. In fact, I loved it and still love it to this day. My businesses took off. I then began to launch passive streams of income. I’m now happier than I’ve ever been in my life.
I knew what I wanted. I saw other people living great lives with an abundance of happiness and I knew I could have that too. I didn’t sit on the fence and cry that I couldn’t have that life too. I went out and did something about it.
I contribute it all to the medicine work ethic.
Dear Medicine,
Although I dislike your training practices very much, I would like to thank you for the strong work ethic that you have taught me. Many countless hours studying for your shelf exams and Steps taught me valuable time management skills that I use to be successful today. Seeing many overworked physicians who were unhappy and complaining about their paycheck made me desire something more. Had I not seen the light because of you, I might have been just another pawn in a never- ending game.
It was worth the months on surgery and OB/GYN. Every prostate that I examined made me want something better out of life. I am thankful that you gave me the adequate number of prostates to examine. Each pelvic exam, while oftentimes smelly and always unpleasant, taught me that I must persevere.
Every attending surgeon that ever belittled me during rounds or in the OR gave me a thick skin. I have used that thick skin while failing numerous times on my way to victory. Each case I scrubbed helped to build my foundation of freedom.
The long nights on call taught me that I’m not that efficient while sleep deprived. Now, I always work well-rested. Thank you medicine, I’ve increased my productivity because of you.
I now work smarter instead of harder, and it’s because of you. You have given me so much — the drive and desire to not be unhappy with life. The drive and desire to do something I am passionate about. The drive and desire to finally be free.
Thank you, Medicine, for four years of hell. Had it not been for those four years, I might have spent a lifetime consumed by fire.
The Bottom Line
You can bitch and moan all you want about the decreasing pay or increasing work hours, just like I did. Just make sure you do something about it — turn all of those negative emotions into positive actions.
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Michael said
October 7 2007 @ 5:21 am
AMEN! I agree with you 100%, as a medical student thinking about leaving the field to pursue other passions.
MSG said
October 7 2007 @ 4:13 pm
Unfortunately the flaw in Johnny Youngblood’s comment is that he has forgotten the amount of time, money, and investment medical school and residency has become. Yes, people work a lot of hours - but often because they’ve not received an adequate education and work jobs that pay shitty.
However a 12 year struggle with an increasingly absurd debt load, increased papaerwork burden, large malpractice dues and claims, and a constantly shrinking financial situation entitles physicians to bitch a bit.
Hoover said
October 7 2007 @ 5:04 pm
MSG, exactly. Great point.
bronx43 said
October 7 2007 @ 7:42 pm
Going by Johnny’s logic, those who work two jobs and overtime can’t complain either, because there are those who earn minimum wage in manual labor. Then again, those in manual labor shouldn’t complain, because there are those who are unemployed. Likewise, those who are unemployed… pretty much anyone who complains is a pansy. Oh…and Johnny Youngblood has never complained in his life about anything.
Half MD said
October 8 2007 @ 7:56 pm
The JY’s of the world are one of the reasons that physicians are seeing declining salaries. In most other industries, people are making more. In fact, even in health care, most professions are making more. Physicians are the only group that are seeing a decline.
I’d bet Johnny also thinks that he’s a saint for deciding to become a doctor. While you need to be a people person to thrive in most medical specialties, no one is going to build a shrine in your honor and consider you a great humanitarian
dr. know said
October 12 2007 @ 9:54 pm
what do you think of the field of radiology?
Hoover said
October 13 2007 @ 11:13 am
Radiology isn’t bad at all. The big money is in interventional radiology where the hours can be poor and unpredictable at times. I’d say look into a Diagnostic Radiology program and forget the procedures. The money is still pretty good from what I understand.
Bubbs said
October 14 2007 @ 2:06 pm
Very interesting reading. I have been in practice for 12+ years and really hate it. I have changed practices 2x and am on the verge of leaving my third practice. For a long time I have thought (and other persons have implied) that the problem was with me. I even went back to school to get a business degree. It only got me a whole heap of trouble…resentment from my pears, anger from my wife and a more keen awareness how screwed up medicine is as a whole. My advice to all of you out there is to get out while you can…even better never get in to medicine. With some rare exceptions…it isn’t worth it and life is too short.
dr. know said
October 14 2007 @ 2:21 pm
bubbs: what is your speciality?
Dr. J said
October 14 2007 @ 2:52 pm
Dr. Bubbs, I quit my residency this summer and I would like to communicate with you about some issues via email. If you’d like, you can contact me at thirdventricle@gmail.com.
bronx43 said
October 14 2007 @ 10:04 pm
Lol, nice email addy Dr. J.
Bubbs, can you elaborate a bit on why you hate practicing?
Dr. J said
October 15 2007 @ 3:22 pm
My two cents… I started residency this summer in a prestigious, competitive program after going through all the motions of medical school. I’ve always had doubts about medicine, and this website captures much of my feelings. I committed myself to finish medical school and landed in residency…it can’t be that bad, right?
Well, bluntly put, being a doctor doesn’t mean anything other than a being a puppet. You are controlled and manipulated from all angles: the attending, senior residents, fellow interns, significant others, management, pharmacy, nurses, hospital auditors, and especially patients. Forget about the 80-hour rule too: I was physically at the hospital for 14-16 hours a day, minus on-call, then once I finally got home, I had to write H&Ps and SOAP notes using the “new and improved EMR” for another 2-3 hours before being able to sleep for 4-5 hours until it all starts again.
Moreover, my career outlook seemed grim as well. I talked to a lot of physicians in practice and most of them expressed fatigue, dissatisfaction, and lack of balance in their lives. I asked other residents how they felt about it, and they generally said that they are doing this because they don’t see capable of doing anything else. I envisioned completing residency, countless exams, fellowships, moving all over the country, huge debts, family stresses, being on-call, physical and mental anguish, losing connections with lifelong friends and family, etc…
I quit because I had the perspective and courage to say it was enough. My fellow colleague cries each night, tells herself to take it one day at a time, and believes that there will be a magical day when all this is over. It will never be over. I sensed a collective delusion amongst the medical community…there is a better life if you allow yourself to see it and seek it.
bronx43 said
October 15 2007 @ 3:40 pm
Thanks for your story Dr. J. I was surprised at first that physicians’ suicide rate is much higher than the general public (1.3 to 1 for males, and 2.4 to 1 for females). However, I now see the sad truth that was once a glorious profession. Your assertion that doctors can’t get out because we can’t do anything else really reflects my sentiments. As doctors, we started early in our educational careers with basic science classes, volunteering, shadowing, etc. The farther along we got down this medical road, the more trapped we were. I feel like I have no way out of my current condition. I truly feel terrible for your female colleague. I hope I have the courage you have, and leave this forsaken career, but I fear I’ve not.
What are you planning to do now that you’ve quit your residency, if you don’t mind my asking.
Thanks again.
Medicine Work Ethic « Medliorate said
October 16 2007 @ 12:00 pm
[…] The Medicine Work Ethic [Med School Hell] […]
immy said
October 16 2007 @ 1:51 pm
Thank you all for your comments all, they are keeping me sane at the moment. I have in recent days given up medicine in my 3rd year at a London medical School for a position in a government organization. Everything I have ever felt about medicine is summed up on this website. I would consider myself a fairly intelligent medical student having already got a degree and PhD(Engineering). I started with good motivation, passion and a “dream” of helping people. The first years were just a memory test, with basic science and concepts that I found simple. As time has gone on however, I know now that that dream is not reality.
I am grieving at the moment coming to terms with the loss of medical school. I am grieving but can’t quite figure out why. I was sick to death of the endless logbooks and practical skills that were of no interest to me. I felt like a puppet even as a medical school and couldn’t see it changing as a House Officer (Resident equivalent), the National Health Service in the UK is indeed the Master of Puppets brainwashing all that it employs. I will write more if anyone is interested and after I have finished crying.
Bubbs said
October 16 2007 @ 3:31 pm
In answer to some questions. I am Pulmonart and Critical Care. I hate practiceing for a number of reasons. Here are some:
1) Call is getting harder. When I was young, I could be up all night….then go out the next night after a few hours of sleep. As I am getting older, I can’t do that anymore. It is a real concern from a patient safety and liability standpoint. There are no “monthly hour limits” in practice. You have to work until you are done or until someone relieves you.
If you work in or in assocaition with a hospital…theri interests are not always the patient or even the docs care for those patients.
2) With call (q 3 nights) it’s hard to have a life. I am married and have children. I am missing out on their growing up. I feel that I am not there for my kids at key and needed times. I hate that. My wife is a trooper…but I am not sure how much longer she’ll hang in there.
3) Many of the patients I see are unfortunate people who want to get well. But many . Many many patients smoke, don’t loose weight, don’t listen to their providers, and then come in and complain why they aren’t getting better. This is not all patients, but the numbers are increasing. It is not very gratifiying and at times it can be a real bummer when your patients just continue the downhill trek of what we all have come to call “the natural history of their disease”.
4) Cost of practice increases…reimbursement decrease..help in the office hard to find…you can connect the dots here. The present system IS NOT SUSTAINABLE…and no one want to really admit it!
5) Elected official at a local, state and federal level really don’t understand what docs, nurses etc have to do to try and give the best care for their patients. Don’t expect support there.
6) Some…not all docs are out there for the WRONG reasons. I won’t elaborate here…but as such there is a lot of “cover your ass medicine” and some milking the system giving those docs trying to do their best a bad name.
7) Malpractice litigation. Need I say more?
9) If you want to do some business arrangements…the government has medicine so regulated that there is a squelching of innovation…truly against what were taught in medical school.
10) There are more…just some to give you an essence.
Bubbs said
October 16 2007 @ 3:34 pm
In answer to some questions. I am Pulmonart and Critical Care. I hate practiceing for a number of reasons. Here are some:
1) Call is getting harder. When I was young, I could be up all night….then go out the next night after a few hours of sleep. As I am getting older, I can’t do that anymore. It is a real concern from a patient safety and liability standpoint. There are no “monthly hour limits” in practice. You have to work until you are done or until someone relieves you.
2) With call (q 3 nights) it’s hard to have a life. I am married and have children. I am missing out on their growing up. I feel that I am not there for my kids at key and needed times. I hate that. My wife is a trooper…but I am not sure how much longer she’ll hang in there.
3) Many of the patients I see are unfortunate people who want to get well. But many are not, and don’t listen to theri providers. Many many patients smoke, drink, don’t take theri meds, don’t loose weight, don’t listen to their providers, and then come in and complain why they aren’t getting better. This is not all patients, but the numbers are increasing. It is not very gratifiying and at times it can be a real bummer when your patients just continue the downhill trek of what we all have come to call “the natural history of their disease”.
4) Cost of practice increases…reimbursement decrease..help in the office hard to find…you can connect the dots here. The present system IS NOT SUSTAINABLE…and no one want to really admit it!
5) Elected official at a local, state and federal level really don’t understand what docs, nurses etc have to do to try and give the best care for their patients. Don’t expect support there.
6) Some…not all docs are out there for the WRONG reasons. I won’t elaborate here…but as such there is a lot of “cover your ass medicine” and some are milking the system giving those docs trying to do their best a bad name.
7) Malpractice litigation. Need I say more?
9) If you want to do some business arrangements that may help efficiency, or patient care…the government has medicine so regulated that there is a squelching of innovation…truly against what were taught in medical school.
10) There are more…just some to give you an essence. I admit that some of these are not such a surprise…but as you get older, your views and priorities change. Also you come to realize your OWN mortality.
Bubbs said
October 16 2007 @ 3:41 pm
One other thing…We neglect are own well being to do this job. That is WRONG. A sytem that instill that is messed up.
bronx43 said
October 16 2007 @ 3:59 pm
Thanks for your answer, Bubbs. My father has a friend who is also pulmonology/critical care, and he is like you, constantly on call. Do you think that other fields are less demanding on the physician’s quality of life, or have you seen evidence that all fields inevitably drain the life out of the practitioner?
Dr. J said
October 17 2007 @ 2:44 am
Dr. Bubbs is right about “neglecting our own well being to do this job.” As a former resident, I know that our hours suck, and that things get better once you practice, but the damage may have already be done.
When I was q3-4 call overseeing ~72 patients, I would have zero sleep for 2 days. I couldn’t sleep at home because of worrying…I just cared too much about my patients. Well, I ended up having some new onset seizures from sleep deprivation. It was pretty frickin’ scary.
That’s just one example of hurting our own selves. I’ve heard other stories, from car accidents to marital discord to suicides.
Be careful out there.
Dr. J said
October 17 2007 @ 2:49 am
immy, thanks for your post. I hope you are doing better. We are here for you if you need anything.
Immy said
October 17 2007 @ 12:01 pm
So many of you guys remain practicing doctors despite so many grievances. I have read many other blogs about doctors and medical students are seemingly totally demoralized and yet they continue to soldier on. I feel like I have missed something??? I am having seriously having seconds thoughts about giving up and can’t figure out if it was the depression that made me quit or the course that made me depressed. Now all I feel is that I was too weak to finish medical school. Am tempted to go back and punish myself and maybe I will finish the course and maybe then I will feel less depressed. I am tempted not to sign my employment contract and just return to medical school.
Perhaps I have the grass is always greener or “black and White” outlook that being a depressed medical students seems to have given me. I think I could pass the medical degree but can’t quite figure out what that would achieve. I still can’t understand why I should feel so bad, I have been offered a good government job with a stable future, 37 hour week flexi time and still I feel extreme guilt at giving up medicine. The NHS brainwashing makes me feel like I have given up a life as a caring person for selfish reasons.
Thanks Dr J for your support and am glad you had the courage to give up, I like your friend, have cried every night before and after giving up medicine, in the hope that Medicine will one day leave me alone to get on with my life.
Old MD Girl said
October 17 2007 @ 8:13 pm
Life is too short to do ANYTHING that makes you depressed. I like med school at the moment, but the minute it gets to the point where I dread going to work, or find myself crying on the way to work, I am Q.U.I.T.T.I.N.G.
I felt like that a lot during previous jobs — not everything in the non-medical field is all sunshine and roses — but I am NEVER living like that again.
Immy, do NOT go back to med school. Take the government job, distance yourself from your med school peers, and see a psychiatrist if you need to work out the depression. In a few years you will look back and think, holy shit, I can’t believe I almost went back to THAT.
Shining Hector said
October 17 2007 @ 9:10 pm
I dunno, I have my doubts too, but there are also going to be problems with anything. It’s easy to say suck it up, this too shall pass and all that, but I think 7+ years of misery to do what’s basically becoming just another job is a lot to ask of anyone, really. I think we’re kind of in a transition state now, all this crap with medical training was set up on some social contract premise that being a doctor afforded one an exceptional place in society and therefore it was acceptable to ask exceptional sacrifices from them, but it’s becoming a not so exceptional position as everyone with a vested interest in taking doctors down a peg smells blood in the water, yet the exceptional sacrifices are still expected. Maybe it’s time to renegotiate a new contract, but med students aren’t really in very strong bargaining position any way you look at it.
Anon said
October 19 2007 @ 2:25 pm
Shining Hector, you’ve totally hit the nail on the head about medicine’s transition state. One more thing complicating the picture and standing in the way of change is that many existing docs seem to foolishly believe that things are going to magically go back to the way they used to be. The social contract is dead. The high pay is gone and it ain’t coming back. All the years they’ve spent tucked in the clinic and on a falsely erected pedestal have blinded them to the economic and social realities taking place in the world around them.
bronx43 said
October 19 2007 @ 5:12 pm
Anon, I would think that only the older doctors who have been practicing before the establishment of HMOs expect the system to revert to status quo ante. I’m sure most young doctors who have never had a taste of the golden days of medicine when doctors charged and insurance companies paid, don’t expect much more than a halt in this current decline.
Chuck McKay said
October 22 2007 @ 10:59 pm
The late Mark McCormack (What They Don’t Teach You at Harvard Business School) said he was grateful for the rigors of a law school education, even though he never practiced law.
It seems to me that Johnny has the same feeling. He appreciates the education, just chooses to use it in a different fashion.
simplerunner » The Medicine Work Ethic said
October 23 2007 @ 9:05 pm
[…] here for […]
Med School Hell » Finding Freedom In The Middle of War — Mindset said
December 5 2007 @ 1:01 am
[…] hoops and inefficiencies that plague medical training — this made it even easier for me. As I wrote about earlier, I turned negative thoughts and emotions into positive […]
Med School Hell » What You Can Learn From Medical Conferences said
February 9 2008 @ 2:06 am
[…] of medicine that you are truly passionate about, you guys would absolutely kill it. I wrote about medicine developing my work ethic in an earlier post, and this idea is a spin off of that broad […]
littlemissmessy said
March 22 2008 @ 12:28 pm
I’m pre-med and am having second thoughts.
I found this blog by googling “pre-med mistake” lol.
I’ve distanced myself from my pre-med gunner peers and the courses.
Now, I’m considering all of my options.
I feel like I was brainwashed by my doctor mom. I feel like Immy and I haven’t even gotten in.
Any advice, anyone?
john said
March 28 2008 @ 6:13 pm
Great website. This just about sums everything up. Medical school is overrated!
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