What the fuck is with all of the hate recently? I’ve seen a huge increase in the amount of comments directed towards me and questioning why I still update this site since I’m out of medicine.
Don’t worry about what I’m doing and go save some lives. Seriously, get a fucking life and don’t worry about me updating this blog. I’m actually starting to think some of you guys have stalking issues.
Let’s take a look at some of the recent comments. ‘MD’ is my favorite commenter lately:
If sleeping in every day and playing WoW makes you feel fulfilled, by all means do it. And if you are going to look back on life with a sense of pride and feel that you had a meaningful existence in doing so, then by all means make yourself happy. I can promise you I’ll never devote a blog to why your ways are wrong or what I don’t like about it.
What the fuck? Do you actually think I sleep in every single day and play WoW all day long? I run a company doing 7-figure revenues every year and you think I play WoW all day? I don’t give a fuck about ‘being fulfilled’ and ‘contributing to society.’ What I care about is my bottom line and financial security for the future. Nothing more, nothing less. Like I’ve said time and time again, it’s all about the Benjamins.
MD will never devote a blog to me because he simply doesn’t have the time. If you think you have the time while practicing medicine, I challenge to you start one that becomes more popular than MedSchoolHell.
Don’t lie to yourself and think it’s about anything else, either. You want money just like the next guy, and you want to obtain it with the least amount of work possible. Fuck all of this “contributing to society” crap that’s been rehashed over and over. That shit is tired, get over it.
I’m not going to lie and say I don’t sleep in regularly and play games a lot. I do. But, I still run a successful company. I have a lot of “free time.”
I love what I do not only because it’s very interesting to me, but also because it gives me an insane amount of freedom to do what I want, when I want.
The Hatorade drinkers like ‘MD’ are really just pissed that they have to wake up each morning at the ass-crack of dawn and go into work while I snooze it up for a few more hours. I can do what I want, when I want while they have to ask for time off and put up with patient care issues while pretending to “feel good” about what they do for a living. Whatever, I see through that shit like saran wrap.
That’s honestly the nuts and bolts of all of the negative comments I’ve received lately, and if you feel differently, please let me know in the comments.
I’m a senior resident and I think you’re right about everything. I was just curious if you had an entry/story about how you left medicine and what you’re doing now.
If you want to talk about “hater” read your post and the kind of language you use in it. I don’t think I have resorted to that. You seem quite angry when challenged on your opinions and when others point out your flaws; perhaps this is why you clashed with the surgeons so much.
Medical School can be such a brutal, dehumanizing procedure, and many times students have to embrace a fair bit of denial to survive.
And the more students have given up to get into medical school (lived in the library for years, getting that 4.0, instead of having a life), the more likely they are to viciously resent anyone who tries to smack them with the frying pan of reality.
It’s like an injured dog snapping at the person trying to help it. He doesn’t know any better, all he knows is he’s hurting.
I’ve entered this year’s cycle for Medical applications in the UK. I love the idea of becoming a doctor but am more than willing to admit that there are probably a few home truths I won’t discover till I’m too far in.
Saying that, I love this blog. It provides a point of view that it so rare in the med blogging world. It gives you a good insight and I have been following Hoover’s blog for nearly 2 years, possibly more. His contributions and others have encouraged me to record my own experiences applying to med school in my blog.
Once again I love this blog. Hoover has a great writing style that makes this blog unique. I can understand people defending their career choice and maybe I will one day but I do not see the need to shoot his posts down. They are accurate comments that are raised by many. Hoover was just clever enough to see what was coming and get out.
Keep on blogging Hoover!
See I was one of those people that was really excited to start medical school. I would wake up everyday to go to class until I realized that faculty is completely inconsiderate of our time. I can see how things can go really sour in medical school for some, especially during second year when it seems like the suffering never stops coming. I’m still happy I am medical school but I am weary of the future because of the health care cluster fuck with primary care (my main interest). And anyone that says it isn’t about the money is plain lying to themselves or have never experienced what it feels like to not have financial security. Plus, how are you going to take care of someone if you can’t take care of yourself/family?
Oh and the whole thing about Hoover being defensive just because he is using “that kind of language” is bullshit. This is a blog, not a publication he is free to use whatever fucking language he wants. I am sure if MD happen to speak to him in person the same language would be thrown around regardless of the mood of the conversation.
Dude MD give it up. If you don’t like the blog don’t come here. You don’t need to defend medicine. Hoover was wise. H hated it. He got out of it. As for language who cares either its his blog. If it offends you once again don’t come. Medicine sucks in just about everyway possible. It is however very interesting. If you love it do it. If you hate it quit. I think the problem is we are not honest with ourselves. How much good are we really doing? Are we just prolonging suffering? Many of our therapies still have no evidence. No one has really thought about it but are we hastening our own demise? Nature use to breed out the weak among us. Now with modern medicine those weak are allowed to breed. I’m on of the weak so i will take it but still in the long run maybe it is a wash.
There is nothing amazing about waking up at 4am knowing that you won’t leave the hospital until at least Noon the next day. If you think that is awesome I try the Jones’ Coolaide.
Hoover, I’m interested in how you made the transition from medicine to business. Although I’m still interested in medicine at the moment, I’m also thinking about what opportunities are available outside of academic/clinical medicine.
Thanks
Yo “MD” shut the fuck up. Really. Nobody wants to hear your bullshit because truth is, it’s drones like you who make medicine suck.
You’re missing the whole fucking point, which is that medical students are realizing that those who have come before us have let the profession of medicine turn into a big, fucked-up pile of soul-sucking shit. (thanks, btw)
Next time your 30 hours into your shift and kissing the ass of some bitchy nurse so she’ll do her job, why don’t you consider why the hospital pays for enough nursing staff so that they only have to work 40 hours a week.
Maybe one day you’ll realize that culture of altruism and self-sacrifice that you’ve bought into is just a bunch of bullshit, brainwashing so you wont complain while you’re used and abused by the system. You are no different than the beaten housewife with two black eyes making excuses for her piece-of-shit husband.
And if your sensibilities have been offended, you should realize that the language, vitriol, and attitude on display on this blog are directly proportional to the betrayal and disappointment felt by those of us who were ready to give everything to the team and then learned that neither the coaches, owners, or fans gave a fuck anymore.
We’re not complaining about what medicine is, we’re complaining about what medicine isn’t.
MD I have a feeling that really you hate all the world and you are angry with everything! It is not surprising that when you are made to see everything not looking up from the rose glasses it does upset you and piss you off,but that does not mean that you need to throw this anger to anyone ! Get a life ! If you have an opinion ,keep it to yourself ,course everyone HAS a right to be individual and have an opinion about different stuff.So there is no need to argue about other people point of view ,course they have their right,and if you don’t like Hoover’s ideas and blog,just cut it out and leave it alone! Learn some respect for people and their individual personalities.
P.s Hoover you doing great ! keep blogging!
If you guys want to rip on medicine go right ahead. I was on here trying to offer the “other side of the coin” and apparently some people just don’t want to hear that side. I can assure you there are some things on here that are outright lies:
1) I have plenty of free time and could write a blog if I wanted. I stumbled onto this page through other medical blogs I’ve read. PLENTY of doctors write blogs, which kind of goes against the “doctors don’t have any free time” thing. I’m simply not interested in writing a blog of my own. I am, however, compiling a short story that may eventually become a novel about my most interesting cases.
2) I’m done with training and NEVER work 30 hour shifts. Nowhere near. If I ever have a 60 hour week, it’s usually followed by a 30 hour week. There is some balance in my field and it’s not all bad. It depends on the field you choose. In my training, I had a grand total of 8 call months scattered over my first two years and had three vacation weeks every year.
3) There is still something special about this field, people do still have a tremendous amount of respect for what we do, and there are still a lot of physicians making good money. No amount of blogging will ever take that away. I see this in my every day interactions. This is something you don’t see as much when you are in medical school, because everyone from RNs to patients, etc knows you aren’t “official” yet. I won’t post my exact income but it’s pretty darn good.
The above things being said, Hoover does make some good points on occasion and I have acknowledged that in some posts. Why have I been posting on here? I suppose I wanted to offer some encouragement and a few positive words about medicine; from someone who struggled at times and had many of the same frustrations as Hoover did but persevered and is reaping the benefits.
If I’m not wanted here I’ll stop posting. If any of you are impressionable enough to be dissuaded from pursuing a career in medicine by Hoover and an anonymous cowardly blog, you probably aren’t med school material anyway. I say that not to be disrespectful or “high and mighty” but because it’s a long hard road and that’s not going to change any time soon.
There should definitely be some changes made to the educational process, without sacrificing quality of education and good experience, and I think in time this will happen. It already is, but with an old institution it will be gradual.
One last thing: In medical school you never get exposure to the “real world” outside of academic institutions, and it’s a lot better than most training facilities. Hoover, that’s something you’ll never experience because you chose another field. Judging by your tone in many of your posts, it’s probably better for everyone that you are not in medicine. Because this attitude of “it’s all about the Benjamins” and every man for himself, it’s just not real inspiring and not a good attitude for people who choose to serve others.
This is not a “pious physician” concept, but could also be applied to nurses, firemen, law enforcement officers, paramedics, teachers, etc. There are many fields that involve helping others and the thing I resent most is the way you seem to mock that.
Your criticisms and complaints, while in some instances accurate, are not very inspiring and often times overly exaggerated.
MD
Thing is ,who really want to become a doctor -they will become and no one will change their minds . Simply because in life,we make our choices who we want to become and what we are going to do in the future. Hoover blog didn’t distract me from loving medicine. It is a part of my being and I think that’s really not going to change because of going to blogs like Hoover’s and reading his experiences and opinions/which are interesting and useful.We make our choice and what we do – it is up to us (What about all the paper crap and TV crap – why don’t make a complaint them?? ).I believe that for some people it is an option to switch from medicine to something else and for some it isn’t.(But it is not like to commit a crime?- and writing about it makes it a crime?..) You wouldn’t make to change my mind about it and I think it is not so easy to give up something you TRULY want. You are a perfect example off that and I think it is great ,that you are standing up for medicine,but this is a blog ,it is Hoover -his point of view ,his decisions,his choices.MD,
Accept that there are people who change the course and have their own way of thinking and going trough life.
I think it’s awesome that you graduated med school and had the guts to get out of medicine. Because, when it comes down to it, life’s about figuring out what it takes to wake up happy… whether it be money, video games, the snooze button, family, or even medicine. I’ll be an MD in 18 months and have realized that in most fields of medicine, I will not be happy. So, I’m brainstorming my other options in life (and loans!). Happen to be hiring?! Keep posting; it makes me laugh!
I read your blog for fun, not for anything else, and I’m one of those poor suckers who are in medicine because I actually want to help.
So while I may not agree with your post (read: not everyone is in it for the money), I totally respect you for going for what makes you happy. Just ignore the haters.
Five bucks says MD’s a surgeon lol…good job on your blog overall and echoing those above I would like to know how you made the transition…keep up the good work!
“Just let them haters hate and watch the money pile up”
I’ll take that bet, MJ. From his job description (if it is to be believed) MD’s specialty sounds most like emergency medicine, or at the very least one of the other lifestyle specialties like pathology or radiology. No way a surgeon gets out of 30 hour shifts after his first two post-graduate years.
MD, what speciality did you go into? Actually don’t leave I will have noone to argue with.
I agree with the above post. No surgeon I know gets out of 30 hour shifts so soon. What is it that you do MD?
As a sidenote:
Snowfall-when I read your posts I get nauseous. I have a hard time following what you’re saying and you’re posts are consistantly full of simple gramatical/mechanical errors. I’m glad you are trying to defend a great site, but unfortunatley I think you may be doing Hoover a disservice.
OK well the truth is I never left, just haven’t been posting. I wasn’t going to comment again but if people are asking me to, I will. I do work in Emergency Medicine. You guessed correctly.
Here’s the thing, and I’ll be open and honest with everyone here. Like Hoover, I went through periods when I wondered if I should have done something else. Considered walking away. Realized that is difficult to do once you build up substantial debt after a few years of loans for medical school. I chose to stick it out and I’m glad I did.
Ultimately I’m still here, finally seeing some of the benefits. It’s a long road. It’s still a tough job, although not as bad as residency. My income is pretty darn nice; even better than I thought it would be when I was in training.
My entire point of posting on here was to just try to make some people see the “other side of the coin”. The point is, for all the things that suck along the way, a lot of other people doing a lot of other jobs have their own frustrations. I see that with friends of mine who have jobs outside of medicine. And to this day I’ve never been able to think of anything else I’d rather do. If I could, I would have done it by now.
Hoover’s concept of passive income is one a lot of people in medicine, and ANY field for that matter, should take to heart. Only problem is, it ain’t easy to make that happen. You can only accomplish that so many ways:
1) Borrow money and start a business, keeping in mind that most businesses fail. This BTW has its own stressors involved and if it doesn’t work you have nothing to stand on.
2) Have substantial income for many years and invest it wisely
3) Have super wealthy parents who will help you invest and live happily forever. Or maybe not–probably not much in the way of self satisfaction from never having to work for anything in your life.
#3 is not an option for most of us. #1 was not something I was interested in doing. Could wind up being a disaster. And if it doesn’t work then you have to go work for someone else, which wouldn’t be easy if you’ve been your own boss for a while. #2 made the most sense to me and my strategy is to live beneath my means and invest as much as possible. Hopefully I’m still want to practice medicine when I’m 55. But if I don’t I shouldn’t have to if I plan things right.
And that’s the problem most people in medicine run into. The “delay of gratification” is difficult. Most feel the need to spend big when they get out, with the attitude of “it’s only money, and I’ll make more”. There is also probably some outside pressures they feel; that as a doctor they should drive a certain car, live in a certain neighborhood, etc.
Point is: If you’re in medicine and unhappy, you can always do something else. But you may find the real world offers some challenges and frustrations of its own. And if you are in medicine and decide to stick to it, make good financial decisions. In doing so you will eliminate a lot of stress down the line and you won’t feel pressured to work 60 hours a week if you live within your means and invest wisely.
Lastly, for all the criticisms of medicine on this board and while there may be an element of truth to many of them, pretty much any job in the world will have frustrations. I remember when I was a kid I wanted to be a professional athlete (like most kids do). Now I wouldn’t do that for anything. The constant travel, time away from their families, being “traded” like slaves and uprooted from one city after another because of the fickle nature of their owners, a fickle fan base, public scrutiny, etc. I once thought this was the dream job and then realized it has a lot of drawbacks. You can find things that are less than desirable about any field.
The rewards of medicine are many and I try to focus on those. Not just the monetary ones. We really do have an opportunity to make a difference. And in today’s financial mess, we have job security which is more than most can say.
I’m always interested in discussions like this and I’ll keep posting if anyone wants to hear from me—and I could do without the comments like “shut the fuck up” because there’s no reason for the anger and disrespectulness. Thanks!
Nice comment MD. You are always welcomed to comment here as far as I’m concerned. I don’t mind the criticisms, but sometimes I will bite back =) And as you know, the language will get crude at times. It’s nothing personal, but I want people to be able to say whatever they want to say at this site and not have to worry about it. They have to be fake all day long at the hospital, and sometimes it feels good to drop the f-bomb without fear of repercussions.
Anyway, I opted for number one in your scenario above. You’re right, it is a big risk. But, I wanted it more than anything and it worked out amazingly well. That debt has been long paid off and the company currently runs debt free.
You have to love it and be a financial risk taker, that’s for sure. I’ve always been entrepreneurial by heart, so it was the natural way for me to go.
westaaron ,my English language isn’t very good..My apology. It is hard for me to express what I mean in English language ..
Hoover – hope I didn’t offended you by my post,course I didn’t mean it .
First off, thank you Hoover! Your website was extremely helpful the past couple of months as I contemplated a major life decision.
I am finishing up my first semester of med school and have decided I will not be returning. There are so many reasons for my choice and it was a difficult decision because for the longest time, becoming a doctor was all I had wanted. I am a non-traditional student who has an MBA and built 2 companies. During my time in med school, I realized that business is my passion. (yes, I know I could combine business and medicine to all the pro-med school people)
As I was explaining my decision to my classmates, life is about opportunity costs. To become a doctor, you will have “delayed gratification” and need to sacrifice many things you want now to have those later. I know first hand about delayed gratification, because starting a business is more than a full-time job. I would spend 80-100 hrs a week and on-call 24/7 during the initial phases of starting the company. This time was During this time, I did have to sacrifice many things. (Hoover, you know this as well)
Although I struggled through my classes, as most non-traditional students do as well as most med students do(and to you traditional students, be kind to the non-traditional, it is a little harder for us initially so be compassionate as we try to adjust to the sciences and the life of med school), it never was about can I do this but more questioning whether I wanted to do this.
I have the upmost respect for those pursuing a medical degree because not only is it difficult, intense, demoralizing, and time-consuming but it tests your perserverance.
One of the reasons I chose medicine is because of the cliche-ish “I want to help people.” If you are doing medicine for this reason but medicine is not your passion, remember you can help people in whatever profession you choose. It may not be life-saving as a ER doc, but it can bring hope and help people by your job. Example, my company was able to provide assistance in buying and transporting 3,000 toys for underpriviledged kids.
Follow your passion!!!
MD your honest positive take on this post is appreciated. Good luck with your passion
http://www.forbes.com/leadership/2008/05/05/physicians-training-prospects-lead-careers-cx_tw_0505doctors.html
Again, if you pursue med school, congrats and the best of wishes to you. For those questioning, remember you are not alone and it is alright to question
Good luck in the business world. Better to do what really drives you than stay with medicine and feel stuck. If you weren’t happy with your decision, better to get out than regret it.
As for the cliche of going into medicine because you “want to help people”, the fallacy with that is you could just as easily have been a nurse, a fireman, a paramedic, teacher, etc. and not have to deal with as many obstacles. I agree with you; there are many ways to help people other than being a physician.
This was the most common question in med school interviews and for any premeds out there, the correct answer is “I want to help people AND I like the leadership role, making big decisions, want to do big procedures, etc.” If you can’t honestly say anything more than wanting to help people as your reason to go to medical school, you shouldn’t go. That is a given, but there has to be something deeper driving you.
Me personally, I knew I’d be miserable taking orders from someone else my whole career, or never getting to be a decision maker. That’s why I chose this over other “helping people” fields. And of course the money was some part of the equation. Although anyone with a brain knows there are plenty of other ways to make a good salary, and if you’re smart enough to get into medical school you can do a lot of other things to make a good living if money is what you’re about above all else.
Finally Hoover, wanted to let you know I’m not “stalking you” online I just surf the net a lot at work when I’m not busy and this web site is on the list of ones I check now, amongst others. I promise I’ll walk away if I have a code or something else critical……
Haha, it’s all good MD =D
Oh God, not the “if you’re smart enough to get into medical school, then you came make similar money doing other things” argument.
That’s the most tired pile of shit I’ve ever heard, and I keep on hearing it. Only a small fraction of medical students can come close to matching their salary in the medical field by doing something else.
Keep in mind that even the salary of a generalist is around $150K. That’s on the lower end of the spectrum. In fact, I would be hard pressed to find more than a handful of doctors who make alot less than that while working full-time. The average salary of all doctors is around $180k – $200k. (last I checked).
Tell me, then. What can you do that can guarantee you a $200k annual salary? Investment banking? Management consulting? Law? Hedge Funds? Private Equity? Entrepreneurship?
Out of the ones listed, how many have higher requirements than those of the average medical school? All except Law and entrepreneurship. However, with law and entrepreneurship, you’re not guaranteed anything. You can easily come out of law school making $40k working at a government job. And most small businesses fail.
So how exactly would your average medical student make similar money out of the field of medicine? The truth is that they can’t. The more accurate statement is this; if you’re smart enough to get into a hedge fund, private equity shop, investment bank, or make it as an associate at a management consulting firm, then you can pull in equal or less cash as a physician.
Bronx with all due respect (which you haven’t shown me in calling my comments a “pile of shit”) I think the argument goes something like this:
As an accountant, to give one example, you can easily make 50-60K out of school. At the age of 22 or 23. Over the four years that this person would have been in medical school, they earn $200,000 or more as an accountant. If they invest wisely over those early years (most probably don’t but they could) they could have approximately 60K in investments, without including any interest or growth of their investment, after four years. The medical school graduate, during that time frame, accumulates over 100K in debt. The accountant could then move up the ladder, or start their own business, and their income could continue to grow over the next 3-5 years while the physician in training only makes 45K or so. Feasible to say if they build up a client base, or start hiring younger people to work for them and make money off of their sweat, they could wind up with a very nice salary and a huge head start having not taken on the debts involved with medical school.
I’m not saying every accountant will earn what a physician does over a lifetime, just saying this is one example and if they move up the ladder or start their own business, they can do quite well.
If they DO wind up making what the physician does, it will only be after working their tail off and putting in LONG hours, much like the physician. Even then it’s not guaranteed. But it’s possible.
I have an acquaintance who is an accountant, out of school less than a year, working for a big company and from what she says, there is plenty of misery in her field as well. I couldn’t do it, I wouldn’t like it, I’m glad I chose what I did.
But there are other avenues and if you have the brains, the work ethic, etc. you can make that kind of salary in other fields.
I’m almost a year and a half out of training and at least in my mind, still playing “catch up” to an extent. I figure once I’m three years out, if I keep living beneath my means and investing/paying off debt, I’ll finally have made up for all the years of school and loans.
I’m 31 now and I’ll be 33 then. Where would I be if I had chosen something else? Most likely hating my cubicle and trying to move up the ladder. Maybe having some success as a business owner?
Regardless I think I’d be wondering what my life would be like if I had gone into medicine.
If putting your nose to the grindstone day in and day out was the secret to success, Chinese sweatshop workers would be the kings of the world.
It’s kind of a moot point, anyway. Maybe it’s the people I come into contact with, but medicine doesn’t really strike me as the kind of place where risk-takers are welcomed. I heard the words “cavalier” or “maverick” many times but never in a positive light. In most realms of human endeavor, getting an education and being a good little worker bee, always painting within the lines and never taking risks or causing trouble will earn you a nice, comfortable middle-class existence but won’t make you filthy rich. Medicine is somewhat the exception as far as pay when it comes to skilled labor, but then again it’s a tightly controlled market. Most Ph.D.’s would love to make what your garden variety pediatrician makes, and put in the long hours and had to be somebody’s bitch to get where they were too. I’d hazard a guess that the average med school graduate would really make less money for the same amount of work and education in some other realm. Our high pay has more to do with the relative shortage of doctors to go around than being smart, educated, and hard-working. Sorry to say, but employers and clients don’t give a damn how much money you owe or the shit you had to go through to get where you are, they just care about what you can do for them and if the guy down the street or across the ocean can do the same job for less. Look at average salary for lawyers and vets, for instance.
MD, sorry if I seemed to be disrespectful towards you, but my reaction was solely to that statement, which is often used against me by my classmates.
You are correct that the medical professional gets off to a slow start, and he/she can make up ground after 5-10 years. My point was more that there is a very wide variety of medical students, and an even greater range of intellect. Based on what I’ve seen, only a fraction of medical students would be able to match or even come close to their income as a physician, even given the lag time for the medical education.
It’s entirely fine with me that people get into medicine for the money and financial stability, but they are deluded if they think that anyone capable of scoring a 30+ on the MCAT has the opportunity to make $200-250k. People need to realize just how rare and how much luck is required in a non-medical profession for a person to make that much money.
Hector, great insight. Your posts are always a pleasure to read.
Yes, Hector you make some excellent points. In terms of “supply and demand” we as physicians have that on our side, since demand exceeds supply in most areas. And the areas where that does not hold true (ie, the most desirable places to live) most physicians will make less money.
It will be quite interesting to see what happens in the next decade or two, because whatever changes are on the horizon in the field of medicine in terms of reimbursement, as long as demand exceeds supply I firmly believe physician’s salaries will not drop substantially. If salaries do drop substantially, so will the number of physicians in the US, which will then further drop the “supply” side of the equation and balance things out.
If you guys get a chance take a look at this book.
http://www.amazon.com/Millionaire-Next-Door-Thomas-Stanley/dp/0671015206
It goes into detail what MD is talking about regarding wealth and not income. Compliments to MD regarding your argument as well as Shining Hectors comments.
(http://www.amazon.com/World-Flat-History-Twenty-first-Century/dp/0374292884) Shining Hector this book has a segment about where globalization can affect health care and dealing with doctors across the ocean.
Bronx you have a valid point as well regarding income opportunities. One of my MBA professors offered to get me a job doing consulting work for a considerable amount of money when I finished my MBA. He was up front with me about not having a life while having this job.
So if you want to earn a considerable amount of money you will have to work for it.
But for my businesses, I don’t mind putting in the work and enjoy what I do as well as the freedom (although I still have other unique stressors), so it makes it easier to put in the long hours.
And to add to the argument made by MD, I have seen our attorneys and accountants work “their butts off” and put in long hours as well, but they enjoy what they do so that makes it worthwhile to them.
Ultimately it depends on the person and what is important to them.
Good luck to you all
MD, I don’t think that’s a completely accurate portrayal of the scenario you put forth. If reimbursement does drop substantially in the future, the initial reaction would be an inevitable decrease in medical school enrollment. However, this cannot be allowed, as further decreases in the supply of physicians would cause a shortage crisis in American healthcare. There is absolutely no way that Americans can receive comparable healthcare without an adequate number of physicians. Therefore, drastic changes would be implemented in the educational process. A large portion of loans would have to be shouldered by the government, and the length of schooling, as well as residency training, would be curtailed. This, in turn, should attract more students to go into the medical profession. However, given the fact that physician salaries are cut, medicine would no longer attract students of the same caliber. This may or may not translate directly into a decrease in the quality of healthcare.
Medicine isn’t a free market, so Econ 101 need not apply. Talk to me again when everyone with an IQ higher than room temperature who applies for med school and residency finds a slot.
Med schools have to turn away qualified applicants every year. That FM residency in Podunk that American graduates won’t consider is swamped with more FMG applications than you can shake a stick at. A reduction in average pay might make some difference in the amount of applicants, but until med schools no longer have full enrollment and hordes of FMG’s don’t continue to see a future in whatever medical dregs they can scrounge up here as ten times better than whatever prospects they had in their home country, it’s not going to make any difference in the number of practicing physicians churned out every year. There’s really a hell of a lot of slack there to still be taken up.
You also have to think the bright-eyed “I just wanna help people” pre-med crowd aren’t all completely duplicitous. I’d say it’s really not 100% about the money for most. The cynicism and greed usually come after it’s far too late to quit anyway. Not everybody’s got the guts to pull a Hoover. You’re also presuming perfectly informed and rational actors with an realisitic appreciation of their abilities and prospects, which is where most economic theory falls flat. Law schools aren’t flooding the market with people aspiring to be that government bureaucrat sitting in a drab office pulling 40K a year, they’ve got dreams of a bright seven figure future in corporate law with enough time left over for pro bono work combatting civil rights abuses. Nobody’s imagines themselves as that average slob when filling out the applications, they only let smart people into law school, after all.
frmrmdtstdtnowbusiness, thanks for linking to The Millionaire Next Door. That book absolutely changed my life. If it weren’t for that book, I’d no doubt be making some huge financial blunders right now like many others in my field that I know are doing.
Bottom line is, what most people equate with “wealth” is in fact not wealth at all—just a lot of expensive things with no savings in place for emergencies or investment growth. It doesn’t matter if you drive a Ferrari and live in a million dollar home; if you can’t survive more than a a few months without income from working, you are NOT wealthy. Biggest blunder made by many physicians, and those in other fields with high incomes.
In response to other comments, first of all, while medicine may not apply to “Economics 101″ I would argue, in fact, that it does to a large extent.
For instance, last year Congress overturned a planned Medicare cut. Why? Because so many physicians said they would refuse to see medicare patients if it passed. In effect, what happened is they saw that the DEMAND would far exceed the SUPPLY and had to pony up the money.
The same could be said for physicians, and groups of physicians who contract with insurance companies. If enough docs say, “I refuse to accept insurance company X because their reimbursement is unacceptable to me” then eventually people who pay for this coverage will be upset since no one will take their plan. They either pay out of pocket or find a new insurance company. Insurance companies need doctors to accept their plans and physicians DO have some degree of bargaining power when they approach it wisely, particularly as a large group of physicians who are all on the same page.
Where I live, if you want to be in the most attractive city in the state, your pay will be 20% less than other areas. If you’re willing to go to smaller towns that are more remote, you can earn substantially more. Supply and Demand at work.
If you think the market will correct by just finding more FMG’s, changing the curriculum, etc, to find people willing to work for less, you are naive. These changes take MANY years to implement. Most residencies could not, should not, and will not be reducing the number of years of training. How could you possibly shorten medical school? What would you cut out? Is there a governing body that would oversee curriculum changes nationwide, and what would they decide is not useful?
The best solution, if reimbursements do continue to drop, will be more mid level providers. And that is scary in itself. I’ve worked with some who are great, I’ve worked with some that flat out scare me and I didn’t want working under my license.
It will be interesting to see how things change in the next 20 years, that’s for sure. I suspect big Pharmaceutical companies will be the first target.
Hi Hoover,
I like medicine but I also think that your website is a really important resource. If some people are afraid to think, then I’m afraid for them. I prefer to go through med school with my eyes wide open. And I really hope other premeds think before they make one of the biggest commitments in their lives.
Rose