Sunday, February 24, 2013

Imagining Being a Young and Restless Physician
A tough, but nervous, tenacious restless race; materially ambitious, but prone to introspection, subject to waves of religious emotions... A race that typical member is torn between a passion for righteousness and desire to get on in the world.
Samuel Eliot Morison (1887-1976)
“You can actually make a lot of money and do a lot of good in the world.”
Andrew Goldman, Interview with Peter Henry, dean or N.Y.U’s Stern School of Business,  February 24, 2013, New York Times Sunday Magazine
I awoke this morning imagining what I would think as a young medical student physician about to select a residency knowing what I know now.  In my imagining, I was 25 years old and married to a fellow medial student.  Together, we were $250,000 in debt.
I would be torn whether to become a primary care physician or a specialist.    Most of my mentors on the medical school faculty have been specialists, but   I would know that
·        The United States desperately needs primary care physicians, they do a world of good, it would be the righteous thing to do,  and they are in short supply, particularly in rural America and in inner cities.

·         Foreign medical school graduates and osteopaths are a growing proportion of primary care physicians. 

·        Most of my classmates envision working for hospitals or large medical groups because starting a practice on your own is difficult, and it is impractical to practice solo or to get financing to do so.

·         Specialists make 2 to 3 times what specialists make, but that Obamacare plants  to  raise primary care doctors by 10% a year over the next 4 years while cutting specialists’  pay.

·         Getting residences is competitive for the ROAD (Radiology, Orthopedics or Ophthalmology, Anesthesiology, and Dermatology), all of whom have shorter work hours, higher incomes, and more balanced life styles.

·        Working for a salary for a hospital or a group was probably my destiny, and I would be interested in a 40 hour work week, fringe benefits, health care premiums, payment of my medical school debt, and malpractice premiums.

·        I would be aware the end-game of health reform was still highly uncertain and my ultimate fate after completing 3 to 5 years of training was unknown as well as where I would fit into the system.
But, given economic conditions for the economy, with a huge national debt and high unemployment, I was not unhappy in my decision to become a doctor.   After all, because of the doctor shortage and the rise of health care as the leading economic growth sector, I was virtually assured of gainful employment.
That was more than I could say for many of my college classmates.  Some had gone to law school. Half of them were unemployed 6 months after receiving their law degrees.  Even those who received their MBAs were having trouble finding work.   Both of which might explain why those seeking admissions to law school and business schools had dropped precipitously y over the last 4 years.   The information technology sector was,  but the financial sector wasn’t going anywhere.    At least,  my wife and I would have the means of paying off our college, medical school, and post-graduate training debts.  All I wanted was to do good and to do well, and I still thought I could do both by becoming a doctor.
Tweet: Knowing what I know now, becoming a physician is  positive thing, especially when one  factors  in conditions of the overall economy.

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