By the first post, are you referring to the first post of this thread? If so, I would suggest that you require some perspective before you go dumping on the opinion of somebody already in the field. I don't think you can fully appreciate or understand how rotten the system is until you work in it. As to how you (or anyone else) will react to working in it, you don't know that until you try. Much easier to look in and criticise as an outsider, IMO.
Some thoughts on your post:
1) Problem is, society DOES expect doctors to be superhuman. The prestige of the job has been chipped away, so you're not treated like a god, but you are still expected to act like one, and be above human traits. That, even for those of us who sneer at all things "prestige", gets a bit hard to take, day in, day out.
2) As somebody who personally cares very little about money and material gains, I've got to say, I have become MORE interested in money as my working environment has deteriorated. Why? Simply put, there has to be some return for being screwed. It's funny - you start trying to put a price on what your sacrifice and stress is worth - because essentially, it's the only compensation that is offered to you. Nobody's offering better working conditions or a better healthcare system - it's money or nothing. It just becomes the commodity that you trade in. It becomes really easy (and enticing) to look outside of medicine, and see jobs you could easily do, that pay triple what you make now, for half the work. Once the "honour" and "privilege" of being a doctor is totally wrung out through years of systematic abuse, it's very seductive to look elsewhere and think "why not?".
Saturday, March 13, 2010
In my view, the first post is immature and unrealistic.
Being a doctor is a job. It is not like turning into some righteous higher powered being, you are not a godsend. As such, you should not be expected to act like one. We are all human.
Money drives us. Power drives us. Fame drives us. Those that deny this are either not human, or are lying. Some are more idealistic, some aren't. These are human traits and this explains the actions most doctors take, and nothing has changed. It was like this before, and it will always be like this. If you were immature enough to think otherwise before you got into medicine, you have yourself to blame. Stop living in fantasy land, this is how things are, and things aren't going to change. I can see the frustration, but what it comes down to, is what you will do. If you care that much about patients and that little about money, continue to work hard, continue to accept smaller payments, why go to another career when medicine will let you help people more? I mean, money doesn't come into this does it? There really is no need for a reward... right?
Not such a purist now, are we?
Being a doctor is a job. It is not like turning into some righteous higher powered being, you are not a godsend. As such, you should not be expected to act like one. We are all human.
Money drives us. Power drives us. Fame drives us. Those that deny this are either not human, or are lying. Some are more idealistic, some aren't. These are human traits and this explains the actions most doctors take, and nothing has changed. It was like this before, and it will always be like this. If you were immature enough to think otherwise before you got into medicine, you have yourself to blame. Stop living in fantasy land, this is how things are, and things aren't going to change. I can see the frustration, but what it comes down to, is what you will do. If you care that much about patients and that little about money, continue to work hard, continue to accept smaller payments, why go to another career when medicine will let you help people more? I mean, money doesn't come into this does it? There really is no need for a reward... right?
Not such a purist now, are we?
Writing stories about doctor shortages and the rate of professional burn out within doctor ranks simply doesn't sell. The public would far rather read about dodgy doctors making mistakes, and greedy doctors who want more money to add to the piles they have already - it's heaps more fun to cut down (seemingly) tall poppies than face up to reality. In short, the public don't really care if doctors are worked to the bone.
It seems to me that the posters on this thread have either not experienced a career/full time employment or went straight from school to med. I say this because EVERY career/place of employment is totally dominated by bull***t politics. That's life - get used to it. The sooner you accept it, the easier it becomes.
I am leaving my (well paid) IT career of 8 years to hopefully start med next year. Why, because IT is full of bull***t politics and is run by bureaucratic Accountants/CEOs/CFOs etc who have no IT knowledge whatsoever. Sound familiar?????
Breathe easy Boys & Girls. Don't let office politics scare you from following your dreams.... even flipping burgers has it share of egos and McManager power trips, so you might as well enjoy what you do. Right?
I am leaving my (well paid) IT career of 8 years to hopefully start med next year. Why, because IT is full of bull***t politics and is run by bureaucratic Accountants/CEOs/CFOs etc who have no IT knowledge whatsoever. Sound familiar?????
Breathe easy Boys & Girls. Don't let office politics scare you from following your dreams.... even flipping burgers has it share of egos and McManager power trips, so you might as well enjoy what you do. Right?
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.
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.
think the main reason why people get so disillusioned with med is because they started out with slightly inflated expectations ofhow amazing it was going to be. I know it's gonna be a slog, but i wouldn't have it any other way.
Sure if i don't ass kiss, it'll take me longer to get where i want to be, and my opportunities maybe limited if i don't play the game
But it's MY career choice and i wouldn't have it any other way
I know this is really easy for me to say now, but i feel i won't develop the gradual hard exterior because i know that this career tests you beyond any other reasonable measure. I coud have accepted my place in business law, but i decided that i want to persue something i really wanted, and i'll work long and hard for it.
Playing the game is necessary at times, but i'm of the belief if i can work hard and be one of the best, then i can get to where i want to be. Unrealistic perceptions or not from consultants, or patients, if i know i do a good enough job, i'll be more than content to go to work everyday. That's just me though
Sure if i don't ass kiss, it'll take me longer to get where i want to be, and my opportunities maybe limited if i don't play the game
But it's MY career choice and i wouldn't have it any other way
I know this is really easy for me to say now, but i feel i won't develop the gradual hard exterior because i know that this career tests you beyond any other reasonable measure. I coud have accepted my place in business law, but i decided that i want to persue something i really wanted, and i'll work long and hard for it.
Playing the game is necessary at times, but i'm of the belief if i can work hard and be one of the best, then i can get to where i want to be. Unrealistic perceptions or not from consultants, or patients, if i know i do a good enough job, i'll be more than content to go to work everyday. That's just me though
Why is there so much bureaucracy in medicine?
Why do doctors have so little rights?
Why is medicine the only profession that allows itself to be controlled and bonded by the government?
Why are greedy, monopolistic colleges still in charge of future postgraduate training?
Why is medicine so hierarchal and less collaborative?
What happens when the medical student tsunami finally happens?
I would suggest you guys read this blog:
http://www.medschoolhell.com
Although he is American, alot of what he says is universal for all medical students and graduates.
Why do doctors have so little rights?
Why is medicine the only profession that allows itself to be controlled and bonded by the government?
Why are greedy, monopolistic colleges still in charge of future postgraduate training?
Why is medicine so hierarchal and less collaborative?
What happens when the medical student tsunami finally happens?
I would suggest you guys read this blog:
http://www.medschoolhell.com
Although he is American, alot of what he says is universal for all medical students and graduates.
This thread has made me wish I get into law! Just to increase options. I'm not so sure. I've heard some very senior lawyers who sort of have the same thing: frustration with the courts, anger that their dreams of litigation turned into paper mountains etcetc. Is this a symptom of medicine or is it a symptom of society in general?
Obviously the problems facing medicine are different to other professions, but are they worse?
Obviously the problems facing medicine are different to other professions, but are they worse?
I have a strange feeling that resurrection this thread will stir up some debate.
I think Medicine is a like a spouse. Every now and then u have fight/bad moments (think: exams, consultants/reg hating u.. ) and you have to take out the trash. It' moments like that which I want to divorce it and run off with (in my case) the girl in my mind that is a playboy playmate (think: commercial airline pilot).
But after the cloud has clear I feel better about it. I realised some times its good (when the patients recover and thank us) and some times they are bad (when the patients want to kill me with a bedpan). Frankly I think im keeping in this for the sake of going to the end cos i dun mind it.. and making a decision there. At the end of the day, I will either be a happy consultant.. or a man with a mid life crisis, a 18 yr old gf and a new job as a plumber. .... Kinda like getting married (or civil service for those inclined).
I think Medicine is a like a spouse. Every now and then u have fight/bad moments (think: exams, consultants/reg hating u.. ) and you have to take out the trash. It' moments like that which I want to divorce it and run off with (in my case) the girl in my mind that is a playboy playmate (think: commercial airline pilot).
But after the cloud has clear I feel better about it. I realised some times its good (when the patients recover and thank us) and some times they are bad (when the patients want to kill me with a bedpan). Frankly I think im keeping in this for the sake of going to the end cos i dun mind it.. and making a decision there. At the end of the day, I will either be a happy consultant.. or a man with a mid life crisis, a 18 yr old gf and a new job as a plumber. .... Kinda like getting married (or civil service for those inclined).
What perfect timing to kick up this old article.
Being exams and all I guess makes us hate med even more right now.
When I was reading this article last yr, I knew I had began losing my real passion for it. At this stage of my life, I must say I'm still so interested by medicine and what it has to offer, yet at the same time tired. Just tired in general, tired of study, tired of filling my time off with part time work, tired of sucking up to consultants and registrars etc only for them to hate you for the tiniest of things, and tired of their unrealistic expectations.
Theres so many things I love doing, and like a little child I don't like to think of the hard work required. I want to photograph, I want to travel, I want to live life doing work that's fun and meeting people and gaining worldly experiences.
But still I want to finish med, because I started, and because all in all as far as work goes, it's a decent job.
One interesting thing though, I read somewhere that Gen X's change career paths about 3-4 times in their life, while gen Y's (us i guess) will change 6+. Now in the old days when Anaesthetists became GP's, and that kind of switching would that be considered a career change? Or is it more like my pipe dream of becoming a commercial airline pilot?
Being exams and all I guess makes us hate med even more right now.
When I was reading this article last yr, I knew I had began losing my real passion for it. At this stage of my life, I must say I'm still so interested by medicine and what it has to offer, yet at the same time tired. Just tired in general, tired of study, tired of filling my time off with part time work, tired of sucking up to consultants and registrars etc only for them to hate you for the tiniest of things, and tired of their unrealistic expectations.
Theres so many things I love doing, and like a little child I don't like to think of the hard work required. I want to photograph, I want to travel, I want to live life doing work that's fun and meeting people and gaining worldly experiences.
But still I want to finish med, because I started, and because all in all as far as work goes, it's a decent job.
One interesting thing though, I read somewhere that Gen X's change career paths about 3-4 times in their life, while gen Y's (us i guess) will change 6+. Now in the old days when Anaesthetists became GP's, and that kind of switching would that be considered a career change? Or is it more like my pipe dream of becoming a commercial airline pilot?
all I meant...not trying to make a distinction as to which job is the most demanding or has the most possibility for catastrophe...pilots, flight controllers, defence ministers, politicians, judges...they also can directly impact many lives...any health care worker who has gone off the rails could potentially kill a patient (a Physio with an incorrect spinal manipulation, a nurse with an incorrect drug dose, a pharmacist giving the wrong drug...). Doctors aren’t always in life or death situations with their patients.
That said, I didn’t disagree with the majority of the quote being specific to Med...many other professions don’t have patients they can harm...a teacher skipping some questions or a lawyer making an incorrect plea wont kill anyone (in Aus anyway). If you arent in it for the patients then you shouldnt be in Med...
I second that AussieChica...L337: the advice of others isn’t always the best for you
That said, I didn’t disagree with the majority of the quote being specific to Med...many other professions don’t have patients they can harm...a teacher skipping some questions or a lawyer making an incorrect plea wont kill anyone (in Aus anyway). If you arent in it for the patients then you shouldnt be in Med...
I second that AussieChica...L337: the advice of others isn’t always the best for you
stand firm by your convictions L337, you're the only one who has to live your life!
"OMGWTFBBQ"... what does the BBQ bit stand for?
I think people can get disenchanted w/ any profession, but i think generally u have 2 sacrifice so much more 2 b a dr... from the age of 15 (when u start yr 11) until the end, its work work work work work work work... o and maybe a little play. it puts undue stress on your family, your relationships, your sanity, your time, etc. its one thing getting disenchanted about an office job u took three yrs of uni 2 qualify 4 (a lot of it spent drinking). its another thing 2 put that effort into med and then "discover" its not all that its cracked up 2 b.
wow, i think i just discovered a bias i have about med. i've always believed that every profession is valuable, and whatever u do, u should do it 2 the best of your ability, and if u do that, you're just as good as someone employed in any other career (i.e. "all careers r equal"). but i think on the inside, i believe med is more demanding.
for the record, i think there r other really demanding jobs (single mother of 10 children, anyone?). however, i think the majority r less demanding than med.
"OMGWTFBBQ"... what does the BBQ bit stand for?
I think people can get disenchanted w/ any profession, but i think generally u have 2 sacrifice so much more 2 b a dr... from the age of 15 (when u start yr 11) until the end, its work work work work work work work... o and maybe a little play. it puts undue stress on your family, your relationships, your sanity, your time, etc. its one thing getting disenchanted about an office job u took three yrs of uni 2 qualify 4 (a lot of it spent drinking). its another thing 2 put that effort into med and then "discover" its not all that its cracked up 2 b.
wow, i think i just discovered a bias i have about med. i've always believed that every profession is valuable, and whatever u do, u should do it 2 the best of your ability, and if u do that, you're just as good as someone employed in any other career (i.e. "all careers r equal"). but i think on the inside, i believe med is more demanding.
for the record, i think there r other really demanding jobs (single mother of 10 children, anyone?). however, i think the majority r less demanding than med.
Maybe so, but you'd have to think that the extremely stressful nature of the medical profession would have a significant influence on this. Also, due to the (unbearable at times?) stress levels, you need to have a BIG commitiment to medicine to be able to be able to treat your patients correctly - if you start not to care, and even loathe them, it could result in catastrophe....
Or at least, that's what I think in any case...
PS - It's interesting to note the reactions I got when I told some of my medicine-aspiring "friends" from school that I was reconsidering my choice of career... After the initial "OMGWTFBBQ!", they just refused to beleive that medicine could be anything but THE dream job (did I mention these guys have the box sets of House and Scrubs?) and proceeded to say that I was "soft". Maybe I should direct them to MSO where Chnaski can give them a good talking to.... B)
PPS - I think it'll be even scarier when i tell my parents ... oh well, it's my life and all that jazz, and it's not like I've ruled med out completely.
Or at least, that's what I think in any case...
PS - It's interesting to note the reactions I got when I told some of my medicine-aspiring "friends" from school that I was reconsidering my choice of career... After the initial "OMGWTFBBQ!", they just refused to beleive that medicine could be anything but THE dream job (did I mention these guys have the box sets of House and Scrubs?) and proceeded to say that I was "soft". Maybe I should direct them to MSO where Chnaski can give them a good talking to.... B)
PPS - I think it'll be even scarier when i tell my parents ... oh well, it's my life and all that jazz, and it's not like I've ruled med out completely.
I dont..burn out and/ or boredom can happen in any job...
Generic:
"get to that point where it becomes a job, where getting out of bed and going to work is just a drag,"
Your motives and reasons may not have changed (or alternatively they may) but this can occur in any profession...you don’t have to be a Dr to loathe going to work or to be still in it for the wrong reasons. Feeling trapped or unsatisfied professionally can be due to many things (just like there are many things which can keep a person in a profession they no longer enjoy).
Generic:
"get to that point where it becomes a job, where getting out of bed and going to work is just a drag,"
Your motives and reasons may not have changed (or alternatively they may) but this can occur in any profession...you don’t have to be a Dr to loathe going to work or to be still in it for the wrong reasons. Feeling trapped or unsatisfied professionally can be due to many things (just like there are many things which can keep a person in a profession they no longer enjoy).
Thanks AussieChica (and no, you don't sound condescending ). I think it's great that you've got that "battler" attitude, and certainly you have much more life experience than me (being a uni student already and all), and I wish you well for medicine. In any case, I got the book "Medicine: A Guide For Prospective Students" by Patrick Mackerras a few weeks ago, and this is one of the standout quotes for me:
At some stage in their professional lives, a lot of doctors get to that point where it becomes a job, where getting out of bed and going to work is just a drag, and the concerns of their pateints becomes an irritation. Whenever you get to that point, whether it be as an intern or someone further down the line, it's time to get help. The day you stop doing it because you care for the people you're looking after as well as for the professional and intellectual satisfaction that you might get from it, is the day that you need to have a long hard look at what you're doing.
Basically, I don't want to ever reach that stage. I mean, you hear all the stories about ******* surgeons, who couldn't care less about anyone, walk around in a haze of glory, have the personal relationship breakdowns, etc etc. In the end, I thought it might be wise to SERIOUSLY consider what I want from life. So yeah, I'll be trying to organise some work experience both at a hospital and a dental surgery to try and make up my mind......because I just don't think I'm ready to make the decision right here and now
@ NightShadow - Well, I think chinaski said one time, that the reason she keeps on going, is because of the fact that, despite all the crap, eventually the conditions will get better.
At some stage in their professional lives, a lot of doctors get to that point where it becomes a job, where getting out of bed and going to work is just a drag, and the concerns of their pateints becomes an irritation. Whenever you get to that point, whether it be as an intern or someone further down the line, it's time to get help. The day you stop doing it because you care for the people you're looking after as well as for the professional and intellectual satisfaction that you might get from it, is the day that you need to have a long hard look at what you're doing.
Basically, I don't want to ever reach that stage. I mean, you hear all the stories about ******* surgeons, who couldn't care less about anyone, walk around in a haze of glory, have the personal relationship breakdowns, etc etc. In the end, I thought it might be wise to SERIOUSLY consider what I want from life. So yeah, I'll be trying to organise some work experience both at a hospital and a dental surgery to try and make up my mind......because I just don't think I'm ready to make the decision right here and now
@ NightShadow - Well, I think chinaski said one time, that the reason she keeps on going, is because of the fact that, despite all the crap, eventually the conditions will get better.
well so far it sounds like you're using really good reasoning, i'm proud of u (hope that didn't sound condescending). it's v. mature 2 b able 2 look at your real motives for something, and then reassess, because they might not be appropriate to the reality of what u desire. i think medicine is amazing, i can read all the doom and gloom, and it just gives me that aussie battler's sense of dogged determination 2 get through it. but if u don't have that strong a desire to go through all the crap, then by all means go for another career which is still interesting, challenging, science-y, people-y, etc. but without all the downfalls of med.
in regards 2 what other ppl say: they're not the ones who r going 2 have 2 live your life, u r.
if i were u i'd spend some serious time at a hospital somehow. idk how, just get in there, get a real feel for the place. get someone 2 beat u up, lol, jk. that's way more realistic than all the tv shows u mentioned (so glad i never got into those except for house, which i got into this yr). if u can spend time there and decide u don't wanna b a dr, awesome, put all your energy into dentistry/whatever. just don't make a major life decision while you're in yr 11 lol.
in regards 2 what other ppl say: they're not the ones who r going 2 have 2 live your life, u r.
if i were u i'd spend some serious time at a hospital somehow. idk how, just get in there, get a real feel for the place. get someone 2 beat u up, lol, jk. that's way more realistic than all the tv shows u mentioned (so glad i never got into those except for house, which i got into this yr). if u can spend time there and decide u don't wanna b a dr, awesome, put all your energy into dentistry/whatever. just don't make a major life decision while you're in yr 11 lol.
Less places maybe, but lower requirements too. Also, I'd be preapred to put in the effort to get in, especially if a career in dentistry is "cushy" (ie. awesome :P ) as it sounds.
@ AussieChica - Beleive it or not, the first career I ever wanted was a scientist (when i was 8), because (i remember saying this) "they get to wear cool white coats." After some serious brainwashing during the years, my parent started preaching the virtues of medicine (most of which I ignored). Then, in Yr.10, I started watching House, Grey's, Scrubs etc and thought, "######, this could be a cool career!" I maintained this attitude until, well, until I cam here really. This site, as well as PagingDr, and visits to see doctors, has kinda made me realise that med isn't the uber career for all the smart ppl like i first thought. I also (with some help from Dr mal) realised that sometimes the most "prestigious" career isn't the best. I realised, that even if I did make it to the top as some elite neurosurgeon, making $500k, would it be worth it? would I have te TIME to spend the money? TO pursue some of my goals in life? To follow my dreams?
I realised that I wanted pretty much what any person wants from life - job stability, excellet pay, good working hours (see previous post - you get the idea) - and that Med isn't the only way to get that (*shock horror*). So yeah....
Although I haven't eliminated the possibiity of Medicine as a career completely, I think it's safe to say, if I had to choose QTAC preferences now, I'd be putting Dent at the top of the list.
@ titan - chicks may dig doctors, but good luck meeting them when you're working 50+hr weeks as a junior doctor lol, jks :P
Anyway, ALL the dental assistants I've ever seen see to be hot 20-somethings (one reason i used to love trips ot my ortho when I had braces). Yet another thing to make coming to work more appealing for dentists, i wonder? B)
@ AussieChica - Beleive it or not, the first career I ever wanted was a scientist (when i was 8), because (i remember saying this) "they get to wear cool white coats." After some serious brainwashing during the years, my parent started preaching the virtues of medicine (most of which I ignored). Then, in Yr.10, I started watching House, Grey's, Scrubs etc and thought, "######, this could be a cool career!" I maintained this attitude until, well, until I cam here really. This site, as well as PagingDr, and visits to see doctors, has kinda made me realise that med isn't the uber career for all the smart ppl like i first thought. I also (with some help from Dr mal) realised that sometimes the most "prestigious" career isn't the best. I realised, that even if I did make it to the top as some elite neurosurgeon, making $500k, would it be worth it? would I have te TIME to spend the money? TO pursue some of my goals in life? To follow my dreams?
I realised that I wanted pretty much what any person wants from life - job stability, excellet pay, good working hours (see previous post - you get the idea) - and that Med isn't the only way to get that (*shock horror*). So yeah....
Although I haven't eliminated the possibiity of Medicine as a career completely, I think it's safe to say, if I had to choose QTAC preferences now, I'd be putting Dent at the top of the list.
@ titan - chicks may dig doctors, but good luck meeting them when you're working 50+hr weeks as a junior doctor lol, jks :P
Anyway, ALL the dental assistants I've ever seen see to be hot 20-somethings (one reason i used to love trips ot my ortho when I had braces). Yet another thing to make coming to work more appealing for dentists, i wonder? B)
Because I know people who have become architects. When I was young, I dreamt of creating buildings nobody else had ever seen. But the reality of architecture is the same as the reality of any creative profession - you have to create what the market wants. I am lucky enough to have some talent with art, music, and cooking - I could pursue a career as an artist, as a painter, and as a chef if I had the appropriate training. But your survival depends on compromising your beliefs and producing what people will want to consume. Since I cannot see myself designing boring houses for a conservative marketplace I do not wish to pursue that career.
IN ANY CASE this thread is not about me. It's about what you will face when you finish your degrees and get out into the workforce.
I am quite upset to read the newspapers and read that all the brightest VCE graduates wish to pursue a career in medicine. If only they knew ...
IN ANY CASE this thread is not about me. It's about what you will face when you finish your degrees and get out into the workforce.
I am quite upset to read the newspapers and read that all the brightest VCE graduates wish to pursue a career in medicine. If only they knew ...
"extraordinary pay, nice hours, excellent employability"
if that is what you're looking for, by all means, go for dent. but just don't b too hasty in throwing out med, u've got 2 yrs to do it. but if one of your primary motivations is "looks like a good job, makes mum happy, fits into dream life scenario etc.", then yes, get out of med now.
if that is what you're looking for, by all means, go for dent. but just don't b too hasty in throwing out med, u've got 2 yrs to do it. but if one of your primary motivations is "looks like a good job, makes mum happy, fits into dream life scenario etc.", then yes, get out of med now.
Sorry I'm a bit late to this thread, but:
I have reconsidered my career path in the light on the wealth of information/advice given to me about medicine in this past year.
Having been always encouraged by my (stereotypical curry) parents to study hard in the promise of an "easy" life with a "high-paying" job in later life, I was somewhat shocked to hear all these accounts of dissatisfaction among docs. At first, I tried to block it out, but as more and more docs (on the net, and in real life) shared the view, i figured it would be wise to reconsider. I always thought at the end of Yr. 12 (or at the very lates, the end of uni) all the hard work stopped, and you could more or less "cruise" on in life...marry, buy a sweet-*** car/house, start a family, enjoy life etc. How very naive I was...
Being at an elitist private school, it's depressing to see so many hard-working, parent-obeying, naive academics say that they want to do medicine without any good reason - you know that they will eventually be dissapointed, but nothing you do or say can persuade them otherwise - it's some kind of drive implanted in their brains - get into med, make parents proud, earn money/prestige as a doctor. Once upon a time, I thought that too...
So yeah, without raving on without a point, i have reconsidered my career choice in terms of what people have said about medicine. I think i may have been able to deal with the crap hours, dodgy pay, and general bad conditions, but what pushed it over the edge for me was the lack of availability of accredited training positions. i mean, after working your sorry *** off to get into med, get through uni, and survive your intern/RMO years, do get a pat on the back, telling you "you've done well, here's something to make your life easier" (ie-a fellowship). No, you get another ~5 years of hell, but first you have to "sell your soul" to get their. I mean, W.T.F
But yeah, though I haven't ruled out med altogether, I would have to say that dentistry is beginning to look very attractive - extraordinary pay, nice hours, excellent employability (number of dentists is decreasing = ) and so on. It sounds almost too good to be true.....
But to all those doing medicine in spite of these pessimistic/gloomy comments, well I simultaneously applaud you for being determined and slap you ("WTF are you insane freaks thinking!!") :P .
I have reconsidered my career path in the light on the wealth of information/advice given to me about medicine in this past year.
Having been always encouraged by my (stereotypical curry) parents to study hard in the promise of an "easy" life with a "high-paying" job in later life, I was somewhat shocked to hear all these accounts of dissatisfaction among docs. At first, I tried to block it out, but as more and more docs (on the net, and in real life) shared the view, i figured it would be wise to reconsider. I always thought at the end of Yr. 12 (or at the very lates, the end of uni) all the hard work stopped, and you could more or less "cruise" on in life...marry, buy a sweet-*** car/house, start a family, enjoy life etc. How very naive I was...
Being at an elitist private school, it's depressing to see so many hard-working, parent-obeying, naive academics say that they want to do medicine without any good reason - you know that they will eventually be dissapointed, but nothing you do or say can persuade them otherwise - it's some kind of drive implanted in their brains - get into med, make parents proud, earn money/prestige as a doctor. Once upon a time, I thought that too...
So yeah, without raving on without a point, i have reconsidered my career choice in terms of what people have said about medicine. I think i may have been able to deal with the crap hours, dodgy pay, and general bad conditions, but what pushed it over the edge for me was the lack of availability of accredited training positions. i mean, after working your sorry *** off to get into med, get through uni, and survive your intern/RMO years, do get a pat on the back, telling you "you've done well, here's something to make your life easier" (ie-a fellowship). No, you get another ~5 years of hell, but first you have to "sell your soul" to get their. I mean, W.T.F
But yeah, though I haven't ruled out med altogether, I would have to say that dentistry is beginning to look very attractive - extraordinary pay, nice hours, excellent employability (number of dentists is decreasing = ) and so on. It sounds almost too good to be true.....
But to all those doing medicine in spite of these pessimistic/gloomy comments, well I simultaneously applaud you for being determined and slap you ("WTF are you insane freaks thinking!!") :P .
Well today at work I did a quick audit of some of the registrars. I said "if a person in year 12 asks you whether it is a good idea to pursue medicine, would you encourage or discourage them?". I asked this question to 8-9 registrars today and a couple of consultants. And a whole bunch of interns/RMO's.
In general the RMO's all said that they would answer a definite yes. One RMO said "I love it!".
The registrars either said "no" or "maybe".
The consultant said "why would anyone want to do medicine now? They must be crazy!". When I asked him why, he said that things had changed a lot from when he was an intern to now. Back then, there was less to know, so medical schools taught less theory and more practical medicine. When you graduated as an intern, you were actually capable of doing many things that 2nd or 3rd year RMO's are doing now. He said that an intern graduating in 2006 has none of the skills that we had, but instead have a lot of theoretical knowledge and a HUGE emphasis on all that touchy-feely stuff. He reckons that a 2006 intern needs 2 years of on-the-job experience before they acquire the skills that an intern in his day had.
This sort of mirrors my own experience. When I was an intern, I loved medicine and thought that I was so lucky that I had by fluke, chosen the "right" course which had put me in a rewarding career. Whenever I read about a doctor being sued, I used to feel sorry for the poor doc because surely the error may have been a misjudgement, but the decision must have been based on the best intentions.
Now that I have gotten older, I do not feel the same. I have seen SO MANY EXAMPLES of shoddy practice, poor decision making, preventable complications and preventable deaths, and iatrogenic complications that arise purely because of hospital culture (needlessly giving IV fluids for example). I now firmly believe that medicine needs to get it up the back end before doctors become motivated enough to reform our profession.
IN ANY CASE next year I won't be working regularly as a doctor any more. I will have some time to reconsider my future.
Oh, another thing - I don't mind 17 year olds, or medical students, or interns criticizing me or questioning me. Fear of authority is another really bad characteristic of doctors. So redorangish, if they want to see for themselves what medicine is like that's fine. Lots of people really enjoy it. But many others (like myself) do not. The trends and the way medicine is heading is not attractive
In general the RMO's all said that they would answer a definite yes. One RMO said "I love it!".
The registrars either said "no" or "maybe".
The consultant said "why would anyone want to do medicine now? They must be crazy!". When I asked him why, he said that things had changed a lot from when he was an intern to now. Back then, there was less to know, so medical schools taught less theory and more practical medicine. When you graduated as an intern, you were actually capable of doing many things that 2nd or 3rd year RMO's are doing now. He said that an intern graduating in 2006 has none of the skills that we had, but instead have a lot of theoretical knowledge and a HUGE emphasis on all that touchy-feely stuff. He reckons that a 2006 intern needs 2 years of on-the-job experience before they acquire the skills that an intern in his day had.
This sort of mirrors my own experience. When I was an intern, I loved medicine and thought that I was so lucky that I had by fluke, chosen the "right" course which had put me in a rewarding career. Whenever I read about a doctor being sued, I used to feel sorry for the poor doc because surely the error may have been a misjudgement, but the decision must have been based on the best intentions.
Now that I have gotten older, I do not feel the same. I have seen SO MANY EXAMPLES of shoddy practice, poor decision making, preventable complications and preventable deaths, and iatrogenic complications that arise purely because of hospital culture (needlessly giving IV fluids for example). I now firmly believe that medicine needs to get it up the back end before doctors become motivated enough to reform our profession.
IN ANY CASE next year I won't be working regularly as a doctor any more. I will have some time to reconsider my future.
Oh, another thing - I don't mind 17 year olds, or medical students, or interns criticizing me or questioning me. Fear of authority is another really bad characteristic of doctors. So redorangish, if they want to see for themselves what medicine is like that's fine. Lots of people really enjoy it. But many others (like myself) do not. The trends and the way medicine is heading is not attractive
We're not all 17 and we don’t all see the glass as half empty You can be a realist and an optimist.
Not every experience of working in Med will be universal and as such, it would be stupid of us to ruin what we see as an excellent thing based upon one testimony (although this truthful and evidenced based perspective is being echoed constantly now)...On the other hand, those who are giving us the info are where we plan to be at in a few years time and you are doing it for altruistic reasons...
This will sound pig-headed but they are our choices to make and a Med degree isn’t that wrong a move, if we believe the knowledge will be useful and the opportunities are there...MBBS graduates can go anywhere, including back to uni to do another degree if we feel it is necessary to do so...There are always other options out there?
I can’t speak for everyone in my generation but if the new IR laws are anything to go by we will all be on contracts anyway?…This brings its own job security issues but it also allows for freedom to change where we are, or barter for better conditions directly with our employer.
I hope medicine moves in a more positive direction but I won’t be waiting around for a miracle to happen if it isn’t. The progress seems to be happening very slowly; how many more young doctors suiciding will it take for change to occur? Surely one is devastating enough especially if it was preventable. Sitting back with a belief that “we suffered so you should too” doesn’t seem like the team-work camaraderie we begin Med school with…We shouldn’t become desensitised to this because we are now doctors competing for training programs.
So where will health be with a mass exodus of doctors? The gov pumps the schools with Med places while all the people who would be training us want to and are leaving…awesome
Feel free to correct me at anytime B)
EDIT: I still believe that Medicine as a career is what I want to do until my experience of working in it dictates otherwise...I know doctors who are fulfilled; although it clearly isn’t doing it for you, regardless of your love for Medicine. It seems that I have selective hearing but I'm happy to accept the risk?
Not every experience of working in Med will be universal and as such, it would be stupid of us to ruin what we see as an excellent thing based upon one testimony (although this truthful and evidenced based perspective is being echoed constantly now)...On the other hand, those who are giving us the info are where we plan to be at in a few years time and you are doing it for altruistic reasons...
This will sound pig-headed but they are our choices to make and a Med degree isn’t that wrong a move, if we believe the knowledge will be useful and the opportunities are there...MBBS graduates can go anywhere, including back to uni to do another degree if we feel it is necessary to do so...There are always other options out there?
I can’t speak for everyone in my generation but if the new IR laws are anything to go by we will all be on contracts anyway?…This brings its own job security issues but it also allows for freedom to change where we are, or barter for better conditions directly with our employer.
I hope medicine moves in a more positive direction but I won’t be waiting around for a miracle to happen if it isn’t. The progress seems to be happening very slowly; how many more young doctors suiciding will it take for change to occur? Surely one is devastating enough especially if it was preventable. Sitting back with a belief that “we suffered so you should too” doesn’t seem like the team-work camaraderie we begin Med school with…We shouldn’t become desensitised to this because we are now doctors competing for training programs.
So where will health be with a mass exodus of doctors? The gov pumps the schools with Med places while all the people who would be training us want to and are leaving…awesome
Feel free to correct me at anytime B)
EDIT: I still believe that Medicine as a career is what I want to do until my experience of working in it dictates otherwise...I know doctors who are fulfilled; although it clearly isn’t doing it for you, regardless of your love for Medicine. It seems that I have selective hearing but I'm happy to accept the risk?
All the best, Amfibius - I'm sure your background in medicine will give you an advantage in these other fields.
velox, I didn't think you were being rude. I just wanted to clarify things.
On that point though, has anyone read or heard of another person's experience in medicine and actually made the decision to pursue another career path? I'm not sure if I speak for most of us when I say that despite all of these negative aspects associated with medicine - there are still many ambitious people that are keen to take the plunge. I'm not sure how many of us are swayed by the dismal accounts. I think a healthy dose of the truth is good to maintain a realistic perspective - but is it honestly affecting the bulk of us? Personally, I think I'm too headstrong to not embrace the opportunity if I was accepted into medicine. At least that way I'd have seen it first-hand and not constantly ask "What if?" Am I deluding myself in thinking that my reasons for wanting to pursue medicine is enough? How does a 17 or 18 year old decide whether they have what it takes to find personal satisfation amongst the chaos?
velox, I didn't think you were being rude. I just wanted to clarify things.
On that point though, has anyone read or heard of another person's experience in medicine and actually made the decision to pursue another career path? I'm not sure if I speak for most of us when I say that despite all of these negative aspects associated with medicine - there are still many ambitious people that are keen to take the plunge. I'm not sure how many of us are swayed by the dismal accounts. I think a healthy dose of the truth is good to maintain a realistic perspective - but is it honestly affecting the bulk of us? Personally, I think I'm too headstrong to not embrace the opportunity if I was accepted into medicine. At least that way I'd have seen it first-hand and not constantly ask "What if?" Am I deluding myself in thinking that my reasons for wanting to pursue medicine is enough? How does a 17 or 18 year old decide whether they have what it takes to find personal satisfation amongst the chaos?
Liv, I think one of the reasons doctors can't or don't 'fight' for changes is because there's not much you can do is there? I mean, OK, so say that you get into a discussion with your superiors about fairer working hours and they disagree with you or simply dismiss your concerns. What can you do? Just stop going to work? Gather up your fellow doctors and stage a 'protest'?
Obviously, as a doctor you have enormous responsibilty to the community, I mean, you're the one who is literally 'saving lives' - if you go on protest, it's not like people are just going to conveniently stop getting sick. So you can't just up and leave. I think that's probably one of the main reasons why "seriously astute" doctors seem so masochistic sometimes
Obviously, as a doctor you have enormous responsibilty to the community, I mean, you're the one who is literally 'saving lives' - if you go on protest, it's not like people are just going to conveniently stop getting sick. So you can't just up and leave. I think that's probably one of the main reasons why "seriously astute" doctors seem so masochistic sometimes
Cheers Amfibius!
I see truth in your words and im not a doctor yet…The question is whether our lives will unfold the way yours has (and there isn’t a reason to say it wont). It is reading posts like yours (and sometimes Chinaski's) that make me think it wise to have a way out of Med, should things go awry because you feel trapped in a profession that is circling the drain (for the reasons we can cite above).
What seems surprising to me is how a bunch of seriously astute people cant seem to improve the situation...things always seem out of your hands (talking about the power struggles and not life & death which probably is out of your hands)...Doctors don’t seem the type to just accept something second rate yet we accept it for ourselves, and recreate it daily (a pattern of abuse where past mistakes aren't rectified); when better conditions, less hours, lower ratios etc aren’t fought for...Do you think this is because the situation really cant be fixed or that it would require enormous change (across the board) that will never eventuate; so you don’t see your perspective of Med changing...
I enjoy your writing style so I'd buy your book It is impressive that you can write like that after a few wines B)
I think I'll repost this when I haven’t worked >12 hours & it isn’t 2am :P It might make more sense
Would you change your mind about choosing Med as a career? Knowing what you do now? (The answer seem obvious reading between the lines but I'd appreciate an outright answer). Should we just try to be the CEO of the hospital instead
I see truth in your words and im not a doctor yet…The question is whether our lives will unfold the way yours has (and there isn’t a reason to say it wont). It is reading posts like yours (and sometimes Chinaski's) that make me think it wise to have a way out of Med, should things go awry because you feel trapped in a profession that is circling the drain (for the reasons we can cite above).
What seems surprising to me is how a bunch of seriously astute people
I enjoy your writing style so I'd buy your book It is impressive that you can write like that after a few wines B)
I think I'll repost this when I haven’t worked >12 hours & it isn’t 2am :P It might make more sense
Would you change your mind about choosing Med as a career? Knowing what you do now? (The answer seem obvious reading between the lines but I'd appreciate an outright answer). Should we just try to be the CEO of the hospital instead
Thanks, but I have no interest in starting a blog. A bit too self-indulgent.
IF the book I am writing ever comes out i'll be sure to let you people know
In any case the thread is about the future of medicine. OK to be fair it's not going to be all bad, but just look around and see how many unhappy / disillusioned doctors there are. We all start off with high ideals and want to keep our motives pure, and then we find ourselves trampled upon by petty bureaucrats who line their own nests while giving us hardly any resources to work with.
IF the book I am writing ever comes out i'll be sure to let you people know
In any case the thread is about the future of medicine. OK to be fair it's not going to be all bad, but just look around and see how many unhappy / disillusioned doctors there are. We all start off with high ideals and want to keep our motives pure, and then we find ourselves trampled upon by petty bureaucrats who line their own nests while giving us hardly any resources to work with.
Er, this was never meant to be a thread about me
trippy, I think i've probably got the wrong personality for the job. Like I indicated, in 2006 I would be eliminated in the interview process if I was honest about my motives. Although, as a smart Yr 12 kid I would have been able to tell them what they wanted to hear to make sure that I got myself in.
As for people who need my help the most - in my OWN opinion it's the people who want to be helped. Patients are not created equal. If I had a donor kidney and had to choose between someone who would comply with treatment and someone who was completely irresponsible, I would give it to the patient who would comply with treatment.
And yes there are times when I love my job. I love some of my patients and we have a great relationship. There are still a lot of people out there who respect you for giving them impartial advice. NOTHING beats the buzz of saving a life, just like nothing beats the depression of failing to prevent a preventable death. I can honestly point to many people walking around today and say that that person is walking around because of ME. Even if they don't remember my name.
I can remember many patients, long gone, whom I failed to save. There was a 21 year old who died on Jan 1, 2000. And a 35 year old girl who waved sweetly at me as she was wheeled into theatre for the very last time. Next time I saw her, she was a disembowelled empty shell with her expertly removed organs arranged neatly on the autopsy table. The pathologist was showing me an "interesting finding" in her liver. My mind was 1000 miles away. I could not help looking at my very dead patient and thinking what a lovely girl she was.
These things stay with you. Sometimes my fiancee sees me staring into space and musing about things. These are the patients I think about.
And let's be clear about this - I do not hate my job. I hate the direction the profession and health care is moving. I hate the waste, the meaningless trials, and the prostitution of medicine for commercial interests. I think it would be fair to say that I love medicine itself - it's just all the other rubbish that comes with the job that I hate.
trippy, I think i've probably got the wrong personality for the job. Like I indicated, in 2006 I would be eliminated in the interview process if I was honest about my motives. Although, as a smart Yr 12 kid I would have been able to tell them what they wanted to hear to make sure that I got myself in.
As for people who need my help the most - in my OWN opinion it's the people who want to be helped. Patients are not created equal. If I had a donor kidney and had to choose between someone who would comply with treatment and someone who was completely irresponsible, I would give it to the patient who would comply with treatment.
And yes there are times when I love my job. I love some of my patients and we have a great relationship. There are still a lot of people out there who respect you for giving them impartial advice. NOTHING beats the buzz of saving a life, just like nothing beats the depression of failing to prevent a preventable death. I can honestly point to many people walking around today and say that that person is walking around because of ME. Even if they don't remember my name.
I can remember many patients, long gone, whom I failed to save. There was a 21 year old who died on Jan 1, 2000. And a 35 year old girl who waved sweetly at me as she was wheeled into theatre for the very last time. Next time I saw her, she was a disembowelled empty shell with her expertly removed organs arranged neatly on the autopsy table. The pathologist was showing me an "interesting finding" in her liver. My mind was 1000 miles away. I could not help looking at my very dead patient and thinking what a lovely girl she was.
These things stay with you. Sometimes my fiancee sees me staring into space and musing about things. These are the patients I think about.
And let's be clear about this - I do not hate my job. I hate the direction the profession and health care is moving. I hate the waste, the meaningless trials, and the prostitution of medicine for commercial interests. I think it would be fair to say that I love medicine itself - it's just all the other rubbish that comes with the job that I hate.
Jellibelli there is no easy answer for the questions you raised.
The reason why I did medicine was for job security. When I enrolled, Australia was in the middle of a recession. I wanted to be an architect, but decided against that when I saw many architects retrenched. I never wanted to be retrenched. The second reason was because I was (like many of you) an ace in sciences.
Patients? What its like to be a doctor? I had no idea. Someone like me would be eliminated in the interview process in the new system as soon as I revealed my motives. Back then, I just had to finish in the top few 0.5% of the state and I was in. Maybe it would have been better for someone to pat me on the back and say "medicine is not for you, my friend".
Maybe it's different now, but back in my time most people would eventually admit that they did medicine for themselves and not because of some noble idea of helping people.
In any case, when you start seeing patients you wonder why you should be helping them at all, when they won't even help themselves! They don't give up smoking, they don't take their medications, they don't value your advice. Dialysis is one such egregious example - miss one dialysis day, and you will turn up drowning in the fluid that you can't excrete. This means that the dialysis staff have to get out of bed at 1am to save your sorry butt. All the while, they are thinking that they set aside valuable dialysis time to treat this patient which could be given to someone more needy on the waiting list. And a lot of people are like this - regularly miss dialysis, turn up to hospital at 1AM, and people still get out of bed, and come to work to save their lives.
And here is another example - I attended a medical emergency for someone who had a cardio-respiratory arrest for low blood sugar (took his insulin, did not take his meal). After 10 minutes I managed to bring him back. I said "we just saved your life!". He looked at me and said "Well that's your job isn't it!". Not a word of thanks. Well yes it is my job, but maybe next time i'll just have another coffee when the code blue alarm goes off.
How would you respond to something like that?
The demise of medicine as a specialty is not new. My father advised me strongly not to do it - which is very unusual for an asian parent. He brought me to meet some of his doctor friends and they all told me the truth - you will work HARD and not be appreciated. To a 17 year old who has just finished Year 12 near the very top, the world was my oyster. I did not believe them.
The reason why I did medicine was for job security. When I enrolled, Australia was in the middle of a recession. I wanted to be an architect, but decided against that when I saw many architects retrenched. I never wanted to be retrenched. The second reason was because I was (like many of you) an ace in sciences.
Patients? What its like to be a doctor? I had no idea. Someone like me would be eliminated in the interview process in the new system as soon as I revealed my motives. Back then, I just had to finish in the top few 0.5% of the state and I was in. Maybe it would have been better for someone to pat me on the back and say "medicine is not for you, my friend".
Maybe it's different now, but back in my time most people would eventually admit that they did medicine for themselves and not because of some noble idea of helping people.
In any case, when you start seeing patients you wonder why you should be helping them at all, when they won't even help themselves! They don't give up smoking, they don't take their medications, they don't value your advice. Dialysis is one such egregious example - miss one dialysis day, and you will turn up drowning in the fluid that you can't excrete. This means that the dialysis staff have to get out of bed at 1am to save your sorry butt. All the while, they are thinking that they set aside valuable dialysis time to treat this patient which could be given to someone more needy on the waiting list. And a lot of people are like this - regularly miss dialysis, turn up to hospital at 1AM, and people still get out of bed, and come to work to save their lives.
And here is another example - I attended a medical emergency for someone who had a cardio-respiratory arrest for low blood sugar (took his insulin, did not take his meal). After 10 minutes I managed to bring him back. I said "we just saved your life!". He looked at me and said "Well that's your job isn't it!". Not a word of thanks. Well yes it is my job, but maybe next time i'll just have another coffee when the code blue alarm goes off.
How would you respond to something like that?
The demise of medicine as a specialty is not new. My father advised me strongly not to do it - which is very unusual for an asian parent. He brought me to meet some of his doctor friends and they all told me the truth - you will work HARD and not be appreciated. To a 17 year old who has just finished Year 12 near the very top, the world was my oyster. I did not believe them.
Thanks for the insight to what it is really like Amfibius; there is no doubt that everyone else found this opinion very valuable and confronting.
I'm not sure if this opinion is valid but do the drug companies put the % mark-up on the prices to pay for the research that was involved in discovering the drug? The money must come from somewhere and I don't think government funding covers it adequately. Nonetheless, it is disheartening to know that politicians are taking over.
Is this demise in medicine as a profession a recent thing? I'm pretty sure there was a time when doctors were respected for the work they did and their contribution to the community. I wonder what happened in our world to change all of that. Perhaps there are too many lawyers, businessmen trying to cash in on health care - a service which will never fail to lose its demand. This is one of the reasons why I was attracted to medicine because no matter what happens in the world - people will always need doctors. Or so I thought.
Even though there are so many negative aspects of medicine, at the end of the day there are still so many ambitious, talented young people that aspire to be doctors. Is there no way of being immune to becoming an unapproachable narcissist? I know it's a cliche but isn't the primary reason why most people who want to be doctors is to help people in the best way they know how?
Amfibius, I'm interested to know what your reasons were for pursuing a career in medicine in 1991 and have those reasons been fulfilled? And also, what makes people stay in the game? What makes doctors, that are suffering from a poor, degrading system stick at it?
I'm not sure if this opinion is valid but do the drug companies put the % mark-up on the prices to pay for the research that was involved in discovering the drug? The money must come from somewhere and I don't think government funding covers it adequately. Nonetheless, it is disheartening to know that politicians are taking over.
Is this demise in medicine as a profession a recent thing? I'm pretty sure there was a time when doctors were respected for the work they did and their contribution to the community. I wonder what happened in our world to change all of that. Perhaps there are too many lawyers, businessmen trying to cash in on health care - a service which will never fail to lose its demand. This is one of the reasons why I was attracted to medicine because no matter what happens in the world - people will always need doctors. Or so I thought.
Even though there are so many negative aspects of medicine, at the end of the day there are still so many ambitious, talented young people that aspire to be doctors. Is there no way of being immune to becoming an unapproachable narcissist? I know it's a cliche but isn't the primary reason why most people who want to be doctors is to help people in the best way they know how?
Amfibius, I'm interested to know what your reasons were for pursuing a career in medicine in 1991 and have those reasons been fulfilled? And also, what makes people stay in the game? What makes doctors, that are suffering from a poor, degrading system stick at it?
Well it was me who wrote the above. I wrote it after having a few too many glasses of wine after a particularly bad day. If I wrote it again I would probably remove some of the stronger words like "corrupt" and "b******s" but it's in the public domain now. My opinion still has not changed though.
When I was a first year medical student (1991) one of my tutors, a lovely soft-hearted woman, told me that she had a chat with the professor. She said "what lovely kids these are". The professor said "yes, and see what we turn them into".
At the time I thought to myself that I would never become one of those arrogant unapproachable doctors feared by the junior staff. I would guard against my tendency to be brusque and try to be friendly an approachable to everyone.
Then I graduated and started working. In my intern year, I discovered that it's not only the patients who have unrealistic expectations of you. So does your unsympathetic registrar and consultant. You discover you have friends and enemies in the hospital. People who want to listen to your problems and sympathize with you. Then there are people who expect you to cope with your workload and send you threatening memoes if your discharge summaries start to pile up. Patients are not the only ones with unrealistic expectations - nurses, medical administration, and some consultants are the same.
To illustrate my point about unrealistic expectations, if you are an intern in some parts of Australia there is a fair chance you will be sent to a country hospital to manage the entire hospital after hours. This means seeing all patients in emergency, managing the wards, and managing the patients in ICU. I know this, because I just returned from a stint in a country hospital where I saw this happening!
Would an airline roster a 1 week graduate from flying school to fly a 737 by himself? Would a law graduate of 1 week be allowed to handle a big case by himself? Would a chef who graduated from TAFE 1 week ago be allowed to cook in a restaurant all by himself? The answer to all of these questions is NO. So why are interns straight out from medical school asked to manage an entire hospital by themself?
(I am trying to put a stop to this - I have approached my hospital to recommend that it should be a 3rd year RMO job with close registrar/consultant support).
Anyway, after a few years of this kind of abuse you become a different person. Last year I had a particularly difficult job where I was kept awake all night by frequent phone calls and expected to go to work the next day. A junior doc (who wasn't my intern) later said to me "geez, when you are relaxed you are actually a really nice guy". That REALLY drove home the point that I had at last, turned into that grouchy arrogant, unapproachable b****** that I had set out to avoid becoming.
Things have gotten worse in the past 10 years i've been a doctor. My starting salary as an intern in 1997 was $39,500. In the same year, I bought an apartment which cost me $110,000. It's now 2006, and interns are paid $42,000. I sold my apartment last year for $320,000. AMA (Vic) have negotiated a "pay rise" for salaried MO's at 3% a year - which is below the inflation rate of about 3.9% - effectively a pay cut of 0.9% per year.
So are state governments allowed to get away with this? Because doctors are a captive market. If interns/RMO's don't like the working conditions, what other options are open to you? What political power do you have? Are we organized as a group to demand better conditions? Will the consultants support you? Or will they squash your career like a fly?
As for myself, I am now 34 and a senior registrar. When I become a consultant, I face the same climb up the slippery slope - join a practice, listen to the senior consultant, have no rights of my own (beyond the right to leave and join another practice). Continue the same **** kissing that you get so sick of when you're in training. Cities are so crowded with specialists that a young consultant has no scope to establish himself on his own. The only other option would be to move to the country where there would be a demand for my services. But that removes me from having a hospital base and from contact with other specialists.
Oh, and it's the same thing when you become a consultant. You can charge the ridiculously low medicare rebate for consultations and get the patients nobody else wants. Or you could charge a gap and be pilloried by patients and other doctors. You want to deliver a good quality service, but economic reality will force you to downgrade your service.
I will be taking a year off and deciding whether I want to continue or throw in the towel. I have gotten pretty good (if I say so myself) at making money outside medicine - so I might do that full time.
When I was a first year medical student (1991) one of my tutors, a lovely soft-hearted woman, told me that she had a chat with the professor. She said "what lovely kids these are". The professor said "yes, and see what we turn them into".
At the time I thought to myself that I would never become one of those arrogant unapproachable doctors feared by the junior staff. I would guard against my tendency to be brusque and try to be friendly an approachable to everyone.
Then I graduated and started working. In my intern year, I discovered that it's not only the patients who have unrealistic expectations of you. So does your unsympathetic registrar and consultant. You discover you have friends and enemies in the hospital. People who want to listen to your problems and sympathize with you. Then there are people who expect you to cope with your workload and send you threatening memoes if your discharge summaries start to pile up. Patients are not the only ones with unrealistic expectations - nurses, medical administration, and some consultants are the same.
To illustrate my point about unrealistic expectations, if you are an intern in some parts of Australia there is a fair chance you will be sent to a country hospital to manage the entire hospital after hours. This means seeing all patients in emergency, managing the wards, and managing the patients in ICU. I know this, because I just returned from a stint in a country hospital where I saw this happening!
Would an airline roster a 1 week graduate from flying school to fly a 737 by himself? Would a law graduate of 1 week be allowed to handle a big case by himself? Would a chef who graduated from TAFE 1 week ago be allowed to cook in a restaurant all by himself? The answer to all of these questions is NO. So why are interns straight out from medical school asked to manage an entire hospital by themself?
(I am trying to put a stop to this - I have approached my hospital to recommend that it should be a 3rd year RMO job with close registrar/consultant support).
Anyway, after a few years of this kind of abuse you become a different person. Last year I had a particularly difficult job where I was kept awake all night by frequent phone calls and expected to go to work the next day. A junior doc (who wasn't my intern) later said to me "geez, when you are relaxed you are actually a really nice guy". That REALLY drove home the point that I had at last, turned into that grouchy arrogant, unapproachable b****** that I had set out to avoid becoming.
Things have gotten worse in the past 10 years i've been a doctor. My starting salary as an intern in 1997 was $39,500. In the same year, I bought an apartment which cost me $110,000. It's now 2006, and interns are paid $42,000. I sold my apartment last year for $320,000. AMA (Vic) have negotiated a "pay rise" for salaried MO's at 3% a year - which is below the inflation rate of about 3.9% - effectively a pay cut of 0.9% per year.
So are state governments allowed to get away with this? Because doctors are a captive market. If interns/RMO's don't like the working conditions, what other options are open to you? What political power do you have? Are we organized as a group to demand better conditions? Will the consultants support you? Or will they squash your career like a fly?
As for myself, I am now 34 and a senior registrar. When I become a consultant, I face the same climb up the slippery slope - join a practice, listen to the senior consultant, have no rights of my own (beyond the right to leave and join another practice). Continue the same **** kissing that you get so sick of when you're in training. Cities are so crowded with specialists that a young consultant has no scope to establish himself on his own. The only other option would be to move to the country where there would be a demand for my services. But that removes me from having a hospital base and from contact with other specialists.
Oh, and it's the same thing when you become a consultant. You can charge the ridiculously low medicare rebate for consultations and get the patients nobody else wants. Or you could charge a gap and be pilloried by patients and other doctors. You want to deliver a good quality service, but economic reality will force you to downgrade your service.
I will be taking a year off and deciding whether I want to continue or throw in the towel. I have gotten pretty good (if I say so myself) at making money outside medicine - so I might do that full time.
Yeah. My Dad would agree with some of the stuff that doctor's said... especially the above... unrealistic expectations of the community, e.g. people demanding their GP to sign their 'disability' payment certificate, demanding the doctor to make up **** so they can get their bloody dole payment and all sorts of other wonderful things like that. [This was VERY common in New Zealand... I'm not entirely sure if it applies to Australia... but I would assume it's not much different here.]
Would also like to add, I don't think that all doctors are 'corrupt', but certainly many of the doctors I've met (including even my own Father and his colleagues), in one way or another, have an obsession with money. You'd think it'd be different in a rural practice. But it's not really. The practice my Dad works at, well most of the doctors there are intent on seeing as many patients as they can... despite this decreasing the quality of the consult. And yet, they keep doing it.
Now of course, a whole lot of other factors come into play here, such as the fact that, rural practices are often very busy and doctors need to get through as many patients as they can. (crappy health system, shortage of rural doctors, blah blah blah)
But still... despite the shortage of rural doctors, even my Dad agrees that this stance of seeing a gazillion patients a day is definitely fuelled by the thought that more patients = more $$ baby...
And oh yeah, pharmaceutical companies are great... they sent my Daddy a birthday cake on his birthday... how thoughful.
Would also like to add, I don't think that all doctors are 'corrupt', but certainly many of the doctors I've met (including even my own Father and his colleagues), in one way or another, have an obsession with money. You'd think it'd be different in a rural practice. But it's not really. The practice my Dad works at, well most of the doctors there are intent on seeing as many patients as they can... despite this decreasing the quality of the consult. And yet, they keep doing it.
Now of course, a whole lot of other factors come into play here, such as the fact that, rural practices are often very busy and doctors need to get through as many patients as they can. (crappy health system, shortage of rural doctors, blah blah blah)
But still... despite the shortage of rural doctors, even my Dad agrees that this stance of seeing a gazillion patients a day is definitely fuelled by the thought that more patients = more $$ baby...
And oh yeah, pharmaceutical companies are great... they sent my Daddy a birthday cake on his birthday... how thoughful.
Medicine is a profession which has lost control over its own destiny. And the fault for this lies squarely on the doctors, who are mostly a bunch of useless cowards in denial. There are a lot of idealistic doctors out there who try to practice good medicine, but that would be less than 1/4 of all the doctors i've come across. Most of them are corrupt b****** who have gotten into bed with the drug companies and care little about the patients they treat, despite giving lip service to doing so.
Bureaucracy has now infiltrated every aspect of medicine. Want to give a patient the latest and greatest drug? You have to justify your decision to some faceless bureaucrat on 1800-888-333 (number for PBS authorities - I know it by heart) who can turn down your application if he can't tick all the boxes. How much do you get remunerated for your operation? Just look it up in the Medicare Rebates book. Because of this bureaucratic interference, the little yellow book has fuelled growth in the fields that are most profitable for doctors. Just look around you - how many people want to do gastro and cardiology? And why? It's because these specialties are well remunerated for not very much work. On the other hand, how many people want to be a country GP? Not many. Why? Because you work extremely hard for a pittance.
Don't believe me when I say that bureaucrats have taken over medicine? OK, go to a hospital. Look at the car parks - see where the bureacrats park their cars? Yup, usually in all the plum spots which are reserved for them. Where do the doctors (who do the REAL work) park their cars? Far away! Even a Nobel prize winner (we have a couple in WA) or an Australian of the Year does not score a better car park than the head petty bureacrat of the hospital. Yes, a small example I know, but it shows you how high doctors rate on their list.
Along with this has come the increasing corruption of the specialty by drug companies and other commercial interests. This malevolent influence has totally duped medicine and co-opted it to drive sales of drugs. Take the recent trial comparing PRN Symbicort vs. regular Seretide + PRN Ventolin - this showed that Symbicort was superior at preventing hospital admissions (no change in overall mortality). However, the obvious question was not even reported in the paper - what about steroid side effects from the increased dose of Symbicort? Or cardiac side effects from the increased dose of long acting beta-agonist?
Such skewed trials are distorting the principle of evidence based medicine and bringing up a new generation of doctors who will know nothing about REAL trials. The only trials they get to perform will be drug company sponsored trials.
Oh, and i'll get on my rant of medical academics. These guys only exist to see their name mentioned in journals. So you see paper after paper with their names on it asking and answering meaningless questions with shoddy research that is only fit for toilet reading. Academics are the worst kind of prostitution - they give the illusion of respectability but are the most corrupt bastards in the field of medicine. Rare is the academic who has NEVER received some drug company gratuity of some kind. In fact, I will venture to say that there is no such thing as a medical academic who has not (at some point) been involved in commercial interests.
And this says nothing of the increasing medico-legal pressure, the unrealistic expectations of the community, the expectation of free medical care, the increasing power of nurses, the lowering of standards in medical schools, increasing government interference ...
All of you are f*****. Get out of it when you can.
Bureaucracy has now infiltrated every aspect of medicine. Want to give a patient the latest and greatest drug? You have to justify your decision to some faceless bureaucrat on 1800-888-333 (number for PBS authorities - I know it by heart) who can turn down your application if he can't tick all the boxes. How much do you get remunerated for your operation? Just look it up in the Medicare Rebates book. Because of this bureaucratic interference, the little yellow book has fuelled growth in the fields that are most profitable for doctors. Just look around you - how many people want to do gastro and cardiology? And why? It's because these specialties are well remunerated for not very much work. On the other hand, how many people want to be a country GP? Not many. Why? Because you work extremely hard for a pittance.
Don't believe me when I say that bureaucrats have taken over medicine? OK, go to a hospital. Look at the car parks - see where the bureacrats park their cars? Yup, usually in all the plum spots which are reserved for them. Where do the doctors (who do the REAL work) park their cars? Far away! Even a Nobel prize winner (we have a couple in WA) or an Australian of the Year does not score a better car park than the head petty bureacrat of the hospital. Yes, a small example I know, but it shows you how high doctors rate on their list.
Along with this has come the increasing corruption of the specialty by drug companies and other commercial interests. This malevolent influence has totally duped medicine and co-opted it to drive sales of drugs. Take the recent trial comparing PRN Symbicort vs. regular Seretide + PRN Ventolin - this showed that Symbicort was superior at preventing hospital admissions (no change in overall mortality). However, the obvious question was not even reported in the paper - what about steroid side effects from the increased dose of Symbicort? Or cardiac side effects from the increased dose of long acting beta-agonist?
Such skewed trials are distorting the principle of evidence based medicine and bringing up a new generation of doctors who will know nothing about REAL trials. The only trials they get to perform will be drug company sponsored trials.
Oh, and i'll get on my rant of medical academics. These guys only exist to see their name mentioned in journals. So you see paper after paper with their names on it asking and answering meaningless questions with shoddy research that is only fit for toilet reading. Academics are the worst kind of prostitution - they give the illusion of respectability but are the most corrupt bastards in the field of medicine. Rare is the academic who has NEVER received some drug company gratuity of some kind. In fact, I will venture to say that there is no such thing as a medical academic who has not (at some point) been involved in commercial interests.
And this says nothing of the increasing medico-legal pressure, the unrealistic expectations of the community, the expectation of free medical care, the increasing power of nurses, the lowering of standards in medical schools, increasing government interference ...
All of you are f*****. Get out of it when you can.
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About Me
- hunterJet
- Crew member of 141 squadron at Tengah Airbase 1973~1975. Frequent Mcgregor club for billiard and Fish & Chip.