“Do you regret being a doctor?”

And the survey says…..

A physician friend of mine recently posted a link on twitter to a national survey by Jackson Healthcare that indicated that 59% of the physicians surveyed were “somewhat unlikely” or “very unlikely” to recommend a young person to enter the medical profession as a physician.  While the survey methodology is scantily described in the appendix of the report, we don’t know what the response rate was or if the questions were designed to eliminate bias.  Also, they use a 4-point scale, at least for this particular question, instead of the academically acceptable 3- or 5-point Likert scale.

Regardless of the potential methodological flaws of the survey, it sparked an interesting twitter conversation between my friend, a young woman considering medical school, and me about whether or not we would recommend the medical field to someone else.  This also  sparked a memory of a conversation I had with my mother when I first told her that I was taking a year off professionally.  After I bemoaned the long hours and high level of stress, I told her that I needed a break from my career as a pediatric hospitalist.  She then asked me a question that stopped me in my tracks, “Do you regret having gone to medical school to be a doctor?”

Is it worth it?

After a long pause, I responded with confidence, “No.  I do not regret going to medical school or choosing medicine for my career.”  The reasons are obvious.  If you look at the average household income in the United States, most physicians fall in the 90th percentile or higher.  When you factor in that many of my colleagues came from two-physician families….well you get the idea.  None of us were starving.

As I had mentioned in an earlier post, I worked to the point of burning myself out fairly early in my career.  Reflecting on that though, I realize that if I had not done that, I would not have two jobs waiting for me while I frolick carelessly in the highlands of Costa Rica for the next 1-2 years.    Also, we probably would not have been able to save enough money to embark on this expat adventure if I had not earned as much as I did as a physician.

Corny as it sounds, I became a doctor for altruistic reasons as do many wide-eyed medical students.  A career in medicine provides a platform to serve others in a meaningful way.  I truly loved my job.  Pediatric medicine is a rewarding, valuable, and satisfying career. I loved my patients. I loved making a difference in people’s lives when they were at their most vulnerable.  I loved working with different people and interacting with the nurses and therapists.  I loved teaching in hopes to make a difference in the next generation of young physicians.  When someone would ask Kara, what her mother did for a living, she would respond, “My mom takes care of sick babies.”  I smiled with pride whenever I heard her say that.

Personally, I would never discourage a young person who wants to go to medical school from doing so.  There are few careers that have the same trifecta of reliable source of high income, inspiring respect, and healthy job outlook.  Computers can’t replace physicians.  Regardless of what the media says about telemedicine and remote doctoring, people want to see a physician who is in the same room as they are, who can reach out and touch their hand if they deliver bad news, who can hug their child once its time to leave the hospital and go home.  Other than myself, I don’t know any unemployed physicians!  So yes, a career in medicine is worth it, but you have to know that it comes with a hefty price.

Are you selling your soul the Devil?

No, you are not selling your soul to the Devil by becoming a doctor but you will have to make some sacrifices.  You do, however, have to be prepared for the sobering fact that medicine is first and foremost a business. When you graduate with $250,000 in debt, making money becomes a priority.  While Hollywood makes it seem like all doctors have private yachts and mansions on the hill, most of us are really just trying to pay off loans and bills.  In San Antonio, my colleagues and neighbors who were doctor’s wives shopped at Target and had their hair done at Fantastic Sams.  They took their kids out to eat on Wednesdays when many of the local restaurants had “Kids Eat Free” Night.  Remember that as a physician, we delay generation of income for much longer than our non-physician peers.  So while many of our peers start making money at the tender age of 24 (assuming they got a master’s degree), most of us continue training into our late 20’s and early 30’s.  By that time, our contemporaries live in gated-communities and have 2 luxury vehicles in the garage of the cookie-cutter suburban house.  To top it all off, banks are more than happy to lend you money when you have an M.D. or D.O. next to your name.  This means that it is very easy to get the doctor mortgage and doctor lifestyle before you actually start making good doctor money to pay for it.  And you haven’t even started cutting into your medical school debt at that point.

I have seen many physicians who planned to provide service to the poor after they finished training (myself for example), but life, kids, and bills got in the way.  If you are in private practice, you also have your staff to look out for.  If you do not make money, you can’t pay your rent, pay your staff, and pay for all the fancy equipment in your office.

I cheated and got around this by going into academic medicine directly after residency.  This meant that I had no overhead and was able to provide necessary care for my patients regardless of their ability to pay.  I also by default became a social worker because while I could take care of patients in the hospital, discharging an unfunded or underfunded patient who needed medicine or follow up care was not easy.  It was frustrating and time-consuming, but at the same time I found it rewarding.  I was never frustrated with my patients, I was frustrated with the system that treats healthcare as a privilege, not a basic right.

There is also an ungodly amount of paperwork involved with practicing medicine.  I hated it more than anything.  I used to tell my boss (who was a good friend also), that I could handle the sickest patient, most difficult mother, and toughest diagnostic dilemma, but I hated filling out my billing sheets.  I hated writing notes to appease some insurance coder that knew nothing about my patients or my skill as a physician.  I hated paperwork.  I will not miss that at all.

As a physician, you also have to accept the fact that you will miss family dinners, your kid’s birthday party, or the school play sometimes.  I once had to leave the house while I was putting my little boy to bed because one of my patients in the hospital took a turn for the worse.  Many of my colleagues also delayed child-bearing and marriage to be able to focus on their careers.  If you want to go to medical school, you have to prepare to face these realities.

What do you tell your children?

Personally, I have never encouraged my children to be physicians.  I want them to be whatever they want to be.  Kara has clearly told me that she would never be a doctor or a nurse because what we do is “Gross”.  She is not a fan of blood and pus and other body fluids, and I have mentioned to her that I tell medical students that if they are squeamish about poop, pee, puke, pus, or snot, they cannot be a pediatrician.

But in the back of my mind, I have often wondered, “What if they grow up to be something outside the medical field, and they do not earn enough to continue the lifestyle Chris and I have provided for them?”  Frankly, that is one of the reasons I wanted them to experience living a simpler life in a developing country.  That way, they can grow up to choose a career based on their passions, not on income potential and the pursuit of a materialistic lifestyle.  I also half-jokingly tell both of them that they should marry doctors when they grow up…….

So what do I tell young people interested in a career in medicine?

As an academic pediatrician, I would of course recommend to my advisees to enter the field of pediatrics.  But if they did not want to be pediatricians, I would tell them to pick a field that would allow them to enjoy the lifestyle they planned for themselves.  This means choosing a field that not only provides the income they needed for said lifestyle, but also provides flexibility for them to enjoy what they earn.  I would also tell them to prioritize what’s important in their lives and not spend their whole life working for “stuff”  that they really did not need.

In the end, I have no regrets because I would most likely not be living the life I have now if I had not become a doctor. Today, I spent all morning blogging at Cafe Orchid while the kids are at summer camp.  Even if at the end of this expat experience in Costa Rica I have to return home with my tail tucked between my legs to go back to the exact same life I had before, at least I will have countless memories that I will never forget.  What could be wrong with that?

So, those of you who are physicians (or something along those lines) what would you tell a young person who wants a career in medicine?

Pura Vida!

About Noemi Gamel

Noemi Gamel is a physician who prefers writing diverse children's fantasy stories instead of medical charts. She is a geeky nomad, too.
This entry was posted in Career-Life Balance and tagged , , , , . Bookmark the permalink.

6 Responses to “Do you regret being a doctor?”

  1. Emi says:

    Super interesting post. I personally think you were born to be a Pediatrician, you are a wonderful role model, compassionate beyond belief, and I was blessed to have had you throughout my training.

    That being said, I think you are asking several different questions here, but they seem to be blending together. “Do you regret becoming a doctor?” is not the same as “Would you do it all over again?”, “Was it worth it?”, or “Would you want your kids to be doctors?” … at least not in my mind.

    I love my job. I love what I do, I love the people I get to do it FOR and WITH. This is a great time in my life, and I have finally reached a place where things have balanced out, and I can truly say I am happy.

    But if I had to do it over again, I never would. By the time I realized what I was sacrificing (namely, time; time with my family, time for kindergarten graduations and playdates, time for outings to the park), I was too far into it to want to pull out. I was blessed with a husband who was extremely supportive, and we worked triple time to compensate for the lack of time. I was felt miserable and guilty and lacking so often. And I know that many working moms (with 20- or 40- or 60-hour work-weeks) feel that way … but when you are working “80” hours a week (you and I know that many work beyond this and report far less), there is no way to convince yourself that it’s all in your head and it’s not a real problem. You’re right, few other jobs would offer the means to take a year off to dedicate oneself to the pursuit of other goals … but it makes me uncomfortable just how many times the pursuit of THIS goal endangered what I really held dear, and made me want to just stop.

    I’m glad I didn’t stop. I really do love what I do. But the seemingly never-ending process of acquiring it makes someone in their late 30s still be a “young” addition to medicine, when my friends and family who chose different paths have been officially in the workforce for almost 20 years – they may make less per year, but they’ve been making it for almost 20 years, whereas I just started. And I don’t think the outcome would justify the heartbreak if I had to choose again.

    So! Would I discourage my kids from being a physician? I’ve made a point of presenting them with the good of my job, and they are proud of what I do, and blessedly well-adjusted. They roll with the punches and know to appreciate the time they have with me. I will not discourage them from medicine if they choose it, because they have seen first-hand what that means, and it means they will have decided that the goal is worth the journey. But I think that far too many people go into medical school truly incapable of understanding what that will mean for their lives and priorities, TRULY mean for their lives and priorities. So I do try to bring all that up to students who ask me for advice. I don’t think I’ve ever deterred an aspiring medical student from applying – but again, I don’t think any of them ever grasped the depth of what I was saying at the time I was saying it. Surely not before they’ve had a family, or a life outside of a linear school model.

    I think the question will be answered differently depending on what every person’s individual priorities are, how much support they received, and how well they were able to “heal” from the process. I do not regret becoming a doctor. Knowing what I know, however, I wouldn’t choose to do it again if I were suddenly 20 years old. To me, the life I have now doesn’t make up for what I may have lost, but I know I did do my best then, and I am doing my best now, and my kids know that and are happy. I hope they find their calling outside of medicine, though … it’s a beautiful choice, but I know many people who have chosen otherwise and are doing beautifully (actually, almost all of my neighbors are in completely unrelated fields, proving that the lifestyle is attainable elsewhere in the workforce).

    These are great questions to ask, and important distinctions to make. Thank you for bringing them up, and for being the wonderful, admirable, lovely friend and role model you have always been! And sorry for the long-winded reply :).

    • Noemi Gamel says:

      Emi,

      Thanks for your kind words and insightful comments. I am so proud of your success. You are correct that regretting the careers we chose is not the same as feeling it was worth it etc. There are so many issues around each question. I agree that many young people in their 20’s have no idea what the sacrifices of choosing a career in medicine mean, even if someone explains it to them. I remember that Chris’s dad (who was an anesthesiologist) and one of his mom’s friends (a hand surgeon) tried to dissuade me from going to medical school. At that time, I was a bright-eyed college girl on a scholarship who responded with a nod and a smile, but I kept thinking, “Well of course you tell me that! You already have the big house and nice car. I want that too.” And I also really did want to help others. So you are right, no matter what advice we give our students and residents, they will need to make their own choice. I hope that by reading this blog people feel empowered to take control of their lives if they feel stuck in a toxic or unhappy situation, whether its a bad job or a bad relationship. If working 100+ hours a week as a cardiac surgeon or a waitress makes someone happy, I say more power to them. But if it doesn’t, then I hope by reading this blog they feel inspired to take the bull by the horns and change their life.
      I miss you terribly! I know I cant claim credit for the wonderful physician and woman you have become, but I at least feel some pleasure knowing I had a hand in training you.

      Noemi

  2. Medicine is like a jealous girlfriend, I’m told. So is physics!

    I had to make the decision of going the MD or PhD path several years ago, and decided to try an unbeaten path. Admittedly, the path I chose has less financial security with similar if not more expectations of work.

    As an undergrad I became very interested in ultrasound as a potential therapeutic modality for treating mental illness. As I studied further, I became invested in how ultrasound altered cellular environments, growth, health, and all that mess. I wrote a paper discussing potential mechanisms for prenatal sonography to induce defects in neural development, and ow, I’m hoping to go to grad school to study the effects of ultrasound on brain development – I guess that makes me, essentially, a pediatric neuropathologist in training.

    From my point of view as a researcher, I feel like doctors have an incredible burden of being expected to know the ins and outs of every tool of the trade. I spent years upon years studying ultrasound specifically, hounded by long nights of exhausting thought and deep contemplation. I can’t imagine anyone in the practice would have spent half the time I did studying that one modality when there are so many other things to draw attention away.

    The sobering reality that medicine is a business has many great consequences in the grand scale of things.. I wish there were more ways to promote medical ideologies in the business, maxim of medical ethics and informed consent, despite funding pressures. I see a lot of mess from psychiatry and the influx of prescription meds for every which thing — something like 70% of US citizens are now on prescribed medications. That should be an indicator of issues that need to be addressed, because we are what goes into our bodies …and long term consequences from these kinds of things won’t be found until, well, long term, you know?

    Best of luck with things. 🙂

    • Noemi Gamel says:

      Yay! I am tickled to have a physicist reading my blog! Thank you for your thought-provoking response. One of my biggest disappointments in medicine was the overmedication of American society to correct problems that were directly related to poor lifestyle choices, so I totally agree that we overprescribe meds. So sad. Keep me posted on your research about the effects of ultrasound on brain development. Sounds very interesting!

      • There’s a lot to talk about. Right now, ultrasound in medicine is business propagated and there are a lot of risks that people do not know about. There is a serious lack of research, too, in regards to human medicine. However, ultrasound has many commercial applications and I think that these should be red flags.

        It makes just about every kind of living organism (that relies on glucose metabolism) grow, so it’s used in microbiology and agriculture because it makes plants and microbes grow after exposure. Also, physical therapists use it to heal soft tissue damage because it makes human tissue regenerate quickly/breaks apart scar tissue.

        The waveform used in prenatal sonography is different, and so you can’t say the exact same amount of these effects happens. Unfortunately, little to no research has been done into if these happen at all.. I’ll be writing my dissertation on the connection between prenatal sonography and the rise in autism.

        I have a petition going to address a lot of shortcomings in prenatal ultrasonography. There’s a terrible lack of studies supporting the safety of ultrasound use, and it’s completely business regulated. Machines are not required to be calibrated, and pretty much anyone in the public – no certification needed – can use them with no restrictions. Very dangerous way to handle that particular thing because nearly every woman in the world gets them during pregnancy.

        https://www.change.org/petitions/health-risks-of-prenatal-ultrasound-the-urgent-need-for-more-research-and-regulation

  3. Pingback: Ladies: “You can have it all, just not at the same time.” | Pura Vida Familia

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