Recently, I was having a discussion with a colleague about being a doctor. She confided in me that if someone asked her about becoming a doctor, she would tell him or her to become a nurse practitioner. After reading the emotional open letter to our policymakers in Washington DC, it may sound like a reasonable suggestion. After all, why go into this much debt and spend so much time in training if your prospects are not much better? More recently, the New York Times article points out job prospects for radiology trainees are thinning, meaning the well known “ROAD” (Radiology, Ophthalmology, Anesthesiology, and Dermatology) to success may soon become a road to nowhere if there are no jobs.
There in lies the question, why become a doctor? If the answer is to make money or to have an easy life, then you probably need to look for a new profession. With healthcare payment reform, doctors can expect lower salaries as bundled payment and cost cutting measures are instituted. Moreover, the demand for healthcare will go up as more patients have insurance, leading to higher patient volumes and the expectation to see more patients with the same amount of time.
So, why become a “doctor”? Simply put, the decision to become a doctor includes a sense of calling. The decision to become a doctor means accepting your duty to at times sacrifice your holidays, weekends, nights and other personal time to help someone else. This sentiment is best reflected by the motto of the coveted Alpha Omega Alpha medical student honors society, “worthy to serve the suffering.” A recent New York Times Magazine article about giving reminds us, the joy in medicine needs to comes from the job itself, taking care of the most vulnerable people in our healthcare system, our patients. And as tough as being a doctor can be at times, it pales in comparison to the tough life of being a very sick or chronically ill patient.
Unfortunately, too many of us may forget this somewhere in training. Burnout is rampant among physicians, an epidemic that threatens the profession. Faculty, who could be powerful role models, instead become too burned out to emphasize the positive of their profession. Medical students who are thinking about going into primary care get burned out during their training, and decide to go into lifestyle oriented subspecialties. Practicing physicians who are burned out decide to leave the profession altogether. Not surprisingly, those with a stronger sense of calling are more resilient to burnout.
Given the long dwell time it takes to train a physician, creating systems that allow doctors to live up to their calling to serve while avoiding burnout is critical to ensuring a healthy workforce and safe care. Unfortunately, the recent debates over new residency duty hour studies this week highlight our failures in this mission. While resident work hour restrictions limit the number of hours worked, the lack of dramatic improvements does not come as a surprise to anyone in medical education. Insiders know that the pace of work and intensity has gone up while many residents often care for similar numbers of patients, but in less time. While some have proposed a controversial move to extend residency training, it is worth considering another solution before we tack on more debt to our graduates. The solution sounds simple: change the type of work residents do to align with meaningful doctoring.
A recent study led by one of my colleagues demonstrates virtually no difference in the types of resident activities have performed in 20 years! A bevy of studies show that at least one third of resident time is spent doing something of “none or marginal educational value” that could be performed by someone else…and that someone else need not be a nurse practitioner or a hospitalist… it could be a clerical worker! While technology could make things easier, adoption of electronic health records has added to the time charting, tying our physicians-in-training to the iPatient, and distancing them from their real patients who could remind them of their calling. Just as there are serious discussions going on in the healthcare community about “working at the top of your license”, we need to critically examine what our residents are doing and when in training. By redesigning the activities of residents to align with their “calling”, we can instill in today’s medical trainees the duty to doctor in the context of duty hours.
Vineet Arora, MD, MPP is an Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. She blogs regularly at FutureDocs.
Experienced Industrial Wall Cladding Renovation Services
My partner and I stumbled over here different page and
thought I might check things out. I like what I see so now
i am following you. Look forward to finding out
about your web page repeatedly.
Can you tell us more about this? I’d love to find out some additional information.
My website acai berry garcinia cambogia vs raspberry ketones 800 mg (Michaela)
Nice post. I learn something totally new and challenging on websites I stumbleupon everyday.
It’s always helpful to read articles from other writers and use a
little something from other web sites.
Hey there, I think your blog might be having browser compatibility issues.
When I look at your website in Safari, it looks fine
but when opening in Internet Explorer, it has some
overlapping. I just wanted to give you a quick heads
up! Other then that, terrific blog!
Also visit my web-site; Tarpon Springs Florida where is the closest gym to me
Good points. As a no medical person my viewpoint in the importance of doctors is has come from past medical treatment. Yes, a prestigious profession, well paid and long hours. After a motorcycle accident where I was hit by a car I know the importance of the years of treatment to half recover. A qualified doctor has a good standing in the community and can help doctor to further their aspirations outside of the medical professions.
I was able to find good info from your articles.
Feel free to surf to my web site … real estate business plan
Hi to all, how is the whole thing, I think every one is getting more from
this site, and your views are good in support of new viewers.
Also visit my web site: dui lawyer oakland
I am noo longer sure the place you are getting your info,but good topic.
I must spend a while learning more or understanding more.
Thanks for great information I used to be on the lookoout for
this info ffor myy mission.
Take a look at my web page :: restaurants in savannah ga riverfront
Hi to all, the contents present at this site are really awesome for people knowledge, well, keep up the nice
Here is my blog post … laser eye surgery center wentzville
Rather nice post. I recently became aware of the site as well as needed to state that I actually treasured surfing around your website posts. Whatever the case We will be signing up ones rss and i’m wishing you are writing once again as soon as possible!
Very good post! We will be linking to this particularly great content on our website.
Keep up the great writing.
Feel free to visit my web blog; you walk bail bonds
I am not sjre where you are getting your information,
but good topic. I needs tto speend some time learning more orr understanding more.
Thanks for fantastic information I was looking for this information for my mission.
Visit my weblog – plastic surgery columbus ohio (Levi)
It’s actually a nice and helpful piece of info. I am happy
that you just shared this helpful information with us.
Please keep us informed like this. Thanks for sharing.
Take a look at my web site free consultation with lawyer
Very energetic blog, I loved that a lot. Will there be a part 2?
Take a look at my blog post is the easy hangout blueprint a scam?
You actually make it seem so easy with your presentation but I find this matter to
be actually something which I think I would never understand.
It seems too complicated and very broad for me. I am looking forward for
your next post, I’ll try to gett the hang of it!
Feel free to visit my webpage :: homepage [Suzette]
After looking at a number of the blog posts on your
blog, I really like your way of blogging. I bookmarked it to my bookmark website list and will be checking back
in the near future. Take a look at my web site too and
tell me your opinion.
Hello there! Do you know if they make any plugins to assist
with SEO? I’m trying to get my blog to rank for some targeted keywords but I’m not seeing
very good gains. If you know of any please share. Thanks!
My site; bail bond jobs
Nice blog dude. Amazing work you did. Congrats!!
It’s hard to come by well-informed people in this particular topic, but you seem like you know
what you’re talking about! Thanks
my homepage; used tires spring hill
hello!,I love your writing so much! proportion we communicate more approximately your post
on AOL? I need an expert in this space to resolve my problem.
Maybe that is you! Having a look forward to look you.
Here is my blog post – Lawyer Youtube
Thanks in favor of sharing such a good opinion, article is fastidious, thats
why i have read it entirely
my web-site – find high quality swiss replica watches
At this time it seems like Movable Type is the preferred blogging platform available right now.
(from what I’ve read) Is that what you’re using on your blog?
my web page: bail bonding license
This is my first time pay a quick visit at here and i am really impressed to read everthing at single place.
My page: In And Out Chiropractic
Howdy! This is kind of off topic but I need some guidance from an established blog.
Is it hard to set up your own blog? I’m not very
techincal but I can figure things out pretty fast.
I’m thinking about setting up my own but I’m not sure where to start.
Do you have any tips or suggestions? Many thanks
Here is my blog post :: 19-how to find a handyman
It’s going to be end of mine day, however before ending I am reading this great article to
increase my know-how.
Here is my webpage :: how to get to cincinnati
Hi there, of course this post is in fact good
and I have learned lot of things from it about blogging.
Here is my homepage – home repair contractors
There are quite a few roofing contractors which undertake this kind of
roofing there would be no flat sections. 4 What Materials Will You Use?
Once there is a capitol roofing possibility of a structural deficiency.
To begin with, then call up the references that he’s listed down. The reputed roofing firm guarantees of strong roof to give complete protection. It can also
be quite scenario capitol roofing specific.
Feel free to surf to my page: roofer Denver co
Having read this I believed it was really informative.
I appreciate you taking the time and energy to put this
content together. I once again find myself
spending a significant amount of time both reading and posting comments.
But so what, it was still worthwhile!
My weblog; best wp themes
Hi to every one, the contents existing at this web page are actually remarkable for people experience,
well, keep up the good work fellows.
Review my homepage :: forex Compare
Great post. I was checking continuously this blog
and I’m impressed! Extremely helpful information specifically
the last part 🙂 I care for such info a lot. I was looking for this certain info for a very long time.
Thank you and best of luck.
Look at my website … foreclosure process Las Vegas
Thanks for finally writing about > Why Become a Doctor?
| The Health Care Blog < Loved it!
My page – auto shop near me Elk Grove CA
Undeniably believe that which you said. Your favorite
justification appeared to be on the net the simplest thing to be aware
of. I say to you, I certainly get annoyed while people think
about worries that they just don’t know about. You managed to hit the nail upon the
top as well as defined out the whole thing without having
side-effects , people could take a signal.
Will probably be back to get more. Thanks
Feel free to surf to my blog post colour mascara Phoenix
If some one wishes to be updated with latest technologies after that he must be pay a visit this site and be up
to date daily.
Here is my weblog: charlotte nc photography
I was extremely pleased to find this website. I need to to
thank you for your time for this particularly wonderful
read!! I definitely loved every bit of it and I
have you saved to fav to check out new stuff on your web site.
my homepage small business phone answering service Glendale CA
Greetings! Very helpful advice in this particular post!
It’s the little changes that will make the most important changes.
Thanks a lot for sharing!
my weblog – tree services Cherrybrook
Hi, yup this post is really nice and I have learned lot of things from it concerning blogging.
Look into my website … ,lawn mower engine repair Clackamas Oregon,
I like the helpful information you provide in your articles.
I’ll bookmark your weblog and check again here
regularly. I am quite sure I will learn plenty of new
stuff right here! Good luck for the next!
my page – experienced criminal defense attorney
Why visitors still make use of to read news
papers when in this technological world all
is presented on net?
my webpage :: Home Inspections Oakville
This blog was… how do I say it? Relevant!! Finally I have found something that helped me.
Feel free to visit my site … top criminal lawyer
This site was… how do you say it? Relevant!!
Finally I have found something which helped me. Thanks!
Feel free to surf to my site success down
Hi there, just wanted to tell you, I enjoyed this blog post.
It was funny. Keep on posting!
My website wwe john cena kids t shirts
I really love your site.. Excellent colors & theme. Did you
create this web site yourself? Please reply back as I’m hoping to create my
own site and want to know where you got this from or just what the
theme is named. Many thanks!
My web page best dui attorney
hey there and thank you for your information – I have definitely picked up
anything new from right here. I did however expertise several technical points using
this web site, since I experienced to reload the web site many times previous to I could
get it to load correctly. I had been wondering if your web
hosting is OK? Not that I am complaining, but sluggish loading instances times will very
frequently affect your placement in google and can damage your quality score if
ads and marketing with Adwords. Anyway I’m adding this RSS to my email and can look out for much more of your respective interesting
content. Make sure you update this again soon.
My website affordable domestic violence lawyer thornton colorado
It is one of the best profession and field to make career. It is sure that you have to do hard-work for it . Genuinely the blog described well about interesting tips. In the age of competition being a doctor is difficult . After the education finding job is more challenging . Thanks to some faithful agencies like Physician Employment who are providing better opportunities .
My partner and I absolutely love your blog and find almost all
of your post’s to be just what I’m looking for. can you offer guest writers to write content available
for you? I wouldn’t mind composing a post or elaborating on some of the subjects you
write related to here. Again, awesome web site!
Take a look at my weblog :: interactive marketing
Some of these sites are los angeles attorney search highly experienced attorneys, you may choose to create the perfect attorney and you can breathe a
sigh of relief as the elderly through ill-conceived agreements.
Your Knoxville DUI attorney has actually dealing with benzene
related injuries include fractures, closed head injuries,
the courts follows a particular area.
Feel free to surf to my site: dui en los angeles
Thanks for finally writing about > Why Become a Doctor? |
The Health Care Blog < Liked it!
Here is my website ,lawn mower parts Canby Oregon,
I am genuinely delighted to read this blog
posts which contains plenty of helpful data, thanks for providing these
my page – Accident Insurance Orchard Homes MT
It’s wonderful that you are getting thoughts from this paragraph as well as
from our argument made at this time.
Here is my web-site :: Lutheran Church Missouri Synod Omaha
Great issues altogether, you simply gained a new reader. What may you recommend about your publish that you just made some days in the past? Any certain?
Love this article! It’s so true, if you enhance an employee’s passion the quality of work will skyrocket! The thing I worry about in this day in age is that students are entering the medical field for the wrong reasons. So many watch these medical shows like House and want to be a doctor because of their false impressions of the medical field. Or, they could be driven by money. I hope we aren’t losing that passion across the board…
The title “Doctor of Medicine” still carries weight in our society. With that respect, however, comes significant moral imperatives to maintain that respect.
Hi Friends (this is for Doctors) i found a one good EMR (Electronic Medical Records) Healthcare Product from http://anytimeconnect.com/ . Its like a life and time saving tool and the product is really good, so if possible just try this product u will also like.
It is a holy profession which provide hope to a dying man.
It no longer makes a difference.
You will never be part of the community. You will have been commoditized. No longer are you a professional. You will be disillusioned, itinerant, unappreciated and underpaid. You are an idiot for spending that much time and money to start life so late and achieve so little.
I think you’ve created a false dichotomy in this essay.
Your physician friend says s/he recommends the NP path because studying medicine isn’t worth it, and you respond that the sense of mission/vocation makes it worth it. Does that mean that nurse practitioners do not have a vocation/mission/sense of responsibility for their patients?
Whoever is caring for patients needs both the fund of knowledge and the professional ethic/vocation to be a great provider. We, collectively – with our NP, PA, and other colleagues – need to figure out a way to return the practice of caring for patients a fulfilling one, without eroding the quality of worklife with unsustainable volume or trivial tasks – and others have commented on how to do this.
A good start is to have all those MD/MBA’s (hot trend = in the 80s and 90s) trade in their MBAs for MPHs
Dr. Rick Lippin
The article may be the culmination of arguments on why not to be come a physician. No wonder, we are so confused.
Firstly, replace ‘healthcare’ with ‘hospital care’. Doctors don’t create health-public health professionals do that. Doctors cure diseases.
Secondly, majority of economies dissociate value (e.g. health) creation from wealth (i.e. earnings) generation.
So there isn’t a revenue model for ‘healthcare’-creation of health, a value!
The Final question remains of Thoreau-If we don’t agree with the system, are we ready to build our Walden?
Doctors have become window washers for the HIT vendors, insurance executives, and hospital CEOs. The intrusions and manipulation of medical care to enable the building of their fortunes and greed is despicable. The CPOE and CDS machines make life nasty for doctors and serve no meaningful beneficial purpose, except, perhaps, for a chimp.
“chimp”? Hey, watch it there!
Very interesting comments from all. As a “seasoned” primary care internist, I suggest the following to deal with the issues noted above.
Bolster primary care:
1. eliminate “Pay for Documentation” so primary care docs can treat patients and not “treat the chart”. Benefit: improved efficiency, improved patient satisfaction, reduced medical error, reduced cost.
2. pay PCPs 30% more than current. Benefit: more PCPs who spend more time with each patient.
3. subsidize medical education costs for PCPs; for example, 10% reduction in med ed costs for each year spent in a primary care specialty.
4. tort reform. Benefit: reduced cost through redduced defensive medicine.
Being a clinical faculty member at U of Hawaii, I think medical education has changed tremendously in the past two decades. Here are a few of the changes that I see:
1. Problem-based learning. Benefit: Structured problem solving is better than the rote memorization of the old school.
2. Patient contact in the first year of med school. Benefit: emphasizes the fact that people should be the reason we go into medicine.
3. Emphasis on self-learning techniques and use of electronic resources (med students care a whole library on their iPads and smart phones). Benefit: Life-long learners are more capable of using rapidly advancing medical science in daily practice.
Patients often ask me how I am reacting to pressures in healthcare. I tell them:
Every day the medical science gets better and better.
Every day I can do something new and better for my patient.
Every day someone makes me feel like a hero.
Every day the business ethic of modern healthcare seems to eat away at my ability to maintain the professional ethic.
But, for me, so far, better science, the ability to help, and personal reward overcome the negative commercialism in healthcare.
Imagine that you tripled the cost of law school, designed an internship of many years, and the government set the prices that a lawyer could charge…you would laugh at anyone interested in practiing law. None of those things have occured, and you hear lawyers constantly complain about the value of their education.
The cost of med school is obscene and forces $$ first thinking. A simple answer is to cut the cost of medical school – or – heavily subsidize tuition (not more loans). Rough numbers here, but 20k physicians graduating each year at 100k debt load is $2 Billion a year. I know that sounds like a lot, but the Feds pay $20 Billion in farm subsidies each year.
Thank you for influencing the industry for future doctors. Your thoughts are highly informative.
I somewhat disagree.
I think this is what we tell ourselves and this is what students say at interviews.
However, I believe many students get into medical school because it is an accomplishment in itself. It’s about getting into the most competitive program, about the prestige of becoming a doctor, about the opportunity for a good career and so on.
I would argue a lot of doctors develop a “sense of calling” during their training. We do long hours and are dedicated to our patients for many reasons. Some of it is because we like what we do, we care about being good at it, we care about our patients and so on. The “sense of calling” is part of this multifactorial puzzle.
The fact that the hidden curriculum is able to transmit this culture however is a very positive thing.
I also differ, for the reasons that Mathieu pulls out, as well as one other: It’s still tremendously lucrative to be a physician. http://www.advisory.com/Daily-Briefing/2013/04/01/The-nine-highest-paid-jobs-in-America-are-in-health-care
As Dr. Arora alludes to, the compensation isn’t what it once was — and new pressures will further tamp down income — but the average doctor’s income is still somewhere between the 98th and 99th percentile.
Thankfully, most physicians enter the profession for nobler reasons. But the draw of dollars can’t be overlooked.
The idea to shift the service-education balance in order to optimize residents learning is a great one. It faces a major problem however. From a system standpoint, residents are paid to provide service. Less service equals lower salary. Debt and finance are already one of the major stressor for residents. You need to optimize learning opportunity without cutting services. There is no easy solutions.
Has medical education changed in any meaningful way since the turn of the last century? I wonder. Other than the number of women now in med schools (a welcome shift from the very XY days of Not So Long Ago), the education itself seems to have absorbed the tech and clinical advances without putting either in the hands of residents in meaningful ways – particularly if residents are still seen as great clerical options by those training them.
I love your question. I worry that there’s still a noticeable percentage of med students who answer it with economic goals, not purpose-related ones. Is reducing the cost of a medical education an option? Perhaps by having interested docs-in-training provide primary care in underserved areas for 3-4 years?