Why not Medical School? Part 2

Reasons 4 – 7

1. Gunners: While this is more of an opinionated statement, I believe that there exists a higher population of gunners in medical school than any other comparable profession field. There’s just something inherent about medicine that attracts gunners. I personally have a one track mind in that once I set a goal, I pursue it at almost any cost. Yet I’ve never tried to succeed by bringing about someone else’s misfortune like gunners are well known to do in order to rise to the top. While I’m quite determined in my career objectives and will probably step on a few toes trying to accomplish these dreams, I still cannot comprehend the gunner’s mentality to intentionally bring out this misfortune. The farther I can be from gunners, the better.
2. Residency: Why is there a need to abuse, harass, or otherwise tease residents? Why are there malignant residency programs in existence that believe the best avenue for training their freshly minted doctors is through sleep deprivation? These are just a few of the outstanding issues surrounding medical residencies. After four years of medical school, the progression should not be into a system where abuse, underpayment, and lack of sleep are common. I would like to believe (even if I’m a little naïve) that residents are at times called to handle life and death situations, why sleep deprive them or give them reason to gripe during these times? I’ve always wondered why there isn’t a huge outcry about improving the quality of residencies and then I stumbled onto this post on SDN. Pardon me; it has to do a bit with money, but the points in the posts still valid to the discussion. For whatever reason, physicians do not see a need to improve this current situation.
3. Compensation is horrible: I don’t even want to get into a discussion on this topic. People are either in the camp of “Doctors should not worry about how much they make, it’s the patients that matter” or “Doctors makes enough. Doctor’s salaries are about 5X -10X that of the average American” or “The artificial restrictions on the field of medicine constrict the salary of physicians away from the rates that the market will bear.” I subscribe to the last of those theory. You may not. Either way, it’s still a reason I considered.
4. Battle for cases: The practice of medicine is undergoing a change. The different specialties in medicine are becoming a bit homogeneous whereas different specialties are now competing for similar cases. Not only are there battles for cases between varying specialties, but in today’s flat world (Thomas Friedman duly credited) medical cases are now shifted to other health providers who can provide their services at a lower cost than physicians. With the advent of Nurse Practioners, Nurse Anesthetics, Physician Assistant or other primary care health providers (”mid-level providers) performing basic cases and slowly eroding physician’s responsibilities, the battle for cases has intensified. In the beginning, mid-level providers required physicians to be present (or required physician oversight) before performing their duties. Nowadays, mid-level providers are requesting more autonomy in their tasks, as well as attempting to increase their duties and responsibilities by encroaching on duties that historically belonged to physicians. Once again, where is the outcry from physicians groups trying to protect their territory or at least forming a coalition to try to adapt to these economic changes occurring around them. Physicians will have to stand unified one day and attack this problem, but as I can currently see, today is not that day, and tomorrow is not looking any better. Whether these mid-level providers can provide a service that is comparable in quality to a physician is not a debate for me to engage in (after all, I am not well versed), but I still understand the basic laws of economics. With different providers offering similar services, there will be an arduous fight for cases in the future; I only pray that physicians as a whole are ready to protect their profession.

For a change of pace, see this cartoon illustrating the different medical specialties.

- to be continued and concluded with next post