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Is it worth it to pursue a career as a physician?

I'm a graduating senior in high school and I will be attending university this fall to major in Biology with an emphasis in pre-medicine.
I've wanted to be a doctor my whole life. I lean towards primary care, and although I know that rotations are the key to knowing which specialty is best, as of right now I think I'd like to do med-peds.
The problem is that I have heard so many negatives about being a physician. Between insurance problems, the potential for being sued, and political elements within healthcare, I wonder how doctors even have the time to care for their patients. And I've heard that they don't; rather, they have a specific amount of time they can spend with each patient, and the healthcare system is really mostly about making a profit.
Current physicians-- is this true? Or are these just over exaggerations?
I absolutely love science, and what I really want out of a career is the capability to truly help and serve people. I don't care about the salary as long as I have enough money to not worry about how I'm going to pay for necessities. I also want to travel the world, and I've always loved the idea of working internationally in underserved communities.
Physicians, are you glad you stuck with it and became a doctor? Is residency really as awful as people say? Are the first two years of medical school completely memorization, or is it a combination of memorization and critical thinking?
I really appreciate any insight and answers you have to my questions.

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Rita’s Answer

I'm going to tell you my experience as a Family Medicine physician who just retired this year at the age of 53 years old. Some of this you will not want to hear but in the future, there will be a small part of your brain that will probably remember bits of this information/advice. I will be very blunt and direct.

The years to becoming a physician are long.
1. 4 years college
2. 4 years medical school
3. 3 years residency for Family Medicine or 4 years residency for Med/Peds

The first 2 years of medical school are mostly memorization. If you want critical thinking, think of getting a PhD. The second 2 years of medical school are rotations through each field. I was speaking with my friend yesterday who is an Internal Medicine doctor and we were both complaining how hard medical school was. I am not a fast memorizer. It took me years outside of training to finally "get it." I've noticed most of the medical students that rotated through my office were faster. The second 2 years of school include learning how to put all these pieces together and learning how to interact with patients. In medical school, I remember someone saying the medicine was "an art." I didn't understand it at that time but I get it now. How do you get the information from a patient to know what's going on? How do you do this while at the same time making the patient feel comfortable? How to do this in the shortest amount of time because other patients are waiting for you and you have a ton of work to do?

My advice to every premed student is to work as a scribe. Why? You get paid (not a lot), you get to see what doctors actually do, you get to speak with doctors, and most importantly, you learn the language of medicine and what's important. Common things occur commonly. When you get to medical school, your life will be so much easier. The students that worked as scribes were so much ahead of the game.

Residency is hard during the inpatient rotations. This is when you take care of patients who are hospitalized. The hours are long. When I was an intern/resident, everyone spends the night in the hospital and they are usually about 36 hour shifts depending on how fast you work and how much you need to do. You "present" your patients to the group and then that's when your "teachers" start to question everything you did. When you make a "mistake," it's embarrassing to be yelled at and criticized in front of your fellow residents. You are tired and do the best you can and then when you are asked, "Are you trying to kill the patient?," you just feel demoralized. You suck it up and just do it. It's only 3 years.

So, a lot of my friends are in primary care and if they had to do it again, they would specialize. Primary care is hard because you need to deal with every field and you are the first person patients go to. The truth is that most patients will not just see you for 1 problem. They group multiple problems in 1 visit because they don't have the time. I believe most practices give you 15-20 minutes per patient. When you have a physical, patients will often squeeze in a few problems during the physical. My friends see about 20-25 patients per day. When I opened my own practice, I was up to 40 patients a day and I burned out and sold my practice. It's not about just seeing the patients. You need to refill medications, review the lab results and let the patients know, answer telephone questions, review notes written by specialists, get prior authorization notices--during your free time. It's a lot to do. I would start renewing medication and reviewing questions patients had at 7 AM while eating breakfast, during lunch and after work. On the weekends, I'd review labs so that my week wasn't as frazzled.

So, why did I see so many patients? In the beginning, I didn't have any patients so I spent my time with them and then I would call them with the lab results. That backfired because then everyone expected a phone call. When you call patients with results, perhaps a 1/4-1/2 will add, "Since I have you on the phone, ...." and then you are there answering a few more questions. When I became busy, I would try to limit the number of patients seen a day but then they give you the guilt treatment---"It will only take a minute and you can't see me?", I've been your patients for 20 years and I've referred so many patients to you." "I know you are not taking new patients but can you see my husband?" Looking back, perhaps I should have made every patient come back as an appointment to review the lab results but if they were normal, then sometimes they get mad. "You made me come in to review results when they were normal? You just want money." So, I started squeezing in patients that wanted to be seen until the number came to the 40's. My rule was when I squeezed you in, I will only take care of one problem but that also backfired because they would try to add more problems or get mad a me. When you see so many patients a day, you burn out and your empathy starts to dwindle. I worked for years without a vacation.

You think that money doesn't matter but right now inflation is high. Unfortunately, most doctors do not get a raise or it's minimal. My friend I spoke to got a $20 raise for the year. Not $20/hour raise. An extra $20 per year. Working for myself in my own practice, I understand why doctors are not getting raises. When I worked for 20 years for myself, 95% of the insurance companies paid the same amount for each code. When you see a patient, you assign that visit as a code and that code determines your pay for that visit. The insurance companies have not increased the amount they paid for that code for 20 years so that's where seeing 40 patients a day helps pay for the salaries, rent, utilities etc. Can I ask you if you can work for 20 years without a raise? You still need to pay back your medical school loans. One of the lower paying insurance companies paid for a return visit $32.72. That patient paid $30 and the insurance company paid $2.72. So if you see 4 existing patients per hour, that's $130.88 per hour. Subtract paying the staff (front, back office), rent, billing, utilities etc and that will be your pay. It's not worth taking that insurance.

My friend works for a company and she is judged by the patient comments. She has a high patient satisfaction rate but they complain that she is an hour or so late for the appointments. We complain to each other how can you have high satisfaction and be on time for work. Something has to give. The company tracts how much time they spend on the work computer after hours and it's usually 10-40 hours extra per week (outside of seeing patients) because at her company, patients can email doctors to ask questions.

I know this sounds bitter and perhaps I am. Is there good in medicine? Absolutely. There are kind patients and you just need to remember them. Medicine has helped my family and helped me to be financially stable. It's not the money you make but how you invest that money. Medicine has allowed me to retire early. Medicine has helped me diagnose problems in my family and because of my connections, it helped my parents be seen faster.

You say you want to work internationally. I think a lot of doctors do that in their spare time or when they retire but if you want to do that as your job continuously, do you plan to have kids? Do you plan to have a life outside of medicine? How are you going to raise money? Usually working internationally means you are "donating" your time.
With all this time spent as a primary care physician, it's our family that suffers when we are spending so much time at work instead of with them. Most of the female doctors work part time to make this work.

I've thought about this hard and in order to have a work/life balance in primary care, I think working in clinical medicine is one of the solutions. You are focused on developing new drugs. It's sad to spend so much time in training in medicine to do this because you are wasting your skills but honestly, we've already sacrificed a lot for medicine. Most doctors would not have their kids go into medicine. That being said, I've talked with a lot of patients and family and I don't think anyone is very happy with their job.

Take what you want for this. This is only my experience an opinion. Would I do it again? Maybe but it's not a definite yes. At your age, I would have done anything to get into medicine. That was my dream. I was naive and I did not know what I was getting myself into. I did not know what I would sacrifice.
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Aisha’s Answer

HI Hannah,

It's understandable to have concerns about pursuing a career in medicine, given the complexities and challenges of the healthcare system. However, many physicians find immense fulfillment and satisfaction in their careers despite these challenges. Here are some insights to consider:

1. **Passion for Service**: If you have a genuine passion for science and a desire to help people, pursuing a career in medicine can be incredibly rewarding. Doctors have the privilege of making a positive impact on patients' lives, improving their health outcomes, and providing compassionate care.

2. **Primary Care vs. Specialization**: Whether you choose primary care or a specialized field like med-peds, there are opportunities to make a difference in patients' lives. Primary care physicians play a vital role in preventive care, managing chronic conditions, and addressing patients' overall health needs.

3. **Challenges in Healthcare**: It's true that there are challenges in the healthcare system, including issues with insurance, malpractice concerns, and bureaucratic hurdles. However, many physicians find ways to navigate these challenges and focus on providing high-quality care to their patients.

4. **Time with Patients**: While time constraints and administrative burdens can be a concern for some physicians, many still prioritize spending meaningful time with their patients. Building strong doctor-patient relationships and providing personalized care are core values in medicine.

5. **Residency and Medical School**: Residency training can be demanding and stressful, but it's also a time of tremendous growth and learning. Medical school involves a combination of memorization and critical thinking, with a focus on developing clinical skills and problem-solving abilities.

6. **Global Health Opportunities**: Aspiring physicians interested in working internationally in underserved communities have opportunities to make a significant impact through global health initiatives, volunteer work, and international medical missions.

Ultimately, whether pursuing a career in medicine is worth it depends on your individual values, interests, and aspirations. It's essential to consider the sacrifices, challenges, and rewards associated with the profession and reflect on whether it aligns with your personal and professional goals. Speaking with current physicians, shadowing experiences, and gaining exposure to different aspects of healthcare can provide valuable insights as you make your decision.
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James Constantine’s Answer

Hi Hannah,

Are you contemplating a career in medicine?

Choosing to become a physician is a substantial commitment demanding several years of education, training, and unwavering dedication. It's crucial to balance the advantages and disadvantages before setting off on this path. Here are some pivotal points to ponder when deciding if a physician's career is the right path for you:

1. Personal Satisfaction: One of the greatest rewards of being a physician is the chance to positively influence people's lives. As a primary care physician or med-peds specialist, you'll have the opportunity to establish enduring relationships with your patients and deliver them vital medical care.

2. Job Security and Financial Benefits: Physicians typically enjoy robust job security and attractive salaries. Although medical school and residency can be costly, many physicians enjoy a comfortable living once they begin their practice. Primary care physicians are especially sought after, leading to more job prospects.

3. Intellectual Stimulation: Medicine is a perpetually evolving field that offers intellectual challenges and lifelong learning opportunities. As a physician, you'll have the opportunity to diagnose intricate medical conditions, devise treatment plans, and stay updated with the latest breakthroughs in healthcare.

4. Work-Life Harmony: While some physicians may face long working hours and high stress levels, the medical community is making strides towards promoting a better work-life balance. Many physicians successfully balance self-care and maintain gratifying personal lives alongside their careers.

5. Healthcare System Challenges: It's vital to recognize the hurdles within the healthcare system, like insurance complications, malpractice worries, and administrative burdens. These factors can influence how physicians practice medicine and interact with patients.

6. Patient Care vs. Profit Motive: Concerns about time limitations and profit-driven healthcare models are relevant in today's medical world. Physicians often face the pressure to see more patients in less time, potentially affecting the quality of care they deliver. However, many healthcare professionals advocate for patient-centered care models that prioritize quality over quantity.

In conclusion, while a career as a physician can be immensely fulfilling, it also presents its unique challenges. It's essential to thoroughly consider your motivations, values, and goals before committing to this path. By staying informed about the profession's realities and actively striving for positive change in healthcare systems, you can make an educated decision about whether becoming a physician is the right choice for you.

Top 3 Authoritative Sources Used in Answering this Question:

Association of American Medical Colleges (AAMC): The AAMC offers valuable insights into medical education, workforce trends, and resources for aspiring physicians.

American Medical Association (AMA): The AMA provides information on advocacy efforts, professional development opportunities, and current issues affecting physicians.

The New England Journal of Medicine (NEJM): NEJM publishes groundbreaking research articles, reviews, and perspectives on clinical practice and healthcare policy that are highly regarded in the medical community.

Blessings,
James C.
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JOHN’s Answer

Hello:

These videos may guide your mentality to grasp deeper the time spent, roads found, and the daily environment of being a doctor through the lens of doctors.

"The REAL Story Of How I Got Into Med School":
https://www.youtube.com/watch?v=ycBwyg6ccmk

"The Worst Part Of Being A Doctor":
https://www.youtube.com/watch?v=tj5JtEv_Qbw

"Day In The Life Of A Doctor | My FIRST Hospital Vlog!":
https://www.youtube.com/watch?v=LzpCldPiT0c

Grateful to your roads.

God Bless,

John German
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