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Why you should not go to medical school

blogs.law.harvard.edu

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Re: Why you should not go to medical school

#61

Post by hugh3 »

mootothemax wrote: post #45
skrebbel wrote: post #44

Earlier quoted context omitted.

Right. Turns out I completely misunderstood every sentence that contains "resident" in that article, then :-) Thanks for pointing it all out. Does make his argument about the bad money bogus though. Nearly every other job is worse money than being a doctor (which is why he compared to investment bankers and the likes)

Does make his argument about the bad money bogus though. Nearly every other job is worse money than being a doctor If you worked those other jobs for 80 hours a week, I think you'd start catching up pretty quickly ;-)

Yeah, but in medicine, by the time you're making the big money you're working much less. Or on whatever schedule you like.

At the age of 29: $45,000 for eighty hours a week.

At the age of 49: $600,000 for forty hours a week.

Re: Why you should not go to medical school

#62

Post by adrianwaj »

patrickgzill wrote: post #57
roentgen wrote: post #48

Earlier quoted context omitted.

I had a different experience. Medical school was easy, I was single and went out drinking / partying two or three nights a week. Not to be crass, but I did well with the ladies. Luckily I can get by on four hours of sleep or less. So, I don't feel like I missed out on much of the early twenties experience. Most of my non-medical friends had jobs and I didn't, but that was the only real difference. Things got a little…

Thank you for your honesty. May I ask, what exactly do you do that you feel justifies your 800k per year? It seems to me that your career is ripe for disruption.

Disruption is learning about and becoming healthy, or for example, one may spend their life savings on some supposed cancer treatment involving chemo, surgery and radiation.

Re: Why you should not go to medical school

#63

Post by marknutter »

patrickgzill wrote: post #57
roentgen wrote: post #48

Earlier quoted context omitted.

I had a different experience. Medical school was easy, I was single and went out drinking / partying two or three nights a week. Not to be crass, but I did well with the ladies. Luckily I can get by on four hours of sleep or less. So, I don't feel like I missed out on much of the early twenties experience. Most of my non-medical friends had jobs and I didn't, but that was the only real difference. Things got a little…

Thank you for your honesty. May I ask, what exactly do you do that you feel justifies your 800k per year? It seems to me that your career is ripe for disruption.

He makes that much as a partner of a practice, not as a doctor at a hospital. This is no different than being a founder of a successful small business.

Re: Why you should not go to medical school

#64

Post by michaelochurch »

codexon wrote: post #26

The reason why it is so hard to become a doctor is because the AMA restricts the number of applicants and schools that can create doctors so wages can remain artificially high. http://www.forbes.com/2009/08/25/american-medical-associatio... http://gregmankiw.blogspot.com/2009/06/physicians-incomes-an...

That post should go straight to the top.

This is also why residents have to suffer ridiculous hours. With the severe limitations on the number of people who can become doctors, the profession is characterized by an extreme workload.

It's seriously wrong. I, for one, would not want to be operated on by a surgeon who'd been working for 21 hours straight. Commercial pilots are limited to 40 flight hours per month, and what they do is a lot less complex than what doctors have to do.

Re: Why you should not go to medical school

#65

Post by jpdoctor »

roentgen wrote: post #48
arn wrote: post #4

So, surprisingly, this rant is more or less accurate, imo. (I went to med school, residency, fellowship) I mean some things stronger than others, but it hits on the major negatives as you go through training. I know a lot of these rants tend to romanticize how hard people's own professions are in a "no one else has it this hard" type stance. We see similar "how hard it is to be a programmer" type rants as well. But,…

I had a different experience. Medical school was easy, I was single and went out drinking / partying two or three nights a week. Not to be crass, but I did well with the ladies. Luckily I can get by on four hours of sleep or less. So, I don't feel like I missed out on much of the early twenties experience. Most of my non-medical friends had jobs and I didn't, but that was the only real difference. Things got a little…

> I make over 800k a year

Does it bother you that you are profiting handsomely from sick people?

Re: Why you should not go to medical school

#66

Post by roentgen »

patrickgzill wrote: post #57
roentgen wrote: post #48

Earlier quoted context omitted.

I had a different experience. Medical school was easy, I was single and went out drinking / partying two or three nights a week. Not to be crass, but I did well with the ladies. Luckily I can get by on four hours of sleep or less. So, I don't feel like I missed out on much of the early twenties experience. Most of my non-medical friends had jobs and I didn't, but that was the only real difference. Things got a little…

Thank you for your honesty. May I ask, what exactly do you do that you feel justifies your 800k per year? It seems to me that your career is ripe for disruption.

The Health Care Finance Administration ( Medicare / Medicaid ) sets reimbursements rates, and most private insurance companies follow suit. So, I don't get to charge whatever I want to read an MRI. And, I don't order the studies that I read, other doctors do that.

The only thing I can control is the number of studies I read. If I work harder and read more, I make more. It just so happens that I am very fast, and I have surrounded myself with fast partners. On average we read two or three times what other radiologists read, so we make two or three times more.

As far as disruption is concerned, for now the law is on my side. Of course a doctor working in India could read studies cheaper than I could. Most doctors complain about malpractice, without understanding the benefits. Trial lawyers hold me liable for my reports, and rightly so. If I miss a small treatable cancer, it can turn into a large untreatable cancer. This liability also confers a monopoly. How can a lawyer sue a doctor in India? Consequently, in order to perform a 'final read' on a radiology study in the USA, you must have trained in USA, be credentialed in the USA, and liable in the USA. This makes it very hard to undercut on price.

So, I'm not sure if I deserve what I make. There aren't a lot of people that can do my job, or withstand the training. Anyway, I'm saving everything I earn, because I don't think it will last forever.

Re: Why you should not go to medical school

#67

Post by roentgen »

jpdoctor wrote: post #65
roentgen wrote: post #48

Earlier quoted context omitted.

I had a different experience. Medical school was easy, I was single and went out drinking / partying two or three nights a week. Not to be crass, but I did well with the ladies. Luckily I can get by on four hours of sleep or less. So, I don't feel like I missed out on much of the early twenties experience. Most of my non-medical friends had jobs and I didn't, but that was the only real difference. Things got a little…

> I make over 800k a year Does it bother you that you are profiting handsomely from sick people?

Not at all. I'm very good at my job, and I worked very hard to get where I am. Sick people should be happy that I'm reading their CT scans. If the pay wasn't good I would have chosen a different field, and somebody else would be doing my job, less well.

For reference, before medical school I worked in IT, and at the age of 23 ( 15 years ago ) I was making six figures. I left that to go back to school, partly because I knew I would be financially rewarded.

Again, see my response below. I don't order the studies I read, and I don't set the reimbursement rates. Additionally, it is Medicare fraud for me to read a study and not charge for it. In short, I have very little say over what I earn.

Re: Why you should not go to medical school

#68

Post by sp332 »

patrickgzill wrote: post #57
roentgen wrote: post #48

Earlier quoted context omitted.

I had a different experience. Medical school was easy, I was single and went out drinking / partying two or three nights a week. Not to be crass, but I did well with the ladies. Luckily I can get by on four hours of sleep or less. So, I don't feel like I missed out on much of the early twenties experience. Most of my non-medical friends had jobs and I didn't, but that was the only real difference. Things got a little…

Thank you for your honesty. May I ask, what exactly do you do that you feel justifies your 800k per year? It seems to me that your career is ripe for disruption.

Generally, rare goods - and skills - are valuable. So going to school for a long time to learn an unusual skill well means that your services are more valuable.

Also, providing a large amount of value in a small amount of time (like accurately interpreting the results of a scan) leads to providing huge amounts of value over the course of a year. Part of the explanation is the sheer volume of individuals he can give a reasonable amount of value to.

Re: Why you should not go to medical school

#69

Post by roentgen »

marknutter wrote: post #63
patrickgzill wrote: post #57

Earlier quoted context omitted.

Thank you for your honesty. May I ask, what exactly do you do that you feel justifies your 800k per year? It seems to me that your career is ripe for disruption.

He makes that much as a partner of a practice, not as a doctor at a hospital. This is no different than being a founder of a successful small business.

Correct. When a CT scan is performed, there are two charges generated. A 'Technical Fee' for performing the study, and a 'Professional Fee' for reading it. The technical fee is almost always larger.

If you work for a hospital they keep the technical fee, and you get whatever professional fees you can collect. Insurance companies hate paying, so they will find any reason to deny. Collection rates range between 60% and 80%.

My partners and I own imaging centers, we collect both fees. So we are running a business, and I don't consider it small anymore.

Re: Why you should not go to medical school

#70

Post by adrianwaj »

jpdoctor wrote: post #65
roentgen wrote: post #48

Earlier quoted context omitted.

I had a different experience. Medical school was easy, I was single and went out drinking / partying two or three nights a week. Not to be crass, but I did well with the ladies. Luckily I can get by on four hours of sleep or less. So, I don't feel like I missed out on much of the early twenties experience. Most of my non-medical friends had jobs and I didn't, but that was the only real difference. Things got a little…

> I make over 800k a year Does it bother you that you are profiting handsomely from sick people?

More importantly, does it bother him that they are sick in the first place, or is he happy?
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