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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

#151

Post by stevenbedrick »

Game_Ender wrote: post #123
roentgen wrote: post #67

Earlier quoted context omitted.

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…

Do you worry about being replaced by computer software? You said you make $800k a year, and for that amount of money you could higher 2-3 PhDs in machine learning and computer vision for each radiologist. Do that maybe 5 times over and give them 5-10 years and productivity and costs for CT scan analysis will probably go way down. After all a radiologist armed with software that prescans each CT scan looking for inter…

I can assure that there are already an awful lot of PhDs in machine learning and computer vision working on the problem of automatically analyzing medical images, and there's been lots of progress over the last few years. There's a really long way to go, however- it's one of those areas where the problem is a lot harder than it seems.

Working in the field has convinced me that radiologists earn every penny, and that there are good reasons for the lengthy residencies and stringent board exams.

Re: Why you should not go to medical school

#152

Post by mahyarm »

pavel_lishin wrote: post #131
michaelochurch wrote: post #105

Earlier quoted context omitted.

There's a fair amount of non-flight work. It'd say that it averages 120 hours of work time total per month. Less than we work, but with worse hours. If you fly international with the majors, you're in good shape. Those guys make $200k easily, but those jobs are essentially inaccessible because the people who get them never retire. The rest make very little, and work a lot harder.

What sort of non-flight work do they do? I'm honestly curious, and I don't know any professional pilots. I imagine there's paperwork to fill out before and after every flight, and maybe mandatory training...

Walking around airports, going through customs, switching planes, waiting for matinee, paperwork, hotels, etc.

Re: Why you should not go to medical school

#153

Post by zmanian »

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'd describe you as a possessing several traits that make you well suited for a career in medicine.

Hypomanic personality. Characterized by low need for sleep, excessive energy.

High IQ/ general intelligence.

Low tolerance for risk.

You are probably making less money than you could as entrepreneur or in finance but that's consistent with your risk tolerance.

The professional medical career path is almost ideal for you and the author of the original post would probably acknowledge this. This is probably less true for many of the individuals who are steered into medicine by the elite educational system.

Re: Why you should not go to medical school

#154

Post by bugsbunnyak »

Game_Ender wrote: post #123
roentgen wrote: post #67

Earlier quoted context omitted.

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…

Do you worry about being replaced by computer software? You said you make $800k a year, and for that amount of money you could higher 2-3 PhDs in machine learning and computer vision for each radiologist. Do that maybe 5 times over and give them 5-10 years and productivity and costs for CT scan analysis will probably go way down. After all a radiologist armed with software that prescans each CT scan looking for inter…

There's a small army of PhDs doing this right now, NIH-funded and in commercial research shops.

A radiologist still must look at every single slice for liability reasons for the foreseeable future. That's the real time cost.

I work for a neurosurgeon in image-guided surgical planning research. One of the challenges is segmentation (labeling) of target areas to use in navigation. (radiologists generally don't do this, for various reasons). I've used some of the best commercial software, and seen some of the top research algorithms. With these, for the `easiest` tumors, we still have to semi-manually choose the region on every 3rd or 4th slice. The best algorithms will interpolate the other slices based on essentially fitting along a levelset. For a typical tumor, it can take 20-40 minutes to do this task - using the best available software!

This is `not` radiology, it's image labeling. It's orders of magnitude simpler than radiology.

There are some promising techniques to, for example, automate detection of changes in volume of some radiographically questionable area (after manual labeling for the first scan). At best, this will add information with no extra time cost.

Re: Why you should not go to medical school

#155

Post by kenjackson »

acgourley wrote: post #133
arohner wrote: post #118

Earlier quoted context omitted.

>There are licensing and board requirements, but conspiracy theories aside they are not designed to create artificial scarcity, they're supposed to keep dangerously ignorant doctors from practicing. Thanks for the comments in this thread, they've been very informative. I'm happy there are certifications, and I believe you that the bar should be raised, but given the huge demand for doctors, why aren't we increasing t…

Just wanted to point out that while it may seem intuitive that increased supply = cheaper prices, thats not how it works with doctors Doctors have the ability and incentive to increase demand, and I remember seeing data that this is what actually happens historically when you increase doctor supply.

How do these ability manifest? I suspect what you might be seeing is latest demand. There are a lot of people that would see the doctor more often, but often don't due to prices. Once access and prices become more reasonable they seek out medical services they normally wouldn't have.

Re: Why you should not go to medical school

#156

Post by shabble »

kenjackson wrote: post #155
acgourley wrote: post #133

Earlier quoted context omitted.

Just wanted to point out that while it may seem intuitive that increased supply = cheaper prices, thats not how it works with doctors Doctors have the ability and incentive to increase demand, and I remember seeing data that this is what actually happens historically when you increase doctor supply.

How do these ability manifest? I suspect what you might be seeing is latest demand. There are a lot of people that would see the doctor more often, but often don't due to prices. Once access and prices become more reasonable they seek out medical services they normally wouldn't have.

Or doctors see their profit-margins / wages declining, and lower the threshold level for various kinds of specialised testing. So, you complain about a mole or a lump, and instead of a quick diagnostic poke and an "It's probably fine", it's off for an invasive biopsy, "Hmm, the results were inconclusive, better safe than sorry" surgical removal, and maybe a few extra scans for follow-up.

I'm sure that there a many areas where a GP would like to schedule a follow-up, but can't justify it on the current evidence, and lets it slide.

Because there's this level of subjectivity in medicine, any increase in supply can easily be countered by the suppliers pumping up demand, keeping D/S exactly the same.

(I'm not a doctor, although I'm friends with a few)

Re: Why you should not go to medical school

#157

Post by shabble »

roentgen wrote: post #81
andrewtbham wrote: post #78

Earlier quoted context omitted.

are you concerned that a computer program could eventually do your job?

I'm not sure if you're being serious or not, but I'll answer. I happen to think real AI will not happen in my lifetime, if ever. This is not an uninformed opinion, I have MS in Neuroscience, and I'm a programmer. I'm sure others reading HN will disagree. It will take nothing less than a full artificial intelligence to do what I do. If you want to read more about early attempts, there is something called "Computer Aid…

You mentioned in an earlier comment about a CT scan being 6k+ images. I'm assuming these are cross-sectional slices or something similar?

I know a guy who's working for one of the big CT manufacturers (Toshiba, I think) working on 3D image-registration and partial analysis. In essence, lining up the features from different slides and sewing them into a 3D model.

One of the big features being looked at was automatic labelling of certain gross anatomical features - I seem to remember something about cardiac veins needing to be marked as part of a scan report? By mostly automating this, it saves time for the user so they can just check they're correct, maybe move them if not, rather than having to do all the work themselves.

I can see this sort of work being much more useful, and happening in a much shorter term than any sort of AI "You have cancer" system. I wonder how you feel about that sort of thing?

Re: Why you should not go to medical school

#158

Post by mattm »

ofca wrote: post #49

They should be treated as Flight controllors. My friend is one and ,it being a high-risk job like being a doctor, they have 8hr workdays with 2 hours of working and 2 hours of resting, and their salaries are sky-high. So sad all those smart,kind and hard-working people are being so used. (plus, so glad I didn't end up in med school, I almost did :)

Do you know how they settled on the 2 hours on/2 hours off deal? I'm interested in alternative working hours to improve productivity and would be interested in knowing more about their schedules.

Re: Why you should not go to medical school

#160

Post by adammichaelc »

roentgen wrote: post #141
mynameishere wrote: post #126

Earlier quoted context omitted.

http://www1.salary.com/radiologist-Salary.html http://www1.salary.com/Physician-Cardiology-Non-Invasive-Sal... http://www1.salary.com/neurologist-Salary.html That radiologists make 100K more than cardiologists and 200k (!!!) more than neurologists absolutely screams market manipulation. Radiology seems literally one generation of Intel processors away from being automated into oblivion. God speed that it is.

I'm not sure if you've ever seen a CT stroke study, which typically includes 4,000 images. If you think a computer can accurately interpret one of these any time soon, I would say you are poorly informed. See my response below, and look into "CAD" and mammography.

You might not see it because it's such an inconvenient thing to see; afterall your income is tied to it. The main factor keeping your income so high is the AMA and its regulatory allies.

With rising costs and increasing pressure to save money in healthcare, you better believe that one day a computer will do your job.

PS You might want to re-read The Innovator's Dilemma and The Innovator's Solution.

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