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Why I quit medicine

gautams.posterous.com

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Re: Why I quit medicine

#71

Post by kyouens »

mattwrench wrote: post #64
devs1010 wrote: post #51

Earlier quoted context omitted.

You can make this argument about most software developers too, while they may create unique applications, they are mainly using the "already known" (existing languages, API's, etc)... You can then go on to apply this argument to nearly any other "white collar" job, accounting is "the application of the already known", etc.. White collar does not mean that you are in a research field and pushing the limits of knowledg…

"Blue collar" was a poor voice of words. You're right that the white/blue collar divide is not a creative difference. But I still feel that software development is a creative field whereas most of medicine is reactive. All fields are based upon past knowledge so the use of APIs seems irrelevant since they are just tools used to create. The criterion to differentiate between creative and non-creative fields seems to b…

There is a certain element of truth to what you are saying. When I was early in my training I was dissappointed in my choice of medicine as a career because I also thought it lacked an outlet for creativity. As a now experienced physician, there are still times when you get to a point in the care of some patients at which the next step is programmatic and rote (if A then B).

However, sometimes--probably most of the time--the patient's presentation is so unclear (e.g. "I just feel weird. . . ."), there are so many variables to juggle in your head at once (twenty different lab values, the way the liver feels, the imaging findings, the color of the patient's sclera, the smell of their breath, their mood) that things become far too complex for any flowchart. These are the times when you need creativity, "book smarts" and perhaps above all, "emotional intelligence" to be a good doctor. There are plenty of doctors lacking one or more of these elements, and they just aren't very good at the job.

Re: Why I quit medicine

#72

Post by llimllib »

peterbessman wrote: post #69
gautamsivakumar wrote: post #53

Earlier quoted context omitted.

Thanks so much for your support. You're right about how important face-to-face interaction is. That is not going to be replaced any time soon - nor should it be. But for the purpose of handover, you still need a written summary of all the patients on a ward that people can refer to. As I mentioned in the post, it would be useful to see who wrote what about each patient - so that you know who to talk to for further in…

Yeah... hackers are usually incredibly naive about compensation outside of their own world. For reference: http://www.medscape.com/features/slideshow/compensation/2011... Bottom line: here in the US of A, your average doc (most certainly NOT an outlier) is making between $150k and $350k. Put that in your VC-backed pipe and smoke it. (Debt? Between $150k-$200k for 4 years of med school. Post med school training, in th…

My wife's still a fellow, but you're right in the ballpark on the salary for residents and fellows. When she was an intern, we calculated her hourly wage at You're low on your med school debt estimate, remember that loans don't just need to cover tuition, but living expenses too. Furthermore, many of her fellow not-yet-attendings are sitting on undergraduate college debt that has been deferred until they become attendings.

Nonetheless! Your overall point is totally valid. I've out-earned her for the past 6 years, but she'll even it out in about 2-3 years as an attending, and doctors frequently work well into their sixties.

(Also: Baltimore represent!)

Re: Why I quit medicine

#73

Post by Irene »

kyro wrote: post #13

Good on you, man. I'm in medical school currently and the emphasis on locking down patient data is one of the most frustrating things to see. I'm convinced that it's a policy that everyone knows has little benefit and yet pushes for ethical brownie points. What's to be gained from freeing up the data far, far exceeds what could potentially be lost. Even freeing up anonymized patient data seems to be met with oppositi…

Kyro, your Hackermed was a nice attempt to bring together those interested in health-related innovation.

As to the OP, there's still a room to improve existing software technologies. And there is still a lack of consensus about best ways for improving handoff processes: http://www.ingentaconnect.com/content/jcaho/jcjqs/2010/00000...

Re: Why I quit medicine

#74

Post by mattwrench »

kyouens wrote: post #71
mattwrench wrote: post #64

Earlier quoted context omitted.

"Blue collar" was a poor voice of words. You're right that the white/blue collar divide is not a creative difference. But I still feel that software development is a creative field whereas most of medicine is reactive. All fields are based upon past knowledge so the use of APIs seems irrelevant since they are just tools used to create. The criterion to differentiate between creative and non-creative fields seems to b…

There is a certain element of truth to what you are saying. When I was early in my training I was dissappointed in my choice of medicine as a career because I also thought it lacked an outlet for creativity. As a now experienced physician, there are still times when you get to a point in the care of some patients at which the next step is programmatic and rote (if A then B). However, sometimes--probably most of the t…

That makes a lot of sense. The above criterion I mentioned does seem to fall apart since I do consider problem solving to be inherently creative even though oftentimes there is only one answer.

Good to hear from an actual physician though. Do you think that your initial disappointment is a unique response or do most med students go through it? I ask because everyone I know who is getting accepted to med school has wanted to be a doctor since high school. I assume that makes med students get tunnel-vision when deciding their career choices and have an idealized, incorrect view of the field. (I figure most future doctors just get over this pretty quickly by finding different, but equally important reasons to be in the field.)

Re: Why I quit medicine

#75

Post by kyouens »

mattwrench wrote: post #74
kyouens wrote: post #71

Earlier quoted context omitted.

There is a certain element of truth to what you are saying. When I was early in my training I was dissappointed in my choice of medicine as a career because I also thought it lacked an outlet for creativity. As a now experienced physician, there are still times when you get to a point in the care of some patients at which the next step is programmatic and rote (if A then B). However, sometimes--probably most of the t…

That makes a lot of sense. The above criterion I mentioned does seem to fall apart since I do consider problem solving to be inherently creative even though oftentimes there is only one answer. Good to hear from an actual physician though. Do you think that your initial disappointment is a unique response or do most med students go through it? I ask because everyone I know who is getting accepted to med school has wa…

I can't speak for everyone else, but for myself, "tunnel vision" explains it pretty well. At some point in high school, I just decided being a doctor was a totally awesome thing to do. I can't remember the real reasons why I chose medicine, but I know it was somewhat vague. I knew doctors were smart and I thought I was pretty smart. I am embarrassed to admit I also may have fantasized about driving a BMW from my big house with a pool straight to the OR, busting in with an "S" on my chest to save somebody's life.

In college, I was drawn to the humanities and to computer science more than to biology, but I stuck with it. I was a willing victim of the rather unhealthy obsession with "getting in" that most pre-meds develop. Medical school, at least at first, was a rude awakening. It was not intellectually challenging (other than by virtue of the sheer volume of material), it was rote, the hours sucked, the and the culture was unpleasant.

It was not until a couple of years into my residency that I started to really appreciate more of the nuances, and to enjoy practicing medicine. As it stands today, I love what I do. I help people in a tangible way, I make a good living, I am respected and valued by my community, and at as I described above, my creative and intellectual muscles get a daily workout. However, I don't do any busting into ORs and, sadly, I don't drive a BMW.

Re: Why I quit medicine

#76

Post by carbocation »

llimllib wrote: post #72
peterbessman wrote: post #69

Earlier quoted context omitted.

Yeah... hackers are usually incredibly naive about compensation outside of their own world. For reference: http://www.medscape.com/features/slideshow/compensation/2011... Bottom line: here in the US of A, your average doc (most certainly NOT an outlier) is making between $150k and $350k. Put that in your VC-backed pipe and smoke it. (Debt? Between $150k-$200k for 4 years of med school. Post med school training, in th…

My wife's still a fellow, but you're right in the ballpark on the salary for residents and fellows. When she was an intern, we calculated her hourly wage at You're low on your med school debt estimate, remember that loans don't just need to cover tuition, but living expenses too. Furthermore, many of her fellow not-yet-attendings are sitting on undergraduate college debt that has been deferred until they become atten…

Average student debt at time of graduation was $148k in 2010 I believe. Also, Baltimore represent!

Re: Why I quit medicine

#77

Post by jonnathanson »

peterbessman wrote: post #69
gautamsivakumar wrote: post #53

Earlier quoted context omitted.

Thanks so much for your support. You're right about how important face-to-face interaction is. That is not going to be replaced any time soon - nor should it be. But for the purpose of handover, you still need a written summary of all the patients on a ward that people can refer to. As I mentioned in the post, it would be useful to see who wrote what about each patient - so that you know who to talk to for further in…

Yeah... hackers are usually incredibly naive about compensation outside of their own world. For reference: http://www.medscape.com/features/slideshow/compensation/2011... Bottom line: here in the US of A, your average doc (most certainly NOT an outlier) is making between $150k and $350k. Put that in your VC-backed pipe and smoke it. (Debt? Between $150k-$200k for 4 years of med school. Post med school training, in th…

And that's to say nothing of big cities. $750k may be an outlier in Eastern MD, but it's not uncommon for specialists in NY or LA to clear $1M easily. True outliers can climb north of there.

Medicine is still an extremely reliable way to become everyday rich, if not outrageously so. It beats the pants off of corporate jobs, and it beats law on average (though law outliers tend to beat medicine outliers). It loses out to investment banking, but the lifestyle is far superior.

A smart person can do a lot worse than medicine.

Re: Why I quit medicine

#78

Post by crusso »

tibbon wrote: post #30
gamble wrote: post #2

Sounds a lot like the medical data startup I joined ten years ago. We were so, so painfully naive about the realities of medical software. Medical records are a trivial technical problem, but an almost insurmountable political and regulatory challenge. I knew our company was doomed when we were talking to another medical software company and saw the literal wall of binders that represented a single FDA approval proce…

While Obama and Congress are talking about how to make regulation more business friendly, why don't they focus on day-1 problems like this, instead of IPO problems? I've never heard of a good company unable to IPO just due to paperwork/regulation, but I've heard of many company not be able to get anywhere due to silly regulatory cruft. See the TacoCopter yesterday... FAA would never let it happen. Or your medical dat…

>While Obama and Congress are talking about how to make regulation more business friendly [...]

Talking != doing.

Re: Why I quit medicine

#79

Post by aptwebapps »

devs1010 wrote: post #43
mhurron wrote: post #40

Earlier quoted context omitted.

>they refuse to upgrade it for fear it might break compatibility with some ancient software It will break, in horrible and unknown ways, and even if it didn't if the company supporting it got wind that you used a different version of IE, or heaven forbid Firefox, that's probably enough to deny support. It's probably not even ancient software, they might have purchased it in the last couple of years. Medical software…

I think it may even go beyond that, where they have even stipulated what other software could be run on the machine. I do know, for example, that they HAVE to run XP, nothing newer, or it would void their support, etc.. its really insane how companies can get away with that, I don't even understand how for a web app (it uses a Java applet, so I guess it goes beyond a regular "web app", but still..) they can demand th…

It seems like there aught to be some sort of liability for mandating insecure practices for your customers.

Re: Why I quit medicine

#80

Post by crusso »

gamble wrote: post #2

Sounds a lot like the medical data startup I joined ten years ago. We were so, so painfully naive about the realities of medical software. Medical records are a trivial technical problem, but an almost insurmountable political and regulatory challenge. I knew our company was doomed when we were talking to another medical software company and saw the literal wall of binders that represented a single FDA approval proce…

As I read the article, I was thinking much the same thing. This guy can build the best medical mouse trap ever -- but between the government red tape, the litigious cya environment, and the slow-to-move hospital industry, it just ain't going to be adopted.

I wish it were different.

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