I am a doctor. I’m pretty happy now, but five years ago I was seriously looking at other options. Why?
–It’s painfully repetitive. You see about the same five things over and over and over. But you can’t let your guard down for a minute or one of those seemingly routine things turns out not to be so routine. Keeping up that kind of schedule and that kind of vigilance all day every day was absolutely exhausting to me.
–You pretty much have two choices when it comes to your practice arrangement. Most of us starting out will end up being employed by a larger organization, which will probably talk a big game about quality care but at the end of the day you’re nothing but a number on a spreadsheet. Your entire worth is based on how much revenue you generate. They want doctors who order too many tests and prescribe too many meds because that’s what makes patients happy, not to mention that they probably own the lab or the radiology equipment as well. (I thought this wouldn’t be the case in the university environment, and admittedly it’s not quite so bad, but it’s way worse than I expected.)
The other option is to hang your own shingle or put together your own group. It’s hard as hell to make money that way, though, and you have to deal with a whole new level of bullshit.
–I want to be a doctor for about 40 hours a week. Any more than that and I become moody and irritable and a worse doctor all around. I’m willing to schedule my clinics to be as convenient to my patients as possible, I never leave my patients without coverage, and I don’t expect to be paid the same as someone who works 70-hour weeks.
When I was in private practice a lot of people wanted to make me feel horrible about that–the old time lone wolves from another era, the new young workaholics, and most especially the aforementioned employers who obviously had a vested interest in getting every drop out of me. (Oddly enough, I’ve never gotten grief about it from a patient.) I was tired of explaining that being in clinic until 6 means that barring emergencies I expect to be wrapping things up at 6, and defending myself for wanting to go home and have dinner with my wife.
I wouldn’t have made it another five years in private practice. I found a niche for myself in academia where I have control over a lot of my own time, I have help with the mental heavy lifting, I have some variety in my days, and I’m not judged solely on my revenue generation. I still get paid plenty, though I could be making half again what I’m making back in private practice, and I do have to live in the sticks. It’s the best move I ever made.