Secret Doctor Conferences...

This is great!... this is getting really juicy!
You guys crack me up!

I agree with both perspectives.... trying to not be extreme either way.. I appreciate Jaymans comments about how you have to be doing it for something other than money. All things considered along with the pressure, liablity, and wear and tear on the body... its not that fun based on my viewpoint..... its a living.

Not all doctors have it in thier heart, nor do nurses... some do it very methodical and do thier job and do it as a means to support thier familiy and don't really "enjoy" what they do.

When asked "if you had it to do all over again, would you?", most will say "its all I know"... they have poured so much of their soul and time to become what they are that its hard to imagine another field?

But I really really appreciate those how are "called" so to speak.
I also really appreciate those who have "giftings" and instincts for it.
I think most of those folks have it in thier heart. Every since they were little, they we built for it.. its in thier nature and they are like a fish in the water when they are doing it. The pressure may get rediculous and the body get worn down, but there is nothing they would rather get "worn out" doing.

yea.. I would like to get paid to parasail off the coast of Costa Rica and skindive off Jamacia while the camera is rolling so I can pay for my time with the proceeds of the film... true there are much "funner" things to do that actually pay more.... but when the day is done and we look back on life and assess what good we have done... its nice to know we spent it helping people... "for what thats worth"

I think its not worth "near" as much when we only do it for a paycheck verses out of love for mankind, but it is still a noble profession.

I admit.. if I won the lottery, they would not see me at work any longer. Because there are other things I value more. I see other ways to "have fun" and help mankind that is an even higher calling and higher good than ministering to those sick in body.

Money talks!.... my hat is off to those who are teachers and do noble professions of which they don't get adequately compensated. Volunteers and such..... I am generally too selfish to do much of that unless I feel I am supposed to.

Speaking of that... the reason there is a nursing shortage is because they won't pay nursing instructors enough.... you can make much more out in the field... so many of the instructors are those who "can't cut it" in the field..... some are there out of love for teaching.. but not all!

Its a hard call to know when to say "no" to doing good. Many get so caught up doing good, that the miss thier calling as to what they are "really" supposed to be doing.

 

A long time ago there was a Book "The Soul of a new Machine" that described the development of a new computer (PDP 11, it has been too long) one of the things the author pointed out is that engineers who develope new computers do it for "pinball" they spent hours and hours planning, designing and debugging the new "machine" to be offered the chance to do it again. I totally understood that. Doc's do what we do for the results, solving the problem, making folks better, seeing results. Not for money but to be able to do it again. Most of us like this. It is many things that keep us going. The money is nice. It lets us take care of our families that we spend too little time with, but for most it is not the motivator. A number of studies have shown that. Most of us do it for "pinball" the chance to do it again. "Pinball" and I would say that any truly engaged professional does it for the same reason, to build bridges, buildings, computers, gardens, parks, to make any thing better than what was before.

 

Looking back, I would have gone into Anesthesia or Pathology...I would have had a much better family life.

 

You know what, I feel like I just knew a lot of people in med school who did it for the prestige and money...and let's not forget the women. Yes, I said it. My friend J.K., was short, balding, pudgy and he was such a whiner...married the hottest thing on wheels. He couldn't stand the "stupidity" of the nurses and the dumb parents who couldn't get it that their kids were not dying. He went into pediatrics!

Why, his father was a pediatrician, he would join his practice. He got himself a BMW just before graduation. He talked about the country club he would be joining. If you've seen the movie, "School Ties", he's the Matt Damon character(not as good looking) whose whole life until his death is pretty much planned out and part of that was being part of the upper crust of society.

 

my apologies, i'm way behind on PC after my trip. so i haven't read the rest of the thread after this post.

one of the times i went in to the student death, er, health center was to check out a strange area of skin on my arm, wanted to be sure it was benign.

i wanted 4 hours after my appointment, missed lunch, missed class, and was i ever mad to hear the doctor outside the door telling the nurse "well here we go, i can't believe i'm wasting my time on this" when she hadn't even seen me yet! now that is a doc that i won't ever be seeing again.

one of you prius docs care to come practice at duke? we need some non-head-cases over here... we'll even provide the service for your prius

 

Extremely interesting thread to me.

What follows is the result of observation.

First, I believe the doctors of this country are too hard on themselves. And the system only makes it worse on them.

The root of the evil in healthcare today is simply money. It has always been the root of all evil. Always will be.

For example......and I believe this to be a very representative one across this country right now. Around where I live in SouthEastern Wisconsin the amount of expansion of physical plant for healthcare related building has been enormous. In just a small 90,000 population city where I live the medical organization (non-profit) has expanded its building of a larger hospital, expanded the number of clinics in the area by at least 10 and increased the size of most of the department floors by 2 to 3 times. This, combined with the absolutely latest in technology at all levels.

But the kicker is this. They have paid for all this through "CASH FLOW". No borrowing, no mortgaging at all. They have at one point said they couldn't afford to finish a cardiology expansion because they ran out of money. They went into an austerity program and fired hundreds of people. Limited overtime due to this as well. Froze hiring. MY GOD. If any business ran a company that way they would deserve to go out of business.

Why? Because if they would only have mortgaged the half billion they spent they would have had the cash flow to do all of the expansion without the limitations they claimed were necessary.

OR

Something even more promising.....they could have reduced the cost of providing healthcare. The cost per patient would have gone down materially, thereby reducing insurance costs to employers. But instead, we are now on track for double digit inflation into the forseeable future.

It almost appears to be a game of hard ball chicken. Who is gonna give up first. The government or healthcare administrators collectively. No one appears to have any incentive to change the system. At every point in this system there are large concerns who just want to keep everything the same.

So, in my opinion, the doctors in this system are but pawns in this entire healthcare problem. I call it a problem because the cost of providing healthcare has become unsustainable. Employers are going out of business, people can not afford healthcare and are declaring bankruptcy merely because they had the misfortune to become severely ill. This is simply wrong.

I volunteered being chair of a local healthcare visionary panel. But of all the complaints that this should be looked into I found it appalling that there was no real community participation. Our commmitee came up with what we thought were "out of the box" ideas. We suggested that the entire population of a county become self insured. But when state legislators got a whiff of it they got involved to stomp out the idea.

I tell ya, our small committee just gave up. The issues are real, they will have large consequences in the near future if not dealt with but for now no one wants to really compromise. It's too big of a game to compromise right now and I personally do not see the way out. The un-insured and under insured are the ones who will get hurt the worst. People with insurance dont want to give up what they have and the providers of healthcare have created a monster with little wiggle room to compromise.

I bow to those here who are medical doctors. I just had Arthroscopy knee surgery, was given a spinal and watched the whole thing on tv while the doctor was doing it. It was awesome. I am just one of those people who have good insurance so will only pay a relatively small amount of the "stated" value of the bill provided to the insurance companies. So, I am one of the lucky ones. But I truly feel for those who do not have what I have.......insurance and access.

If anyone here has any real insights into these thoughts I truly would love to read them. They were provided as honest and informed as I can be.

 

In medicine your either a hero or a zero!.....

There is a tremendous amount of positive feedback that comes from helping people beyond thier expectations.... on the other hand, if you fullfill thier worst fears, those same people will crucify you and eat you for lunch!

It is good for the ego, and sense of worth to help people... its a challenge to figure out their problems and fix them, and then be praised for it!

Similiar to golf... a game that takes a bag full of tools and you figure out how to get that little ball in that hole way down yonder with the least amount of strokes!....

Even so with medicine, you take that emense bag of tools full of knowledge and figure out how to get the job done with the least amount of strokes.....
Yea.. just a game..... to many at least!....

Like making money.... some are so good at it... its just a fun game!... Too bad I don't have that problem!

 

hey, sounds like fixing cars...

you get it right, you're great. you get it wrong, you're a freaking idiot, a high school dropout, etc. and unfortunately that rep ends up hitting mechanics in general.

but taking a broken car and making it work, getting it right the first time and in the quickest manner possible is a real rush for my husband. good for the mind, good for the ego. makes him feel good about putting people in safer vehicles than they came in with.

there are lots of fields like this out there.

 

Squid, what other way is there to learn about a rare circumstance than to encounter it yourself? What possible other solution would you propose, then?

I just said that we work hard for 3-5 years (or longer in some specialties) to see as many cases as we can (100, 105 or more hours per week as an intern for me) to get as much experience as we can cram in. But we can't see everything. That's part of what makes medicine so rewarding and humbling -- you can think you've got it all down, and then you'll get another curveball. I understand your uneasiness, though.

There is no substitute for experience! You can't teach it, you can't shortcut it! And respectfully, an "experienced physician" encountering something he hasn't personally seen before is nothing like a resident in the same situation. The experienced physician has had to improvise before, and will bring the many benefits of that experience to bear on the situation. (And he probably knows something about the situation already, in truth, either read or discussed with a colleague.)

Ask any surgeon how often improvisation comes into play in the OR. Even in something that would sound routine to you, like, say, an appendectomy or a tubal ligation. If you get an honest answer, it'll be interesting for you. Medicine is an art as well as a science; that's the way it is.

 

I think your on target about the big money at the top calling the shots.... Drug companies, Insurance, big money etc etc.... all the medical personnel get caught in the crossfire just trying to do a good job.

Hospitals are turning into businesses rather than medical facilities that care about people.

That happens when a business man runs a hospital rather than a Dr. or at least an RN.. someone who has training and a heart for people. Money has become the bottom line rather than why the organization was built in the first place.

It happens in all fields... One day someone had a dream about building a car, a plane, a train, better this, better that.... it catches on and becomes so popular that in time the vision of good that created whole venture in the first place is reduced to merely a money making venture.

Welcome to America!

 

Perfect example of reality.
Doing most procedures are often not "textbook"... they have alterations, things go wrong and you have to improvise, something may even break or get dropped on the floor and its part of a kit so you have to do without it to avoid opeing a whole new kit.

The unexpected always leers around the corner... a good surgeon, Doctor, Nurse, or anyone who does specialty procedures usually has to be an "engineer".

what I mean by that is that its not an exact science and you have to fall back on creative juices to bail yourself out sometimes.... people without creative juices only do well when everything goes perfect, or rather falls in line with procedures already planned out and studied and trained for in advance.... whether unexpected or not...

Without being bias.... thats why those types of jobs are dominated by males... its in their nature to think technical and be an engineer.... there are many areas of medicine where that is not so required... but it usually does not have to do with direct patient contact.. because people are unpredicable. Many of the technical areas do not require as much patience and heart as others where females are strong.

Now I'm sure I opened a whole new can of worms! :lol:

 

I freely admit, along with the others, that it's an imperfect system. To say it's not worth pursuing all the expertise one can get is just plain nihilistic. Would YOU see a doctor who espoused that attitude?

To be fair, most of us read extensively, listen to lectures, talk with colleages, read web boards, and otherwise consume information to try to learn more than what we can see personally in our short lifespans. In fact, we're required to do a certain amount of this anyway to keep our licenses ("continuiing medical education"). That helps. But our patients are the ones who really teach us, and nothing teaches quite as vividly as a mistake.

You're quite right about the point of diminishing returns in the long hours of training. You definitely do reach a point where it isn't a learning experience anymore. Some of it is just being a cog in a machine, frankly. But it's a compromise -- it's the best balance between two unworkable extremes that has been found, so far. The pendulum has swung a bit away from the long hours, recently. It will be interesting to see what the effects are.

 

"Without being bias.... thats why those types of jobs are dominated by males... its in their nature to think technical and be an engineer.... there are many areas of medicine where that is not so required... but it usually does not have to do with direct patient contact.. because people are unpredicable. Many of the technical areas do not require as much patience and heart as others where females are strong.Now I'm sure I opened a whole new can of worms! "-Windstrings

CAN OF WORMS OPENED!!!

As a resident who recently decided which field to go into (and seeing all my classmates/friends struggle with the choice), I think many women (and many of my male friends too) were/are discouraged away from the "technical (I assume you mean surgery)" fields due to the abusive attitudes accepted if not encouraged by many surgeons.... not due to their lack of technical/creative ability. After all, OB-gyn (also a "technical" surgical field) is now dominated by women. Anyways-everything will be changing soon as now nationwide ~52% of medical students are women!!

 

:lol:

oh man, i should have figured. but to tip the scales back into balance, my old college buddy (female) was in the converse situation once and i got to hear about that story. let me tell you, it was worth a laugh or 10.

i'd pick a female doc for most things just because i prefer to support women in professional fields. plus, they seem to be nicer at that yearly checkup. however, i don't have anything against male docs at all.

 

Meaning, your female friend saw an attractive male doctor, and hilarity ensued? I'm. Covering. My. Eyes.

I wish I had a toll gate for this thread that charged four thousand dollars per sweeping and unwarranted generalization. =) They are flying thick and fast at this point, and I'd be retired by the morning and not have to worry about any of this stuff anymore...