At a restaurant recently, I heard a man proudly announce to the host, “The reservation is under Dr. Smith.” He made sure to emphasize the word “Doctor.” I suppose he wanted some recognition of his chosen profession; after all, becoming a doctor is no easy task. Who could blame him?
For much of my medical career, however, I would actually go out of my way NOT to disclose my profession. I never announced my title when meeting someone new. People seldom understood my reluctance to share this detail of my life.
My reluctance to share my profession as a doctor was due to the many aspects of my career that were eating away at me--all things that no one ever told me before I became a physician. Because I felt married to medicine I didn’t want to talk about it when I wasn’t working. In some ways I felt like I could be a “normal” person if I didn’t identify myself as a doctor.
Please don’t get me wrong; my medical career has been an intensely gratifying experience at times. I have loved caring for families, comforting a patient faced with a difficult illness, and easing physical discomfort. I am honored by the trust that so many patients had in me throughout their journey to optimal health. But twenty years in this profession has led me to some serious introspection. If you are a physician, perhaps you can relate to my experience. If you are thinking about a medical career, please read carefully.
Here are ten things I wish I had known before I became a physician:
1. There are other ways to help people.
I became a medical doctor because I wanted to help people. Sound familiar? I never considered any other ways by which I could help ease the sufferings of the human race. I loved helping people and I still do--just in a very different way than I was taught in residency.
As a professional speaker, I now help women In medicine navigate the chaos to reclaim their career satisfaction which will help them lead a more balanced life.
2. Medical school trains doctors to fix ONLY what is broken.
My entire training was focused on improving ailing health and prevention was never addressed. That’s like applying bandages without telling the patient how to prevent the wound in the first place! I quickly learned that I enjoyed educating patients about prevention and giving them the information they needed to live their optimal lives. However, there was a disconnect between what I wanted to do and what made sense to me (prevention) and what my profession focused on (fixing), which led to growing dissatisfaction in my career.
3. The insurance companies dictate everything.
I hoped that I could just incorporate more health and wellness counseling with each patient as part of the visit. The insurance companies don’t pay doctors to take the time for health and wellness counseling. They pay doctors to treat problems the counseling could have prevented. And they withhold payment as long as they can--if they decide to pay at all. Let’s just say that the insurance system is not designed to benefit the patients or the doctors.
Over the years, I was able to spend less and less time with patients (which I loved) and more time on the computer checking required boxes so that I could get reimbursed (a most loathsome activity).
4. Doctors typically make less and less each year AND work longer hours.
There is not a lot of explanation needed here! With most professions, the financial benefits increase as experience and knowledge increase. In medicine, doctors are paid by negotiating with insurance contracts. These contracts are not negotiated based on merit, but by manpower. The bigger the group of doctors, the better the negotiating prowess. As a solo practitioner in private practice, I faced an uphill battle.
Even for physicians who are not in a private practice, finances can become an issue. The average physician has a student loan debt of over 200k. They are not able to make an income until a minimum of age 29 after a residency.
5. Medicine can be a very difficult profession for an empath.
Some people are more empathetic than others. An empath dedicated to treating the pain of others will experience collateral damage. For me, seeing forty patients a day was very exhausting. I felt so much sympathy and concern for the maladies of my patients that I was drained both physically and emotionally. The help I offered to others was, in fact, hurting me.
I needed time to recuperate and take better care of myself but I never made that a priority. I have learned over the years that self care is a necessity. Several of my talks focus on self care and boundary setting for medical professionals.
6. A physician’s family will make tremendous sacrifices.
It is easy to think that the choice of a career in medicine only affects you, but that is not the case. Families of physicians also feel the burden of career stress, emotional and physical absence. In my case, the demands of medicine left me drained, and I know that had a negative impact on my children and my spouse.
Two decades of practicing medicine taught me that there is a way to minimize the effects of stress on your family.
7. A physician will face a tremendous amount of stress.
Unfortunately, the stress of medical school does not cease upon graduation. In medical practice that stress can range from severely ill patients, malpractice, handling difficult patients, neglected family members, and ever changing rules and regulations. To put things into perspective, when a physician has a bad day at work, it usually means someone died.
To make matters worse, physicians are trained to be stoic. The more stress I handled, the more accomplished I felt. Needless to say, this is not sustainable long term.
8. Time is always in short supply.
Physicians are expected to constantly stay up to date on newly emerging trends in their specialty, attend conferences, and keep on top of daily patient loads. At home, families and life responsibilities occupy precious hours away from the office. There often is very little time for physicians to dedicate to their own health and wellness.
Physicians, especially female physicians, need to be proficient in time management, multitasking and outsourcing. These are great tools to get more done but sometimes there is a cost related to overly efficient time management.
9. No one cares for physicians like they care for their patients.
For a profession that touts kindness, compassion, and benevolence, physicians are seldom recipients of kindness or compassion in most cases. According to American college of Emergency medicine, each year, 300-400 physicians die of suicide. Suicide rates are 250-400% higher in female physicians compare to females in other professions. In the general population, males complete suicide 4x more often than females but female physicians have an equals suicide rate to male physicians. Many doctors have undiagnosed depression in addition to substance abuse.
10. Sadly, medical doctors are often “overqualified” to change careers.
Physicians may have trouble transitioning to a different career. Before I decided to become a professional speaker, I did some work as a medical expert, considered a career in teaching, and even thought of working for the insurance companies…which would not be ideal for me. Thankfully I was able to translate my positive experiences as a medical doctor into being an entrepreneur and a professional speaker. I feel a sense of satisfaction knowing that I can still use my degree to help people but in a way that makes sense to me also.
Overall, a career in medicine can be very satisfying. Surely, not every physician will experience the frustrations and difficulties I have experienced. I firmly believe that, like all major decisions in life, the decision to pursue a career in medicine should be made carefully and with as much information as possible.