January 1999
Volume 63 |
Number 1
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VENTILATIONS
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| So Your Child
Wants to Become a Doctor! |
Let us assume that your child in college wants to become a physician
and asks your opinion. So, you think of the traditional elements
that one evaluates for any career: power, prestige, money, interest,
security, mobility. You assess your current situation based first
on what your expectations were upon entering medical school and
second on the relative changes in nonmedical careers (business,
science, teaching, law, architecture).
I will bet that a significant number of physicians would viscerally
say, "Don't do it! It is not worth the effort and aggravation."
However, if you examine your current career path, not compared
with previous earnings in a fee-for-service environment, but in
contrast to the current status of other career opportunities,
you might reconsider your answer. Even in today's rapidly changing
business climate, medicine still emerges as the "blue chip stock"
of careers. The average median income of all physicians
still beats the average median income of all other professions
(and, no, CEO is not a separate profession). Let us look at each
element separately.
Power - While many physicians believe that their medical
practice has been restricted by managed care, anesthesiologists
have largely been spared. Reimbursement may be lower, but no one
is telling us how to provide anesthesia care when in the operating
room. Doctors still have the power to order tests and provide
services, but they may have difficulty receiving reimbursement
and must defend their decision.
Prestige - Public confidence in medicine has remained
constant, and physicians are still the most trusted members of
society (the least trusted are, you guessed it, lawyers and politicians).
Applications to medical schools are down only 12 percent from
the record 47,000 applicant pool in the mid-1970s.
Interest - I think that most physicians still
view their medical practice as stimulating and challenging. After
all, anesthesia is the task of giving lethal drugs in toxic doses
while continually resuscitating - what could be more exciting?
Security - In general, physicians have not seen
wholesale layoffs of colleagues. It is fair to say that anesthesiologists,
after having a short-term "glut" of personnel, are now anticipating
widespread shortages for the next five years.
Mobility - With few exceptions, one is still able
to find employment in or around major cities. In the near future,
every city may need anesthesiologists.
Money - Anesthesiology is usually one of the top
three highest paid specialties. Physicians, in general, make more
than 95-98 percent of all other Americans. Some anesthesiologists
have lost income over the past few years. However, unless they
are talking to the 2-5 percent of the people who earn as much
as they do, it is best not to complain publicly to general audiences.
Overall, the elements of medical practice have not changed much,
while the business of medicine has changed considerably. One must
still spend four grueling years cramming medical knowledge into
one's head. Then it is on to four or five years of 80 hour workweeks,
redefining one's notion of a good night's sleep. Finally, one
emerges as an attending physician that has a society's highest
trust in his or her ability to practice in behalf of their patients'
best interests.
Medicine is intellectually stimulating and constantly changing
to keep one's fervor alive, and it is universally altruistic to
satisfy one's compassion. As for the money, going from zero to
$100,000 annually is still the dream of every college graduate,
and medicine virtually guarantees it.
– M.J.L.
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