By Dr. James M. Dahle, WCI Founder
Medicine is a wonderful profession which does vast amounts of good. I attended my 10 year medical school reunion recently and I was even more impressed with the accomplishments of my classmates than I was 14 years ago when I first met them. As a fourth year medical student, I served on the admissions selection committee. Ours was the final committee, and we only really saw the applications of students who were more than qualified to be there. They had passed the initial academic screens with high GPAs and MCAT scores and had checked all the relevant boxes showing they had done research, had experience in health care, had shown leadership skills (and not just potential), and a desire to serve others. They also had already impressed their two interviewers. We were left with 300 applicants, all qualified to be there, to select a class of 100 from. It was no surprise to me to see the quality of the people I attended school with after helping with that process.
One of my classmates was working 120 hours a week as a trauma and emergency surgeon. I was impressed with the dedication that leads someone to come out of residency and sign up to work MORE hours than they did as a resident. Another, a small-town family doctor in Canada, is the classic country doctor. He takes ER call, does colonoscopies and EGDs, does C-sections, and performs appendectomies in addition to the usual stuff big-city FPs do. Another does sports medicine and is heavily involved in running a ski clinic at a local ski resort. Several, like me, were working 3 or 4 days a week and pursuing other interests with their time- One is raising her family, another works in health care IT, and another literally just won the world championship cycling race for her age and gender. As a general rule, doctors are wonderful people, with immense ability and dedication. I hope people like this continue to choose medicine as a career. But I can understand why many talented people may choose something else these days.
The Bogleheads recently had a thread titled “Why are so many physicians unhappy with their careers?” that generated 110 comments within the first 24 hours. I find it amazing to compare the general attitude toward medicine between online forums. Everyone is mostly optimistic on Student Doctor Network, which primarily caters to pre-meds, medical students, and some residents. Everyone is mostly pessimistic on the physician-only Sermo, which includes residents but is primarily composed of attending physicians. There you can see countless physicians trying to figure out how to deal with declining reimbursement, increasing bureaucracy, onerous student loan burdens, and difficult patients. It seems everyone is either trying to get out of medicine, or at least opting out of the 3rd party payer system. These are definitely NOT the golden days of medicine.
Keeping the Good Doctors in the Business
One of the things I hope this website does is to do some small part in keeping good people in medicine. I want intelligent, accomplished, happy, talented doctors taking care of me when I'm old and sick. One of the best ways I can do that is to help physicians deal with their unique financial issues so that medicine still provides an overall financial award sufficient to attract these accomplished individuals. I want doctors to not only be able to keep their practices open, but to be so financially successful that they wish to donate time and money to worthy causes.
Graduating medical students now have higher loan burdens at higher interest rates along with lower starting salaries (at least when adjusted for inflation, and many times even without that adjustment) and fewer opportunities for ownership. Rather than being millionaires by 40, far too many still have a negative net worth at 40! However, physicians can still have the good life. It requires more financial discipline than it used to, and it requires more time. It also requires a physician to acquire a knowledge base and skill set in personal finance and investing. If physicians can decrease the amount of their money skimmed off by Wall Street, the IRS, bad financial decisions, and poor investments, perhaps they can maintain a similar after-tax, after-expense income to what the last generation of physicians enjoyed. I hope regular readers of this blog feel they are gradually acquiring the knowledge, skills, and discipline to find financial success sufficient to allow them to continue to pursue their professional and personal dreams while providing the rest of us with world class medical care.
What do you think? Can today's pre-med students still achieve financial success in their careers? What can be done to keep medicine attractive to good people? Comment below!