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GADOM said:   IF you want to go into medicine then go for the MD. If you want to do sports medicine it will take at least 8 years (4 Years school, 3 years FP residency, 1 year fellowship). You can then make between 180 and 250k for about a 45-47 hour work week with predictable hours depending on the practice setting.

Let me politely disagree with that. Nurse anesthetist does 4 years of nursing school and 1-2 years of anesthetist training. Depending on the setting, they make anywhere from $175K to $225 K. For the most part, it's 8/day job with NO LIABILITY ISSUES.

Given modern state of medicine in the US, I can confidently venture a guess that mid-level providers will do better then physicians long term. Remember, EVERY mid-level provider is in the union. Physicians are not; we can not unionize by law. No one looks out for physicians' financial well being. AMA is a joke; last membership number I heard was less then 25% Public still has and will have a perception of "greedy doctors" no matter what happens with healthcare system overall.


It shouldn't be about money since you are making enough with your current job. You are not too old to change your occupation. If your family is willing to support your decision and your family will not have significant financial distress, then it may be worth considering it. But the main question is...how do you know you will enjoy your occupation as a physician? The description you gave fits a job as a nutritionist....not a physician. If you really want to go a medical school, go volunteer at a hospital. Go face the realty. You will realize that becoming a physician has it's reward and stress.


You might want to check out this thread at bogleheads where someone asked pretty much the exact same question. (if the incomes matched I would say OP is the same person in each). http://www.bogleheads.org/forum/viewtopic.php?f=2&t=94898


Whoever gave you the average sports medicine salary is either wrong or using misleading stats. Sports medicine is a fellowship from internal medicine, family medicine, and orthopedic surgery. However, from orthopedic surgery it is a completely different field, it is surgical. Those guys like most orthopedic surgeons make very good money, however, typical sports medicine from IM/FM in a salaried job makes around 150k because typically their pt encounters take longer, although insurance is less of an issue and the hours are predictable. Don't tell me about a friend of a friend who is the sports medicine doctor with the Knicks and pulls 400k with minimal work and sees all the Knick games for free, yes there are jobs like that but they are few and far between.

Sports medicine is NOT particularly competitive, don't know where people got that from. Within Internal Med, the fellowships that are most competitive are Cards, GI, allergy. Even if you go through family practice which is not that competitive, sports medicine isn't too bad, because most family practice people don't do fellowship, and if you do a decent job in family residency with a little sports medicine research the fellowship is yours. I know of no family practice people showing an interest in pursuing that fellowship, although the ones I know represent a small sample size.

Nurse anesthesist is a great field, although the poster who recommended it left out one part, in addition to nursing school, and 1-2 year nurse anesthesist school(depending on school), you almost always need 1-2 years as an ICU nurse before you will be accepted to nurse anesthesist school. And since you can't just start as an ICU nurse that requires some time on the floors as a general nurse, that is extra time, although you are compensated well for that, it will be very different than being a nurse anesthesist so that will affect work enjoyment depending on what you like. Also nurse anethesist does not really have anything to do with nutrition/fitness so unsure about if OP would enjoy that.

Regardless to get back to the OP, from what you say about your interest in nutrition/fitness, most of medicine even sports medicine has little of that(unfortunately), and even the fields that do, it will be SOLID 10 YEARS before you are practicing what you envision the ideal scenario to be as residency, med school will not entail any of that. However, personal trainers do a lot of that and deal with clients interested in improving their fitness/nutrition(in contrast to majority of pts). When I signed up for gym membership, they offered me a free session with personal trainer, which I took. I chatted with her and she told me she's a full time accountant, however, she always loved fitness/nutrition, so she does personal training on the side with a couple clients each week in addition to her full time job. She remarked about loving the idea of being able to do it full time but almost none make what she makes at her current job, unless you're lucky enough to break into servicing extremely rich people, celebrities, athletes, etc. So I think doing something like that part time could be a good outlet for this interest, and it might take off and maybe you will be one of those few who break into that upper tier and making good money while doing fitness/nutrition. Someone recommended being a nutritionist which in theory would entail some of your interests, however, in practice physicians only call for nutritionist in those with special diets such as celiac disease, and poorly compliant diabetics. So if you think it will be some mildly overweight people attempting to become very fit, you will be quite wrong.

If you hate your job, then a change may very well be a good idea, but an interest in fitness/nutrition and an interest in medicine, given the realities of modern healthcare have almost nothing to do with each other.


GADOM said:   cga said:   bytem3 said:   cga said:   I'd rather have the rudest most obnoxious surgeon open me up than a polite and courteous, but less skilled and experienced surgeon cut me open.
You would not be the norm. Everyone says that they want the most skilled person. But in reality, most patients prefer (and are less likely to sue) someone with better bedside manner, even if they are otherwise average (or not even). Some patients will leave the care of a highly-skilled physician for many reasons, including they don't get the options/answer they want or they don't like their bedside manner. There have been several publications about this (NEJM comes to mind). ...

I've had occasion to choose between surgeons, both for myself and for others, and have always looked into who's the best very carefully. Sometimes nurses give the best advice along those lines because they have nothing to gain or lose by expressing an opinion. I would almost invariably wind up choosing the least friendly surgeon, the one least willing to communicate---the type of person I would least want to have a beer with, but who is so busy and so well known and respected among his peers for his skill and experience---that he no longer has to prove anything to anyone. But I agree and understand that I'm in the minority on this. However, I don't think that makes me wrong. At least not in this case.


I can tell you from evaluating risk management cases I see far more issues with the obnoxious/ arrogant doctors exactly because they are obnoxious and arrogant (the nurse is afraid to bring up an issue, the patient is afraid to reveal an important symptom because he shuts them down or discounts them ("where did you go to medical school"), they fail to participate in patient safety/QA activities) they are more prone to make a mistake and less prone to seek help to get out of a theraputic misadventure. All of which leads to increased risk of true harm to you as the patient.

The good news is we almost always settle those cases because those doctors make awful defendants on the stand.
Well, I guess that's the difference between a rude, obnoxious, skilled surgeon and a rude, obnoxious, skilled and stupid surgeon. I've never had the misfortune of being forced to deal with the stupid version.


emgeecee said:   Whoever gave you the average sports medicine salary is either wrong or using misleading stats. Sports medicine is a fellowship from internal medicine, family medicine, and orthopedic surgery. However, from orthopedic surgery it is a completely different field, it is surgical. Those guys like most orthopedic surgeons make very good money, however, typical sports medicine from IM/FM in a salaried job makes around 150k because typically their pt encounters take longer, although insurance is less of an issue and the hours are predictable. Don't tell me about a friend of a friend who is the sports medicine doctor with the Knicks and pulls 400k with minimal work and sees all the Knick games for free, yes there are jobs like that but they are few and far between.

Do these actually exist? I've always heard that practices pay the team for the right to be the team's physician (for the notoriety, etc).


I was saying that more for effect than anything else. I vaguely remember meeting one guy who was an opthalmologist in DC for the DC pro hockey team(Capitals?, maybe that's right), remember him saying his ophtho group is the teams optho doctor on call for all the hockey games, said they were selected because group had good rep, but that they got paid x amount(remember it being very low) for the year for being on call and having to go the games(apparently all the doctors hated hockey, so did not view going to the games free a plus), plus service fee if they do anything. But yes they did it for the prestige, as he said their practice had a (hopefully) tasteful sign in front saying official ophthalmologists of X team.


I know numerous people with less money, more debt, more kids, and possible less intelligence who went to medical school and are successful MDs.

Stop thinking its a holy grail. It's not. But, for the right person, it can be an incredibly rewarding career.

Personally, I would ALWAYS chose a career over a job.

I would strike while the iron is hot. Regret is a bitch of gi-normous proportions.

Take baby steps. Just takes some courses and take the MCAT. Re-evealuate after that.


Look you sound like a borderline ADD type. This and your interests make you poorly suited to med school. You like reading about health/fitness/lifestyle so why not do something in that business, which is booming and offers a great lifestyle, unlike medicine which is in decline and offers a relatively poor lifestyle in comparison? IE start a gym or a yoga company or etc? You're not making much now so the downside is low


This reminds me of an old Ann Landers column, where a guy wrote in to say that he always wanted to go to med school, but was now in his 40s. He concluded with something to the effect of, "If I go back to school, it'll be 8 years before I become a doctor and I'll be 50 years old by then!"

Ann Landers' response: "How old will you be in 8 years if you DON'T go back to school?"


emgeecee said:   I was saying that more for effect than anything else. I vaguely remember meeting one guy who was an opthalmologist in DC for the DC pro hockey team(Capitals?, maybe that's right), remember him saying his ophtho group is the teams optho doctor on call for all the hockey games, said they were selected because group had good rep, but that they got paid x amount(remember it being very low) for the year for being on call and having to go the games(apparently all the doctors hated hockey, so did not view going to the games free a plus), plus service fee if they do anything. But yes they did it for the prestige, as he said their practice had a (hopefully) tasteful sign in front saying official ophthalmologists of X team.

Sports teams are very savvy and know our country is sports crazed. And MDs are jock-sniffers like a large percentage of our society. Practices PAYand or give reduced cost services to be able to say they are the "team MD" for the Lakers/Kentucky Wildcats. The only MDs who get "free" publicity - through word of mouth and being mentioned in articles are situations like the surgeon in Alabama who is univesrsally regarded as the best in doing ACL/MCL repair or a MD that is the best in doing Tommy John surgery.

These MDs/therapists would kill and, therefore, pay to be affiliated with certain college/pro teams.


Agree that some teams may get paid by the physician, but many good college/pro teams have enough money, and will want to get the best in their fields in that area, physicians that aren't necessarily hurting for pts, and if they aren't compensated at least something(even if it's below their typical rate), they may not want to do it. The doctors who are willing to kill/pay to be the oncall plastic surgeon(the ophtho guy I mentioned earlier, mentioned that DC's hockey team has an oncall plastic surgeon) for a hockey team is not usually the same plastic surgeon the hockey team wants(i.e. a well known guy with an already busy practice). Given a pro teams/big college team's yearly budget, a football team setting aside 5k for a top neurologist to be on call might be a better investment than receiving 50k from a neurologist willing to pay 50k to be that football team's neurologist.


Go for it! I actually had a similar post 2 years ago. I was working in the corporate world and making upper 5 figures, too. I sat in front of a computer most of the time. It was a comfortable life, but not what I wanted. I started taking night classes at community college and now, two years later, at age 26, I'll be starting New Jersey Medical School in August. Just make sure you want to do it. Obviously, I'm sure you're not in it for the money, because you'd be better off working in the corporate world and playing the game. I hope you have done a lot of volunteering and have a good amount of clinical experience. Brains isn't the whole package. You probably know most of this stuff already. Shoot me a PM if you want more thoughts.


I am an audiologist and we have had former lawyers apply to both our doctorate program as well as to programs in speech-language pathology.
A male relative was a lawyer and decided to change gears at your age to becoming a nurse.
There are many health care occupations to choose from besides becoming an MD; you should explore the options and choose what appeals to you.
I am a big advocate for being happy in your work considering you spend a large chunk of your waking hours doing it!


TheDragonn said:   (I have a decidedly non-sciencey background)I'm curious -- what is your background? Were there particular types of undergraduate courses that you found interesting?

I thought about going to medical school too, when I was much younger, but I decided against it. I've never handled sleep loss well, and people told me that medical residents were expected to work around the clock. As I look back, I think my personal health has probably been better through the years by having the time to enjoy country living and gardening and outdoor activities.

ETA: I also have a strong interest in nutrition and find that purchasing and preparing good food does take time.


I can't give any first-hand advice about this, but the PBS series Nova has run a periodic series following doctors from their days at Harvard Medical School. One of the participants, Tom Tarter, was (and is) a big, burly, pony-tail wearing, Harley riding former bouncer and weightlifter who entered Harvard Medical School at 31. Despite being such an "outsider", he went on to become a successful emergency care doctor. I remember watching one of the episodes several years ago, and Dr. Tarter really fascinated me. I wish my doctors were as cool and bada- as him.

More information about the series is available at http://www.pbs.org/wgbh/nova/body/doctors-diaries.html

My point is, it's definitely not too late for you. Good luck with your decision!


TheDragonn said:   I should say it up front that the marriage will come WAY, WAYYYY ahead of this decision. My marriage brings me so much more fulfillment than the 9-to-5 ever could

Consider yourself very lucky that you have that.


I just started an accelerated nursing program (after finishing prereq's). In 15 months I'll have a BSN. Then, a job in an ICU. Then, sky is the limit.

If you have a chip on your shoulder, I suggest that being a male nurse is not for you. (even though you will get fast-tracked).


TheDragonn said:   Other pertinent info: I'm smart and have no doubt that I could get *IN* to a program, but it would likely require a year of post-bac science courses (I have a decidedly non-sciencey background), time planning while applying, MCATs, etc.

I wouldn't be so sure about that. One of my friends did this at your age (career change from i-banking/structured finance) a couple years ago and did the post-bacc at USC. He had a 3.9 undergrad GPA (UCLA), and a 3.9 in the post-bacc program, and a 33 MCAT, and he got 4 interviews from low tier schools and got no acceptances. I will say he was in the most disadvantaged class of applicants (Asian male in CA). This experience humbled him quite a bit.

Medicine is extremely competitive right now, and it's only going to get worse.

And yes, he completely regrets his decision, and is going through a depression period right now.


As a current resident MD that went a nontraditional route, my only two pieces of advice would be:

1) Don't do it unless you are 100%, absolutely certain it's the ONLY career for you. As others have mentioned, it's going to take at least 7 years and be a huge emotional, physical and financial hardship. It's rewarding, but really, really difficult. No self pity, but be realistic with what working 80+ hours over nights, weekends, holidays means. You don't just punch a clock, it's a much bigger commitment than any other career I can think of.

2) Don't do it for the money. I know this is a forum about being cash savvy, but there are much easier, more creative ways to make money than being an MD. Even in the health care field you could be a PA, physical therapist, RN, pharmacist and making plenty of cash (often >$100k with a MUCH shorter training and much gentler hours 40-45/week rather than 80+). If you're clever enough to go to medical school, you're clever enough to carve out a niche in any career where you'll be financially rewarded. Medical school will cost at least $200k and during your residency you'll max at $50k despite working 80 hours/week. That's a big swing in your 30s, when most people start socking cash away. Don't get me wrong - docs make good money and many start at $200k or more - but it's not worth the money to work in something so draining unless you love it anyway.

Hope that helps. Good luck making your decision!


zhelder said:   I can't give any first-hand advice about this, but the PBS series Nova has run a periodic series following doctors from their days at Harvard Medical School. One of the participants, Tom Tarter, was (and is) a big, burly, pony-tail wearing, Harley riding former bouncer and weightlifter who entered Harvard Medical School at 31. Despite being such an "outsider", he went on to become a successful emergency care doctor. I remember watching one of the episodes several years ago, and Dr. Tarter really fascinated me. I wish my doctors were as cool and bada- as him.

More information about the series is available at http://www.pbs.org/wgbh/nova/body/doctors-diaries.html

My point is, it's definitely not too late for you. Good luck with your decision!

You must not have watched the documentary very carefully because I thought it painted a rather bleak picture of doctors' lives. Tom Tarter was so "successful" that he ended up losing numerous jobs and becoming an itinerant doctor who doesn't see his (fourth!) wife for weeks on end while he's away on various gigs. His financial situation is precarious at best, and he doesn't even have health insurance. http://www.pbs.org/wgbh/nova/doctors/tom.html

To the OP, 30 isn't old if this is what you really want to do, but don't do it for the money. It's a long and painful road, and you'll most likely be in debt up to your eyeballs at the end of it. The money won't even begin to make up for everything you'll have sacrificed.


ahough said:   No self pity, but be realistic with what working 80+ hours over nights, weekends, holidays means. You don't just punch a clock, it's a much bigger commitment than any other career I can think of.lol plz...all you guys think you're the only ones working "hard."


1)I'm an MD, subspecialized, 34 y/o, been in practice almost 2 years now. I was very traditional- straight into med. school after college. I make good money now, reasonable hours. The stress level is still high (very complicated cases), but I feel a little bit normal. I still go home tossing and turning about cases every so often. I'm on call every 3-4 days/weekends/holidays.
2)Getting into med school- it's not as easy as you say it is. Have you taken upper level college classes? Have you aced organic chemistry/biochem/physical chem/physics? It wasn't super hard for me but many of my 'smart' classmates had a hard time. MCAT sucks, and the minimum requirements go up each year... I knew a few older people in my class (a 30 y/o ex banker, 50 year old ex-marine) and they all did great- very dedicated.
3)Med school- very very tough, especially if you want to do well (to get into a popular subspecialty). I guess if you goal is just to pass it could be much easier, but personally for me it was VERY VERY emotionally and mentally tough. I was a very top notch college student (always top 1-2 students in upper level science classes like organic chem, p.chem, with a very high MCAT) and I had a tough time trying to be ranked highly. I have cried maybe 4 times in my life- at least 2 of those were during medical school.
4)Residency- tough too- think of the busiest its been at your job- it's like that all the time (around 80 hours, depending). I know other jobs can be tough- this is a tough job.

So all that being said, should you go to medical school? Maybe- it depends. If this is something you really want, go for it. But you had better want it for all the right reasons, b/c you will pay dearly for the next 10+ years. You finances will be shot, you will be tired, and you will have taken on a field which defines you. Good luck.


Whilst the surgeon eagerly waits on his next patient you can see the inspiration, satisfaction, determination and brilliance in his face. The surgeon may seem like a fierce creature on choosing his next instrument to use on the patient, and his discussion on the patients ability to take long strides in his future walk of life. Not only does he predict the patients future lifestyle, he predict's the excellence of his close friends; the instruments. The instruments that the surgeon relys on also rely on the surgeon's future, life, cutting-time and inspiration.

The surgeon MUST take time to gather up his passion towards his instruments:-

"My surgeon often used to present his fine tools before I felt the effect of anesthetic; not only did this calm me down but it was truly visible on how inspired the surgeon is about his job"
"the surgeon was a masterpeice upon all masterpieces in life, such as the Moan Lisa or Snake Charm. The surgeon was similar to a transparent bulb in that you could see the 'guts' of the bulb and get an idea on how it may function, but, you can NEVER predict on when it may fiz.
"I would like to see the day when somebody would be appointed the surgeon somewhere who had no hands, for the operative part is the absolute least part of the work."
"Just the actual physical ability to hold four instruments simultaneously and do some of the things that he was able to do is mind blowing to any surgeon." - The patient is waving. Fantastic.
"I met the surgeon - he offered me a cigarette."
"Let me alone: I have yet my legs and one arm. Tell the surgeon to make haste and his instruments. I know I must lose my right arm, so the sooner it's off the better. "


Fantastic. The surgeon raised an eyebrow
Fantastic. The surgeon raised an eyebrow
Fantastic. The surgeon raised an eyebrow
Fantastic. The surgeon raised an eyebrow
(the patient offered the surgeon for a cup of coffee) - excellent


Here are my thoughts (As a 39 year old Family Practice doc; Med School 22-26yo, residency 26-29yo):

1. Finances: You should start by pricing med school. This will be one of your biggest deal maker/breakers. A quick check on my Alma Mater lists IN STATE tuition about $25,000. (Thinking about going to Harvard? That's about twice as much.)Calculate that over 4 years (Assuming your spouse supports you for all other expenses) and you're coming out of Med School with $100,000 in student loan debt. Now, the good news is that you hopefully can get federal loans, but remember that they're 30 year loans. You won't start paying them until the end of Residency (since money will probably be a little tight to pay it earlier). With 1 year application time, 4 years med school, and 3-5 years residency, that means you start paying them in about 10 years and you'll be 70 when you make your final payment. (Oh, if your spouse supports you for this plan on huge alimony if you divorce... just FYI.)

2. Specialty: I would argue against Primary Care since these tend to be the lowest paying fields and tend to be more "fields of love"... it gets frustrating to watch a surgeon make 4 times more than you do if you don't love your job. The top pay is usually for one of the surgical (or cosmetic) specialties like Derm, Ortho, (I knew a Family Practice doc that specialized in Vein Treatment that brought in 800k) (Surgical Podiatrists make more than a family practice doc most of the time). But the cost of these specialties is longer residency (Primary Care = 3 years, Surgical = 5+ years).

3. Residency: Sometimes it means up-rooting your family for a new state; so remember that. Also, it's 3-5 years of 40-50k salaries.

4. Start-up costs: Once you've finished your residency, you have 2 main options: Solo practice or Group Practice. Solo practice can bring in good money but you start alone and need some start-up capital. You have to negotiate your own contracts so you don't get as good of deals. Group is the way to go in my opinion... but usually that means you're the low man on the totem pole when you start.

5. Benefits: Pretty much recession proof. Once you've done your time, the money is good. How long do you want to work? We've assumed you're going to become a doctor at 40; so you've got maybe 25-30 years of work ahead of you. If you want to retire when you turn 60 I would really argue against it. But I think you're young enough to make it worth it. But remember, social security takes a 10 year hit (No income for 5 years, low income of 3-5 years) so don't depend on that. Your 401k contributions are zero for these years (unless it's changed in 10 years, residencies don't offer any 401k money and I probably wouldn't have put much in because money was so tight anyway.) After residency, it takes about 3-5 years before you're getting the full salary and have an established practice.

That's some "off the top of my head" thoughts. PM me if you have further questions.


I had a friend who was 29 years old, embark on the medical school and is now a successful general practional. He had his engineering degree from G Tech and worked as an engineer for the big 3 for few years before he made his mind.


another alternate path (with a doctor title) is becoming a DPT (https://en.wikipedia.org/wiki/Doctor_of_Physical_Therapy).


You need an outstanding achievement from a reputable College with an impressive MCAT score to be considered for Medical School. Having Non-science major and claiming to be smart (I am sure you are) to be in is oxymoron. 4.0GPA from B.Com does not translate to 4.0GPA in B.Sc and Engineering. Make sure you consider the above before dumping your career for a change.

DPT (I think this is what you want) on the other hand, is very do-able. Doesn't require much strength in academics and there are plenty of schools in the US with more enrollment space compared to the number of applicants

One of my colleague (along with MANY OTHERS) is now 44 and went to school with me when he was 35. You are definitely not late in the game.

GL.


You can always try "dipping your toe in the pond" by starting to take the lower division pre-health classes at community college at night/online. If you get an A in every class than you can start on the next step by taking the upper division pre-health classes though extension (or whatever your state calls it) at the local state college.


Summary:
1. Your salary, not so bad
2. Saving, very low
3. Cost of going to Med School, very high. Require loan
4. Going to Med school means that you won't be able to spend much time with your family (80 hours a week +). Worst than your current job? hell yea.
Length = 8-9 years (if you want to be a specialist). Sometimes, you'll be treated like crap
5. Smart is not good enough if you're going to a top med school. Gotta be smart smart and hard working. Otherwise, pick a regular med school.
6. You need 1 year of science courses and you gotta do well or you won't get in.

I say if you're committed, take part time science course first. Then go and take your MCAT and decide later. I have a lot of friends who change their mind, not because they are not smart enough. All from a top 3 school with excellent grades.


i started med school at 36. yes i grappled with the decision much like you. I came to the realization that nearly a decacade was going to going by whether or not i was in med school. And yes, that time has gone by and now I have a MD degree. I went into a specialty that has very good earnings and the "math" has worked out favorably. Pursue your Bliss my friend.


One of the biggest reasons for being a doctor is to date hot chicks. Since you are already married, it is pointless now... Just joking. Going back to med school would give a huge burden to your family because your wife is not a big earner, and it will put pressure to your marriage... It maybe too late for going to med school...


I have learned a lot here. All of these posts have inspired me to maybe start a business. I wonder if I can make a living entertaining medical school student's wives, for a small fee. Sounds like I would have lots of clients, it would be entertaining work, and would not take much time. I could be in-and-out lickety-split.


Good days in Medicine are Behind per my Doctor friend.


dhodson said:   the majority of physicians attempt to fix things.

... often on people who deep down have no intention of following thru on the fix ... losing weight, stopping smoking, adopting a healthier lifestyle ...

or who have deep seated mental issues which impede their adoption of any health improvement.


quicky said:   Good days in Medicine are Behind per my Doctor friend.

your friend is a proctologist?



I am a second year resident. 28 years old.

I recommend that you do NOT go to med school. Its just not worth it. only do it if you REALLY love medicine and couldn't be happier doing ANYTHING else.

if you go to med school, you are a full time student (that really isnt that bad, but you incur debt), then an indentured servant for 3-5 years. or longer if you sub-specialize. then an uphill battle your whole life, making less each year, while you work longer hours. and you watch all your other friends have fun/build savings the entire time. DONT DO IT.


STEALfromCAGgive2FW said:   quicky said:   Good days in Medicine are Behind per my Doctor friend.

your friend is a proctologist?

I thought for proctologists things are always looking up?


cga said:   GADOM said:   cga said:   bytem3 said:   cga said:   I'd rather have the rudest most obnoxious surgeon open me up than a polite and courteous, but less skilled and experienced surgeon cut me open.
You would not be the norm. Everyone says that they want the most skilled person. But in reality, most patients prefer (and are less likely to sue) someone with better bedside manner, even if they are otherwise average (or not even). Some patients will leave the care of a highly-skilled physician for many reasons, including they don't get the options/answer they want or they don't like their bedside manner. There have been several publications about this (NEJM comes to mind). ...

I've had occasion to choose between surgeons, both for myself and for others, and have always looked into who's the best very carefully. Sometimes nurses give the best advice along those lines because they have nothing to gain or lose by expressing an opinion. I would almost invariably wind up choosing the least friendly surgeon, the one least willing to communicate---the type of person I would least want to have a beer with, but who is so busy and so well known and respected among his peers for his skill and experience---that he no longer has to prove anything to anyone. But I agree and understand that I'm in the minority on this. However, I don't think that makes me wrong. At least not in this case.


I can tell you from evaluating risk management cases I see far more issues with the obnoxious/ arrogant doctors exactly because they are obnoxious and arrogant (the nurse is afraid to bring up an issue, the patient is afraid to reveal an important symptom because he shuts them down or discounts them ("where did you go to medical school"), they fail to participate in patient safety/QA activities) they are more prone to make a mistake and less prone to seek help to get out of a theraputic misadventure. All of which leads to increased risk of true harm to you as the patient.

The good news is we almost always settle those cases because those doctors make awful defendants on the stand.
Well, I guess that's the difference between a rude, obnoxious, skilled surgeon and a rude, obnoxious, skilled and stupid surgeon. I've never had the misfortune of being forced to deal with the stupid version.


I would say, respectfully, that unless you have access to the kind of data I do like 30 and 100 day mortality rates, post-op infection rates, 30 day readmission rates etc you would not really be able to tell which type you had dealt with.




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