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Can I ask what motivates you to be a doctor? Is it that if you don't rage out and quit by the time you enter your 40s you can start expecting a really sweet lifestyle, if you properly monetize your certifications and experience?
I feel a little guilty that I never went to college and liked computers instead and was clearing $500k/year and retired in my 30s. But at least when a doctor has a garage full of sports cars society nods and says "oh yeah well he's a doctor that's why" whereas I have to do shit like live a low key life and give to EA so I don't trigger class rage.
All the doctors like that are DINCs, from a prior time (aka the 90s), or from one of the well paying specialties. 300k a year starting in your 30s with 500k in debt isn't enough to make you rich until late in the game if you intend to put 2-3 kids through college and so on, if ever. Sure you can push state school or not pay but if you went through it you want to protect your kids from dealing with it.
These days the doctors are on the receiving end of class rage though, everyone is mad at us on both the left and the right, thinks our job is easy and easily automated, and wants us to make less money. Thus my long ass rant.
That said I do it because I want to help people and I like teaching. It's also interesting as hell. Medicine is hard because it is much poorer define than most knowledge work which means there is a lot of room to learn and research and for your job to stay interesting over the course of your career.
It is pretty astounding to hear that health spending occupies an increasingly larger share of GDP yet doctor compensation is worsening.
I obviously don't know anything but from the outside it does seem like one of those things where the more you learn and the faster you think on your feet the more good you can do. When, you know, the cases aren't boring and you have to remind the patient yet again that they don't get better unless they actually take the meds as prescribed.
I think this should be pretty intuitive if you think about government and academic spending. More administrators and more middle managers are rampant everywhere and drive up costs. Market activity is somewhat protective against this, but healthcare has too much going on that doesn't resemble a market.
One of the remaining perks that hasn't eroded is that you bring in the revenue for the hospital. Even an IM doc brings in 4-5 times their salary in revenue to the hospital. This gives some independence, should we choose to use it (we often don't because residency beats that out of us). You want me to fill out a yearly HIPAA training. Fuck off, fire me if you want. You won't.
This patient is having an emotional breakdown and really needs it? I'm skipping my mandatory meeting and spending time with the patient and their family.
Moments like that matter a lot.
Also, if you are smart and motivated you can discover entire new ways of helping people, stay on the bleeding edge, redefine what the standard of care is...and so on.
Even bad patients can be rewarding when you finally help them to the ah-ha moment.
Good stuff is out there.
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