Why I don’t want to be a doctor

At Life in the Fast Lane, we try to provide educational posts and commentary to stimulate discourse in the field of health. With such a diverse audience reading the blog, the only thing the writing team can be assured of, is that we will never be able to please all of the people all of the time!

To some readers the posts are too medical, others deem them too obtuse, and others still want a more evidence based approach…

I was taken by one recent readers letter which I will reproduce in full…’cos I like it.

Our reader wrote

Sir, too many of your links and blogs lately concentrate on why med students want to become med students. It’s dull. And lacks adequate perspective.

…and continued with

I love Life in the Fast Lane. It’s interesting and pertinent to the work I do. It is regularly funny and best of all it discusses grammatical idiosyncrasies. But of late I have been disappointed by the recurrent theme of medical students blogging about why they want to become doctors. Personal understanding of your own motivations and intentions is important. Especially when considering such an expensive and time consuming life change. But does it make for inspired reading?

Lets be honest, it’s really not difficult to see why people are motivated to become doctors. Yes, it is academically challenging and usually costs you a pretty penny, but your reasons for trying to become one are usually standard issue. I’m guessing if you became a doctor it was for one or some of the following:

  1. You wanted to help people and be involved in some of the most intimate and important events of their life
  2. You wanted to cut people open and play with what you found inside
  3. You loved the lateral thinking challenge of making a difficult diagnosis
  4. You wanted to see more people naked (probably not something you’d admit to in a blog)
  5. You wanted access to cool drugs (again, unlikely you’d admit it)
  6. Your mother made you watch Dr Quinn medicine woman too much as a child
  7. You had the grades to do it, so you did it.

And there are certainly plenty of advantages to being a doctor

  1. You are largely given social respect and admiration as you’re handed your degree
  2. No one is going to the put the word ‘just’ in front of the word doctor
  3. You have autonomy and decision making power
  4. You are generally well remunerated for your work

Don’t get my wrong, I’m not anti-doctor. I have enormous respect for my medical colleagues. Especially those who contribute to Life in the Fast Lane as they are all capable of remembering that humour and polite human interactions are always indicated in medical practise. And I appreciate that being a doctor is challenging and demanding.

But what I am saying, is that making the decision to become a doctor is rarely such an unusual decision that it should warrant multiple blogs. So maybe next time Life in the Fast Lane is looking for a human perspective on a career in an Emergency Department they could ask a more original question. Like, “why I don’t want to be a doctor…

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  1. eva diva says

    grossly exaggerated and overstated reasons why i don’t want to be a REAL doctor:

    1. Patients cause massive emotional stress. They demand. You supply. It’s a business skill they never teach us in med school. You also dish out more empathy than you ever knew you were capable of, and when you get home, you’re more burnt out than the mac n cheese you forgot about for dinner.
    2. The too many patients with print offs from the internet who huff off without an antibiotic Rx for a head cold. Fill in the same for the oxy junkies. But they get red in the face when they tell you how you know don’t know your asshole from your mouth. Yeah. Respect. I can haz? One day?
    3. You slowly graduate from: “just” a med student, to “just” an intern, to “just” a resident, to “just” a fellow … 10 years later you might make it to “just” a hospitalist (and then you get to justify why you didn’t want to pursue a specialty). I’d say roughly 1/3 of the US population actually thinks of doctors as a noble profession. Everyone else knows more than you do. “But, doc, the webmd symptom checker said I have lupus!” (“It’s not Lupus!” -- house)
    4. It’s impossible to educate “the tainted” who already come with a formed opinion in their minds and DARE YOU to change it. Sorry patient, you sucking up all of my energy because YOU are looking for an argument and feel I am a suitable challenger — does not mean I’ll actually play along. Doctors don’t actually get paid for having an intellectual conversation about vaccines causing late-onset Autism in the 60 something adult male population from the H1N1 shot (I wish I made this up, a 60 year old was actually concerned about getting Autism from the swine flu shot). Even trying to explain how that’s impossible would set you back in the day and make all your other pts delayed… I just love walking into a room with a patient chewing me out for not respecting their time. I almost want to open the door and show them Bob, your reason for me being late.
    5. It’s hard not to get jaded from seeing that the system is screwed. And it’s even harder not bringing that misery home. Logistical challenge is trying to discharge a patient with newly diagnosed oxygen dependent COPDer with an oxygen tank… when the pt and her husband live out of their car. And it’s the middle of winter. And she doesn’t want to go to a women’s shelter because she has to leave her husband. And we can’t get her the oxygen she needs unless she does.
    6. We don’t get paid to counsel, change minds, have conversations, refute webmd.com — but most detrimental to ALL of us — doctors don’t get paid to think. They get paid to order. If you’ve GOT cadillac health insurance, I mean that’s more than most of us. Your doc might as well use it? Just a bit? Let’s just order everything in the catalogue and see what happens.
    7. Autonomy and in decision making is almost laughable. Finding formularies for each health care plan? They cover X inhaler but not the vestibules, and inhaled steroids aren’t covered period. But you can go old school and get $4 cromolyn instead. Is that just is good? Well… Prior auth form here, write insurance company letter there, do the run around. Autonomy in decision making, it is not. Delegating, now we are getting some where. The social workers / pharm techs / nurses page us when we screwed up (and we do a lot — what we think — what insurance doesn’t cover lovenox?!?). there now needs to be a plan B because insurance won’t pay for it.
    8. You get more questions from your family and friends when you are handed your degree, and a little respect, however…. You actually have to turn in any respect you got because in a few weeks, you are going to be the attending’s FRESH MEAT!

  2. says

    Thank you eva diva
    LOVE a good rant…hope you feel better having unburdened yourself of that well crafted monologue…I feel better already for reading it!

  3. Anonymous says

    I might suggest that in the States renumeration and autonomy are wavering. Reimbursement is becoming increasingly difficult and control has been wrestled by administrators. Even the technology we’ve created, while incredible, has taken what what we have.

    The only thing I play with inside of people is stool, by the way. .

    But it’s still cool overall. The challenges are amazing. I love the relationships. It’s good to be at a point where I can reflect.

  4. says

    Your site has a wide variety of topics. This one caught my eye. Did you read the survery from Investors Business Daily abut how many Doctors will leave the profession once the new Healthcare system goes into effect?
    Thanks for all the information you have.

  5. eva diva says

    Ha! Unburdened no. We all carry it. Some wear it better than others. The bile is always greener on the other side, etc. One should probably enter medical school with a surplus of kitten and rainbow feelings in order to not end up cursed with too much cynicism.

    There is one point I and the reader who submitted your post neglected to mention — one of the very best things of getting and MD over any other doctorate is the tremendous amount of flexibility you have in career options. But nobody dares to talk about anything other than saving the world, one patient at a time, as their primary motive for wanting to pursue the art of doctoring. No one talks about the power of an MD in the role of research and advancement of medicine. Yes, I said RESEARCH. Not practicing medicine. However, the large majority of MDs want nothing to do with the most powerful influential benefit of their degree.

    I believe that the most autonomy a doctor can ever get is one in the field of translational research. Only doctors can run a clinical trial. They can apply basic science to the medical world. Without a doctor in medicine, Imatinib (Gleevec) could not have changed/invented an entire field of medicine. A PhD collaborated with an MD, and had another MD run the trial. This opened up an entire field of pharmacology with monoclonal antibodies. And it changed CML from a death sentence to a chronic illness.

    That, my friends, is how you change the world. Or consult social work, I hear they are really good at that. 😉

  6. says

    There are the things that I wish the dean had mentioned on that fateful day that we all sat, goggle-eyed, in anticipation of the rest of our lives. Really, there should have been some sort of warning so that we could all cry in realisation and quit before we figured out what we’d gotten into. But, as things stand, they tell me that there is apprently some sort of doctor shortage, and so this would be a counterintuitive move.

    Here are the reasons why I wouldn’t want to be a doctor:

    1. The paperwork. No one told me I’d have to function as a glorified secretary for the first couple of years out of med school, on call all hours of the day and night. And then you move on to even more paperwork. My consultant’s IN tray is stacked to the hilt.

    2. Pontificating public. If you think that you can make an ED run better, lets see you try. I am sorry that you had to wait 2 hours to be seen, clearly there are people sicker than you in there. So crying to the media about it is just going to make us dislike you.

    3. Patients who believe that everything they read on the internet is true. Do you SERIOUSLY not want to vaccinate your children against polio because some silly people went to court about it AND LOST? And, no, IV vitamin C is unlikely to cure your cancer.

    4. The lack of family/social life. You thought that you didn’t have a social life in med school? Check out your social life as a junior doctor. Apparently the solution to this is to dump your other friends and only hang out with people from work. This is also the reason I use to repeatedly explain to my very-asian mother why I am in long-term relationships now. No, I am not too young, and in a couple of years I won’t have the time to meet people and I don’t want to end up like some of my registrars -- married to my job and alone.

    5. The health system -- it needs more funding, and sensible people to regulate it. It is depressing to go to work every day and see all the ways in which it is dismally deficient.

    6. Dealing with the invisible people in society -- clearly they need help. They are the drunk, homeless, the nameless. Everyone else ignores them. We can’t. Even if they’re throwing up on themselves and smell bad, we still have to stitch them up. And sometimes, there is nothing that you can do, and that is sometimes the saddest, most frustrating thing of all.

    Of course there are heaps more reasons. These are my main ones.

    But I’m still going to do it. The reward far outweighs the cost. And seriously? It’s still a pretty awesome job.

  7. Sherif Mostafa says

    i’m a 28 years old fresh graduate GP, and i can proudly declare that i spent 7 years of my life studying to be something that i HATE to be, Medicine SUCKS everywhere with its STUPID residency and specialties and being cut off all the ppl u know and YES, U’VE NO SOCIAL LIFE COZ U R A DOC…. and if i could go back in time, i’d NEVER EVER even think of applying for the misery i’m going through now :(

    my concept in the past 7 years, was to study hard and be a bright respectable doctor -or as i assumed- and work in a respectable hospital or whatever where they respect ur hard years of studying and pay u well for them, huh!

    in my country, doctors -especially the young once- are being taken advantage of, in every way it might be -- maybe that explains my hard tone- and i insist that if i could go back in time, many things would’ve been changed, or so i hope!!!!!!!!

    now excuse my, I’m confused!!!!!
    thx for ur time readin this :)

  8. Burt Cumberpatch says

    I work in mental health, for my sins. A number of years ago when I started I was full of naïve optimism about the gloriously diverse, fascinating and multi-perspective world of psychiatry. I imagined the intellectual excitement of interpreting my patients symptoms in an interwoven thought-web of neuroscience, anthropology, sociology, psychology and philosophy, to formulate the precise forces at work within them and their environment that were manifesting as their experience of mental distress.

    Here is the reality

    1. Yes you do have to do the above, but it is absolutely exhausting, hopelessly subjective, and ultimately feels like fruitless mental masturbation half the time
    2. 99% of people you see every day want to die -- it rubs off after a while
    4. Risk assessment, risk assessment, document your risk assessment, then risk assess that documentation, then fill out this tick box risk assessment, now this free text risk assessment, and don’t forget the online risk assessment *sigh*
    5. The drugs don’t work. I don’t think I have seen a single person improve in a meaningful way on antidepressants. Antipsychotics work because they will make you fat, diabetic and dopey.

    Perhaps the only saving grace is that I work in the UK and not the US. I don’t think I could get out of bed in the morning if I knew I might be medicating a 4 year old with valproate and zyprexa later on that day.