June 2nd, 2011 by Dinah Miller, M.D. in Opinion
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Here at Shrink Rap, we often talk about the stigma of having a psychiatric disorder. It’s funny, but society has it almost ranked, so that certain illnesses are very stigmatized–schizophrenia and schizoaffective disorder, and borderline personality disorder, to name a few, and others are pretty much socially acceptable: Attention Deficit Disorder, for example, especially among the high school/college crowd where the patient often gets identified (or self-identifies) as the source for those late-night stimulants that so many kids cop.
It’s not just the patients. Psychiatrists are also stigmatized, and that doesn’t help much when our society talks about the shrink shortage.
Exalya writes:
I’m a first (almost second) year medical student with a strong passion for psychiatry. I love listening to your podcasts; you give me hope for my future when the drudgery of first year classes is getting me down, and I feel like I always learn something useful.
That aside, I am writing to you seeking some advice. Read more »
*This blog post was originally published at Shrink Rap*
May 21st, 2011 by DrWes in Opinion
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I wonder if we’re in danger of stifling fun in medicine.
Certainly there are still fun things to do in medicine (ablating a pesky accessory pathway safely, for instance). But as I watch the newly-minted medical school graduates emerge from their long, sheltered educational cocoon, I wonder what their attrition rate will be from medicine once they see our new more-robotic form of health care community.
There is a social camaraderie in medicine when you train. Maybe it’s the “misery loves company” syndrome. In medical school you stick together through thick and thin because few others understand what you’re going through. You strive for the day when, collectively, you earn the designation of “doctor of medicine.” There’s a strength in numbers.
But as our work flows become regimented, our geographic coverage areas more dispersed, and our hours more fragmented, I’ve seen the loss of the collegiality of the doctor’s lounge being replaced with the coldness of e-mail blasts. I’ve seen the loss of summer picnics with my colleagues’ families replaced with “Doctor Appreciation Day.” After work get-togethers that included our spouses and kids are have long since gone – most of us just want to get back home to re-group for the next day ahead. Read more »
*This blog post was originally published at Dr. Wes*
March 27th, 2011 by Edwin Leap, M.D. in Health Policy, Opinion
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My column in Sunday’s Greenville News.
‘Medical education shouldn’t cost an arm and a leg.’
I was talking to a young man who is starting medical school this fall. His tuition at one of South Carolina’s newer schools will be $40,000 per year. That’s admittedly on the high end. On the low end, it runs a paltry $33,000 per year. And this is all after college, of course. He and others like him are taking out loans to the tune of $240,000 to pay for their medical educations. Another young woman I recently met is in residency and her loan payments are around $2000 per month.
Thinking back on my own medical education, it seems my tuition was around $5000 per year. But then, what with all the Saber Toothed Tigers, Neanderthals and stone surgical tools, things were simpler.. These days, I don’t know how students will do it.
The thing is, American healthcare is expensive. But so is medical education. As we embark on this century, what are the odds that physicians with $240,000 loans for medical school will be able to offer inexpensive care? What are the odds they will enter low-paying specialties? They might be interested in charity care at first, but when the first loan payments come due all the good intentions in the world won’t change the fact that lenders want their money back. Likewise, it won’t change the hard reality that it will be extremely hard for these young physicians to pay for their student loans, buy a house, have a practice (pay malpractice) and raise a family; at least without making a large amount of money in their practices. And then there’s this striking (but seldom mentioned) fact: student loans are non-bankruptable. Student loans are friends for life, or until payed off. Whichever comes first. Read more »
*This blog post was originally published at edwinleap.com*
February 23rd, 2011 by KevinMD in Health Policy, Opinion
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There are plenty of reasons why medical students aren’t choosing primary care as careers. Lack of role models. Perception of professional dissatisfaction. High burnout rate among generalist doctors. Long, uncontrollable hours.
But what about salary? Until now, the wage disparity between primary care doctors and specialists has only been an assumed reason; the evidence was largely circumstantial. After all, the average medical school debt exceeds $160,000, so why not go into a specialty that pays several times more, with better hours?
Thanks to Robert Centor, there’s a study published in Medscape that shows how money affects career choice among medical students. Here’s what they found:
Sixty-six percent of students did not apply for a primary care residency. Of these, 30 percent would have applied for primary care if they had been given a median bonus of $27,500 before and after residency. Forty-one percent of students would have considered applying for primary care for a median military annual salary after residency of $175,000.
And in conclusion:
U.S. medical students, particularly those considering primary care but selecting controllable lifestyle specialties, are more likely to consider applying for a primary care specialty if provided a financial incentive.
Money matters. There should be no shame for new doctors to admit that. After all, they’re human too, and respond to financial incentives just like anyone else. And when most medical students graduate with mortgage-sized school loans, salary should be a factor when considering a career. Read more »
*This blog post was originally published at KevinMD.com*
October 30th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Tips, Opinion, Research, True Stories
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I heard a 23-year-old woman complain: “I must be getting old when 11:00 at night is late.” It got me thinking.
It turns out that the explanation for why teens are natural night owls has recently been elucidated. They can’t help it — they just don’t get tired until way later in the evening. Then, of course, their bodies want to stay asleep well into the next morning in order to feel sufficiently rested. Since most of them are stuck with the artificial structure of school hours, they’re screwed — and condemned to suffer constant fatigue from cumulative sleep deprivation. Old news.
Then I started wondering about the back end of this phenomenon. Even though our American “youth culture” attributes great coolness to late-night happenings, since this pubertal sleep shift is biological, there must come a point at which their pineal glands go back to releasing melatonin at a more reasonable hour. Does 10 years sound about right? I remember not being nearly as enamored of the “all-nighter” by the time medical school rolled around, as opposed to college, where staying up all night was a regular occurrence. Certainly by residency (ages 26 to 30), it was a killer. Read more »
*This blog post was originally published at Musings of a Dinosaur*
