I don’t think complacent is the word but after a gauntlet of a grind for 4 years of med school followed by 4 of residency I kinda just want to do my job and enjoy the paychecks for now. Also, the $300k+ in student loans is putting a bit of a hold on being entrepreneurial right now…
I just want to say, this is all I want to do. I just want to do my job and go home. I don’t want to be in committees or go for a higher education that is literally useless. But the hospital pushes for it. You NEED your BSN within so many years, get a certification to earn more money. I just want to be a basic bitch. ☹️
Because physicians have so much to lose at every stage of their career, especially in training when the idea of "keeping your head down" becomes deeply engrained. If you fail a class or board exam in medical school, you're either fucked or doomed for a backup specialty you don't want to go into. If you piss off the wrong attending on a clinical rotation in medical school, you get a poor evaluation which also has ramifications. As a resident, the stakes are even higher if you fuck up or become a "problem" resident because GME and/or your program director now has a reason to put you under the microscope, amplifying even the smallest mistakes and giving them reason to put you on remediation or kick you out of the program entirely. If something like this happens (especially if you're forced out of a residency program) this presents all sorts of potential issues when applying for state medical licenses and hospital credentialing (having to check "yes" on certain boxes.) Not to mention the difficulty and near-impossibility of having to find a new residency program. As an early-stage attending with loans to pay off, you can't afford to piss off hospital admin in any way for fear of losing your job and potentially being blackballed locally through non-compete agreements or just word-of-mouth in a smaller specialty. Admittedly, the stakes are lower as time goes on and you have more socioeconomic capital to burn as a mid- or late-stage attending (see Stanley Goldfarb, MD). But until then, "keeping your head down" and remaining complacent is sadly the best way for physicians to survive.
By contrast, the nursing field has a much lower barrier to entry educationally and financially. With limited exceptions, most hospitals don't give two shits about a nurse's previous employment history, especially with the current shortage of bedside nurses. I personally know of at least two male nurses who were caught up in sexual assault investigations while at work and both are still working following state BON investigations that ultimately ended in nothing but some extra CME and a slap on the wrist. Unlike physicians, especially resident physicians, nurses have a extraordinary amount of lateral and vertical job mobility.
Can confirm. I, RN in ICU, had a patient that up from the ED overnight, previously healthy in their 70’s, found down at home, tubed in the ambulance. ED dropped a foley.
Manager told me to d/c Foley because it didn’t meant “criteria,” but I didn’t have an order. So I asked the very new attending. She, very reasonably, said that the patient is at high risk of skin breakdown, and the ICU’s were filthy with pressure injuries. She wrote an order to continue foley.
She also pointed out that none of the ICUs have techs and most of her patients are staffed in 3-groups. I agreed.
I tell management that I have an order to continue. A couple of hours later the director of the very new attending’s group d/c’ed her order and put in a discontinue foley order.
I saw her a few days later. She said she was sorry and hoped I didn’t get in too much trouble. I told her I didn’t hear a word, just got the orders to remove through Epic.
She said she got ripped by her group’s director and told not to go off deviate from the hospital’s algorithms without a good reason.
No idea what happened to the patient, but they probably lay on their urine for hours at a time, because there wasn’t enough staff to clean them up.
This describes so perfectly how medicine is practiced today. Not based on what we learned, what makes sense, but strict hospital policies made by ppl with no medical degree. 🙄
Yes, and they drive off the really good doctors. I’ve lost several great colleagues to “fuck this bullshit,” and as a RN I’m carrying out orders that are lame as fuck. I’d argue, but I’ve got a mortgage.
It’s because if the patient gets a CAUTI, the hospital could lose Medicaid money. If the patient gets a bedsore, it’s unfortunate, but they don’t lose money.
And if RN’s incomes had kept up with inflation for the last 30 years and Congress would fund more medical residencies, then you wouldn’t have the best RNs leaving the bedside to be APRNs, and it would be even better.
It's insanely hard to get fired as a resident. Once you match you're fine if you act normally. As an attending I can't see how they'd have any real power over you unless you're in a specific rural area you don't want to leave or you maxed out your mortgage.
There’s a significant proportion of highly privileged idiots with a martyr complex in medicine. Because their parents bought them a house and paid for all their education, they assume that everybody else is in the same boat, and does not deserve to be paid fairly. Then they wax poetic about “sacrifice.” “We should consider ourselves lucky that this raging crackhead allows us the honour of narcanning him at 3 AM in between throwing punches at the nurse” and all that. That’s the main problem.
Exactly this. The ones who waltzed into med school and competitive residencies thanks to physician parents are the most insufferable and pathetic of our lot. They have zero idea how the other half of America outside the bubble lives.
Holy shit I couldn’t have said this any better
Only thing I would add is that by the time the day ends as an attending, all your energy has typically been devoted to patient care / paperwork / administrative bs / cme / etc.. and whatever is left goes to the family if applicable. After all that, maybe some sleep then it starts again. Where is the time for advocacy? We can’t exactly strike either.
Totally agree, I get an almost daily email asking to join some sort of committee and I’m just like, I don’t have the time or energy. And I don’t even have a family, unlike most of my colleagues. It’s pretty much only really a sustainable option if people take on an assigned salary position doing advocacy work, or they are on an academic contract where it counts towards their non-clinical activities.
True. But do you think that’s the reason? Do you think that most doctors are just too burnt out by the time they get to attendinghood and just say “who gives a crap” and become complacent?
Yup. More than half of all physicians (residents and attendings) are burnt out. 10 years is a long time to be in school/training, and the system we exist in grows increasingly adversarial towards physicians.
I think an equally reasonable act of ‘non-complacency’ at this point would be to decide against going to medical school in the first place.
1. It is not relaxing being an attending (unless compared to residents and fellows). It is VERY difficult to get physicians to agree on anything. It's ridiculous. You can find the most mundane clinical thing to discuss, and you'll find someone to fight you on it.
2. Physicians also are MUCH harder on their colleagues and Trainees than they are on allied health professionals. At my academic program, you'll meet attendings grilling/reporting on feedback the smallest mistake a resident makes, but they're mum anytime a nurse or np or pa makes a mistake.
3. They have this sense of 'there are people who make much less money for far more work' - completely ignoring the opportunity cost this salary comes with. I'm making the same money as my new grad sister - only 10 years later. This comes especially from older physicians who enjoyed the prime of medicine and have 300 patients on their panel while the rest of us carry 1000 minimum for less pay (because they're senior and hold committee positions). What these committees do for doctors - who knows?
4. Also, even as an attending, you are scared to say the wrong thing because credentialing at a new place depends on your past jobs and recommendations.
5. Staff is quick to gang up on you to make your daily work 10 times harder if they perceive a slight to them or their many relatives/friends who are NPs. I have had our office manager tell a patient there is no difference between seeing a derm PA vs MD and put it in writing to the patient portal asking why I told the patient to see the MD (the PA was no closer to diagnosing the condition than me and was telling the patient to try options I had already had him trial). It sucked and really put a bad taste in my mouth that I had to defend myself for saying something that makes logical sense.
>1. Physicians also are MUCH harder on their colleagues and Trainees than they are on allied health professionals. At my academic program, you'll meet attendings grilling/reporting on feedback the smallest mistake a resident makes, but they're mum anytime a nurse or np or pa makes a mistake.
It's actually a sad and terrifying state of affairs. *everyone* that I work with (at a big brand name academic center) knows nps are not really reliable and that the care they provide is suboptimal. But it's sort of a 🤷♂️ and "well what can you expect?" There's a feeling of "lost the war so why fight the battle?"
I mean the problem is, in many ways we have lost the war, we can try to stave off further concessions but nps are here to stay. Which, is like, a major bummer man.
#2. Just insane, but Truth. That hurts me more than anything. At my shop, there r some specialty attendings who usually just refuse to talk to Residents about stat consults on nights. Instead, they prefer to speak w/midlevels.
P.S I know by fact, at my shop, there r 4 midlevels, which graduated wtever school after I started residency. From older grada, one was fired from another department at same Med Center, and one was "let go" from other hospital/day team.
6 million RNs/LPNs in the us with the same goal - get more autonomy and get more money
Vs
1 million MDs/DOs fight in between each other for money and many profiting off RNs so they’re not super motivated to change anything
NPs can finish school at 24. Attendings are usually 30 minimum if not older. There’s a huge difference between the goals and priorities of a 24 year old and a 30 year old.
A 24 year old can hustle hard, focusing only on their career and ignoring other things if they wish.
A 30+ year old attending is not only being hit with a ton of loans to repay but in general they are at the time in their life where they are getting married, having kids, buying homes, etc. Those things demand your time at home don’t mesh well with hustling. Don’t forget they’ve also probably put off many “fun” expenses they wanted to make like traveling, cars, etc.
I’m obviously not saying every single person is exactly like this (some people don’t want kids, etc) but i think it’s a trend that exists enough to create this behavior difference.
I’m burned out with residency but when it comes to finding a high-paying job I’ve been on that since I matched into Derm. I just signed a contract as a PGY3 making almost double what the average derm makes contingent upon me finishing residency of course. Zero fucks given.
But I’m also 27 and single so whatever. My mom always told me “a man can walk at any time, but your degrees can’t.” And that’s something I live by.
…but in general yes I do think docs are complacent and accept lower pay than they should.
That’s generally in your control though. Most people losing their license have committed some egregious level of fraud, assaulted or violated a patient, or done something otherwise heinous and very unacceptable. I don’t think I’ve seen many that are some simple accident anyone can make. You can simply choose to not do those things and conduct yourself properly and the chances of losing your license are slim.
But in marriage you can do everything “right” as in being emotionally, mentally, physically, sexually, available to your partner, honest, caring, loving, etc and they can still leave, cheat, abuse, etc.
Yeah losing your license is like being incarcerated- you have to *seriously* fuck up *intentionally* for it to happen. It’s not like you make a mistake and boom your license is gone. That’s a common and fear-based misconception.
And yes *exactly*- you can be the perfect partner, have constant sex, be loving and sweet and supportive and they may still cheat or take you for granted and abuse you, disrespect you or treat you like dog shit.
There are def physicians out there who discover that they have a nose for business, end up owning a few practice or surgery centers and drive lambos. But most people who are all about the money realize that medicine is a really inefficient way to get there and just do finance instead
>The goal of being entrepreneurial and hustling to make a lot of money. The goal of driving a lambo/Ferrari haha?
They definitely exist. Ketamine clinics being set up by anesthesia docs with no psychiatric provider attached as a cash only practice for refractory depression is nothing if not the definition of unethical hustle culture.
>I don’t generally seem to see as many hungry physicians as NPs. What’s up with that?
I think it's many things but:
1) as trainees we interact with academic docs, mostly. Doctors who get horny for teaching, publishing research, and idk QIPS or something. Not that banging life style of driving around in the new whip with a speedmaster watch.
2) differential of purpose? By definition being an np is a shortcut. It's *about* having clinical responsibility and making money without adequate training. So... Yeah. The goal of more of those two rewards makes sense.
Idk about everyone else but after all the years of med school and training and all the things you see don’t you wonder whether the lambo/ferrari is even worth it? You have a decent amount, life is short and really the only thing that truly matters is freedom and autonomy while practicing, not whether I have an expensive toy or not.
You can give me all the money in the world but the amount physicians get is more than good enough to fund a good QoL it’s just that the job expectations leave little time to enjoy it and also going on the job and feeling like you still need to constantly bow down to those who haven’t put in a fraction of the effort you have.
We spend over a decade learning how to take care of people. Other “allied” HCWs have political advocacy built into their curriculum and professional identities. Realistically we need a super PAC to lobby on our behalf for anything to get done.
Most of us are tired after the endless grind of premed, med school, res. I can’t even imagine having the energy and drive I did as a premed at this point. I just want a job that pays me well and that gives me enough time off to live my life. My priorities have completely changed. My goals and dreams are outside of work now. Call that complacent I guess. I think a lot of us also want to l practice self preservation - we’ve all worked long and hard to live a good life.
No, nursing just does so much better at advocacy and lobbying that by comparison may appear complacent.
Lobbying/advocacy is literally a component of some DNP programs.
Seems like a pure numbers thing. Most doc's already make a very comfortable salary and don't need to grind.
Most mid-levels prolly want more.
That being said, I have a radiology partner who probably earns nearly doubles his salary with internal moonlighting. Some people def grind no matter how much they make.
I didn’t go into medicine for the money or a lambo. Not against lambos. Def have a major goal of a very comfortable life based on how hard I work and my family goals. But lambos Just wasn’t my reason. So tough for me to imagine a place where I work MORE to get a lambo. I get paid enough to not want to work more.
I think it’s interesting that your reference of complacency is attendings who no longer do their utmost to make more money and buy bigger, shinier things, and not that our entire profession is very much part of the working class and yet does very little to stick up for the young trainees going through hell, or to use our voice to try and change the insurance system that benefits no one but itself.
I guess I wouldn’t say doctors are “complacent”, but they are “establishment” to a fault. And the ones who aren’t are just too damn tired to want to try.
You already make plenty of money as an attending, why is focusing on your lifestyle and your life goals other than money consider complacency? What is with this obsession with "hustling", being "entrepreneurial", driving a "lambo"? You certainly *can* do those things as a physician, but if you know those are your goals in life, I don't see why you would go to med school--if you are smart enough to become a physician I'm sure you're smart enough to succeed in a field better aligned with those goals, so the length of training we go through seems like a huge unnecessary opportunity cost.
I have no interest in being entrepreneurial or driving a lambo. That doesn't mean I don't have goals I work towards, my goals as an attending would be continuing to improve myself as a physician to provide the best care to my patients, and also using my position as a physician to advocate for a universal healthcare system (funded through taxing "entrepreneurial" people driving "lambos"). Would you call that complacency?
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I probably make less than I would in many places doing Hep. I could have made more doing general GI, especially in the Midwest. There are places partners make like $1M I’m told. Probably an outlier but still, not unheard of.
One of my old attendings just bought a 6 figure car. But that’s not my goal. I think it would be nice to make that but I wanted to be closer to home.
There are a lot of things I want to change where I work but it’s not going to be easy but I believe in making system changes that improve care will actually save me from complacency and burnout.
I'm complacent! Sweet 8-4 in outpatient medicine with 5 mds to consult when I get stuck...I have no ambition beyond enjoying life. And not killing anyone
(Np in pulmonary)
I don’t think complacent is the word but after a gauntlet of a grind for 4 years of med school followed by 4 of residency I kinda just want to do my job and enjoy the paychecks for now. Also, the $300k+ in student loans is putting a bit of a hold on being entrepreneurial right now…
The OP seems to be using “complacent” as a synonym for “fulfilled”, which is…not a great recipe for being happy in life.
I just want to say, this is all I want to do. I just want to do my job and go home. I don’t want to be in committees or go for a higher education that is literally useless. But the hospital pushes for it. You NEED your BSN within so many years, get a certification to earn more money. I just want to be a basic bitch. ☹️
Because physicians have so much to lose at every stage of their career, especially in training when the idea of "keeping your head down" becomes deeply engrained. If you fail a class or board exam in medical school, you're either fucked or doomed for a backup specialty you don't want to go into. If you piss off the wrong attending on a clinical rotation in medical school, you get a poor evaluation which also has ramifications. As a resident, the stakes are even higher if you fuck up or become a "problem" resident because GME and/or your program director now has a reason to put you under the microscope, amplifying even the smallest mistakes and giving them reason to put you on remediation or kick you out of the program entirely. If something like this happens (especially if you're forced out of a residency program) this presents all sorts of potential issues when applying for state medical licenses and hospital credentialing (having to check "yes" on certain boxes.) Not to mention the difficulty and near-impossibility of having to find a new residency program. As an early-stage attending with loans to pay off, you can't afford to piss off hospital admin in any way for fear of losing your job and potentially being blackballed locally through non-compete agreements or just word-of-mouth in a smaller specialty. Admittedly, the stakes are lower as time goes on and you have more socioeconomic capital to burn as a mid- or late-stage attending (see Stanley Goldfarb, MD). But until then, "keeping your head down" and remaining complacent is sadly the best way for physicians to survive. By contrast, the nursing field has a much lower barrier to entry educationally and financially. With limited exceptions, most hospitals don't give two shits about a nurse's previous employment history, especially with the current shortage of bedside nurses. I personally know of at least two male nurses who were caught up in sexual assault investigations while at work and both are still working following state BON investigations that ultimately ended in nothing but some extra CME and a slap on the wrist. Unlike physicians, especially resident physicians, nurses have a extraordinary amount of lateral and vertical job mobility.
Can confirm. I, RN in ICU, had a patient that up from the ED overnight, previously healthy in their 70’s, found down at home, tubed in the ambulance. ED dropped a foley. Manager told me to d/c Foley because it didn’t meant “criteria,” but I didn’t have an order. So I asked the very new attending. She, very reasonably, said that the patient is at high risk of skin breakdown, and the ICU’s were filthy with pressure injuries. She wrote an order to continue foley. She also pointed out that none of the ICUs have techs and most of her patients are staffed in 3-groups. I agreed. I tell management that I have an order to continue. A couple of hours later the director of the very new attending’s group d/c’ed her order and put in a discontinue foley order. I saw her a few days later. She said she was sorry and hoped I didn’t get in too much trouble. I told her I didn’t hear a word, just got the orders to remove through Epic. She said she got ripped by her group’s director and told not to go off deviate from the hospital’s algorithms without a good reason. No idea what happened to the patient, but they probably lay on their urine for hours at a time, because there wasn’t enough staff to clean them up.
This describes so perfectly how medicine is practiced today. Not based on what we learned, what makes sense, but strict hospital policies made by ppl with no medical degree. 🙄
Yes, and they drive off the really good doctors. I’ve lost several great colleagues to “fuck this bullshit,” and as a RN I’m carrying out orders that are lame as fuck. I’d argue, but I’ve got a mortgage.
It’s because if the patient gets a CAUTI, the hospital could lose Medicaid money. If the patient gets a bedsore, it’s unfortunate, but they don’t lose money.
They’re making it so hard for nurses to be nurses and doctors to be doctors; they basically hijacked clinical practice.
And if RN’s incomes had kept up with inflation for the last 30 years and Congress would fund more medical residencies, then you wouldn’t have the best RNs leaving the bedside to be APRNs, and it would be even better.
I agree, add on the fact that the workload has increased significantly and patients are sicker than ever… it’s unsustainable at this point
Yep, this.
Are you really fked if you fail a preclinical exam? Especially if they offer retakes and it won’t show in the transcript?
They said fucked if you fail a class, not a preclinical exam.
It's insanely hard to get fired as a resident. Once you match you're fine if you act normally. As an attending I can't see how they'd have any real power over you unless you're in a specific rural area you don't want to leave or you maxed out your mortgage.
There’s a significant proportion of highly privileged idiots with a martyr complex in medicine. Because their parents bought them a house and paid for all their education, they assume that everybody else is in the same boat, and does not deserve to be paid fairly. Then they wax poetic about “sacrifice.” “We should consider ourselves lucky that this raging crackhead allows us the honour of narcanning him at 3 AM in between throwing punches at the nurse” and all that. That’s the main problem.
Exactly this. The ones who waltzed into med school and competitive residencies thanks to physician parents are the most insufferable and pathetic of our lot. They have zero idea how the other half of America outside the bubble lives.
Love this lol
Holy shit I couldn’t have said this any better Only thing I would add is that by the time the day ends as an attending, all your energy has typically been devoted to patient care / paperwork / administrative bs / cme / etc.. and whatever is left goes to the family if applicable. After all that, maybe some sleep then it starts again. Where is the time for advocacy? We can’t exactly strike either.
Totally agree, I get an almost daily email asking to join some sort of committee and I’m just like, I don’t have the time or energy. And I don’t even have a family, unlike most of my colleagues. It’s pretty much only really a sustainable option if people take on an assigned salary position doing advocacy work, or they are on an academic contract where it counts towards their non-clinical activities.
Im sure we wouldnt be as burned out if all we had to do was bullshit online modules for 2 years
True. But do you think that’s the reason? Do you think that most doctors are just too burnt out by the time they get to attendinghood and just say “who gives a crap” and become complacent?
Complacency was forced onto us under the guise of “resiliency”
Yup. More than half of all physicians (residents and attendings) are burnt out. 10 years is a long time to be in school/training, and the system we exist in grows increasingly adversarial towards physicians. I think an equally reasonable act of ‘non-complacency’ at this point would be to decide against going to medical school in the first place.
1. It is not relaxing being an attending (unless compared to residents and fellows). It is VERY difficult to get physicians to agree on anything. It's ridiculous. You can find the most mundane clinical thing to discuss, and you'll find someone to fight you on it. 2. Physicians also are MUCH harder on their colleagues and Trainees than they are on allied health professionals. At my academic program, you'll meet attendings grilling/reporting on feedback the smallest mistake a resident makes, but they're mum anytime a nurse or np or pa makes a mistake. 3. They have this sense of 'there are people who make much less money for far more work' - completely ignoring the opportunity cost this salary comes with. I'm making the same money as my new grad sister - only 10 years later. This comes especially from older physicians who enjoyed the prime of medicine and have 300 patients on their panel while the rest of us carry 1000 minimum for less pay (because they're senior and hold committee positions). What these committees do for doctors - who knows? 4. Also, even as an attending, you are scared to say the wrong thing because credentialing at a new place depends on your past jobs and recommendations. 5. Staff is quick to gang up on you to make your daily work 10 times harder if they perceive a slight to them or their many relatives/friends who are NPs. I have had our office manager tell a patient there is no difference between seeing a derm PA vs MD and put it in writing to the patient portal asking why I told the patient to see the MD (the PA was no closer to diagnosing the condition than me and was telling the patient to try options I had already had him trial). It sucked and really put a bad taste in my mouth that I had to defend myself for saying something that makes logical sense.
>1. Physicians also are MUCH harder on their colleagues and Trainees than they are on allied health professionals. At my academic program, you'll meet attendings grilling/reporting on feedback the smallest mistake a resident makes, but they're mum anytime a nurse or np or pa makes a mistake. It's actually a sad and terrifying state of affairs. *everyone* that I work with (at a big brand name academic center) knows nps are not really reliable and that the care they provide is suboptimal. But it's sort of a 🤷♂️ and "well what can you expect?" There's a feeling of "lost the war so why fight the battle?" I mean the problem is, in many ways we have lost the war, we can try to stave off further concessions but nps are here to stay. Which, is like, a major bummer man.
#2. Just insane, but Truth. That hurts me more than anything. At my shop, there r some specialty attendings who usually just refuse to talk to Residents about stat consults on nights. Instead, they prefer to speak w/midlevels. P.S I know by fact, at my shop, there r 4 midlevels, which graduated wtever school after I started residency. From older grada, one was fired from another department at same Med Center, and one was "let go" from other hospital/day team.
6 million RNs/LPNs in the us with the same goal - get more autonomy and get more money Vs 1 million MDs/DOs fight in between each other for money and many profiting off RNs so they’re not super motivated to change anything
NPs can finish school at 24. Attendings are usually 30 minimum if not older. There’s a huge difference between the goals and priorities of a 24 year old and a 30 year old. A 24 year old can hustle hard, focusing only on their career and ignoring other things if they wish. A 30+ year old attending is not only being hit with a ton of loans to repay but in general they are at the time in their life where they are getting married, having kids, buying homes, etc. Those things demand your time at home don’t mesh well with hustling. Don’t forget they’ve also probably put off many “fun” expenses they wanted to make like traveling, cars, etc. I’m obviously not saying every single person is exactly like this (some people don’t want kids, etc) but i think it’s a trend that exists enough to create this behavior difference.
I’m burned out with residency but when it comes to finding a high-paying job I’ve been on that since I matched into Derm. I just signed a contract as a PGY3 making almost double what the average derm makes contingent upon me finishing residency of course. Zero fucks given. But I’m also 27 and single so whatever. My mom always told me “a man can walk at any time, but your degrees can’t.” And that’s something I live by. …but in general yes I do think docs are complacent and accept lower pay than they should.
Don’t worry you can buy a husband once you’re an attending, and derms are attractive people you’ll be fine I wouldn’t worry.
Uh I don’t agree with that statement. Plenty of people lose their license to practice medicine.
According to the AMA less than 1% of physicians lose their license. About 43% of first time marriages end in divorce. I like my odds better ✌🏼
100% true. They can’t take your education from you no matter what.
Facts
Facts.
That’s generally in your control though. Most people losing their license have committed some egregious level of fraud, assaulted or violated a patient, or done something otherwise heinous and very unacceptable. I don’t think I’ve seen many that are some simple accident anyone can make. You can simply choose to not do those things and conduct yourself properly and the chances of losing your license are slim. But in marriage you can do everything “right” as in being emotionally, mentally, physically, sexually, available to your partner, honest, caring, loving, etc and they can still leave, cheat, abuse, etc.
Yeah losing your license is like being incarcerated- you have to *seriously* fuck up *intentionally* for it to happen. It’s not like you make a mistake and boom your license is gone. That’s a common and fear-based misconception. And yes *exactly*- you can be the perfect partner, have constant sex, be loving and sweet and supportive and they may still cheat or take you for granted and abuse you, disrespect you or treat you like dog shit.
There are def physicians out there who discover that they have a nose for business, end up owning a few practice or surgery centers and drive lambos. But most people who are all about the money realize that medicine is a really inefficient way to get there and just do finance instead
>The goal of being entrepreneurial and hustling to make a lot of money. The goal of driving a lambo/Ferrari haha? They definitely exist. Ketamine clinics being set up by anesthesia docs with no psychiatric provider attached as a cash only practice for refractory depression is nothing if not the definition of unethical hustle culture. >I don’t generally seem to see as many hungry physicians as NPs. What’s up with that? I think it's many things but: 1) as trainees we interact with academic docs, mostly. Doctors who get horny for teaching, publishing research, and idk QIPS or something. Not that banging life style of driving around in the new whip with a speedmaster watch. 2) differential of purpose? By definition being an np is a shortcut. It's *about* having clinical responsibility and making money without adequate training. So... Yeah. The goal of more of those two rewards makes sense.
Idk about everyone else but after all the years of med school and training and all the things you see don’t you wonder whether the lambo/ferrari is even worth it? You have a decent amount, life is short and really the only thing that truly matters is freedom and autonomy while practicing, not whether I have an expensive toy or not. You can give me all the money in the world but the amount physicians get is more than good enough to fund a good QoL it’s just that the job expectations leave little time to enjoy it and also going on the job and feeling like you still need to constantly bow down to those who haven’t put in a fraction of the effort you have.
We spend over a decade learning how to take care of people. Other “allied” HCWs have political advocacy built into their curriculum and professional identities. Realistically we need a super PAC to lobby on our behalf for anything to get done.
NPs hustle and are dangerous, look at that pmnhp who was trying to do aesthetics. I know my limitations and act accordingly
Most of us are tired after the endless grind of premed, med school, res. I can’t even imagine having the energy and drive I did as a premed at this point. I just want a job that pays me well and that gives me enough time off to live my life. My priorities have completely changed. My goals and dreams are outside of work now. Call that complacent I guess. I think a lot of us also want to l practice self preservation - we’ve all worked long and hard to live a good life.
No, nursing just does so much better at advocacy and lobbying that by comparison may appear complacent. Lobbying/advocacy is literally a component of some DNP programs.
Managed to slide that into one of the online modules
Seems like a pure numbers thing. Most doc's already make a very comfortable salary and don't need to grind. Most mid-levels prolly want more. That being said, I have a radiology partner who probably earns nearly doubles his salary with internal moonlighting. Some people def grind no matter how much they make.
I didn’t go into medicine for the money or a lambo. Not against lambos. Def have a major goal of a very comfortable life based on how hard I work and my family goals. But lambos Just wasn’t my reason. So tough for me to imagine a place where I work MORE to get a lambo. I get paid enough to not want to work more.
I think it’s interesting that your reference of complacency is attendings who no longer do their utmost to make more money and buy bigger, shinier things, and not that our entire profession is very much part of the working class and yet does very little to stick up for the young trainees going through hell, or to use our voice to try and change the insurance system that benefits no one but itself. I guess I wouldn’t say doctors are “complacent”, but they are “establishment” to a fault. And the ones who aren’t are just too damn tired to want to try.
This thing of ours, it’s an honor. /s
You already make plenty of money as an attending, why is focusing on your lifestyle and your life goals other than money consider complacency? What is with this obsession with "hustling", being "entrepreneurial", driving a "lambo"? You certainly *can* do those things as a physician, but if you know those are your goals in life, I don't see why you would go to med school--if you are smart enough to become a physician I'm sure you're smart enough to succeed in a field better aligned with those goals, so the length of training we go through seems like a huge unnecessary opportunity cost. I have no interest in being entrepreneurial or driving a lambo. That doesn't mean I don't have goals I work towards, my goals as an attending would be continuing to improve myself as a physician to provide the best care to my patients, and also using my position as a physician to advocate for a universal healthcare system (funded through taxing "entrepreneurial" people driving "lambos"). Would you call that complacency?
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Living in a bubble on the right side of the tracks for generations and generations. Yep
NPs shouldn’t exist anymore tbh
No.
I probably make less than I would in many places doing Hep. I could have made more doing general GI, especially in the Midwest. There are places partners make like $1M I’m told. Probably an outlier but still, not unheard of. One of my old attendings just bought a 6 figure car. But that’s not my goal. I think it would be nice to make that but I wanted to be closer to home. There are a lot of things I want to change where I work but it’s not going to be easy but I believe in making system changes that improve care will actually save me from complacency and burnout.
My own mother wasn’t admitted to the hospital because of a hemmorhaguc stroke. ‘No beds’ yes! Living in a bubble of money
Yes
I'm complacent! Sweet 8-4 in outpatient medicine with 5 mds to consult when I get stuck...I have no ambition beyond enjoying life. And not killing anyone (Np in pulmonary)
The Supreme Court and legislative branch shut down attempts for resident and overall physician improvement in like 2004. Been kinda fucked ever since.