Discouraged by mentors re: peds/ICU

[Nivens]

Hi everyone- happy friday

I am experiencing a lot of mixed emotions about my choice of career and I was hoping the power of groupthink could help me sort some of them out. I am a third year (male- I'm not sure why I thought that was relevant...) student who was CERTAIN I was going into anesthesia when I started med school. However, I realized 2 things pretty early on: 1) I love working with kids and 2) I love the ICU. Both revelations were completely unexpected, but that's life for you. Anyways- the more I hung around the PICU, the more excited I got, and before long I was answering everyone's favorite question to ask a med student- "What are you going to specialize in?"- with variations on "Pediatrics/PICU."

This is where things began to get problematic. My family, friends and lifetime medical mentors did not share my enthusiasm. It got worse when my Step 1 score came back high enough to do more "desirable" and lucrative things like orthopedics (which everyone assumes I already do anyways- I stand 11 feet tall), dermatology and ENT. Comments have ranged from "Are you sure???" and "I hope you're independently wealthy," to "You will be absolutely miserable, no question.", and almost all end in a sales pitch for one of the aforementioned fields.

So far I've dealt with it ok- there has been some occasional wavering and private negotiation with myself ("Maybe I can stand pediatric ortho...") but the medicine that fascinates me is critical care and the population I want to treat are kids. I am 99.9% ok with every aspect of my decision except for one thing- money.

Gasp, I know- how dare I speak that word! Hearsay! Sin! But hear me out.

I am in debt. Crazy debt. I went to a private undergrad, and am attending a private medical school without scholarships. I one day want to have a huge family and be able to provide for them all of the fantastic opportunities my parents worked so hard to provide me. I want my wife to be able to be a stay-at-home mom (because that is her dream, and I respect that). I want to be able to help my parents, and her parents, if they need it. I don't need a fancy car, or a big house, but I went to school a really long time, worked really hard, and am terrified I was called to one of the few medical specialties that might leave me unable to dig us out of this hole, much less ever get us ahead. I am just so scared of making a decision that I am going to regret later on. Any advice/insight/encouragement would be greatly appreciated.

Much love,
McTwisp

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[MEN2C]

Pediatrics makes some of the lowest salaries yet are on the top five of 'very satisfied'. The other top four? Geriatrics IM, Infectious Disease, Dermatology, and Neonatal and Perinatal medicine. So one is another pediatrics subspecialty, two are some of the lowest paying specialties, and there's dermatology (which,to be fair, does always rank high as well). Orthopedics surgery is not in the top 15. Why are so many people unhappy? Lots of reasons. One is that people who go into a specialty because it's the one that loved generally end up happy so those who loved ortho are happy in ortho and those who loved peds are happy in peds. But those who loved peds and went into Ortho might very well regret their life when they end up always thinking about the 'what if I was doing something I loved instead of doing this procedure on Friday night at 8pm in the hospital?' Whatever specialty you do, you will spend a large part of you waking life doing. If you hate that part of your life, the other parts of your life likely won't make up for that.

 

[mvenus929]

So... good news and bad news. Good news is that a PICU fellowship is one of the few pediatric subspecialties that actually pays off in the long run. The bad news is that they still don't make a ton of money compared to a lot of specialties. If you have crazy amounts of debt, it will be difficult to pay off your loans and do everything that you want to do (including allowing your wife to be a SAHM). I'm sure it's possible, but it will be difficult, particularly since for the first six years of your paid career, you're going to be making relatively little.

That said, if you really like PICU, then it's not out of the question. You may be able to get some of your loans paid for if you work for a non-profit for some time after you finish fellowship. And if it's what makes you happy, you're going to be much happier in the long run than if you went into something just for the money.

 

[michigangirl]

I would have recommended doing a combined pediatrics and anesthesia residency based on your interests BUT the extra years of training may be a dealbreaker for the resident/fellow salary an additional 2-3 ears. I have PICU colleagues who are making 300+ -- but they are not in academics. I'll be honest with you, most things in academics don't pay as well as out in the community. Another option is to do anesthesia followed by a 1 year peds anesthesia fellowship, which will offer many of the benefits of ICU, but again, if you stay in academics, the salary profile goes down compared to private practice. But anesthesiologists do make a bit more. But not a reason to do anesthesia.

I understand you're in debt. But you are very passionate about your career choice, and you will make it work if you need to. You will definitely make more than a general pediatrician. It's a challenging career, but it seems that's what you want. No regrets, friend. The vast majority of my PICU colleagues including myself started their faculty positions with major educational debt. But they go home at the end of every shift or call doing what they love-- and everyone is comfortable. I can't dream of doing anything else.

Happy to discuss more by pm if you like. Remember, there are programs for loan repayment (i.e. free money from NIH), service-- this is by no means a dealbreaker.

 

[Giic]

Hi everyone- happy friday

I am experiencing a lot of mixed emotions about my choice of career and I was hoping the power of groupthink could help me sort some of them out. I am a third year (male- I'm not sure why I thought that was relevant...) student who was CERTAIN I was going into anesthesia when I started med school. However, I realized 2 things pretty early on: 1) I love working with kids and 2) I love the ICU. Both revelations were completely unexpected, but that's life for you. Anyways- the more I hung around the PICU, the more excited I got, and before long I was answering everyone's favorite question to ask a med student- "What are you going to specialize in?"- with variations on "Pediatrics/PICU."

This is where things began to get problematic. My family, friends and lifetime medical mentors did not share my enthusiasm. It got worse when my Step 1 score came back high enough to do more "desirable" and lucrative things like orthopedics (which everyone assumes I already do anyways- I stand 11 feet tall), dermatology and ENT. Comments have ranged from "Are you sure???" and "I hope you're independently wealthy," to "You will be absolutely miserable, no question.", and almost all end in a sales pitch for one of the aforementioned fields.

So far I've dealt with it ok- there has been some occasional wavering and private negotiation with myself ("Maybe I can stand pediatric ortho...") but the medicine that fascinates me is critical care and the population I want to treat are kids. I am 99.9% ok with every aspect of my decision except for one thing- money.

Gasp, I know- how dare I speak that word! Hearsay! Sin! But hear me out.

I am in debt. Crazy debt. I went to a private undergrad, and am attending a private medical school without scholarships. I one day want to have a huge family and be able to provide for them all of the fantastic opportunities my parents worked so hard to provide me. I want my wife to be able to be a stay-at-home mom (because that is her dream, and I respect that). I want to be able to help my parents, and her parents, if they need it. I don't need a fancy car, or a big house, but I went to school a really long time, worked really hard, and am terrified I was called to one of the few medical specialties that might leave me unable to dig us out of this hole, much less ever get us ahead. I am just so scared of making a decision that I am going to regret later on. Any advice/insight/encouragement would be greatly appreciated.

Much love,
McTwisp

You should never go into a medical specialty based on how much money you think you're going to make for it. I'm sorry, I might sound old-fashioned. But medicine should be a calling that defines your life, and you really should enjoy it for the most part (minus minor irritations here and there in your job). It really should not be just a job. Therefore, I will advise you to absolutely go into PICU if indeed you feel strongly about it. You will be a better doctor doing what you love, than doing what pays higher.

Secondly, I will say - I know lots of PICU doctors in private practice who, with a combination of moonlighting coverage, make >500K per year. Of course, they have no free time, as they spend all their days off moonlighting at different hospitals to make this money. But you can do that for a few years.

 

[ruralsurg4now]

I'm not in Pediatrics at all, but I will say that in my medical school we had a guy who was AOA and he decided to go into Psychiatry. When I heard that, I was like "what?" but I guess that's on me. That guy was more mature than a lot of people and he wanted to pursue something he was interested in. Keep in mind that whatever you decide to do, you'll be doing for decades. If you're doing something you can only maybe think about tolerating, you'll find yourself either bitter or burned out pretty quickly. Especially when it comes to being in the OR. It's like if you stuck me in Radiology. Some people would just be focued on the money or lifestyle, I'd be wondering where the light switch was and climbing the walls after about two days.

You may have crazy debt, but you WILL be able to pay it off as a physician. It may take you longer or you may have to not live what you perceive as "the doctor lifestyle," but so what? If you don't need a big house or a fancy car, you'll do fine because the whole "keeping up with the Joneses" mentality is what really puts a financial strain on physicians.

Lastly, why are you listening to other people? Clearly the only thing important to them is "how much money will this specialty make?" There's literally no concern for whether you like it or not. Based on that, you should have gone into business and tried to become a hedge fund manager or something. Would you listen to people if they told you to do that? Why not? (Or if you would, then you're screwed, lol.)

 

[ruralsurg4now]

and there's dermatology (which,to be fair, does always rank high as well)

This is probably unfair and rude of me to say, but that's probably because people who go into Derm, I think, find happiness in money. Like, honestly, how does anyone get excited about treating acne and wrinkles? The only think they ever talk about is how much money they make. I'd probably need to start using drugs if I woke up one day and found out I was a Dermatologist.

 

[bowlofmushypeas]

This is probably unfair and rude of me to say, but that's probably because people who go into Derm, I think, find happiness in money. Like, honestly, how does anyone get excited about treating acne and wrinkles? The only think they ever talk about is how much money they make. I'd probably need to start using drugs if I woke up one day and found out I was a Dermatologist.

That is unfair and rude.. with a spouse and friends who will (cross your fingers!) and have gone into derm as well as a strong personal consideration I had with going to derm, I roll my eyes at people who think derm happiness comes solely from money and lifestyle. Yes, I actually do find acne interesting--maybe not a few whiteheads, but I've absolutely seen it devastate lives. There are really awesome autoimmune conditions, infectious diseases particularly overseas, weirdo cancers, congenital conditions, phakomatoses.. on the other hand, how does anyone get excited about doing surgery? To each her own.

To the OP, I've had the same concerns though my interests are even less financially "practical" because the subspecialties I'm considering are more academic and less procedure = less $ than most gen peds. Family have also been grudgingly supportive about the financial aspects because it can hard to understand why people wouldn't just pick the highest paying position for their Step score. I definitely think money and lifestyle should be important considerations just like they are in ANY field--we just don't like to admit in medicine, but it's also only a fraction of the big picture. On rotations, I've met everyone from the least to most enthusiastic about peds and other fields so I suspect that the culture in medicine is just a big judgefest unfortunately and should be largely ignored unless they come from a place of personal experience or facts.

For what it's worth, I've met plenty of subspecialists in my position and those in yours who have gone into higher paying fields like PICU and safely supported large families including parents and a stay-at-home spouse. I'm not sure that they had fancy cars, but that doesn't sound important to you anyways. What I have found is that the few peds who end up disliking their jobs often stress the busy lifestyle (e.g. PICU) rather than the $ aspect. The vast majority of PICU docs I've met, however, have been super bright, happy, and well-rounded folks!

 

[oldbearprofessor]

Please keep a discussion about the pros and cons of dermatology as a career out of the pedi forum.

 

[bowlofmushypeas]

Please keep a discussion about the pros and cons of dermatology as a career out of the pedi forum.

Sorry OBP! Couldn't help myself. Hopefully OP is finding opinions helpful nonetheless

 

[Nivens]

I definitely am- thanks everyone for talking me down off the proverbial ledge.

It's amazing to me how difficult we make committing to a specialty on ourselves. My classmate and I were discussing her career prospects, and she confessed that she really loved her OB-GYN rotation. So naturally, I asked if that was her working diagnosis going forward, and she replied "Oh no- I could never introduce myself as an OB-GYN. I think I'll just do radiology, they have a great life." (she hated her rads rotation)

Anyway- I feel much better about my decision. Look for another post in a month when this dose of resolve wears off

 

[ruralsurg4now]

she replied "Oh no- I could never introduce myself as an OB-GYN. I think I'll just do radiology, they have a great life." (she hated her rads rotation)

Well, you can hate a rotation without hating the specialty, for example if it just stinks at that rotation. But if she hates the specialty and is going into it, she's going to get a rude awakening rather quickly.

 

[Cuthbert]

So far I've dealt with it ok- there has been some occasional wavering and private negotiation with myself ("Maybe I can stand pediatric ortho...") but the medicine that fascinates me is critical care and the population I want to treat are kids. I am 99.9% ok with every aspect of my decision except for one thing- money.

Gasp, I know- how dare I speak that word! Hearsay! Sin! But hear me out.

It's ok, money does make a difference. With that said, do what makes you happy. When I told my mentors/attendings I was going into peds, they all had the same responses as yours. But I could not see myself doing anythings else. I think that many physicians are unhappy with the decision that they themselves made, and they feel the need to justify that decision by putting other specialties down: "I wouldn't do peds; they don't make any money." or "I wouldn't do OB/GYN; they get sued all the time." or "I wouldn't do rad; all those guys do is count their gold bullions in the dark."

You can make money in peds by the way. I'm not specialized, but I make good money because I joined the right group in the right city (for me). Life is crazy and busy; but overall, I'm very happy with my decision.

 

[Nivens]

Ka-tet

Thankee-sai

 

[PinkBeta84]

From my experience, the ROAD aside, there are more negative/discouragement given when asking for advice when it comes to committing to a specialty. OB/Gyn is one of the worst.

 

[thekuch1144]

Well, you can hate a rotation without hating the specialty, for example if it just stinks at that rotation. But if she hates the specialty and is going into it, she's going to get a rude awakening rather quickly.

Seconded. I hated my peds rotation, was at a county hospital where we had more interns+med studs than patients. Still decided I liked peds, and loved my sub-I at the city children's hospital, it was night and day.

To respond directly to OP, you're going to be doing what you go into for 50+ hours a week, 48+ weeks a year, for 30+ years. When it's all said and done, going into a less well reimbursed field will make those first 5-10 years a little tougher. When you're old and grey with a bunch of little grand-Nivens running around, no one ever says they'd go back and do something they hate more for a little more money.

 

[slford00]

I know this thread is a few months old, but I'll go ahead and throw in my two cents in case Nivens is still out there listening.

(I'm a Peds resident starting NICU in July)

You should absolutely do Peds/PICU if that's what you love the most, for reasons many people have already outlined. If you live to have a long, fulfilling career, I don't think you're going to look back on your career from your deathbed and say "Man, I really wished I had saved a lot fewer toddlers' lives who have gone on to have long lives, careers, and families of their own so that instead I could have made 400+ a year treating skin cancer instead of 200-250/yr in the PICU."

Peds ICU isn't adult cardiology or radiology, but it is plenty lucrative for someone who doesn't want a multimillion dollar mansion and private plane.

And one crucial point that's has barely been alluded to: thanks to the federal Public Service Loan-Forgiveness Program, if you make IBR payments on your loans for 10 years while working at a non-profit hospital (and essentially every children's hospital is non-profit), your federal student loan debt will be forgiven at the end of 10 years. And the 6 years of Peds residency/fellowship counts toward those 10 years, which means you're looking at only 3-4 years of "real" payments before your debt is forgiven. IBR payments for a resident/fellow range from $0 (yes, this is true; that was my monthly payment all through intern year) to $100-300/mo, possibly lower if your spouse has no income.

Money is nice but should not be the driving factor of one of the most important decisions of your life.

 

[DermViser]

Hi everyone- happy friday

I am experiencing a lot of mixed emotions about my choice of career and I was hoping the power of groupthink could help me sort some of them out. I am a third year (male- I'm not sure why I thought that was relevant...) student who was CERTAIN I was going into anesthesia when I started med school. However, I realized 2 things pretty early on: 1) I love working with kids and 2) I love the ICU. Both revelations were completely unexpected, but that's life for you. Anyways- the more I hung around the PICU, the more excited I got, and before long I was answering everyone's favorite question to ask a med student- "What are you going to specialize in?"- with variations on "Pediatrics/PICU."

This is where things began to get problematic. My family, friends and lifetime medical mentors did not share my enthusiasm. It got worse when my Step 1 score came back high enough to do more "desirable" and lucrative things like orthopedics (which everyone assumes I already do anyways- I stand 11 feet tall), dermatology and ENT. Comments have ranged from "Are you sure???" and "I hope you're independently wealthy," to "You will be absolutely miserable, no question.", and almost all end in a sales pitch for one of the aforementioned fields.

So far I've dealt with it ok- there has been some occasional wavering and private negotiation with myself ("Maybe I can stand pediatric ortho...") but the medicine that fascinates me is critical care and the population I want to treat are kids. I am 99.9% ok with every aspect of my decision except for one thing- money.

Gasp, I know- how dare I speak that word! Hearsay! Sin! But hear me out.

I am in debt. Crazy debt. I went to a private undergrad, and am attending a private medical school without scholarships. I one day want to have a huge family and be able to provide for them all of the fantastic opportunities my parents worked so hard to provide me. I want my wife to be able to be a stay-at-home mom (because that is her dream, and I respect that). I want to be able to help my parents, and her parents, if they need it. I don't need a fancy car, or a big house, but I went to school a really long time, worked really hard, and am terrified I was called to one of the few medical specialties that might leave me unable to dig us out of this hole, much less ever get us ahead. I am just so scared of making a decision that I am going to regret later on. Any advice/insight/encouragement would be greatly appreciated.

Much love,
McTwisp

You do know you can do Pediatric Anesthesiology right? Here you can do anesthesiology, work with kids, AND work in the ICU -- all the things you want. So what's the problem?

#2 - It's obvious that lifestyle and family life is important to you, and that's completely OK. Stop feeling guilty because of it. Your job does not define you, nor should it. You are not a martyr. Thus, choose your field accordingly based on what you deem important in life to you and your family. You're luck that you have a Step 1 score in which you are still able to consider better lifestyle specialties. You have an enviable position. Take advantage of it.

 

[NewPup22]

I literally posted a question like this 2 days ago. I'm glad to see I'm not the only one with these concerns.

 

[mvenus929]

Yeah but from what I understand, peds anesthesia (anesthesia + peds fellowship) doesn't typically run a PICU, peds critical care (gen peds + critical care fellowship) does. I'd like someone to correct me of I'm wrong about this, bc I'm not really considering peds anesthesia for that reason.

It's an option. One of my attendings in the PICU was a peds anesthesiologist. He might've been grandfathered into the system, though... I don't know of any young attendings that went that path.

 

[mahurkar]

Just throwing my 2 cents.. Pretty much everyone has already stated and repeated the famous and known consensus of "do what you want to do, and do not just follow $". While my fiance applied to Uro, I applied to Peds and I've been having (sort of) the same doubts as you have. Now, I definitely don't see myself as a stay home mom and also I want to make my own money because I want to be as financially independent as I can be from him. So, if PICU is what you really want to do and money is a big concern for you, then let me tell you, you have nothing to worry about. I've known general pediatricians make 250+K a year, Peds-ICU 300K a year and even Peds-cards (which you should also consider) 350K+. I believe you would be able to take care of yourself, your wife, 3 kids and even your parents in the future !

So, go for it!

 

[Stitch]

Just throwing my 2 cents.. Pretty much everyone has already stated and repeated the famous and known consensus of "do what you want to do, and do not just follow $". While my fiance applied to Uro, I applied to Peds and I've been having (sort of) the same doubts as you have. Now, I definitely don't see myself as a stay home mom and also I want to make my own money because I want to be as financially independent as I can be from him. So, if PICU is what you really want to do and money is a big concern for you, then let me tell you, you have nothing to worry about. I've known general pediatricians make 250+K a year, Peds-ICU 300K a year and even Peds-cards (which you should also consider) 350K+. I believe you would be able to take care of yourself, your wife, 3 kids and even your parents in the future !

So, go for it!

Not sure where you got those numbers, but as someone who's been interviewing in PICU and has a wife who's a general pediatrician, those salaries are way high. It's true that peds ICU, NICU and peds cards are comparatively well reimbursed, and you will be fine in any of those fields. Reimbursement varies depending on region and practice type, with academic centers typically paying a bit less than private practice does, with the benefit of less clinical time and more research/QI opportunities. You will not be poor anywhere, though compared to adult specialties, you'll get payed quite a bit less.

As to the question of anesthesia, traditionally peds anesthesiologists attended in PICUs, and in fact the first intensivits were anesthesiologists. The current model is mostly peds critical care trained people, with some older anesthesiologists taking some shifts. There are/were a few programs that trained you in both anesthesia and peds critical care as a five year fellowship, but the ACGME is (or has) shut most of that down, so now you'd have to spend an extra three years of residency to do both anesthesia and peds critical care (nine years training total if you include peds residency; there's no path from anesthesia to peds anesthesia to peds critical care). Most of the anesthsiologists I know who attend in the unit, either did peds, then critical care then anesthesia, or are older and did anesthesia and have only taken care of kids for a long while. And the majority of them spend most of their time in the OR, not on the unit. There's someone on this board who is dual trained and may be able to comment in more detail.

Something else to consider would be doing anesthesia with a cardiac fellowship +/- a pediatric fellowship. Pedi cardiac anesthesia is seriously awesome and interesting. Getting these kids through their operations is challenging and rewarding.

 

[michigangirl]

There's someone on this board who is dual trained and may be able to comment in more detail.

Something else to consider would be doing anesthesia with a cardiac fellowship +/- a pediatric fellowship. Pedi cardiac anesthesia is seriously awesome and interesting. Getting these kids through their operations is challenging and rewarding.

See post #4 above.

 

[mahurkar]

Not sure where you got those numbers, but as someone who's been interviewing in PICU and has a wife who's a general pediatrician, those salaries are way high.

Oh they're real, but you already mentioned what the catch is. These numbers were thrown to me by private practice physicians from west/central Texas, two hours away from a large city (cough cough.. Dallas ). Anyway, leaving all the vocational and selfless arguments aside, you can always aim for those kind of salaries, depending on how much time you're willing to trade in and if you also invest in having some strategic offices around the city. But if being a mom or a dad who's going to miserably suffer missing one of your kid's soccer game, then yep, you'll take a substantial paycut.

 

[DermViser]

You should never go into a medical specialty based on how much money you think you're going to make for it. I'm sorry, I might sound old-fashioned. But medicine should be a calling that defines your life, and you really should enjoy it for the most part (minus minor irritations here and there in your job). It really should not be just a job. Therefore, I will advise you to absolutely go into PICU if indeed you feel strongly about it. You will be a better doctor doing what you love, than doing what pays higher.

Secondly, I will say - I know lots of PICU doctors in private practice who, with a combination of moonlighting coverage, make >500K per year. Of course, they have no free time, as they spend all their days off moonlighting at different hospitals to make this money. But you can do that for a few years.

Sorry, but those who have your attitude tend to burn out the fastest. The level of martyrdom from physicians, doesn't help the situation. It is JUST a job. A job that can be very satisfying and the ability to make a difference, but in the end it is just a job, esp. for those who have a family and children.

 

[mvenus929]

Sorry, but those who have your attitude tend to burn out the fastest.

Do you have any data on that? Just curious.

 

[DermViser]

Do you have any data on that? Just curious.

Yes, in the Journal of Martyrdom. Are you serious? You truly believe that calling it a "calling", thus meaning at the expense of family life, hobbies, rest, etc. is healthy? Do you know why reimbursements continue to fall? It's bc of this martyrdom on behalf of physicians (many of whom are old school), which has allowed others, such as insurance companies, to take full advantage of the profession.

Look at what has happened in which so many private practices have been swallowed up by hospitals, as they can no longer run without being in the red, so they have to join a hospital entity. I'll eventually be going into Pediatric Dermatology, which actually isn't even as close to being lucrative, as say MOHS and Dermpath from a procedural standpoint. Not to mention it's very rare that we do biopsies on children (we try to avoid them). I'm doing Pediatric Derm through Derm, as to my knowledge it can't be done through Peds. It's one of the most rewarding specialties. However, with that part of what is so rewarding is that it allows me time to give my patients my undivided attention at work, and then when I'm done, I can go home and have fun and come back refreshed the next day. When things become a "calling", to where doctors try to humanly (which is impossible) fill this martyrdom role, this only leads to further disappointment and exhaustion. Do you really think a doctor can go at full speed for 30-40 years without there being any consequences?

 

[oldbearprofessor]

So, the only choice is to treat being a physician like punching a clock and when home you're done and when at work you work vs living the job 24/7? Seems like there might be a middle ground and that ground might look different for different specialties and individuals. It might even look different at different times in a physicians career.

Personally, I have always gotten the most satisfaction from going the extra step for families of my patients, regardless of whether they indicate their appreciation. That includes coming in when not on call/staying late when there is a reason, it means lots of committees, etc. I'm not entirely sure that this has ever caused me exhaustion, but again, I don't live the job 24/7. I leave that to the pedi surgeons.

It seems that doing things like attending a patient's funeral by a pediatrician to support the family, or doing community service activities for free, etc, make the job much better, not worse. YMMV of course, but I'm pretty confident that the overwhelming majority of pediatricians, generalists and specialists share the view that extra work, sometimes without pay, for the sake of children is worth it. Martyrdom? Hardly. Can it be taken to excess? Sure, so can anything.

There is no need to choose job vs family as a pediatrician. That is an artificial choice. You can do a lot of off-hours work and still make it to most of the family events. I actually think that might even be better for the family in many ways. Again, that's not saying the goal is to be have latch-key kids, but there's a middle ground. Kids can live with knowing that their parents must sometimes miss a sporting event to sit at the bedside of a very sick child, etc, even when not on call.

 

[michigangirl]

So, the only choice is to treat being a physician like punching a clock and when home you're done and when at work you work vs living the job 24/7? Seems like there might be a middle ground and that ground might look different for different specialties and individuals. It might even look different at different times in a physicians career.

Personally, I have always gotten the most satisfaction from going the extra step for families of my patients, regardless of whether they indicate their appreciation. That includes coming in when not on call/staying late when there is a reason, it means lots of committees, etc. I'm not entirely sure that this has ever caused me exhaustion, but again, I don't live the job 24/7. I leave that to the pedi surgeons.

It seems that doing things like attending a patient's funeral by a pediatrician to support the family, or doing community service activities for free, etc, make the job much better, not worse. YMMV of course, but I'm pretty confident that the overwhelming majority of pediatricians, generalists and specialists share the view that extra work, sometimes without pay, for the sake of children is worth it. Martyrdom? Hardly. Can it be taken to excess? Sure, so can anything.

There is no need to choose job vs family as a pediatrician. That is an artificial choice. You can do a lot of off-hours work and still make it to most of the family events. I actually think that might even be better for the family in many ways. Again, that's not saying the goal is to be have latch-key kids, but there's a middle ground. Kids can live with knowing that their parents must sometimes miss a sporting event to sit at the bedside of a very sick child, etc, even when not on call.

It is safe to say that OBP has summarized the feelings of the vast majority of intensivists at academic instiutions on this board. Martyrdom is not the right word. Satisfaction is. Satisfaction means different things to different people, and what I love about academics, despite a lower salary, is that it's complex, its always interesting, and its everything BUT punching the clock. Yes, I may get called at 10 p.m. at night to approve a restricted medication for which I am the gatekeeper, I may have to rush back in on my way home because they need help with a very complicated case, I may get paid a bit less than out in the community. But it works for me. I have seen some folks take it to another level where one could argue it's martyrdom. Their family lives suffer, and they regret it later. But that's a very small minority.

 

[mvenus929]

Yes, in the Journal of Martyrdom. Are you serious? You truly believe that calling it a "calling", thus meaning at the expense of family life, hobbies, rest, etc. is healthy?

Yes, I was being serious. I've seen some data on why physicians burn out, but I've generally seen that those who go into the profession because it is a calling (rather than for money or lifestyle), get more satisfaction. The fact that pediatrician a have one of the highest satisfaction rates despite being one of the lowest reimbursed specialty supports this view.

And saying something is a calling does not imply that you do it at the expense of family, hobbies, rest, etc. you can be dedicated to something without devoting every waking moment of your time to it.

 

[DermViser]

Yes, I was being serious. I've seen some data on why physicians burn out, but I've generally seen that those who go into the profession because it is a calling (rather than for money or lifestyle), get more satisfaction. The fact that pediatrician a have one of the highest satisfaction rates despite being one of the lowest reimbursed specialty supports this view.

And saying something is a calling does not imply that you do it at the expense of family, hobbies, rest, etc. you can be dedicated to something without devoting every waking moment of your time to it.

I wasn't talking at all about reimbursement. I was referring to lifestyle. Referring to something as a "calling", means that it is at a higher level than say things such as eating, proper sleep, spending quality time with family, etc. esp. in the case of Pediatric ICU. Medicine is a career, which can be highly satisfying, and in working with children, I can absolutely agree. However, when you define yourself by your career, that makes you very 1-dimensional and allows others such as insurance companies and hospitals to take advantage of you, of which Pediatrics as a specialty has done (esp. in its support of Obamacare).

 

[oldbearprofessor]

Time to let this thread come to an end.