Why would anyone go into primary care nowadays?

[circulus vitios]

What makes you think that you know the first thing about my pedigree?

The vast majority of people don't go to those schools so it's just a guess that's probably right.

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[DermViser]

Yup. I do. That doesn't mean that I didn't graduate from an Ivy with a decent GPA and score better on the MCAT than anybody giving me crap in this thread.

I want to go to a DO school because I think there will be fewer stat obsessed douchebags there. I think that as a DO, I won't get ragged on for actively choosing a primary care specialty without concern about the financial implications of that choice. I work with some exceptional doctors who are DOs, and I have seen that they are not any less than their MD colleagues in the eyes of the people who really matter, that is our patients and their families.

They aren't stats obsessed but they are specialty obssessed just like allopathic students. Most people who go to D.O. school, go there bc they couldn't gain admission to an M.D. school. I guess they do have the market cornered on ranting about "D.O. discrimination" in the match process though.

 

[sinombre]

Yup. I do. That doesn't mean that I didn't graduate from an Ivy with a decent GPA and score better on the MCAT than anybody giving me crap in this thread.

I want to go to a DO school because I think there will be fewer stat obsessed douchebags there. I think that as a DO, I won't get ragged on for actively choosing a primary care specialty without concern about the financial implications of that choice. I work with some exceptional doctors who are DOs, and I have seen that they are not any less than their MD colleagues in the eyes of the people who really matter, that is our patients and their families.

You won't get "ragged on" for choosing primary care at an MD school. Not sure why you think you would.

 

[Promethean]

The vast majority of people don't go to those schools so it's just a guess that's probably right.

The problem with playing odds like that is that there are always outliers. Hope your diagnostic skills are founded on more than statistics and guesses.

 

[circulus vitios]

The problem with playing odds like that is that there are always outliers. Hope your diagnostic skills are founded on more than statistics and guesses.

Sounds a lot like "you're going to be a terrible doctor" so this thread really has come full circle.

Primary care sucks --> Other careers are better than medicine --> No they're not --> MD vs DO --> Burnett's Law

 

[Promethean]

You won't get "ragged on" for choosing primary care at an MD school. Not sure why you think you would.

Have you been following this thread?

I explained that I am going into primary care because it is what I wanted to do, and then I made a glib comment about how if I cared more about money, I would pick something else. I followed that up with an admission that yes, I understand that people who engage in the profession that I used as an example might have some qualities that I lack. The result was still gaslighting and other personal attacks, rounded out by bringing up my interest in DO as evidence of my obvious low status. I've been ragged on for my answer in a thread about why people choose primary care, presumably by MD hopefuls.

Which part of that had you missed?

 

[Espadaleader]

I really can't see why anyone would want to into primary care. P4P, mid-level encroachment, requirements from the NCQA, payers etc. Its just too much. I don't want my financial stability to rest on loan repayment (people on SDN talk like its easy to get loan repayment) or working in an remote underserved area that I cannot choose.

It's not about making money. It's about being stable. Also some people have different priorities. If you have children, spouse, or are a breadwinner (you take care of your disabled mother and your kid siblings etc.) you need to make money. Period. If I could have the option of making 300k per year and making 100k a year and still see patients and have career satisfaction I am going to pick the path with more money. Medicine isn't all about money but when students are taking upwards to half a million dollars in debt for medical school money is a concern.

On an aside though, I don't think I would go into primary care even if PCPs were paid double...

 

[Promethean]

Sounds a lot like "you're going to be a terrible doctor" so this thread really has come full circle.

Primary care sucks --> Other careers are better than medicine --> No they're not --> MD vs DO --> Burnett's Law

Dude, you compared me to Forrest Gump and then assumed that I couldn't possibly have gone to a decent school. Don't whine that I gave it back.

 

[Psai]

People go into specialties because that's what they want to do too. It's just that there are more people who have primary care as their only option whereas people in specialties are more likely to have had multiple choices available. Medical students don't pick a field because of an impression that they make more money.

 

[alpinism]

Yet another reason to avoid primary care. Vaccine costs have increased so much in the past few years that many Peds and FM docs can no longer afford to offer them to patients. The ones that still do are losing tons of money every year.

http://www.nytimes.com/2014/07/03/health/Vaccine-Costs-Soaring-Paying-Till-It-Hurts.html?_r=0

 

[BestDoctorEver]

You won't get "ragged on" for choosing primary care at an MD school. Not sure why you think you would.

Not too sure about that... I got 'ragged on' the other day by a classmate for saying that I am interested in psych...

 

[Promethean]

My original answer stands. I want to do primary care for the same reason that I want to be a physician. Because it is all I want to do, and nothing else is going to satisfy me, and heaven knows I've tried to find something else that would. It isn't what you are supposed to say on a personal statement, but it is true.

All the people who don't want to do it, great. Please, enjoy your specialties, and you and I can both hope that you aren't forced into mine by necessity.

 

[Psai]

Yet another reason to avoid primary care. Vaccine costs have increased so much in the past few years that many Peds and FM docs can no longer afford to offer them to patients. The ones that still do are losing tons of money every year.

http://www.nytimes.com/2014/07/03/health/Vaccine-Costs-Soaring-Paying-Till-It-Hurts.html?_r=0

I wonder how many of those idiots refusing vaccines now will realize how stupid they were when they see how terrible these easily preventable diseases actually are.

 

[Silent Cool]

I'm entering medical school next month and I'm basically taking loans for my entire COA. That + my undergraduate loans make my total debt close to $300k once I graduate. That is the equivalent to a down payment for a $1.5 million mansion. After I pay it all back in 10-20 years, I will probably have paid a total of close to $500k.

My question is, what possible reason would a med student in my situation have for pursuing primary care or related fields? And why do medical schools not address this problem especially when everyone and their grandma are saying that there is a great need for primary care docs??


Posted using SDN Mobile

Because their step 1 score sucks and they couldn't hack it for something better?

 

[AlbinoHawk DO]

Says the premed. Along with the ridiculous hours it encompasses. Money isn't everything.

Says the med student (not that it would matter because you'd call me MS-1) that is in his 30s and has more life experience than you do. I come from poverty, so when I say money isn't everything, I'm the one that can claim that. And if you think I haven't worked hard, you're dead wrong.

Do you have self-esteem problems? Seriously. I see you on every thread going "YOU LOWLY MS-2. PRE-MED! YOU MS-1!!!" I'm going to let you in a little secret: we all laugh at you because we know if the best usage of your time is to try to argue with people you think are below you, your life must be miserable.

 

[AlbinoHawk DO]

gotta look at the debt too.

I see people making 70k a year, but have no debt. They live very comfortably.

vs.

making 200k a year but being a million in debt from student loans, house, car, and other necessary non luxury things (in the states)

personally, I would rather be in the latter than the former.

We did just look at debt and after taxes you still end up in the top 10% in this country. Do you think other people don't have to buy houses and cars? Jesus.

 

[DermViser]

Says the med student (not that it would matter because you'd call me MS-1) that is in his 30s and has more life experience than you do. I come from poverty, so when I say money isn't everything, I'm the one that can claim that. And if you think I haven't worked hard, you're dead wrong.

Do you have self-esteem problems? Seriously. I see you on every thread going "YOU LOWLY MS-2. PRE-MED! YOU MS-1!!!" I'm going to let you in a little secret: we all laugh at you because we know if the best usage of your time is to try to argue with people you think are below you, your life must be miserable.

Your life experience doesn't matter with respect to medicine. My reference to money isn't everything, is referring to medical students these days more preferring lifestyle. Has nothing to do with being poor or rich myself. A swing and a miss for you.

 

[DermViser]

Not too sure about that... I got 'ragged on' the other day by a classmate for saying that I am interested in psych...

Will be interesting to see where that classmate ends up.

 

[KanyeWes]

We did just look at debt and after taxes you still end up in the top 10% in this country. Do you think other people don't have to buy houses and cars? Jesus.

being top 10% isn't all that big of a deal when half of this country pays nothing in taxes.

the issue with others is that they usually aren't weighted down by a huge debt, interest, and years of not making "real" money (ie years spent in med school, residency, fellowship).

you might not have been around people with money, but I have. Trust me, being top 10% doesn't do as much as you think. the problem is further exacerbated when u live in la, nyc, or some places in florida.

 

[DermViser]

My original answer stands. I want to do primary care for the same reason that I want to be a physician. Because it is all I want to do, and nothing else is going to satisfy me, and heaven knows I've tried to find something else that would. It isn't what you are supposed to say on a personal statement, but it is true.

All the people who don't want to do it, great. Please, enjoy your specialties, and you and I can both hope that you aren't forced into mine by necessity.

I think the point being made is that to do primary care the ROI would have been greater doing PA/NP vs. being primary care physician, esp. now since the govt. will be putting on more govt. mandates on PCPs, and making them more administrators over NPs/PAs rather than actually seeing patients.

 

[AlbinoHawk DO]

Your life experience doesn't matter with respect to medicine. My reference to money isn't everything, is referring to medical students these days more preferring lifestyle. Has nothing to do with being poor or rich myself. A swing and a miss for you.

In respect to medicine? If we extend that logic, you have no idea whatsoever about any other job or profession, so how can you claim what is fair for physicians? Because you pop pimples? Oh please. You're such a child.

 

[DermViser]

In respect to medicine? If we extend that logic, you have no idea whatsoever about any other job or profession, so how can you claim what is fair for physicians? Because you pop pimples? Oh please. You're such a child.

Who says I ever talked about other jobs or professions? NPs and PAs work in the same profession. It's just a different way to get there. Might want to step inside medical school first.

 

[KanyeWes]

In respect to medicine? If we extend that logic, you have no idea whatsoever about any other job or profession, so how can you claim what is fair for physicians? Because you pop pimples? Oh please. You're such a child.

seriously, pull your head outta your b***

 

[AlbinoHawk DO]

being top 10% isn't all that big of a deal when half of this country pays nothing in taxes.

the issue with others is that they usually aren't weighted down by a huge debt, interest, and years of not making "real" money (ie years spent in med school, residency, fellowship).

you might not have been around people with money, but I have. Trust me, being top 10% doesn't do as much as you think. the problem is further exacerbated when u live in la, nyc, or some places in florida.

100% of this country pays taxes. Income tax is only 1 form of taxation. If we look as a percentage and impact of purchasing power, the poor have the raw end of the deal.

As a physician, you still come ahead in regards to money. You ARE making real money during residency and fellowship. How much do you think you'd make with your bachelors straight out of college? 40-60k, which is the amount you make as a resident or fellow. Your only trade off is 4 years of debt and time in school which still you come ahead in. Lets extend this logic for a second. Are you going to say a bachelors is a waste of time because you're not doing as amazing as those High School graduates making "real" money for those 4 years? Basic economics should be part of the prerequisites from now on.

 

[AlbinoHawk DO]

Who says I ever talked about other jobs or professions? NPs and PAs work in the same profession. It's just a different way to get there. Might want to step inside medical school first.

Already stepped inside it.

 

[DermViser]

Already stepped inside it.

Well, then it's obvious that you don't know what you're talking about. Start...no finish a semester first.

 

[BestDoctorEver]

being top 10% isn't all that big of a deal when half of this country pays nothing in taxes.

the issue with others is that they usually aren't weighted down by a huge debt, interest, and years of not making "real" money (ie years spent in med school, residency, fellowship).

you might not have been around people with money, but I have. Trust me, being top 10% doesn't do as much as you think. the problem is further exacerbated when u live in la, nyc, or some places in florida.

Wow.. I would like to live in the part of country where 50% pay no taxes.. Sale tax, property tax etc... Please this is SDN--Not Fox News or MSNBC where people are repeating nonsense they hear from Hannity and Chris Hayes/Chris Matthews/Rachel Madow..

 

[KanyeWes]

Wow.. I would like to live in the part of country where 50% pay no taxes.. Sale tax, property tax etc... Please this is SDN--Not Fox News or MSNBC where people are repeating nonsense they hear from Hannity and Chris Hayes/Chris Matthews/Rachel Madow..

this is an objective fact, homie. don't politicize it. this aint fox news.

 

[DermViser]

Wow.. I would like to live in the part of country where 50% pay no taxes.. Sale tax, property tax etc... Please this is SDN--Not Fox News or MSNBC where people are repeating nonsense they hear from Hannity and Chris Hayes/Chris Matthews/Rachel Madow..

Half this country (47% I believe) doesn't pay federal income tax.

 

[AlbinoHawk DO]

Well, then it's obvious that you don't know what you're talking about. Start...no finish a semester first.

But then wouldn't you just I am a lowly MS-1.5? lol

 

[Promethean]

Ignore is a wonderful feature.

 

[DermViser]

But then wouldn't you just I am a lowly MS-1.5? lol

It doesn't matter what you are, since you were already talking about "D.O. discrimination", then no number of years will help you.

 

[AlbinoHawk DO]

It doesn't matter what you are, since you were already talking about "D.O. discrimination", then no number of years will help you.

Hahaha

 

[BestDoctorEver]

Half this country (47% I believe) doesn't pay federal income tax.

They don't pay federal income tax is a different story... I used to work 40hrs/week making 20k/year going to school full time and used that money to pay everything from tuition/food/housing etc... Should I have paid 25%+ federal tax like someone who was making 200k+/year? You guys/gals make your call... I wish a lot of privilege med students could look beyond their little own bubble...

 

[DermViser]

They don't pay federal income tax is a different story... I used to work 40hrs/week making 20k/year going to school full time and used that money to pay everything from tuition/food/housing etc... Should I have paid 25%+ federal tax like someone who was making 200k+/year? You guys/gals make your call... I wish a lot of privilege med students could look beyond their little own bubble...

We should jump from 0% federal income tax to 25% federal income tax? Who said that? Certainly not me. Here's an idea: EVERYONE who lives in this country pays some amount of federal income tax. Think of it as your patriotic duty.

 

[BestDoctorEver]

We should jump from 0% federal income tax to 25% federal income tax? Who said that? Certainly not me. Here's an idea: EVERYONE who lives in this country pays some amount of federal income tax. Think of it as your patriotic duty.

Patriotic duty my a$s when most rich people hire an arsenal of lawyers/accountants to do their taxes so they can get their effective rate to the lowest amount possible... I am not ready to give the government my money to finance individual/corporate welfare, give foreign countries that don't even like us.

 

[DermViser]

Yup. I do. That doesn't mean that I didn't graduate from an Ivy with a decent GPA and score better on the MCAT than anybody giving me crap in this thread.

I want to go to a DO school because I think there will be fewer stat obsessed douchebags there. I think that as a DO, I won't get ragged on for actively choosing a primary care specialty without concern about the financial implications of that choice. I work with some exceptional doctors who are DOs, and I have seen that they are not any less than their MD colleagues in the eyes of the people who really matter, that is our patients and their families.

Yes, bc we know there are TONS of Ivy-league educated with a decent GPA and score better on the MCAT applicants who are clamoring to get into D.O. schools as their first choice.

 

[DermViser]

Patriotic duty my a$s when most rich people hire an arsenal of lawyers/accountants to do their taxes so they can get their effective rate to the lowest amount possible... I am not ready to give the government my money to finance individual/corporate welfare, give foreign countries that don't even like us.

No one is talking about corporations, tax writeoffs, and capital gains which is taxed differently than income. As an individual living in this country, you owe federal income tax, just like everyone else, no matter what your salary may be. The other side could make the argument that they don't wish to finance food stamps, Medicaid, etc. for those who are lazy and abuse the system. Tough. Both of you have to pay federal income tax, period.

 

[username456789]

Says the med student (not that it would matter because you'd call me MS-1) that is in his 30s and has more life experience than you do. I come from poverty, so when I say money isn't everything, I'm the one that can claim that. And if you think I haven't worked hard, you're dead wrong.

AlbinoHawk, I get what you're saying and I certainly identify with a lot of it too. That said, I was in a similar position to you and thought I knew best due to my experience and meager upbringings.

The fact is, though, that at some point you'll likely come to realize that, as you progress through the years of medical education and residency training, that outlook is very likely to change. If you take out loans of any significance, that alone begins to really weigh heavily on you and your life plans. Not to mention the slow realization that many people with far less education and medical experience than you are employed solely to limit what you may do and ensure that you get paid less for doing more.

There are a lot of frustrations inherent in medicine. Many of them are not necessarily unique to medicine and can be experienced in prior jobs/careers as well. But there are a significant number of hurdles that are indeed specific to our career paths, and eventually it's very easy to get discouraged.

Of course, I hope that you can keep your perspective throughout your many years of training. I really do. When I was in your shoes, I was absolutely the first one in line to proudly proclaim that I would gladly sign up to work for the lower end of doctor salaries. Hell, that's a whole boatload more than my parents ever made, combined. Maybe it's the ever-increasing costs of medical education combined with the high interest and declining reimbursement/respect/autonomy . . . but man, this **** really starts to kick you around.

 

[DermViser]

When I was in your shoes, I was absolutely the first one in line to proudly proclaim that I would gladly sign up to work for the lower end of doctor salaries. Hell, that's a whole boatload more than my parents ever made, combined. Maybe it's the ever-increasing costs of medical education combined with the high interest and declining reimbursement/respect/autonomy . . . but man, this **** really starts to kick you around.

Funny how everything changes, once you see the number of zeros in the amount of money you owe in loans. However, forget even that, the amount of bureaucracy and impositions placed on primary care as the "gatekeeper" in medicine is what has destroyed primary care. Its any wonder people in primary care have switched over to direct pay/concierge care systems.

 

[KanyeWes]

AlbinoHawk, I get what you're saying and I certainly identify with a lot of it too. That said, I was in a similar position to you and thought I knew best due to my experience and meager upbringings.

The fact is, though, that at some point you'll likely come to realize that, as you progress through the years of medical education and residency training, that outlook is very likely to change. If you take out loans of any significance, that alone begins to really weigh heavily on you and your life plans. Not to mention the slow realization that many people with far less education and medical experience than you are employed solely to limit what you may do and ensure that you get paid less for doing more.

There are a lot of frustrations inherent in medicine. Many of them are not necessarily unique to medicine and can be experienced in prior jobs/careers as well. But there are a significant number of hurdles that are indeed specific to our career paths, and eventually it's very easy to get discouraged.

Of course, I hope that you can keep your perspective throughout your many years of training. I really do. When I was in your shoes, I was absolutely the first one in line to proudly proclaim that I would gladly sign up to work for the lower end of doctor salaries. Hell, that's a whole boatload more than my parents ever made, combined. Maybe it's the ever-increasing costs of medical education combined with the high interest and declining reimbursement/respect/autonomy . . . but man, this **** really starts to kick you around.

exactly.

I have lived rich, and dirt poor (like for real poor). I understand can empathize with alb's perspective. but the debt will start to crush all that idealism outta ya.

seen it happen all the time with buddies of mine.

 

[530364]

I swear this forum is like the same damn 10 people bitching about the same things. Don't you all have something better to do??? Stop thinking about medicine for like 10 seconds and get a hobby.

 

[username456789]

I swear this forum is like the same damn 10 people bitching about the same things. Don't you all have something better to do??? Stop thinking about medicine for like 10 seconds and get a hobby.

You sound mad.

Why are you mad?

 

[Promethean]

I swear this forum is like the same damn 10 people bitching about the same things. Don't you all have something better to do??? Stop thinking about medicine for like 10 seconds and get a hobby.

I hear you. But seriously, the ignore function is making this forum positively pleasant to use. Try it and see!

I do need a hobby. There are people on SDN who seem to have nothing better to do than rack up high post counts without really contributing anything of substance. I don't intend to be one of them. But this week the fam is away and I am really, really bored, and figured a few flame wars were cheaper than going out. SDN distracts me from checking my inbox every 20 minutes to see if my AACOMAS app is verified yet. So, I can space that out to every 30 or so.

 

[DermViser]

I swear this forum is like the same damn 10 people bitching about the same things. Don't you all have something better to do??? Stop thinking about medicine for like 10 seconds and get a hobby.

Why are you so angry? SDN = Student DOCTOR Network, hence talking about medicine.

 

[DermViser]

I hear you. But seriously, the ignore function is making this forum positively pleasant to use. Try it and see!

I do need a hobby. There are people on SDN who seem to have nothing better to do than rack up high post counts without really contributing anything of substance. I don't intend to be one of them. But this week the fam is away and I am really, really bored, and figured a few flame wars were cheaper than going out. SDN distracts me from checking my inbox every 20 minutes to see if my AACOMAS app is verified yet. So, I can space that out to every 30 or so.

Esp. as a premed on an Allopathic forum.

 

[tco]

You sound mad.

Why are you mad?

He's just complaining.

 

[530364]

You sound mad.

Why are you mad?

I'm venting. I'm annoyed because I come on here occasionally to find useful information and respectful conversations and have to wade through the same bull**** posted by the same people. If you don't have something useful to contribute to the conversation or can't say it in a respectful way then just don't say anything. This could be a great resource but it is filled with 99% of meaningless crap. Vent over.

 

[tco]

Thy name is irony.

 

[DermViser]

I'm venting. I'm annoyed because I come on here occasionally to find useful information and respectful conversations and have to wade through the same bull**** posted by the same people. If you don't have something useful to contribute to the conversation or can't say it in a respectful way then just don't say anything. This could be a great resource but it is filled with 99% of meaningless crap. Vent over.

Feel better?