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The darker side of being a doctor

282 points · 342 comments · Danhale93

  1. cmiles8 · · focus · HN ↗
    The challenge in the US is that the best and brightest increasingly have no interest in entering the medical profession. The debt, crazy years of minimum income, all to let an insurance company admin dictate your every move and while more and more physicians become a labor pool for PE healthcare tracked with metrics fit for warehouse workers (edit: and that’s not OK in a warehouse either). All to earn a decent income but no longer the top of the market. A decent mid-level developer or tech executive makes more than nearly all physicians. No sane top performing talent would dive head first into that mess.

    There are exceptions of course but when my brother was considering medical school he visited about 10 different top physicians to seek input and advice and nearly all said if given a Time Machine they wouldn’t do it all over again. That was a real wake up call.

    If you go into medicine as a business entrepreneur and build a successful medical business then there’s opportunities for one to still taste some of the glory of the medical profession that once was. Outside that it’s basically a reasonably well paid life of indentured servitude. Yes you’re “helping people” but that only carries you so far which is why so many just burn out and leave.

    Massive reform is needed but the powers that be between the AMA and insurance companies seem unlikely to let that change happen unless it’s forced on them by Congress, and that too seems unlikely for now. Something more alike to an apprenticeship model where one grows up from EMT, to nurse, to physician fits the current business model much better than trying to preserve the old world “Officer vs enlisted” model where folks enter the profession directly as officers (physicians).

    1. Aurornis · · focus · HN ↗
      > A decent mid-level developer or tech executive makes more than nearly all physicians.

      I’ve had access to various compensation data products and I’ve done hiring at distributed companies across dozens of US states. This is not true unless you’re defining “decent mid-level” as working for FAANG. Conversations about developer comp always get skewed toward the top end for top 5-10% devs, with the median numbers being a lot lower.

      > If you go into medicine as a business entrepreneur and build a successful medical business then there’s opportunities for one to still taste some of the glory of the medical profession that once was.

      I don’t know what you mean by “glory of the medical profession” if your definition of achieving it is… not being a medical professional?

      Are you just talking about the money and social prestige that comes from being wealthy? The medical professionals I know didn’t go into the career because they wanted to maximize salaries. The days of becoming a physician primarily to seek money and social status are dwindling because there are better ways to make a lot of money where you get to sit at a desk and write emails, and honestly that may not be a bad thing. Let those people go be lawyers and finance bros or mediocre product managers.

      1. Schlagbohrer · · focus · HN ↗
        Yes anyone who thinks engineers (HW or SW) are all paid amazingly needs to start taking in the wages of contractors too when calculating averages. Even many engineers working at FAANG HQs are lowly paid, abused contractors, making $50k-$80k.

        I know personally of one big famous tech firm that has QA devs making literal minimum wage, because they are contracted from an outsourced firm. But 100% of those people's work is directed by and exclusively for the big tech firm so like all contracting it is an obvious paperwork scam to just mistreat their workers.

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