Ruminations of an Online Instructor / MD

Reasons *Not* to Become a Doctor / Day 8 Comment on a Blog Outside Your Niche

May 8, 2008 at 9:10 am | In 31 Day Comment Challenge, Blogging, Distance Education, Dr. Kirsti A. Dyer, Medical Profession, Online Instructors, Ruminations Blog | 4 Comments
Tags: 31 Day Comment Challenge, Becoming a Doctor, comment08, Education Blogging, Education Blogs, Medical Profession, Medicine, State of Medicine

Last semester I had one of my college students ask me if I was “the physician who gave up medicine to raise her children.” At first I thought this was an interesting rumor going around about me, spread by the students and then realized in many aspects it is true.

True my *clinical* medical career has been on hiatus since the birth and NICU admission of my youngest 6 years ago for a variety of reasons, but I still consider myself sharing my medical knowledge through teaching.

An article in Forbes this week by Tara Weiss on “Reasons Not to Become a Doctor” confirmed as my husband emailed me, that I was ahead of my time. Many of the reasons she cited for reasons not to become a doctor were also reasons that I’d come up with for taking a hiatus from practice.

• Few opportunities for *predictable* part-time work. Before I had my daughters I worked in a variety of part-time clinical settings, often with erratic schedules . After having them, I knew I needed a more predictable schedule. I’ve seen a lot of women physicians having to choose between career and family after having children, because people don’t want “part-time physicians.”
  
• Lack of autonomy. I found it extremely frustrating that my day was determined by a medical assistant with limited education scheduling patients for an appointment every 10 – 15 minutes, during which time we’d have to review the chart, see the patient, write any prescriptions and chart the visit. This severely limits the amount of time physicians can spend educating patients about health.
• Loss of respect for the profession. Once upon a time, physicians were the resource people visited to gain medical knowledge. Now with the Internet, physicians have become the ‘gate keepers’ patients must pass through on their way for further services.
  
• Threats of lawsuits. Getting sued by a patient is a major concern. I don’t know of too many professions who go to work daily with the threat of a lawsuit hanging over their every move.
• Hefty Paychecks are a thing of the past. I have not seen any appreciable change in physicians salaries that I’ve seen in the last > 10 years, despite an increasing cost of living and rise in student loans. Even with a dual professional income my husband (a Senior Web Developer) and I could not have bought a home in the Bay Area or the East Bay Area.
• Low reimbursement for services. Medicine, particularly primary care, seems to be one of the few places where people go in for services and still do not feel that they need to pay the entire bill. The plumber or the car mechanic would not take partial payment on services that they provided.
• Increasing student loans. There is a future of looming medical-school debt, which is higher than ever. I was lucky to *only* be $50,000 in direct medical school debt which I worked to get paid off within 10 years of graduating. Getting my loans paid off has allowed me the luxury of working part-time, because the pressure of the hefty monthly loan check is no longer there.

I think it is a sad state of the medical profession if 57% of 1,175 doctors questioned in a 2007 survey would not recommend the field to their children. Even though my daughters talk about medicine, I would not recommend becoming a physician to them as a profession *unless* there are drastic changes in the field.

To pursue medicine, you put your life on hold for > 10 years with the promise that you’ll get out with a respected job with decent pay; this no longer seems to be the case. I’ve spent time over the past 10 years educating people about the reality for doctors today.

Making More of an Impact as a Teacher

When I took a hiatus from clinical practice to raise my daughters in their early years, I hadn’t thought about what I might be able to do with my medical degree. I was invited to interview to teach Nutrition at our local college. I was hired for the position and am now teaching the 17th class of College Nutrition.

The great thing for me about teaching is that I feel I am still able to do one of the things I liked best about patient care–health education. I am able to teach students how to make good healthy choices for life and stay healthy, instead of taking care of people who have chronic diseases.

By teaching college Nutrition & Wellness, I still able sharing my medical knowledge and experiences. Teaching is my paid community service.
Day 8: Comment on a blog outside of your niche

The activity for Day 8 is to find and comment on a blog that is outside of your normal interest areas.

My normal ‘niche’ areas would be grief, loss and bereavement and also Nutrition, the two areas that I teach. I realize that I have a lot of different interest areas, but since I don’t post much even in my normal areas, posting in *any* blog would still probably meet this criteria.

I decided to post to two different blogs.

• The first posting was a response to the Forbes article on “Reasons Not to Become a Doctor.” Although this is my professional ‘niche’ I generally don’t comment on news websites.
• The second posting was on a Mommy Blog about joining a Blog Party for an online event for Moms. This is my second professional ‘niche’ these days, but I haven’t been to much involved with the online mom community.

Accomplishments Day 8

1. Following up on older posts, posting a response on another new blog, Open Stacks, the post that inspired yesterdays look at Blogorrhea vs. Bloquacia.

2. Responding to comments that I have been getting.

3. Catching up on blog posts. (I fell a bit behind on the daily posts).

4. Reflecting on why Teaching is a better place for me right now than medicine.

5. Posting in two different blogs outside of my normal ‘niche.’

6. Writing and Posting Day 8 Comments.

Reflections Day 8

I continue to be amazed by the support and interaction from the educational blogging community. I realize that the purpose of the 31 Day Challenge is to interact with people in other blogs, but with over 115 participants people are bound to be busy. I am also feeling that I may have found my ‘niche’ with the educational blog community. Time will tell.

I am still having to push myself a bit to respond to blog posts as part of the challenge, perhaps not wanting to be accused of Blogorrhea in blog posts.

Revelations: The revelations were mostly personal, in response to the Forbes article. I feel fortunate to have ’seen the handwriting on the wall’ or read the tea leaves correctly in the late ’90’s that medicine was not the place that I thought it was going to be when I started medical school in the late ’80’s. I am also fortunate to have an interest in teaching and in particular online teaching, as a place for a logical, but related career shift.

Image: Sanja Gjenero. Be Healthy. Royalty Free Use.

This blog post is part of The Comment Challenge, comment08.