A Dying Profession

By Arie Friedman, MD

As a physician from a family of physicians, I frequently find myself being asked if I would recommend my profession to a young person. With the looming shortage of doctors faced by this country, I believe this is indeed a critical question. In the finest tradition of medical school instructors everywhere, I usually try to answer by proposing a thought experiment:

Think about how you would respond if your beloved son or daughter, now a 19 year old straight A student at a top college, came to you and and asked your advice about a career option that possessed the following characteristics:

1. The course of training for this profession is extremely long - between seven and twelve years after college graduation.
2. The first four years of training will occur in a post-graduate school that costs as much as $43,000 per year in tuition and fees alone.
3. Post-graduate degree programs only accept the best students with the most competitive resumes. In fact, it is widely rumored that many prospective applicants avoid taking interesting college courses for fear of hurting their grade point average.
4. The intense schedule of this professional school will usually preclude concurrent employment for any serious student.
5. The indebtedness experienced by graduates can only be described as crushing.
6. Upon finishing school, graduates will receive only a single take-it or leave-it job offer for the mandatory three to eight year on-the-job post-educational apprenticeship.
7. The salary during this apprenticeship will range between $46,000 and $56,000 per year.
8. Apprentices experience extremely arduous working conditions. In fact, employers routinely violate the industry standard of an 80 hour work week.
9. A few years ago, these apprentices brought a federal class-action suit against their employers for colluding to set salaries and working conditions. In response, Senator Edward Kennedy pushed through legislation that granted these companies a retroactive federal anti-trust exemption. The class-action suit was subsequently dismissed.
10. Upon graduation from training, members of this profession will have to deal with a widely recognized crisis in liability lawsuits.
11. An extremely complex federal law was recently passed that would so significantly impact the profession that 65% of practitioners opposed it, 50% believe their income will drop, and 46% will now consider looking for a new line of work.
12. The new law has essentially eliminated the entrepreneurial opportunity for practitioners to own one of the facilities in which they work.
13. Practitioners experience the yearly threat of federally mandated pay cuts through an arcane and bizarre price-fixing scheme. The most recent of these pay cuts was scheduled to be 21% . A reduction in gross revenue of this magnitude threatens to put many small practitioner-owned companies out of business.
14. The President of the United States has more than once scapegoated members of this profession in nationally televised speeches (here and here).
15. Practitioners remain uncompensated for a very large percentage of the work they do for their clients.
16. Typical workers in this profession spend many more than 40 hours a week at work.
17. Members of this profession experience very low job satisfaction with as many as 43% responding in the affirmative to a survey asking if they would leave their careers if they could afford to do so.

All of the above despite a growing and severe shortage of these professionals, the extremely high regard in which these professionals are held by their fellow citizens, and the fact that every single human being will need their services at multiple points during their lifetime.

At this point, your adult child runs out of breath and looks at you expectantly.

What advice would you give about the decision to enter this particular line of work?

Dr. Arie Friedman, M.D. is a general pediatrician and medical practice owner in Lincolnshire, Illinois. He blogs at Stuffy Noses and Sore Throats and BrokenMedicine.com.

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