The case against family medicine

[rmorelan]

I feel like being a teacher really depends on you... I remember a couple elementary school teachers who just didn't really care about teaching the students and seemed like they were having a very relaxed and easy time. Even in high school I had a couple teachers like that.

Also had a few who do their job of teaching/marking and never seem stressed.

 

In contrast, some teachers were always stressed out over the smallest things, always snapping over every little thing, those people would be stressed in any field

 

can be field dependent and experience as well of course - creating new content is much more stressful than just doing the same thing for the 15th time

[aaronjw]

actually was a high school teacher for a year - computer science - and it can certainly be stressful I guess, but not potentially panic inducing.

 

Neurosurgeons aren't panicy people.

 

Last thing you want is a twitchy neuro when the stress levels start to rise lol

[rmorelan]

Neurosurgeons aren't panicy people.

 

Last thing you want is a twitchy neuro when the stress levels start to rise lol

 

nope they have ice water running through their veins. The worst I heard from a neuro surg when things went sideways was "well, that's not ideal"

[Exocytosis]

Come back after you perform a cranial operation at 3am on someone who's dying and been shot in the head... then compare that to teaching math to kids.

 

And yes i have worked with kids.

 

Psh, easy peasy. Reach in, take out bullet. Boom. Done.

 

Now teaching kids long division? That's clearly much harder.

 

This is my earnest opinion and not at all a joke I am amazed that people took seriously.

[bloh]

An internist I worked with told me if he could do it again, he would do family. His piece of advice was that, "No one ever tells you medicine gets easy, it takes a while, but eventually you master all the knowledge you need if you are committed to learning it and then all you're left with is the patients. Choose a type of medicine based on the type of patient encounters you like or don't like. I like to make people feel comfortable and happy. You know what makes patients feel good, when the family doctor who they've known for 30 years comes to see them in the hospital. In spite of whatever I do for them that's what makes them happy and I will never have that relationship with patients. No one will have the relationship with patients family doctors can have."

 

.

 

That's a pretty myopic representation of family medicine. The truth is that the vast majority of your patients will NOT be happy with you in family medicine. They'll be angry with you when you refuse dumb referrals they think they need and when you brush off their 8th chief complaint as you head for the door.

[Lactic Folly]

I'm always battling how to explain things to a patient without it coming off as if I'm talking down to them, because I know I personally get quite irked as a patient when a physician who doesn't know my occupation is talking to me about "poop" or "belly pains." But you can't assume anything, even if your patient is educated.

 

I just throw out both terms at the same time and see which one they pick up on when they reply, e.g. "Do you see a nephrologist for your kidneys?"

[NLengr]

nope they have ice water running through their veins. The worst I heard from a neuro surg when things went sideways was "well, that's not ideal"

 

That's pretty standard for any surgeon.

 

Panic kills the patient when crap goes wrong in the OR.

[HycrestJIT]

That's a pretty myopic representation of family medicine. The truth is that the vast majority of your patients will NOT be happy with you in family medicine. They'll be angry with you when you refuse dumb referrals they think they need and when you brush off their 8th chief complaint as you head for the door.

 

Family medicine is not for everyone, but it certainly isn't anything resembling the sh*tstorm you're describing. Or maybe it is, if you don't have the people and management skills to succeed in it.

[Dongzhuo]

The bigger problem is not the perceived importance from the general public but your own ego driven perception of self importance.

 

My father in law was a fairly renowned engineer who at the top of his career was a Canadian representative to the UN at a number of conferences. You'd never know it though. He was just a northern boy who spent more time talking about his family, friends, and sports than he did his career.

 

His career was his job, his family was his life.

 

Now if you have an empty life and deeply rooted self esteem issues then I can see some of you'd be wrapped up in the outward perception of your career or potential career and the income earned.

 

A nurse is unhappy with her job and wants to be an MD.

A manager is unhappy with his job and wants to be the CEO

The Vice president is unhappy with his job and wants to be the President.

An AHL player is unhappy with his job and wants to be in the NHL

 

Do they have deep seated self esteem issues or do they want to strive for greatness?

[Dongzhuo]

So . . . .

 

what are you going to do?

 

I will give an update as my R2 year draws to a close

[Lactic Folly]

A nurse is unhappy with her job and wants to be an MD.

A manager is unhappy with his job and wants to be the CEO

The Vice president is unhappy with his job and wants to be the President.

An AHL player is unhappy with his job and wants to be in the NHL

 

Do they have deep seated self esteem issues or do they want to strive for greatness?

 

Well, the common thread in these examples seems to be unhappiness - so even if these people achieve what they purportedly seek, I wager they will still be unhappy as long as they are focused on comparing themselves to others. There will always be a CEO of a bigger company, a president of a more prestigious university, a higher paid NHL player elsewhere.

[RunningGuns]

Although I definitely couldn't imagine being a General Practitioner myself, I have the utmost respect for my GP. He's been there for my family for over 30 years, and has done a lot in the community, such as opening our first emergency clinic. Although the majority of us have been referred to specialists at one point or another, he's definitely our primary care provider that we bring our concerns to and discuss options with. To further add to his character, when my grandmother was diagnosed with terminal cancer, he used to drive out to her place and check on her every couple of days until she passed away. He even made suggestions on how to make her home more accessible as she lost her ability to walk and became bed ridden. He's entirely worthy of respect by his patients and peers.. In my opinion, I don't think being a GP takes away from that.

[Pink Tulip]

Well, the common thread in these examples seems to be unhappiness - so even if these people achieve what they purportedly seek, I wager they will still be unhappy as long as they are focused on comparing themselves to others. There will always be a CEO of a bigger company, a president of a more prestigious university, a higher paid NHL player elsewhere.

 

^^^^^^^^^^^ this.

 

A nurse is unhappy with her job and wants to be an MD.

 

Do they have deep seated self esteem issues or do they want to strive for greatness?

 

You're picking a huge (and stupid) fight with nurses if that's how you think. Don't open a can of worms you clearly don't understand.

 

GPs are much better than their Google "counterparts". Striving to be a surgeon because of it's "greatness" doesn't work. You're defining "greatness" by income solely, which hopefully isn't the only reason people enter the MD profession. I don't completely understand why surgeons are seen are on top of the MD scale other than for income. Your GP should be the primary provider, meaning he settles your worries and keeps you healthy. If you have questions or concerns about your health, you see your GP. You only see a surgeon when there's something gravely wrong, they help you, and then it's back up to your GP again to keep you in good health. They're ideally there for your whole lifespan (or as much as they can). You come to rely and trust your GP to know you and your body and how to take of it properly.

 

So in that regard, I have more respect for GPs that actually take the time of day to be there for you for years, not just for a couple of hours. There's a different depth of trust and relationship between GP-patient that you just don't get as a surgeon. You don't need personal skills to pop out a kidney. If anything I feel bad for many of them because they work so many hours and are always exhausted (from what I've heard).

[Dongzhuo]

^^^^^^^^^^^ this.

 

 

 

You're picking a huge (and stupid) fight with nurses if that's how you think. Don't open a can of worms you clearly don't understand.

 

GPs are much better than their Google "counterparts". Striving to be a surgeon because of it's "greatness" doesn't work. You're defining "greatness" by income solely, which hopefully isn't the only reason people enter the MD profession. I don't completely understand why surgeons are seen are on top of the MD scale other than for income. Your GP should be the primary provider, meaning he settles your worries and keeps you healthy. If you have questions or concerns about your health, you see your GP. You only see a surgeon when there's something gravely wrong, they help you, and then it's back up to your GP again to keep you in good health. They're ideally there for your whole lifespan (or as much as they can). You come to rely and trust your GP to know you and your body and how to take of it properly.

 

So in that regard, I have more respect for GPs that actually take the time of day to be there for you for years, not just for a couple of hours. There's a different depth of trust and relationship between GP-patient that you just don't get as a surgeon. You don't need personal skills to pop out a kidney. If anything I feel bad for many of them because they work so many hours and are always exhausted (from what I've heard).

 

How many times do I have to reiterate this has nothing to do with money...

[Dongzhuo]

Well, the common thread in these examples seems to be unhappiness - so even if these people achieve what they purportedly seek, I wager they will still be unhappy as long as they are focused on comparing themselves to others. There will always be a CEO of a bigger company, a president of a more prestigious university, a higher paid NHL player elsewhere.

 

I guess unhappiness could be defined in many ways. I'd rather call it..... Hunger. If you were 100% satisfied that would mean no drive no hunger to push on to achieve more

[Lactic Folly]

I guess unhappiness could be defined in many ways. I'd rather call it..... Hunger. If you were 100% satisfied that would mean no drive no hunger to push on to achieve more

 

Agreed - but that can be done within the context of family medicine - being the best you can be to serve your patients and community, establishing needed programs, taking on greater roles in various organizations, etc. This is different than envying the perceived prestige that specialists have, which is a less productive endeavour.

[Fullmetal_Biochemist]

I don't understand. You made the decision (no one forced you), so take the consequence of your own choice. Why complaining? Be it good or bad, it was you that choose this path.

[BoyInTheBubble]

I guess unhappiness could be defined in many ways. I'd rather call it..... Hunger. If you were 100% satisfied that would mean no drive no hunger to push on to achieve more

 

By this dumb logic, you'll never be happy. Ever. You can be satisfied, fulfilled, self-actualized and any other term AND STILL WANT MORE.

 

You are obviously unhappy. You came on here to vent about your many frustrations. You seem to ignore or have an excuse for everything. People probably look down at you because you look down at yourself. People won't respect you if think you're the embarrassment.

 

People don't refer to specialists because the specialist is smart. They refer to them because they chose to focus their training in the area that the patient needs that you haven't learned.

 

You made into and through medical school, so you aren't useless. If you don't want to be a family doctor, change fields. If you continue to be one, be proud of the fact that you help people out and make a lot of money doing it. You apparently don't care about the money, just want to be held up high on a pedestal and revered in a prestigious light from afar!!

 

Being bored to death as a family doctor for your career is an envious position to most people. Do something other than self-loathing in your spare time.

[tooty]

I'd argue that you can 'do more' and make a world of difference for your patients by being an excellent GP.

 

There are hacks in family medicine. It's one of the hardest specialties to master. Why not take pride in knowing that patients are better off in your care vs the next guy?

[medigeek]

OP probably wouldn't even be happy if he was a billionaire CEO and a world famous physician.

[rmorelan]

OP probably wouldn't even be happy if he was a billionaire CEO and a world famous physician.

 

ha maybe but I do think the OP has a point - many people just won't be comfortable only the GP's station in medicine. Some people think doing something for money (beyond a point) is silly, some people think doing something for helping others solely is silly, some people think doing something for respect to a large degree (again after minimums in other areas are met) is silly but still these are all very common reasons in medicine for people doing what they are doing. They OP could easily BE happy if he does value respect primarily if he was in a different field than FM.

[futureGP]

ha maybe but I do think the OP has a point - many people just won't be comfortable only the GP's station in medicine. Some people think doing something for money (beyond a point) is silly, some people think doing something for helping others solely is silly, some people think doing something for respect to a large degree (again after minimums in other areas are met) is silly but still these are all very common reasons in medicine for people doing what they are doing. They OP could easily BE happy if he does value respect primarily if he was in a different field than FM.

 

it is OP's personal case against FM. he values respect, and family doctors are not known to get respect from the lay public (though many do, depending on their relationship with the patient base).

 

OP might've been happier had he chosen a surgical field where the results of his work are very concrete and easy to appreciate.

 

So why is OP in FM again?

[TheBoss]

There was a custodian who worked in my school's cafeteria. Great guy. Did his job exceptionally well. Kept the place clean. Treated students well. Did whatever he could to make sure the cafeteria was a good place to eat in. I respected the guy, and I'm sure many other people did too. But I would consider it to be a different kind of respect that what OP is looking for. If we really wanted, we could probably tease apart the word into more precise terms, where OP's kind of respect is distinct from some other kinds of respect that are gettingthrown around here.

[Dongzhuo]

There was a custodian who worked in my school's cafeteria. Great guy. Did his job exceptionally well. Kept the place clean. Treated students well. Did whatever he could to make sure the cafeteria was a good place to eat in. I respected the guy, and I'm sure many other people did too. But I would consider it to be a different kind of respect that what OP is looking for. If we really wanted, we could probably tease apart the word into more precise terms, where OP's kind of respect is distinct from some other kinds of respect that are gettingthrown around here.

 

Thank you. Couldn't have phrased it better myself. QFT.

[Dongzhuo]

ha maybe but I do think the OP has a point - many people just won't be comfortable only the GP's station in medicine. Some people think doing something for money (beyond a point) is silly, some people think doing something for helping others solely is silly, some people think doing something for respect to a large degree (again after minimums in other areas are met) is silly but still these are all very common reasons in medicine for people doing what they are doing. They OP could easily BE happy if he does value respect primarily if he was in a different field than FM.

 

Its like a girl choosing a guy. There should be bare minimums for certain things that are of course Personal. If it's an otherwise great guy but he's 5'2 (no offense), it's going to be a problem for some girls but not all. Or if he's otherwise great but has only grade 11 education that could be a problem too for some. People value different things.