A Few Questions About The Medical Profession (From Someone In Law)

[pikachu89]

(Not sure if this is the correct sub-forum -- let me know if it isn't)

 

 

I am considering applying to medical school over the next 2-3 years but I have a few questions regarding the medical profession. While I have done some research, I have been unable to find answers to my specific questions, which are informed by my previous career involvement. Any advice (or hint as to what terms I should be searching on Google) you can provide will be much appreciated. I realize the answers may vary according to the practice area, so any thoughts regarding the scope of this difference would be helpful. 

 

I’ll give you my questions first, though they may be clearer if you read them in the full context of my post that follows the list of questions.

 

1. To what extent is business development a required or necessary element in the medical profession? This includes attending regular cocktails, community events and other activity the aim of which is to find and maintain clients.
2. To what extent are there jurisdictional barriers to the medical profession? Specifically, is it difficult to switch provinces after being admitted to practice?
3. To what extent does learning and practicing medicine involve learning factual material and applying it (as opposed to, say, using a unique context to inform a creative solution, the strength of which may be arbitrarily determined?)
4. Is retention a problem in the medical profession? For example, is there such thing as “doctor burnout” following which physicians will leave the profession to do something else?
5. Realistically, is job security ever an issue once you find your first job, both now and long-term? 

 

My questions have been prompted by a number of factors. Specifically, I’m a law student (with confirmed employment at a top-tier multi-national firm following the completion of my degree) but I have realized through my studies and work so far that law is not what I thought it was. I feel that the drawbacks may outweigh the benefits and I’m not opposed to changing course if medicine has a better outlook. I may also continue to keep the option on my long-term radar and consider it in a few years if my situation changes. I have a quasi-science background (undergrad science minor) and practice in an area of the law that overlaps directly with science, so I feel that medicine is not so foreign as to elude my abilities. Further, I have always thought about practicing medicine, and my interest in science is part of what prompted me to pursue the area of law I am practising now. Additionally, I’m looking at medicine as opposed to other professional science degrees because I am interested in helping people directly but I am curious about the complexity of addressing individual health concerns from a research perspective if possible (I imagine pharmacy is also like this to some degree) while maintaining the security of professional accreditation that offers a relatively positive career outlook and flexibility in practice area (at least when beginning). 

 

My complaints about the law are reflected in the questions above. Business development is a crucial factor to success in the legal practice (if you don’t bring in enough clients, you don’t make partner). The social element is incredibly pervasive and every context I find myself in requires me to make small talk, schmooze with potential future clients, and befriend people I have no interest in knowing (I'm a “learned extrovert” but much prefer not to interact with others and instead to do my work). A lot of importance is placed on contacts, and lawyers who have families/friends who are important appear to do better, or at least succeed with less effort. For example, many who are arguably less competent but whose parents/friends/neighbours are presidents, etc. of the companies in our client base appear basically to be guaranteed a healthy career. Those who are not in this situation, to my understanding, need to be social. I am neither, and I feel like I am facing an uphill battle, without a large contact base to dip into to keep my career afloat or the social aptitude to build one. The law firms or employers that do not sustain this type of environment do not interest me from a pecuniary or quality-of-work perspective.

 

Jurisdiction is an additional source of concern. I am employed and studying in a province different from that which I come from, and while I wish to stay here for the next few years, I’m unsure if I want to remain forever. In my situation, switching provinces appears to be incredibly difficult/impossible once I am a few years into practice. (Trust me on this one – I don’t want to divulge information that will identify me, but I am correct in what I say with respect to the provinces in question in my specific situation).  

 

Long-term prospects are also a bit dim. Most law-trained professionals do not appear to still be practicing law decades after their training, burnout and a lack of job security being primary reasons. Even at top firms this is the case.

 

Lastly, with respect to my overall learning style, the law does not appear to align well with me on a cognitive level. Everything is very abstract and there is basically never a right answer to a client’s problem. While I have acquired strong abstract learning skills in law school and feel I am adept at research, too much of what I do is so subjective and subject to arbitrary review (even the greatest arguments only win half of the time) such that the only meaning I can derive from my work is the fact that I’m getting paid, as well as the intellectual stimulation, but I do not feel I am making a difference (and even where I do, the client is a large company that is basically just reducing its expenditures through my services). I would much prefer to apply sound, confirmed and proven information to a factual scenario (of a patient, etc.) than what I am doing now in the law, which appears too imprecise to predict and likely to change in a year anyway (given the nature of judicial reasoning and the evolution of the law) as well as being too much of a drop in the ocean to make a difference to anyone. 

 

Anyway, this should give good insight into what has prompted my inquiry. Thanks for your time. 

[B3.572A]

Just from the writing of the OP, I can feel it is not from a typical life science majored premed I do not know too much about the questions raised by the OP, but just want to express my encouragements. I think OP's background in law and training in logical reasoning can surely lead to a uniquely successful career in medicine. Good luck!

[not my real name]

As someone who came from law and is currently aiming at med, I hear you.  I can tentatively answer your questions, but, really, most people in here are either applying to med or in med school, so you might not get the answers you are seeking. Here are my relatively informed guesses.

• To what extent is business development a required or necessary element in the medical profession? This includes attending regular cocktails, community events and other activity the aim of which is to find and maintain clients.

I highly doubt this is significant feature of medical practice, unless you are talking about private practice (private plastic surgeons might have to go out and recruit patients...) I think for some office-based specialties you do need to make contacts among referring physicians (if you are a specialist), but I'm not sure how much that dominates your work. If you are in a hospital or clinic, I'm pretty sure you don't have to worry about patient levels.

That said, you do mention a certain discomfort at the social aspect of law practice. Would this apply to actually working with patients as well? With some exceptions, medicine is a patient-centered profession. How would you feel spending your entire day working directly with patients, which inevitably involves building links, empathy, etc.. Granted, this is *very* different from "schmoozing" - I hate cocktail party talk, but love working individually with clients/patients. 

• To what extent are there jurisdictional barriers to the medical profession? Specifically, is it difficult to switch provinces after being admitted to practice?

From friends who are in med, it seems very easy to move between provinces. I do not believe there are any significant barriers.

• To what extent does learning and practicing medicine involve learning factual material and applying it (as opposed to, say, using a unique context to inform a creative solution, the strength of which may be arbitrarily determined?)

This is probably a complicated answer... Medicine is evidence-based, so medical decisions need to be rooted in factual and supported material attempting to explain natural phenomena. It is probably much less abstract than law from this perspective.  That said, science is not as concrete as we like to imagine, so I'm sure there are many many situations in practice where you need to think outside the box in terms of diagnosis and treatment. I think only a practicing physician of years experience could really answer this question.

• Is retention a problem in the medical profession? For example, is there such thing as “doctor burnout” following which physicians will leave the profession to do something else?

Again, from doctors I know, yeah doctor burnout is an issue. You work in a high stress environment, you deal with very emotional issues, you see people die, and you have to make good decisions. Granted, some environments are likely more stressful than others (ER trauma doctor versus, I don't know, dermatology? No disrespect to dermatologists intended). That is a recipe for burnout, no question. Is it more/less frequent than in law... I have no idea. Maybe there is more job satisfaction? Maybe the social perception of doctors vs. lawyers helps you deal with the workload.

• Realistically, is job security ever an issue once you find your first job, both now and long-term? 

Depending on province and where you want to live, finding employment in your field in some urban areas can be challenging (from various news reports I've read recently).

 

Feel free to private message me if you have any questions re: making the switch.

[BTJJ]

I've been practicing law for over 15 years, and after careful consideration have applied to medicine for many of the same reasons as the OP.

 

As far as interprovincial mobility in the legal profession, it is not that difficult anymore from a licensing standpoint. Even in Quebec where I practice, with our "distinct" Civil Code and civil law tradition, we can now get admitted to other provinces' bars with little difficulty. The barriers to movement however have everything to do with marketing and networking. For example, a securities lawyer in Toronto will have little difficulty being admitted to the Law Society of Saskatchewan, but good luck finding any clients in Saskatchewan in need of your services. A divorce lawyer in Moncton can pick up and move to Winnipeg, but he will have to leave behind all of his contacts and sources of client referrals. I practice in tax, an area of federal jurisdiction; my expertise is easily transferrable to Calgary or Vancouver and becoming licensed in BC or Alberta is a trivial obstacle, but my clientele will not follow me to the west nor will my 15 years of contacts and networking. It doesn't matter what field of law you are in; you could be a trademark or patent lawyer, both fields of exclusive federal jurisdiction, and therefore your expertise and qualifications are as valid in Vancouver as in Toronto or Halifax, but if you can't bring your clients with you, you can't move - or you can move and start over. If you have around 3 years experience you can get a job elsewhere and you are not expecting to be bringing a book of business. After five years, if you don't have a portable book of business, your job prospects are limited. If you do have a portable book of business, you can write your own ticket where ever you wish.

 

By way of contrast, a month or so ago, a new medical clinic (general practice) opened up in downtown Montreal. They leaked to the press that they didn't have enough patients. The next morning people were lined up outside the door waiting for the clinic to open - some camped out overnight. I've been spending the last 15 years trying to fill my "dance card" for my law practice, with mixed results. A couple newly minted MDs can fill their patient list in 2 days. That appears to be the case for generalists at least, who don't need referrals. I have no idea what it is like for specialists - do they need to "schmooze" the GPs to get referrals? Or are they just as booked up. For specialists who practice in hospitals, I would think that being able to play "office" politics skillfully would be a key to success. From what I hear, hospital politics can be quite brutal. Keep in mind however, that my views on medical "marketing" are based on conjecture and a handful of discussions with practicing physicians, not personal experience.

 

As for the introvert/extrovert divide, keep in mind that medicine has far, far more "human" interaction than law. In law one may need to do the schmoozing/cocktail circuit to build a clientele, but much of one's time is spent reading, writing and studying. With email replacing the telephone for many simple communications, much of a lawyer's life can be spent quietly in front of a computer screen, reading and composing documents and correspondence. In medicine, unless you're doing autopsies, I would think much of your day is spent meeting, talking and interacting with living people - in medicine, just "doing your work" involves a high degree of interaction with other people. Medicine might relieve you of having to be a salesman, but if interacting with people in not your thing, medicine might similarly not "feel right" for you. On the other hand, much of the physician human interaction, such as a patient consultation, will be face to face, one-on-one. Often introverts function rather well in private one-on-one situations, and only experience diminished functionality in the unstructured group events such as a cocktail party, "meet-and-greet" or similar social events.

 

If you're interested in research, my understanding is that a big part of success in research involves securing financing, so you're back to being a salesman for your projects, pitching your ideas to those who hold the purse strings, and schmoozing with those who finance medical research. If you bring in the research dollars, you're the king; if not - well, I don't know what happens to researchers who cannot secure funding.

[Intotheblue12]

I think a lot of lawyers run into this problem. You have to bring in your own business, whereas being a doctor, your clients line up for you. If I were OP I would probably do some volunteering where you are doing 1 on 1 work with people all day long to see if its something you can see yourself doing. Is law really that bad that after 15 years people are trying to quit?

[Bede]

OP (and other lawyer-MD types),

 

Do you find that there is a huge disconnect between the ideals of the legal profession and the reality of the profession? Perhaps more than any other profession?

[makingfetchhappen]

OP if you like the work that you are doing now, I think it might make more sense for you to stay in law than to leave for medicine, just based on your questions.

I agree with what the posters above have mentioned and I would also like to add my two cents.

It sounds like your main problem is that you like being in private practice, but worry about developing a book of business. It can be very difficult to build a book in some fields/firms/cities/areas of law, that's for sure. But I would not let a dislike for small talk, schmoozing, and cocktail parties make you think that you cannot do it. No magic happens at cocktail parties. In fact, I personally do not think they are a very good use of time for developing business.

Business more often just comes from maintaining your genuine friendships and business relationships. You need to be a people person for this, but not an extrovert at all. It's all about keeping in touch with people and being able to maintain a wide social circle. You sort of need to genuinely like a lot of different kinds of people and enjoy conversation with them. If you think you can do that and make a point to follow up and keep friendships going, then that is the only ability you should need. Also, lots of lawyers build a reputation as being an expert in a certain niche and they write papers on their areas of law, give talks, etc. Making a name for yourself as a trusted expert is much more important than small talk.

Do you think Linda Rothstein or Sheila Block got where they are by making great jokes at cocktail parties? Nope, they put their names out there as experts in their fields and probably also by keeping involved in their communities, but it's their work that it is the more important part.

I would suggest trying to find mentors who have been successful in your field and meeting with them regularly for ongoing advice. Learn enough from them and through other research about your specific area of law and legal market to determine whether you can make it to the partner level if that is what you want. The only thing I would worry about is that it seems like 10 years ago you could make partner 5-10 years out, and now it's getting to be more like 15 years out or more. If you like the work and you can see yourself making partner someday, the financial rewards would definitely be there. However, you need to have some certainty that you will get there someday and be happy making an associate salary and working associate hours for the next 10-15 years. Also, a lot of partners work long hours their entire careers as well. This is where burnout, lack of job security, and also uncertainty (will you make partner?) come into play. At the end of the day, I would hold onto that big firm job and aim to impress so you get hired back after articling. It's tough out there but once you pass that hurdle, at least you can be comfortable in that big firm for a while. If you decide to pursue medicine, hold onto that job until you get accepted, and while you are articling put your heart and soul into it as if you are not considering medicine. It's tough out there even for the brightest lawyers so your employment at a top firm is not something to be taken for granted. In this case a bird in the hand is worth many in the bush!

Hopefully my insight is a little bit useful for you and feel free to PM me if you'd like to pick my brain about this some more. I'm only a mid-level, but I feel like I have learned a lot about the profession in the past few years that I did not know starting out.

As far as relocating to a different province, friends of mine in medicine say this is not too difficult, you could even move to the states. Job security is amazing in family medicine and most specialties, but some specialties there are problems developing with over saturation.

 

When it comes to uncertainty, I don't think medicine is going to be any better than law. No matter what area of medicine you are in, there are going to be adverse reactions and side effects all the time, and all you can do is make the best decision you can with the evidence that you have. I would say that law is actually easier that way because all you have to do is tell your client what the likely outcome will be (or that it could really go either way and neither is more likely) and the decisions are theirs to make, not yours. Also, clients going to court are much more aware and accepting of the risk that they might lose than say a patient consenting to treatment is aware or accepting of very rare but very serious side effects or complications. You sound like a smart a conscientious person, disliking uncertainty comes with the territory of a good professional I think and comes easier with time. Imagine being a doctor and prescribing some straightforward medication to a patient and as a side effect they have a severe complication or even die? This can happen even if you are the most prudent doctor making the best decision. I imagine that dealing with uncertainty is an even bigger problem for doctors, but they just have to learn to accept it because they cannot help people without any risk.

Bede: I'm not sure what your question is exactly but there are difficulties in law in that, like medicine, it's a helping profession, but in certain ways it can be more difficult to help them. Doctors get to help people by prescribing medicine and performing procedures on a large number of people. Lawyers who help people going to court need to spend a long time helping each client. Even the smallest court case is going to take a minimum 40 hours of a lawyer's time, and most people will have trouble paying for that. Criminal lawyers who accept legal aid have an extreme and unrealistic limit on the amount of hours that they will get paid for to do a trial. Family lawyers have huge problems with this too and a lot of people who need them end up self-representing. You can't just go out and help people who need a lawyer and expect to keep a roof over your head, so that can be very frustrating and is one thing that makes medicine so appealing.