When I first started medical school, I thought medicine was something that I could fall in love with. It is like going on a date with the girl you’ve always liked. In the beginning, you think she is so perfect. You would endure through anything just to be with her. You overlook the bad things about her, and magnify the good. But when the infatuation dissipates, you’ve realized the huge difference between what you saw through your “love” goggles, and what is actually in front of you.
I am in medicine for 4 years now. And there have been many days when I’ve wanted out. But as I look closely as my situation, I think I’m a bit unfair to lady medicine.
There is nothing bad about medicine by itself. Promoting health, preventing illnesses, and curing diseases are all good things. Those are much, much better than bankrupting an entire country. (I’m looking at you, Wall Street.) But what really sucks about medicine is the whole system built around it: the bureaucracy, mountains of paperwork, and loss of power for the doctors. (And yes, that includes medical school.)
Medical school is merely a replica of the American healthcare system. You’ll get your fair share of bureaucracy, bullcrap work, and loss of power.
It would be a crying shame if I left medicine due to the piss-poor education system. The more I reflected upon my future (wondering if I will stay or if I will go) I’ve realized that you can love anything — from engineering, accounting, art, writing … and even medicine — in the right environment.
If all the criteria for the right environment match up, you will enjoy medicine. As you enjoy medicine more and more, you will get better and better at it. Eventually, you will be so good at your work, you can make a huge impact in the world. And of course, those who provide the most benefit are also those who receive the most rewards. I’m not just talking about inner peace and satisfaction. I’m talking about fame, money, and whatnot that go along with success.
I can’t claim the idea, because I learned about it through Daniel Pink’s book, Drive: The Surprising Truth About What Motivates Us.
Would you like to know what are the criteria for a magical “right environment?” If so, keep on reading …
Basically, an activity, work, or hobby must meet the following 3 criteria for you to get satisfaction from it:
- autonomy – the ability to do what you want, when you want
- mastery – the ability to keep on getting better at what you’re doing
- higher purpose – the meaning behind the work you do
If all the criteria are met, you’ll have an incubating ground for mastery. People will love their work so much, they’ll dedicate their lives to it. That is how you get the Mozarts, Van Goghs, Einsteins, and other masters of the world. All these people went in their field, not for the external rewards, but because of the internal rewards. They like what they do so much, they would still keep on working even if they weren’t paid.
On the flip side, if any of the criteria is missing, you can still do the work without any problem. Heck, you may even be good at it. But you won’t get joy from it. This scenario very much describes the common person. He doesn’t want to get out of bed at 7:00 AM for work. He dreads the horrible commute. He daydreams about winning the lottery and quitting the job. He can’t wait to leave at 5:00 PM (maybe even a little earlier, if he can help it). If he doesn’t get paid, he’ll stop working in an instant.
How Medical School Kills Passion
If you’ve been following my site, there is one ironic thing you’ve probably picked up: I hate medical school. And for good reason too. Your exposure to medicine during school does not meet any of the criteria.
You pretty much have no autonomy whatsoever. Your courses are pre-determined. Your schedule is pre-determined. Your exams are pre-determined. The hours you spend on rotations are pre-determined. If you try to deviate from what is expected, your grades will suffer.
If your grades suffer too much, you won’t graduate and become a doctor.
For the 4 years, you’ll definitely
learn memorize a lot of facts, but I could hardly consider that medicine. On rotations, you may or may not get to do a few procedures here and there: suturing, drawing blood, holding retractors … You certainly won’t get to do enough procedures, even the minor ones, to get good at them.
And anyways, the exposure you get to medicine is way too broad. You may graduate as a jack of all trades, but you’re also a master of none.
Seriously … Does the work you do while in medical school matter? Does memorizing a lot of information benefit patients? Does doing the scut work make the world a better place?
For most medical students, the primary purpose of medical school is to graduate and become a doctor. Everything else, including helping people, is secondary. (If your goal really was to help people, you would have done it without going to medical school.)
How the Healthcare System Kills Passion
As you graduate from medical school and become a doctor, it may not get any better.
In residency, expect no autonomy. Your program will own you. I have no yet gone through it myself, but I’ve heard it is worse than medical school. Oh joy!
Once you are done with residency, there is a lot more autonomy. As long as you have a medical license, you can do whatever the heck you want. However, most people choose to work in a hospital or join a group practice. Doing so will restrict your freedom. But at least, you’ll feel secure with your job. (Beware! The security is an illusion.)
Since the American healthcare is the most regulated industry in the world, there is definitely a lot of restrictions on what a doctor can safely do. Politicians, third-party payers, lawyers, and special interest groups all got their grubby little hands in the honeypot. They all want to dictate what doctors can and cannot do.
If you wanna survive as a physician, you’ll have to obey your many masters. Having one master is unpleasant. Having many masters absolutely sucks! Maybe that is why medical school is academic hell. This way, your miserable life as a doctor will seem like heaven compared to your wretched life as a medical student.
Expect little or no autonomy.
Your medical license will grant you freedom in terms of medicine you want to practice. You can legally do surgery, even if you did not have the training in residency.
If you see enough patients, you can master whatever medicine you do.
Having a higher purpose depends you. Medicine could just be a job to feed yourself and your family. Or it could be a platform to do a whole truckload of good for the community and for the world.
I admit … Higher purpose can exist.
How to Love Medicine Again
Doctors’ main reason for quitting medicine is the lack of autonomy. They frequently complain of increased regulations, increased paperwork, and decreased reimbursements. All these restrict doctors from practicing how they want to practice.
Therefore, if you wanna love medicine as much as you did when you were a naive pre-medical student, you have to seek autonomy.
It is hard to find it in the current healthcare system.
It is hard to find it working for a hospital.
It is hard to find it working for someone else in a private practice.
It is hard to find it accepting Medicare and Medicaid.
It is hard to find it accepting money from insurance companies.
You can find freedom and autonomy by being as self-reliant as possible. Work for the patients only. Not for anyone else. Cut out all middlemen. Get rid of everyone that is trying to piggyback off of you and your patients.
It is time to go back to the old-school method of medicine. Cash only. No insurance. Doctors and patients only. No outsiders and unnecessary deadweight.
Imagine what this would look like. Prices are transparent. Patients will know how much each item costs before getting the treatments. Medicine is suddenly affordable. Bills are no longer inflated to cover the low-balling insurance companies and excess overhead. There is more patient satisfaction: less wait time and more face time. The doctor knows each patient personally. The patients’ health improves, because they’re treated like a valued human being.
This is something I can fall in love with. This is why I chose to become a doctor.
For thoughts about medicine and its future, visit the About Alex section and look for “Musings (My Philosophy on Medicine).”