1 Boring Old Man

How Being a Doctor Became the Most Miserable Profession

The Daily Beast

April 14, 2014

A former student of mine, a cardiologist, was seeing me on a consultation because of an abnormality in a test. The question was, "Did I need a cardiac catheterization?" I knew I didn’t. I expect the referring doctor knew I didn’t. The cardiologist quickly knew I didn’t. He also knew that I blogged about the excesses of the pharmaceutical industry. I have a surprisingly respectable LDL ["bad cholesterol"]. Yet he said meekly, "How do you feel about Statins?" I answered, "Not big on them." But he persisted, "We like to see the LDL under a hundred in people with risk factors." I won’t go on, but I felt sorry for him. Like most doctors, he’s surrounded by Guidelines, Managed Care contracts, Medicare rules, etc. The original test was probably not really necessary, nor was the referral, nor would’ve been the Statins. But that’s the way it goes these days [No, I’m not on Statins].

This weekend at a neighborhood Bar-B-Q, I was talking to a neighbor who has a weekend place near where I now live. He’s an Ophthalmologist and I was talking to another friend’s daughter whose job is helping doctors learn to use electronic medical records. The Ophthalmologist laughed and told us that his group [twenty doctors] has 250 employees most of whom are involved with filing insurance and keeping up with the ever changing guidelines on electronic medical records. etc. etc.

I could go on like this for hours, but will spare you. It’s not whining, it’s the truth about practicing medicine right now. I’ve been exceedingly lucky in my life, and missed a lot of the misery that has developed since I reported to medical school in 1963. I changed to a specialty by choice that actually was one of the few that allowed me to evade the misery. That wasn’t the reason I changed, but just blind luck. I didn’t have much in the way of financial ambition and, again by luck, neither did my wife. I had a decent reputation when I left academia so I had a steady referral base for the years I practiced. In retirement, I work for free as a volunteer. Doctors who work for free can practice without the modern strangle-holds. I’m a lucky guy, still glad I went to medical school.