Experience points

I get a lot of hits from a link in this pre-medical student forum, and reading through it, I was actually quite horrified. My Don't Become a Doctor series is all about the downsides of the practice of medicine, but I didn't think people were actually sitting down and calculating the costs, trying to balance out MBA vs JD vs MD. A word to the wise, DDS wins that contest every time.

The prevailing argument throughout the forum revolves around whether physician compensation is adequate to defray the costs of medical school and residency. I think that you can add and subtract all the dollar figures you wish, but that's not the cost of medicine.

The real cost of medicine is not that I will make only ~$130k as a general internist. The cost to me is that from the age of 21 to 29, I was doing nothing but studying and working. My friends got jobs, got married, bought houses, and in some cases had kids. I did none of these things. My single friends spent their evenings hanging out in the social scene, developed big networks of associates. I don't know anyone outside of health care.

Undoubtedly, you'll say that there are plenty of docs who got married in med school, had kids in med school or residency, and have all the things that I mentioned: a wife, a home, a family, a big network of friends and social support. This is true. But do you think any of those new spouses or new parents wanted to spend 80 hours a week in the hospital away from their families? Many of my friends with kids never saw their child's first words or first steps. As I like to say, one of my colleagues celebrated the birth of his child by taking an afternoon off. I tell people this jokingly, but it's true. He took a half day.

Who cares about the money? Medicine cost me my twenties. I can't put a dollar figure on that. While other people were backpacking Europe, I was scouting out the best spot in the library to study. While everyone else was amassing a treasure trove of experience points and leveling up, I've been sitting at lvl 1.

If you ask me today if it was worth it, I'll say yes. I am doing something that I love, and I am getting paid handsomely for it. I have reached a point in my life where I am finally reaping the benefits of all that sacrifice, but the thing about sacrifice, you have to give up something good to get something good.

Shiny new toys

Someone in my hospital bought a new Mercedes CLK AMG convertible. It's almost a crime to be driving it outside in the weather we've been having. Still, it's managed to keep its shine, despite some mud splatter and water spots. I saw it in the physician parking area while I was heading in, and I couldn't help but stop and gawk.

One of my colleagues spotted me in the parking lot and caught up to me. He saw what I was looking at and whistled. "Man, that's a beautiful car." We both stood there for a while, in awe of such a fine piece of German engineering.

When I became an attending, I bought a fancy car. It wasn't too fancy, but certainly was not entry level. In the parking lot, it's very respectable, but clearly shows that I am not a subspecialist. I have nothing to be ashamed of. Considering my salary, it's quite a nice car, but my car's sticker price isn't even half of the CLK AMG cabriolet. This person laid out near $90k and is driving it in winter weather in the Midwest.

Every now and then, I think that I could be making more money. I could be working better hours. I could have an easier life. I have certainly earned it. And when I see something so gorgeous, that I can probably never own, it hurts sometimes. I think my colleague saw me comparing the Mercedes to my car.

"Y'know," he noted. "It's too bad that you can't judge a physician by the car he drives. Then it'd be really easy to find a good doctor." We both got a good chuckle and headed inside.

One of the things that I realized during medical school is that the value of something can seldom be measured with dollars. Doing something I love, that is worth a CLK AMG Mercedes. It's worth a Lamborghini Murcialago. It's worth an Aston Martin DB9. It's worth far more to me than 4 wheels and some metal. I can't really quote scripture and verse, but there is one line from Isaiah (55:2) that I like: "Why spend your money for what is not bread; your wages for what fails to satisfy?"

Sure, I'd like a fancier car and a bigger TV and a fancy house. I'd like a lot of things. But at the end of the day, they are things. And things cannot bring happiness. Joy is doing, not owning.