Grass is always greener.....are you happy with your choice of specialty?

[Yowza]

Don't think I'd do well emotionally in another specialty. I need to see definitive results with my work and cataract and LASIK surgery give you that positive reinforcement. Personally, I don't know how retina specialists do it; must be the bigger paydays. I'd be miserable seeing patients who see poorly all day.

[CordMcNally]

Don't think I'd do well emotionally in another specialty. I need to see definitive results with my work and cataract and LASIK surgery give you that positive reinforcement. Personally, I don't know how retina specialists do it; must be the bigger paydays. I'd be miserable seeing patients who see poorly all day.

You'd do well in EM. There's nothing more satisfying than a patient coming to the ED in an ambulance saying they can't walk because they are having too much pain. You tell them you'd like to try a non-narcotic approach and then they get up and storm out of the ED. If that isn't positive enforcement then I don't know what is. It warms the cockles of my heart. I feel like I'm watching my child take their first steps.

[eyecandy]

Same with ophthalmology, esp Cornea—extremely happy with my choice. Restoring people’s sight is amazing and sometimes I can barely believe I somehow trained to do this. The constant approval & praise from patients all day is heart-warming and so satisfying. Though the praise is likely setting me up for failure in personal relationships outside of work, I can have too thin a skin sometimes. He giveth & taketh…work place hazard I’d guess for many types of surgeons.

[K82]

You'd do well in EM. There's nothing more satisfying than a patient coming to the ED in an ambulance saying they can't walk because they are having too much pain. You tell them you'd like to try a non-narcotic approach and then they get up and storm out of the ED. If that isn't positive enforcement then I don't know what is. It warms the cockles of my heart. I feel like I'm watching my child take their first steps.

I always enjoy your wit Cord, but that one made me laugh out loud!

[STATscans]

I'm a radiologist and I'm happy overall with my choice of specialty in medicine although at times I envy my colleagues who have more patient contact. This is somewhat funny since a big reason why I chose radiology was to have decreased pt contact! I like my interactions with pts for procedures/exams and am told that I'm good with patients by the techs and nurses so its not that I'm antisocial, I think I just prefer brief contact. I knew that this choice would prohibit me from experiencing all the front line highs and lows from getting to know pts well and getting the kudos from appreciative pts in whom you made a difference. But, it also has allowed me to skip the drug seeking, the drama kings/queens, the revolving door bunch, etc.

I remember in med school when I was doing a surgical rotation the attending asked me what I was going into and I told him radiology. His reply was "so you don't want to work for a living?". I laughed with him but I was thinking inside "not like you're working, that's for sure". Radiology has been a good life style practice, but that has changed over the years. I used to rarely get called in the evening and overnight, now we work shifts all evening and overnight and are working nonstop during those periods.

Radiology has been great financially and has allowed me to become FI. If I had to go back and do it all over again I think I would make the same choice, but I thought it might be interesting to hear what others thoughts are on their choice of practice. The grass is always greener but do you really wish you were on the other side of the fence?

I pretty much sound like you. I’m good at what I do and good also with procedures. Patient, nurse, techs love me. But I am glad I don’t have to do patient care every hour that I work.

I would pretty much pick radiology all over if I had to. I was among between pathology, cardiology, surgery and EM mostly. But glad I’m in the dark room, most of the time.

[runfast00]

10 years in private practice FM.

I wouldn't do it again. FM is so broad and practice creep with mid-levels. The financial liability isn't worth the financial rewards.

Even in the first 10 years in practice I have seen less respect, less autonomy, more paperwork, and less revenue per hour in practice. And most days I still love my job because I see a difference by helping my patients become healthier or guide them through a complex disease.

If I did it again maybe I would have done ENT or dermatology.

[dayman]

I'm a radiologist, no regrets. It's not perfect but I'd pick it again.

Radiology is weird as a so-called "lifestyle" field though. We do have great time off, both in amount of vacation and ability to completely unplug from medicine while off. But radiology is 24/7/365 now and our night and weekend shifts (almost always understaffed, covering multiple hospitals) can be brutally busy in a way that I don't think most non-radiologists realize.

[HikingDO]

10 years in private practice FM.

I wouldn't do it again. FM is so broad and practice creep with mid-levels. The financial liability isn't worth the financial rewards.

Even in the first 10 years in practice I have seen less respect, less autonomy, more paperwork, and less revenue per hour in practice. And most days I still love my job because I see a difference by helping my patients become healthier or guide them through a complex disease.

If I did it again maybe I would have done ENT or dermatology.

I’m FM and have been doing it for 20 years. I literally don’t know 1 FM doc who loves their job, for the reasons you stated above and more. Not sure what I would have specialized in if I could go back in time, I don’t remember hiking or mountain biking residencies back then, but if they existed that would have been the way to go!

[PedsCCM]

Pediatric critical care is a fantastic field. Very little scope creep, kids are fun to work with and largely get better. Maybe more importantly, they want to get better. Nothing in the world like seeing a 4 year old who is intubated dance along with Baby Shark. We also don't have the fractioning of specialization that you see in the adult world. I get to care for neuro, cardiac, medical and surgical pathologies. The bad days are REALLY bad though. Thankfully those are infrequent.

[Eye3md]

I'm a radiologist, no regrets. It's not perfect but I'd pick it again.

Radiology is weird as a so-called "lifestyle" field though. We do have great time off, both in amount of vacation and ability to completely unplug from medicine while off. But radiology is 24/7/365 now and our night and weekend shifts (almost always understaffed, covering multiple hospitals) can be brutally busy in a way that I don't think most non-radiologists realize.

dayman, I think I get where you are coming from with this remark about the perceived lifestyle field of radiology and what the job really entails. When you are off, it’s all good, but when you are at work, it’s overwhelming many times, because of the volume of work. I have a friend, who is in radiology in the southwest, and I’m amazed at how many scans he has to read through when he’s at work.

[engerland66]

Private practice GI. Few years in. Democratic group. Partner. Own ASC. Would not do anything else. Great mix of office and procedures (not too long). ERCPs sometimes stressful, but no other significant anxieties or worries. This was my goal from 2nd year of med school and thankfully it worked out despite naysayers saying “private practice is dead”.

[Panscan]

dayman, I think I get where you are coming from with this remark about the perceived lifestyle field of radiology and what the job really entails. When you are off, it’s all good, but when you are at work, it’s overwhelming many times, because of the volume of work. I have a friend, who is in radiology in the southwest, and I’m amazed at how many scans he has to read through when he’s at work.

Volume/person is related to the desire to make money of the individual rads. Could easily read less and make less. Most rads don't want to do that.

The amount of vacation in PP rads is frankly ridiculous compared to essentially all other specialties and employment situations. There are people literally getting 12-18 weeks off. I have never heard of a job where you get 1/3 of the year off with no call and reading an extremely narrow modality such as mammography in another specialty besides rads. It would be like if you were a general surgeon who only did appys all day and literally nothing else.

I love rads subject matter and the job FWIW just the employment paradigms especially in private practice make no sense to me and I don't really see them repeated anywhere else in any other field of medicine. Would rather have a little less time off and not have calls be absolutely miserable where you are doing 3x FTE work. Again this is something I haven't really heard of in any other field and am not sure why it's a thing in radiology, I guess because PACS enables it? Not sure how it's legally defensible, it seems pretty clear to me you could look at normal business hours volumes and establish that as a normal volume and then if you have a mistake during a time where you are literally doing an integer multiple of that, it would look pretty bad.

[Dusn]

Volume/person is related to the desire to make money of the individual rads. Could easily read less and make less. Most rads don't want to do that.

The amount of vacation in PP rads is frankly ridiculous compared to essentially all other specialties and employment situations. There are people literally getting 12-18 weeks off. I have never heard of a job where you get 1/3 of the year off with no call and reading an extremely narrow modality such as mammography in another specialty besides rads. It would be like if you were a general surgeon who only did appys all day and literally nothing else.

I love rads subject matter and the job FWIW just the employment paradigms especially in private practice make no sense to me and I don't really see them repeated anywhere else in any other field of medicine. Would rather have a little less time off and not have calls be absolutely miserable where you are doing 3x FTE work. Again this is something I haven't really heard of in any other field and am not sure why it's a thing in radiology, I guess because PACS enables it? Not sure how it's legally defensible, it seems pretty clear to me you could look at normal business hours volumes and establish that as a normal volume and then if you have a mistake during a time where you are literally doing an integer multiple of that, it would look pretty bad.

I agree completely. I know ophthos who see 100 patients a day and they’re definitely missing stuff — they just might be working too fast to realize it. I think the patient volumes is a growing problem across medicine.

That being said, I agree that the problem might be the worst in radiology and the number of missed critical findings in the radiology reports I see really seems to reflect the rushed way they were read. They don’t even seem to be reading the reason for the study. For family members, I don’t care what the read says any longer. I always ask for a copy of the images on a CD and ask a competent radiologist friend or family member to look at it.

Sorry to sound like I’m bashing radiology. I think this issue of too many patients —> poor quality of care is universal across medicine, not just rads.

[Random1]

Out patient IM, 20+ years. Started out traditional Outpt/InPt then transitioned to OP only.

I'm satisfied with the way my career, but I dont think I would do it again if I knew ahead of time what it was really like. For the most part , days are generally pleasant. As commented above you feel like you are the dumping ground for everything in medicine from forms , to referrals , to anything no one else wants to do or see. But the worse part is the patients who have become more demanding through the years. I used to have a few demanding patients. Now it seems that everyone is.

Though the years I have tailored my practice, I have someone else do the forms and all the other "garbage". No nights weekends or holidays, and still make enough to become FI at 53. A lot of practicing is what you make of it, especially in IM. So life is good, but I guess it could be greener some where else.

[Zaphod]

All of this is an issue with the linearity of pay in medicine. Unless you own a practice, take a cut from other docs/midlevels, etc...you're paid essentially like an hourly worker. See pt get x, always. never more, sometimes less.

Its even less than that ofc as you top out the marginal tax rate, which is the part I dont get as much. Why crush yourself too far into the marginal rate (if it requires extra hours/work in said specialty) if you're getting much less but of course your risk is not capped at all.