By Nicole Spector
The news that New York University will offer free tuition to all its medical school students, with the hope of encouraging more doctors to choose lower-paying specialties, offered hope to those wishing to pursue a career in the field.
However, becoming a doctor remains one of the most challenging career paths you can embark upon. It requires extensive (and expensive) schooling followed by intensive residencies before you’re fully on your feet. The idea, generally, is that all the hard work will pay off not only financially, but also in terms of job satisfaction and work-life balance; then there’s the immeasurable personal benefits of helping people, and possibly even saving lives. In terms of both nobility and prestige, few occupations rank as high.
So why is there waning interest in being a physician? A recent report from the Association of American Medical Colleges projected a shortage of 42,600 to 121,300 physicians by 2030, up from its 2017 projected shortage of 40,800 to 104,900 doctors.
There appears to be two main factors driving this anticipated doctor drought: First, young people are becoming less interested in pursuing medical careers with the rise of STEM jobs, a shift that Craig Fowler, regional VP of The Medicus Firm, a national physician search and consulting agency based in Dallas, has noticed.
“There are definitely fewer people going to [med school] and more going into careers like engineering,” Fowler told NBC News.
Fowler also speaks to the desire among millennials to be in hip, urban locations — a luxury you likely won’t get when you’re fresh out of medical school and in need of a residency.
“This is why places in middle America hire firms like ours,” Fowler said. “They're having a harder time attracting people."
But perhaps the more interesting story lies not with those deciding to eschew medical degrees; it’s with the people who went through all that training, who became doctors — and then decided to opt for another path.
This drastic career change can be a result of new med school grads being unable to find a residency within a reasonable period of time.
“Graduating med school doesn't mean you’ll get into a residency,” said Fowler. “There aren't enough residency slots for medical grads. So you have that population of people who have an MD but didn't practice for that reason. There is this bottleneck effect.”
The Mounting Bureaucracy
This “bottleneck effect” doesn’t usually sour grads on staying the course, Fowler finds, but he does see plenty of doctors in the later stages of their careers hang up their stethoscopes earlier than expected. Some cite electronic health records (EHRs) as part of the reason — especially old school doctors who don’t pride themselves on their computer skills. New research by Stanford Medicine, conducted by The Harris Poll, found that 59 percent think EHRs "need a complete overhaul;" while 40 percent see "more challenges with EHRs than benefits."
And then there are those doctors who left medicine because the cons of the job started to far outweigh the pros.
“After 20 years, I quit medicine and none of my colleagues were surprised. In fact, they all said they wish they could do the same,” Dr. Amy Baxter told NBC News.
“I began to feel like an easily replaceable cog in the health care machine. With the [enforcement] of EHRs, I had to spend more time as a scribe. One night a child I was treating had a seizure and I couldn’t get the medicine to enable them to breathe because their chart wasn’t in the system yet. This kid was fixing to die and I, the doctor, couldn’t get the medicine. It was demoralizing.”
Baxter left pediatric emergency medicine to head a company that develops physiological products for personal pain management.
Dr. Ha-Neul Seo, director of global recruitment at EF Education First in London, was a general practitioner in the U.K. for several years before heading to the U.S. to study health care management and policy. She wound up leaving medicine to focus on education because she felt, to some extent, she’d defaulted into a career that turned out to be more tedious than expected.
“As a patient you want your doctor to love and be passionate about their work — and I realized that wasn't me,” Seo said. “Some parts were incredible, but the moments when I felt I was making a true difference were too few and far between. And then there was the issue of work-life balance. I had my first child and was barely seeing him. The schedule was relentless.”
Dr. Nicole Swiner, a physician and author, has stuck with being a doctor because she loves it so much, but she deeply empathizes with those who decide to leave.
“It has gotten worse for all of us, unfortunately — whether you work in the hospital or in the outpatient setting,” she told NBC News. “We are burdened more by nonmedical business or insurance professionals without any medical training. It's disheartening. I have transitioned to more part-time clinical work [so as to focus more on] speaking, writing and consulting."
"Become a full-time consultant, author, speaker, entrepreneur, baker, cheerleader — whatever. Just be happy. Life's too short,” Swiner said.
Source: NBC News, August 18, 2018, (https://www.nbcnews.com/business/business-news/doctor-out-why-physicians-are-leaving-their-practices-pursue-other-n900921)