Because it’s a good gig

Dr. Danielle Ofri wonders why anyone wants to be a doctor any longer.

You hear it all the time from doctors — they would never choose medicine if they had it to do all over again. It’s practically a mantra, with the subtle implication that the current generation of doctors consists of mere technicians.

When I first started in practice, I found such comments both perplexing and annoying. I loved medicine and was excited to come to work every day. I considered those naysayers jaded has-beens, fusty old-timers pining away for the nonexistent “days of the giants.”

However, as the years have passed, the warts of medicine have grown more conspicuous to me. During some of the more stressful days — crushed by impossible time constraints and ever more onerous bureaucratic demands — I can’t deny that the thought of giving up clinical practice has crossed my mind. Life would be so much easier….

Yet, each year, a new wave of enthusiastic medical students floods our clinics and our wards. Part of me always wonders: Why do these students still choose to become doctors?

I’ll get the whining over with first.  Yes, practicing medicine can be a gigantic pain in the ass.  You have to deal with illness and injury as a routine part of the job, and as a result you often have to deal with people during their most vulnerable, fearful or angry moments.  You have to wrangle with insurance companies and licensure boards and bureaucracies.  Often your job will require long hours or lost sleep or trips to the wards on weekends.  Much of your job will suck.

It’s still a good gig.

First of all, I’m pretty sure that most professions have aspects that make them a pain in the ass, as well.  I can think of one lawyer whose job isn’t all beer and skittles.  I am closely related to a couple of engineers, and neither lives a life of unadulterated leisure.  Any job worth anything has its crappy bits.

Every applicant to medical school gets asked why they want to be a doctor, and the correct answer is “Because I want to help people.”  You can add in other stuff about science and the wonder of the human body, etc., but you must say you want to help people.  (In the film “Gross Anatomy,” Matthew Modine is pressed to give an honest answer to the question after saying he wants to help people, and he grins and says “Money.”  In real life, he would have been shit-canned faster than a Vanilla Ice greatest hits album.)  And you know what?  It had damn well better be true.  If, at the heart of your goal of becoming a doctor there is not a sincere desire to help people, you will be miserable.  But of course if you do want to help people, then there’s a tremendous reward in becoming a doctor.  Few other professions offer the same opportunity to make people’s lives better.  That goes a long, long way.

But let’s get back to Matthew Modine’s answer.  Dr. Ofri writes:

It certainly can’t be the money — Wall Street is the faster and more reliable route to wealth, as evidenced by the skyrocketing of applications to M.B.A. programs.

If you’re going into medicine just for the money, then she’s right.  You’re picking the wrong job.  (For the record, I know that I would hate a job in the financial sector far more than any crappy part of being a physician.)

However, I’m going to share some truth with you.  Men, take a good slug of fortifying tonic.  Ladies, loosen your girdles and pull your fainting couches way up close.  (For the best “brace yourself” advice I’ve read in a while, see here.)  I’m about to be really honest.  Lean in close so you can hear me whisper.

The money doesn’t hurt.  And I probably wouldn’t take this job for substantially less.

I know, I know.  You’re not sure how you can go on living in a world so cold as this.  I’m sorry for ripping the veil from your eyes.  Be strong.

So yes, one of the pluses of being a doctor is that you make a comfortable living and your job is generally pretty secure.  Part of the reason I chose to do what I do is that I wanted to know I could live a financially stable life.  I made it through residency and fellowship in large part because of the knowledge that my salary would multiple several times over once I was done.  And there are sufficient frustrations and challenges to this profession that if I hadn’t known that, I would likely not have chosen it. Having been accused of using “over-artful” phraseology recently, I’ll just lay it out there and run the risk that you will think me horribly venal.

Even though I’d rather not have to field questions in the middle of the night, or go through the tedium of renewing my license every couple of years and keeping my credentials current, or worried about getting sued, it’s still a good gig.  I get to help people.  It’s interesting work.  I make a good living.  It can be a pain in the ass, but (in the words of the late, great Peter Falk) it’s not cancer either.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. The trick to paying people is to pay them enough that money is not a concern. Paying them more than that really doesn’t change their motivations much.

    The flip side to this is that “enough that money is not a concern” is a moving target. A software programmer in her mid-20s living in a flop in SF might take $60K/yr with some options to sweeten the deal. The same software programmer looking to stay in SF but adding a marriage, a child, and a mortgage is going to need a heck of a hike in cheddar.

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