Remember, Medicine Was Your Plan A

crispydoc Uncategorized 6 Comments

Perspective in allopathic medicine is often (regrettably) present in homeopathic doses.

This post, much like the vitamin B shot your last patient reported getting from the local Clinica Malpractica down the street, is intended to compensate for a perceived deficiency of perspective that may well be imaginary.

Not What I Thought It Would Be

Many of us become disillusioned with medicine over time. We come to believe the oath we have taken is less Hippocratic and more Hypocritical:

  • It's less about helping people than billing people.
  • Instead of master diagnosticians solving puzzles, we say, "I don't know what that is, but let's try some steroids/pain medicine/antibiotics and see if it goes away."
  • Our patients view us as antagonists instead of partners, suspicious of the care we suggest: "Mom is in tears because of her broken hip, please do something! Morphine makes mom crazy, what kind of lousy doctor would suggest that?!"
  • "Doc, I'm not sure I'll be able to afford those antibiotics you are prescribing me." [Universally stated by someone with a pack of premium cigarettes in one shirt pocket and the latest iphone in the other].

It's easy to feel like we are trapped in our medical careers.

For perspective, may I remind you that medicine was likely your first through tenth choice of career, and that as you go about rejecting your plan A, everyone else you know has probably spent much longer scrambling to make their plan B work.

Medicine Was My Plan A

I recall phone calls with a childhood friend as he graduated college and moved from job to job while pursuing a career in the arts in a large metropolitan area.

My twenties were spent in libraries and classrooms that stayed open late, pursuing a first choice medical career that unfurled before me.

My friend spent his twenties hoping for a lucky break that never quite materialized.

He waited tables.

He sold tickets to improv and comedy shows by walking into businesses and dazzling the work pool with his humor.

He worked in telemarketing.

Each job was just enough to allow him to swim instead of sinking.

He appeared to enjoy tremendous autonomy. He went out every weekend with friends. He knew the best dive bars and hippest eateries. (By using the term "hippest," I suspect I've disqualified myself from ever laying claim to cultural currency).

I showed up where I was told at the ungodly hours I was told to be there.

Eventually The Balance Shifted

My friend married and decided he'd had enough of struggling. He returned to graduate school for a more secure path to funding the family he and his spouse eventually started. By this point he was on plan J or plan K (I'd lost count).

I graduated med school and residency, and after over a decade of working hard, I began to cut back at work.

My friend completed graduate school, working at a series of jobs that typically lasted 1-2 years. I can summarize a decade of conversations in one statement: Having to answer to a boss sucked.

Per our most recent conversation, it still does. He now shows up where and when he is told. His family and mortgage depend on it.

The Moral Of The Story Is Gratitude

Medicine is a jealous mistress.

Medicine is also an incredibly generous sugar daddy.

It's easy to feel like a punching bag. The ever-wise Vagabond MD has observed the hospital will not love you back.

Yet medicine confers an outsize income where a very desirable middle class lifestyle can easily be made compatible with a reduced clinical workload.

If you are a physician struggling with burnout, you are in a rut that is a real and incredibly painful catalyst for change. This is not meant to diminish your struggle.

But if you can find a few crumbs of gratitude under the sofa cushions of pity, take a step back and acknowledge that you are rejecting your plan A (instead of having your plan A reject you).

Hopefully, there's both comfort and empathy to be found in approaching rejection of your medical career from a position of gratitude.

Comments 6

  1. Hey CD,

    There are few careers that allow one to reach FI within 10 years. And you only have to perform average after graduation. There is much less of a “winner take all” aspect with Medicine.

    There are also few careers where your meaning is “baked in the cake”.

    I never expected much from Medicine. It has delivered way more than I ever wanted or needed.

    It helped that I had an incredibly low expectation of what Medicine needed to do for me.

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      Dr. MB,

      It’s your combination of low expectation and low burn rate that means in your eyes, medicine was bound to overperform. And you are spot on, that the most mediocre of doctors is capable of reaching financial independence even accounting for a predictable number of rookie mistakes on the way.

      The surprise is how few of us appreciate what a spectacular mediocrity we have lucked into.



  2. Medicine been berry berry goood to me. Medicine was my plan J. You never step in the same river twice. I stepped in at 30 when I started med school and stepped out at 65. What time in the river presents is opportunity. If you approach opportunity as if it’s victimizing you then you deserve a shitty life and your shitty life is on you. Opportunity could care less how you feel. This idea that your time should be spent suffering the orgasm of “seeking my passion” is living a pretense. If you live a pretense you deserve to be unhappy because it shows a massively immature understanding of reality. Every 12 year old is unhappy because a 12 year old has neither autonomy nor power and it’s nuts to spend 50 years living like a 12 year old, but so much of medicine including physicians nurses and admin is devoted to living like 12 year olds and stuffing Sysco cookies in you mug every day. It’s the biochemistry of the Sysco cookie stuffing that keeps em coming back.

    I found medicine charming. I had a boat load of knowledge and a bag chock full of skills that I could use to make a difference in a probable outcome in someone’s life. That was my job and I did my job. I was prudent and middle class in my life style, and was able to fund middle class without debt, and an excess I could invest, and eventually had enough to step out of the river and hole up on the shore. In the mean time I raised 2 good kids to adulthood and spent my life with my wife. Plan J did not victimize me it presented me with opportunity. All of the plans A through I, presented me with opportunity.

    “They say I’m crazy but I have a good time
    I’m just looking for clues at the scene of the crime
    Life’s been good to me so far.”

    “Lucky I’m sane after all I’ve been through
    (Everybody say I’m cool) (He’s cool)
    I can’t complain but sometimes I still do
    Life’s been good to me so far”

    “They say I’m lazy but it takes all my time
    (Everybody say oh, yeah) (Oh, yeah)
    I keep on going, guess I’ll never know why
    Life’s been good to me so far”

    Might as well got nothin’ better to do.

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      Rejecting with gratitude sounds like the perfect mindset for moving on from medicine.
      Maybe that’s the million dollar idea t-shirt/bumper sticker you start selling?

      Love when you visit, my friend,


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