(no title)
the_d3f4ult | 2 years ago
There's just no reason to do the job when you can get the same compensation working remotely in tech. Looking through the "Who's Hiring" thread is soul-crushing. Physician salaries are the only ones that do not grow relative to inflation and have decreased year-on-year relative to inflation for decades.
I do believe that the rigorous training model leads to a higher quality of care and much deeper understanding of the disease process. But, why would anyone want to do the job? It's just not worth the liability anymore. That said, is anyone hiring an ophthalmologist with CS and Math degrees?
trentnix|2 years ago
In the 2010s I owned a high-end bicycle and sporting good store. It was 7 days of 10+ hours a day most weeks. And it was very nearly non-profit or barely-profit for most of its run. If you know anyone that owns a bike shop, you should give them a hug. They need it.
Nearly every Friday afternoon, just after lunch, a few of my customers who were physicians or surgeons would pull up in their Model X or Cayenne to get service for their 10k road bike they were taking to their vacation home for the weekend. On more than one occasion, one of them would exasperatedly tell me how much they envied me and how lucky I was to be doing what I "loved". As I confronted my busy, work-filled weekend cemented to the shop to deal with the fickle and spoiled public, I had to chuckle as they drove away in their luxury vehicles to their luxury vacation home with a nicer bike than my own.
In retrospect, I've concluded that the real problem they faced is they'd built a life dependent on a physician or surgeon's income. They were told they were building a castle, but instead they built a prison. The fact is, you just can't spend enough money to truly escape the stresses of your work, but you can certainly spend enough money to become shackled to it.
haldujai|2 years ago
This. All of a sudden you go from 70k/year as a senior resident to 400k/year+ as a specialist with no financial education. Add on a decade worth of burnout (especially in training but ~60% in attending physicians) and living in relative poverty (70k/year - interest on $200k in debt doesn't leave much) and you end up with a group of mostly financially illiterate people making up for lost time and depression by overspending on luxuries with their new found income.
If you can believe it I worked with people who made > 1m and started having anxiety that they couldn't cover their mortgages when covid slow-downs resulted in a 25% pay cut.
Physicians are well paid, and I don't mean to suggest otherwise, but it's a really shitty path to earn that paycheck if money is all you want out of the career considering what you give up to get there (e.g. all of your 20s and spending 5 years working 24 hour shifts every 3-4 days and 2/4 weekends) and how stressful the job can be.
Obviously this is a generalization, and no one is forcing them to overspend, but I strongly suspect an element of this spending pattern is driven by unhappiness/regrets based on interactions with colleagues. Medical training is a lot of (very) delayed gratification until you get to the end and realize it is no where near as fulfilling/satisfying as promised.
analog31|2 years ago
There's no law that you have to live a rich lifestyle. Part of that may be feeling the need to maintain the class status that you were born into, and that you expect your kids to be born into. Case in point, my friend came from a working class background.
BurningFrog|2 years ago
hotpotamus|2 years ago
The industry term is "golden handcuffs".
chimeracoder|2 years ago
> In retrospect, I've concluded that the real problem they faced is they'd built a life dependent on a physician or surgeon's income. They were told they were building a castle, but instead they built a prison. The fact is, you just can't spend enough money to truly escape the stresses of your work, but you can certainly spend enough money to become shackled to it.
I don't know why you're making the leap in assuming that, just because you knew some physicians and surgeons who seemed to be inflating their lifestyle to match a high income, that OP is necessarily doing the same. There's no indication in their post of any of that.
giovannibonetti|2 years ago
I don't know how things are in the US, but here where I live in Brazil, my doctor friends always tell me how in medicine things aren't anymore as rosy as they were before. It seems like there has been a large increase in the supply of physicians by universities and the younger generations face way stiffer competition to move up the professional ladder than before.
catchnear4321|2 years ago
> As I confronted my busy, work-filled weekend cemented to the shop to deal with the fickle and spoiled public
> And it was very nearly non-profit or barely-profit for most of its run. If you know anyone that owns a bike shop, you should give them a hug. They need it.
some serious mental gymnastics to land this hypocrisy. someone else struggling differently? here’s an anecdote about how “their kind” are bad. incredible stuff.
read carefully, your comment suggests you don’t much like anyone other than bike shop owners.
maybe that’s why things felt so hard?
weatherlite|2 years ago
What ? Most U.S physicians make 300K + after residency with job security set for life. The real bright ones, the "faang" doctors make close to a million. Show me anyone in tech who can have that guaranteed for him. You're basically guaranteed to join the millionaire club if you decide to work enough years even as a mediocre doctor. Yes its an extremely difficult job I have no argument there, but there's no comparison to tech in terms of compensation or job security.
jimmydddd|2 years ago
chimeracoder|2 years ago
Most US physicians also pay for a lot of work-related expenses out-of-pocket (insurance, continuing ed, etc), and due to the nature of tax codes, most that often is not actually deductible in practice (particularly since they'll usually end up paying AMT).
There's a lot of variance depending on which specialty you choose and where you work, but as a point of reference: most new attending physicians in metro areas are actually netting less than an engineer in the same area who has been working since graduating college[0]. (And that's before you factor in any student debt, or the opportunity cost of forgoing ~10 years of gainful employment).
> with job security set for life.
May have been true 40 years ago, but definitely not true today, especially for certain fields.
[0] If two people graduate college at the same time, and one goes into medicine and the other goes to work as an engineer, the engineer will easily reach career level (senior) by the time the other person is done with their residency.
PheonixPharts|2 years ago
It's also very easy to get a 200k+ remote eng job, even now, that will allow you to spend as much time with your family as you like, rarely have you working past 5pm, and working in predictable, relatively low stress (potentially fun!) problems all day.
The job security is a good point, but job security isn't as meaningful for extremely high stress jobs since the risk of burnout is much higher. Doesn't matter if it's easy to get work if you find that work destroying your personal life.
unknown|2 years ago
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foobiekr|2 years ago
trashface|2 years ago
Your MD degree and the AMA literally writing laws on your behalf limits labor supply competition like nothing in tech. You may have noted 250K+ tech layoffs in last year or so. Many of those people could probably code circles around you. Where are the physician layoffs? There aren't any.
If you want fewer hours, work fewer hours. What are they going to do, fire you? They can't. There is a shortage as this notes.
haldujai|2 years ago
In other countries like Canada it’s also near impossible to get a job in a surgical specialty (and until 2 years ago other ones like radiology), especially in a desirable city despite huge shortages and backlogs because our jobs use a lot of expensive resources.
> If you want fewer hours, work fewer hours. What are they going to do, fire you? They can't.
They can, many jobs set a minimum FTE you can work.
They also reduce fee codes (with a system known as relative value units/RVUs) so you have to work harder to make the same money. We’re at the mercy of payers in US/Can.
My specialty (radiology) has had work-unit compensation periodically slashed over the last 10 years (20-30%) that’s been offset by reading more cases (and to a lesser extent technological advances making reading faster although studies have gotten far more complicated to read with modern treatments).
There’s also the increasing clinical demand and generally caring about the humans on the other end. I don’t want to read 50-90 CT scans on a ER shift but I have to because the studies are being ordered, the patients need their reports, and we don’t have enough radiologists.
wrp|2 years ago
moneywoes|2 years ago
carabiner|2 years ago
As someone who recently transitioned to a tech role, I'd urge you to focus on applying to companies related to your existing fields (ophthalmology, medicine, surgery, and their derivatives) who happen to be seeking SWE's, rather than general tech companies. Especially Series A, B, C startups. Look up all the companies that make your equipment or the software that you use, and go to their jobs pages. See anything that is tech or tech adjacent: swe, swe test, qa engineer, automation engineer, data engineer, anything mentioning python or javascript. The job market is the worst in 20 years and so the only companies that gave me the light of day were the ones in my previous field (energy and mechanical engineering).
FrustratedMonky|2 years ago
nradov|2 years ago
xvedejas|2 years ago
lostlogin|2 years ago
Sort of. The equipment is so expensive that the actual solution is usually to work the rooms and equipment harder. Night shifts, early starts and evening work are actually shit.
matheusmoreira|2 years ago
His other complaint was about the stagnant wages. More doctors will only compound that problem.
unknown|2 years ago
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Traubenfuchs|2 years ago
I don‘t know what it is with doctors world wide having zero awareness of their maximum privilege and zero perspective on how their average and median fellow citizens do.
Yes it‘s hard, but so are many, many other jobs you don‘t hear much about.
iancmceachern|2 years ago
smarmgoblin|2 years ago
Since I’ve been in tech I’ve been laid off several times, and it’s not clear that compensation or demand will always be as hot as it is right now. I’m not complaining but if you take any satisfaction in actually helping people, there’s a real possibility you won’t find that anymore.
That said, you have options. If you’re willing to work at a junior or mid-level role, companies probably won’t care much what you did before. Maybe wait til the next boom in hiring happens, jump on the hype train. With your technical skills there’s probably some very unique research roles you could fill if you’re interested in that lifestyle — although the compensation is not super appealing. If it doesn’t work out, I feel like you could go back to surgery right?
matheusmoreira|2 years ago
Yeah. I used to enjoy this blog, written by a person who hated US medical school:
https://web.archive.org/web/20101218031844/http://www.medsch...
SamoyedFurFluff|2 years ago
I’m surprised you can’t leverage this into a product role or a consulting role for startups in the medical space. You know shit about med systems!!
SongofEarth|2 years ago
https://news.ycombinator.com/item?id=36111596
May be try talk to some similar AI companies is a good idea, at this time the pay can be really good.
throwaway173738|2 years ago
lostlogin|2 years ago
It’s a seriously big deal in his world.
When domain experts write make their own tools, the results are so much better than when an outsider does it for them.
moneywoes|2 years ago
NemoNobody|2 years ago
Tech is a terrible place to be employed right now - at least you will still have a job for the foreseeable future.
Plus, if your income is around the average eye surgeon salaries in the US (250k-300k according to some random website) - your income places you in the 97th percentile.
I'm not saying you should suck it up and deal with it - not at all, this is wrong and you feel the way you do for a reason. It isn't your fault anymore than it's someone's fault for getting stuck at a dead end job.
We are all in the same boat... except for those in super yachts.
The truth is simply that most people are far worse off than you. Except for the billionaires, we are all poor.
epicureanideal|2 years ago
Same has been happening to software engineers for the last 10 years at least. Salaries go up but not as fast as inflation.
I’ve gotten higher titles and more responsibility over the years but inflation is still winning compared to 5+ years ago.
> That said, is anyone hiring an ophthalmologist with CS and Math degrees?
As soon as the job market recovers I think you’ll have no problem finding a job in software.
TheCoelacanth|2 years ago
Over the past one year, they've probably done worse.
brutusborn|2 years ago
s1artibartfast|2 years ago
I work with maybe 2 dozen retinal surgeons, and it seems like a pretty cushy gig. High 6 figure salary, mostly working from home, providing input for clinical trials and product development. Some do it part time and still maintain private practices.
hn976827|2 years ago
Spoken with the true conviction of a position of privilege, and blinded by the very same. (No pun intended.)
Hint: The majority of U.S. citizens have it worse than you.
throwaway173738|2 years ago
mixmastamyk|2 years ago
No one really gets those (statistically). I never did, despite being great at what I do. Basically a lottery system where the one lucky person who did the same exact problem two days ago wins.
speakfreely|2 years ago
nostrademons|2 years ago
If you ask 40+ year old software engineers, the biggest problem with the profession is the need to re-train every 5-10 years or face obsolescence. I'm in my early 40s, been doing this 20 years, and I've re-trained 4 times on new technology before finally switching into management. I just had an emergency medical procedure done. My surgeon graduated medical school in 1981, before I was born. He's able to learn one set of skills and then keep milking it for 40+ years.
akkartik|2 years ago
Tech displaces industries, yes, but in the history of tech there has never been a company that stopped needing software engineers.
If you ask your surgeon he'll tell you how many times he feels he's retrained in his 40 year career. It's not going to be 0.
And don't your two paragraphs contradict each other? Isn't the need to retrain every 5-10 years a big sign that software engineers are not going anywhere?
I would agree with everything you wrote if it was prescriptive rather than normative. I would like software engineers to work themselves out of a job. And I'd like technology to be stable so we can focus on something besides the tech aspect of a company. But that seems poles apart from the world we live in.
haldujai|2 years ago
I’m far removed from this work environment now but at 10 years of SWE in a FAANG one seems to be making ~$350k-400k in total compensation? Not sure how many make it to L6 or higher, I defer to other commenters here.
If you consider the competitiveness of high earning jobs (especially in desirable markets, probably the top 20% of candidates), the opportunity cost during a decade of training I would imagine a similar %ile candidate in CS would be making more in major cities.
With that said physician income is relatively similar in metro vs cheaper COL areas so if you wanted to work in non-tech cities or smaller metros specialty physicians would probably make more.
With that said, with the hours and work intensity I put in now I could probably do 2 FTE SWE jobs (at least comparing to what it was like 10+ years ago).
VirusNewbie|2 years ago
djmips|2 years ago
dsr_|2 years ago
You want to give better care to patients, which means more time per visit and at least three breaks per day (morning, lunch and afternoon). You want to have more coworkers so that you can have consistent on-call work. Increasing the quality of your life-work balance will improve the quality of your work.
As a resident, you likely did 24 hour shifts -- or worse. That was just hazing: nobody does their best work while sleep-deprived, and training in it doesn't improve things. You need reform throughout the system.
You need a union. And one of the things that union needs to focus on is getting more people into this line of work.
FredPret|2 years ago
They probably wouldn’t even advertise for an ophthalmologist/ CS / Math person, because I think there’s probably only the one of you!
rcarr|2 years ago
theGnuMe|2 years ago
I mean there's a bunch of AI stuff/hype now, you could probably find something if you want to leverage your MD? I imagine you'd have a lot of insight into what would actually work well in practice and improve outcomes.
I just skimmed your comment history, so you already know about AI diagnostics e.g. https://health.google/caregivers/arda/
And worldcoin probably needs an opthamologist who can help ensure the retina id scans are stable... there are also a lot of retina scan companies anyway for digital identification that probably need an opthamologist. It may be as simple as keeping a set of scans over time so you reauthenticate in person and get your token updated like when you get a passport renewed for example. But maybe there's other stuff like preventing adversarial attacks.
Or maybe robotic surgery? Or maybe start your own? You might be able to patent something even.
This being HN, the world is your oyster and all.
catchnear4321|2 years ago
> I do believe that the rigorous training model leads to a higher quality of care and much deeper understanding of the disease process.
you somewhat answer your own question in the prior sentence. maybe not want, maybe called, or cared, maybe something else. not that it is binding or permanent, not that it should be.
but for all of the words spent about how it is a bad choice, how it has harmed you directly, how the money isn’t great, you’re bringing up positives, for patients.
you sound burned out. that’s not a criticism, nor should it be a badge of honor. maybe i have totally misjudged, but the career choice doesn’t sound like a purely financial decision for you.
even if not, even if i misjudge this, you, you did that ten hour plus death march. you gave your best efforts though that patient may go blind anyway, though they may feel punitive about it towards you.
you still did it. someone had to. by your own words, the patient NEEDED the procedure. you needed to go home, and be with family.
the patient got the procedure.
in case no one else has said it, or joining in with anyone that already has:
thank you, stranger.
Pigalowda|2 years ago
You must know this? Have you not seen their comments on HN medical threads? So vocal and often horribly wrong it would be comical if it wasn’t so depressing.
I’m not going to one up you with my own sob story, but it’s like you say for all of us everywhere in the US - but you can really only complain to other MDs. Outsiders will demand you work more, get paid less, get sued more, and grovel. They hate us, so don’t complain to them. In the end they will get what they want - automated service by LLM combined with other diagnostic software and nursing. They will then complain for the return of the human physician. It’s so typical.
You are perfectly suited to giving them automated service. Just spitballing and probably wrong - have an optho specific app with an LLM and maybe a plug in smart phone device that has object detection/instance segmentation for diabetic retinopathy. Cataracts detection might be secondary? There’s plenty of products for retinopathy and looks like Inception networks do fine for cataracts. Other eye pathologies that are easily visually diagnosed are on the table too. Why see 40 patients when you could see 150 and the LLM/app have done the referral, initial screening questionnaire, and your nurses/MAs write your note/rx/orders etc. Ideally you should be like a dentist (they clearly figured this out already). You walk into the patient’s room do a quick eye exam, say what needs to happen, don’t answer any questions, and walk out. They hate you already anyways, might as well lean into it.
- Currently an imaging fellow in the cartel.
belmarca|2 years ago
I have great respect for physicians I have worked with in IT for years. However I do not have patience for this sort of argument. You can always find another job if you'd like to, like everybody else. And unlike the majority of the population, you can set yourself up to have the financial freedom to do so.
No "sane" person "hates" doctors. They just don't pity them.
---
BTW, the tech FOMO is just FOMO. Grass is greener. Software engineering can be very exciting (just like medicine), but also very boring (just like medicine). Compensation is a really bad metric. If you value your time off, then don't become a physician. Sounds to me like some people just can't ever be fulfilled (usually the more privileged)!
MobiusHorizons|2 years ago
haldujai|2 years ago
- Also a radiologist who gets told I’m egregiously overpaid when [insert immature AI tech] can definitely do my job better.
labcomputer|2 years ago
> but you can really only complain to other MDs. Outsiders will demand you work more, get paid less, get sued more, and grovel.
Oh yes, this is exactly what I want. I don't care about anything my GP does, except whether they kiss my feet when I schedule an appointment. How do you know me so well?
noleetcode|2 years ago
mvanlonden|2 years ago
iancmceachern|2 years ago
unknown|2 years ago
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aiphex|2 years ago
unknown|2 years ago
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singleshot_|2 years ago
If you worked in tech, you could help people see... advertisements. That's potentially more lucrative but it's gotta be depressing after a life of that to reflect on one's life work.
GiorgioG|2 years ago
TacticalCoder|2 years ago
But...
> There's just no reason to do the job when you can get the same compensation working remotely in tech.
Compared to serving ads and/or engaging in surveillance capitalism, at least there's a lot of comfort in that they're doing (and you 're doing) a useful job.
So I know it's not much but thanks a huge lot for what you're doing.
matheusmoreira|2 years ago
I know how you feel. I gave up on tech as a teenager and I still wonder what would've happened if I had stuck with it. Feels like it's impossible to switch careers now.
Where I live practicing medicine used to be a respectable profession but that's completely changed for the worse in the last 20 years. The communists currently running my country are literally quoted saying "we must create a new generation of leftist doctors who accept working for less". They flooded the job market with doctors.
mavelikara|2 years ago
US doctors have to put in long hours because there aren't enough of them. Are things different in your country?
merek|2 years ago
For a typical surgeon in the US, how common are lawsuits from patients?
Do you have plans to run your own clinic (if not already doing so)? If so, would this address some of your current issues (work hours, compensation) at the risk of having to operate your own business?
the_d3f4ult|2 years ago
Not very common. Pretty much everyone gets sued at some point in their career, but it's rare to break through the malpractice insurance ceiling. That said, it's always in the back of your mind and when it happens it messes with you psychologically.
>Do you have plans to run your own clinic (if not already doing so)? If so, >would this address some of your current issues (work hours, compensation) at the >risk of having to operate your own business?
It's complicated. While being your own boss has a lot of perks, the path to ownership is not straightforward anymore in the current era of private equity. Some of the things that suck are not related to the financial aspects.
fragmede|2 years ago
mensetmanusman|2 years ago
iancmceachern|2 years ago
https://www.arcscan.com/
I can make an intro if you're serious
alar44|2 years ago
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jasmer|2 years ago