Blog Archives

Not Quite What I Was Planning

Years ago, I read a beautiful book called Not Quite What I Was Planning: Six-Word Memoirs by Writers Famous and Obscure edited by Larry Smith and Rachel Fershleiser. The premise, based on Ernest Hemingway’s short story, “For sale: baby shoes, never worn,” is that contributors summed up their lives in six words. Famous participants include Margaret Atwood and Stephen Colbert, among others.

I thought about the book last year when I was at my medical school reunion. A dozen of us sat around a round table and talked about what we had been up to for the last 30 years. After we finished, we concluded that the overriding theme was that all of us were doing something different than what we thought we would be doing. I found that concept refreshing, and I suspect it might reassure current students who feel burdened with big decisions. This year, “Not Quite What I Was Planning” is the theme for my college reunion’s Class Panel. 

Check out the book!

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Great Things About Being a Physician

Years ago my physician dad told me that it was important to select a specialty whose bread-and-butter you could still enjoy. For orthopedists, it’s back pain. Interestingly, it’s probably back pain for us emergency physicians as well!

Along those lines, I devote a reasonable fraction of my blog entries to the downsides of being a physician because I want to ensure that those who are considering a career in medicine understand and can tolerate the more mundane – even negative – aspects of their planned profession before they can’t turn back.

I’m very happy, then, in contrast, to use today’s blog entry to showcase Medscape’s Best Things About Being a Doctor piece. It’s interesting how many of the physicians interviewed mention having a “tangible” effect on their patients’ lives.

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A Bad Prognosis for Emergency Medicine

I read a fascinating piece by Dr. Thomas Cook in the December edition of Emergency Medicine News. In it, he cites work done by Cameron Gettel, MD who devised an interesting way to assess the attrition rate of emergency physicians (EPs): Gettel and his colleagues used data from the Centers for Medicare and Medicaid Services (CMS), noting which healthcare providers stopped billing CMS for emergency medical services. Gettel used this information to calculate the attrition rate for EPs. What he and his colleagues found is that the EP attrition rate was approximately 5% prior to the pandemic while it shot up to approximately 8% in urban spots and more than 11% in rural areas during the first year of the pandemic.

Using information from the American Board of Emergency Medicine, Gettel found – shockingly – that the median age of attrition for male EPs was 53.5 years and for female EPs was 43.7 years in 2019. This means that the median EP career was around 23 years long for men and fewer than 14 years long for women. Wow!

It’s absolutely critical that medical students who are considering a career in emergency medicine think about what their professional trajectory might be, considering the short median lifespan of the typical EP.

For more information on this interesting topic and how attrition might affect the job market, the need for physician personal finance training, and who applies to emergency medicine, see Dr. Cook’s piece here.

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“Unhappy is He Who Depends on Success to be Happy” – Alex Dias Ribeiro, Former Formula 1 Race Car Driver

Age-related professional decline is the last thing many doctors want to think about. Those who have just finished years of arduous training can’t imagine that they have only 15 years until they will deteriorate (statistically true), and those of us in middle age don’t want to think about our impending, cognitive retreat from medicine. And yet, this fantastic piece in the Atlantic “Your Professional Decline is Coming (Much) Sooner than You Think” by Arthur C. Brooks is a fascinating, well written article about happiness, gifted and accomplished people, and personal relevance with multiple interesting celebrity examples. Brooks also proposes some quasi-solutions (or at least some work-arounds). I strongly recommend this compelling piece for physicians of all ages and stages.

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Leaving the Medical Workforce

Beware: The article I’m about to recommend has a bitter tone, but it’s important for those who are considering the medical field to hear all perspectives. Plus, many of the issues this anonymous writer brings up – understaffing, corporate medicine, twisted financial incentives, lack of fulfillment – are on point.

Here’s the piece.

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About Dr. Michelle Finkel

Dr. Michelle Finkel

Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital. She was appointed to the Assistant Residency Director position for the Harvard Affiliated Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more

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