Thursday, March 20, 2008

Do You Need a Doctor? It better be for skin

Breaking News (that all of us in Medicine already knew)!!! Young doctors all want to be Dermatologists. Yes, there is a sudden overwhelming interest in skin, pores and hair after spending years in premed, medical school and residency. Taking care of the whole person? Doing a work up for abdominal pain and removing a sick appendix? Evaluating kidneys or hearts or thyroid glands? Arthritis, hypertension and headaches? Forget it!

It's skin that's in!

This is the week for the Residency match and the New York Times tells us that the most sought after residencies are Dermatology and Plastic Surgery. Thank heavens there are only 320 new slots to fill in Derm or there would be no doctors left for anything else. The sad thing is that the Residents who don't get their first pick will be defaulted to other specialties and will be forced to take care of all of us when we are really sick. I don't know about you, but I kind of want my doctor to WANT to do Medicine...not have that be the last option.

Why is this occurring? The answer is lifestyle, money and prestige. Certain specialties are known as the R.O.A.D. to happiness. R.adiology, O.pthalmology, A.nesthesiology and D.ermatology. These specialties are in great demand by young doctors because they make money, have limited or no call and provide a nice lifestyle. Derm, like plastic surgery, and ENT has turned into a cash cosmetic business. Patients are always happy and no insurance hassles to deal with.

Our health care system is structured to get these results. Government interference and regulations, hassles, debt, malpractice, consumer apathy and entitlements have brought us to this point in time. Although I support universal health care for all, with the current system it will just create more burden on underfunded providers and hospitals.

I'm happy for the excited new doctors in training. I just hope there will be someone to take care of me and the other boomers as we hit Medicare age.


Healthnut said...

I don't see this lasting. Injecting or implanting foreign matter into the body will only create opportunities in the autoimmune disease arena. When you look at people like Donna Versace, how can you even say this is a "healing" profession? I don't even think she understands what got injected in her.

Jonathan said...

In talking with physicians in the local area, a further problem appears to be the high cost of living as a disincentive to practicing here. Newly minted residents, whether generalists or specialists, are simply unable to afford to remain in the area once they complete their training. If this anecdotal information is indeed correct and represents a trend, and consequently we’re unable to attract new talent to this area as older physicians retire, I echo your concern, “I just hope there will be someone to take care of me and the other boomers as we hit Medicare age”.

ERP said...

Ugh. It is distrubing. I think Emergency medicine (my field)is also getting more competitive for the lifestyle issue more than anything else(we certainly don't earn what Derm and Plastics do!). I also wonder how much "ER" and shows like that have influenced people. I went into ER because I get bored too easily and need something new and exciting to come along. I like problem solving. I do like the schedule flexibility as well. I never thought much about money and insurance and and other such practical matters.

Rich said...

I don't blame them -skin lesions are much more interesting and less messy.

Rich said...

BTW I like the new you!!! ;))

tracey said...

How terrifying to think that the oncologist who treated me last year would have "settled" if he didn't get the R.O.A.D. he wanted. blurg! I'm with you - it'd be nice to know this is his life's work and passion, not somethingto do til I get that sweet spot shooting botox.

On a happier note - Im glad you enjoyed the "honest R&B song.
I've read your blog and enjoyed the 'what is this" you've posted.

Barbara K. said...

I find this understandable, but discouraging. What can be done to either make primary care more attractive? That's where the urgent need is.

Toni Brayer MD said...

Tracey: The ROAD is a fairly new phenomena so your Oncologist chose that specialty and is likely dedicated and satisfied.

barbarak: It truly is discouraging and dangerous for the health and economics of the Nation. I don't see much happening that would cause a change.

Healthnut said...

It looks like the field of dermatology maybe slowing down. I just found this article in the LA Times, "Cosmetic Surgery Business Sags as Purse Strings Tighten",1,110612.story

I wonder will happen to these women in the long run. For their safety, they should have their implants and botox removed. Botox is botulism and implants are foreign inside the body.

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