Years later, I was working with EHR for a government job. I decided to earn a 2nd master’s of public health. I wanted to go deeper in the details of the healthcare system. I embarked on a new round of research and a rigorous curriculum. We studied the extreme details of the history of Medicare, Medicaid, health economics, policy analysis, eligibility determination, medical billing, healthcare finance, epidemiology, etc. I did a capstone project on Agent Orange and its impact on the VA healthcare system.

In 2008 we had to compare and contrast the healthcare proposals by each presidential candidate. It was very interesting, and we knew healthcare reform was pending. I learned a huge amount about the system.

My conclusion is that the healthcare system does need major reform. The focus should most definitely be on primary care such as family practice, pediatrics, internal medicine, etc. But the flawed Medicare payment system based on fee-for-service created a ridiculous problem spanning decades. The system tends to favor specialists like radiologists (as you noted). But that is economically inefficient. The focus should be on primary care like in France which has the #1 system ranked by the World Health Organization.

The US spends the most on healthcare but gets the least return on investment compared to other countries. There is an extreme shortage of primary care. They are woefully underpaid and overworked. You are 100% right. A person should choose an MD only if the desire is to care for patients.

The high-paying specialties like dermatology and radiology need to be scaled back (i.e. EROAD). The focus needs to switch to primary care. The MD/PhD also needs to be scaled back. But primary care is blatantly overwhelmed and discriminated against (in my opinion).

Meanwhile, I am glad I continued to stay in biomedical engineering. I am working on a 3rd master’s in ME and hope to do a PhD. I would like to focus on 3-D printing and opengl programming with applications to medical device manufacturing. I also saw veterans with prosthetic legs in a race in Texas. I am also interested in prosthetic devices and mechanical design with Solidworks or finite element analysis and continuum mechanics.

I’m really glad I chose to stay in biomedical engineering rather than go to medical school. I recommend alternatives to medical school like a graduate degree in health informatics, FDA regulatory affairs, biomedical engineering, MBA and healthcare finance, accounting and medical billing electives, etc. The demand is very high and pay is good.

http://www.youtube.com/watch?v=zqjH2aVowsc

Thanks to the bleak outlook of the pharmacy profession (and of course my burning desire to practice medicine), I am now contemplating going to med school to further fulfill my purpose. I understand there will be huge sacrifices involved, but I’m still leaning towards reaching the epitome of patient care as a physician. With that being said, pharmacists do play a large role in the PREVENTION of hospital admissions through counseling and finding drug therapy problems in a community setting. Do you have any thoughts on this? Should I just be content and focus on my career as a pharmacist?

I read your stark recollection of the film to the soundtrack of Rasiohead, the King of Limbs.

You have captured the essence of existence; we must all accept the seemingly unnecessary pilgrimages of life as they are our life. As such we should celebrate every moment of it.

It was pino grigio by the way.

Thanks.

I’m very happy with my choice, and I can guarantee you that I would be miserable if I was a “creativity consultant”. But that may just be a function of my simplicity and desire for a circumscribed life, rather than a valid argument against your choice of profession. I think your rant is interesting, but ultimately lacks perspective. We’re not all Ludwig Wittgenstein, some of us have to be content being Maurice Drury.

I’ve explored and shadowed and gotten into a variety of health graduate schools (physical therapy, public health, clinical psych, physician assistant, nurse practitioner, and social work). I, however, place a high value on living life fully, and love camping and traveling and spending time with family and friends. I also have clinical anxiety and low-grade depression, as well as a low tolerance for sleep deprivation (it makes me physically sick, perhaps due to all the high stress things I’ve done so far). When I tell people quality of life is important to me, they call me lazy and say I will always regret not going to medical school. This application cycle I was accepted to Emory PA, Duke PA, Vanderbilt’s accelerated NP program, Emory public health, and a few others.

I am leaning towards Vanderbilt’s NP program due to greater autonomy, independence, public health involvement, and leadership opportunities compared to PAs, but every week or so someone tries to convince me I need to go to medical school. I’ve talked with countless PAs and NPs who love their jobs, though the two PAs I’ve shadowed regretted not going to medical school and have tried to convince me to go to medical school. I think I have a good grasp on my values. Is it so wrong to want to pursue NP (vs MD) because of shorter training and better quality of life? I will always strive to know my limits as a provider and continue learning to improve myself. People have been so mean and insulting to me.