Family medicine is not the career many people think it is. While it can be very rewarding in many ways, the current climate for being a physician in Canada is a toxic one. If your offspring is the type who is so driven to medicine that they won’t mind a life of self-sacrifice, then by all means let them spend their lives in a poverty-stricken, developing country where they can do an immense amount of good. If they are bright and ambitious enough to successfully handle medical training and are looking for a career that will allow them to have high quality of life, to raise a family, and retire at a reasonable age then there are dozens of paths for them to follow. Medicine is not one of them. Here are the reasons why, at least in Canada.
1. You will be a minimum of 30 to 35 years of age when you actually start working and earning since it takes at least 10-15 years after high school before you finish your education.
2. You will be a minimum of $150,000 to $250,000 in debt when you finish.
3. You will put in very long hours both in training and when you start working. A forty hour work week will seem like a dream vacation.
4. If you make a mistake people die…
5. You have to stick your fingers in very unpleasant places. Pus and dead bodies smell awful.
6. Suicide and divorce rates are way higher in medical students and physicians.
7. If female, your fertility will be declining by the time you finish training. If you have a family while in training (presuming you have the opportunity to find a partner) you will barely have enough time to get to the bathroom between work duties and looking after young children.
8. Do not expect to spend much time with your family. You will miss many important family events due to working and being on call.
9. Don’t expect to be on-call at the golf course, like docs in the movies. You will be tearing your hair out (if you have any left) in the ER, OR, or office.
10. Physicians are paid by an insurance plan run by individual provinces and territories. The cost of your staff, rent, utilities, and accountancy fees all come out of this, so expect about one-third of what you are paid to go for overhead.
11. You have no control over the amount you can bill. Fees allowed by government insurance programs have been static for years, or, are even going down. You can only increase income by working longer hours.
12. A plumber would laugh at you if you offered to pay him what a family doctor gets for a house call these days (seriously).
13. You have none of the benefits of an employee. Life, disability, and malpractice insurance, retirement savings, maternity leave, sick leave… are all on your own dime. Vacations cost you money, because you won’t earn while away, but you will continue paying overhead expenses.
14. Because your earning years are spread over a shorter period of time, you will pay much higher income tax for the same income as someone who starts working ten years earlier.
15. The government will treat you like an employee, controlling what you are paid, where you can practice, and even if you can practice.
16. Governments often renege on contracts they sign with physicians.
17. Physicians can bring any provincial government to its knees by all taking the same week off. They will never do so for ethical reasons. When doctors get fed up, they leave; and they did so (in droves) from Nova Scotia in the 1990’s when the provincial government broke their contract.
18. Professional incorporation used to make up somewhat for lack of employment benefits for doctors. This is now being labeled as a “loophole”, and physicians are labelled “tax cheats” by the politicians who legislated it in the first place. Most doctors would gladly trade their corporations for a government pension.
19. There are huge numbers of lab reports, consultants’ letters etc., to be read and dealt with by doctors, as well as time-consuming administrative duties. This is unpaid labour.
20. You will be expected to spend a minimum of 50 hours a year going to school to keep up to date with medical advances. You do not get time off to do this, nor do you get paid.
21. There are no benefits to seniority in medicine. All you get is wrinkles. Many doctors cannot afford to retire, because they do not have access to generous inflation indexed pensions like the ones politicians vote for themselves.
22. The cost of providing good medical care to a rapidly aging population is expensive. The federal government legislated free health care for everyone years ago but left most of the responsibility of paying for it to the provinces. The provinces can no longer afford to fund the system.
23. Politicians rarely seek or listen to the advice of physicians on important healthcare issues. Many provincial health boards have NO doctors on their staff. They do a lousy job of running the health care system.
24. An aging population will ensure that the Canadian healthcare system as we know it is going to collapse within the next five to ten years unless drastic measures are taken. These measures will likely not be taken.
25. Politicians will blame physicians when the system collapses.
26. Telling people that they are going to die is a common and difficult task for family doctors. Telling people that their small children are going to die is heartbreaking.
Bottom line: You will probably never starve to death as a family physician. You will, however, have a less than optimal quality of life, earn far less money than most people think, and be a target for politicians who don’t want to take the blame for the mess they’ve made of our healthcare system.
There are lots of other careers for a bright young person to pursue. Look at the alternatives.
Photo courtesy of Pixabay — Public Domain.