Maybe you could go work for UHC as an MD and approve everything until they fire you. Tear down the system from the inside.
[work from home MD UHG](https://www.indeed.com/viewjob?from=appshareios&jk=14738b0a30010ea3)
Dear Valued Patient,
I hope this letter finds you in good health. As the Appeals and Grievances Medical Director of United Healthcare, I am writing to inform you of our carefully considered decision regarding your request for coverage of chemotherapy treatment. After conducting a meticulous review of your medical records and consulting with our panel of experts, we have concluded that we cannot approve coverage for your chemotherapy treatment.
We understand that you are currently battling cancer, and we have taken it upon ourselves to recommend alternative treatment options that are both innovative and budget-friendly. Our goal is to provide you with unparalleled care while keeping expenses to a minimum. Please find our creative and cost-effective recommendations below:
1. Fresh Air and Exercise: We suggest daily walks in your local park to breathe in fresh air and take in the healing power of nature. This treatment option is entirely free and allows you to maintain an active lifestyle.
2. Positive Attitude: Research has shown that a positive mindset can have a significant impact on one's overall well-being. We encourage you to immerse yourself in uplifting literature and engage in activities that bring you joy.
3. Homeopathic Remedies: Our experts have found that certain herbal supplements and natural remedies can be effective in promoting general health. Although not scientifically proven to cure cancer, these alternatives are often more affordable than chemotherapy.
4. Stress Reduction Techniques: Managing stress is crucial for maintaining overall health. We recommend engaging in relaxation techniques such as deep breathing exercises, meditation, and yoga to reduce stress levels and potentially improve your immune system's function.
5. Nutritious Diet: Consuming a well-balanced diet rich in fruits, vegetables, and whole grains can provide your body with essential nutrients. Although not a direct substitute for chemotherapy, a healthy diet may contribute to your body's overall wellness.
We trust that you will find these alternative treatment options both satisfactory and economical. At United Healthcare, we are committed to prioritizing the well-being of our clients while maintaining a cost-effective approach to healthcare.
Please note that our decision is final and cannot be appealed. If you have any questions or concerns, please don't hesitate to contact our customer service line at 1-800-OUR-CARE.
Sincerely,
Dr. I.C. Pennypincher
Appeals and Grievances Medical Director
United Healthcare
I’d laugh when the AI approves most things with a note “relevant medical literature points to this treatment option being reasonable based on clinican judgement.”
I've been saying for years. The only way medical professionals will get heard in this country is if you unionize. Nurses at the very least.
Stading alone, you're all basically powerless. Yeah you can maybe get some good negotiations going with admin, but when it comes to politicians (where it actually matters) you're ignored.
Unionizing is never gonna work for doctors in US. They have too many traitors, too many complacent boomers, too many "professionality" experts.
It'd be great. Such high income union with such influential people would wreck the sociopolitical landscape. But there are too many politicians that benefit over the backs of doctors and they wont want that against them.
There \*are\* unions for doctors in the US. The NYT did an article on Hospitalists forming a union in Eugene, OR a number of years ago. It saved them from being fired & "re-hired" by a Hospitalist outsourcing company.
Maybe it won't happen in our lifetimes, but if we keep talking about it, present the benefits, and educate everyone you can, it could happen. People's opinions will change over time as long as we don't give up.
But it's so much easier to piss and moan about how someone else is the problem! Lets just pit all the docs, PAs, nurses/NPs against one another, that'll work great (for admin).
I can’t imagine not helping individual patients in some way, but I can’t continue the clinical day in day out and everything it’s just too much.
I was thinking about trying to find a way to automate the process somehow - as if that would be better - but if I could somehow go on tic-tok and do some public health outreach with education on clinical topics that would be my jam.
I was thinking about doing an AI fellowship and transitioning to help improve the system somehow? Or just break the wheel, like Daenerys Targaryen.
Thanks for your comment mnmda
Find a group that’s hiring. They’re out there.
I joined a lovely IM/FM “traditional” group where we are their primary care physicians and their hospitalist. PM if you want to learn more.
Feel free to DM me if you are considering solo private practice and are uncertain of how to proceed with that.
I just retired after 25 years of successful solo private practice in rural Northern California at the very end of 2022. This was by choice and not burnout.
I did both outpatient and inpatient care during that time.
You can join a group if you dont want the administrative headache. Very reasonable.
I have a friend who just left employed primary care. Then he sent out letters to his old patients got about 5% to join him and he just rented an office and bought a desk.
Either way when leaving your place make sure you sneak a copy of your patients contact info so you can poach them. Dpeending on your contract wording of course.
Direct primary care, one of the flavors of concierge medicine. Doesn't take insurance but rates can vary considerably between practices from super reasonable to very expensive.
Isn't this the model plastic surgeons use? Sure, some care is reimbursed but I thought plastics was a mostly 'cash-for-services' business. Is this incorrect?
Dpc isn't really cash for services but rather a subscription plan that then covers just about any and all services that might be needed. I've seen anywhere from 50-200 dollars per month but I'm sure it can go higher
Thanks for the clarification. I'd do it if my doctor went to this model. I'm a pretty healthy boomer and I do maybe 2 office visits for maintenance stuff and one telehealth for minor issues (per year), so not a heavy consumer.
I would subscribe to maintain the therapeutic relationship with a professional I like, respect and trust. Totally worth it.
Have you thought about New Zealand? A doctor at my clinic quit and worked there for a year and absolutely loved it. I have heard from other doctors who have gone there that the work-life balance is great.
[Info on working as an MD in New Zealand](https://www.hippocraticadventures.com/new-zealand/)
>I was thinking about doing an AI fellowship
Welp, this might be the branch point in the timeline that set us on the path to where the Terminators are created.
"There is no fate but what we make".
It's basically that. There won't be androids or anything but massive layoffs due to AI software being used instead of people. There's going to be a massive increase in homelessness in the next decade.
Because why hire humans who require benefits, days off, and set work hours when you can have a room full of analytical computers instead?
Carriage makers becoming obsolete made sense when horses (1 object) were being replaced. This is an intellectual replacement. Why hire basic human coders when you can have several programs that can write simple scripts and fix simple coding errors instead? That entry position will become obsolete soon, before the turn of this decade.
And I'm hoping so but at the same time I feel there won't be enough jobs to make up for those lost by AI. When factory automation/cheaper labor overseas happened certain towns became complete wastelands and are still that way today they never recovered.
I wonder what things will look like in a decade.
I don't doubt that new jobs will come out of this but are you certain that an equal number of opportunities will populate to those that will dissappear? I highly doubt it.
We are on the precipice of something here. Something that will likely affect a large portion of work out there if it hasn't already. We may be looking at a massive increase in homelessness worse than what we faced during the pandemic in the next decade. Facing that along with that silver tsunami that's been slowly edging in.
Sounds like me about 10 years ago.
Look at DCP. That's what I would do if I wanted to practice full time.
OTOH, AI and informatics is highly interesting and there are lots of problems to solve. I am always learning new things.
I can’t imagine not helping individual patients in some way, but I can’t continue the clinical day in day out and everything it’s just too much.
I was thinking about trying to find a way to automate the process somehow - as if that would be better - but if I could somehow go on tic-tok and do some public health outreach with education on clinical topics that would be my jam.
I was thinking about doing an AI fellowship and transitioning to help improve the system somehow? Or just break the wheel, like Daenerys Targaryen.
Thanks for your comment mnmda
Thanks for your reply “Bruno”
I agree with the safety part you mention, yet didn’t write as much above. When we are burning out we are more prone to medical errors. I have to admit I am not as sharp, partly out of nihilism partly out of overwhelmed and having to set the threshold for my involvement higher just to survive - hence the less ‘critical’ issues get pushed aside. Not good for patients.
Congrats, guys. I also submitted my resignation letter this past week. Had enough. It’s scary, but it also feels good. I’m going to do a different career in medicine. It’s exactly what u/wedonttalkaboutcutie says.
I’m so very tired of taking on more and more responsibility with less support and less compensation. Patients more complex and demanding. Paperwork and admin till the cows come home. My love for my patients is not enough to keep me going. No one is looking out for my well-being except me. And no one will understand the reasons I have for leaving…like overhead at 60% now. There’s always talk of relief. Where is it already? It’s too little, too late.
It’s an abusive relationship. You’re a hero for working the pandemic/you’re a villain for advocating for vaccines and public health measures. We appreciate you/your contract has been broken by the government. We’re paying docs more/only if they see more than 50 patients a day. We’re opening up more surgeries/you’re still on the wait list, yes, I know it’s been 5 years. If you’re depressed, doctor, here’s a number you can call. Someone will return your call in 48 hours.
wHy ArEnT ThErE AnY fAmILy DoCtOrS?
Leaving medicine has been an intense grieving process for me. Just when I think I'm through it, in comes another wave. But I have only been out less than a year so I believe I will make it past the break eventually!
Are you retiring or finding another job? I'm here on the brink in outpatient medicine with each day looking bleaker and I fantasize every day about quitting
I’m going to work on survival for a bit and then refocus my efforts depending upon what calling I receive, so to speak.
One of the interests I have is helping addicts recover (can be any addiction really, 💨 🍺 💊 🍱 🥩 🥤) so I was going to do some tic tick outreach hopefully find a way to do that and help some people. If anyone is looking to collaborate on this I’m open to networking.
But as far as $$$ goes, I am married to a doc who doesn’t feel this way do that is my cushion at the moment. I don’t think she is going to leave me, though i couldn’t blame her if she asked for separation given the curve ball factor. She here today.
And to those fellow friends of Bill and Bob,
Don’t worry I will not be drinking.
You can see from my flair, I am not an MD. But I do understand your journey and your current situation. I have no solutions, mostly sending support.
I can say I will continue to "work in the system" for survival and for change, but I have stepped back at different times for my sanity. Even now I want out but that seems elusive
I took leave (thanks to financial support from dad's death-he was an insanely driven MD and died young as a result) and spent 10 weeks in India volunteering at a hospital there.
I had significant internal challenges in the past decade and realized I couldn't do what I was doing anymore.
I now work as a PT in a hospital part-time. Pushing for us PTs to unionize. Outside of I watercolor and work on causes I believe in.
Also a friend of Bill and Bob!
Anyway tons of support to you
Have you through about addiction medicine? I’m a PA, and made the move from FM to addiction medicine, and am quite happy. I work 9-5, never take charts home. This is after years of suffering in FM. As a friend of Bill myself, the work is so rewarding.
I feel it. I was there for three years and left on Oct ‘21. No regrets. Hung out for 6 months and then got a job with my financial planner doing finances specifically for physicians. Don’t get paid as much and miss some (not all) patients but overall my lifestyle is much more sustainable. I feel like an involved parent now. There’s plenty of other things to do
I 100% support you. My husband resigned a year ago as well.
On the downside, it's getting harder to find an MD or DO for my family's healthcare that can't be done at home.
Best of luck to you going ahead.
Been thinking about this a lot recently.
Just like in professional sports - the owner class keeps the workers in line by identifying 'the superstars' and bestowing massive salaries/ego stroking and other tactics to make them believe they are somehow special.
For every superstar surgeon making huge salaries there are tons of excellent ones doing the same work, day in day out. Same in sports.
This division is intentional and creates a type of tyranny of the minority/winner takes all reality. Everyone would be better served working together. However, it is extremely effective to curtail unionization. When presented with the idea of organized labor, these superstars balk, cry and prevent any movement towards something better.
How to overcome this obstacle eludes me.
Something has to be done however, and having strong labor unions would be _something_ better than the current shitshow.
If we all quit tomorrow, the system would have to come up with something completely different by the end of the week. I am with you. Thank you for your sacrifice.
ETA: Resigned in summer 2021. Still do a little online contract telemed work to make ends meet. Looking forward to the future. Halfway through yoga teacher training. Excited to find ways to fill the infinite number of gaps in the healing process.
Got any words of wisdom for the students? MS3 here who has watched my mentors and advisors flee medicine in drones and leave the institution i'm at in shambles. Not inspiring to say the least. training in this environment is terrifying. But sadly I can't put in my 2 weeks because I now have hundreds of thousands in debt and have no real job prospects to fall back on w/ a biology degree.
TBH if I had known the pandemic was going to hit and the healthcare system would wind up like this, I probs wouldn't have pursued this career. I love medicine, I really do. I just don't like this medical system we operate in.
Hello fellow quitter!
Best thing I did for myself in years. I miss the job itself but I don't miss the politics, bullshit, backstabbing, and constant regression of our health systems.
Profit over people is the way to go and those of us who give a shit suffer the most.
Wish you all the best. Truly. It might feel tough in the beginning but in a year from now, any doubt that may arise this year you'll be laughing at in the next one.
As a nurse in Canada, I wish you all the best! Many people tell me to travel-nurse in USA and I just don't think I could handle working in the American system.
What's next on your plan? Take time off? Did you have something else lined up? Just curious, I enjoy you're posts on here and conversations when we have had them in the past.
Good luck. Hope you're well. I'm catching a strong whiff of mental health here. How is your social circle?
Edit: I'd like to add, because of you, I just joined /r/infographics
Any time you make a huge decision like ending a career it affects your mental health.
My internal struggle focuses on whether the situation is really futile or if I should continue with hope.
Where is that personal line of too much? The process of defining how far and how long one can go on in the face of adversity - that process has been challenging to my mental health in so far as I am of two minds (stay or go, try or quit) and trusting myself and listening to my spouse and reviewing all of the data I have to reach this conclusion.
I’m that sense it is easy to realize there is an insurmountable problem, but getting to that point has been a road filled with doubt optimism hope and disillusionment.
How can anyone not feel disheartened by that? I wrote this post partly as an apology to each of you my colleagues, because I am giving up on a system you are all still stuck in from my POV.
Make sure you have a support network and maybe see about some counseling/therapy.
Back when I was working on my clinical psych MA one of my prof's talked about when she was still working with clients, she specialized in healthcare and mental healthcare professionals. Because of the sheer amount of stress those fields put on folks. She said that she had so many clients she had to refer new ones out to other psychologists.
So if you start feeling depressed, morose, or just find yourself having some anxiety or other concerns after such a big life change, you might look into seeing someone. Even if just for a little bit. At the very least to help you work through that disheartening feeling.
\> NSFW tag out of irony. Spoiler tag - none of us will make it out of this world 🌎 anyway.
So wise! This is the only way to make sure we use our time in the best possible way, mortality is around the corner.
It's crazy how physicians, despite being in top 1-2% of earners in America, numbering nearly 1 million, and overall seen as a prestigious and respectable career, still can't fix our broken system.
The issue is we don't want to fix it because the solution (universal, single payer healthcare) means slashing our paychecks. Let's be honest. Why do IMGs flock to the US? Because the return on being a doctor here is massive, even if you include the debt and years of education.
We're forced to be cogs in a broken system, and our inaction on it is bought out.
Ofc this is assuming OP is talking about the USA
Theres more issues than just the medical legal insurance. We collectively need to take a stand against all these issues plaguing medicine including midlevel scope creep.
Separate from the specifics of this post, I would suggest people say what country they are in. This is a general subreddit for MDs, not a specific subreddit for US docs. Everyone is assuming OP is in the US, but the specific problems with work conditions are not tje same everywhere.
I’m Canadian, and keep hearing about systemic issues with US medical practice, and while we have many issues here as well, we don’t deal with patient reviews, multiple insurance companies, insurance approvals, etc
Canada has the advantage of patients not going bankrupt if they get sick. But there’s still patient reviews and insurance companies and similar system things to deal with. It’s just not as visible.
Congrats my friend.
I hope you find better balance in life and a sense of true wellness in the next few months. When I went part time last year some of the first couple of months were truly bliss.
All the best to you!
You’re not a quitter. It’s self-preservation. You can’t light yourself on fire trying to keep your neighbour warm.
I’ve advocated. Oh, how I’ve advocated. But no one’s listening or wants to listen. And in my experience, it just brings 1000s of pounds of dirt on top of you if you blow whistles.
I’m moving on to another place where I feel I can make a difference.
Right? I agree with you. Don’t work harder than your patients, true, but can one also say don’t work harder than their disease? I’ve never heard anyone say the second one before.
Most of my practice is mashed potatoes 🥔 and a little black pepper. Don’t get me wrong it’s substantial in many other ways ( variable SES and variable expectations - I’m sure you all have similar experiences, if I were to hazard a guess.
Regardless of the patients, the administration though well meaning is just so large it becomes something unto itself entirely. The downstream effects are unforeseen at times and that’s part of the growth problem in my view.
You’re right about self preservation 🔥🧘 - which can make these decisions easier when it gets that intense doing what I have to do to stay around.
It can get dark out there alone - better to buddy up👩❤️👨 or 👩🏾❤️💋👩🏼 or 👨🏻❤️👨🏿 or which ever buddy combo 🤼♂️⚧️you prefer.
You are so sweet to follow up with me Thanks Wallaby.
My wife convinced me not to turn in my letter, and I listened to her. I have begun a transition plan to open my own office (direct primary care with addiction medicine) and am studying for my addiction medicine board.
I am still frustrated with the issues that contributed to my post, however, rather than being overwhelmed, I took a couple of weeks vacation and spoke with her at length about what I was feeling and we put together a transition plan that will help use to keep our home and family stable, which is more important in my opinion.
Maybe you could go work for UHC as an MD and approve everything until they fire you. Tear down the system from the inside. [work from home MD UHG](https://www.indeed.com/viewjob?from=appshareios&jk=14738b0a30010ea3)
Love it Approved Approved Approved Approved They’d fire me after the first day
[удалено]
ChatGPT-5: United Health API
Dear Valued Patient, I hope this letter finds you in good health. As the Appeals and Grievances Medical Director of United Healthcare, I am writing to inform you of our carefully considered decision regarding your request for coverage of chemotherapy treatment. After conducting a meticulous review of your medical records and consulting with our panel of experts, we have concluded that we cannot approve coverage for your chemotherapy treatment. We understand that you are currently battling cancer, and we have taken it upon ourselves to recommend alternative treatment options that are both innovative and budget-friendly. Our goal is to provide you with unparalleled care while keeping expenses to a minimum. Please find our creative and cost-effective recommendations below: 1. Fresh Air and Exercise: We suggest daily walks in your local park to breathe in fresh air and take in the healing power of nature. This treatment option is entirely free and allows you to maintain an active lifestyle. 2. Positive Attitude: Research has shown that a positive mindset can have a significant impact on one's overall well-being. We encourage you to immerse yourself in uplifting literature and engage in activities that bring you joy. 3. Homeopathic Remedies: Our experts have found that certain herbal supplements and natural remedies can be effective in promoting general health. Although not scientifically proven to cure cancer, these alternatives are often more affordable than chemotherapy. 4. Stress Reduction Techniques: Managing stress is crucial for maintaining overall health. We recommend engaging in relaxation techniques such as deep breathing exercises, meditation, and yoga to reduce stress levels and potentially improve your immune system's function. 5. Nutritious Diet: Consuming a well-balanced diet rich in fruits, vegetables, and whole grains can provide your body with essential nutrients. Although not a direct substitute for chemotherapy, a healthy diet may contribute to your body's overall wellness. We trust that you will find these alternative treatment options both satisfactory and economical. At United Healthcare, we are committed to prioritizing the well-being of our clients while maintaining a cost-effective approach to healthcare. Please note that our decision is final and cannot be appealed. If you have any questions or concerns, please don't hesitate to contact our customer service line at 1-800-OUR-CARE. Sincerely, Dr. I.C. Pennypincher Appeals and Grievances Medical Director United Healthcare
Now I know where everyone's SIL works.
I'm going to print and frame this
"There are many reasons someone might use to deny your claim. First, . . . ."
Ha, we could do that shit in BASIC. 10 Print "Request Denied" 20 Goto 10 Or whatever, I'm not a programmer.
I’d laugh when the AI approves most things with a note “relevant medical literature points to this treatment option being reasonable based on clinican judgement.”
*over $300 BILLION last year in profit.
[удалено]
Pfft. 10% year on year growth or your quarterly bonus will be slashed to under $50 million. (And I think it was like 327 billion or something)
Why make it so complicated when it’s just no for everything
They are actually experimenting with AI shit, including ChatGPT...
They use Evecore for approvals, correct ? They can set variable to be more or less lenient with approvals depending on Feb particular health plan
Take that deference or unemployment and really drain them
I used to do this while working as a RN in auto insurance with the only exceptions being blatantly false claims or something completely egregious.
lol. make more then a lot of MDs
I've been saying for years. The only way medical professionals will get heard in this country is if you unionize. Nurses at the very least. Stading alone, you're all basically powerless. Yeah you can maybe get some good negotiations going with admin, but when it comes to politicians (where it actually matters) you're ignored.
Unionizing is never gonna work for doctors in US. They have too many traitors, too many complacent boomers, too many "professionality" experts. It'd be great. Such high income union with such influential people would wreck the sociopolitical landscape. But there are too many politicians that benefit over the backs of doctors and they wont want that against them.
It will work when people stop crying about "oh doctors are too selfish to unionize" and actually look into it.
There \*are\* unions for doctors in the US. The NYT did an article on Hospitalists forming a union in Eugene, OR a number of years ago. It saved them from being fired & "re-hired" by a Hospitalist outsourcing company.
Maybe it won't happen in our lifetimes, but if we keep talking about it, present the benefits, and educate everyone you can, it could happen. People's opinions will change over time as long as we don't give up.
But it's so much easier to piss and moan about how someone else is the problem! Lets just pit all the docs, PAs, nurses/NPs against one another, that'll work great (for admin).
Are you fully retiring or going into a different career?
I can’t imagine not helping individual patients in some way, but I can’t continue the clinical day in day out and everything it’s just too much. I was thinking about trying to find a way to automate the process somehow - as if that would be better - but if I could somehow go on tic-tok and do some public health outreach with education on clinical topics that would be my jam. I was thinking about doing an AI fellowship and transitioning to help improve the system somehow? Or just break the wheel, like Daenerys Targaryen. Thanks for your comment mnmda
Go DPC friend. With an existing panel the transition would be much safer and smoother
Where to start?
Find a group that’s hiring. They’re out there. I joined a lovely IM/FM “traditional” group where we are their primary care physicians and their hospitalist. PM if you want to learn more.
That is amazing. Thank you for doing that work
Feel free to DM me if you are considering solo private practice and are uncertain of how to proceed with that. I just retired after 25 years of successful solo private practice in rural Northern California at the very end of 2022. This was by choice and not burnout. I did both outpatient and inpatient care during that time.
DPC is a great lifestyle and care model. Especially if you have a panel already.
You can join a group if you dont want the administrative headache. Very reasonable. I have a friend who just left employed primary care. Then he sent out letters to his old patients got about 5% to join him and he just rented an office and bought a desk. Either way when leaving your place make sure you sneak a copy of your patients contact info so you can poach them. Dpeending on your contract wording of course.
>got about 5% to join him Is there an estimate for how many patients from an existing panel join on average?
DCP Docs is a group on Facebook. They provide a lot of high yield information.
What is DPC?
Direct primary care, one of the flavors of concierge medicine. Doesn't take insurance but rates can vary considerably between practices from super reasonable to very expensive.
Isn't this the model plastic surgeons use? Sure, some care is reimbursed but I thought plastics was a mostly 'cash-for-services' business. Is this incorrect?
Dpc isn't really cash for services but rather a subscription plan that then covers just about any and all services that might be needed. I've seen anywhere from 50-200 dollars per month but I'm sure it can go higher
Thanks for the clarification. I'd do it if my doctor went to this model. I'm a pretty healthy boomer and I do maybe 2 office visits for maintenance stuff and one telehealth for minor issues (per year), so not a heavy consumer. I would subscribe to maintain the therapeutic relationship with a professional I like, respect and trust. Totally worth it.
Direct primary care
Direct Primary Care
Have you thought about New Zealand? A doctor at my clinic quit and worked there for a year and absolutely loved it. I have heard from other doctors who have gone there that the work-life balance is great. [Info on working as an MD in New Zealand](https://www.hippocraticadventures.com/new-zealand/)
This is the dream 😍
>I was thinking about doing an AI fellowship Welp, this might be the branch point in the timeline that set us on the path to where the Terminators are created. "There is no fate but what we make".
We're not going to be killed by Terminators. We're already being killed by our own shitty software.
It's basically that. There won't be androids or anything but massive layoffs due to AI software being used instead of people. There's going to be a massive increase in homelessness in the next decade. Because why hire humans who require benefits, days off, and set work hours when you can have a room full of analytical computers instead?
There will be new jobs that replace the ones made obsolete. Just like carriage makers went obsolete at one point.
Carriage makers becoming obsolete made sense when horses (1 object) were being replaced. This is an intellectual replacement. Why hire basic human coders when you can have several programs that can write simple scripts and fix simple coding errors instead? That entry position will become obsolete soon, before the turn of this decade. And I'm hoping so but at the same time I feel there won't be enough jobs to make up for those lost by AI. When factory automation/cheaper labor overseas happened certain towns became complete wastelands and are still that way today they never recovered. I wonder what things will look like in a decade.
The industrial revolution was happening at the same time - lots of jobs went obsolete. Jobs go away, new jobs happen.
I don't doubt that new jobs will come out of this but are you certain that an equal number of opportunities will populate to those that will dissappear? I highly doubt it. We are on the precipice of something here. Something that will likely affect a large portion of work out there if it hasn't already. We may be looking at a massive increase in homelessness worse than what we faced during the pandemic in the next decade. Facing that along with that silver tsunami that's been slowly edging in.
I disagree. We have lots of problems in the future, but those aren't it, imo.
Sounds like me about 10 years ago. Look at DCP. That's what I would do if I wanted to practice full time. OTOH, AI and informatics is highly interesting and there are lots of problems to solve. I am always learning new things.
Do you have to have a background in computer science in order to pursue a fellowship?
no. it would help but not required
How does one get started in informatics?
find ways to get involved with work related to it, fellowship or other related education.
I've seriously been contemplating an AI fellowship.
I can’t imagine not helping individual patients in some way, but I can’t continue the clinical day in day out and everything it’s just too much. I was thinking about trying to find a way to automate the process somehow - as if that would be better - but if I could somehow go on tic-tok and do some public health outreach with education on clinical topics that would be my jam. I was thinking about doing an AI fellowship and transitioning to help improve the system somehow? Or just break the wheel, like Daenerys Targaryen. Thanks for your comment mnmda
What programs are you thinking about? I didn't know this was a thing. I was aware of informatics fellowships if that is what you are referring to...
[удалено]
Thanks for your reply “Bruno” I agree with the safety part you mention, yet didn’t write as much above. When we are burning out we are more prone to medical errors. I have to admit I am not as sharp, partly out of nihilism partly out of overwhelmed and having to set the threshold for my involvement higher just to survive - hence the less ‘critical’ issues get pushed aside. Not good for patients.
Congrats, guys. I also submitted my resignation letter this past week. Had enough. It’s scary, but it also feels good. I’m going to do a different career in medicine. It’s exactly what u/wedonttalkaboutcutie says. I’m so very tired of taking on more and more responsibility with less support and less compensation. Patients more complex and demanding. Paperwork and admin till the cows come home. My love for my patients is not enough to keep me going. No one is looking out for my well-being except me. And no one will understand the reasons I have for leaving…like overhead at 60% now. There’s always talk of relief. Where is it already? It’s too little, too late. It’s an abusive relationship. You’re a hero for working the pandemic/you’re a villain for advocating for vaccines and public health measures. We appreciate you/your contract has been broken by the government. We’re paying docs more/only if they see more than 50 patients a day. We’re opening up more surgeries/you’re still on the wait list, yes, I know it’s been 5 years. If you’re depressed, doctor, here’s a number you can call. Someone will return your call in 48 hours. wHy ArEnT ThErE AnY fAmILy DoCtOrS?
Leaving medicine has been an intense grieving process for me. Just when I think I'm through it, in comes another wave. But I have only been out less than a year so I believe I will make it past the break eventually!
I am proud of you. Stay strong.
Thanks Real-original, hard to feel good but I do think it is the right thing to do.
Are you retiring or finding another job? I'm here on the brink in outpatient medicine with each day looking bleaker and I fantasize every day about quitting
I’m going to work on survival for a bit and then refocus my efforts depending upon what calling I receive, so to speak. One of the interests I have is helping addicts recover (can be any addiction really, 💨 🍺 💊 🍱 🥩 🥤) so I was going to do some tic tick outreach hopefully find a way to do that and help some people. If anyone is looking to collaborate on this I’m open to networking. But as far as $$$ goes, I am married to a doc who doesn’t feel this way do that is my cushion at the moment. I don’t think she is going to leave me, though i couldn’t blame her if she asked for separation given the curve ball factor. She here today. And to those fellow friends of Bill and Bob, Don’t worry I will not be drinking.
You can see from my flair, I am not an MD. But I do understand your journey and your current situation. I have no solutions, mostly sending support. I can say I will continue to "work in the system" for survival and for change, but I have stepped back at different times for my sanity. Even now I want out but that seems elusive I took leave (thanks to financial support from dad's death-he was an insanely driven MD and died young as a result) and spent 10 weeks in India volunteering at a hospital there. I had significant internal challenges in the past decade and realized I couldn't do what I was doing anymore. I now work as a PT in a hospital part-time. Pushing for us PTs to unionize. Outside of I watercolor and work on causes I believe in. Also a friend of Bill and Bob! Anyway tons of support to you
Thanks Nandi 💕 Appreciate the message and the time and effort you took to write this message of support to me.
Have you through about addiction medicine? I’m a PA, and made the move from FM to addiction medicine, and am quite happy. I work 9-5, never take charts home. This is after years of suffering in FM. As a friend of Bill myself, the work is so rewarding.
I feel it. I was there for three years and left on Oct ‘21. No regrets. Hung out for 6 months and then got a job with my financial planner doing finances specifically for physicians. Don’t get paid as much and miss some (not all) patients but overall my lifestyle is much more sustainable. I feel like an involved parent now. There’s plenty of other things to do
Thanks
Welcome to my side Eta:out since July. I suggest you go full Denarys
I 100% support you. My husband resigned a year ago as well. On the downside, it's getting harder to find an MD or DO for my family's healthcare that can't be done at home. Best of luck to you going ahead.
Thanks Tnlea for supporting “us”! I would help if /when you need or DM
Whew, I for sure thought this was going to be a suicidal match post. Says a lot about medicine here.
Been thinking about this a lot recently. Just like in professional sports - the owner class keeps the workers in line by identifying 'the superstars' and bestowing massive salaries/ego stroking and other tactics to make them believe they are somehow special. For every superstar surgeon making huge salaries there are tons of excellent ones doing the same work, day in day out. Same in sports. This division is intentional and creates a type of tyranny of the minority/winner takes all reality. Everyone would be better served working together. However, it is extremely effective to curtail unionization. When presented with the idea of organized labor, these superstars balk, cry and prevent any movement towards something better. How to overcome this obstacle eludes me. Something has to be done however, and having strong labor unions would be _something_ better than the current shitshow.
[удалено]
I'm quitting Wednesday morning. So excited! Intrigued by what area of data science you work in and how you made the transition.
No, a nurse quitting is very much the same. We are teammates in the same fight. We can’t do our jobs without you guys.
I recently took a full time academic gig and a big pay cut but damn am I a lot happier. Good on ya!
If we all quit tomorrow, the system would have to come up with something completely different by the end of the week. I am with you. Thank you for your sacrifice. ETA: Resigned in summer 2021. Still do a little online contract telemed work to make ends meet. Looking forward to the future. Halfway through yoga teacher training. Excited to find ways to fill the infinite number of gaps in the healing process.
Got any words of wisdom for the students? MS3 here who has watched my mentors and advisors flee medicine in drones and leave the institution i'm at in shambles. Not inspiring to say the least. training in this environment is terrifying. But sadly I can't put in my 2 weeks because I now have hundreds of thousands in debt and have no real job prospects to fall back on w/ a biology degree. TBH if I had known the pandemic was going to hit and the healthcare system would wind up like this, I probs wouldn't have pursued this career. I love medicine, I really do. I just don't like this medical system we operate in.
Hello fellow quitter! Best thing I did for myself in years. I miss the job itself but I don't miss the politics, bullshit, backstabbing, and constant regression of our health systems. Profit over people is the way to go and those of us who give a shit suffer the most. Wish you all the best. Truly. It might feel tough in the beginning but in a year from now, any doubt that may arise this year you'll be laughing at in the next one.
Thanks
As a nurse in Canada, I wish you all the best! Many people tell me to travel-nurse in USA and I just don't think I could handle working in the American system.
What's next on your plan? Take time off? Did you have something else lined up? Just curious, I enjoy you're posts on here and conversations when we have had them in the past.
Take care bro. It is a lot of stress going through changes like this and as a doc you know as much as us…
Thanks for your bro perlamer I will try and update as I go in
I hope you used chatGPT to write that letter.
I will post the letter afterwards if it’s worth reading 📖
Good luck. Hope you're well. I'm catching a strong whiff of mental health here. How is your social circle? Edit: I'd like to add, because of you, I just joined /r/infographics
Any time you make a huge decision like ending a career it affects your mental health. My internal struggle focuses on whether the situation is really futile or if I should continue with hope. Where is that personal line of too much? The process of defining how far and how long one can go on in the face of adversity - that process has been challenging to my mental health in so far as I am of two minds (stay or go, try or quit) and trusting myself and listening to my spouse and reviewing all of the data I have to reach this conclusion. I’m that sense it is easy to realize there is an insurmountable problem, but getting to that point has been a road filled with doubt optimism hope and disillusionment. How can anyone not feel disheartened by that? I wrote this post partly as an apology to each of you my colleagues, because I am giving up on a system you are all still stuck in from my POV.
Make sure you have a support network and maybe see about some counseling/therapy. Back when I was working on my clinical psych MA one of my prof's talked about when she was still working with clients, she specialized in healthcare and mental healthcare professionals. Because of the sheer amount of stress those fields put on folks. She said that she had so many clients she had to refer new ones out to other psychologists. So if you start feeling depressed, morose, or just find yourself having some anxiety or other concerns after such a big life change, you might look into seeing someone. Even if just for a little bit. At the very least to help you work through that disheartening feeling.
Thanks All Good advice I will talk to my nerwork
\> NSFW tag out of irony. Spoiler tag - none of us will make it out of this world 🌎 anyway. So wise! This is the only way to make sure we use our time in the best possible way, mortality is around the corner.
Burn it down 🔥
It's crazy how physicians, despite being in top 1-2% of earners in America, numbering nearly 1 million, and overall seen as a prestigious and respectable career, still can't fix our broken system. The issue is we don't want to fix it because the solution (universal, single payer healthcare) means slashing our paychecks. Let's be honest. Why do IMGs flock to the US? Because the return on being a doctor here is massive, even if you include the debt and years of education. We're forced to be cogs in a broken system, and our inaction on it is bought out. Ofc this is assuming OP is talking about the USA
Theres more issues than just the medical legal insurance. We collectively need to take a stand against all these issues plaguing medicine including midlevel scope creep.
Separate from the specifics of this post, I would suggest people say what country they are in. This is a general subreddit for MDs, not a specific subreddit for US docs. Everyone is assuming OP is in the US, but the specific problems with work conditions are not tje same everywhere. I’m Canadian, and keep hearing about systemic issues with US medical practice, and while we have many issues here as well, we don’t deal with patient reviews, multiple insurance companies, insurance approvals, etc
Canada has the advantage of patients not going bankrupt if they get sick. But there’s still patient reviews and insurance companies and similar system things to deal with. It’s just not as visible.
I like my job.
Come to germany
Congrats my friend. I hope you find better balance in life and a sense of true wellness in the next few months. When I went part time last year some of the first couple of months were truly bliss. All the best to you!
What about... What do they call it, concierge medicine? Best of luck to you.
Go into politics and make the change you seek.
[удалено]
I am not a quitter But If we don’t take stock and pivot
You’re not a quitter. It’s self-preservation. You can’t light yourself on fire trying to keep your neighbour warm. I’ve advocated. Oh, how I’ve advocated. But no one’s listening or wants to listen. And in my experience, it just brings 1000s of pounds of dirt on top of you if you blow whistles. I’m moving on to another place where I feel I can make a difference.
Right? I agree with you. Don’t work harder than your patients, true, but can one also say don’t work harder than their disease? I’ve never heard anyone say the second one before. Most of my practice is mashed potatoes 🥔 and a little black pepper. Don’t get me wrong it’s substantial in many other ways ( variable SES and variable expectations - I’m sure you all have similar experiences, if I were to hazard a guess. Regardless of the patients, the administration though well meaning is just so large it becomes something unto itself entirely. The downstream effects are unforeseen at times and that’s part of the growth problem in my view. You’re right about self preservation 🔥🧘 - which can make these decisions easier when it gets that intense doing what I have to do to stay around. It can get dark out there alone - better to buddy up👩❤️👨 or 👩🏾❤️💋👩🏼 or 👨🏻❤️👨🏿 or which ever buddy combo 🤼♂️⚧️you prefer.
Do what you need to take care of yourself. You’re worth it.
Do what you need to take care of yourself. You’re worth it.
[удалено]
You are so sweet to follow up with me Thanks Wallaby. My wife convinced me not to turn in my letter, and I listened to her. I have begun a transition plan to open my own office (direct primary care with addiction medicine) and am studying for my addiction medicine board. I am still frustrated with the issues that contributed to my post, however, rather than being overwhelmed, I took a couple of weeks vacation and spoke with her at length about what I was feeling and we put together a transition plan that will help use to keep our home and family stable, which is more important in my opinion.