Is a Career in Family Medicine Worth It?

Recently, I sat with a few third-year family medicine residents mulling over career options. With looming student loan debt and that dreaded feeling of not yet having started many of the life events such as getting married, buying a house, and starting a family that their peers have already embarked on, the conversation of whether it is really worth it came up. The exhaustion of residency with 'its hectic schedule, lack of sleep, and enormous amounts of paperwork has many of them feeling that maybe it won't be quite worth the hundreds of thousands of dollars they borrowed to pay for the dream of being a physician.

My more senior colleagues scoff at this. Lacking the level of student loan debt that more recent graduates, myself included, have acquired, they firmly believe that while we may not make as much as some other specialties, we are well paid. On the surface, I think this rings true. I bring home a far larger income than my non-physician friends and family.

Yet, I also understand the nearly crippling debt. Fortunate enough to qualify for an income based repayment plan, I still have taken on additional per diem and side clinical jobs to cover my monthly bills. I have not made foolhardy choices to buy luxury cars or live in a large manse, but I do have three children, one in daycare and one on the cusp of heading to college. I worry about bills and having nothing put aside for a rainy day. When I have sat with the ourfinancial advisors at work and looked at the numbers, well, let's just say I won't be taking an early, or likely even an "on-time" retirement.

Despite a decent salary, much of the necessary work I do, from patient phone calls to prior authorization paperwork is uncompensated. From a monetary perspective, it is unlikely my medical degree will ever turn me a profit.

I do not wish to discourage my third-year residents. After all, most of us, especially those who have opted to be primary-care physicians, chose medicine for reasons beyond finances. My career offers me a wealth of opportunities to care for patients, counsel families, and treat disease. Every day I get to learn and every day I am intellectually challenged. I may not be changing the world on a grand scale, but each day I am privileged to help individuals in my corner of globe. Is it enough to make up for the fact that I will likely be paying off student loan debt for the next twenty years or so?

My life, despite the lack of luxury, remains full and I cannot imagine having another profession. I worry about the changes in payment models and decreasing reimbursements. I cringe at seeing medical decisions taken from the hands of physicians to insurance administrators and government officials, who are looking mostly at a bottom line. Still, I have the urge to fight for appropriate compensation for the work I do every day. My relationships with my patients motivate me to wrestle back my autonomy. Medical school with its long hours in the library and labs studying for marathon board exams followed by exhausting residency training that challenged me physically, mentally, and emotionally all led me to a career, a life, where I get to be someone's family doctor. When a patient calls me to tell me the difference a treatment created or a family thanks me for the care I provided, my medical education and the high costs of pursuing it were worth it. This field has never been for the weak and I think that more than ever medicine needs to be pursued by those seeking excellence. We also need to advocate for the needs of the excellent so that they do not choose abandon medicine as simply unworthy of the sacrifice.