Hey everybody. This is Dr. Inc. To bring you another episode of the truth about employed physicians. I’m really excited this week to bring you my son, John, who was a third or fourth-year medical student at Midwestern University. Indiana University, which is where I attended. And we’re going to unpack a series that is going to take many weeks.

But I think it’s a series that you’ll find interesting if we dialogue about different elements of being a physician. And the spirit of this is, based upon a book that I’m in the process of writing for young physicians that talk about really some of the. Important elements. I think they need to know.

And the spirit of that is things that I really want to share with my son. John is his dad when it comes to being a doctor, but I also find some of the conversations I have a jot about being a doctor to be pretty interesting too because his generation has. Some interesting views about medicine that aren’t always congruent with what I was taught.

And I think this is going to be some good dialogue talking about it. So, John, tell us a little bit about yourself so our audience can get to know you and get to know about where you’re at. Okay. Sure. Yeah. So from the Midwest, from it’ll state of Indiana and I left the state to go to Another school for undergrad.

Went in pre-med knowing I wanted to go into medical school afterward. I got a psychology degree that was the most intriguing area of undergrad that I found that I felt would be most applicable to actually practicing medicine compared to doing chemistry or biology or biochemistry, because the reality is in most doctors and medical students know this, you’re never going to use those things again.

I felt like it was a waste of my time to study so hard on those topics when I didn’t care that much about them and I wasn’t ever going to use them again. So I went out now you went in as a chemistry major. I went in as a chemistry major and then it’s just psychology. When I realize one, I liked psych better.

And two, I wasn’t gonna use chemistry again. So why go through the hardship of chemistry? Chemistry is easy. So when you went to undergraduate and you went to the university of Alabama, it’s okay to say that. And we’re coming up with the time of the year when people like football and college football, and it’s a fun time of the year for you in that context.

But you went to undergraduate knowing you want to be a doctor. Is that right? Yeah. Yeah. That’s true. How did you know that? I think just.

I don’t know. I feel like there were a lot of things growing up that I just felt like I was called to be a doctor. Of course, you get that little bit of extra push and experience. You grew up in the household of a doctor. So you get the extra time where you get maybe in a small town, you see all the.

Patients around town, always saying hi and asking about their medical problems and getting prescriptions at Lowe’s and those kinds of things, and going and stay on St on the sidelines at different high school sports events and going in for waiting in the doctor’s lounge while babies were being delivered and rounding on patients, all those things that I guess, most the average.

10-year-old or 12-year-old or 15-year-old. They’re not going to get that experience even if they think they want to go into medicine, they don’t have I think there’s a little bit more of a disconnect about what it’s really and I never, I don’t think I was ever know how would I say it?

Under the impression that by choosing medicine, I was choosing some really easy route. I feel like a lot of people on the outside looking in. Don’t necessarily know what it actually takes to get there or what it’s like when you’re actually a doctor. And so I think I had a little bit of an advantage of, I knew for the most as much as you can, what I was getting myself into as far as like the time commitments and the importance of prioritizing creating balance in your life as much as possible and different things like that.

And but I think all of my exposure early on really led me down that path. And I had exposure to plenty of other things in my life and throughout college. And I still felt like that was what I wanted to do. And I was like, continue to get more experienced. And throughout this first subject, we’re going to talk about is the doctor’s life.

Okay. And okay. I think anybody I love the life that I have as a doctor. I’m so fortunate and really consider myself very blessed to be a doctor and to love the life that I have. And I think hopefully most medical students are anticipating that sort of. The good life that they’re going to have and what the doctor’s life is going to be.

You don’t quite know what it is unless you grew up with somebody who was a doctor, or somebody’s family member who was a doctor. So I’m interested in just in, even in this subject right now, hearing you talk about it. What were some of the things that made you say it’s great to have the doctor’s life and what were some of the things that made you go?

I don’t know if I really want to be a doctor because I see the other side, how hard it is to be a doctor. Sure. Some of the advantages of being a doctor I’d say are the just the constant learning and intelligence that it takes. I think that. There’s a lot of critical thinking and problem-solving.

That’s not necessarily true, it’s true for a lot of jobs, but not for all jobs. It’s a lot more, I feel like mental labor than physical labor. Not to say that there are not both there to downplay anything else, but so to me that was interesting and I’ve always enjoyed physical labor, but I think that I’ve always had greater strength in.

Problem-solving and thinking through things and learning. And so that was always attractive. I think that the ability to live a moderately nice lifestyle, the paychecks that are available for you get paid, what you’re worth, I think for what you do. And I think that that’s really valuable and because you’re a valuable member of society, you get.

You have a little bit of extra negotiating power and you also have social power in that you can help benefit your community and unique ways that other professions are not able to, you have extra insight and trust from community members. I always think that you can use that for a lot of good things.

Yeah. We always try to and still try to do that in our moment. And our family. Did your peers watch you grow up as a doctor’s kid in school? I always say, got it. Made main, come on. It’s the easier life for you. Yeah, I think that I feel like you get that more when you get older, when you’re like a young kid, knowing for the most part people kids just don’t know.

Or you don’t know I feel like it’s just your normal. You just kinda think everyone’s, life’s kinda like this. And so you probably take a lot for granted as a kid, but. I never felt like we lived a super extravagant lifestyle is I felt like we, I never worried whether I was going to eat anything or be able to participate in extracurricular activities or things like that.

But I didn’t feel like we were doing all sorts of crazy things and driving the nicest cars and I think there’s that little moderation in that was beneficial and that I never, I didn’t even consider myself that different than anyone than someone else who was from a different background.

I think that was invaluable and gave me a good perspective and good appreciation for everyone else and their different positions that they came from that might not have been as fortunate where they did not, or did it. Sometimes I have to worry about what they’re going to eat the next day or.

Things like that. So you didn’t, find it to be a negative growing up as the doctor’s kid in terms of the expectations, perceptions, that sort of stuff. I don’t, feel like I did. I don’t think I ever struggled with those things really that much. I didn’t really feel those pressures. I just, if there were any pressures like that, I just took them on and tackle them.

I never. I don’t know, I guess maybe this is when I, one of the things that it takes to go into medicines that you see something that’s challenging and you take it on and does a thing to be defeated, not something to defeat you. And it’s just, you might have to put in more work or you might have to do this or that.

And I feel like I was always one that liked to step up to the plate of whatever the challenge was. And I feel like that’s something that anyone who goes into medicine has to be able to do step up to the plate in the face of adversity or challenges. What were some of the elements there that you didn’t care for?

Grew up with a doctor. So are there any that you found is there’s always Scott the inconsistency of the schedule of a doctor think you’re going to be offered this time and then you’re not, or you have to go in, cause you got to call you’re on a call or things like that.

That as a kid are not that enjoyable, but it does. I’m a medical student at your doctor, not necessarily that enjoyable, I don’t think they’re ever enjoyable in the unpredictable world. Yes. So I was in something that I never really liked I don’t like the social stigmatization that comes with being a doctor.

I think it’s one of the few careers where people would truly, have a feel for where you, they know almost that you’re financially and socially, most likely financially and socially successful. And there’s these pressures and expectations that you need to do this, or do that, or live here, go on this trip and blah, blah, blah, blah, blah.

And I don’t think I’ve ever liked that. I think that’s, my own business. And if I’m in that forever, I was in that position. They earned it. It wasn’t just, it didn’t just happen. It took, it takes years and a lot of hard work and expertise to get to that point. And yeah, I think that’s.

Yeah, it’ll make it like that part, but nothing else stuck out to you in terms of your own personal experiences that you saw as being some challenges associated with the doctor’s life? Cause I serve, I certainly feel like the opportunities that are created by my profession. And by some of the economic forces that go along with it that provide security and provide resources to do things really outweighed most, any of the negative elements with the and doctor.

And I think to your point, the greatest challenge, and this has changed really from the time you were born till now, for me in practice is. The unpredictable world for me and, as a primary care doctor, when I used to take care of hospital patients that were adults do OB do pads did really did everything inpatient and outpatient being on call and being available 24 seven was, pretty challenging at times.

Now, I think things have moved forward for a number of reasons to the point that. Life is less unpredictable for me now I still do obstetrics. So by definition, that’s going to be a little unpredictable. Yup. And I still love obstetrics and delivering babies, but I think it’s a little more predictable now than it used to be.

And I think your generation is going into medicine in the future. I think that’s the, for navigation that we’re going to see more and more. I think most of your generation of doctors don’t like, and won’t like, and won’t tolerate quite as much the unpredictable world as they do the predictable world.

What do you think of that? I think there’s just a bigger focus on having separate lives. There’s, I think there’s a bigger focus on having a work-life and family life and social life and kind of having things broken up rather than having your work life be like a steam roller over everything else.

That’s yeah. There’s like a bigger awareness of that now, especially with the high rates of burnout better in the medical field. I think that’s especially true. He’s really important. Interestingly enough you’re married and have been married now for how long? Two and a half years. Two and a half years.

So you’re Y fully as been with you on this medical journey that you’ve gone through. And I know for me, my wife has very much been a significant factor in bringing stability to my life, but also she’s understood some of the sacrifices that she had to make as the spouse of a physician.

It’s not a great gig all the time. It can be pretty tough. Yeah, but yet I know for me she’s my rock she has had a tough day. She’s the one that kind of smooths it all over. And I can’t wait to get at home to get to her because she’s safe and secure and comfortable to me in a way that nobody else is.

And just like my whole family operates in that way. But my wife in particular has proven to be a very important part of that process for me. But she’s had to sacrifice. She has no, she knows the relational sacrifice that she’s had to make because of me being in medicine. Tell me a little bit about how that’s played out for you even in medical school with your life.

I think that I don’t know for one, one thing that I think is that I really appreciate it. Or I’m thankful that going into medical school? I got married during my first year of medical school. Couple months in, in between two important exams says, took an exam early, got married, came back and took another exam.

Damn. So it was pretty stressful. And so I think, I feel like that was the baptism medical school for my wife, because we did a short little, like two day honeymoon and I was like, all right, sorry, honey. I came down and got married, but now I needed to go stay in the library for the next four days straight.

You’re not going to see me, even though we just got married because I needed to make up for the time I lost to study for this exam coming up. And then after that we can be married. And so it was just like she was went through that fire reckoning day one and most people know the first semester of medical school is often the hardest semester of medical school is you adjust to just how much more of it that it takes from you than it did an undergrad. At least for me some people they flip through it, but I think most people have to work harder during it. And it’s been really nice to, have my wife be a part of that in that we’re going through the whole process together and she’ll be able to have a full when we get to the the end of everything after residency and I’m an attending or going through.

So practicing to have been there throughout the whole journey, I think is going to be really valuable to there’s not really going to be many other people. There really no one else who’s going to fully understand all that. It took to end up where we were. And I think that reaching that point when I get there, I’m not going to feel like it was, I just did it for me.

I feel like I, it was like, she did it with me. You know what I mean? It’s she, it’s also, this should be a secondary side degree I don’t know, step down degree for people who went through the medical school process with their spouse, because there was so much work and sacrifice from them as well.

The first year and then studying for step one. And then after that you’ve got clinicals where now you’ve got got eight to 10 to 12 hours a day. And then when you’re home, you’re studying because you didn’t get to study during the clinicals. And just feels like your time just gets eaten away by either eating away at, and to have someone who is understanding of that and supportive of that and allows you to have a little bit of escape from all of that is just so powerful.

So I agree with you and. As your your late mother and I got married similar to you and I got married in my second year of medical school halfway through. So we’re pretty similar in that context. And, she had a deep understanding of all the sacrifices that were needed for me to get to the level that I was now, your step-mom whom really has been your mom most of your life.

She came on board though after I was an attending position. So she got to miss all the junk associated with medical school and residency, which for our audience especially if you’re younger are a doctor to be, or a younger physician the junk that I’m talking about and the hardship that really is part of that process.

And your mom often comments, she doesn’t, she didn’t, she wasn’t there. She doesn’t know. Kind of what that was like, but you’re like mother certainly did. And I know your wife certainly understands and challenges. I feel important to point out that even though there’s all this junk and challenges of going into medicine and being a doctor, you never want to take it for granted.

It’s a blessing to have the opportunity to go into medicine as well. Not to, I don’t. I never want to be too much of a complainer cause it’s a great opportunity. And an honor, and there’s so many ranks in of people you have to compete with to get to this point who would love to be in your love to be in your position.

So really to just even though it is hard, it’s fulfilling and. I don’t know. I feel like in a lot of ways in honor and a blessing to be able to do so, sure it is. Does your wife’s ever facet about it? Sometimes she says she wished she’d married a doctor instead of a medical student.

Yeah Yeah, solid. And that’s reasonable. That is very reasonable. It is, but too late for you. It is one of those realities though that happens is you do tend to think that, Oh, the next level is going to be so much easier from medical student to resident and resident to attending you really, do you always think this is going to get better?

It’s going to get better. And it does in some regards because your professional responsibilities and your, sense of even inner identity is what the world is growing in the process. But the same things that eat at those relationships and try and steal from relationships like your marriage will continue at every level that you’re at.

And so it really does take any termination. To not let it get out of your road. And I would maintain that. What you’re doing now in medical school is actually setting up or creating the right boundaries and the, right architecture for you to have a healthy marriage in the context of medicine and not saying it’s well, it’ll get better when I’m a resident.

Oh, it’ll get better when I’m an attending. No, I think what you do now makes a difference. What do you think of I think, and I feel like the fallacy is. It will get better as though it’s just going to happen on its own. I think you make it better. I’m very much a you make your life what you want it to be.

I think that having that personal volition or I think people have the ability to create what they want. And so if that’s something that’s important, you make it better. Like you make the time for the things that you care about. And I think that’s Valuable. And there’s a lot of people who do that well, and a lot of people who do it poorly and I think everyone should strive to be someone who does it well, but you need to have a, you have to have a personal awareness and self-awareness to make decisions, to make things better.

And. Prioritize the things that are most important to you. Yeah, I agree. I totally ultimately become a doctor. It requires a radical commitment, right? That’s the whole process from undergrad to medical school to residency, it is the Supreme sacrifice you have to make to really accomplish that goal.

But I think at the same token, what we’re talking about here in terms of vital relationships, Yes, whether it be relationship with your spouse, whether it be a relationship with a family member, maybe even your faith life, you require a radical commitment to maintain it because other things will encroach upon it.

And it’s really quite hard. What, speaking of that radical commitment, though, for you here you are, you’re a third year going into fourth year. Have you considered it a ramp that whole process to go through to get to this point? Yeah, it feels right. Pretty radical. I just feel like you, I dunno, it just feels like such a commitment once you’re in it, when are you going to, it feels like you can’t stop.

It’s once you’re in undergrad trying to get into medical school, it’s one thing, cause you have, if you don’t get into medical school, you’ll go a different route. You’ll do, or maybe a re reapply again or whatever, but. Once you’re in, it’s okay, you’re in, this is your shot.

You’re paying 20,000, $30,000 a semester tuition or more to go to the school. So by the time you’re through a year, through a full year, if you’re taking out loans, you’ve got 40 to 60 to 70 or more thousand dollars in debt. And now you’re like now I have no choice, but to keep going Most people want to keep going and I do, but it does feel and it just takes up all your time.

I think that’s the big thing is just the amount of time that it takes the commitment of time. Is the biggest thing where you, it’s hard to maintain the hobbies that you used to have, or the friendships that you used to have, or the other things. And you really whittle down to the. Four or five things that you consider the most, absolutely most important things in your life that you’re going to prioritize and make happen on an either daily or weekly or monthly basis.

Yeah. That reminds me of the four burner theory that is out there when it comes to what it takes to accomplish a goal in that four burner theory. The idea is that it’s like a stove with four burners and. Only so much fuel can go into the stove and it’s hard to equally fire each one of those burners, right

📍 The fact is that the 4 burner model creates tension in your doctor life, which will in turn expose 8 truths that are valuable to reflect on. So the radical commitment needed to go into medical school and to become a doctor. So requires most all of that fuel and energy to go into that one burner, to be a doctor while at the same time your, family, your hobbies. Your other elements that are important to you get less fuel, less intention.

Have you found that to be your experience as well? Oh yeah. Very much yeah, it feels because everything’s so high stakes all the time that you feel like you can’t help, but put majority of your energy towards your school in all the time. If you don’t pass this test, if you don’t. Honor this clerkship, if you don’t get this letter of recommendation, if you don’t do the secretary curricular, if you don’t just all these things.

And the thing is that the reality is you’re not making those, the importance of those things up in your head. They are. Yeah. It’s not like to get something right. To get to the next stage. Because the reality is if you do terrible and step one if you get a 200, you’re not going into dermatology.

It’s just not going to happen. I don’t, it doesn’t matter. And so, then so your options, so you came into medical school to do this one thing, but yeah. And you don’t perform so much for doing that one thing, either you’re dropping medical school or you’re going into something that’s not what you personally might’ve wanted to do.

And so that’s where you feel that pressure of, I don’t want to not do what I came. I’m going through all these years at school. Did you ex. I don’t want to have to do Y just because I didn’t perform, so in order to perform, you have to prepare and that’s takes the Tundra, prepared all the food, all the farmer.

And so that’s where you end up with that, putting everything towards that one, and it feel it, you start, you can, other things start dying now, the hobbies and the working out and the hanging out with people and the things like that. And so I think it’s The only way to counter that is to be intentional and for me to schedule things and try to maximize my time.

And usually for me during each clerkship or during each like system subsection, like cardiology or gr or whatever, I literally schedule everything out for the whole month in order to figure out how to get all of the study that I need done in order to get the grade that I want. Yes. But also that not only helps me get the grade I want, but it allows me to free up more time to do things that I care about such as try to work out four or five days a week, or make sure that I’m spending time with my wife every day.

Just those things that I think are important during the day or during the week, but they’re not just going to happen. You have to commit to, I’m not gonna. Turn on the TV when I get home and waste my time I’m instead, I’m going to keep studying so that I can be done by seven 30. I can hang out with strand for my wife for an hour.

Yeah. And then I can chill out and go to bed and then start over at 5:00 AM the next day or whatever time. Yeah. It requires some discipline in that process. A lot of it, ideally I think if the most successful people, if they’re, they may be super, highly intelligent, And they can fast forward over all that stuff and they just get it.

But I think the majority of people, if they really try and balance this all out, it does require some interdiscipline, which is part of the qualities of being a good doctor. And that’s all, kinds of things built into that, but it’s, radical and it’s really challenging, but I think it leads to some of the under-development of, some of the skills that frankly, your peers develop because.

They don’t have to go through such a radical commitment. They go get an undergraduate degree and they go into the work world and, they start living life. Either get married, sir, live in life and they’re doing their job that requires certain amount of focus, but it doesn’t require that intense focus that, four burner model they’re able to actually balance things out and find that middle ground.

Whereas here you are living your life compared to those peers and all of a sudden. For me, I always said, I felt like I was living in a cave like those years I went from undergraduate school into residency, those four or five years or so, even my first year of residency was pretty intense.

I’m not sure a whole lot what happened in the world at that time. It’s you’re hidden away a lot.

The content with the, that man just knew this, what it required. I was very attentive to my wife during that time. And there were a lot of things that didn’t happen and I’ve actually remained, maintain a great involvement with my church and with some friendships in that, but the rest of the world, TV, media, cultural stuff, I pretty much was oblivious to it, to be honest.

And it requires that, Oh, for sure. I feel like it’s literally, you’re studying all day. You’re doing. Reading your textbook junior practice questions, senior flashcards, you look up like, Oh wow. Something big happened today in the world. Okay. Back next class card. Next practice question. Nothing I can do about that.

It’s such a, it feels like such a bubble from the rest of the world almost. And in more, ways than one, because also at the same time, we’re not really working. We’re not getting a paycheck. You just have to have this guaranteed money. From, Oh, you’re paying for all the saying we’ll pay for you, pay for it eventually.

But in the moment you just get the check in your bank account and you have your things paid for. So you are able to fully focus, not having to work, but you also, aren’t dealing with a lot of those normal life things. That’s better. What that the rest of the world are working and going through and those world events and those things actually affect them.

But when you have that guaranteed you’re going to be able to make your rent payment, you’re going to have. Money for food because you’re guaranteed those loans because uncle Sam knows you’re going to pay him back with a seven, 8% interest rate. And so they’ll give you the money.

Oh, the other thing, we’ll talk about that in another subject. Cause that’s an interesting thing because there is the debtor’s life and we will spend some time talking about that, but yeah, it there is a lot required of you and, I think it creates blind spots. Honestly. I know for me. They’re black, a blind spot is hard for you to even say what a blind spot is in your life, because that’s the nature of it.

It’s a blind spot. You don’t even know it exists. And I think for a lot of medical students and even in a residency and even attending physicians because of this whole process and because of the intensity of it and the intense focus, we tend to underdeveloped some of the skills that are necessary.

To manage wife. I like the rest of the world. And whether that be our financial under-development, whether that be our social relationship under social skills even our physical health, I think becomes neglected a little bit becomes underdeveloped because of the sacrifice needed. Have you found yourself sometimes feeling like you’re a little blind in some areas?

I think that’s definitely true. Just I think for me, I’ve never been the huge social life person. And so for me, that’s not as big of a deal. I think for my wife, it is more so she’s more cares about having a social life. And I could just have a couple of close friends and call it a day. Yeah. But I think the physical health is the thing.

That’s the most challenge just finding the time in the day to workout. Kinda throw my whole life. I’ve pretty much worked out or did some sort of activity or played a sport pretty much just, about every day. Yeah. And now it’s if I am not scheduling it into my day is not going to happen.

There’s just not enough hours. And I can see the difference in my functioning when I haven’t worked out for a couple months, because I got caught up in my internal medicine clerkship and it was just 5:00 AM to 6:00 PM. And on top of the studying and don’t you don’t, have time to work out.

And yeah, I think that’s for me the biggest one. But it’s also a priority to me as well. So yeah, I have to make time for that. Who am I? I can’t appoint anyone else and say, Oh, you made me not do this or that it’s more if I, was, going to do, I needed to make it happen. But push comes to shove the intensity that’s required.

When you’re going to sacrifice something, it’s am I going to sacrifice, am I not going to see my wife at all for the next two months? Or am I going to not work out? And so I guess I’m not working out. Yeah. Forced rank order that you really do, find yourself in that position. I have to compliment you on the fact though that you were wise in your adaptive processes by marrying an accountant.

If you thought that you were going to have some financial blind, spots, you compensated for that by choosing Americans rather than that’s pretty smart, actually, that was good on your part. Not every doctor can choose that wisely, but I think that’ll work out in your favor. I do. And so marrying a lawyer that’s right.

As you went through undergrad, even, and. You didn’t meet your wife to be to literally later in your college career. Relatively speaking, but did you find it hard to interact with other. I guess to look for a girlfriend to look for relationships, because you felt like you didn’t have this much of a social life or as much time to pursue it or, even now when you look at say some of your unmarried peers in medical school and, they’re like, it’d be great to have a social life, but I don’t have time to go look for people.

Yeah. I think undergrad, it was undergrad. Wasn’t a problem. There’s plenty of time. And. It’s a commitment, but I’m not you, make you can, you make time for those things. You, have time to make time and just, it’s a lot easier. And, but now I, I definitely, when I look at my colleagues who are would like to find a significant other.

I dunno how that I don’t know how they could do it because there’s just not, there’s hardly time to create that social life, to truly get to know someone well enough to know. Do you want to spend the rest of your life with them and or do you even just want to date them regularly? Because your schedule is so irregular that your nose you’re available for three months and then you’re doing away rotations for two months and you don’t see them for two months and then just like that, whatever you might’ve had fades away.

And definitely don’t envy. Those people who were in that situation, going through a medical school, a residency, you’ll see, most of them do like same medical school right now. Almost hitting the pause button, just almost by definition. They’re like, you know what? I’m not even going to worry about this right now.

Yeah. That’s I think that’s the majority is it’s either. They’re desperately looking to try to go ahead and find someone before they get to residency or. The majority of 90%, I feel are just I don’t think I’m going to be able to have a significant relationship during this time period.

Something falls in my lap. I’ll take it, but I’m not, I don’t have the capacity or the fuel available in my burners to prioritize that right now. They’re putting it all towards their education, just like that follows the cultural drift right now, though. Two of, most of delaying marriage till later in life.

It all kind of fits. Into that process as well, I believe. Yeah. And so I, even, when I was in medical school, that was still a thing. The minority of us were married when we were in medical school, the majority were unmarried and even those hardly ever got married during medical school, I was an exception.

You’re an exception, but it’s because we knew those people. Yeah. I don’t know anyone who has met someone during medical school and got married during medical school. It’s always, yeah. And knew them before got married during cause how the timing of things worked out, but no one who’s Oh, we met each other first year med school and we got married fourth year of med school or someone that just you don’t, really see that.

So you’re, part of generations. Z are you part of right? I’m right on the line. Okay. So you could consider yourself either, either 1995. So just yeah. Your generation of what we can call it either one millennial or generation Z. How do, you think your generation views the life of a doctor any differently than say what you’ve seen me view life as a doctor, as you grew up watching a dad who was a baby boomer, right on the edge of bathing, a baby boomers, view of medicine being X.

Ray was really has been, my identity has been my whole everything of who I was. It required that from me. And I’ve continued to live in that vein, but I don’t think most millennials or generation Z are embrace the medicine the same way that I do. Do you think it’s different? Yeah, I think that there’s definitely a greater prioritization of balance.

Much more about having a life outside of medicine, much more about A I dunno, maybe a means to an end, rather than being the end. Yeah, that’s So I’ve heard people in the physician fire movement. Talk about that. About medicine being a means to an end, to get to the point where you can retire early the fire movement. Is that the kind of stuff you’re talking about when you say that or is there really other things that you’re talking?

Oh it’s, hard to say. I think probably this part of it, of the fire, maybe functional penance retire, really. But I think more of just people who are striving, they don’t, I just think that there’s a, almost like an identity crisis that people don’t know who they are. They don’t know what they want, but they want to go live life.

They want to travel around there. It’s people feel like this generation is like trying to find itself. And Having the means of a physician gives them the ability to go do that. Having the funds and maybe some of the time off I think visitors have more time off for sure than the average worker.

And so there’s some ability to do those do some of those things and yeah. I don’t know. I feel like for a lot of people, it’s more of a job and less of a calling now than it used to be. That makes some sense to me. I see that in that context, that’s I think why, I think we’re seeing this movement towards physician employment too.

The most recent stats show that most graduating residents about 90% or so she chose to be employed as opposed to going into private practice or kind of going out on their own where oftentimes that was really built into your identity and certainly your purpose. But now it’s a job you get hired for a job.

Is that the case? Yeah, I think it’s definitely more people just work in jobs now rather. Yeah. I think the fact that just accurate, there’s just people want to. Not have to deal with all the overhead and the managing staff and all of that. They’d rather just sign a contract and get their checks every week and be able to do what they want with it.

And when they’re at work, their doctor, when they’re not at work, they’re whoever they want to be there. It feels maybe a little bit less of a. It feels a little bit like a group that’s less engaged in the community. Yeah. And, I’m sure it’s not to say that they don’t care about people or care about the code.

Definitely not. Definitely not. Doctors are altruistic as a whole right. Using that doctor position outside of the hospital. Like more just when I’m doing my work in the community, like that’s what I’m doing, but when I’m outside yeah. I’m going to be whatever I’m going to be. I don’t, want to be, I don’t want to have that.

Follow me out something. Yeah. I have medical students and residents that do rotate with me and I always get a chance to talk to them and get to know them and so forth. And even in the process of recruiting new doctors to join our medical group, what I see is this sort of mentality of, I like to use the term urban anonymity.

And that is that a lot of I, cause I’m at a small community, a small town, a lot of doctors are doctors to be doctors and training and they think is an interesting gig where you’re in a small town, but most of them don’t want to live in a small town because there’s this they’re known, there’s this sense that they’re known by everybody and there’s no anonymity that exists for them to be off.

Okay. And. I’ve always embraced that as just the doctor’s life. Okay. But it’s a thing, isn’t it? It’s a real thing among your generation and among your group of young doctors that a lot of them prefer the richness of what comes in the urban life opportunities, things, places to go, things to do.

That’s the thing, like they won’t, people want it to be a job and they don’t want it to define their whole life anymore. I feel like for you. Your generation is more, it like your job being a doctor is who you are, is what you are. And for people now it’s just for, a lot of them it’s, my job.

And then outside of it, I’m, it could be something completely different. Yeah. That’s not really who I am. It’s just what I do. Yeah. So is that, how you’re thinking? I dunno. I feel like that’s something you get to develop as you go. Three. I don’t think you, I don’t think that sort of happens until you’re in residency.

I think as you go through the training, you turn yourself into what you want to be here. So I think I’m too early still to really say I feel like I was called, I feel I consider it a calling to go into medicine, but I see the, about the merits of the, having the balance of. Having it be a more of a job, not fully, it’s a little bit more of what you do and not who you are, but I don’t know.

I thought there’s a nice, in-between spot, a sweet in-between spot where it’s, who you are. You don’t know, try to hide it or downplay it, but it doesn’t take over your entire life. And I think that’s where I w where I want to be where it’s a part of my identity, but it’s not all that I am or all that.

I’m about. There’s more depth than that, right? Yeah. You’ve, I feel like you’ve, there’s a common idea of Doctors need to be an inch deep and a mile wide, rather than way down deep, rather than a an inch wide and a mile deep. They got it. They got to have this broad little everything.

That’s the family part of your care. That’s what I do. It’s part of the identity thing versus having like more. Depth in terms of a more dynamic, I think people want a more dynamic. Yeah, no. Interesting. Yeah. I think just as the world has grown in America has changed and things have changed. I think that it feels more possible probably than it used to.

Yeah. As healthcare has changed. It’s way more possible for people to do that than it used to. They used to be so. I’m not going to hold you to this, but what, specialty are you interested in? Right now I’m planning on doing orthopedic surgery. Okay. Easy to get into. No, not easy. It’s not no.

One of the more difficult yeah a lot of people consider it one of the top three or four most difficult up there with Durham and neurosurgery and. I are one of the toughest ones probably got ya, but good things don’t come easy. Yeah know. And but that’s required some sacrifice is probably on your mind all the time.

Yeah. To get to that level then. Yeah. Yeah. Especially going through your third year of medical school, there’s a lot of, lot that rides on your third year of medical school. I feel like. And end of second year of medical school between step one, step two, clerkship grades, evils trying to get all the extracurricular stuff in volunteering, research leadership.

It’s just that’s a lot. Yeah. It’s even when I’m not studying, I’m still doing something related to that career. Yeah. I’m aware of it. It’s interesting. I was fortunate enough to be AOA and at Iowa medical school, much like you’re going to an Ivy medical school. Although I was pretty ignorant about what that meant and all the business that went with that.

But but what I didn’t do no back in my day, all the people that wanted to go into the higher value specialties we often accused them of being called gunners because they were the people, our peers, he would pretty much ruthlessly do anything they could. To put themselves in an advantage compared to their peers.

So they would look better. Do you guys are still exist in medicine? That’s still a thing. Yes, it is. Yeah, I think so. I don’t think you have to be a gunner in order to go into competitive specialties. I think there’s gunners not going into competitive specialties, but there are definitely gutters. And you’re not one of them though.

I wouldn’t consider myself one of them. I think gunners are willing to do, put them do what it takes to get themselves where they want to be, but also willing to run over anyone in their path to do I feel like I’m a little bit more, I’m going to do what it takes to get where I want to be. But also when everyone else to end up where they want to be too, at least within my circle, I got, yeah.

Of the anonymous, other 30,000 medical students out there right now. To me, everyone in my class has competing with all of them. So I want everyone in my class to succeed, but those are the people I know. Like you want your friends in the faces that I feel like it used to be a little bit more take down everyone around you.

And I think I’m a little bit more okay. And just generally medical school culture now is a little more, let’s all, everyone in our little circle succeed. Try to be the rest of the world, the rest of the medical school students or whatever. And yeah, I want to see all my buddies do well and yeah. I always wanted my peers to do well too.

And I always liked it when they did it’s a funny thing you put on, you put the ultra competitive people together in groups and compete with one another at the next level. And there is a certain amount of sorting that goes on. There’s a certain amount of true. Yeah. Minor or major competition.

It seems like that goes on. Even if it’s mental gymnastics internally where you’re comparing yourself to others, seems sort of part of the system but then there always have been, I’ve been glad that it’s interesting to hear there still are that gutters, the the ones who are at all costs.

I think there’s always going to be the gutters. I think there probably are as well. It’s interesting. What kind of, as we wrap up today’s session, which I think has been very interesting to me the doctors lives a great life. I said in the beginning and I’ll say it again. I love everything about my life as a doctor.

I do it’s imperfect. And and generationally, I’ve had to reconsider and reflect on you. Just some of the things, even from talking to you about how can I be a more balanced and better doctor, but just very interested in your interest in orthopedics and what is it about the orthopedic doctors life that makes you think that’s what I want to do?

I think the orthopedic doctor’s job. Or their task, I think is a lot of what I like. I like working in the hands. I like the surgery. I think I like working with the bones rather than soft tissues. And so orthopedics seems like the route, as far as that goes, it has nothing to do with it.

It’s one of the most highly compensated specialties. I think there’s always a little bit of bonus in that. Okay. All right. Just interested in knowing if that influences things at all. I think that one of the. Nice things about that is one, it gives you with how much healthcare has moved towards employment.

I think orthopedics is one of the specialties that allows you to have success more easily, have a successful private practice. Okay. I’m very interested in being part of a private practice or group practice and you part of owning like a surgery center and Be part of the machine of health care, but not run by the machine of healthcare as much.

And so I think that, provides the opportunity. Orthopedics will provide the opportunity for the lifestyle that I want. As far as allowing me to create the balance in my life, as that I want work be compensated appropriately for the work that I do. And do you use the skills that I want to develop?

Those are the skills that I like. And I think there’s a lot of advantages to it. I’d recommend it. So last question. Just circling back around to your wife’s comment. I know she’s not here. Maybe I should be asking her, but I’m going to ask you anyway. And that is your wife has said that she wishes sometimes that she had married a medical student, that she had married a doctor.

And I know what she means by that, and I know what you meant by that, but I think it’s an interesting point. And that’s because it points back towards this very topic that we’re talking about it, and that is the doctor’s life. And I think people look at the doctor’s life. That’s right. They see the end result.

And if they’ve not gone through the process to get there, or they don’t know what it’s like being in it, they have a FA. Fantasy like version or view of it. That it’s great. That’s what your wife alluding to. I don’t want to go to the harder stuff I want to get to the good stuff at the end.

Yeah. But again, they’re like, I love my life. It’s a great life. Just can you comment on what you think you wouldn’t, you’re projecting this, you’re going to, you’re guessing what it’s going to be like, but what part of the doctor’s liked you look forward to the most. Oh, goodness. Not being cool.

All right, that’ll be nice. So United, I actually have my wife’s grandparents stopped asking me, when am I going to get a job, start making some money. When am I going to pull my weight? And I don’t know, have the. I’m looking forward to having the autonomy and ownership over what I do. Not having feeling a greater sense of ownership over the patients I’ve taken care of and the you might have, you’re gonna always, you’re gonna have people looking over your shoulder pretty much your whole life, but.

Eventually you become, you’re an expert in your field and mode, majority of people. Can’t, aren’t gonna be able to question, tell you that what you’re doing is the wrong way to do X, right? When you’re in surgery, the CEO of X hospital doesn’t have a clue how to do surgery and they’re not going to walk and say, Oh, you need to be doing, do it like this and this.

I mean like they they wouldn’t even think to do that because. You’re the expert. And I liked the idea of being the expert in something. Eventually I will remind you on that note though, is CEO of that hospital will tell you which one of the orthopedic products that you can choose to use will be the cheaper product for them.

And they’ll make more money from than the one you might choose to instead that’s the thing. Yeah. And that’s why you have your own little surgery center and have your group practice that does your surgeries there. There’s always a little tension that exists, no matter the specialty. So that’s an interesting thought.

Some of the, in the, some of the other lifestyle things, I think that’d been a doctor affords that are enjoyable after years of saying no to everything continually putting everything off the thing. That’s true. Yeah. So this is good. John, I really appreciate this time that you’ve had, and I’m looking forward to our additional discussions on a host of other subjects that I think young doctors are grappling with and older doctors grapple with as well.

And for our audience out there I think that this probably the doctor’s life has maybe brought for some. Ideas and thoughts that you have. I welcome your comments, John. Welcome to your comments, your questions on our website at a doctrine incorporated where you can find the truth about employed physicians.

You can ask questions on our speak pipe. That’s at the website. You can engage us in a host of different ways in the podcast via the blog, itself. We invite you to engage with us in this and we’ll look forward to you hearing our next episode at the truth about employed physicians.