More Money, More Problems: Contemplating a Career in Healthcare

Posted on 6.29.2012 by Chantal

It seems I've reached an uncomfortable impasse in thinking about my future. Paradoxically, I've never been more sure of my “career path,” yet I'm plagued with more doubts that you can imagine. My mother has been a nurse for over 20 years so I was bit by the medicine bug fairly early. I can remember being maybe 4 or 5 and lining all of my stuffed animals in a row on my bed. My mother would give me Skittles and some small plastic cups and I would dispense to each “patient” a daily dose of medications. If anyone asked, I was doing rounds. Obviously.

For a few years in high school I decided I wanted to be “an obstetrician who doesn't deliver babies because that's gross.” Somehow it didn't occur to me that obstetricians are also gynecologists.

I certainly experimented with other futures. Marine biologist, veterinarian... (Both of which are hilarious if you know me now and are familiar with my utter lack of interest in animals.) I decided at some point in high school that medical school sounded far too daunting and that I should become a poet instead. As if that's somehow an easier career path.

But at the end of the day, I always returned to medicine. In college, I studied social sciences but always with a focus on health. Culture and health. Gender and health. Religion and health. Sexual health. Something inside of me was screaming: YOU WANT TO WORK IN HEALTHCARE! HEALTHCARE! HEALTHCARE! Intentionally or unintentionally, I became very good at ignoring that voice.

Little did I know it, my early high school self was on to something. Flash forward a bunch of years and I'm pretty certain that I want to be an OB/GYN. I've gotten over my childish aversion to birth. In fact, I've become sort of obsessed with it. I feel deep down that it's my calling to serve women. So why become a doctor, you ask? Well, I've been asking myself that same question and it's the primary source of my discomfort. I work with doctors every day and I notice myself physically squirming when they ask that dreaded question, “So what's your plan? Are you going to med school?” “MmmyesI'mplanningoniteventuallymaybe,” I mutter sheepishly.

It's not that I haven't considered other options. I came aboutthisclose to becoming a midwife. In fact, I was accepted to a top program and was supposed to start my nurse midwifery training last year. I chose to hold off for reasons that are much too longwinded to get into here. But I have tremendous respect (and a fair bit of jealousy) for midwives. The truth of the matter is, though, that medicine is a hierarchy. Those two little letters (M and D) bestow power and with power comes freedom (and also responsibility, as I learned from Spiderman). Freedom to work wherever I want in a variety of different settings. Freedom to super duper specialize in some obscure but very important niche that no one's filled yet. Freedom to change my mind somewhere down the line and still have a job to fall back on.

The flip side of course is that I don't believe in hierarchy. I don't believe that doctors are inherently smarter or better at caring for people than nurses. I don't even believe that a person necessarily needs formal medical training to offer quality care. (Fuck yeah, lay midwives!) And above all, I don't believe in a for-profit healthcare system. I don't believe in doctors (or insurance companies!) getting rich off of other people's illness.

And then there are the social aspects of medicine. Being a doctor means being thrust into a position of authority. When doctors speak, people listen. When you put on a white coat, people respect and even fear you.

I'm not trying to say that doctors are bad. That's far from the truth. But they exist and participate in a system that is fatally flawed. The power to heal is a great one. And I believe that doctors individually and as a group owe more to the communities they serve.

How am I supposed to reconcile my passion for medicine, in general, and women's health, in particular, with my anti-authoritian politics? Will a 6 figure salary change my priorities? I can't let that happen. But how to stop it? I don't know. In just about any other circumstance I would argue that it's futile to try to change a system from within. But, honestly, is anyone making any progress in changing the healthcare system from the outside? Just take a look at so-called Obamacare. Sure, more Americans will have access to insurance than before. And hopefully, more people will be able to afford preventative and emergency care when they need it. But at the end of the day, insurance companies are still making the big bucks. And it will always be cheaper for them to deny services than to provide them. This I am sure of.

So what's a lonely anarchist and aspiring physician to do? I'm going to avoid churning out some half-assed answers to satisfy my need to wrap this post up neatly. Because really I have no clue. And I'm more excited and more frightened than ever.