What's the (percieved) pecking order in medicine?

[Frank E]

As per title, which practitioners think they are a cut above practitioners in other fields of medicine?

[yazoo]

The old adages often remain true:

Medics know all and do nothing. Surgeons know nothing and do everything. Pathologists know everything and do everything but it's all too late.

That leaves a few groups out, of course, but you can make it up from here. Anaesthetists, for example, tend to be great at the first few letters of the alphabet .

Basically, it's a bit like med school. Your own one is best! One specialty is generally viewed as bottom of everyone's heap (except their own), but I'll not put it in writing!

[Hughman]

The old adages often remain true:

Medics know all and do nothing. Surgeons know nothing and do everything. Pathologists know everything and do everything but it's all too late.

That leaves a few groups out, of course, but you can make it up from here. Anaesthetists, for example, tend to be great at the first few letters of the alphabet .

Basically, it's a bit like med school. Your own one is best! One specialty is generally viewed as bottom of everyone's heap (except their own), but I'll not put it in writing!

Aww, spoil-sport. You are anonymous on this forum

[evian]

Yeah pretty much like Yazoo said - your own is the best!

I got told (by a surgeon) the other day that "traditionally, the best" did surgery, but then if you didn't make it, you move down the ranks to medicine. But even if that was not sucessful, one becomes a paediatrician. If all failed, psychiatry.

But then within surgery there are subspecialties (e.g. neuro) seen superior to others (e.g. breast). It's all politics and egos, really.

[kick]

what really gets me is that some go into a specialty thinking they will be well respected rather than going into a specialty with genuine interest!

[Frank E]

I was just curious, being in the line of work where working 'on the tools' has lower esteem. Someone was bemoaning how other disciplines views their discipline.

[phantom]

No good deed goes unpunished.
(A.K.A. The good Physician will always be stepped over by everyone else.)


I entered physician training for several reasons. The intricacies of internal medicine interested me. Because I like to know things, to see patients come in with their complex problems and watch their story play themselves out and come to a conclusion that is satisfying. Because I respected the Physicians I studied under. But it has become increasingly obvious that all is not 'even' in the real world.

As I embark on my specialist training, I start to wonder whether or not I have made the right decision.

It is no secret that Physicians will ultimately earn much less than the Surgeon or the Radiologist. And definitely much less than the Anaesthetist. A trade-off for the lack of procedural income? Or more a culmination of goodwill being taken for granted? How often have Physicians been passed over (or not give the same work incentives) at each round of enterprise bargaining? Even the medicare benefits schedule are a starkly obvious sign that society values my clinical acumen much less than other specialties.

What does the government (and medicare) value more? The follow-up Physician consultation of a patient with multiple medical problems, or an Anaesthetist giving sedation for a CT scan? It seems the latter... And the private insurance rebates show a more of a discrepancy. See ten medical patients in one afternoon, or perform one epidural? Or maybe look after a handful of patients in private hospitals? Have you tried finding a private hospital bed for a medical patient? There's no chance of it - because there's no money in it. Hospitals make more money from an operation, and so they're more likely to have a bed afterwards. Better off filling a bed with a prime-paying Orthopaedic patient than someone with pneumonia.

Whilst many of us will vouch that life isn't all about money, it's hard to think that a full-time-Physician will earn less than a part-time-Radiologist. And the Radiologist will get to see their family more often, take holidays more often, have more time for the other things in life. I ask myself (at the risk of sounding somewhat obnoxious) if there really are that many 'pluses' of Physicianship compared to other specialties.

Is it really a 9-to-5 job? Are there public hospital positions available? Is it really less stressful? Is there more respect for a Physician?

The answers seem to be obvious, but are coloured by our own ideas of what makes us tick, restrained by our moral sensibilities.

Which leads me to consider my future role in the public or private sector.

I don't intend to see any private inpatients. It's financially not viable. Why go around seeing patients in hospital beds in *their* rooms, when they can easily come to *my* rooms? I would rather spend time with my children and my family than keep my phone on all night. I would rather hold onto my own dignity than become a post-surgical lacky for the higher-paid surgeons. I firmly believe the newer generation of Physicians will also have the same ideals. If this is anything to go by, there will be an even bigger gap in the medical care of private inpatients.

I intend to stay in Physicianship because that's what I love. But if asked to evangelise the benefits of Physicianship over every other specialty, my conscience will prevent me from lying. Don't do Physician Training.