Dr. Margaret Craig began her career as a nurse and midwife, which she considers
one of the most beneficial things she could have done to prepare for being
a physician.
Often, students think a job in a medical office teaches them enough. Craig
disagrees. Medical students are sometimes too idealistic and really should
experience the job before they get into medical school. Many of the students
she went to medical school with had no life experience.
"I had 500 deliveries before I was admitted to medical school," she notes.
"Anyone going into OB should at least have sat with a laboring woman or delivered
a litter of puppies."
A delivery can make for some long shifts -- sometimes 24 hours straight.
You need to work up to that kind of stamina! But while delivering a baby or
performing surgery can be exhausting, Craig says the high points of the job
make it all worthwhile.
Craig loves seeing toddlers she delivered in the store with their mom,
or saving a woman who was having complications. The toughest times are comforting
young women with cancer, or young couples whose premature baby didn't
make it.
Craig is in private practice, which brings its own set of challenges. While
her practice is great and she and her staff get along wonderfully, the costs
of maintaining an office and paying malpractice insurance mean a lot of overhead.
"I have to pay $26,000 each year to my medical liability insurance company
before I can see one patient," Craig says.
Overhead is indeed a huge cost for physicians of all stripes -- not just
OB/GYNs. According to Juanita Grant, a medical association researcher, high
earnings don't reflect the take-home pay of physicians.
In her area, "an average GP [general practitioner] earns $144,000 and has
an overhead of 42 percent. So take away almost half of that, then there are
student loans and car payments and mortgages. They're probably making
$50,000 or $60,000 clear by the time it's all done."
What's all the talk about money, when we're supposed to be talking
about medical care? These days, the two go hand in hand. Or so it seems. But
not everyone's entirely comfortable with that.
With the move toward managed care, Craig says the face of medicine is changing.
"I predict more indifferent physicians and more physician burnout. Those physicians
that do survive are the better businesspersons, not the better physicians
or more caring physicians."
In other words, survival of the fittest in the business world doesn't
produce the fittest doctors.
Dr. William Anderson is a 30-year OB/GYN veteran. He sees
the high cost of malpractice insurance as one of the worst trends in medicine.
The $26,000-a-year price tag on malpractice insurance is driving many would-be
obstetricians into other areas of medicine or into pure gynecology. Anderson
has seen his own workload in obstetrics go up as this trend continues.
Another disturbing trend Anderson has noticed is a lack of interest in
working the kinds of hours you have to work to deliver babies. This isn't
a profession to get into if you want early nights and late mornings -- but
some people treat it that way. Anderson laments this.
"You have to be really dedicated. Today, young doctors don't want
to work nights, weekends and holidays. They're more concerned about their
lifestyles."
There's a move toward working OB/GYNs in shifts. So if your patient
is about to deliver and it's your day off, you won't do the delivery.
Anderson isn't sure he likes the system.
On a happier note, the feeling you get when you make someone well is the
real reward of the profession. Anderson chose this specialty because he prefers
to see young, healthy patients that he can really help. Other branches of
medicine carry a heavier burden of serious illness and death.
For people thinking about entering this specialty, Anderson advises preparing
for a long education and hours. Make sure you're ready for the long delivery
that lies ahead.