To make my money and get out, then retire as a professor in the PI. As to most of medicine being a con, I don't know how you see stabilizing a gunshot victim, unblocking a clogged artery via catheterization, or removing a section of necrotic bowel as a scam. The vast majority of the disease we see is caused by lifestyle- eat right, don't smoke, avoid physical injuries, exercise regularly, and don't drink alcohol and you can enjoy a nice, worry-free life.Moretorque wrote:What is your dream ? a lot of mainstream medicine today is a con for the most part, what is your take on this.
The trouble is, people don't want to do these things, then they come begging pharmaceutical companies for their lifestyle-induced diabetes, hypertension, etc, because people are lazy and they want quick fixes. Pharma preys on the laziness of the masses, trying to create pills for the ailments their lifestyles create.
Now, what's wrong with medicine?
Doctors that just mindlessly prescribe because they heard X is the hot new drug.
Doctors that don't recommend lifestyle modification.
Much of oncology is futile, but much of it is also excellent. Stop giving chemo to 80 year old dudes with squamous mets un every organ to the tune of hundreds of thousands of dollars.
Orthopedics and elective surgeries- when you're a hammer, everything is a nail. Often these docs will trick even themselves into believing a patient needs a treatment that may or may not yet be indicated.
Statins guidelines are terrible and categorize healthy people as suck.
Blood pressure guidelines are also terrible.
Salt intake guidelines are horribly misguided to the point of being retarded.
Mental health needs an overhaul. First line for everything is pills instead of lifestyle modification, because it's faster and easier for the provider.
There's a lot of good stuff though. We're damn good at treating sepsis and other infections. Anesthesia is incredibly safe. Trauma surgery has come a long way. Life expectancy continues to do well, and functional life expectancy has increased along with it. We've got excellent outcomes for those with good insurance compared to the rest of the world. I mean, it's really a complex topic.
Part of the issue is that people have this expectation that doctors and science have so many more answers than we actually do. We're still very much in the infancy of medicine and science, and likely will not have answers to many of the great questions within our lifetimes. Literally every other page in a medical textbook is either a theory or "research in this area is ongoing." We do the best be can with the tools we have. Most of the time, it pans out positively. But real life medicine isn't a bunch of perfect people with all of the answers like on TV- it's a bunch of human beings working to the best of their available knowledge, and sometimes that knowledge isn't entirely correct.
Pharmaceutical companies are largely to blame, as they are downright predatory in their practices and we're dependent upon the research they provide us with to guide treatments. The trouble is, they tend to hide any reports that don't show their medication favorably, so we aren't working with a full set of data. But doctors don't make money off of drugs- it's actually illegal for us to do so. We don't own pharmacies, nor do we receive kickbacks. It's illegal for pharma reps to buy us anything larger than a sandwich nowadays lol, they literally can't even give me a free Bic pen with their logo. So it's not like we prescribe drugs to line our pockets- we're prescribing what we believe to be best based on the limited data presented to us.
I don't intend to end up in a prescriptive role, personally. I'm more likely going to be doing something short term in nature- emergency medicine, anesthesiology, radiology- fields that kind of exempt me from the pharma BS.