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Outskirts Press - Daniel A. Capen

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27 pages

English

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Since author Daniel A. Capen attended medical school in the 1970s and ’80s, a lot has changed in American health care training and the practice of medicine. With A Buyer’s Guide to a Medical Career: A Long Trip Down the Rabbit Hole, Capen aims to inform those interested in a career in medicine of these changes. By being better prepared, new practitioners can better prevent stress and job burnout.

Once independent, providers then became substantially regulated and now are pinned by large insurance companies and practices controlled by private equity. Capen has witnessed growing outside controls and costs and shrinking reimbursement. By preparing future medical students and doctors with bluntly stated information drawn from forty years of practice, Capen provides insider guidance before readers embark on a medical career.

Sujets

Personal Memoirs

Biography

Autobiography

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Publié par	Outskirts Press
Date de parution	09 juin 2023
Nombre de lectures	0
EAN13	9781977265562
Langue	English

Informations légales : prix de location à la page 0,0500€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.

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A Buyer’s Guide to a Medical Career A Long Trip Down the Rabbit Hole All Rights Reserved. Copyright © 2023 Daniel A. Capen v1.0
The opinions expressed in this manuscript are solely the opinions of the author and do not represent the opinions or thoughts of the publisher. The author has represented and warranted full ownership and/or legal right to publish all the materials in this book.
This book may not be reproduced, transmitted, or stored in whole or in part by any means, including graphic, electronic, or mechanical without the express written consent of the publisher except in the case of brief quotations embodied in critical articles and reviews.
Outskirts Press, Inc. http://www.outskirtspress.com
Cover Photo © 2023 www.gettyimages.com . All rights reserved - used with permission.
Outskirts Press and the "OP" logo are trademarks belonging to Outskirts Press, Inc.
PRINTED IN THE UNITED STATES OF AMERICA
Table of Contents
Foreword
1: The Initial Phase
2: The Eighties, the Wonderful Eighties, the Reagan Years
3: Decade of the ’90s
4: Y2K decade
5: 2010 Era or Blame, Crime and Struggle
6: Please Be Sure of Your Purchase
Foreword
" In all its not the same as it was" Harry Styles 2022. "As It Was"
Hi. I want to let you know I was always afraid to write a book. I was wondering if it should be a "mystery " type a la Tami Hoag, or a "horror" novel a la Steven King .I was kind of afraid no one would want to hear what I have to say, but I’m writing this so you can be informed. I am sure this is a combination if you consider the last 50 years of my career in the Medical space. If you are contemplating a career in Health Care you should read on.
Most writers have either a great fictional mind or have a story to tell, or have an axe to grind. In my case I have a story to tell about the last 50 years of American medicine. I also have a personal axe to grind. More on that later. Just keep an open mind while reading this. I call this a buyers guide because you are contemplating a huge investment.. Oh yes, to be sure you are going to pay your money and your time so pay attention to the choices available to you and how the changes from the past will drastically impact your career.
The main purpose of this work is to assist you to make an informed decision about a potential career in medicine. Now the career includes nursing physician assistant and nurse practitioner. I want you to understand that my career spanned 5 decades and it began in the ’70s, so what’s going on today is very remotely related to what was going on then. A whole lot of changes have occurred since that decade. Lots of dominoes tipped over to dictate American Medicine today .I’m going to try to tell this story so you can make your own conclusion about 1) the direction of American medicine and 2) your appetite for that sort of career and the time and cost of the education. Parents encouraging children to "become a doctor" meant a whole lot different to my generation than it means now believe me.
Hopefully my recollections and musings mean something, but not sure some of the things I experienced will ever occur again. Most historians agree that you won’t know where you are going without knowing where you have been. So here we go. The process is not necessarily easy or pleasant ,but goal oriented people can deal with it. Im just uncertain that the end result is the same. You are about to cross a bridge from youth to the real world. The crossing will involve passing up the seemingly inviting waters of the Fun River. The process is a sacrifice, but one I look upon as worthwhile.
To this day, it’s the same process as I encountered in the ’70s when I was getting into medical school and finishing medical school and trying to find a residency. It was highly competitive. It remains so today, and while a lot more was hands-on and think oriented back then, it is now more remote learning and algorithmic thinking. You will need to answer the question of whether 4 years college 4 years medical school and 3–7 years residency are truly necessary to read and follow flow charts of algorithms to treat people..Is the education really utilized to its maximum when rule number one is to avoid costs. Obviously no one questions the need to develop manual skills and three dimensional awareness for procedures, yet in many situations those skills will never be authorized.
From my era to present day the "Medical Landscape" has drastically morphed. In my opinion, (IMO) for the younger text generation, it has changed in a few ways for the better with 40 years of research and development and advances in the science of all areas. Robots now do some of our work. Computers do a bunch as well However, in many ways there have been many changes for the worse. The cost of the education has become staggering. The time requirements from start to finish have increased, in no small part due to work hour limitations instituted in the 1990s. The same service reimbursements have continued to decline. Headaches of an independent practice have mounted . The legislation regulating the practice of medicine has expanded and the litigation of malpractice cases has increased. Lots to consider.
Look lads and lassies, when all publications now talk of physicians expressing job burnout and job security, those were never a topic in the first 4 decades of my practice. When the landscape says , according to US News and World report that Physician fell to the 6 slot in terms of desirable jobs in health care, behind Nurse practitioner and Physician assistant and well behind health care and /or hospitals Ceo you readers need to take notice.
Once you decide which trajectory American medicine is taking and once you decide my recollection is relatively accurate one, you can make an informed choice about whether you want to venture down the rabbit hole. Maybe you also have to take into account that I am writing from memory. There really wasn’t time for me to keep a daily diary. So I acknowledge memory imperfection-not senility.
1
The Initial Phase
" Long Ago In a faraway Place" Ralph Carmichael. When I think of the Cross.1970
I was born in 1949, so my career basically spanned seven decades. As of this writing I am 72. It was around age 14 that I fell in love with the idea of becoming a doctor, and it became firmly implanted when in college because it became clear that professional baseball was a long reach. Early school was some fun ,but a family friend was a doctor and I was constantly advised to study. My mom was school teacher my dad an attorney and home advice was the same. Grades and athletic achievements were in that order. I was in a Catholic High school and admission to College of The Holy Cross was relatively easy.
In that era the proverbial teachings were pervasive in grade school, high school and college. The tenets were work and study hard, get and education and choose a great career. Maybe this was forged from a rust belt working town, but throughout all me education students from a far wider geographic range were the result of those same principals being drummed into their heads. Guess it was the mantra of that era. It was a recipe for success.
Pre-med at that time allowed for non science major but advisors made it clear that sciences and math were also requirements that were paramount. I played baseball all four years and achieved low excellent grades and above average ,but not stellar MCAT scores. The competition to a) get into medical school and b) obtain a good residency was pretty intense. Grades from college MCAT scores and Interviews for med school were all fairly stressful. During this process it was the early 1970"s. The Vietnam war was raging and the draft lottery was looming ,adding to the angst. Thankfully as a "Year of The Ox" birth sign I simply put my head down. Thankfully that was a good quality.
At the college level there were publications, meetings, and advisors to help assist in navigating the career landscape. However then there weren’t test prep opportunities. One could take MCAT s 2 times and that was it. Applications needed to be completed during junior year. The entire process consumed hours and frequently interrupted sleep. Councilors and classmates were the major source of information. All the team baseball road trips found me in the rear of the bus with a chemistry of physics text. No wonder my Batting average and GPA were inversely related. It was becoming clear that a baseball career was not in the cards but alumni Medical professionals occasionally interfaced with pre med students and no one presented anything negative about a career in medicine.
The interview process began early in senior year. The anxiety associated with the interview process was palpable. The advice was never say you wanted to be financially secure. Funny but our current health care system has essentially made that issue a moot point.The stock answers were directed toward helping people and I am certain that is the case in the majority now as it was in the 70,s. Others wanted independence in making decisions, others wanted opportunity for research. Research opportunities will always exist ,but in the current form, most decisions are now guided by treatment algorithms and payor guided treatment parameters.
My interviews ranged from easy going conversations to obscure questions about race religion and politics. In one interview rapid fire questions resulted in me interrupting the second question with the middle of my first answer. In that one I made the error of gazing out his window .That terminated when he screamed "Look at me when I’m talking to you". Hilarious now ,but very unnerving then. After interviews the wait ended soon after the holidays. I had applied to 8 schools, was accepted by three and chose Albany Medical College. A wise choice for me.The education was more on practical skills and critical thinking which was best suited for me.Hours were long and un