Medicine for Money conclusion: money, happiness, alternatives

As I help my blog through its identity crisis, I’d like to apologize to the followers who couldn’t care less about this physician income series. It is written primarily for premeds, particularly those using and contributing to studentdoctor.net, where the question of physician income, as well as “should I do medicine for the money” comes up all the time. I felt compelled to write this series for two reasons, one being to offer a dose of reality to premeds drooling over some magical $200K pot of gold at the end of the medical education rainbow, because, as you’ll see in this post, money isn’t an efficient currency with which to purchase happiness. The second reason is to show any non-physician readers that not all doctors are “in it for the money.” As someone who started down this track later in life, I was forced to think about income primarily to answer the questions “will I be able to provide for my family as a resident?” and “will I be able to manage the debt that I incur?” Not to mention the opportunity cost of leaving behind a career first to go back to college and take the prerequisites for medical school, then apply to medical school (one year process), and finally move on to medical school itself, effectively turning my back on 7 years of salary. In my circumstances that meant trading about $350,000 worth of income for ~$200,000 worth student debt. For a “nontraditional” (read: “old”) applicant to medical school, “should I do medicine for the money?” is a laughable question; reflecting on physician income is simply pragmatism, a necessary evil.

Anyway, onward to the conclusion of this series. Can money buy happiness?

I just asked google for the third time this week. It took that many running starts to get through the top hits because, well, they sucked. The articles were too long, boringly written, and extrapolated the meager results of a couple of studies into overreaching, overblown conclusions.

I see this abuse of research everywhere (forgive the digression). In education, the idea of “learning styles” (visual learning, auditory learning, kinesthetic learning), is still fairly pervasive, even though there is no significant empirical evidence that catering to one sensory input actually improves learning. I don’t actually care that people, including the majority of educators in American public schools, believe in learning styles without having any tangible evidence for their beliefs. What irks me is how people exaggerate the importance of a lack of evidence. Some psychologists did a review of the existing research on learning styles and found that no experiment in the existing fund of knowledge had been designed in a way that it could actually provide evidence for the popular model of “learning styles.” Based on that literature review, people have started completely rejecting the theory.

I’m not saying I support or reject the notion of learning styles. Maybe I’ll rant about that in a different post. What I’m saying is, this group of psychologists didn’t even conduct an experiment. They didn’t prove or fail to prove anything. They just did a literature review and said, to date, no one had supported “learning styles” with adequate research. And then people latched on to their article, sensationalized it, and started trashing the entire idea of “learning styles” as if there were suddenly a glut of new research that concretely and permanently disproved any “learning styles” theory. People just don’t understand research and it’s limitations. Digression over, perfect segue.

Plenty of different studies have examined people’s responses to money, and the results of these studies are almost always discussed by the media under the theme “can money buy happiness?” One study showed people pictures of money before giving them a piece of chocolate. Compared to the control group, which consisted of people who were not shown pictures of money, the people who did see the images consumed their chocolate more quickly.

The people who conducted the study admitted that this could mean anything. The money-viewers might have thought about all of the germs and nastiness on dollar bills, which could have prompted them to eat more quickly. The germs serve as another possible explanation for the research finding, and if the findings of your research have multiple possible causes like that, your study has “confounding variables.” If you have any confounding variables you cannot make a causal inference. You cannot say one thing causes another; in this case you can’t even say “pictures of money cause people to eat more quickly.” Although that is the phenomenon that was observed, there were confounding variables. “Fear of germs causes people to eat more quickly” is just as plausible an explanation. The experiment would need to be designed in a way that eliminated confounding variables if you wanted to directly link money, and not germs, to the people’s behavior.

In spite of that, the media grabs hold of studies like this and blows them way out of proportion. Not only do they report that money was the cause of the quickened eating, confounding variables be damned, they take it a step further and say that money takes away people’s ability to savor things. Talk about a flying leap. And don’t even get me started on how the media latched onto the studies that purported “anything over $75,000 per year doesn’t increase happiness,” or the dismal lives people have led after winning the lottery.

Can money buy happiness? Maybe. Maybe not. It depends on you more than it depends on the results of any study. Chances are, if you’re a happy, well-adjusted person you’ll be happy with or without a lot of money and other factors should dictate your career decisions. Conversely, if you’re generally unhappy, hard to satisfy, and prone to whining, no doctor’s salary is going to make that go away.

Money is rarely a primary motivator anyway. People usually pursue money as a means to some other end. Motivation is a complex psychological phenomenon. Suffice it to say, secondary motivators don’t have much leverage to improve happiness. Life outlook, personality, and attitude are much stronger correlates to happiness. Some people need nothing to be happy. Others aren’t satisfied with anything.

It helps to have your basic needs met, no doubt. It helps to have a little extra. But there are a lot of different ways to get there; medicine is just one option. If you feel like money is one of your primary motives, you’d be a fool not to consider other career options.

That’s it, no more about money for a while.


My narcissism is bipolar

What the hell is blogging, anyway? I mean aside from the obvious cases where people are either talented writers, have something useful to say, are hilarious, or some combination of all three.

What about the other 99.9% of us who brazenly post the written equivalent of our verbal diarrhea on the interweb? What are we doing? What are we thinking?

Jeffrey Parks wrote an excellent post¬†about this, especially relevant to medical, or medicalish, blogs that talk about patient encounters. For a minute he looked like he was going to throw in the towel on his blog. When it was Jeff (who didn’t, and still doesn’t, know me), I was sitting there thinking, “damnit man! You can’t stop writing!” I sent him an email saying “I understand how you’re feeling (and basically, you’d be a major turd if you didn’t feel this way), but you probably shouldn’t stop writing. Your blog is great, people love it, and you’re getting new readers every day. Unless you’re at a point where you’re going to start producing lousy, uninspired content, you should keep writing.”

They guy even wrote me back, thanking me for my “well-honed thoughts.” A truly awesome blogger. But what about the rest of us? What about the people who write about every boring thing they do on a given day as if the whole world were starving for their opinions and melodrama? Should we keep writing? God, why would we?

I started this blog thinking I had something to say that people might enjoy reading. That was arrogant.

I stayed away from this blog for months, thinking I should give up writing because how could I ever have anything to say that would be worth reading? That was insecure.

Insecurity and arrogance are both forms of narcissism. Blog for your ego, avoid blogging for your ego…you’d think you end up at the same place at the end of the day. But you don’t.

For one thing, people read this stuff. Whoever you are reading this, thanks for stopping by! I don’t know who you are, but you show up in my stats panel. And I genuinely appreciate your taking the time to read this drivel, whether you think it’s good or you think it’s crap. If you ever feel inclined to say something, please comment. It makes the blogging experience better for me, you, and other readers.

Secondly, inaction, or some emotional/paralytic avoidance of action, has completely different results than action, even if the motives for both behaviors are essentially the same. I could avoid blogging to preserve my ego, or blog in an attempt to feed my ego. Action takes courage, and cultivating courage is a good thing.

If you’ve thought about blogging, just do it. It doesn’t matter what you write (your best posts according to readers won’t be what you expected anyway). It doesn’t have to be perfect (and it won’t be). All it takes is a little chutzpah. Write for yourself. Develop a healthy indifference to what your potential critics might say. Come to terms with the inevitable: some of your writing will be crap.

Some of it could be good, but you’ll never know if you don’t write anything. The only thing you learn by not writing is that you didn’t have the balls. At least, that’s what I learned. And then I hit blog puberty.