Sixteen years ago - in 2000 to be exact- , this article was written by Polly Miller, the managing editor of Medical Economics: "Physicians have a public image of being serious, even stolid. You're trained to curb your imagination: Think of horses, not zebras. So when we asked in an informal poll: "If you hadn't become a physician, what would you have done with your career?" we honestly didn't expect responses like "NASCAR driver," "a dancer with a solid trust fund," and "clothes designer or serviceman." In addition to such offbeat replies, we did, of course, receive lots of predictable ones: "If I weren't a doctor, I'd be rich" ("retired," "independently wealthy," "a rich man's wife"). "Teacher," "farmer," "computer programmer," and "managed care executive" also figured prominently. The reasons for those choices are typical, too: love of teaching and children, love of growing things and being outdoors, fascination with computers, a desire to improve our health care system. And, as one doctor notes, managed care is where "all the big money" is. A sizable number of physicians are drawn to the law, despite the longstanding antipathy between the two professions. Why? "It is a fascinating profession that needs honestpeople," one doctor says. "I think I'd enjoy the challenges," says another. "Lawyers earn more money, and the government isn't regulating their practice," opines a third. "I'd like the opportunity to defend people," explains a fourth. A Virginia rheumatologist admits to having considered the law, but concludes, "I'm glad I chose medicine!" On the other hand, an Iowa pulmonologist feels he missed an opportunity in international business law. He'd have taken Japanese, Russian, or Chinese as electives. Along similar lines, a Kansas FP would have gone into international relations or diplomacy. Computer programming or engineering appeals to many physicians. "It's what I used to do," says one. Another likes the idea of turning his computer hobby into a productive activity. Then there's the physician who sees writing computer code as a way to "avoid having to deal with serving patients." Going after the big money Quite a few respondents think they'd have ended up in the world of finance. "Wish I'd become a stockbroker or banker!" declares a North Carolina FP. Money is one attraction. An investment manager wannabe cites the "financial reward, and it doesn't take much time." To another doctor, the "bankers' hours and exorbitant pay" look good. "I love watching money grow—it's like a game!" says a Kansas pediatrician, perhaps forgetting that the market took some dramatic dips during his 24 years in practice. But the attraction of investing is also intellectual. A doctor who might have been a "mutual fund manager" says he's "taken an interest in markets." Reasons to be a stockbroker range from "it strikes me as a science" to "nobody gets physically hurt if you make a mistake." For still another physician, the lure is the sheer risk of trading. However, nobody opted for the riskiest financial occupation of all: day trader. Almost as many physicians see themselves as businesspeople. Curiously, nobody is specific about the kind of venture—not even the doc who says he'd set up shop at the seashore. ("It's quiet.") Despite their reluctance to commit to a particular product line or service, these doctors are sure they'd enjoy the freedom and reliable income they're not finding in medical practice. Seeking ways to heal and help On the other side of the coin, a goodly number of physicians would go into a healing or helping field: clergy, psychologist, counselor, alternative medicine practitioner. More than a few questionnaires say "priest." And many doctors who started out as pharmacists, nurses, technicians, and other health workers think they might find more fulfillment in those former jobs. Some doctors would put their clinical skills to use as veterinarians. "No insurance, no managed care, payment is made when services are rendered (what medicine was like 30 years ago)," explains one. Another likes "being able to help animals, sharing friendship with people and animals." One FP started out to be a vet and switched to human medicine only because he was allergic to cats. Cure the allergy, he says, and he'd go back in a minute to treating tabbies. Expressing creative and adventurous urges Many doctors would choose to be writers, musicians, or artists. However, observes an Indiana gastroenterologist, "if I had not practiced medicine, I would not have become as good a writer." A doctor who'd prefer to be a musician calls it "my lifelong dream." Several say, simply, "Music is more fun." Notes a doctor who'd like to be a jazz pianist: "Musicians are always smiling, especially jazz musicians." And one physician explains music's attraction thus: "It touches people. The fascination and complexity are like medicine's." Art and architecture are a powerful draw not only because they permit the expression of creative urges but also because they provide "something tangible to show for my work," as a handful of physicians put it. And a doctor who'd like the best of both the artistic and clinical worlds would be a medical illustrator. "I love anatomy!" he declares. Some of your colleagues would rather soar at the controls of an airplane, as commercial pilots. "I like flying," several physicians explain. "I'd be able to see places and do things," say others. And what attracts a couple of docs to driving race cars? "I find it interesting," is all one of them can manage to say. Vrooomm! Combining science with teaching As you'd expect, science is a haven for doctors fed up with clinical work and insurance hassles. Often it's combined with teaching on the high school or college level. Chemistry, biology, biochemistry, physics, and pharmacology are the principal choices, but a surprisingly large number of doctors imagine themselves as marine biologists. "It combines my love of water with my love of biology," one explains. The outdoors also attracts physicians who think of themselves as farmers, landscapers, forest rangers, ecologists or "environmental sanitarians," geologists, or wildlife management specialists. Several of the doctors who'd like to be farmers say they grew up on a farm. So does the one who speculates, "I'd be financially better off as a farmer." Whether or not the subject is scientific, many doctors are drawn to teaching as an avocation, perhaps because it's already a part of their job—and clearly one they find satisfying. That may be why your colleagues offer relatively few explanations for choosing teaching—the attraction is self-evident. The only two reasons of note run along the lines of "the opportunity to guide students and learn from young children" and "the vacation schedule." Some physician-teachers would like to combine teaching with athletic coaching, "for love of the game," as one puts it. From there, it's only a step to being a professional athlete. ("In my dreams!" says a doctor who fantasizes about playing major league baseball.) Celebrity of a different sort is the dream of a few doctors who would choose careers as entertainers. "Emotional release" and "enjoyment" are the lures of acting on stage and screen. A physician who'd rather be a movie star asks rhetorically, "Why not?" And a doctor who thinks he'd like to be a rock star cites "the money one makes." Law enforcement, anyone? "I almost became a New York policeman!" says a Pennsylvania anesthesiologist. Another doctor, perhaps with a strong diagnostic bent, thinks he'd like to be an FBI agent, because "similar thought processes are involved in solving medical and criminal problems." In a slightly different vein, one doctor would be a firefighter, for "the excitement." To be the ultimate giver and taker of life is the aspiration of one physician. Either that, or he was joking when he wrote "GOD." In any case, he put down no reason—as if one were needed. Then there's the multitude of doctors who see no alternative to medical practice. In response to our question, one New Jersey ophthalmologist wrote: "Sadly, I don't know what I'd do if I weren't a doctor. If I did know, I would quit medicine and take up that other career." But his is the lone negative voice among a clamor of positive ones. Many others say, in effect, "I've never even thought about what I'd be if I weren't a doctor." Several replied with a succinct "Zilch." Dozens more physicians profess their love of medicine over all other occupations. One California FP typifies this group when he says: "I'd commit suicide. Being a doctor is the only career I've ever wanted!""[1] Sixteen years later, do you think doctors might have changed their minds? Let us know by voting in the poll above.
