by Diana Stanley
Special to The Student Doctor Network
Dr. Conrad Fischer
Despite the growing number of scientific advances over recent years, the ability of doctors to cure or deal with diseases that were fatal not ten years ago, and heightened recognition by patients for those in the medical profession, a study conducted by Dr. Conrad Fischer suggested that many in the medical field were highly dissatisfied with their careers. Armed with these alarming results, Dr. Fischer set out to let everyone know that now is an exciting era in medical history and, quite possibly, the best time to be in medicine. The result is his book, Routine Miracles.
Dr. Conrad Fischer, author of Routine Miracles, is an infectious diseases specialist and a prolific teacher of medicine; he has published twelve books for the medical community. He is also an influential medical advocate. He was instrumental in the construction and passage of legislation that led to the near eradication of pediatric AIDS in the United States. He was formerly the Associate Chief of Medicine for Educational and Academic Activities at SUNY Downstate School of Medicine. He has been Chairman of Medicine for Kaplan Medical since 1999, and has held Residency Program Director positions at both Maimonides Medical Center and Flushing Hospital in New York City. He lives in New York City with his two boys.
Dr. Fischer recently sat down to talk to the Student Doctor Network about his research.
Please explain a little about your research for Routine Miracles and what surprised you the most?
There is an enormous disconnect between patients who feel the “miraculous” nature of what they receive in terms of treatments and a near-numb “routineness” of flat emotionality from doctors. I can’t help but feel the root of the problem stems from our own medical school faculty and senior physicians poisoning the minds of medical students. In our own research data it shows that 80% of medical students feel that medicine was better 25 years ago and that the public does not trust them. They identify senior physicians and faculty as the source of this impression. So, our best role models for a life of practicing medicine, and pursuing a life of investigation turn out to be the most damaging influence of all.
Why is this the best time to be practicing medicine and why is it the worst time?
Treatment is the best it has ever been by far. We now have brain operated artificial limbs, hearing restoration, cancer cures, corneal transplants in four minutes, and cures that seemed like science fiction a few years ago. It is hard to write good science fiction because the facts catch up so fast. Paradoxically, a recent study showed that more than 90% of primary care doctors are dissatisfied. There is an unprecedented level of demoralization at a time when we can heal people in so many amazing new ways. The worst news is that our freshest and newest members, students, interns and residents firmly believe medicine was better before and we are devolving as a profession. They are not motivated to follow a life of investigation that will give us the next generation of scientific and medical breakthroughs.
You work with students every week. How are they different from you and your colleagues 20 years ago?
Students and especially residents are less cynical, less sarcastic and more professional than they were 20 years ago. This is because of the mandatory decrease in resident work hours. You couldn’t possibly expect the same energy and compassion when you were up for 36 hours straight. Now residents rest a little and you are kinder, warmer, and not burnt out and cynical. Most MDs do not see this. They look down on new students telling them it was better before.
Students on the other hand seem more concerned with personal economic issues. They think the sky is falling in medicine, so they should find a nice high paying subspecialty to hide in. There is virtually NO drive to consider careers of investigation that might lead to new cures. So, you have nicer and kinder people taking care of patients, but who rarely question how they might find a cure. In 20 years I predict the rate of medical advancement will be dramatically diminished.
In your opinion what three things need to happen quickly to help fix our healthcare system?
- Universal coverage
- Doubling of the research budget at National Institutes of Health
- Decrease or supplement the cost of Medical education so that students choose a future that is not based on income potential or concerns about paying off student loans.
Why are you such a fervent advocate of universal health insurance coverage for all U.S. citizens? How do you respond to arguments against—and fears surrounding—implementing a system of socialized medicine?
First off, universal coverage is just the right thing to do. I think the concern about financing is ludicrous. We did not worry about financing when the military budget went from 350 billion to 750 billion, which is considerably in excess of the amount needed for healthcare reform.
“Socialized medicine” is a scary word to frighten ignorant people. We have Medicare as a government run system as the largest insurer in the country. We have the veteran’s hospitals as the largest system in the country and it all works well.
Doctors are scared for their paychecks. Other people are, frankly, just unconcerned with people who will be sick if they think they have to pay for it.
If we are to live in a Great Civilization, we MUST take care of all our citizens, Period.
Routine Miracles
As you stress in Routine Miracles, young doctors are frequently weighed down by hundreds of thousands of dollars in student loan debt. What would you change about how we finance medical school education?
I would subsidize the medical schools to lower tuition and I would add trading a year of tuition for every year you spend in a lab during research. We do it for the military, why not for research?
It only costs about $2.4 billion a year for EVERY student in the country. That is about what we paid for ‘cash for clunkers’ car program.
What is your relationship with insurance companies like?
This is the only thing that 95% of MDs and students agree on – it is HORRIBLE! If I had to deal with insurance companies full time, I would drop out of medicine. I also find it unconscionable that while facilities are closing because of budget gaps, the CEO of Aetna insurance is getting a 32 million dollar salary.
What do you hope people will take away from reading Routine Miracles?
Unless we take better care of the emotional well being of our best and brightest students and trainees, in terms of seeing the grandeur of finding new cures and treatment, the amazing advancement in medicine will screech to a near stop. There is action to take here. It is about fixing the disconnect between breakthroughs and the complete lack of excitement and engagement of the “Best and Brightest” new doctors. Routine Miracles is about how, in an age of extraordinary advances, we need to get our students into the lab and in a life of investigation and discovery. If we don’t do this now, the future will be a lot less bright.
Another older physician telling us how we should feel about the medicine. If I had the opportunity to do it again, there is no way I would go into medicine.
Should we not care about income? Take the pediatrician or fam med doc that makes $90,000 per year, with $200,000 in debt after 7 years education beyond undergrad. Now look at the CRNA who makes $130,000 with virtually minimal debt after only 2 years education beyond undergrad. What is wrong with this picture? Sorry but physicians will be great at what they do if they are happy, and part of that happiness involves peace of mind. Not sure how anyone with that income:debt ratio could ever have peace of mind.
Dr. Fischer raises a lot of good points. I think the main point is that there should be more options to go into needy areas like primary care and have loan forgiveness. I also applaud him for promoting the need for doctors doing translational research which rarely gets mentioned among all the cries for primary care docs.
Dr. Fischer,
What a great interview, and I am excited to read this book. I chose to drop out of medical school for the reasons mentioned, and though I’ve found another ‘doctoring’ area in health care (not D.O. or M.D.) that I’m very happy with, I think that (1.) patients and (2.) medicine as a field loses out from losing people like me due to poorly managing itself.
Your comments on medical school faculty and senior physicians are spot on. Unfortunately, it will take another decade to get these people out of the system – by which time the medical system in our great country ought to become even worse. Medicine being operated as a business harms us all. If medicine were treated as something other than a commodity, perhaps the well-being of our country and the medical research progress of the world would be significantly ahead. Until medicine is considered a common good outside the grasp of private entities, the situation may not improve.
He is an idiot
I am sure the man means well, but he obviously does not have his finger on the pulse of today’s medical students. We too are very disastified with medicine. The worry of debt, government run medicine, and the continuing decline in reimbursement has made medical school a risky investment. Most people do not realize this until they are to far in and at that point there is no turning back. I can say confidently that the majority of my class regret going into medicine. While I absolutely disagree with the above “He is an idiot” comment, I feel that he is one of the older physicians that have been practicing for a long time and pulling in a good income. He does realize what it is like for us today who will be coming out in so much debt.
Family physician making $90,000?!?!?! Who in their right mind would enter FP? The argument to that is because “people enjoy it.” I hope you enjoy getting paid as much as a nurse and make less than a PA.
I sat for review course with Dr Fischer. Man is far away from being an idiot. Dr Fischer is very passionate about what he does and he isnt afraid to speak up. “Older physician” who cares about whats going on with medicine… its RARE for a change. LOL
For those of you,who went to medicine to hit the jackpot overnight might as well change career now! There are bunch of other professions out there with bigger income and less time/effort investment and smaller student loans. As long as you are have passion for it. Remember, you have to do something that you really like every day, whole day or night lol. If you dont like your job, you wont be happy doing it or achieve “peace of mind” regardless how much you are getting paid.
We all can, well, most of us, id problems and negativity of medicine today from docs’ as well as, patients’ standing point of view. Majority cant afford medical insurance despite of 12-16 hrs work day shifts. How many of those, who work in hospitals, can actually afford to be treated there without filing Chapter 7/11 afterwards???
Sadly, new generation of docs coming out of med schools have same IGNORANCE as “older physicians” or professors who taugt them. Just because “older” ones are too afraid to change or claim they are “beter”…..
Courage is the ability to confront fear, pain, risk/danger, uncertainty, or intimidation. “Physical courage” is courage in the face of physical pain, hardship, or threat of death, while “moral courage” is the ability to act rightly in the face of popular opposition, shame, scandal, or discouragement
DOCTORS!!!
stop whining about income. You will still make enough, lol.
drop your IGNORANCE and you will feel free and before you know it, you will be performing “routine miracles” yourselves.
Natasha,
Your input is not only incomprehensible, it’s retarded.
I agree her input is pathetic. I am sick of hearing the “If you like what you do” line. Yes, we like what we do, but we expect to get paid appropriately for what we do. No one said they want to hit the jackpot, but I do not want to work for the government for a salary that is not enough for the amount of work, money, and time I put into this terrible job.
LOL
if you really liked what you did, it wouldnt be “terrible job”…..
Besides, its never too late to change careers…. even for you.
And, if you really putting time and effort into it, and yet, still not successful, then your business skills suck. Attitude sucks for sure lol.
I suggest you go and learn how to manage money lol.
Guys,
Read this book! Trust me! It’s worth the read. It’s hard to explain the impact the book really has through forums, or even through reading an interview, but I’m telling you, it is a quality book! I sincerely advise going to your local Barnes and Nobles and at least reading the first few chapters, it won’t cost you a penny. I guarantee you will be addicted to it. It not only speaks about the modern advances in Medicine, but also speaks about the modern attitude toward Medicine from the view-point of BOTH physicians AND patients alike. It’s an interesting and enlightening breath of fresh air to be able to hear it from the patient’s mouth, both the good and the bad since often times we are so caught up with our own view-point.
The book is FILLED with information about cutting edge medical technology, and how modern advances in Medicine are really changing the quality of life of humanity. This book speaks to all audiences and it is a book that is FULLY ACTIONABLE. It talks about the dynamic between the physician and the patient and Medicine’s evolution from the times where physicians were the sole care taker, to the present time where the patient/physician relationship is stronger. It speaks about how because of this stronger bond and trust between the patient and physician, patient care has improved, and mortality has decreased.
I feel the measurement of success hinges on the meaningful interactions we develop with our patients, and that we can overcome any obstacle by abiding by a central philosophy: serve every patient to the utmost of our ability, impacting them in a way that transcends a merely business-like relationship.
Look guys, I am not a promoter of this book. I’m just a big fan of its content after reading it through. I have bought several copies to send to friends of mine both in medical and non-medically related fields, and I think most of you will be equally as enthusiastic as I am if you pick it up. It’s a MUST READ in my opinion for anyone in the health care field especially medical students/residents. After reading it, if it were up to me, I would make it part of any Medical School curriculum. For any of you who truly appreciate medicine and its modern advances, this book will not let you down. I promise you!
LOL i have the book, reading it slowly
have to study hehe
But again, its not the book, its people with limited vision and their attitude towards things.
If person isnt open, book wont help….
regardless of its content.
Dr Fischer and everyone who participated did excellent job writting this book.
By the way, excellent point jijoe,
i will order another copy for my friend so she would stop snatching it from me
Jijoe, I agree also with you. The book is great so far. I only got through the first five chapters but it is definitely helping me out and lowering my stress level knowing that there is light at the end of the tunnel..lol
Although the book may be good, I will definitely not buy it because conrad fischer is just out to make money. Just go and attend one of his courses- he is pretty much marketing during the ENTIRE time he’s there. Either it’s this book or one of his other medical books. I’m convinced he’s just out to make money. He is lewd, obnoxious, and immoral. He has hit on me as well as at least one other girl in my our class. I wouldn’t support such a worthless d-bag who is so desperate for fame, attention, and younger female med students.
believe in medicine and be happy about breakthroughs. however, avoid conrad fischer (if you only knew how much of a creep he is!)
Well dermbound, here is my problem with your claims.why didn’t you report Dr.Fischer when he tried to hit on you? why do you tolerate harassment, sister? You should not! And also why to study from Conrad Fischer’s , go and read someone else, since you believe he is such a creep, there are many boutiques out there trying to sell usmle stuff. Let me guess, you didn’t get enough attention and now you are trying to blame him for being such a great teacher, and very popular and very successful. I am sick and tired of women who claim that they have been harassed and they do nothing about it! It is either he violated his role as a teacher and you should do something about it, or stop trying to defame his character in a public forum. The book is excellent and very inspirational, and I and thousands and thousands of students attend Dr.Fischer’s classes he is the best and most prolific faculty you will ever see in your life.