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Being a physician is a horrible career move right now. As a former Math/CS major turned eye surgeon, I can't help but think about how much easier my life would

Being a physician is a horrible career move right now. As a former Math/CS major turned eye surgeon, I can't help but think about how much easier my life would be had I stuck with tech. It's hard to understand exactly how hard the job is until you've lived it. I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime and then spent 2 hours at the hospital because a patient needed an emergent procedure. They might go blind despite my efforts and I have to live with that. I also may get sued, if they're feeling spicy, despite going to heroic lengths to help this person. My son was asleep before I got home. There's just no reason to do the job when you can get the same compensation working remotely in tech. Looking through the "Who's Hiring" thread is soul-crushing. Physician salaries are the only ones that do not grow relative to inflation and have decreased year-on-year relative to inflation for decades. I do believe that the rigorous training model leads to a higher quality of care and much deeper understanding of the disease process. But, why would anyone want to do the job? It's just not worth the liability anymore. That said, is anyone hiring an ophthalmologist with CS and Math degrees?

SamoyedFurFluff 3y ago
> That said, is anyone hiring an ophthalmologist with CS and Math degrees? I’m surprised you can’t leverage this into a product role or a consulting role for startups in the medical space. You know shit about med systems!!
- SongofEarth 3y ago
  It can be really hard to leverage this combination of skills, the demand for cross-discipline talents is usually much lower than for a single skill set, but also much deeper when the demand exists, it's going to take some serious searching to find a match but likely it's worth it. There was HN post about working with radiologists when building a AI diagnosis company: https://news.ycombinator.com/item?id=36111596 https://news.ycombinator.com/item?id=36111596 May be try talk to some similar AI companies is a good idea, at this time the pay can be really good.
- throwaway173738 3y ago
  In the US medical device companies usually have a board of practitioners to give advice about the state of the art and the challenges with existing practice in the field. You can also start building your own device or system and plan to sell it, but you should find someone to consult on how to lobby the FDA and CMS as early as possible, because some devices get stuck in De Novo or PMA for years, and that’s a big risk to take. You’ll also need to have a long term plan for how the company will grow as you get closer to regulatory approval. A “product role” in these companies is very heavy on managing regulatory approval and making sure the company doesn’t get sued.
deleted 3y ago
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mvanlonden 3y ago
We’re hiring founding engineers at Develop Health! https://jobs.lever.co/develophealth.io?utm_source=hackernews&utm_campaign=saveadoc https://jobs.lever.co/develophealth.io?utm_source=hackernews...
- iancmceachern 3y ago
  Yes! The prior authorization process is so broken! I've been battling Blie Shield for months in a effort to fix theirs
xvedejas 3y ago
The biggest complaint I always hear from people in the medical field is the long hours. It sure sounds to me like that (and thus any knock-on problems) could be solved by more practitioners, spreading the work around. I can't speak for you, but personally, a proper work-life balance in comparison to these horror stories is surely worth a possible salary cut?
- lostlogin 3y ago
  > It sure sounds to me like that (and thus any knock-on problems) could be solved by more practitioners, spreading the work around. Sort of. The equipment is so expensive that the actual solution is usually to work the rooms and equipment harder. Night shifts, early starts and evening work are actually shit.
  - whimsicalism 3y ago
    That makes no sense, if the capital is expensive then you should hire more labor.
    - lostlogin 3y ago
      That is literally what I'm saying. Staff are worked harder as shifts are introduced. It is not a nice way to work. Sure, it helps reduce the number of patients, but it destroys work/life balance and that is what the OP was raising as an issue. It is also hard to get patients to agree to having tests done at 5am or 9pm, so it's a case of diminishing returns. The staff penal rates go up too, so the squeeze comes from all sorts of directions.
      - greiskul 3y ago
        > It is also hard to get patients to agree to having tests done at 5am or 9pm, so it's a case of diminishing returns. In the US? With health care prices as they are? There are people that travel to entirely other countries for access to health. I'm plenty sure lots wouldn't mind at all to have an exam at 9pm if it meant it was way cheaper.
smarmgoblin 3y ago
I dropped out of an MD/PhD program after I passed Step 1, it’s hard to articulate exactly how it felt staring down the barrel of a career in medicine but this is sort of what I feared. Since I’ve been in tech I’ve been laid off several times, and it’s not clear that compensation or demand will always be as hot as it is right now. I’m not complaining but if you take any satisfaction in actually helping people, there’s a real possibility you won’t find that anymore. That said, you have options. If you’re willing to work at a junior or mid-level role, companies probably won’t care much what you did before. Maybe wait til the next boom in hiring happens, jump on the hype train. With your technical skills there’s probably some very unique research roles you could fill if you’re interested in that lifestyle — although the compensation is not super appealing. If it doesn’t work out, I feel like you could go back to surgery right?
- matheusmoreira 3y ago
  > it’s hard to articulate exactly how it felt staring down the barrel of a career in medicine Yeah. I used to enjoy this blog, written by a person who hated US medical school: https://web.archive.org/web/20101218031844/http://www.medschoolhell.com/archives/ https://web.archive.org/web/20101218031844/http://www.medsch...
lostlogin 3y ago
I know an eye surgeon who wrote a piece of software that streamlined the referral process for cataract surgery. It’s a seriously big deal in his world. When domain experts write make their own tools, the results are so much better than when an outsider does it for them.
- moneywoes 3y ago
  Curious if you have a link
merek 3y ago
Thanks for sharing. A couple of questions if I may: For a typical surgeon in the US, how common are lawsuits from patients? Do you have plans to run your own clinic (if not already doing so)? If so, would this address some of your current issues (work hours, compensation) at the risk of having to operate your own business?
- the_d3f4ult 3y ago
  > For a typical surgeon in the US, how common are lawsuits from patients? Not very common. Pretty much everyone gets sued at some point in their career, but it's rare to break through the malpractice insurance ceiling. That said, it's always in the back of your mind and when it happens it messes with you psychologically. >Do you have plans to run your own clinic (if not already doing so)? If so, >would this address some of your current issues (work hours, compensation) at the >risk of having to operate your own business? It's complicated. While being your own boss has a lot of perks, the path to ownership is not straightforward anymore in the current era of private equity. Some of the things that suck are not related to the financial aspects.
  - czbond 3y ago
    > Pretty much everyone gets sued at some point in their career, but it's rare to break through the malpractice insurance ceiling. Attorneys don't want to ruin a doctor's career by going above the limit of their malpractice into personal funds. They target the policy as their bogey and work from there.
s1artibartfast 3y ago
Look at medical device and pharma companies with a strong optha pipeline. I work with maybe 2 dozen retinal surgeons, and it seems like a pretty cushy gig. High 6 figure salary, mostly working from home, providing input for clinical trials and product development. Some do it part time and still maintain private practices.
fragmede 3y ago
https://www.gene.com/scientists/ophthalmology https://www.gene.com/scientists/ophthalmology
matheusmoreira 3y ago
> Looking through the "Who's Hiring" thread is soul-crushing. I know how you feel. I gave up on tech as a teenager and I still wonder what would've happened if I had stuck with it. Feels like it's impossible to switch careers now. Where I live practicing medicine used to be a respectable profession but that's completely changed for the worse in the last 20 years. The communists currently running my country are literally quoted saying "we must create a new generation of leftist doctors who accept working for less". They flooded the job market with doctors.
- mavelikara 3y ago
  > They flooded the job market with doctors. US doctors have to put in long hours because there aren't enough of them. Are things different in your country?
  - matheusmoreira 3y ago
    Yes. Same hours but nosediving pay because we now have an infinite amount of deeply indebted doctors fresh off medical school competing for the same jobs. Wages are literally decreasing year upon year for the average brazilian medic. Workload is also increasing because healthcare managers are starting to interfere more and more in patient care. They want 10 minute consults.
    - mavelikara 3y ago
      So hours are long, and the number of Drs in the market are increasing. Are the number of patients increasing, or the time consumed by each increasing, or unemployment among Drs increasing?
      - matheusmoreira 3y ago
        > Are the number of patients increasing The number of patients is literally never ending. It's a property of the decentralized public health system. If you have resources to spare, patients will be sent to you. No matter how much time and money you pour into healthcare, it's never enough. It's as if demand instantly scaled to exceed capacity. > or the time consumed by each increasing On the contrary, it's reducing. Cheap fast consults in popular clinics are now the norm. Doctors are doing more in less time for less money. The numbers are embarrassing, especially when converted to USD. The only consolation is it's still pretty good due to our low cost of living. Brazilian software developers working for american companies for a salary that would be inhumane to an american put doctors here to shame. I'm talking 2-4x, depending on the company and exchange rate. It wasn't like this before. > unemployment among Drs increasing? A few years ago I saw someone joke about doctors driving Ubers for the first time. It's looking more and more likely each year. I'm also seeing doctors simply abandon the profession straight up.
alar44 3y ago
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FredPret 3y ago
Just as an aside, I imagine there would be cool medical device startups working on smart glasses / artificial eyes. They probably wouldn’t even advertise for an ophthalmologist/ CS / Math person, because I think there’s probably only the one of you!
- rcarr 3y ago
  With the rise of AR/VR this guy could probably make bank in the coming years.
epicureanideal 3y ago
> Physician salaries are the only ones that do not grow relative to inflation Same has been happening to software engineers for the last 10 years at least. Salaries go up but not as fast as inflation. I’ve gotten higher titles and more responsibility over the years but inflation is still winning compared to 5+ years ago. > That said, is anyone hiring an ophthalmologist with CS and Math degrees? As soon as the job market recovers I think you’ll have no problem finding a job in software.
- brutusborn 3y ago
  Same has been happening to all labour. At least in Aus I think labour’s share has been going down since the 80s
- TheCoelacanth 3y ago
  Last 10 years? You must be joking. Software engineer salaries have done much better than inflation over the past ten years. If yours personally hasn't, you should have been asking for a raise or looking for a new job. Over the past one year, they've probably done worse.
  - epicureanideal 3y ago
    Do you have some statistics for this? Also, most of the inflationary damage was done in the last 3 years. Unless 10 years ago you started at a very low salary I don’t think they’ve gone up significantly after inflation. If you were already a senior engineer 10 years ago for example.
    - latency-guy2 3y ago
      Use BLS. Compensation for the average employee profile of "Software Developer" has far exceeded inflation. I can't remember the exact timeframe, but roughly 2016 - 2022, salary for the profile of Developer has gone from ~$86k to ~$130k mean. I think that beats inflation quite significantly.
      - 3y ago
carabiner 3y ago
> That said, is anyone hiring an ophthalmologist with CS and Math degrees? As someone who recently transitioned to a tech role, I'd urge you to focus on applying to companies related to your existing fields (ophthalmology, medicine, surgery, and their derivatives) who happen to be seeking SWE's, rather than general tech companies. Especially Series A, B, C startups. Look up all the companies that make your equipment or the software that you use, and go to their jobs pages. See anything that is tech or tech adjacent: swe, swe test, qa engineer, automation engineer, data engineer, anything mentioning python or javascript. The job market is the worst in 20 years and so the only companies that gave me the light of day were the ones in my previous field (energy and mechanical engineering).
- FrustratedMonky 3y ago
  This. This is best advice. I can't imagine there isn't some software company that could use a doctor-SWE combo. Usually SWE struggle not knowing the subject matter they are coding about. It is the subject matter experts that they need.
  - iancmceachern 3y ago
    This, I work with these people all day. There are tons of medical device and medtech companies that need people with both medical and technical backgrounds.
  - haldujai 3y ago
    Even large corporations, Matt Lungren is a notable radiologist with a tech background and was hired at AWS and is now CMIO at Microsoft + Nuance.
- nradov 3y ago
  Companies in the healthcare technology space typically prefer to hire physicians as product managers rather than engineers. There's a shortage of product managers who understand clinical workflows. Lots of job openings.
mixmastamyk 3y ago
> soul-crushing tech salaries No one really gets those (statistically). I never did, despite being great at what I do. Basically a lottery system where the one lucky person who did the same exact problem two days ago wins.
- speakfreely 3y ago
  I've found it's really about your negotiation and your confidence to ask for it. I've hired software engineers and frequently talk with others who do hiring, and I can confirm there's plenty of people who are making $120-140k who could've come in at $160-180k+ just by asking for it.
  - mixmastamyk 3y ago
    Sure, but doc is most likely talking about the $300k folks with 500k TCO at BigTech. Not the ones slaving away at Initrode.
weatherlite 3y ago
> There's just no reason to do the job when you can get the same compensation working remotely in tech. Looking through the "Who's Hiring" thread is soul-crushing. Physician salaries are the only ones that do not grow relative to inflation and have decreased year-on-year relative to inflation for decades. What ? Most U.S physicians make 300K + after residency with job security set for life. The real bright ones, the "faang" doctors make close to a million. Show me anyone in tech who can have that guaranteed for him. You're basically guaranteed to join the millionaire club if you decide to work enough years even as a mediocre doctor. Yes its an extremely difficult job I have no argument there, but there's no comparison to tech in terms of compensation or job security.
- jimmydddd 3y ago
  The job security issue is huge. Many of my tech and finance friends in their early 50's are getting pushed out of their jobs, while my physician friends in their 60's can keep their career as long as they want. A family member recently visited a dr. in his late 70's.
  - hn976827 3y ago
    Difference is that in tech you can retire with 50. Few people who still work at 70 do so by choice.
    - Mordisquitos 3y ago
      So can many physicians. Furthermore, I'm willing to bet that most doctors in the 50–70 age group that continue to work do so not because they cannot retire, but rather because they do not want to retire because they find their practice fulfilling.
      - haldujai 3y ago
        Not true, some do (stereotypically the surgeon with 4 ex wives and children that don’t know them) but it really depends on your country/practice pattern. On one extreme Canadian physicians are (generally) ineligible for pension/retirement benefits. Many US private practice jobs are the same. Academic US jobs usually have some form of retirement support. Add in the opportunity cost of not earning income until you’re 30+ as well as loans and I don’t think it’s a fair characterization to say “most physicians in the 50-70 age range want to work”, especially full time and considering burnout rates of ~50-60%. Can’t speak about Europe which has very different compensation structure and debt burden.
TacticalCoder 3y ago
I've got friends and family that are physicians and they also work a lot. They're in the EU so at least the "getting sued" part is close to non-existent (there's still a risk but typically only if there's a real fuckup). At least one of them also complain that the job isn't paid well enough and that the job kinda lost some of its luster. But... > There's just no reason to do the job when you can get the same compensation working remotely in tech. Compared to serving ads and/or engaging in surveillance capitalism, at least there's a lot of comfort in that they're doing (and you 're doing) a useful job. So I know it's not much but thanks a huge lot for what you're doing.
Traubenfuchs 3y ago
Your income is relatively insane (multiple 100k), you have ultimate job security even in old age, opening a private practice makes your income essentially open ended depending on how much hard work you put in, you can help your loved ones and yourself to better navigate health care, will always receive priority treatment and probably have the job with the highest social standing that exists. I don‘t know what it is with doctors world wide having zero awareness of their maximum privilege and zero perspective on how their average and median fellow citizens do. Yes it‘s hard, but so are many, many other jobs you don‘t hear much about.
- iancmceachern 3y ago
  Like farmers
trashface 3y ago
This viewpoint is just plain crazy. If you worked in tech you'd be totally disposable, just like all the rest of us programming drones. Hit 40-50 and boom, unless you've transitioned into management, suddenly no one wants to hire you, or if they do its half of what you were making before. Your MD degree and the AMA literally writing laws on your behalf limits labor supply competition like nothing in tech. You may have noted 250K+ tech layoffs in last year or so. Many of those people could probably code circles around you. Where are the physician layoffs? There aren't any. If you want fewer hours, work fewer hours. What are they going to do, fire you? They can't. There is a shortage as this notes.
- wrp 3y ago
  This needs explanation. If there is such an extreme shortage of talent, why can't doctors demand better terms, e.g. shorter hours?
  - MichaelZuo 3y ago
    This is what I don't get, if there was such an extreme shortage then the average visit to a family doctor should cost hundreds of dollars.
  - haldujai 3y ago
    Sometimes they do, look at the UK strike for an example although the environment here is no where near as toxic. One of the shortage issues is that it takes 9-12 years to train a specialty physician. For example we need more radiologists today but we can’t fix that until we increase residency spots which won’t impact the job market for 6 years so until then I’m reading more than I want to, even though I’d gladly work less for less total compensation. Someone has to do the work though and I can’t just say “not me” and leave the studies unreported. There is a human on the other end who needs care.
  - LadyCailin 3y ago
    They can, just not alone. If they were to unionize in sufficient numbers, there would be nothing to do but meet the demands. But “unions are bad” is the prevailing belief in the US, not to mention the huge amount of efforts that companies and the government go through to suppress them.
hn976827 3y ago
> Physician salaries are the only ones that do not grow relative to inflation Spoken with the true conviction of a position of privilege, and blinded by the very same. (No pun intended.) Hint: The majority of U.S. citizens have it worse than you.
- throwaway173738 3y ago
  So what? Making a doctor’s life better doesn’t preclude making everyone else’s life better. I think we should buoy everyone who isn’t in the capital class. This crab bucket mentality has got to go.
  - hn976827 3y ago
    Totally. The criticism was that the post responded to literally claimed that physicians have it worst of all since everybody elses compensation has been growing more than inflation. Which is just nonsense.
dsr_ 3y ago
"I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime" You want to give better care to patients, which means more time per visit and at least three breaks per day (morning, lunch and afternoon). You want to have more coworkers so that you can have consistent on-call work. Increasing the quality of your life-work balance will improve the quality of your work. As a resident, you likely did 24 hour shifts -- or worse. That was just hazing: nobody does their best work while sleep-deprived, and training in it doesn't improve things. You need reform throughout the system. You need a union. And one of the things that union needs to focus on is getting more people into this line of work.
GiorgioG 3y ago
I know this probably won’t make you feel better because you know this, but you’re actually making a huge impact on the quality of people’s lives. I work in tech (though not at a FAANG company) and my wife decided to go back to school (now that the kids are relatively self-sufficient) and she is hospice nurse. She gets home exhausted from 13-14 hour shifts. Having said that she feels so much more satisfaction than I ever have writing code to update a value in a database.
haldujai 3y ago
I agree, I left a FAANG and startup to pursue medicine (not that finances were my motivation) and my co-founder who went back to a FAANG is earning more than most physicians now. I’m far removed from this work environment now but at 10 years of SWE in a FAANG one seems to be making ~$350k-400k in total compensation? Not sure how many make it to L6 or higher, I defer to other commenters here. If you consider the competitiveness of high earning jobs (especially in desirable markets, probably the top 20% of candidates), the opportunity cost during a decade of training I would imagine a similar %ile candidate in CS would be making more in major cities. With that said physician income is relatively similar in metro vs cheaper COL areas so if you wanted to work in non-tech cities or smaller metros specialty physicians would probably make more. With that said, with the hours and work intensity I put in now I could probably do 2 FTE SWE jobs (at least comparing to what it was like 10+ years ago).
- djmips 3y ago
  But is that high paid era over?
  - haldujai 3y ago
    Could be. Could also happen in medicine (many think the golden era for compensation is nearing its end) A decade ago nephrologists in a dialysis unit were making high 6 figures until private-equity moved in and now they make 1-200k.
- VirusNewbie 3y ago
  Most people cannot last 10 years in FAANG. It’s up or out.
  - MichaelZuo 3y ago
    It's a pretty reasonable expectation for the 95th percentile. IDK how that translates to surgeons, maybe 70th-80th percentile?
    - 3y ago
Pigalowda 3y ago
You’re on the wrong forum to complain about the medical field. These SWE think you’re a privileged complaining brat (ironic) who breezed through the 15 years of school and training and don’t deserve anything but disrespect. You’re part of the medical cartel and for the most part, they despise you. Your salary is deemed too high and you are expensive overhead that needs to be decreased - hence the outrage and popularity of these articles here. You must know this? Have you not seen their comments on HN medical threads? So vocal and often horribly wrong it would be comical if it wasn’t so depressing. I’m not going to one up you with my own sob story, but it’s like you say for all of us everywhere in the US - but you can really only complain to other MDs. Outsiders will demand you work more, get paid less, get sued more, and grovel. They hate us, so don’t complain to them. In the end they will get what they want - automated service by LLM combined with other diagnostic software and nursing. They will then complain for the return of the human physician. It’s so typical. You are perfectly suited to giving them automated service. Just spitballing and probably wrong - have an optho specific app with an LLM and maybe a plug in smart phone device that has object detection/instance segmentation for diabetic retinopathy. Cataracts detection might be secondary? There’s plenty of products for retinopathy and looks like Inception networks do fine for cataracts. Other eye pathologies that are easily visually diagnosed are on the table too. Why see 40 patients when you could see 150 and the LLM/app have done the referral, initial screening questionnaire, and your nurses/MAs write your note/rx/orders etc. Ideally you should be like a dentist (they clearly figured this out already). You walk into the patient’s room do a quick eye exam, say what needs to happen, don’t answer any questions, and walk out. They hate you already anyways, might as well lean into it. - Currently an imaging fellow in the cartel.
- haldujai 3y ago
  I remain optimistic that some people here are open to learning so I still try sometimes. - Also a radiologist who gets told I’m egregiously overpaid when [insert immature AI tech] can definitely do my job better.
  - Pigalowda 3y ago
    I am not optimistic here. This is the lion’s den - I’m here to see what the predators have in store for us. Back in early residency it exposed me to CNN and real time object detectors and a co-resident and I made a little proof of concept app that detects ICD/PM on CXR. So I think there’s value to me here - just no value in proselytizing and apologetics. They don’t like us and are here to eliminate us.
jasmer 3y ago
Most devs are not earning anywhere near what a doctor is.
mensetmanusman 3y ago
Is working for half time for half the salary an option?
noleetcode 3y ago
Would you be willing to share your story of how you made the switch? CS major here considering going into medicine (despite your best efforts to convince otherwise :) ) but the general coursework wasn't something I targeted in school all those many years ago.
trentnix 3y ago
I've no doubt the stress of your work is immense and the constant threat of litigation (and the expense of the insurance to fight it) can be overwhelming. As a recipient of multiple eye surgeries (I had strabismus as a kid), I am grateful for competent professionals like you. But I think you buried the lede. In the 2010s I owned a high-end bicycle and sporting good store. It was 7 days of 10+ hours a day most weeks. And it was very nearly non-profit or barely-profit for most of its run. If you know anyone that owns a bike shop, you should give them a hug. They need it. Nearly every Friday afternoon, just after lunch, a few of my customers who were physicians or surgeons would pull up in their Model X or Cayenne to get service for their 10k road bike they were taking to their vacation home for the weekend. On more than one occasion, one of them would exasperatedly tell me how much they envied me and how lucky I was to be doing what I "loved". As I confronted my busy, work-filled weekend cemented to the shop to deal with the fickle and spoiled public, I had to chuckle as they drove away in their luxury vehicles to their luxury vacation home with a nicer bike than my own. In retrospect, I've concluded that the real problem they faced is they'd built a life dependent on a physician or surgeon's income. They were told they were building a castle, but instead they built a prison. The fact is, you just can't spend enough money to truly escape the stresses of your work, but you can certainly spend enough money to become shackled to it.
- hotpotamus 3y ago
  > They were told they were building a castle, but instead they built a prison. The industry term is "golden handcuffs".
  - algkkb 3y ago
    [flagged]
- BurningFrog 3y ago
  The grass is always greener in another profession, and my problems are always uniquely bad :)
  - catchnear4321 3y ago
deleted 3y ago
[deleted]
nostrademons 3y ago
Tech is temporary, though. The reason salaries (and profits) are so high is because tech companies, when successful, displace whole industries and capture the revenue in a more labor-efficient way. But once the industry has been displaced, you don't need the software engineers anymore. Eventually the tech company becomes a dinosaur that the finance department milks for profits and share buybacks, and then gets replaced by a younger, hotter tech company. If you ask 40+ year old software engineers, the biggest problem with the profession is the need to re-train every 5-10 years or face obsolescence. I'm in my early 40s, been doing this 20 years, and I've re-trained 4 times on new technology before finally switching into management. I just had an emergency medical procedure done. My surgeon graduated medical school in 1981, before I was born. He's able to learn one set of skills and then keep milking it for 40+ years.
- akkartik 3y ago
  This whole comment needs a big "citation required". It's all anecdotes and speculation. Tech displaces industries, yes, but in the history of tech there has never been a company that stopped needing software engineers. If you ask your surgeon he'll tell you how many times he feels he's retrained in his 40 year career. It's not going to be 0. And don't your two paragraphs contradict each other? Isn't the need to retrain every 5-10 years a big sign that software engineers are not going anywhere? I would agree with everything you wrote if it was prescriptive rather than normative. I would like software engineers to work themselves out of a job. And I'd like technology to be stable so we can focus on something besides the tech aspect of a company. But that seems poles apart from the world we live in.
NemoNobody 3y ago
I understand your situation - it's all of our lives too. Nobody that works for a living has had a raise compared to inflation, all of us have less than we ought to. Tech is a terrible place to be employed right now - at least you will still have a job for the foreseeable future. Plus, if your income is around the average eye surgeon salaries in the US (250k-300k according to some random website) - your income places you in the 97th percentile. I'm not saying you should suck it up and deal with it - not at all, this is wrong and you feel the way you do for a reason. It isn't your fault anymore than it's someone's fault for getting stuck at a dead end job. We are all in the same boat... except for those in super yachts. The truth is simply that most people are far worse off than you. Except for the billionaires, we are all poor.
catchnear4321 3y ago
> But, why would anyone want to do the job? > I do believe that the rigorous training model leads to a higher quality of care and much deeper understanding of the disease process. you somewhat answer your own question in the prior sentence. maybe not want, maybe called, or cared, maybe something else. not that it is binding or permanent, not that it should be. but for all of the words spent about how it is a bad choice, how it has harmed you directly, how the money isn’t great, you’re bringing up positives, for patients. you sound burned out. that’s not a criticism, nor should it be a badge of honor. maybe i have totally misjudged, but the career choice doesn’t sound like a purely financial decision for you. even if not, even if i misjudge this, you, you did that ten hour plus death march. you gave your best efforts though that patient may go blind anyway, though they may feel punitive about it towards you. you still did it. someone had to. by your own words, the patient NEEDED the procedure. you needed to go home, and be with family. the patient got the procedure. in case no one else has said it, or joining in with anyone that already has: thank you, stranger.
theGnuMe 3y ago
>That said, is anyone hiring an ophthalmologist with CS and Math degrees? I mean there's a bunch of AI stuff/hype now, you could probably find something if you want to leverage your MD? I imagine you'd have a lot of insight into what would actually work well in practice and improve outcomes. I just skimmed your comment history, so you already know about AI diagnostics e.g. https://health.google/caregivers/arda/ https://health.google/caregivers/arda/ And worldcoin probably needs an opthamologist who can help ensure the retina id scans are stable... there are also a lot of retina scan companies anyway for digital identification that probably need an opthamologist. It may be as simple as keeping a set of scans over time so you reauthenticate in person and get your token updated like when you get a passport renewed for example. But maybe there's other stuff like preventing adversarial attacks. Or maybe robotic surgery? Or maybe start your own? You might be able to patent something even. This being HN, the world is your oyster and all.
aiphex 3y ago
This might sound crude, but a man who becomes a physician (and especially a surgeon) gets his pick of the most attractive mates as well as a high social status for life. That's pretty strong motivation for many.
iancmceachern 3y ago
These people might: https://www.arcscan.com/ https://www.arcscan.com/ I can make an intro if you're serious
singleshot_ 3y ago
Respectfully, the "reason to do the job" is that you help people see. That's pretty cool. I understand the rest of the experience is pretty poor, but you do have a pretty fair amount of "helping people" potential at work. If you worked in tech, you could help people see... advertisements. That's potentially more lucrative but it's gotta be depressing after a life of that to reflect on one's life work.

SamoyedFurFluff 3y ago

> That said, is anyone hiring an ophthalmologist with CS and Math degrees? I’m surprised you can’t leverage this into a product role or a consulting role for startups in the medical space. You know shit about med systems!!

SongofEarth 3y ago
It can be really hard to leverage this combination of skills, the demand for cross-discipline talents is usually much lower than for a single skill set, but also much deeper when the demand exists, it's going to take some serious searching to find a match but likely it's worth it. There was HN post about working with radiologists when building a AI diagnosis company: https://news.ycombinator.com/item?id=36111596 https://news.ycombinator.com/item?id=36111596 May be try talk to some similar AI companies is a good idea, at this time the pay can be really good.
throwaway173738 3y ago
In the US medical device companies usually have a board of practitioners to give advice about the state of the art and the challenges with existing practice in the field. You can also start building your own device or system and plan to sell it, but you should find someone to consult on how to lobby the FDA and CMS as early as possible, because some devices get stuck in De Novo or PMA for years, and that’s a big risk to take. You’ll also need to have a long term plan for how the company will grow as you get closer to regulatory approval. A “product role” in these companies is very heavy on managing regulatory approval and making sure the company doesn’t get sued.

deleted 3y ago

[deleted]

mvanlonden 3y ago

We’re hiring founding engineers at Develop Health! https://jobs.lever.co/develophealth.io?utm_source=hackernews&utm_campaign=saveadoc https://jobs.lever.co/develophealth.io?utm_source=hackernews...

iancmceachern 3y ago
Yes! The prior authorization process is so broken! I've been battling Blie Shield for months in a effort to fix theirs

xvedejas 3y ago

The biggest complaint I always hear from people in the medical field is the long hours. It sure sounds to me like that (and thus any knock-on problems) could be solved by more practitioners, spreading the work around. I can't speak for you, but personally, a proper work-life balance in comparison to these horror stories is surely worth a possible salary cut?

lostlogin 3y ago
> It sure sounds to me like that (and thus any knock-on problems) could be solved by more practitioners, spreading the work around. Sort of. The equipment is so expensive that the actual solution is usually to work the rooms and equipment harder. Night shifts, early starts and evening work are actually shit.
- whimsicalism 3y ago
  That makes no sense, if the capital is expensive then you should hire more labor.
  - lostlogin 3y ago
    That is literally what I'm saying. Staff are worked harder as shifts are introduced. It is not a nice way to work. Sure, it helps reduce the number of patients, but it destroys work/life balance and that is what the OP was raising as an issue. It is also hard to get patients to agree to having tests done at 5am or 9pm, so it's a case of diminishing returns. The staff penal rates go up too, so the squeeze comes from all sorts of directions.
    - greiskul 3y ago
      > It is also hard to get patients to agree to having tests done at 5am or 9pm, so it's a case of diminishing returns. In the US? With health care prices as they are? There are people that travel to entirely other countries for access to health. I'm plenty sure lots wouldn't mind at all to have an exam at 9pm if it meant it was way cheaper.

smarmgoblin 3y ago

I dropped out of an MD/PhD program after I passed Step 1, it’s hard to articulate exactly how it felt staring down the barrel of a career in medicine but this is sort of what I feared. Since I’ve been in tech I’ve been laid off several times, and it’s not clear that compensation or demand will always be as hot as it is right now. I’m not complaining but if you take any satisfaction in actually helping people, there’s a real possibility you won’t find that anymore. That said, you have options. If you’re willing to work at a junior or mid-level role, companies probably won’t care much what you did before. Maybe wait til the next boom in hiring happens, jump on the hype train. With your technical skills there’s probably some very unique research roles you could fill if you’re interested in that lifestyle — although the compensation is not super appealing. If it doesn’t work out, I feel like you could go back to surgery right?

matheusmoreira 3y ago
> it’s hard to articulate exactly how it felt staring down the barrel of a career in medicine Yeah. I used to enjoy this blog, written by a person who hated US medical school: https://web.archive.org/web/20101218031844/http://www.medschoolhell.com/archives/ https://web.archive.org/web/20101218031844/http://www.medsch...

lostlogin 3y ago

I know an eye surgeon who wrote a piece of software that streamlined the referral process for cataract surgery. It’s a seriously big deal in his world. When domain experts write make their own tools, the results are so much better than when an outsider does it for them.

moneywoes 3y ago
Curious if you have a link

merek 3y ago

Thanks for sharing. A couple of questions if I may: For a typical surgeon in the US, how common are lawsuits from patients? Do you have plans to run your own clinic (if not already doing so)? If so, would this address some of your current issues (work hours, compensation) at the risk of having to operate your own business?

the_d3f4ult 3y ago
> For a typical surgeon in the US, how common are lawsuits from patients? Not very common. Pretty much everyone gets sued at some point in their career, but it's rare to break through the malpractice insurance ceiling. That said, it's always in the back of your mind and when it happens it messes with you psychologically. >Do you have plans to run your own clinic (if not already doing so)? If so, >would this address some of your current issues (work hours, compensation) at the >risk of having to operate your own business? It's complicated. While being your own boss has a lot of perks, the path to ownership is not straightforward anymore in the current era of private equity. Some of the things that suck are not related to the financial aspects.
- czbond 3y ago
  > Pretty much everyone gets sued at some point in their career, but it's rare to break through the malpractice insurance ceiling. Attorneys don't want to ruin a doctor's career by going above the limit of their malpractice into personal funds. They target the policy as their bogey and work from there.

s1artibartfast 3y ago

Look at medical device and pharma companies with a strong optha pipeline. I work with maybe 2 dozen retinal surgeons, and it seems like a pretty cushy gig. High 6 figure salary, mostly working from home, providing input for clinical trials and product development. Some do it part time and still maintain private practices.

fragmede 3y ago

https://www.gene.com/scientists/ophthalmology https://www.gene.com/scientists/ophthalmology

matheusmoreira 3y ago

> Looking through the "Who's Hiring" thread is soul-crushing. I know how you feel. I gave up on tech as a teenager and I still wonder what would've happened if I had stuck with it. Feels like it's impossible to switch careers now. Where I live practicing medicine used to be a respectable profession but that's completely changed for the worse in the last 20 years. The communists currently running my country are literally quoted saying "we must create a new generation of leftist doctors who accept working for less". They flooded the job market with doctors.

mavelikara 3y ago
> They flooded the job market with doctors. US doctors have to put in long hours because there aren't enough of them. Are things different in your country?
- matheusmoreira 3y ago
  Yes. Same hours but nosediving pay because we now have an infinite amount of deeply indebted doctors fresh off medical school competing for the same jobs. Wages are literally decreasing year upon year for the average brazilian medic. Workload is also increasing because healthcare managers are starting to interfere more and more in patient care. They want 10 minute consults.
  - mavelikara 3y ago
    So hours are long, and the number of Drs in the market are increasing. Are the number of patients increasing, or the time consumed by each increasing, or unemployment among Drs increasing?
    - matheusmoreira 3y ago
      > Are the number of patients increasing The number of patients is literally never ending. It's a property of the decentralized public health system. If you have resources to spare, patients will be sent to you. No matter how much time and money you pour into healthcare, it's never enough. It's as if demand instantly scaled to exceed capacity. > or the time consumed by each increasing On the contrary, it's reducing. Cheap fast consults in popular clinics are now the norm. Doctors are doing more in less time for less money. The numbers are embarrassing, especially when converted to USD. The only consolation is it's still pretty good due to our low cost of living. Brazilian software developers working for american companies for a salary that would be inhumane to an american put doctors here to shame. I'm talking 2-4x, depending on the company and exchange rate. It wasn't like this before. > unemployment among Drs increasing? A few years ago I saw someone joke about doctors driving Ubers for the first time. It's looking more and more likely each year. I'm also seeing doctors simply abandon the profession straight up.

alar44 3y ago

[dead]

FredPret 3y ago

Just as an aside, I imagine there would be cool medical device startups working on smart glasses / artificial eyes. They probably wouldn’t even advertise for an ophthalmologist/ CS / Math person, because I think there’s probably only the one of you!

rcarr 3y ago
With the rise of AR/VR this guy could probably make bank in the coming years.

epicureanideal 3y ago

> Physician salaries are the only ones that do not grow relative to inflation Same has been happening to software engineers for the last 10 years at least. Salaries go up but not as fast as inflation. I’ve gotten higher titles and more responsibility over the years but inflation is still winning compared to 5+ years ago. > That said, is anyone hiring an ophthalmologist with CS and Math degrees? As soon as the job market recovers I think you’ll have no problem finding a job in software.

brutusborn 3y ago
Same has been happening to all labour. At least in Aus I think labour’s share has been going down since the 80s
TheCoelacanth 3y ago
Last 10 years? You must be joking. Software engineer salaries have done much better than inflation over the past ten years. If yours personally hasn't, you should have been asking for a raise or looking for a new job. Over the past one year, they've probably done worse.
- epicureanideal 3y ago
  Do you have some statistics for this? Also, most of the inflationary damage was done in the last 3 years. Unless 10 years ago you started at a very low salary I don’t think they’ve gone up significantly after inflation. If you were already a senior engineer 10 years ago for example.
  - latency-guy2 3y ago
    Use BLS. Compensation for the average employee profile of "Software Developer" has far exceeded inflation. I can't remember the exact timeframe, but roughly 2016 - 2022, salary for the profile of Developer has gone from ~$86k to ~$130k mean. I think that beats inflation quite significantly.
    - 3y ago

carabiner 3y ago

> That said, is anyone hiring an ophthalmologist with CS and Math degrees? As someone who recently transitioned to a tech role, I'd urge you to focus on applying to companies related to your existing fields (ophthalmology, medicine, surgery, and their derivatives) who happen to be seeking SWE's, rather than general tech companies. Especially Series A, B, C startups. Look up all the companies that make your equipment or the software that you use, and go to their jobs pages. See anything that is tech or tech adjacent: swe, swe test, qa engineer, automation engineer, data engineer, anything mentioning python or javascript. The job market is the worst in 20 years and so the only companies that gave me the light of day were the ones in my previous field (energy and mechanical engineering).

FrustratedMonky 3y ago
This. This is best advice. I can't imagine there isn't some software company that could use a doctor-SWE combo. Usually SWE struggle not knowing the subject matter they are coding about. It is the subject matter experts that they need.
- iancmceachern 3y ago
  This, I work with these people all day. There are tons of medical device and medtech companies that need people with both medical and technical backgrounds.
- haldujai 3y ago
  Even large corporations, Matt Lungren is a notable radiologist with a tech background and was hired at AWS and is now CMIO at Microsoft + Nuance.
nradov 3y ago
Companies in the healthcare technology space typically prefer to hire physicians as product managers rather than engineers. There's a shortage of product managers who understand clinical workflows. Lots of job openings.

mixmastamyk 3y ago

> soul-crushing tech salaries No one really gets those (statistically). I never did, despite being great at what I do. Basically a lottery system where the one lucky person who did the same exact problem two days ago wins.

speakfreely 3y ago
I've found it's really about your negotiation and your confidence to ask for it. I've hired software engineers and frequently talk with others who do hiring, and I can confirm there's plenty of people who are making $120-140k who could've come in at $160-180k+ just by asking for it.
- mixmastamyk 3y ago
  Sure, but doc is most likely talking about the $300k folks with 500k TCO at BigTech. Not the ones slaving away at Initrode.

weatherlite 3y ago

> There's just no reason to do the job when you can get the same compensation working remotely in tech. Looking through the "Who's Hiring" thread is soul-crushing. Physician salaries are the only ones that do not grow relative to inflation and have decreased year-on-year relative to inflation for decades. What ? Most U.S physicians make 300K + after residency with job security set for life. The real bright ones, the "faang" doctors make close to a million. Show me anyone in tech who can have that guaranteed for him. You're basically guaranteed to join the millionaire club if you decide to work enough years even as a mediocre doctor. Yes its an extremely difficult job I have no argument there, but there's no comparison to tech in terms of compensation or job security.

jimmydddd 3y ago
The job security issue is huge. Many of my tech and finance friends in their early 50's are getting pushed out of their jobs, while my physician friends in their 60's can keep their career as long as they want. A family member recently visited a dr. in his late 70's.
- hn976827 3y ago
  Difference is that in tech you can retire with 50. Few people who still work at 70 do so by choice.
  - Mordisquitos 3y ago
    So can many physicians. Furthermore, I'm willing to bet that most doctors in the 50–70 age group that continue to work do so not because they cannot retire, but rather because they do not want to retire because they find their practice fulfilling.
    - haldujai 3y ago
      Not true, some do (stereotypically the surgeon with 4 ex wives and children that don’t know them) but it really depends on your country/practice pattern. On one extreme Canadian physicians are (generally) ineligible for pension/retirement benefits. Many US private practice jobs are the same. Academic US jobs usually have some form of retirement support. Add in the opportunity cost of not earning income until you’re 30+ as well as loans and I don’t think it’s a fair characterization to say “most physicians in the 50-70 age range want to work”, especially full time and considering burnout rates of ~50-60%. Can’t speak about Europe which has very different compensation structure and debt burden.

TacticalCoder 3y ago

I've got friends and family that are physicians and they also work a lot. They're in the EU so at least the "getting sued" part is close to non-existent (there's still a risk but typically only if there's a real fuckup). At least one of them also complain that the job isn't paid well enough and that the job kinda lost some of its luster. But... > There's just no reason to do the job when you can get the same compensation working remotely in tech. Compared to serving ads and/or engaging in surveillance capitalism, at least there's a lot of comfort in that they're doing (and you 're doing) a useful job. So I know it's not much but thanks a huge lot for what you're doing.

Traubenfuchs 3y ago

Your income is relatively insane (multiple 100k), you have ultimate job security even in old age, opening a private practice makes your income essentially open ended depending on how much hard work you put in, you can help your loved ones and yourself to better navigate health care, will always receive priority treatment and probably have the job with the highest social standing that exists. I don‘t know what it is with doctors world wide having zero awareness of their maximum privilege and zero perspective on how their average and median fellow citizens do. Yes it‘s hard, but so are many, many other jobs you don‘t hear much about.

iancmceachern 3y ago
Like farmers

trashface 3y ago

This viewpoint is just plain crazy. If you worked in tech you'd be totally disposable, just like all the rest of us programming drones. Hit 40-50 and boom, unless you've transitioned into management, suddenly no one wants to hire you, or if they do its half of what you were making before. Your MD degree and the AMA literally writing laws on your behalf limits labor supply competition like nothing in tech. You may have noted 250K+ tech layoffs in last year or so. Many of those people could probably code circles around you. Where are the physician layoffs? There aren't any. If you want fewer hours, work fewer hours. What are they going to do, fire you? They can't. There is a shortage as this notes.

wrp 3y ago
This needs explanation. If there is such an extreme shortage of talent, why can't doctors demand better terms, e.g. shorter hours?
- MichaelZuo 3y ago
  This is what I don't get, if there was such an extreme shortage then the average visit to a family doctor should cost hundreds of dollars.
- haldujai 3y ago
  Sometimes they do, look at the UK strike for an example although the environment here is no where near as toxic. One of the shortage issues is that it takes 9-12 years to train a specialty physician. For example we need more radiologists today but we can’t fix that until we increase residency spots which won’t impact the job market for 6 years so until then I’m reading more than I want to, even though I’d gladly work less for less total compensation. Someone has to do the work though and I can’t just say “not me” and leave the studies unreported. There is a human on the other end who needs care.
- LadyCailin 3y ago
  They can, just not alone. If they were to unionize in sufficient numbers, there would be nothing to do but meet the demands. But “unions are bad” is the prevailing belief in the US, not to mention the huge amount of efforts that companies and the government go through to suppress them.

hn976827 3y ago

> Physician salaries are the only ones that do not grow relative to inflation Spoken with the true conviction of a position of privilege, and blinded by the very same. (No pun intended.) Hint: The majority of U.S. citizens have it worse than you.

throwaway173738 3y ago
So what? Making a doctor’s life better doesn’t preclude making everyone else’s life better. I think we should buoy everyone who isn’t in the capital class. This crab bucket mentality has got to go.
- hn976827 3y ago
  Totally. The criticism was that the post responded to literally claimed that physicians have it worst of all since everybody elses compensation has been growing more than inflation. Which is just nonsense.

dsr_ 3y ago

"I saw 40 patient's in clinic today in 8 hours without lunch or any kind of downtime" You want to give better care to patients, which means more time per visit and at least three breaks per day (morning, lunch and afternoon). You want to have more coworkers so that you can have consistent on-call work. Increasing the quality of your life-work balance will improve the quality of your work. As a resident, you likely did 24 hour shifts -- or worse. That was just hazing: nobody does their best work while sleep-deprived, and training in it doesn't improve things. You need reform throughout the system. You need a union. And one of the things that union needs to focus on is getting more people into this line of work.

GiorgioG 3y ago

I know this probably won’t make you feel better because you know this, but you’re actually making a huge impact on the quality of people’s lives. I work in tech (though not at a FAANG company) and my wife decided to go back to school (now that the kids are relatively self-sufficient) and she is hospice nurse. She gets home exhausted from 13-14 hour shifts. Having said that she feels so much more satisfaction than I ever have writing code to update a value in a database.

haldujai 3y ago

I agree, I left a FAANG and startup to pursue medicine (not that finances were my motivation) and my co-founder who went back to a FAANG is earning more than most physicians now. I’m far removed from this work environment now but at 10 years of SWE in a FAANG one seems to be making ~$350k-400k in total compensation? Not sure how many make it to L6 or higher, I defer to other commenters here. If you consider the competitiveness of high earning jobs (especially in desirable markets, probably the top 20% of candidates), the opportunity cost during a decade of training I would imagine a similar %ile candidate in CS would be making more in major cities. With that said physician income is relatively similar in metro vs cheaper COL areas so if you wanted to work in non-tech cities or smaller metros specialty physicians would probably make more. With that said, with the hours and work intensity I put in now I could probably do 2 FTE SWE jobs (at least comparing to what it was like 10+ years ago).

djmips 3y ago
But is that high paid era over?
- haldujai 3y ago
  Could be. Could also happen in medicine (many think the golden era for compensation is nearing its end) A decade ago nephrologists in a dialysis unit were making high 6 figures until private-equity moved in and now they make 1-200k.
VirusNewbie 3y ago
Most people cannot last 10 years in FAANG. It’s up or out.
- MichaelZuo 3y ago
  It's a pretty reasonable expectation for the 95th percentile. IDK how that translates to surgeons, maybe 70th-80th percentile?
  - 3y ago

Pigalowda 3y ago

You’re on the wrong forum to complain about the medical field. These SWE think you’re a privileged complaining brat (ironic) who breezed through the 15 years of school and training and don’t deserve anything but disrespect. You’re part of the medical cartel and for the most part, they despise you. Your salary is deemed too high and you are expensive overhead that needs to be decreased - hence the outrage and popularity of these articles here. You must know this? Have you not seen their comments on HN medical threads? So vocal and often horribly wrong it would be comical if it wasn’t so depressing. I’m not going to one up you with my own sob story, but it’s like you say for all of us everywhere in the US - but you can really only complain to other MDs. Outsiders will demand you work more, get paid less, get sued more, and grovel. They hate us, so don’t complain to them. In the end they will get what they want - automated service by LLM combined with other diagnostic software and nursing. They will then complain for the return of the human physician. It’s so typical. You are perfectly suited to giving them automated service. Just spitballing and probably wrong - have an optho specific app with an LLM and maybe a plug in smart phone device that has object detection/instance segmentation for diabetic retinopathy. Cataracts detection might be secondary? There’s plenty of products for retinopathy and looks like Inception networks do fine for cataracts. Other eye pathologies that are easily visually diagnosed are on the table too. Why see 40 patients when you could see 150 and the LLM/app have done the referral, initial screening questionnaire, and your nurses/MAs write your note/rx/orders etc. Ideally you should be like a dentist (they clearly figured this out already). You walk into the patient’s room do a quick eye exam, say what needs to happen, don’t answer any questions, and walk out. They hate you already anyways, might as well lean into it. - Currently an imaging fellow in the cartel.

haldujai 3y ago
I remain optimistic that some people here are open to learning so I still try sometimes. - Also a radiologist who gets told I’m egregiously overpaid when [insert immature AI tech] can definitely do my job better.
- Pigalowda 3y ago
  I am not optimistic here. This is the lion’s den - I’m here to see what the predators have in store for us. Back in early residency it exposed me to CNN and real time object detectors and a co-resident and I made a little proof of concept app that detects ICD/PM on CXR. So I think there’s value to me here - just no value in proselytizing and apologetics. They don’t like us and are here to eliminate us.

jasmer 3y ago

Most devs are not earning anywhere near what a doctor is.

mensetmanusman 3y ago

Is working for half time for half the salary an option?

noleetcode 3y ago

Would you be willing to share your story of how you made the switch? CS major here considering going into medicine (despite your best efforts to convince otherwise :) ) but the general coursework wasn't something I targeted in school all those many years ago.

trentnix 3y ago

I've no doubt the stress of your work is immense and the constant threat of litigation (and the expense of the insurance to fight it) can be overwhelming. As a recipient of multiple eye surgeries (I had strabismus as a kid), I am grateful for competent professionals like you. But I think you buried the lede. In the 2010s I owned a high-end bicycle and sporting good store. It was 7 days of 10+ hours a day most weeks. And it was very nearly non-profit or barely-profit for most of its run. If you know anyone that owns a bike shop, you should give them a hug. They need it. Nearly every Friday afternoon, just after lunch, a few of my customers who were physicians or surgeons would pull up in their Model X or Cayenne to get service for their 10k road bike they were taking to their vacation home for the weekend. On more than one occasion, one of them would exasperatedly tell me how much they envied me and how lucky I was to be doing what I "loved". As I confronted my busy, work-filled weekend cemented to the shop to deal with the fickle and spoiled public, I had to chuckle as they drove away in their luxury vehicles to their luxury vacation home with a nicer bike than my own. In retrospect, I've concluded that the real problem they faced is they'd built a life dependent on a physician or surgeon's income. They were told they were building a castle, but instead they built a prison. The fact is, you just can't spend enough money to truly escape the stresses of your work, but you can certainly spend enough money to become shackled to it.

hotpotamus 3y ago
> They were told they were building a castle, but instead they built a prison. The industry term is "golden handcuffs".
- algkkb 3y ago
  [flagged]
BurningFrog 3y ago
The grass is always greener in another profession, and my problems are always uniquely bad :)
- catchnear4321 3y ago

deleted 3y ago

[deleted]

nostrademons 3y ago

Tech is temporary, though. The reason salaries (and profits) are so high is because tech companies, when successful, displace whole industries and capture the revenue in a more labor-efficient way. But once the industry has been displaced, you don't need the software engineers anymore. Eventually the tech company becomes a dinosaur that the finance department milks for profits and share buybacks, and then gets replaced by a younger, hotter tech company. If you ask 40+ year old software engineers, the biggest problem with the profession is the need to re-train every 5-10 years or face obsolescence. I'm in my early 40s, been doing this 20 years, and I've re-trained 4 times on new technology before finally switching into management. I just had an emergency medical procedure done. My surgeon graduated medical school in 1981, before I was born. He's able to learn one set of skills and then keep milking it for 40+ years.

akkartik 3y ago
This whole comment needs a big "citation required". It's all anecdotes and speculation. Tech displaces industries, yes, but in the history of tech there has never been a company that stopped needing software engineers. If you ask your surgeon he'll tell you how many times he feels he's retrained in his 40 year career. It's not going to be 0. And don't your two paragraphs contradict each other? Isn't the need to retrain every 5-10 years a big sign that software engineers are not going anywhere? I would agree with everything you wrote if it was prescriptive rather than normative. I would like software engineers to work themselves out of a job. And I'd like technology to be stable so we can focus on something besides the tech aspect of a company. But that seems poles apart from the world we live in.

NemoNobody 3y ago

I understand your situation - it's all of our lives too. Nobody that works for a living has had a raise compared to inflation, all of us have less than we ought to. Tech is a terrible place to be employed right now - at least you will still have a job for the foreseeable future. Plus, if your income is around the average eye surgeon salaries in the US (250k-300k according to some random website) - your income places you in the 97th percentile. I'm not saying you should suck it up and deal with it - not at all, this is wrong and you feel the way you do for a reason. It isn't your fault anymore than it's someone's fault for getting stuck at a dead end job. We are all in the same boat... except for those in super yachts. The truth is simply that most people are far worse off than you. Except for the billionaires, we are all poor.

catchnear4321 3y ago

> But, why would anyone want to do the job? > I do believe that the rigorous training model leads to a higher quality of care and much deeper understanding of the disease process. you somewhat answer your own question in the prior sentence. maybe not want, maybe called, or cared, maybe something else. not that it is binding or permanent, not that it should be. but for all of the words spent about how it is a bad choice, how it has harmed you directly, how the money isn’t great, you’re bringing up positives, for patients. you sound burned out. that’s not a criticism, nor should it be a badge of honor. maybe i have totally misjudged, but the career choice doesn’t sound like a purely financial decision for you. even if not, even if i misjudge this, you, you did that ten hour plus death march. you gave your best efforts though that patient may go blind anyway, though they may feel punitive about it towards you. you still did it. someone had to. by your own words, the patient NEEDED the procedure. you needed to go home, and be with family. the patient got the procedure. in case no one else has said it, or joining in with anyone that already has: thank you, stranger.

theGnuMe 3y ago

>That said, is anyone hiring an ophthalmologist with CS and Math degrees? I mean there's a bunch of AI stuff/hype now, you could probably find something if you want to leverage your MD? I imagine you'd have a lot of insight into what would actually work well in practice and improve outcomes. I just skimmed your comment history, so you already know about AI diagnostics e.g. https://health.google/caregivers/arda/ https://health.google/caregivers/arda/ And worldcoin probably needs an opthamologist who can help ensure the retina id scans are stable... there are also a lot of retina scan companies anyway for digital identification that probably need an opthamologist. It may be as simple as keeping a set of scans over time so you reauthenticate in person and get your token updated like when you get a passport renewed for example. But maybe there's other stuff like preventing adversarial attacks. Or maybe robotic surgery? Or maybe start your own? You might be able to patent something even. This being HN, the world is your oyster and all.

aiphex 3y ago

This might sound crude, but a man who becomes a physician (and especially a surgeon) gets his pick of the most attractive mates as well as a high social status for life. That's pretty strong motivation for many.

iancmceachern 3y ago

These people might: https://www.arcscan.com/ https://www.arcscan.com/ I can make an intro if you're serious

singleshot_ 3y ago

Respectfully, the "reason to do the job" is that you help people see. That's pretty cool. I understand the rest of the experience is pretty poor, but you do have a pretty fair amount of "helping people" potential at work. If you worked in tech, you could help people see... advertisements. That's potentially more lucrative but it's gotta be depressing after a life of that to reflect on one's life work.