Dear Readers:
Dr. Warren hopes to help all who
ask his advice and to enlighten all who read Ask Dr. Warren.
For your own well being please keep in mind that advice you read here may
not apply exactly to your own situation, and that if you are sick, no information
on the web can take the place of a hands on examination by your physician
who knows you and cares about you.
Average health and strength should suffice to be pediatrician. There are no special physical requirements although examination skills do depend on normal eyesight and hearing or eyesight and hearing which can be corrected to normal with aids or lenses. Intelligence is a basic requirement for the other skills to be learned.
There will always be a need for pediatricians but salary and availability of positions may be affected by insurance companies and federal regulations.
New technologies and discoveries can have a dramatic and unpredictable impact on the practice of medicine. The future of all medical fields will include an ever increasing burden of paper work to meet requirements of governmental regulators and insurance companies. Since the independent (self employed) practitioner must know how to manage the business aspect of his practice, a significant amount of his time will be spent dealing with the changing requirements of both government and insurers.
The particular language you take in high school probably won't make a difference regarding getting into medical school. Getting good grades in any language course and learning communication skills will. Physicians who speak any language fluently besides their country's mother tongue provide a significant service to those who speak only the physician's second language. In the USA, Spanish is an excellent choice for a second language since there is a large Spanish speaking population in many urban areas.
Being on call can certainly sometimes be a drawback to a career in pediatrics. If you enter private practice, you can arrange for coverage with other physicians. I have a partner with whom I share the call schedule. I'm not on call every night, but of course, sharing call means I have to be on call on half the holidays. This past weekend when we both were going to a wedding for one of our staff's children, we arranged for another pediatrician to cover our practice. Not all physicians take call at night. In some places, physicians can sign out their practices to a service which provides coverage. Theoretically, at least, these arrangements must meet the approval of any HMOs with which the physician has a contract since the physician is obliged to provide care for his patients 24 hours a day/seven days a week. Not all pediatricians work in private practice. Many clinics are open only during certain hours. Some do not provide a physician on call when they are closed. The pediatricians who work for these institutions only have to be available during the hours of clinic operation. Finally, not all physicians make themselves available after hours. Their patients have to seek care elsewhere in the event of an emergency.
To put being on call in perspective, don't forget that physicians aren't the only ones who have to work holidays and weekends. All of our policemen and firemen have to take turns working undesirable shifts in order to provide the full time service we take for granted. When you go to a restaurant or a show, or even shopping during your time off, you will be served by somebody who is working instead of enjoying time with friends or family. The list of those who work holdiays and weekends is endless.
The future of human beings rests with our children, therefore the health and survival of our species depends on the health of our children. Each pediatrician does his part not only to treat the illnesses of children, but also to immunize children to prevent disease, and to educate parents in ways to keep their children safe and healthy. On an organizational level the American Academy of Pediatrics acts as child advocates in this country and around the world. For more information on AAP child advocacy programs check http://www.aap.org/advocacy/advohome.htm.
1. The question
about why I decided to become a pediatrician was answered in the second
interview. 
2. You
may need to be more specific in your question. There are lots of skills
that are not required to work with children. For example, there's no math involved
in dealing with children. On the other hand, there is math involved in
calculating drug dosages, but minimal skills will get you by on that.
You do need to be patient and gentle when dealing
with children, although I'm not sure that qualifies as a skill. A love
of children that shows through warmly as you relate to them is a plus.
Knowledge of child development and what can be expected from children of
different ages comes in handy in dealing with them. Then there are specific
examination and diagnostic skills needed to be a pediatrician which a person
learns in medical school and residency.
3. I work
about 60 hours a week.
4. Subtract
60 from the number of hours in a week, and the amount of free time I have
left depends on how much sleep I get. I could use more time for leisure.
It isn't so much the amount of time I have as the obligation I have to
take night call and work weekends and holidays which allows my personal
life to be interrupted by patient needs and sometimes makes me miss things
I'd like to do. I've discussed this aspect in other interviews and would
appreciate your reading them rather than expecting me to repeat it for
you.
5. I am
certainly compensated for the work I do. I make a good living, but I work
very hard to do it. I think you meant to ask if I'm compensated adequately.
I'd have to say that since I work more hours now than I did in 1993, and
I earn less, the answer is no. If the result were that health care was
costing the average Joe less, I'd have to say that's reasonable, but my
income was never a big part of the burgeoning health care costs. Pediatricians
are not highly paid compared to any other physician or any other professional.
Since my increased work for less pay is fattening the wallets of HMO CEOs,
I feel gypped.
6. This
question was definitely answered in another interview. You'll just have
to look for it.
7. There
is no standard part of the day that is most hectic. The day becomes hectic
when the unexpected happens. Since medical emergencies happen, those are
obvious things that make the day hectic. When there's a lot of illness
in the community, it seems like there aren't enough hours in the day to
see all the patients. Then if a very sick kid comes in or an unexpected
emergency takes a lot of time, the waiting room fills with people anxious
to be seen.
The unexpected can happen other ways too. These
days, we're so dependent on our computer that if the office computer has
a problem, the whole day gets thrown off kilter. If patients show up late,
they still expect to be seen. That can throw the office behind schedule.
Any procedure can take longer than expected. Some kids cooperate. Others
don't. A smooth sailing day can become hectic in an instant.
8. There's
not that much blood and guts in pediatrics. If that's the only reason you
would stay away from a career in pediatrics, pediatrics may be just fine
for you. You don't necessarily have to draw blood in your office. You can
send those kids to the lab. Many insurance companies make that the easiest
way to go. You don't have to do any minor surgical procedures either. Those
as well as major procedures can be sent to specialists.
Of course, you will have to be exposed to these things during your residency. But I think you quickly get used to the amount of blood and guts you have to see. I was always very nervous about doing things to patients, especially things that hurt, but as I got better at doing those things, I became more confident.
If you can't handle the sight of any blood without
passing out, then you really ought to consider a different career. There's
just no way to get through medical school and residency without seeing
some blood. To be honest, though, there's no way to get through life, especially
parenthood, without seeing some blood.
9. I like
to help people, and I believe I make a valuable contribution to the lives
of my patients and the world. For more insight and greater discussion of
this and other questions, I suggest you read my other interviews with students.
You can find the links to them on the student page.
It's not my desire to give you, or any kid who wants
to ask me a question for school or personal reasons a hard time. I encourage
kids to "Ask Dr. Warren," but I get tons of e-mail every day, and I can't
take the time to do everybody's homework for them. The rules for asking
me questions are clearly spelled out on the e-mail
page where it says, "Students who have been assigned to interview
a pediatrician should not send their entire assignment, but only questions
that are unique and different from questions previously answered."
The links to previous interviews are clearly posted there with the request
that students read those interviews before sending me any questions.
1. How much of the classes you took in high school was helpful in your career as a pediatrician?
2. What impact do you think technology has on your career?
3. What do you think the future trend is for being a pediatrician? In another words, is it a good choice being a pediatrician in terms of income and the number of jobs available?
2. Technology constantly provides new tools for evaluation and treatment of patients. Even the running of a medical office can be dependent on computer technology.
3. There will always be jobs for pediatricians, and they will always earn a reasonable living unless there is some major, unforeseen change in the delivery of medical care. In general, pediatricians earn less than they did 5 years ago, and it is possible that medical incomes will continue to decline as additional changes occur in the way in which health care is financed.
2. After
completing training (residency) you can set up your own practice by renting
space, buying equipment, and making yourself available to patients. Participating
in various HMOs and insurance plans can be a source of new patients. If
you don't want to start your own practice, you can join an existing practice
or look for a job in a clinic or hospital. Advertisements for positions
can be found in various medical journals, newspapers, and on bulletin boards
in hospitals and medical schools.
3. I
have my own practice. It allows me to be independent, be my own boss, and
set my own schedule. I also get top form a relationship with my patients
which may not be possible in some hospital or clinic settings. On the other
hand, working in a hospital or clinic would provide me with set hours and
a set salary.
4. There's
a lot of competition for getting into medical school, so you need good
grades, the higher the better. I can't give you a number. High school isn't
a time to specialize. You need a full sequence (4 years) in all your major
subjects: English, Social Studies (history, economics, civics), Math, Science,
and Language.
5. Anything
that makes you stand out from the crowd will help you compete. Good SAT
scores, good MCAT scores, participation in activities especially community
service and especially in a leadership position, work experience in a medically
related field such as volunteering at a hospital.
6. I
don't know what the other professions earn, but you will find your question
about pediatricians' income and all your remaining questions except the
last one already answered on my Web site. If you didn't pay attention to
the list of previous student interviews on the instruction
page for sending me e-mail you can find links to these interviews at
the student page.
Please take the time to look through these interviews as you should have
done before sending yours to me. The fact that you didn't take the time
is evident in that you sent me a generic letter addressed to "Dear Sir
or Madam" with all your questions.
11.
A good physician should be intelligent, well educated about medicine with
a thirst to continue learning since medicine is always changing, well trained
in the skills required for examination and any other skills he may use
such as surgery, kind, considerate, gentle, concerned first for the health
and well being of his patients, honest, ethical, good at communicating
with his patients and teaching them, respectful of his patients, understanding,
mindful of his patient's dignity, and willing to give his patients enough
time to meet their needs.
2. It's
crucial to be able to communicate well with patients in a sympathetic manner.
If patients don't understand what you tell them and believe you have their
best interest at heart, they won't follow your advice.
3. I
have answered this question very clearly before. Please see previous interviews
available on the student page.
4. The
personal qualifications (qualities) to be a pediatrician are: A pediatrician
should be kind, caring, gentle, patient, honest and ethical, genuinely
concerned about helping people, love children, committed to educating and
helping his patients and their parents, dedicated to the well being of
his patients, intelligent, well educated, have good diagnostic skills.
Besides liking kids, a pediatrician better like parents since a good part of the pediatrician's job is providing support and education to parents in dealing with their kids. I don't hink a pediatrician has to dislike anything, but I would think a person committed to the well being of children would have a strong dislike for advocates of policies that are counter to the interests of children.
I don't think any particular learning style or working
style is required to be a pediatrician other than an honest commitment
to learning (it never stops) and caring for patients.
5. Junior
high and high school provide the fundamental building blocks of knowledge,
research skills, and study skills. You should learn it all well.
6. Pediatricians
will rely increasingly on new vaccinations to prevent infectious diseases
as efforts are made to reduce antibiotic use to avoid the problem of multiply
resistant organisms.
Health care delivery will continue to be affected by changes in funding either by insurance companies or by government intervention.
Rapid diagnostic tests based on monoclonal antibodies
will become available for a number of diseases. Genetic testing will become
more exact as technologies become available for treatment of genetic diseases.
New technologies are always becoming available. Recently, Dermabond, a
skin glue, became available for closing minor lacerations instead of using
sutures.
7. It's
crucial to speak the same language as your patients. Communication through
an interpreter is less effective since it eliminates the personal interaction
between patient and physician and makes it difficult for the physician
to appreciate the shadings of meaning conveyed by the patient's tone and
body language as he speaks.
Understanding the impact of a patient's culture
on his beliefs about health matters is also important. With knowledge about
a patients cultural beliefs, physicians can provide advice consistent with
the patient's beliefs so that the advice will be followed. In those instances
where the patients beliefs are detrimental to his health the physician
can anticipate the problem and try to find a solution. No matter how well
intentioned a physician's advice or actions, if they offend his patients,
they will not follow his advice and may seek care elsewhere.
8. Pediatricians
are in an excellent position to provide organized support for child issues.
On an organizational level the American Academy of Pediatrics acts as child
advocates in this country and around the world. For more information on
AAP child advocacy programs check http://www.aap.org/advocacy/advohome.htm.
Individual pediatricians can provide their expertise to setting up health programs in their community, giving talks to parents, and volunteering for community events where a pediatrician is needed.
I can't help but feeling that my Web site is an
example of providing help which makes my community (the world at large,
or at least on the net) a better place.
9. Math:
It's essential in research. In pediatric practice, the math is simple -
just calculations of medication dosages and fluids.
Science: The knowledge a physician has about diagnosing and treating patients is based on sciences of biology, chemistry, physiology. To be able to critically analyze new medical knowledge a physician must be able to understand the research behind it. Medicine is an art, but its foundation is science.
Social Studies: An understanding of world events can make you a better person and a more effective child advocate. It gives you a perspective on what's important. But their is no direct application of Social Studies to pediatrics.
Language Arts: We've already discussed this. Communication
with patients, and in the case of pediatrics, their parents, is an integral
part of the practice of pediatrics.
10.
I've answered questions about salary in previous interviews. I have no
knowledge regarding starting salaries or top salaries.
This answer can easily be reworded to answer your question about requirements. You would have found this and more information by reading other interviews with Dr. Warren. They can be found at the student page.
The personal attributes to be a pediatrician are: A pediatrician should be kind, caring, gentle, patient, honest and ethical, genuinely concerned about helping people, love children, committed to educating and helping his patients and their parents, dedicated to the well being of his patients, intelligent, well educated, have good diagnostic skills.
Besides liking kids, a pediatrician better like parents since a good part of the pediatrician's job is providing support and education to parents in dealing with their kids. I don't think a pediatrician has to dislike anything, but I would think a person committed to the well being of children would have a strong dislike for advocates of policies that are counter to the interests of children.
The more years you're in practice, the more experience you get, same as with any endeavor. The experience required to be a pediatrician is obtained during residency which is on the job training (that's a quote from another interview).
Relationship to health care?!? Pediatrics IS health care for kids. It's part of health care. Am I misunderstanding this question?
Most physicians who work for hospitals will get standard benefits such as health insurance, malpractice insurance, sick leave, vacations, CME (continuing medical education). I cannot give you details since I am self employed. The majority of physicians in the USA are self employed like me. They may take vacation, but the less they work, the less they earn. A self employed person purchases his own health insurance. Malpractice insurance is a business expense. Self employed physicians have the option of contributing to a retirement plan like any other self employed person. Usually, to have a retirement plan, a self employed person must also contribute to a retirement plan for his employees. What I'm saying, is the self employed have benefits, but they are also the ones who pay for the benefits.
There are lots of opportunities for pediatricians to be employed. Many go into private practice. Those physicians who are not self employed may work for HMOs, medical groups, the military, or hospitals. Some teach or do research. Depending on the organization of their departments they may rise through the ranks or be recruited by more prestigious institutions if their reputations become widely known because of noteworthy accomplishments or administrative skills. Physicians in private practice may also be recruited by institutions, or may choose to leave private practice for other employment. A pediatrician's education and skills provide him with a wide range of employment possibilities.
Being a pediatrician requires a lot of knowledge plus a variety of diagnostic and treatment skills and the intelligence to put this knowledge and these skills together appropriately. I would classify that as a high level of difficulty.
Medical terminology is to practicing medicine as your own language is to every day life. If you don't speak the language (medical terminology) it is difficult to learn new material by reading medical literature. Without medical terminology, it would be difficult to write a note in a chart that indicates what the patient's complaint and the doctor's findings were, and it would be close to impossible to convey this information to a colleague for the sake of consultation. Given how one uses language to think, if you don't know medical terminology, it's harder to think medically, and medical thinking is the whole basis of how a physician applies his intelligence to providing care.
Thank you for your cooperation
I like being a pediatrician because I like taking care of kids, but I think the teacher wants to know why YOU want to be a pediatrician.
There are certainly higher paying jobs than pediatrician, even as a physician, but pediatricians certainly earn a decent living, so, yes. It is financially beneficial to work as a pediatrician.
There are lots of opportunities for pediatricians to be employed and advance in their careers. Those physicians who are not in private practice may work for HMOs, medical groups, the military, or hospitals. Depending on the organization of their departments they may rise through the ranks to chief of their department or be recruited by more prestigious institutions if their reputations become widely known because of noteworthy accomplishments or administrative skills. Physicians in private practice build their practice based on their reputations. I suppose you could consider a growing practice career advancement. Physicians in private practice may also be recruited by institutions, hold other jobs in which they may advance while in private practice, or may choose to leave private practice for other employment. A pediatrician's education and skills provide him with a wide range of employment possibilities with potential for advancement.
1.
I work 48 to 60 hours a week not counting emergencies and calls answered
when I'm on call and the office is closed. I work between 5 and 7 days
a week. It depends on whether I'm off or on call for the weekend.
2.
I enjoy spending time on my computer. If not I wouldn't have had a Web
site for you to visit. I don't watch much TV, but I try to watch a few
of my favorite dramas, including ER. I always found time for my kids when
they were home. My wife and I try to get out to a movie once in a while.
I'm dedicated to providing good care for my patients, but I have a partner
I share call with. My practice isn't my life.
3.
I worry very much about making a mistake. It doesn't make me nervous, because
I know what I'm doing and I'm diligent about what I do. It just keeps me
on my toes. I double check everything and try to keep good records.
4.
College was great. It was among the best 4 years of my life. You have to
become organized in order to get your work done. I worked very hard, but
I found plenty of time for fun. Medical school was a chore at first. It
wasn't intellectually stimulating. It was just a lot of stuff to cram into
your brain. Later on it became more interesting. The students formed study
teams to work together on learning the material. Nobody tells you how much
to study. When you're grown up, you have to decide for yourself. Nobody
can study all the time, so we made time for study breaks. I got married
at the end of my first year of medical school. My wife was very understanding
when I had to study, and we did things together when I took a break.
5.
Internship was exhausting. So was residency. We got more than 12 hours
of sleep a week, but when we were on call at night, if it was very busy,
we didn't get any sleep at all and still had to work the next day. That
meant 36 hours without sleep. We were on call every third night. That kind
of schedule isn't legal anymore. Now, after a night on call interns and
residents have to take a day off.
Once, after a busy night on call when I was an intern,
I was at a conference. We were all sitting around a big wooden table. Suddenly,
there was a loud thump. The speaker stopped speaking and the room became
silent. I picked up my head to look around and see what had happened, and
I realized that I had fallen asleep. When I fell asleep I fell over and
my head landed on the table with a loud thump.
6.
Bursting arteries are a rarity in pediatrics, but there is some blood.
I suture lacerations in my office, and I have to give shots. If you work
in an emergency room seeing trauma patients, even though there aren't a
lot of bursting arteries, there's plenty of blood and gore.
7.
Getting into medical school is very competitive. Even though you will need
a firm background in science, your ability to work with patients demands
good communication skills, so your humanities and language courses are
just as important. Your best bet is to take a full 4 years of all your
major subjects (Science, Math, English, Language, Social Studies [civics,
history, economics]) at the most advanced level you can.
8.
Depends what you mean by a payoff. I enjoy what I do. I'm proud of my work
and feel that I'm a valuable member of society. My work is rewarding, but
there have been a lot of changes in the practice and regulation of medicine
which are frustrating. You can read about that if you check some of my
other interviews.
I make a decent living, but I'm by no means wealthy. I
work very long hours and pay the price in fatigue and missed family events.
There are better ways to get rich, but they are not what I wanted to do
with my life. My dream was to be a pediatrician, and in the balance, I'm
living my dream, so I guess it paid off in the end.
If your questions haven't been answered here, perhaps you would like to
question?!?
