Every once in a while in life, if you look carefully enough, you’ll regret paying attention as life smacks you right upside the head with a dose of reality. ‘Cause you know what, the world kinda sucks. Death and pain and sadness and corruption and despair.
In my free time as a fourth year I have been reading and paying attention to the world and politics and realized once again, and on a deeper level than ever, that things suck. And I feel sad, and cynical, and guilty for being cynical before my career even starts.
Let’s look at medicine, plagued with so many problems. On the federal level, it is fighting for its life to have evidence-based regulation, or vaccines, or to not go back decades in progress we’ve made. What about insurance companies, who control how physicians practice and bog them down intentionally with appeals to not take care of people while profiting off of them. Private equity is making for-profit corporate medicine the new standard and turning doctors into commodities and patients into customers. The term Provider is not inclusive; it’s meant to make us a dispensary. At the local level, our Phoenix city council is making it illegal to provide healthcare or feed people in public parks, intentionally targeted at the most vulnerable people—the unhoused.
Personal to us at this point in our careers is academic medicine, which historically has focused on profit and not net patient outcomes, and to this day hasn’t truly changed.
And for the quality of people in medicine? The older generation can be stereotyped as mean or money-driven, but the new ones? Inappropriate nepotism, donations-based acceptances, and lies on medical schools applications are all present problems that exist. Do you think these people are going to become Patch Adams? Our profession itself is full of dirt, so how can we ever be expected to fight against the mud being flung at us from the outside?
Then I picked up The Social Transformation of American Medicine and realized the history of doctors sucks. The AMA has been straight-up malicious and pushed against better American health to make money, in the guise of patient interests. Also, I have been reading on AI in medicine and although it has many good things to offer, the negatives are quite concerning. Yet some who push for more AI seem to forget the humanistic aspect of medicine, the attraction of AI blinding them to valid concerns of what happens when we lose connection to others. Not to mention the legitimate dangers AI can pose. Oh, and have you seen what is happening in Oregon? Look up “PeaceHealth Emergency Medicine Controversy Oregon” and read about how the system is actually so screwed if we keep this up.
Basically, I find my optimism for medicine and my feelings about the field I’m in to be waning. And I haven’t started yet. During our first month in school, one of the faculty described medicine as a “noble profession.” Maybe in the 1700s when being a doctor wasn’t popular, or money-making. But not today. From the system to the individual, medicine is so grossly flawed that to call it noble ignores all the wrongs it has and will cause. Maybe some day it will be noble, but boy do we have work to do.
I understand this is a long list of grievances, but there is a lot wrong to deal with, and there is seemingly no answer to it all. I just wanted to vent because I finally had the last little bits of the wool pulled back from my eyes recently and hated what I saw. Or maybe the extra time in year four allowed me to really sit with what I’ve already seen and know. Frankly, I feel guilty for feeling this way, because seasoned attendings have dealt with this for a long time and are burnt out from it, so who am I to feel this way?
Don’t worry, I’m not giving up, either because I care, am too stubborn to quit, or a combo of both. But I just have been really sad lately, and I thought I’d share that. Collectively we are often afraid to open our mouths about sensitive topics, or fear, or shame, leaving us thinking nobody else feels our way, but I’m gonna bet at least one other person does. So if you feel a little disillusioned with medicine, whether you’ve been fighting for four years or forty, you’re not alone.
I hope you have a good day, thanks for reading.
Travis Seideman
Travis Seideman is a member of the Class of 2026 at UACOM-P. He attended Northern Arizona University where he studied Exercise Science and Psychology. He is pursuing Family Medicine and is passionate about increasing primary care access in Arizona, especially for underserved areas.