Diverse Opportunities in Contemporary Medicine, 1969
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diverse opportunities in contemporary medicine martin m cummings md young people who conscientiously devote their talents and energies in their chosen field of work will find that ample opportunity awaits them but nowhere will they find opportunities so abundant and diversified as in medicine and its many allied health fields which together comprise the nations health services industry in 1950 the health services industry was the nations fifth largest employment field in i960 it ranked third behind agriculture and construction today it ranks second close behind construction by the end of this decade it may very well surpass both to become the nations top employment field there are four major reasons for the rapid continuing growth of the health field doubtless the most significant factors are the for presentation to bucknell premedical students february 17 1969

Page  2 2 enormous scientific and other advances which have been made in medicine and its allied fields during the 20th century these remarkable advances have thrust us into the golden age of medicine secondly there is a growing health-consciousness on the part of the american public people are more concerned about protecting their health and that of their families than ever before thirdly national prosperity and increased earning power are enabling the public to satisfy its desire to have more and better medical care a fourth reason is that the nations population is increasing at the rate of more than three million persons a year to put scientific and medical gains into wider application and to assure that all citizens receive ample health care more and more young men and women are needed in virtually all the health professions and related occupations

Page  3 3 in all there are at least 700 different career possibilities in the health professions and occupations no two are alike each involves different skills talents and interests each offers its own rewards challenges and personal satisfactions todays medical patients require highly specialized and carefully coordinated care by various members of the medical team whose efforts are directed by the physician take for example the fairly typical case of a coronary patient in earlier times his treatment largely consisted of putting him to bed at home the physician and the patients wife watched over him and with the help of neighbors tried to keep him in good spirits today the coronary patient is sent to a hospital where the latest and best new drugs electronic monitoring equipment and other facilities and care await him there men and women in many health professions and occupations under the guidance of

Page  4 4 the physician will aid in his care and if necessary in his rehabilitation they will include in addition to the attending physician and physician specialists different types of nurses members of the nutrition-dietetics staff laboratory x-ray and other technical personnel and depending upon the circumstances possibly a physical therapist occupational therapist medical social worker and rehabilitation counselor this intense specialization has brought americans the finest medical care in the world but the demand for the skilled highly trained personnel to provide the many required services is continuing to exceed the available supply of personnel leaders in medicine and allied professions estimate for example that the nation will need 268000 more professional nurses 125000 more practical nurses at least 50000 more physicians 40000

Page  5 5 more speech pathologists 38000 more medical technologists 30000 more dietitians and 18000 more medical social workers will also be needed within the next five to ten years they also estimate that we will need hundreds of thousands of auxiliary personnel in hospitals laboratories and other medical facilities during this same period those who choose to prepare themselves for these and other health career opportunities will share in the challenges confronting medicine in its never-ending effort to provide more and better health care and services for all and they will enjoy the many rewards including the immense personal satisfaction which comes from helping to make life better for others i hope you will not consider it immodest if i share my own experiences in medicine with you as an example of how many different professional opportunities come from a career in medicine in 25 years since my graduation from bucknell i have been able to do the following

Page  6 6 a treat the sick and disabled individual b perform research on problems of health and disease c teach a generation of medical students d perform as a scientist administrator in the largest and most sophisticated medical programs in the world va and phs e serve as director of the worlds largest and most modern research library and information center modern medicine is said to have begun with hippocrates because of his bold break with tradition and superstition he spoke out against mystical healing rites that had been practiced for generations his studies of hundreds of patients led him to maintain there was nothing magical about disease and that every disease could be explained he taught that each disease arose from a natural cause and that once started it developed in stages and followed a definite course

Page  7 7 hippocrates was the first physician to use a scientific approach to the study and treatment of disease he carefully followed the progress of different diseases in his patients recording the various stages and noting the effects of the treatment thus he not only established the signs and symptoms of many diseases but also made it possible for other physicians to predict the course of a disease and its possible outcome many of the descriptions of disease that he wrote more than two thousand years ago are still quite accurate hippocrates did much to establish the physician as a professional man and a man of science he contended that a physician is bound by a code of ethics and by the scientific laws of his calling a physician's prime objective he often said is to make the sick well doing this without any pretentious show societies problems nave changed considerably since the time of hippocrates the population of this country is also changing in its make-up the greatest amount of medical service is needed

Page  8 8 by children and by elderly people with the childhood diseases that plagued previous generations no longer a threat more and more children are surviving the first years of life the 7 respiratory and infectious diseases of the middle years are also on the decline as a result the number of children under fifteen will increase by almost twenty million by 1975 and the number of people over sixty-five by more than six million 3 the national standard of living has been improving steadily as has the educational level of the american people the higher the income the more likely a person will be to seek medical services he might otherwise feel he can do without the better educated he is the more likely that he will appreciate the need for medical attention americans are now getting more medical care than ever before and the demand for it is continuing to increase

Page  9 9 more and more people are subscribing to group health plans or are purchasing family health insurance policies to assure 9 themselves of medical services in times of need thus individuals who might not otherwise have sought help are now crowding doctors offices by 1975 health insurance plans are expected to cover many more thousands of families than they do now advances being made by medicine itself are also responsible for the need for physicians research has made it possible to save many lives and to conquer many diseases it has been estimated that nearly two million people are now alive because of advances made in the diagnosis and treatment of disease and many thousands of people once handicapped by chronic diseases such as arthritis and heart disease are living active and productive lives most of these people to continue their new lease on life must remain under a physicians care

Page  10 10 with the growing need for physicians more medical schools will have to be built and present schools will have to be enlarged this will create a need for more medical professors physicians who will make teaching their career thus adding to the opportunities in medicine as old problems are solved and new ones develop the need for basic and clinical research in medicine will increase some of this need will be met as it is now by medical school professors willing to spend part of their time in research however as the demand for answers to medical problems increases research will have to expand beyond medical schools and university medical centers voluntary and government health agencies and other institutions waging battle against disease are already making plans to underwrite full-time projects by career researchers

Page  11 teaching is very much a part of medicine from its earliest days the challenge of medicine was conveyed by one physician teaching another clinics seminars scientific meetings are in effect teaching sessions when the physician in private practice instructs his patient in carrying out the treatment he has prescribed he is teaching many physicians seek the stimulating and rewarding experience of teaching medical students if you are interested in teaching three possible opportunities await you you may teach and still continue your private practice by joining a medical school's part-time teaching staff your teaching will be confined to several hours a week spent instructing medical students at the bedsides of patients in the school hospital or delivering lectures in your specialty should you want more teaching duties and yet wish to retain a small private practice you may be assigned a clinical professorship if you are a very good physician then you would have your offices in the schoofs hospital see your private patients there but not be free to make many house calls

Page  12 12 the third possibility is an appointment as a full-time member of a medical school faculty you would devote your time to teaching and would with your students be responsible for the care of patients in the hospitals wards and clinics such an arrangement will provide you with considerable time to spend on research projects if you are interested in research and have no desire to be a practicing physician there will be no need for you to serve a prolonged clinical apprenticeship you will be able to seek a research position as soon as you receive your medical degree preferably you should have at least a year of internship there are many ways other than a full-time teaching position to devote yourself to research opportunities exist on the staffs of the national institutes of health and other government agencies private research institutes pharmaceutical companies and many commercial

Page  13 13 concerns and research laboratories affiliated with the medical field voluntary health agencies such as the arthritis and rheumatism foundation and the american heart association provide research grants for basic studies into the mysteries of the diseases that still plague mankind what are the financial opportunities in medicine in the choice of a career in our society earning a living is a consideration that cannot be overlooked as a physician you can be certain of one thing your medical degree will always assure you a means of livelihood it will not be a short cut to sudden wealth but it should in keeping with your abilities provide a very comfortable living for you and your family how tories affiliated with the medical field voluntary health agencies such as the arthritis and rheumatism foundation and the american heart association provide research grants for basic studies into the mysteries of the diseases that still plague mankind what are the financial opportunities in medicine in the choice of a career in our society earning a living is a consideration that cannot be overlooked as a physician you can be certain of one thing your medical degree will always assure you a means of livelihood it will not be a short cut to sudden wealth but it should in keeping with your abilities provide a very comfortable living for you and your family how do physicians compare financially to the rest of the population mortories affiliated with the medical field voluntary health agencies such as the arthritis and rheumatism foundation and the american heart association provide research grants for basic studies into the mysteries of the diseases that still plague mankind what are the financial opportunities in medicine in the choice of a career in our society earning a living is a consideration that cannot be overlooked as a physician you can be certain of one thing your medical degree will always assure you a means of livelihood it will not be a short cut to sudden wealth but it should in keeping with your abilities provide a very comfortable living for you and your family how do physicians compare financially to the rest of the population more than 75 per cent of all active physicians are self-employed only 10 per cent of the general population is self-employed about 85 per cent of all physicians own their own homes as compared to 60 per cent of the general population the

Page  14 14 average physicians home is worth about 35000 the average private home about 11000 sixty per cent of all physicians own two or more cars as compared to 13 per cent of the rest of the population your rewards in medicine will be many you will know the deep emotional fulfillment of lessening pain and suffering and of restoring the sick and the injured to health you will experience the satisfaction of bringing a new life into the world and of easing the passing of an old one you will know the joys of the healer you will sense the inner thrill that comes with the knowledge that your diagnosis is correct you will experience a feeling of pride as you watch your patients follow your prescribed treatment to recovery you will understand what it means to be the unwavering source of comfort and strength to your patients and their families you will also

Page  15 15 come to know the grief and sorrow which attends death the misery of poverty and hunger and the frustrations of society generally the rewards of a medical career are the personal property of every dedicated and devoted physician to try to identify them all is almost impossible they are known only to the doctor and he is best qualified to reveal them every now and then an eminent physician is moved to write about his most enduring moments in a lifetime in medical practice dr i s ravdin former professor of surgery at the university of pennsylvania school of medicine in discussing his experience in medicine said there were many satisfactions that come from a good physician-patient relationship the thrill that comes to the physician who has played an important part in the recovery of a desperately ill patient cannot be easily described the inner satisfaction that results from such a circumstance is more rewarding than any words can convey and any financial gain that is received

Page  16 16 time sympathy and understanding must be lavishly dispensed but the reward is to be found in that personal bond which forms the greatest satisfaction of the practice of medicine in no other profession does one realize the same sense of achievement and the gratitude of your many patients will bring constant joy to perhaps a tired spirit a reward richer than all the gold you may accumulate the personal bond that develops between a physician and his patient often leads to fine and lasting friendships yet the unique elements of the physician-patient relationship are carefully maintained the flow of helpfulness always is in the direction of the patient and the physicians professional independence remains unchallenged as dr william bennett bean an iowa city internist put it a physician achieves nobility by being a companion to his patients

Page  17 17 but a companion who is a little taller a little stronger and a little wiser the practice of medicine after a long apprenticeship said dr bean puts one immediately into the position of respect and a chance to gain trust it shows independence of judgment and action it encourages the use of intellect if he achieves intellectual honesty the physician is beholden to no man no political group no industrial machine medicine is an ever growing and rapidly progressing profession that is continually nurturing new ideas new discoveries and new cures medicine will never bore you it will stimulate you there will be times when you will feel more like a detective than a physician as you search for elusive clues to a patients complaint and try to track down the hidden culprit that is the cause of the trouble but your reward will be great and it will be in the pleasure of having solved a complicated case or contributed to the

Page  18 18 improved health of your community through the application of preventive medicine public health or mental health im pleased to see bucknell retain its special interest in educating premedical students for this all of you should be grateful to professor kieft who has been recognized by the medical community as an unusual sponsor of their interests and those of the scientific community at large