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Information for people contemplating
a career in emergency medicine and
other medical specialties

By Kevin Pezzi, MD


The pros and cons of specializing in surgery

Russian doctor or medical student
I planned to include a picture of a surgeon to celebrate your entrance into the medical profession, but I instead decided to use a photo of a Russian doctor to remind us that no matter how bad we doctors have it here, our colleagues in some other nations put up with hassles we cannot imagine (ever wash and reuse a needle and syringe?) and are paid less than some unskilled laborers.

Q: I will be starting at Wayne State University School of Medicine this August. I have invested about 500 hours shadowing physicians in dozens of specialties (and primary care fields) in order to find a niche that will provide the best match for my personality and goals. Although I found several specialties I think I could enjoy, by far my favorite has been orthopedic surgery. This seems to combine the satisfaction of immediate impact (which you can no doubt appreciate as an ER doc) with reasonable monetary compensation. I would go on with my myriad reasons for favoring this particular match, but I understand you are a very busy man, unlikely to be interested in hearing me wax eloquent about my newly kindled romance with the knife. I was wondering though if you would mind sharing a bit of your wisdom on the merits (and demerits) of such a surgical subspecialty.

Answer by , MD:

The cons:

The pros:

Henry Ford and the secret of making boring things fun

While doubling worker pay to twice the industry average generally “lit a halo above Ford's head,” his generosity also triggered sharp criticism from people who said he was “a traitor to his class.” That is yet another illustration of how some people can find justification for criticizing almost anyone.

While Ford was far from perfect, he was a remarkably talented and fascinating man, as I discussed in a long blog posting about one of the most evil men in history (Adolf Hitler), whose wickedness overshadowed the one big thing he did right: take a bankrupt economy in total collapse and make it roar to life. Wouldn't you just love it if our leaders could do the same thing? Had they achieved even half of what Hitler did, we'd now be singing “happy days are here again.” BTW, my article is off the Richter scale in terms of intensity, so don't read it if you've recently eaten. That article is certain to anger people who are too close-minded to consider that the history we've been taught is hardly the full story, but others will likely revel in some of the amazing tidbits of history I present.

Ford correctly thought that paying his workers more would heighten their motivation to do better work, but more money was not the panacea for the noxiousness of repetitive factory work. Variety is the spice of life, and monotonous factory work doesn't inherently offer enough variety to provide the pleasure that humans voraciously seek. While it doesn't inherently offer that variety, there's a secret to making almost anything enjoyable. Had Ford and other automakers discovered that, they could have averted many of the problems that plagued (and ultimately contributed to the bankruptcy of) American automobile companies, such as absenteeism, drug and alcohol abuse, and an aversion to work that made many employees focus more on escapism than on devotion to doing a good job.

One of my beefs with teachers and professors is that they don't teach some essential life skills, such as how to make almost anything fun. During 12 years in school and often four or more years in college, there is surely an hour to spare that could give people the secrets to combating boredom, which will affect virtually everyone—if not at work, then likely in one's marriage. I discuss these secrets in my books and websites, but even though I am addicted to reading and have pored over a mountain of books, magazines, and articles, I've never seen another author discuss this topic.

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