Live like a student now, or live like a student forever.

Here’s a puzzle for the bold and the clever

If a dollar’s a lot like a lever

You can be foolish or prudent

To live like a student

For now, or even forever.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I went back to adventures in temporary positions until they have an Electronic Medical Record (EMR) system I can get along with. A winter in Nome, Alaska, assignments in rural Iowa, a summer with a bike tour in Michigan, and Urgent Care in suburban Pennsylvania stretched into the fall. Since last winter I’ve worked in Alaska and western Nebraska, and taken time to deal with my wife’s (benign) brain tumor.  After a moose hunt in Canada, I am back on the job in western Iowa.  Any identifiable patient information has been included with permission.

I didn’t get into this business for the money, and I have a strong aversion to debt. I stayed hungry in medical school till I got a National Health Service Corps scholarship: the Feds paid for my tuition and books and sent me a monthly stipend which paid rent and groceries, but not enough for a car.  In return, I promised to work at a designated Medically Underserved Area, a year for a year.  As I had all along intended to work in the Indian Health Service, I mistakenly didn’t view the contract as debt acquisition.  I savor the memory of my IHS days, but I would recommend that course now only with cautions.

Because debt is debt. Our daughter’s med school financial counselor advised her that she could “live like a student now, or live like a student forever.”

Lending institutions then and now approach medical students with loan offers. On a corporate basis, the payoff works well.  Students can borrow money against the future high earnings.  The lenders’ pitch goes something like “Hey, you’re going to make so much money in the future, why suffer through years of poverty?”

Those students who take the bait for 4 years can acquire debts that last for decades. Some get locked into suboptimal job situations.  And some keep borrowing, maintaining a high-dollar lifestyle but without building wealth.

A banker once told me a lot of doctors have a smaller net worth than their monthly Adjusted Gross Income.

Between keeping a simple lifestyle and Bethany’s wise management of our funds, I can afford now to work as much as I want, and keep visiting new places. For the next few weeks we’ll be in western Iowa.

We have a snug apartment attached to an ancillary service building, and we share kitchen and living room space with a medical and a pharmacy student. The building even carries a sign that says ”STUDENT HOUSING.” And living with students brings back memories of my early career.

I started today learning my 13th Electronic Medical Record system in 25 months.  All have major weaknesses, and this one promises a steeper learning curve than most.  I take no comfort in the fact that Corporate plans to replace it in less than a year.

The community turned out larger, more prosperous and energetic than we anticipated, and the hospital itself appears well-organized and well-run. The primary care area’s layout minimizes the time wastage inherent in larger medical operations.

And, for the time being, I don’t mind living like a student again.





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