Diagnosis: Medical Professional

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Medical Professional: Pathogenesis, Clinical Features, and Diagnosis

Introduction – A medical professional is a condition which is the consequence of many years spent in the traditional education system. It is often followed by having a very narrow skill-set in which one can earn a living. To earn this income the person has to jump through many hoops and their career is micromanaged to death.

Pathology and Sites of Involvement

Gross inspection – Clinical signs are fairly obvious, marked by an aura of superiority, high spending pattern, a cycle of debt accumulation, divorces, depression, substance abuse, and and unhealthy lifestyle.

Anatomic Sites – Fortunately, this disease mostly afflicts the frontal cortex of diseased individuals. Some will have hippocampal involvement but that often happens if the disease goes undetected for more than 10 years. This author believes that the average diagnosis is made within the first 7 years of these individuals becoming attendings.

In the female population the authors also observe flattening of the forehead, the inability to smile properly, fuller lips, and an unusually elevated nipple-line.

Though the disease rapidly spreads to the patient’s bank account, this process is often partially remedied when they desperately scramble financially in their 50’s.

Epidemiology and Risk Factors

Men and women are equally affected. Though the disease appears to be more advanced in immigrant physicians and those who live in countries such as the US, Canada, Australia, and UK.

In the US there are less than 1,000,000 individuals who hold an active medical license. This author is too lazy to figure out how many dentists, PA’s, NP’s, and pharmacists are also afflicted. Though, on gross inspection, it appears to be a less severe presentation in this subgroup.

Most recent studies show that 89% of all physicians are symptomatic and 99% are carriers of the heterozygous gene which was identified as BRKE_AS_FK.

The variable phenotype of this gene is augmented if the diseased individual has a shitty marriage, a poor social network, and delusions of grandeur.

Risk Factors

The biggest risk factor to becoming a medical professional is having a high income. The authors realize that this might sound circular since it comes with the profession but it’s important to point out that a high income isn’t forced on the medical professional patient.

Other risk factors include a high maintenance partner or parents who are selfish and just want their medical professional offspring to be rich in order to brag to others.

Having struggled through medical school or not having particular liked residency is a large risk factor as well which often leads to trying to outspend one’s unhappiness with the eventual profession.

Lack of hobbies or lack of a second income source is also a risk factor. We believe this leads to feeling vulnerable. The lack of feeling secure is a risk factor for becoming a fragile medical professional.

Factors associated with decreased risk are:

• enjoying your morning routine
• having supportive and caring friends
• placing less emphasis on what money can buy
• having multiple hobbies and interests.

Not being willing to be someone else’s bitch seems to be fairly protective as well.

Pathogenesis

A medical professional results from multiple compounding factors which generally culminate some time in the 2nd-3rd year of being an attending.

We believe it’s caused by a prolonged delayed gratification, along with a seemingly endless supply of income. This income soon caps out and the individual realizes their new financial equilibrium.

Upon realizing that the most they will ever earn is somewhere in the $500k-range, the income thermostat resets and the afflicted individual starts looking enviably to their neighbors on pill hill who are earning $2-5 million a year with a half-college degree.

We believe this is when the first neurochemical changes start taking place in the frontal cortex. Bitterness begins to set in.

By the 5th year the shitty nature of the profession becomes glaringly obvious. All that knowledge regarding the balance of chloride and sodium in the distal tubules gets thrown out the door when the patient insists on antibiotics “or else they will leave you a bad review” or “report you to your supervisor”.

Population Health

We would be remiss to point out that financially independent medical professionals are detrimental to society. Much of the income and revenue generated in our societies comes from healthcare which is, at its core, managed by medical professionals.

If physicians decided to cut back on undesirable work, retire early, or only practice the kind of medicine they deem fit, we would no longer seen the billions of dollars which healthcare earns executives, politicians, lobby groups, and insurance companies.

The authors, first and foremost, believe that the herd should come before the its individual members. As such, we find that suffering medical professionals by way of slavery to the profession, is ideal for society.

Furthermore, the more medical professionals are willing to suffer and the more money they end up spending, the easier it will become for the other select few to escape the rat race. With fewer full-time medical professionals, the labor will be remunerated at higher rates and those working per diem will be at even greater demand.

Clinical Manifestations

Patient Presentation – The medical professional can be hard to diagnose because most of these ill individuals live on pill hill, drive the same German or electric automobiles, have the same 3,000 sqft+ homes, and socialize with other medical professionals.

We believe this disease-masking is somewhat intentional and allows the medical professional to justify the suffering brought on by their chosen actions.

Diurnal pattern – Invariably, medical professionals get way too little sleep. This is believed to be due to trying to accomplish too much with their days. However, another theory is that they avoid going to bed because they want to extend their freedom before bedtime, as much as possible.

Others experience so much anxiety before going to work the next day that they can’t fall asleep until they are fully exhausted from sleep deprivation.

The cycle of pre-bedtime anxiety and morning dread is fairly routine. The weekends are often filled with doing way too much, trying to make up for working full-time during the week.

Male Presentation – The male individuals seem to be harder hit by this disease than females. It’s believed to be due to co-infection with workaholism, alcoholism, and the realization that men have a shorter lifespan and a higher risk of heart disease earlier in life.

Male medical professionals also have to contend with female patients and coworkers. Since the medical boards and society, as a whole, believes all men to be sexual deviants, it’s a constant battle proving that you’re not trying to sneak a peek at the hairy, saggy, shriveled genitalia of the opposite sex.

Men will often display symptoms of being curt, dismissive, and can’t be bothered with simple day-to-day affairs. Waiting in line can cause a boiling-over state and someone driving slow in front of them might as well be jamming a pencil into the medical professional’s eyes.

During their road cycling routines, they will have a shitfit if someone is casually biking on their fixie in the bike lane. It’s believed that the medical professionals are running some sort of a race in their heads – wondering, what could possess the half-breed in front of them to think themselves worthy to share the bike path with this medical professional and bike slowly on top of that.

In their mind, the male medical professional is envisioning ways of sabotaging this individual should they ever see them in their practice – maybe by losing a guidewire in them or inadequately anesthetizing them before hemorrhoid banding.

Female Presentation – Women have their own battles once afflicted with being a medical professional. Their responsibilities as mothers aren’t factored into their workload – it’s simply an expectation on top of their full-time work.

Should they decide to take time off of work to mother their offspring, they will have to contend with trying to get back onto their career track. Though, perplexingly, they won’t refrain from complaining when a female coworker is out on maternity leave.

Female medical professionals are also of the belief that medicine is a male dominated field even though the primary care clinics are filled with female nurses, and an equal number of male and female medical professionals. This confused observation, we believe, may add to their symptomatic presentation.

Sexual harassment is considered to be a big problem for female medical professionals, confirmed by numerous studies. And because it’s believed to be “part of the profession”, a reluctant acceptance of this issue drastically expedites the severity of the disease state of a female medical professional.

Symptoms –  In a recent case-control study of 6,120 medical professionals, 73% reported feeling burnt out, exhausted, fatigued, and unchallenged by the clinical work. A cohort study of 700 medical professionals identified the following:

• lack of interest in home-life
• the desire to spend more money to feel alive and experience desire
• gastrointestinal symptoms such as diarrhea and nausea when hearing the word ‘fibromyalgia’
• urticaria when working with mentally challenged union nurses
• vaginal pruritis when encountering a medical director who got the job because their tongue reached the furthest up someone’s gluteal cleft
• murderous rages at the sign of an EHR upgrade

Signs – Other double-blind, randomized, controlled, uh…, systematic reviews, and meta analyses, showed that 69% of those medical professionals with at least 5 years of attending years under their belt demonstrated the following signs:

• having way too much fucking debt
• owning stupidly big homes in way too nice of a neighborhood
• claiming that they work a 40-hour week when in fact they work closer to 60
• excess flatulence during their OR days
• more time spent trading stocks than analyzing MRI films in the reading room
• an out-of-control Netflix watch-list
• offspring raised by grandparents, nannies, and shitty schools
• addiction to porn, coffee, weed, alcohol, gambling, debt, and spending
• a complete and utter surrender of the possibility of ever enjoying their work
• displaying way more fear of a lawyer than concern for a patient

Physical Exam – Few medical professionals allow themselves to be subjected to a physical exam, therefore the data is sparse. The small number of medical professionals which we roofied and examined, displayed characteristics reminiscent of World War veterans.

Central obesity and muscle wasting was the most commonly observed of these physical exam findings. Unkempt pubic hair came in at #2.

Excess ear canal cerumen, sunken eyes, and thunder thighs were also observed in the majority of the medical professional we examined.

Post-mortem analysis was quite revealing. Those who died rather young – either due to suicide, heart attacks, or cancer – had way more debt than savings. They owned a lot of shit. Usually more than 1 home. Multiple vehicles. Tons of gadgets and a lot of other personal possessions which didn’t fit in their graves.

Postmortem on those who died at an older age, revealed that these individuals had millions and millions of dollars in their retirement accounts. The author concludes that medical professionals scramble to save and invest wisely sometime in their early to mid-50’s and, out of fear and panic, end up accumulating way more money than they can ever spend.

Psychological Analysis – A study of 850 primary care doctors identified the whiniest group of all medical professionals across various studies. By comparison, a study of 275 specialists, identified slightly less whiny but more financially stressed out individuals.

Thoughts of suicide were highest among residents and highest in specialty medical professionals. Within a decade after residency, most medical professionals had replaced most of their suicidal thoughts with Johnny Walker.

Laboratory – Blood tests on medical professionals revealed very high levels of blood cortisol levels, high insulin levels, and spikes of serum glucose. Also, we noted, low testosterone in men and high estrogen in women.

It seems that elevated cholesterol levels correlate well with the disease stage. We weren’t able to identify other lab values as staging indicators which we believe is due to the numerous medications medical professional take, masking such values.

Lab testing of the medical professional’s finances revealed an interesting ratio of debt to income which is pathognomonic for a medical professional. The value we’ve identified is 3.3 mmol/L, which tends to hold fairly steady well until their late 40’s.

Comparing medical professionals to a happy control group, we have found that the control group, on average, has a debt/income ratio of 0.009 mmol/L.

Money spent on a vacation and money spent on a home were incredibly sensitive diagnostic tools to diagnose medical professionals. In our study we found that the average medical professional purchased a home 3 standards of deviation above the mean.

Vacation spending was further helpful for staging and grading of the medical professional. The more disseminated and terminal the disease, the more likely that the medical professional will have spent in the 5-digit range on their last vacation. A single such expense annually was fairly diagnostic that this medical professional was a primary care physician and multiple such expenses annually was diagnostic for a specialist medical professional.

We replaced vacation spending with purse and shoes expenses for single male and female physicians, respectively.

Imaging – Perhaps one of the best ways to diagnose a medical professional is through imaging. The images we reviewed displayed multiple luxury automobiles, nice watches, designer shoes, massive homes, expensive attire, plastic surgery, and incredible vacation shots.

This, of course, was quite a sharp contrast when we compared it to the psychological state of these medical professionals who appeared everything short of end-stage miserable.

Staging a medical professional through imaging seems to be the most effective clinical strategy. While in other diseases we have seen penis-size correlating well with the brand of luxury automobiles, in medical professionals their specialty designation seems to directly related to this particular imaging result.

It’s fairly easy to diagnose a medical professional and we believe have found the Tesla Imaging Method (TIM) to be 98% sensitive. Porsches and German cars, with models starting with the letter M, seemed to be diagnostic as well in a certain racial subset of medical professionals.

The number of vehicles in a household and the ratio of rooms to individuals living in a home were also quite helpful diagnostic and staging criteria for medical professionals.

Diagnostic Evaluation

The diagnostic evaluation is guided by the patient presentation, symptoms, and physical examination findings.

Diagnosis – This author disagrees that the medical professional can be diagnosed based on their medical license alone. We have found case studies of those who had a medical licence and managed to live happy, productive lives without overextending themselves financially; some, even, without using their medical licenses. Their high income allowed them to achieve financial independence early which allowed them to practice the kind of medicine most appealing to them.

Role of Presumptive Diagnosis – Based on our current research, however, and the high correlation of the MD/DO designation and a miserable fucking lifestyle, we suggest that the treating clinician have a very high suspicion of these licensed individuals.

With the presence of a medical license the treating clinician should develop a presumptive diagnosis of the patient being a medical professional and ending up in the shoes of many other miserable medical professionals.

Intervention should be initiated immediately by telling the patient about all the bullshit which they haven’t even encountered yet as medical professionals, such as, medical board investigations, lawsuits, sexual harassment complaints by patients and staff, falling ill, job loss, market crashes, burnout, substance addiction, divorce, death of loved ones, and sabotage by shady employers.

Staging of Disease – We have concluded that the best way to stage the disease is by taking into account the specialty of the medical professional, their debt/income ratio, and how many years they are out of residency.

Other factors to take into account are any family history or personal history of mood disorders or substance abuse. Medical problems such as hypertension, diabetes, or high cholesterol should factor into this staging as well.

Stage I – Minimal disease. Likely still in residency. Early signs of burnout. Incorrect notion that their $50k residency salary was/is ‘way too little’.

Stage II – Resetting of their financial thermostat has taken place. The medical professional is an attending and has already bought a new car, is eying or has already bought a home well above the median US home prices.

Stage III – Complaining about their life all the time. Bitter, miserable, unhappy, and overwhelmed. Still loves the practice of medicine but disillusioned because they thought they would be doing so much more good for patients; slowly giving up on that idea. Blaming pretty much everyone but their spending habits.

Stage IV – Already one divorce under their belt. So far in debt that the idea of getting out of debt is not even on their radar. 3+ chronic medical conditions (hypertension, joint pain, obesity, high cholesterol, dyspareunia, ED, GERD, seborrheic dermatitis). They stare at the local barista while in line and fantasize how awesome it would be to have her job.

Stage V – Severe disease. Thinks about suicide all the time and has a pretty good plan in place. Or stopped giving a fuck a while ago. Feels hopeless. Stopped blaming others but is too exhausted to take action. Their misery is contagious which has left them with very few individuals around them.

Remission – Remission is paramount to successful treatment. A few medical professionals will see the light and recognize that their high hourly income allows them to work as little as they want. They will have downsized massively and are enjoying their lifestyle. However, this disease isn’t curable and thus they are always at risk of relapse whether through debt, a bad event, a lawsuit, or some related bullshit.

We aren’t sure of the utility of the classification system since it appears that any medical professional who starts out at stage I is pretty much destined to hit stage III+. However, recognizing stage II-III can help the treating clinician prevent further decline and hopefully create a state of remission.

Differential Diagnosis

Narcissists tend to gravitate towards professional roles, therefore it’s possible to see more narcissists in medicine – though the percentage is quite small. These medical professionals tend to give medicine a bad name and set the tone for living lavishly.

Medical professionals can sometimes be confused for filthy rich individuals – those who were born with millions of dollars in their trust funds or those who worked their fucking ass off to accumulate millions of dollars and 100’s of skills. We believe this might be an innate mimicry phenomenon which is really fucking stupid unless the patient believes that it’s impossible to ever burn out.

Natural History – The author wants to point out that most physicians went into medicine to practice medicine. Period. Something about treating and healing attracted these individuals and though some have developed egos around their profession, most still have huge cardiac chambers and get emotional priapism when they are helping patients.

We believe that physicians drink the Kool Aid and either believe that they need to work the same 40-hour weeks as other mortals or feel a pressure to optimize their income because it’s the ‘merican thing to do. Others might work a ton because it has become a habit from undergraduate years, medical school, and finally, residency.

Many don’t realize how important financial literacy is. And they don’t think it’s possible that they will ever tire of their profession or burn out or that anything bad could happen. After all the sacrifices they’ve made to be a doctor, they can’t fathom that anyone would try to take that away from them (looking at you, medical board and sue-happy patients).

Treatment

Surgical Methods – The most drastic intervention in medicine is always surgery and we have demonstrated that this technique can be effective for some patients. Our technique, drastic downsizing, is quite effective though it’s hard finding medical professionals who are willing to undergo the procedure.

Our IRB wouldn’t allow us to force these medical professionals into forced poverty even though the authors firmly believe that they would have incredible results.

Oral Medications – There are a few non-prescription, over the counter remedies which are readily available to medical professionals in order to heal them. However, these are often found in boring financial books which have unbearable and common side effects of boredom, nausea, fatigue, and headaches.

A few great blogs, like Early Retirement Extreme, and some great podcasts, such as Radical Personal Finance, are also available OTC, at no cost. Unfortunately, they can be a little dry and don’t have enough pretty pictures or wrestling kittens to generate patient interest.

Prescription medications are available in the form of a solid financial advisor. However, we have observed in our observational studies that patients would rather spend $250/month at the mall than spend that money on a financial advisor. Most medical professionals have a household spending of around $15,000 per month but find $250 to be a rip-off. A curious phenomenon, indeed.

Alternative Remedies – Acupuncture doesn’t seem as effective, though, acupunch to the face seems desperately necessary for some medical professionals in the later stages of this putrid disease.

The authors have performed animal studies (aka, members of the medical boards) and found that financial news and media, in general, is in fact, harmful to medical professionals.

Though we highly doubt such well-intentioned sources, such as the news media, would ever squeeze out misleading information, it seems that there is a direct correlation with unhappy medical professionals and their Yahoo Finance or CNBC consumption.

Financial Diet – Much like other lifestyle intervention, a financial diet is as effective as rewarding your fat child with Twinkies when he does his chores.

All studies show that if patients consume far less than they spend, if they avoid debt like it’s herpes, and if they focus their first few years on paying down their student loan debt, saving a healthy sum for retirement, and then cut their hours to a level that’s sustainable, instant remission is possible.

Dr. Deez Nutz, a prominent dietician out of Azerbaijan, has demonstrated that the following financial diet can achieve a 94% remission if done properly:

1. The patient will need to hire a financial advisor
2. They will need to educate themselves on their finances
3. Paying off debt should become priority #1
4. Downsizing the household budget should follow
5. All expensive habits should be replaced by free/cheap ones
6. Once financial independence is achieved, patient can do whatever they want with their money
7. To protect against relapse, don’t assume large debt and inflate spending very slowly
8. It’s recommended to check in with a fellow like-minded individuals along the way

Vaccination – With great excitement, we would like to report that the gene targeting vaccine WKE-TH-FK-UP, which is being developed by the UCCBLOG lab in Bangladesh, has shown amazing preliminary results.

The main problem is that it needs to be administered by the parents of individuals before they ever become medical professionals. The authors have noted that, unfortunately, because parents have their heads so far up the government’s asses, they leave education up to others.

Vaccination, in the form of education, is much easier said than done. This author, who shoots blanks and is thus barren, realizes that being a parent is hard as fuck. But, if you’re gonna play the game, then ya might wanna come prepared.

Prevention – All studies show that preventing a child from ever going into medicine is not the solution to preventing the formation of a medical professional. Plenty of other professionals end up developing overlapping symptoms as a medical professional.

Lawyers, engineers, dentists, executives, professional athletes, and even some entrepreneurs aren’t immune to acting like a medical professional.

Information for Patients

Your doctor wants you to understand that your diagnosis – a medical professional – isn’t curable but there are ways for you to achieve complete remission and experience minimal to no side effects.

The process starts with you recognizing and accepting that practicing medicine is a tough profession which is highly regulated and is riddled with landmines.

There is absolutely no reason for you to suffer as a medical professional. With the ability to earn a very high hourly income, and the fact that you can work part-time or per diem in your profession, it makes sense to cut back on your hours – a lot.

Your time on this earth, particularly the time you have which isn’t spoken for, is one of the most valuable things you’ll ever have. You should be able to spend it any way you wish.

To achieve a satisfactory lifestyle and not experience the common symptoms of being a medical professional, your doctor suggests that you do all of the following:

• sell the expensive home and rent the cheapest home you feel safe in
• attack student loan debt and get rid of all other debt
• max out retirement accounts and save and invest 70% of your income
• get a good financial advisor and actually listen to them and use them
• stop using your kids as an excuse as to why you spend so much
• get rid of your car
• recognize and protect against the risks of your profession
• buy damn near everything used
• hang out with people who make far less money than you do
• do things in life you genuinely enjoy doing and slowly cut back on work
• eventually build a secondary income source to be less reliant on medicine as a profession
• talk to other medical professionals who have gotten fucked by the system and ask yourself how you would handle it

If you experience any sudden outburst of laughter and joy after starting this routine, please feel free to go out with your friends to a bar and exercise your liver.

If your new-found freedom makes you want to scratch your head as to why the shit you ever were willing to slave your life away for someone else, feel free to share your experience with others.

If you find yourself still working full-time in medicine after you have achieved financial independence, don’t fear, this isn’t a relapse as long as you’re enthusiastic and happy and aren’t whining all the time. You have hit your jackpot.

If you become financially independent but suddenly find yourself with zero free time, don’t panic, you’re likely doing all the things you love doing and probably earning some money doing it. You’re doing what you always wanted to do.

Should you find all the above to be too much work or end up not wanting to see them through, don’t despair, there are a ton of medical groups which would love to have you see all their patients while they pay you a tiny cut of what they pocket in profits for their shareholders or executives.

Author Disclosures: This author despises how tightly regulated the practice of medicine is and has grown to dislike medicine quite a bit. He still loves the genuine practice of medicine but can’t seem to get the medical board and lawyers off his nutsack long enough to be able to engage in it. This author is heavily biased and believes that the majority of physicians need to flip their financial paradigms and become financially independent early so that they can practice the exact kind of medicine the want – which is the exact kind of medicine that patients need. 

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