I am a Doctor of Medicine who practices as a General Surgeon.  General Surgery is the oldest specialty field in surgery.  At one time, all surgery done in hospitals was done by a General Surgeon.  As medicine has gotten more complex, the fields of Orthopedics, Neurosurgery, Gynecology, Urology, etc., have developed.

How would you describe what you do?

I practice in a five surgeon group in a rural area that has a 225 bed hospital   We are a private, fee-for-service group,  and not owned by a hospital.

Quick Facts!
How much do general surgeons make? The average pay is between $200,000 and $400,000. To see how much this doctor makes Click Here.

How to become a general surgeon? You’ll need to finish high school, medical school, and 4 years of residency to become a general surgeon. You can also specialize for 2 years. See how this doctor became a general surgeon Click Here and Here.

My practice is not typical of most General Surgeons, since the majority of surgeons live in big cities and sub-specialize.

What does your work entail ?

My practice, luckily, encompasses most areas of the original practice of General Surgery.  I enjoy the variety of cases I am able to handle.

I perform thyroid and parathyroid surgery, non-cardiac thoracic (chest) surgery( including infections and cancers), benign and malignant disease of the breast, abdominal surgery such as gallbladder, stomach, colon and and appendix cases, in addition to abdominal hernias.  I also do some gynecology surgery such as hysterectomies, although most of these cases are done in most hospitals by gynecologists.  My practice also involves vascular surgery, including abdominal aortic aneurysms.  I also treat skin and soft-tissue tumors, including melanomas.
In our hospital, my partners and I are also the trauma surgeons, taking care of victims of car accidents and other types of trauma.

I am in the office one and a half days a week, in surgery two-three days a week, performing 40-50 cases a month.  I usually get part of a day off each week.  Although I took call every other weekend earlier in my career, I now take call every fifth weekend.

How did you get started as a general surgeon?

In high school, I always enjoyed my science classes.  Our school had career days, and the physicians who would talk were always happy in their careers, and I started to look harder at this profession.

During college, an Ear, Nose, and Throat (ENT) surgeon in my home town took me into surgery to watch him work (probably can’t do this now days) and I was hooked.

I went through medical school, though, thinking I would be an Internal Medicine specialist, but during my internship several of the Surgery residents took an interest in me, and I switched to General Surgery.

What do you like about being a general surgeon?

I like the personal rewards that General Surgery gives me.  I enjoy taking a complex medical problem and figuring out what is wrong  or being able to take a sick patient to the operating room, working hard during the case, and, most of the time, having the patient recover and be better than they were before the surgery.  The majority of my patients appreciate the care they receive by me and my partners, and this in itself is very rewarding.

In my particular practice, I enjoy the variety of diseases I can care for and the cases I can perform.  I would be bonkers if I had to do the same thing every day, like a cataract surgeon (although they are at the bank and golf course hours before me!)

What do you dislike?

I dislike several things:  having to deal with insurance companies and Medicare, both of whom are constantly trying to cheapen my services and talents; getting up at night to take care of folks who are drunk or drugged and are in automobile accidents, hurting themselves or others ; taking care of people who have spent a lifetime not taking care of themselves, and having them expect miracles from my care.

How do you make money/or how are you compensated?

Since I live in a retirement area, about 60% of my income comes from Medicare (most Surgeon have 35-40% Medicare).  25% is private insurance, 5% Medicaid and a growing percentage, 5-10%, is no insurance.

We write off a significant amount of care, counting the discounts of Medicare and Medicaid, in addition to the charity care.  The IRS does not allow us any deduction for this free or discounted care.

How much money do you make as general surgeon?

I make approximately $325,000 a year.  No one knows what will happen to medical reimbursement with the new health care bill.

What education or skills are needed to be a general surgeon?

A budding Surgeon must be focused.  In college,  I recommend seeking counsel with your college’s pre-med advisor, who can steer you to the courses you will need to get in med school.  Good grades, not making stupid mistakes out of the classroom (yes, med schools usually do background checks) and hard work help get you into medical school.  General Surgery is a five year residency after medical school.  Yes, it is hard work (total of 25 years of school and training).  Yes, I enjoyed my training and yes, I would do it again!

What is most challenging about what you do?

Staying up with the ever changing science of surgery, and keeping focused on my patients when forces like the government and insurance companies try to do something that is not right.

What is most rewarding?

Realizing that something I am able to do with my brains or my hands is important in a patient’s life.  Occasionally it is life saving, but most of the time just personally rewarding.

What advice would you offer someone considering general surgery?

The work to get here is hard, and the number of General Surgeons in the U.S. is dropping each year.  Your talents will be very valuable to hospitals and patients in the future due to supply and demand of your profession.

How much time off do you get/take?

I go to one or two surgical meeting yearly, and take an additional 2-3 weeks off.  I live in a vacation area, and enjoy my time off locally, also.

What is a common misconception people have about what you do?

They think General Surgery is like general practice, and not a five -year surgical specialty.

What are your goals/dreams for the future?

I am working on some business ventures with my family.  I  enjoy traveling, and would like to use my surgical skills in other countries.

What else would you like people to know about what you do?

I think it is important for someone entering my profession to take time for their family and become involved in their community.  Both are important parts of a balanced life.

I treat sick animals and I put up with people.

How would you describe what you do?

In veterinary medicine you’ve got to do two things: you treat the animal, and then you’ve got to use psychology on the owner. Everyday I put up with people like that. And I make the joke that one end of the leash is easy to deal with. The other end of the leash is very difficult to deal with. If a person can’t deal with these individuals that are very demanding, that read the Internet too much, that think they know everything, if you can’t look past those people, and, bite your tongue at times, you won’t get very far.

Quick Facts!
How much do veterinarians make per year? According to payscale.com veterinarians make between $50,000 and $90,000 per year. To see what the veterinarian interviewed here makes Click Here.

How to become a veterinarian?You will need a high school education, a college degree typically in a field of animal studies or biology, and 4 years of veterinary school. To see how this veterinarian got his start and what he said about the requirements need to become a veterinarian Click Here and Here.

But, you know, we’re really treating people psychologically, and we’re treating the animal in their health needs; whether it’s cosmetic surgery or whether it’s sick animals’ treatment, routine health care, or disease prevention. It’s a broad spectrum of needs that the animals have. And then you add the mix of the people into it, and that’s what we do here everyday. Everyday. And some days, if the moon is full, we the wackos…You think I’m lying, but they come in that front door one after another. The ones that you just say, “Oh, God,” you know, “they’re coming in again?”

What does your work entail?

I come in at 7:30 and I begin treatment of sick animals, and I have my practice a lot different than others. I believe that the animal is in better care at home than it is sitting back here all night without anybody around it.

When you save an animal’s life or some little old lady comes in here and gives you a hug because you have saved her animal’s life. That’s what it’s all about. Some people don’t think it is. Some people think it’s money. The most rewarding thing to me is what I do for the animal.

So, all my sick animals come in between 8:00 and 9:00 in the morning, the ones I’m treating on a daily basis. I get through that, answer telephone calls, and then spend two hours doing surgery. Most are routine surgeries: spays and neuters and ear trims and tail docks, de-claws, whatever anybody wants done to their animals. And then you have your emergency surgeries…you’ve got things that are more of a medical need rather than the routine stuff.

And then after lunch, I spend from 1:00 until 5:00 doing routine health care for animals. That’s when I have my clinics. And I used to spend—when I did large animals—from 6:00 in the morning until 10:00 at night, full tilt. Now, I’m here about eight hours a day, and I try to put everything I can do into eight hours, and that’s Monday through Friday, with emergencies at night, and a few Saturdays from eight to twelve doing routine stuff. I try not to do any of my surgeries on weekends. And then Sunday, hopefully, you sit down and you don’t have anything to do.

How did you get started as veterinarian?

At some point I finally decided that was what I wanted to do for my life’s work. I knew it when I was fourteen or fifteen years old, but it’s something that takes many people a while to figure out. There’s some place along the way that the light finally comes on and says, “This is what I want to do.” It doesn’t always work out that way, but that’s what most people in veterinary medicine do.

What do you like about what you do?

I like the challenge of diagnostics. I like the satisfaction of saving an animal’s life. I like the things that we do to make animals live longer, live more productive lives, spaying and neutering, and all healthcare. Now our cats are living to seventeen or eighteen years of age, and our dogs are fifteen and sixteen, and when I started practice, if you had a fourteen-year old cat, it was old. And then once in a while, it’s rewarding when somebody comes up and thanks you for what you’ve done for (Fifi) or (Foofoo). If money was in it, I wouldn’t have done large animal. Because large animal[care] was rewarding; delivering calves and treating sick animals, and the fire engine calls were lots of fun, but there was no money in it. There never is any money.

The animal has very little ability to tell you where it hurts; whether they’re feeling better or whether you’re doing the right thing…Diagnosing sick animals is the most challenging part of it all…

Now, the equine specialists, they get lots of money. But it takes a person that can really bullshit to be an equine specialist. And it takes a certain person to be any kind of a specialist. You’ve got to kind of bullshit your way through it.

What do you dislike?

Probably the biggest thing I dislike about it is having to put up with the general public. I don’t mind the hours working. Some people do, not me. But, people griping, complaining about a bill or, you know, it just kind of…you can be having a great day, and somebody come in and complain about their bill, and it just ruins your whole day. That’s the thing that I hate about it. I really do.

How do you make money/or how are you compensated?

Disease prevention, vaccinations, routine healthcare is probably where most of the income is generated. Surgery can be a source of income. The sale of healthcare products: flea products, heartworm preventions, even prescription dog foods is another source of income. Probably the thing that you get least for your time is in diagnostic and treating sick animals, as far as your percentage of time you spend with an animal, compared to what you do with the routine things: the vaccinations and healthcare…But, those are your areas where you make money.

How much money do you make as a veterinarian?

When I was doing large animal; obstetrics, delivering calves, doing that was the most exciting part of the practice. Because every one was different. The exciting part of what I enjoy doing more than anything in this practice is surgery, whether it’s general surgery or whether it’s emergency. I enjoy it because it’s just me and the dog in there, and one other person. I think it’s probably the most rewarding part of this thing is the surgery that you do: the saving the lives, the making lives better. I just enjoy the hell out of surgery.

What education or skills are needed to do be a veterinarian?

Well, of course, you have to have four years of college. With the right classes, the right grade point average, having an advisor that gets you down the right path, being in a state that has a veterinary school has a lot of advantages. This state does not have a veterinary school, so they have to rely on contracts with other surrounding states to take so many veterinarians a year. Some people even if they don’t get into a veterinary school on their first application, they have to continue on with maybe a masters in some field, or just continue on with some more education. And then there is four years of veterinary school. There is no internship unless you want to specialize in something, and go and have an internship with a qualified veterinarian that is a specialist in his field. And that’s it on education. That’s it. You know, really, if you get in and go out and practice, it takes eight years.

A person should like sciences, they should like math, they should like to work hard, have as high a grade point average as you can have, and most of them have to work for a veterinarian, either during summer during their four years before they get into school. You have to have some degree of intelligence. You have to apply yourself and be able to make a four point grade average or as high as you can get to a four point average. Sciences and math are so important, you have to have a desire and ability…And some people just can’t get science. Some people can’t get math. And you’ve got to have skills in both of those areas in order to make your way in college and toward the prerequisites that you have to have for veterinary school.

What is most challenging about what you do?

Diagnostics. The animal has very little ability to tell you where it hurts; whether they’re feeling better or whether you’re doing the right thing. You have to rely on the owner, you have to rely on the sixth sense. Diagnosing sick animals is the most challenging part of it all…Diagnosing and being able to have a working relationship with that animal to know whether it is doing better, and taking history from the fifteen to twenty minutes you spend with a person in there…I can’t have somebody come in with a sick dog, and drop it off and say, “Here, fix it.” Because I’ve got to have a whole lot more information than that. Diagnosing sick animals is probably the most difficult and challenging of all the things that we do.

What is most rewarding about being a veterinarian?

When you save an animal’s life. When you save an animal’s life or some little old lady comes in here and gives you a hug because you have saved her animal’s life. That’s what it’s all about. Some people don’t think it is. Some people think it’s money. The most rewarding thing to me is what I do for the animal.

What advice would you offer someone considering this career?

Be damn sure this is what you want to do. It’s a long ways through veterinary school. The first year is probably the most grueling part of the whole thing. The gross anatomy where you’ve got all these species of animals to learn about. You have to have dedication, and have patience, and you need to have a work ethic.

It ain’t an 8-5 job, there are many times you have to put in longer hours. I’d say that most veterinary students come away from school with about $150,000 in debt, and that takes a lot out of your income to start with. It’s a difficult road the first five years out of school. You just don’t come out of veterinary school and say, “Here I am. I’m a veterinarian,” you know, “…and you’re going to get this big salary, and life is going to be great. It’s not. The person needs to have patience, and want, and have a desire. There has to be that desire to be a veterinarian. Just because it looks like it might be monetarily rewarding, it won’t be for a while.

How much time off do you get/take?

Personally, all I take off is one week a year. And I’m not the normal. Most veterinarians today that go into a group practice, they will get probably a month off a year. I would say that’s going to be pretty well normal. But not for somebody that’s a single-man practice. You don’t get to take off a week here, a week there, you know. People get tired of you not being around and go someplace else, because it’s very easy for them to just go across the street or down the road. Here in this town we have seven or eight clinics.

What is a common misconception people have about what you do?

That we make lots of money. That is the most common misconception. We are probably the lowest paid of all the professionals. If you talk about lawyers and dentists and even chiropractors. You could even put chiropractors in there. You know, we’re probably one of the lowest paid professional group that there is. That’s the biggest misconception. That we are filthy rich, and we ain’t. We just…we’re just about like anybody that has a business. Just making it…

What are your goals/dreams for the future?

It’s to be able to slow down in five years and to work part-time. I don’t ever foresee completely retiring unless I am unable to perform. This has been my life work, so I’m not going to give it up that easily. I don’t want to give it up that easily.

What do you do for a living?

I’m a radiologist and I also sub-specialize in interventional radiology.

How would you describe what you do?

Radiology is using technology and a variety of imaging techniques to look at the human body and diagnose problems.

Quick Facts!
How much do radiologists make a year? According to payscale.com and others radiologist salary ranges from $50,000 to $200,000 per year. For more accurate information see how much this doctor actually makes Click Here.

How to become a radiologist? You’ll need to get your high school degree, graduate medical school, and go to residency. To see how this doctor became a radiologist Click Here and Here.

That includes: x-rays, fluoroscopy, which is kind of real time x-rays; CT scanning, which is using x-rays and computer reconstructions to look at the body; MRI scanning, which is using magnetic resonance, which includes radio frequency waves and a high-strength magnetic field to look at the human body; ultrasound, which uses high frequency sound waves to look at the body; Overlay and nuclear medicine, which involves injecting a very small amount of radioactive substance in a person tagged to a substance that will go to different parts of the body and show how they’re functioning.

We’re basically Doctors’ doctors because the patients don’t come to us. The doctors have a patient, and then they have a problem that they can’t solve without our help, and so they come to us whether it’s by ordering a test or consulting us with a problem that they need help figuring out…We’re problem solvers, and a lot of the time, whatever we see and say is going to determine the course of the patient’s therapy.

Then interventional radiology is a sub-specialty. In interventional radiology, we use imaging techniques and minimally invasive techniques to do a lot of things that used to require surgery, including treating arterial disease with balloons and stints, being able to drain different areas of the body including the bowel ducts, the kidneys, and fluid collections or abscesses, any place in the body, and then also using the imaging guidance to do biopsies of almost any place using a skinny needle. So, a lot of imaging allows us to do things more targeted than having to actually open somebody up.

What does your work entail as a radiologist?

We work from 7:30 in the morning till about 5:00 at night, and other radiologists work longer hours in some places, but that’s our normal work day. And then once a week I’ll be on call for general radiology, and I usually get a call about every 15 minutes. We have (T1) lines to our homes and teleradiology so we look at the images while at our homes many times while on call. The emergency rooms just keep us hopping because now they’re conditioned to use imaging for almost everything. And so, about every 15 minutes, we’re looking at another CT scan or some sort of examination. And then at one other time of the week I’m on the interventional call. That’s not as busy, but it can be…Sometimes, I can go for an evening and not get called, but if I do get called, it means that I’ve got to go into the hospital, do a procedure that could last anywhere from an hour to four hours. And then once a month I’m on call for the weekend; Friday, Saturday and Sunday.

How did you get started?

I was in television before. Then at twenty-nine I decided I wanted to go to medical school.  I went into medical school thinking that I would do something more standard as far as medicine, like internal medicine, or surgery, or obstetrics and gynecology. But as I went through, I realized, especially at the time I was there, that the technology was booming, and CTs had just come out, and MRIs were just coming out, and that there were all of these different types of interventions that could be performed using the imaging that saved lots of money, lots of time, lots of pain.

The consulting interaction with the physicians is very satisfying because we get to scratch our heads and think through things and talk to them. And they have information that I don’t have from doing their examinations, and knowing the patient, and I have information that they don’t have about what I can do and what I can see, that would help them. And so, it’s a collaborative process with other physicians that’s satisfying.

I could usually do the procedures as out-patients instead of a week-long hospital stay, and it was all fascinating to me. So, that’s what I chose to do as a residency and then wound up in private practice.

What do you like about what you do?

We interact with almost every different aspect of medicine. We work with pediatrics, obstetrics, surgery, internal medicine, all the sub-specialties, and so there’s a huge range of things that we participate in. It’s hard to get bored because it’s hard to keep up with everybody, they expect us to know more about them than their patients. We’re basically Doctors’ doctors because the patients don’t come to us. The doctors have a patient, and then they have a problem that they can’t solve without our help, and so they come to us whether it’s by ordering a test or consulting us with a problem that they need help figuring out an answer to, or help taking care of. We’re problem solvers, and a lot of the time, whatever we see and say is going to determine the course of the patient’s therapy. So, even though, you don’t get quite as much satisfaction from the patient contact and the patients being really grateful to you—a lot of times they don’t even know that you’re the one who figured out what was wrong with them—but you do get a lot of satisfaction in knowing that what you’re doing makes a big difference in the lives of all of these patients every day.

The interventional part of it, I do have patients. I take care of them. I have patient contact and interaction as their physician; doing procedures on them, and a lot of the procedures that I do allow me to help people in ways that if it wasn’t for us they would have had to have major surgeries for. And so that’s satisfying. The consulting interaction with the physicians is very satisfying because we get to scratch our heads and think through things and talk to them, and they have information that I don’t have from doing their examinations, and knowing the patient, and I have information that they don’t have about what I can do and what I can see, that would help them. And so, it’s a collaborative process with other physicians that’s satisfying.

What do you dislike?

Well, I think all physicians, and radiologists probably as much as anybody else, are unhappy about the way the control of medicine has been taken out of doctors’ hands in a lot of ways; by the government, by insurance companies, by hospitals. The amount of bureaucracy, the amount of paperwork, the number of obstacles that are placed in your way in actually just taking care of what we’re supposed to be taking care of, is real frustrating. And in this state, in particular, because of the way that the government has changed reimbursements, we have a much lower medicare reimbursement rate than most every place else in the country. I think Puerto Rico maybe is the same. But we’ve got a real low one, and most of the other reimbursement rates are keyed off of the medicare rate.

I don’t want this to sound like I’m complaining about how much money I make, because I’m very happy with what I do, but in order to continue a practice, you’re going to have to be able to recruit new physicians to the practice. And the problem for us, as well as the problem for other physicians in the state, is that somebody coming out of a training program looks at what the reimbursement rates are here compared to someplace else, and they have to really want to be here to make the sacrifice that they’re making financially to come here and stay here. I think we’re losing a huge number of physicians in this state to other places because of that, and I don’t see that turning around any time in the near future. So that’s disappointing to me, because we’ve always had a really good medical community here and the in the rest of the state—really high-quality physicians—and I fear that in the future, the standard is going to be lowered because the financial incentives are going elsewhere.

How do you make money/or how are you compensated?

We only make money when we’re doing something. We’re paid fee-for-service. We bill for what we do, and the insurance companies, the government, and/or the patients pay us for our services. We don’t own any of the equipment. Something that most people don’t realize is that there are two fees for radiology: one is a technical fee and one is the professional fee. The technical fee is paid to the facility or whoever owns the equipment that the procedures are performed on. The equipment is really expensive, and reimbursement rates for that is pretty high. Our portion of the total cost of an imaging procedure is usually between 5 and 10%, whereas the technical component is between 90 and 95%. We’ve chosen not to own imaging facilities for equipment because that puts a sort of a vested interest for us to do more procedures on that equipment, to earn more money off of it. And we felt like it was and, some people don’t have a problem with that, we just felt like it was a conflict, and it might make us make choices that were altered by financial concerns rather than patient concerns.

How much money do you make as a radiologist?

I’m going to have to guess here, but I would say that probably if you count the amount that we contribute to our pension plan and the amount that we are salaried and our bonus, and don’t count other things like insurance—health, malpractice, disability, and that sort of thing—I’m going to guess it would be right around $500,000 a year.

What education or skills are needed to be a radiologist?

Well, obviously, you have to go to medical school. You have to have a college degree to get there. So you need a four year college degree, four years in medical school, an internship, a four-year residency, and a one to two-year fellowship after that. As far as skills, they need to be a problem-solver. Some people are good at memorizing things. Some people are good at problem solving. Some people are good at both, not too many, but it’s not good enough just to know a lot. You have to be able to apply that, and in a lot of ways what we do is like extremely complex video games. I mean, we’re using images and we’re using all sorts of information to figure out the answers. And so two things that are really key are visual and spacial orientation, and analysis skills. If you are able to think three dimensionally based on two-dimensional objects—drawings, pictures—if you can think three dimensionally, you can turn things around in your mind, upside down, sideways, backwards, forwards, with limited amounts of information, then you probably have one of the major skills necessary. If you can’t do that, this may not be the field for you.

What is most challenging about what you do?

There’s really two. One is that if you’re highly trained at what you do, and something that I tell patients is “You don’t want your doctor to be excited, or surprised, or thrilled about what he’s doing with you. You want him to be a little bit bored with it.” Because you want him to know it so well that he’s seen it, and it’s second nature for him to be able to do it. And so you’re so highly trained at it that ninety-five percent of the time, you know the answers pretty quickly and pretty easily. So one of the challenges is when it’s not challenging, because you’ve done it over and over, and you know it so well is to still do it as intently and with as much perfectionism and professionalism as you would if it was the first time you had done it. And sometimes you’re under a lot of chronic fatigue, so one of the challenges is to do it just as well when you’re exhausted as you do when you are fresh in the morning.

What is most rewarding?

Well, it’s obviously financially rewarding, but I guess the major reward that most of us have is that we know that what we do makes a difference in people’s lives, and that if we weren’t there for them at the time that they needed us, that things wouldn’t go as well. We know we make a difference for doctors who are struggling with trying to help patients, we know we make a difference in the patients’ lives, we know we make a difference in our community. Even when things are hard, you feel good about what you’re doing, all of the frustrations are tolerable, because you feel like what you’re doing is worthwhile.

What advice would you offer someone considering this career?

Well, that would depend on what stage of life they’re in. If they’re in high school then I would say, “Find somebody who does this and then ask them if you could come visit and see what it’s really like,” and most radiologists are delighted to have people come by and spend a few hours with them and let them see what they’re doing and what it’s really like. Because some people might say, “This is something I would go nuts doing,” or, “Gosh, I’m fascinated with it, and I really would like to do this.”

If you’re in college and you want to do it, the big thing that you’re going to have to do is get into medical school, and that’s hard to do. You’ve got to get good grades and you’ve got to score well on the entrance examination. And so, the answer to that is, find out what it requires to get in and then figure out if you can do it, and then go for it. But that takes a lot of self- sacrifice to do that.

If you’ve made it into medical school already, you are not going to be encouraged to go into radiology, nor will you get a lot of exposure to radiology. And so, by the time you’re ready to make your decision about what sort of career you would like to pursue, you almost haven’t had very much information about radiology or enough to make the choice. And so, if you think that you’re interested in it—and when you’re in medical school, you’re going to have to be a little bit of a self starter and just go by the radiology department and meet the professors there, and tell them that you’re interested, and ask them to help you decide whether this is the right career for you—and get some exposure. Because in medical school, you do get exposure to primary care, surgery, obstetrics, pediatrics, and some of the other sub-specialties, but very few people get much exposure to radiology before it’s too late to choose it. I think radiology and orthopedic surgery are the two most difficult residencies to get. So the other side of that coin is that if you want to get into the radiology residency, you’re going to have to do well in medical school. And actually, that’s another sacrifice—to suck it up and…everybody that goes through medical school gets to be a doctor as long as they pass all the courses, but not everybody gets to do what they…anything they want to. You have to finish reasonably high in your class in order to be able to get to do radiology.

Two, count the costs. I was married and had a child, and then had another one when I was in medical school. And most people, when they enter into medical school at that stage of life and are married, do not get out of medical school with their marriages intact. So, count the costs. Understand that it’s going to be difficult. Understand that people who are there who are younger than you are going to have a little more energy than you, but that you’re going to be more disciplined than they are, and so that kind of balances things out. But one of the things that my wife and I did when she was completely on board with this decision, was that if, at any point in the process, our marriage was in trouble because of it, that our marriage took priority, and I would…I would bail on that and do something else. And so, I think if you have a marriage or a family and you do it, then you have to make some real priority choices in your life in order to survive it and get out on the other side.

Otherwise, doing it later in life gives you somewhat of an advantage because a lot of the people who come straight out of college are a little burned out, and they also may or may not be certain that that’s what they want to do. Whereas when I came, I was absolutely certain that that’s what I wanted to do, and I was excited to be there, and enjoyed—strangely enough, most people don’t enjoy that much of medical school—but I enjoyed most about it because I wanted to learn the things I was learning and I felt very privileged to be able to even be there. I remember looking up from a microscope one time in one of the classes, and looking around and just saying, “I can’t even believe I’m here. I’m grateful for this.”

How much time off do you get/take?

Well, this year I might not get any. Typically, radiology practices try to have somewhere between ten and twelve weeks of vacation a year, and it’s a little bit like being an air traffic controller. You concentrate so hard for so many hours, even though it doesn’t look like you’re working that hard because you’re sitting in a chair in a dark room, and it’s comfortable, and you can drink coffee and…The amount of concentration that you’re having to put forth is way more than other people understand. And so, you need some periodic breaks just to let your mind rest and to be fresh. And that’s what people shoot for. And radiologists can do that because they don’t have files worth of patients who are looking to them as their doctor. And if a specific doctor isn’t there then there isn’t the, “I’m disappointed or unhappy,” because most of the patients don’t know us personally, so as long as one of us is qualified in doing the job, it’s not too much of a problem for us to take time off. There’s some flexibility involved.

Unfortunately, there’s a nationwide shortage of radiologists and, as I said, it’s hard to recruit them here. So, about every four or five years, we’ll go through a period of time where our vacation drops to almost nothing because of the inability to keep adequate staff on hand to manage the vacation time. Because, basically, in our practice, if we’re fully staffed, we have a ten-man practice, and we’re paying people to be off all the time, working eight people and having two people off at all times. So, right now we’ve got eight people with nobody off. This is actually my last day off, I’ve had four days off and this will be the last time I’ll get to do that for a while until we can get somebody else in.

What is a common misconception people have about what you do?

Well, amongst the general public, I don’t think they have much of a clue what we do. They get a bill from us and they don’t even know who we are or what they’re paying for.

A second one is that the public has not recognized, over the last 30 years, how most of the significant diagnostic effort in medicine has shifted from history and physical exam to imaging, and that imaging is now becoming the new physical examination. In fact, in the emergency rooms, when people come in, often they get a CT scan before they even see a doctor. And they want us to tell them what’s wrong with them before they’ve even seen the patient. So, the actual significance and value of what we do, in terms of the decision-making process in medicine, I don’t think is understood very well by the general public. The doctors, of course do, but the public doesn’t.

And the third one is that 50 years ago, radiologists didn’t work very hard and didn’t have nearly as much business. I mean, they did x-rays and fluoroscopy. They didn’t have ultrasound, they didn’t have CT, MRI, they didn’t have interventional radiology and so they just did a few things. Those things could be done during routine working hours, they didn’t even take call for years. And so, the impression in the medical community, among the physicians, is that radiologists have a cushy job and don’t work very hard, and there’s some jealousy because of that. And we also make good money. But the reality is, though, that now, when we’re on call, we probably work harder than any other physicians because the emergency rooms are completely dependent on us, and the other doctors are dependant on us when they get into a crisis with a patient in the middle of the night.

Often, the surgeons, or neurosurgeons, obstetrics, gynecologists, and other doctors, don’t have to come in to see a patient because they can get them scanned, we can tell them what’s going on, and if everything’s okay, they can wait until the next morning to take care of it. Whereas, they used to have to come in all the time and see them. So, the workload, the call requirements, and the stress of being kind of bottom line for a lot of decisions, is far greater than most physicians have any idea of. They still kind of have the 50 year ago paradigm that we don’t work very hard and…They’re coming around because they’re starting to see. But when you read a (a lot of) CT scans in a night that’s an awful lot of work, with people who are at times potentially going to be paralyzed or die if you say something wrong. It’s an awful lot of work and a lot of stress that people don’t understand.

What are your goals/dreams for the future?

Well, I want to finish well. I’ve got another 12 years or so that I’m going to practice and I want to stay competent and do a good job and take good care of patients. But I also, as much as anything else, want to try to help my younger partners continue to build their practice in a way that they will have as much benefit from it, and be able to continue to benefit our community as much as I feel like I have.

What else would you like people to know about what you do?

In general, medicine is reaching a crisis. The baby boomers are getting old. There’s a bunch more of them that are going to be needing healthcare. Our healthcare system is going to be drained financially and is being drained financially. And the imaging side of that is growing exponentially, and so, the government is going to be looking for ways to limit the amount of imaging that’s done on patients, and in the meantime, they’ve been cutting our reimbursements 10% a year or so. There’s going to reach a tipping point with that, where radiologists…all the radiologists will say, “That’s enough. I’m just…I’m done,” and they’re going to quit. We don’t have enough radiologists as it is. And so, the government is probably going to have to make a choice as to whether or not to allow imaging to be shipped overseas, to be read by people who may not have the same kind of training or credentials and don’t work at the same level that American radiologists do. That’s not across the board. There are excellent radiologists around the world, but not all of them.

And the other is that they may start to use less trained individuals to interpret the imaging procedures. Sort of like instead of going to see a doctor, you go to see a nurse practitioner. They may start using people and saying, “Okay, we’re going to allow these people to read the images.” I think the American public doesn’t really understand what we do very well, and doesn’t understand the level of care that they’re getting, and that it may be almost invisible to them if that change is made, but it will be a phenomenal change in the quality of care that they are receiving. It may not happen because the doctors who are ordering the procedures will be so uncomfortable about their medical-legal risks. Somebody besides a fully trained, credentialed radiologist is interpreting the exams…they might not allow it to happen.

But I just fear that the crunch of the increasing numbers of people, the increasing numbers of imaging procedures, and the decreasing amount of reimbursement is going to force things to occur that would be less than beneficial for the patients in the long run. And then, the legal side of it is that if physicians don’t order imaging done and something is wrong, then they get in trouble. I think probably 40% of what I do is doctors ordering these tests in order to cover their rear ends from malpractice suits. So, changing those tort laws so that they’re not so afraid, that if they don’t order these things that they’re going to be sued, and the other is training more radiologists and starting soon, because it obviously takes a long time to get them out. It’s predicted that there’s going to be an absolute shortage of radiologists for at least the next twelve years, and I can’t imagine that it’s not going to last longer than that unless they do something. So, train more of them, and reform the malpractice laws so we’re not doing so many procedures that are unnecessary.

What do you do for a living?

I connect sales, sales management, and marketing candidates with companies in the laboratory industry. The laboratory industry supports physicians by providing information about a patient. This information is utilized to determine next steps in the patient’s treatment. I do work with some companies that are research laboratories. Their products are the building blocks of information for pharmaceutical industry and medical device industry to use in product development.

How would you describe what you do?

I get to know my client companies – what they do, why they are unique, what their compensation packages, and specifically what jobs they need to fill and what type of experience, education, and attitude they desire for their successful hire.

If you like a team environment, this is not for you. No one is on your team. The candidate only wants the job. The client wants to fill the position and would rather not have to pay you a fee. So, if you need someone to care about you this is not for you.

I try to find the right person and convince them to interview with my client company. If all goes well, I make a placement.

What does your work entail?

Lots and lots of phone time. I probably spend 5 hours a day on the phone. A wireless headset is a must. I enter information about candidates and companies into a software system that tracks all of my calls and activities. I probably send 100 emails a day that are personal and then another 1000 emails a day to potential candidates. Because you are dealing with people, there are always emergencies and schedule changes. I check my email as early at 6 am and as late as 10 pm.

How did you get started?

I was a regional sales manager at a diagnostics company and traveled over 60% of the time. I had a child and wanted to reduce my travel and still make the money that I was used to making. I had been so disappointed with the quality of work that recruiters did for me, I just knew I could provide a better service.

What do you like about what you do?

I love the people interaction. I enjoy being an expert in my field. Lastly, I love helping someone in the job search or a manager that needs a great hire.

What do you dislike?

I dislike people who say they will do something and then don’t. And because of the number of people that I deal with, I have this happen more often.

How do you make money/or how are you compensated?

I make money when a candidate that I have presented is hired by a client company. They pay me 30 days after the hire. Usually, I guarantee that the candidate will be there for a period of time. If the candidate leaves before that time period, I have to replace the candidate with another candidate or refund their money.

How much money do you make?

Usually, I get an agreed upon percentage of the base salary. Industry average percentages range between 20 – 30%. The only variable is how many candidates I place during the year. The lowest year I have had was 13 placements (I was pregnant – very sick). My candidate’s have salaries that range between $45k to $150k per year. So you can do the math….It is important to understand that there are different classes of recruiters. There are internal company recruiters that make salaries similar to any HR person. There are external recruiters that do contract work who make a set amount for a period of time and some bonus based on success. There a lot of “mom and pop” recruiting companies that are run out of their home. Because of their low expenses they don’t have to make very many placements in order to be successful. Larger firms like MRI hire recruiters and pay them some % of the %. Usually 30-40% of the base fee. I would be very careful if you are considering joining these types of firms. It would be important to understand what type of working hours they are expecting – some expect 10 hours a day. I saw a survey the other day that said the average third party recruiter (like me) makes $85k. I am not average.

What education or skills are needed to be a recruiter?

I think, to be the best recruiter, you need to have hired and fired employees. Not very many recruiters actually have this type of experience. And most managers are so stressed when talking with recruiters, they never ask the background of the recruiter.

What is most challenging about what you do?

Dealing with people as a product is very difficult. I can sell like a champion and then turn around and watch my product walk off.

What is most rewarding?

The flexibility, the money, the people interaction and the fast pace are very rewarding.

What advice would you offer someone considering this career?

I would say that is important to be honest with yourself about what makes you happy. If you like a team environment, this is not for you. No one is on your team. The candidate only wants the job. The client wants to fill the position and would rather not have to pay you a fee. So if you need someone to care about you this is not for you. If you have not hired and fired, I think you are at a distinct disadvantage. Lastly, you have to invest in this business. I have an expensive tracking system, an expensive website www.phcconsulting.com, an expensive phone system, 6 expensive computers, and I pay for ongoing training and candidate development tools. My costs this year are greater than $200k. It is very stressful to see this type of money going out, knowing that I have to make that plus in order to make a living. If you aren’t going to invest, you won’t be successful. I get calls from fellow recruiters asking if I think they should pay to have a website redone or get an administrative assistant. I have had both of these for 9 years. They are struggling to make a living. I think there is a correlation here.

How much time off do you get/take?

I have all major holidays (not all government holidays) and I probably take another 6 or 7 days vacation. I’m a bit of a work- aholic. But if you don’t answer the phone, you could miss that great candidate or client. I know other recruiters take off more (those that work for themselves) but they don’t earn what I do…

What is a common misconception people have about what you do?

They think this job is easy. I have sold for a long time. This is the most difficult sale.

What are your goals/dreams for the future?

I have 2 full time recruiters, 1 full time office manager/administrator, and some backup researchers now. I want to have 4 to 5 full time recruiters. I would like to take more time off to be with my family and to spend more time riding horses.

What else would you like people to know about what you do?

They can read my blog at www.phcconsulting.com/WordPress/ if they would like to learn more about this industry, the job search, how to work with recruiters and a lot of other neat information.

I’m a neurosurgeon.

How would you describe what you do?

Neurosurgery is a specialty that involves the diagnosis and treatment of conditions affecting the brain, spinal cord, peripheral nerves, and their supporting and surrounding structures.

What does your work entail as a neurosurgeon?

Three days a week I operate on the brain, the spine, or peripheral nerves. Two days a week I’m in the office seeing patients. I also teach medical students and I give lectures to residents.

How did you get started?

I became interested in medicine because I had a brain tumor when I was nine months old, so I was around a lot of doctors. I also watched the Donna Reed Show where Donna Reed’s husband was a pediatrician and I thought he had a nice life. And that’s the truth.

What do you like about what you do?

I help a lot of people. They come back to me and they say, “Thank you for helping me. I feel much better.”, “Thank you for helping me. My pain is gone. Thank you for taking out my brain tumor.”

[The misconception is]That you have to be really smart to be a brain surgeon. I know a lot of people who are not smart, who are just hard workers and got through their residency. So, I think the joke, “Well, hey, it’s not brain surgery” isn’t necessarily accurate. I think it’s something that takes years to learn and it takes a lot of studying…But I don’t think that you have to be really smart.

I have four partners in my group who get along great. I can make my own schedule. I don’t have to work as hard if I don’t want to. One of my partners is much younger and has four younger kids, and he’s able to work less. We’re able to, in a sense, set our own schedules.

What do you dislike?

I dislike dealing with insurance companies who either deny payment for legitimate claims or delay payment for legitimate claims. In Pennsylvania they pay less for certain procedures than the same Blue Cross/Blue Shield company would pay for another city three hours away, like Cleveland or Columbus, which are comparable sized cities to Pittsburgh. The pay is between 50% and 100% higher in Columbus or Cleveland than it is in Pittsburgh. And that’s because Blue Cross/Blue Shield has the overwhelming majority of contracts in Pennsylvania, or at least in Western Pennsylvania, whereas in Ohio, there are lots of competing insurance companies.

How do you make money or how are you compensated?

I get paid for surgery. Of course, different people’s insurance pay different amounts. Medical assistance pays less. Medicare pays a little bit more. Private commercial insurance like Blue Cross/Blue Shield, Health America, United, Aetna pays a little bit more, but pretty much everything is based on Medicare.

I would recommend neurosurgery. Nationally there is a big shortage of neurosurgeons now and there will continue to be a shortage of neurosurgeons for at least the next 20 years. The number of training programs has not increased in the last 15 years and more and more neurosurgeons are retiring earlier because of high medical malpractice costs and because of the stress of the profession. So, the number of neurosurgeons now, in the year 2007, is the same as the number of neurosurgeons in 1991, yet the population of the United States has obviously grown by a third since 1991. So, neurosurgeons are busier than ever…

One insurance company will be 116% of Medicare, another insurance company will be 111% of Medicare, so everything is a multiplier of Medicare. So, it makes you a little uncomfortable that the federal government, which sets Medicare reimbursement rates, really is setting the reimbursement rates for everybody else.

How much does a neurosurgeon make?

It depends.  It can be anywhere from $400,000 to over a million.  It’s really a function of how hard you work and how your practice is set up.

How much money do you make as a neurosurgeon?

About $600,000.

What education or skills are needed to become a neurosurgeon?

Four years of medical school, a year of internship, and then neurosurgical residency is an additional six years. So, my training was seven years after medical school.

What is most challenging about what you do?

Micro-brain surgery done under the microscope for aneurysms or certain deep tumors. Uses of computers for a lot of surgery is standard now, so I think using a computer for brain surgery and using a microscope for brain surgery are the most challenging aspects of the job.

What is most rewarding?

Personally, I think just having the patients come back and say, “Thank you for helping me.” I have a wall full of thank you notes. A lot of people thank me, but when somebody actually sends me a thank you card, I put it up on my wall. And after 20 years, my wall is pretty much full with thank you cards.

What advice would you offer someone considering this career?

The entry into medical school is pretty much now the same as it was 20 years ago. You need about a 3.6 GPA and you need to have reasonably good medical MCATs, Medical College Admission Test scores. And then once you get into medical school, then you can decide on any medical or surgical specialty. And you rotate through the different specialties and you see what you like or which professor inspires you. But you have to want to work hard because residency is hard, but even when you go into practice, a normal work day is 10 to 12 hours a day, and there’s always some night and weekend call. I have four partners, so I’m on call every fifth night and every fifth weekend, which doesn’t mean I operate at all those times. It means I have to handle phone calls and emergencies. So, a lot of hard work and good grades in college and to get into medical school.

How much time off do you get/take?

Well, we have requirements for continuing medical education. So, we have to go to approximately two meetings a year and those are usually in nice places. I’m going to San Diego in three weeks. I just came back from Washington D.C. in the spring. So, you get sort of a chance to go on a nice vacation to a nice place for a meeting. And then usually the amount of time you take off, other than the meetings, is about four weeks a year.

What is a common misconception people have about what you do?

That you have to be really smart to be a brain surgeon. I know a lot of people who are not smart, who are just hard workers and got through their residency. So, I think the joke, “Well, hey, it’s not brain surgery” is an understatement. I think it’s something that takes a lot of years to learn and it takes a lot of studying, and you have to keep up with your field, you know, read two or three journals a month, take your courses, go to the meetings go to continuing medical education things. But I don’t really think that you have to be really smart. I mean, I know a lot really smart neurosurgeons but I also know a lot of neurosurgeons who are not real smart. I mean they’re not geniuses.

What are your goals/dreams for the future?

I’d like to, at some point, stop operating and just teach residence full-time. I’d like to be able to do more laboratory research, which is hard to do unless you’re doing it full-time. I did laboratory research for a year and a half during my residency and if you’re doing it full-time, you can do it. But to do research in a laboratory when you’re actually practicing neurosurgery is essentially impossible. So, I’d like to be able to teach residents full-time because I think that’s very satisfying and do some clinical research.

What else would you like people to know about what you do?

I would recommend neurosurgery. Nationally there is a big shortage of neurosurgeons now and there will continue to be a shortage of neurosurgeons for at least the next 20 years. The number of training programs has not increased in the last 15 years and more and more neurosurgeons are retiring earlier because of high medical malpractice costs and because of the stress of the profession. It’s a stressful profession. So, you have 98 residency programs graduating 136 residents a year and there are about 150 neurosurgeons leaving practice each year because of health or retirement or what-have-you. So, the number of neurosurgeons now, in the year 2007, is the same as the number of neurosurgeons in 1991, yet the population of the United States has obviously grown by a third since 1991. So, neurosurgeons are busier than ever because the population is growing and the number of neurosurgeons has remained just about the same as it was almost 15 years ago.

Pharmaceutical Sales Representative

How would you describe what you do?

I manage a territory of NW Arkansas that consists of approx. 250 physicians. I am in charge of calling on a list of physicians, created by myself, my partners, and my company, and selling the doctors, nurse practicioners, and physician assistants the efficacy, safety, dosing, and clinical data of two products in which I have responsibilities for: basically bringing educational value to the office and physicians.

I have had patients in the waiting room thank me for what I do or tell me a success story of how my product changed their life. I enjoy the health field and I feel like I am making a difference each day in someone’s life.

I am also responsible for calling on pharmacy’s in my territory to keep up to date on my products and my competition. I am responsible for my "business" and must manage a monthly budget, travel and expense reports, appointments with clients, dinner programs, email, voicemail, and overall coordination with my teammates.

What does your work entail?

As a rep, I am required to make 8-10 calls on physicians a day, 2 pharmacy calls per day, and recording what happens during each call in my computer. I speak with the doctors through walk ins, appointments, lunch and learns, or dinner programs arranged through my company. I travel to each city within my territory and plan out my week based on my partners and the schedules of the physicians or existing appointments. Some days are full of waiting and a feeling of not accomplishing a lot, other days are really good and making good long calls with physicians and feeling like you had educated a physician on your product, and sometimes you are rejected by offices, but you have to keep going and keep up your motivation to do your job.

What do you like about what you do?

I enjoy going into different environments, making relationships with many different people in different offices, helping provide important information and samples for patients that may not be able to afford prescription medicines. I have had patients in the waiting room thank me for what I do or tell me a success story of how my product changed their life. I enjoy the health field and I feel like I am making a difference each day in someone’s life. I enjoy not being at a desk all day, constantly moving around, the flexiblity of my job is a great perk. I have great benefits provided by my company, a company car without the expense of gas or car insurance, and quaterly bonues based on how my products are performing in the market.

What do you dislike?

I am constantly in and out of my car going to different offices and that can become cumbersome in the HEAT, RAIN, or SNOW. Traveling to meetings for a week or special trainings are usually not something I look forward too either.

What skills and education would someone need to become a pharmaceutical sales rep?

Potential candidates must have a Bachelor’s Degree or higher. Some companies would like to see experience in outside sales. Someone who is very organized, responsible, and motivated. You manage your own territory and have a district manager who will come down and ride with you for two days about every 4-6 weeks.

Some days are full of waiting and a feeling of not accomplishing a lot, other days are really good and making good long calls with physicians and feeling like you had educated a physician on your product, and sometimes you are rejected by offices, but you have to keep going and keep up your motivation to do your job.

Your driving record is also of importance so it should be clear of all accidents or speeding tickets. The company does run a full background check, credit check (because you will have a company AMEX), and degree check of possible candidates.

How do you make money?

We are paid a base salary based on our years of Sales experience or Pharmaceutical experience, we have an annual review of our performance in which we are given a merit increase based on our rating, and finally we are paid 4 bonuses throughout the year based on our product’s performance in market share and volume growth. There is a lot of opportunity for advancement in this industry and each company will be competitive with the next in pay.

How much money do you make?

I currently make a base salary of $57,000 per year with bonuses around $17,000 per year.

How much time off do you get?

We are given four weeks of vacation, one week between Christmas and New Year’s is company provided, and all of the major holidays, we also receive 5 personal days to use throughout the year. Basically , whatever a doctor’s office would close for, then we have that day off as well.

What is most challenging about what you do?

I feel like trying to get in front of some doctors to have a conversation can be challenging and frustrating, having a doctor tell you what you want to hear instead of what they really think, managing the territory and making up for lost time if you were to be off on vacation or if a doctor is off on vacation.

What is most rewarding?

Having a doctor tell you a success story about how your product helped a patient, having a patient thank you for doing what you do, getting a nice bonus check!

What is the biggest misconception people have about what you do?

People think that Pharmacuetical reps are just like "UPS" drivers in the sense that we deliver samples and get a doctor’s signature, a signature collector, female reps just flirt with doctor’s all day, we are just caterer’s for offices, etc….

What advice would you offer someone considering this career/job?

Ride with someone who is currently a representative and see if it is what you could see yourself doing in the future. Getting someone who is already a representative to pass along your resume is a huge help. A lot of it is internal recommendation and it is a lot of who you know sometimes.

What are your goals/dreams for the future?

I just want a career that works for my lifestyle, that continues to make me happy, and something in which I have room for advancement and will always be needed!

Is there anything else you would like people to know about what you do?

Some people either have it or they don’t when it comes to selling skills and relationship building. It is important to remember this job is about the patients, not yourself, not competition bashing, helping to educate the doctor and his staff and ultimately help the patients! This is a great job to have for any walk of life, family, part time or full time. I really enjoy my career and do not forsee any changes in the future.

My actual title is called a Respiratory Care Account Manager, but the job description is actually selling critical care and surgical type products in the hospitals and surgery centers.

How would you describe what you do?

The people I call on within the hospital for the products I carry range from anesthesiologists, to surgeons, to nursing staff, critical care, intensive care units, and then also into the purchasing department and the administration. Not very often, but sometimes CEO’s and CFO’s of hospitals. My main two products are types tracheotomy and endotracheal tubes. The tracheotomy tubes are basically a product for patients that go home and have trouble with some type of upper respiratory abnomally or problem. And the endotracheal tube line is more for surgeries.

A lot of people think that because we’re out there selling different products and pharmaceutical companies are selling all these different drugs that it’s driving our insurance up really high…in one sense you can look at us and say ‘yeah it does’…But I guess at the end of the day if you are on your deathbed do you want a product that is from Target, or do you want a product that has been in research and development for a long time and has had some of the best scientists in the world world looking at it?

The doctor administers the anesthesia and once the patient is anesthetized they keep them alive by a ventilator which is connected to the endotracheal tube.

What does your work entail?

It really entails knowing your customer’s very well, knowing what they do really helps you. I come from a nonclinical background in college. I have a double major in marketing and management, and I knew I wanted to get into medical device sales so I took a few premed classes, anatomy and physiology, some basic type classes to kind of get me a little bit of a jump start. It really helps me to know exactly what the doctor’s, or nurse’s, job responsibilities are. It allows me to just be able to communicate with them better. It’s actually a great job for those that are independent and self driven. I basically can wake up whenever I want. I work out of my home office here, and I basically run a territory.
It’s a pretty large territory, probably anywhere between 50 to 70 some hospitals, and hundreds of little surgery centers all over the place. Typically on Monday’s I stay in the office all day just setting up my week and calling on doctors, and catching up on e-mails and whatnot. So it’s really nice just to wake up and be in your pajamas and work all day. The rest of the days I’m typically up around six o’clock, 6:30 and then heading out to some accounts and calling on the doctors. I typically get to about three or four accounts a day depending on traffic and how you set your day up. I also go to my accounts that I’ve already sold to and make sure that they’re happy with the product and that they’re satisfied and they’re getting the benefits that I told them they would get out of a certain product. Just basically making sure that they’re happy and they’re getting what they need.

How did you get started?

I knew in college that I wanted to get into the field so I took a few premed classes and it kind of got me started. It’s a tough industry to get into without sales experience, and it doesn’t necessarily have to be medical device sales, or medical sales for that matter. It kind of depends on the position that you’re going for, but a lot of times they look for people who have proven sales experience and then they hire them. It’s so tough anymore to get into sales without experience. It’s kind of a rough deal, sometimes you just hope that somebody takes a shot with you to give you the opportunity to show that you can sell if you don’t have any sales experience. I started out my first job in sales was selling

I’ve read a couple articles that said that sales, any type of sales, was one of the quickest ways to establish a good wealth base, and I can’t think of a better way to do it. You’re helping other people improve their lives and getting paid a very nice monetary value for it.

treadmills for physical therapy and accelerated sports fitness. I had 2 1/2 years of experience there and then moved my way into medical device sales.

What do you like about what you do?

Well, we talked a little bit earlier about the flexibility of your schedule. I’m very independent and self driven, so I don’t really like reporting to a cubicle every day and just kind of being locked up. I like to be able to get out and just meet new people and everything. One of my biggest things I like about this job is that you know you’re helping, you know you’re improving somebody’s life. People don’t choose to go to the hospital, it just happens that they get sick, or they get diagnosed with the disease or something, knowing that you’re selling a product that helps them or betters their lifestyle is really a great satisfaction. That’s probably the biggest thing that I like about it.

What do you dislike?

It can be very tough working with doctors and clinicians. A lot of them have their set beliefs, and it can kind of be a tough sell sometimes because there are so many of these older doctors that are out there, and they’ve been practicing for more years than I’ve probably been alive and it’s tough to convince them of a new product sometimes. It’s tough to break down old walls and foundations, so that can be a little tricky. Some people would say they dislike having quotas. I know some people are just scared to death about quotas, but growing up playing sports and stuff it is like a competition, and that’s kind of the way I approach a quota, that it’s competition. So I kind of enjoy that. I just enjoy it so much that I don’t think there’s a whole lot I can say negative about it.

How do you make money/or how are you compensated?

I’m currently set up with a base salary of $50,000 and then a commission on top of that. It’s kind of nice in that the base salary gives you the peace of mind knowing that you are going to have income coming in no matter if you’re selling something or not. But really when you want to make the good money, you start really selling a lot of products, and you meet your quota. And typically what they’ll have is $50,000 base salary, and then if you’re at 100% of quota to plan then you should make around $120,000 total, and in my case it’s whatever you go over quota at the end of the year they pay you 15% on top of that as well.

How much money do you make?

I made $120,000 last year, this year I’m on pace to make about $135,000-$140,000.

Would you say there are any perks to this career?

Yeah, absolutely there’s great perks. Companies are different, but with this job I have a company car. I don’t have a car payment, I don’t pay for car insurance, and I don’t pay for gas. They provide me with a laptop, they pay part of my Internet bill, they pay part of my office phone line, and they pay for my cell phone, let’s see, and what else do they pay for. They set me up with an office, they gave me my printer and all of my office supplies are paid.

What education or skills are needed to do this?

I would definitely say a bachelors degree is very helpful. You know now it all kind of depends. To be real honest you definitely want to have a bachelors degree, and some people say a Masters but I don’t have a Masters and I’ve got a couple friends that went and got their masters degree and it took them longer to get a job than it took me, and they’re not making any more than I am. With that being said it’s kind of a tossup. You might be able to open up a couple more doors for you if you have your Masters, or it may bump you up a little bit in your base salary if you have your masters, but a lot of times it really comes down to if you know somebody in the company. As far as skills, you definitely you want to have a good personality, you want to be approachable by other people, you want to be able to communicate your opinions and your thoughts in a manner that doesn’t look like you’re just a sales rep, and I don’t really consider myself a sales rep. I’m more of what they would call a sales consultant. Whereas you’re kind of consulting them, you say ‘look I know my stuff and I’m not trying to sell you on something that I don’t think you need, I’m trying to consult you on a better product that’s not only good for you but its also good for the patient.’ In my field typically at the end of the day it comes down to patient care, and if you’ve got a product that’s going to provide quality patient care you’re going to be successful.

What is most challenging about what you do?

That would probably be finding your decision-makers within the hospital. Because a lot of times you get people who are like, ‘Oh yes, I like your product’, but they don’t have the authority or the power to push the product through. We call these people champions. People that like your product and push it through. Anymore, you can’t really just go into hospital and show them a product and then they’re like ‘I want that product, let’s go ahead and order that product tomorrow’. Typically you’ve got to have one person who’s really fired up about the product, and then they’ve got to pull it through three, or four, or five different committees, and then all the committees have to approve it. So really the challenging part is finding someone who’s going to bat for you within the hospital.

What is most rewarding?

Just knowing that you’re selling a product that’s maybe keeping a mother alive for another couple of years, or saving somebody’s life that like a father, or son, or whoever it might be. Just knowing that you’re helping other people in their daily lives, and in some cases saving lives. A lot of times they call them ‘life altering products’, just knowing that you’re helping somebody is the most rewarding thing I get out of it.

What advice would you offer someone considering this career?

I guess if I could go back and do it all over again, I would try to have a little bit more of a biology background along with a business background. That would open up a lot of doors. I know that with the few classes that I did take, anatomy and physiology and medical terminology, those kind of classes definitely did open up some peoples’ eyes. I think chemistry type classes, kinesiology, and some other classes like that would really show employers that this person has known what they wanted to do and have been working towards it. I think having more of a biology background with an addition to your business background would be ideal. And also a big thing would be just to get out to hospitals and if they have programs within colleges or high schools you can actually get in, like say an operating room. Sometimes they have these programs where they can bring you in and maybe you can job shadow the anesthesiologist, or a cardiologist, or a brain surgeon, or a spine surgeon or something like that, so I definitely look for some opportunities like that to get in, to get a firsthand experience with it.

How much time off do you get/take?

It grows each year, you start off with 10 days with paid vacation, in California, you can actually roll your vacation over to next year so, and in addition to your seniority in the company you can even get more than that.

What is a common misconception people have about what you do?

A lot of people think that because we’re out there selling different products and pharmaceutical companies are selling all these different drugs that it’s driving our insurance up really high. It’s kind of a double-edged sword. Because in one sense you can look at us and say ‘yeah it does’, but if you turn it around and you look at it from medical device industry you know, it’s just business and they’re providing new technologies just like anything, with the better technology you are able to do things better, your prices are going to go up. So with technology advancing different products and everything it’s making them better, but also a lot of research and development are going in to so we have to make up our costs there and everything. It’s really a cycle that, you know everybody wins some, but everybody also gets hit a little bit with. But I guess at the end of the day if you are on your deathbed do you want a product that is from Target, or do you want a product that has been in research and development for a long time and has had some of the best scientists in the world world looking at it?

What are your goals/dreams for the future?

My goal is really to advance into a more advanced type surgical position, such as let’s say pacemakers and defibrillators, or spine surgeries types of products where I’m working directly with the patient and working with the surgeons. Those positions tend to pay more and they’re a little bit more rewarding in the fact that you’re actually working directly with the patient, and at the end of today you know like three or four days later after the operation or the procedure the patient comes back in and says ‘I’m feeling so much better, thank you’. That’s really rewarding and I’d like to get to that stage. I’ve always thought about going into management as well and that’s kind of the path that you typically take. In order to advance to a manager or a management position you typically have be in the field for two or three years and show that you can sell, that you’re experienced that you can succeed.

What else would you like people to know about what you do?

I think it’s a very rewarding industry. I think I’d just reiterate the fact that if someone is in to helping other people and getting paid for it, then this could be something for them. I want to be wealthy. I want to be able to take care of my family and friends and be able to do the things that I want to do and travel and I just have a lot of things that I want. I’ve read a couple articles that said that sales, any type of sales, was one of the quickest ways to establish a good wealth base, and I can’t think of a better way to do it. You’re helping other people improve their lives and getting paid a very nice monetary value for it.

I’m a Pharmaceutical Sales Rep for Pfizer.

How would you describe what you do?

I would describe it as a sales person calling on doctors and my job is to get doctors to use the drugs that I’m selling. And I have four products, so I have to get them to write my four products for the patients. 

What does your work entail?

You see anywhere between 10 and 15 doctors a day for 5 days in a week. You call on those doctors who are the biggest prescribers, so I would look at a computer

You’re offering a product that a lot of times, people don’t believe in and you have to make them believe in that product because if your product wasn’t superior to most other products, it wouldn’t be out here.

and look at a doctor’s profile and if they have a lot of potential to write my products, I target those doctors and try to get those doctors to write my product.  During the work week, you travel a lot. Some territories are bigger than others, but mine’s about two hours long, so some days I’m two hours away from home in a small town calling on a small clinic or there’s other days when I’m in a bigger city and I call on the doctors there. In some work weeks you have speaker programs where you have doctors come in and you take a specialist, a well-known specialist from another state or city. And you take them into offices and let them talk about their experiences with your products and how they had success stories with your products. And what you’re trying to do is try to influence those doctors into writing your product.

What do you like about what you do?

Personally, I enjoy being out and moving around. I’ve had a desk job and I liked it as well, but I really like being out and being moving around all the time because you’re always running into all different kinds of people. You get to see different kinds of people every day.

You have to have something to offer these companies. The pharmaceutical companies are the most applied to companies in the United States right now. More people want to work in pharmaceuticals than any other. My company actually gets more applications per day than Wal-Mart. That’s huge, so it’s very competitive to get into and if you’re going to try to get into it, don’t get discouraged if you get turned down for a while. It took me over a year to get hired.

And just meeting all the different people and interacting with those people is probably one of the top things that I like about it, and also, it’s just like your territory is your business. It’s just like having your own business and that’s your territory to work and try to maximize your profits and everything in that territory.

What do you dislike?

There’s a lot of pressure with this job. The company increases your quotas every year, so you have a lot of pressure to outdo what you’ve already done. So with most drug companies 100 percent isn’t good enough. 100 percent is the bare minimum, so you’re trying to outdo 100 percent. You want to have a 160 percent quota and there’s a lot of pressure. And with this job as well, there is a lag time as far as getting your reports. So, if I go into an office and make a sale, I don’t hand over a prescription for

You have to be like a chameleon. You have to blend in to every situation. You have doctors who are big sports fans; you have doctors who could care less about any sport…You have to blend yourself to be able to have conversations and communicate with all kinds of different people.

the doctor to give to a patient. I have to count on them to write it after I’m gone. So you don’t get the satisfaction of making that sale every day like you would if you was a regular salesperson, if you were selling a product that you carried with you. You have to monitor that data later on. You don’t reap your crop right there, you have to wait until later to see how it turned out.

How do you make money/or how are you compensated?

With most pharmaceutical companies you get a salary and you also get paid commission on your drugs that you sell. So, if you sell 160 percent of one product, you get paid on 60 percent over that quota. The more you sell the more you make, so the harder you work, the more money you make. You also get a company car, you get free gas, you get to provide a lot of meals for offices and doctors and you also get to eat with them for free. You get free car insurance, great benefits, stock options. I would say there’s $20,000 added onto your salary that you don’t see that you get in just perks, that come with the job.

How much money do you make?

In a given year, as a pharmaceutical rep, you can’t really say how much you make because you could make anywhere between $70,000 and $100,000 or you could make less. If you don’t make your sales, you don’t make as much. But usually a base salary for a pharmaceutical sales rep with minimal experience, you’ll start out

I don’t have a boss walking down a hallway every hour to check on me and make sure I’m doing my work. They trust you with millions of dollars worth of samples. They give you a car. They trust you with a car and they trust you with a company expense account. ‘Freedom’, is probably the one word to say what I like the best about it.

about $50,000 a year base salary. If you have a base salary of $50,000, you could make $20,000 in bonuses if you did real well. And that’s not counting the $20,000 worth of stuff that you get as far as your cell phone paid, your car’s paid for, your car insurance is paid for and your gas is paid for. You can count that as about $20,000 more as well a year.

What education or skills are needed to do this?

You have to have a good personality. You have to be able to deal with all different kinds of people. You have to have a four-year Bachelor’s Degree, so you must go to college. You must get a degree. And most of these companies are looking for people who are leaders and people who are very competitive. So, you have to be able to show that, and you have to be able to…You have to be like a chameleon. You have to blend in to every situation. You have doctors who are big sports fans; you have doctors who could care less about any sport. They’ve never played a sport, they’re more into science and more into research and stuff. You have to blend yourself to be able to have conversations and communicate with all kinds of different kinds of people.

What is most challenging about what you do?

A lot of times, the most challenging is just getting access to doctors. You’ll go in some clinics where they see 15 or 20 reps a day. You have to stand out. You have to do something different and a lot of times all they want to do is come up and sign your piece of paper to get your samples and then they’re out. They’re very busy. So, getting time with those doctors, I would say, would be one of the hardest things and most challenging. And the other thing is a lot of times your product is very expensive and you have to get them to buy it and show your product is worth it.

What is most rewarding?

I would say the most rewarding to me is just being able to be out on my own. I don’t have a boss walking down a hallway every hour to check on me and make sure I’m doing my work. They trust you with millions of dollars worth of samples. They give you a car. They trust you with a company expense account. I really like that.  ‘Freedom’, is probably the one word to say what I like the best about it.

What advice would you offer someone considering this career?

I would say if you’re a college student, you need to be very involved. You need to be involved in every club that you can and hold positions in that club to where you can show that you have improved something or you have accomplished something because that’s what this company’s about. I mean, most pharmaceutical companies, they want you to improve your territory, so if one year you sold 110 percent, the next year, they’re going to expect you to sell more. So you have to be able to prove that you’re competitive and that you want to win and that you want to do better. Any leadership stuff that you’ve been involved with or if you’ve had success in another sales job, you need to be able to prove that, and show it you did it and how you’re going to do it with any other company.

What is a common misconception people have about what you do?

I think a lot of people, as far as when you walk into an office, whether it’s a patient or it’s a secretary or if it’s a doctor, they just think you’re there to deliver samples. A lot of times pharmaceutical reps are dressed very nice, we drive nice vehicles and they think that you just make a bundle of money and you don’t do any work, when it is really extremely hard. It’s an extremely hard job and a lot of pressure on you and what you do is work. You’re offering a product and a lot of times, people don’t believe in it and you have to make them believe in that product because if your product wasn’t superior to most other products, it wouldn’t be out here. It wouldn’t be being used. I would say just learning the science background and then just the misconception is that you don’t do anything when you really do work very hard.

What else would you like people to know about what you do?

I think that they should just know that it’s not an easy job. It’s not easy like a lot of people think. It is hard and like I said before, there’s a lot of pressure. And it’s very, very hard to get into. Very seldom does a person come out of college and get a pharmaceutical sales job. You have to have something to offer because these companies, the pharmaceutical companies are the most applied to companies in the United States right now. More people want to work in pharmaceuticals than any other, you know. I mean, my company actually gets more applications per day than Wal-Mart. That’s huge, so it’s very competitive to get into and if you’re going to try to get into it, don’t get discouraged if you get turned down for a while. It took me over a year to get hired.

I’m a speech pathologist.

How would you describe what you do?

I primarily work with the geriatric population helping people

I enjoy just talking with the patients. I love the elderly…I love hearing and laughing at their stories, that’s the best part.

had strokes, swallowing difficulties, or who have cognition impairments.

What does your work entail?

I usually work from 7 to 3. I work in a nursing home. I usually see anywhere from 7 to 10 patients a day. I see most of my patients in the morning, see some at meals. There’s lots of paperwork involved and lots of notes…that’s about it. It’s between 36 to 40 hours per week. What do you like about what you do?

I enjoy just talking with the patients, I guess. I love the elderly so that helps out. I love hearing and laughing at their stories, that’s the best part.

What do you dislike? The monotony. Everyday you kind of doing the same things, a lot of these patients have cognitive impairments, they don’t have any short term memory so every day is like Groundhog Day pretty much.

How do you make money/or how are you compensated?

I get paid on an hourly rate. I contract for various nursing homes but the nursing home doesn’t actually pay me. They pay my rehab company who pays me.

How much money do you make as a speech pathologist? Probably around 60 to 70 thousand in a year.

What education or skills are needed to be a speech pathologist?

Generally you need about 4 years of undergrad plus two years of a grad school to get your Masters…I don’t know about skills, you pretty much develop them all in college if there is such a skill.

What is most challenging about what you do?

I think Speech pathology is really diverse, there’s just a lot of areas to treat so it’s hard to be specialized. You need to be

Everyday you’re kind of doing the same things, a lot of these patients have cognitive impairments, they don’t have any short term memory so every day is like Groundhog Day pretty much.

and that’s why I’ve chosen the adult population but there’s just so many types of disorders and treatment, I almost feel like they should limit it more.

What is most rewarding?

The most rewarding part I think would be working with stroke patients and seeing a lot of them recover. Those who weren’t able to swallow at all or were on feeding tubes or those who couldn’t speak at all because of the stroke, it’s really rewarding when they are able to get some of those capabilities back.

What advice would you offer someone considering this career?

I would tell them to specialize at the beginning you know, to choose either adults or children. I know it is kind of hard to do that but if they could specialize I think it would make it easier for them in the long run. Just make sure that you are working with the right population, be it adults or children, and realize that there is going to be a little bit of monotony. There is probably more monotony with adults but either way…try to be as creative as possible to make each day a little bit more…livable.

How much time off do you get/take?

I get 6 paid holidays. My job is pretty flexible though if I want to work on Sunday for a Friday or a Saturday and take off one day during the week I can.

What is a common misconception people have about what you do?

People assume that Speech Pathologist only work with people who either stutter or have articulate problems and those are just sprinkles on the cake compared to what we really do.

Is there anything else you’d like people to know about what you do? No (laughs) I don’t think so, unless you need to ask me some more questions.

How would you describe what you do?

I do order entry of physician orders for the medications that they want to administer in the hospital. There’s the patient chart where the doctor will document and write everything that’s going on with the patient and all the medications and tests and procedures that he wants done. When a medication is written it is faxed to the pharmacy where a pharmacist will review the patient’s allergies, other medications that they’re taking, and appropriateness of the dose. We then enter that into a computer system which goes through a pharmacy database and a robot which is linked to that database

There’s a lot of difference between a Walgreen’s and a hospital pharmacy, and I would work in both before I’d ever think about being a pharmacist.

will fill those prescriptions as well as technicians that work within the pharmacy will manually fill those prescriptions and then distribute them to the right patients.

What does your work entail?

The position which I have is a Float Pharmacist which means that in our hospital, each unit of the hospital, whether it be an intensive care unit or the orthopedic floor or the stroke unit, each floor has a specific pharmacist that covers that area and works with those patients, doctors, and nurses on a regular basis. When one of those pharmacists either has the day off or is sick or for whatever reason, the Float Pharmacist will cover those areas. So, on any given day, I can be working with any floor of the hospital. For instance, this week I’m going to be covering the neuro-trauma ICU and the surgical ICU areas. That specific position calls me to come in at seven in the morning and I’ll leave at 3:30 in the afternoon. I’ll come in, I’ll go down to the ICU, and I’ll go through those reports while entering any orders that come from the physicians. I will answer questions from the nurses. I’ll answer questions from the physicians. Some of the questions might be specifically related to the drugs and maybe what’s prescribed or side effects, dosing questions, others that are usually given by nurses can

I think it’s a really common misconception that a pharmacist is told what to do by the physician and they just do it.

be anything from, “Why isn’t my medication here?” to “Can I get a refill on this?”. Certain medications have certain things that we have to monitor with their use. There are some medications that we have to monitor specifically. Drugs that are commonly prescribed together can interact with each other so there’s reports that have to be reviewed. There’s a policy within the hospital that the physician can write a prescription for a medications and the pharmacy is “to dose”. Which means that the pharmacist is responsible for looking at the patient’s kidney function, blood levels for that specific medication, and can change the doses of the medication based on what our opinion is of how they’re metabolizing that drug. So, there are certain reports that we have to go through every day.

How did you get started?

I thought that I wanted to do something in health care after I was in college for a couple of years and decided to shadow. I ended up shadowing some nurses, a physical therapist, and occupational therapist and then eventually a pharmacist. I liked what I saw when I shadowed the pharmacist. And the one that I ended up shadowing was the director for a hospital pharmacy in the town that I was going to school at. She offered me a job as a technician and then I ended up working in the pharmacy.

What do you like about what you do?

I like that I get to be a member of the health care team and involved with health care in general, but I’m not the type of person that would want to have to deal with the blood and the guts and the gore and the actually physically taking care of the patient. I had considered being a physician but I liked that a pharmacist could work 7:00 to 3:30, probably 95 percent of the time. I’m not on call. I don’t get called after work. I have a set salary which is pretty good. If I wanted to go part-time, it’s very easy for a pharmacist to go part-time. You can work two 10-hour days and make the same amount of money that a lot of other professions make full-time. I can leave the profession if I had a child and wanted to step out for five years. It would be very easy for me to leave my job and then have no trouble at finding another job when I wanted to go back to it, even though I’ve been gone for five years.

What do you dislike?

Let’s see, I dislike that a lot of the time I’m in front of the computer. I dislike that a lot of it is kind of repetitive tasks, and that depends on what type of pharmacist you are, too. There are pharmacists that are much more clinical and aren’t doing those repetitive tasks but the position that I am, I do do a lot of that. I dislike that. It depends where you are and who you happen to be working with, but there are some health care professionals that don’t appreciate what a pharmacist can bring to the table. There are those that really do appreciate and acknowledge the knowledge that we have and how we can help them. It kind of depends on where you’re working.

How do you make money/or how are you compensated?

I make $46.50 an hour. I get paid hourly, but I don’t clock in. So, I’ll get paid for a 40-hour week if I happen to be working my regular shifts. If I need to stay an hour late to finish something then I don’t get paid overtime for that. But if we are short a pharmacists one evening and they need someone to work five hours of overtime,

If I wanted to go part-time, it’s very easy for a pharmacist to go part-time. You can work two 10-hour days and make the same amount of money that a lot of other professions make full-time.

in other words, they ask you to stay late, then I would get paid overtime. But if I’m just finishing something up, then I don’t get paid overtime.

How much money do you make?

About $97,000.

What education or skills are needed to do this?

To become a pharmacist, it’s a minimum of six years of education. Where I went, you had to have a year of prerequisites which were kind of normal prerequisites of Math, English, all of those things. And then it was a five-year pharmacy program. A lot of people have their four-year Bachelor’s and then decide to go to pharmacy and it’s still five years after that, regardless of if you have a degree or not, you have to spend five years in pharmacy school. That gives you a doctor of pharmacy’s degree.

What is most challenging about what you do?

Probably staying current on everything, on all of the changes and all of the new drugs, and all of the changes in the care of treating a certain disease. There’s guidelines that change all the time, so staying current on everything is probably the most challenging.

What is most rewarding?

Probably that I can be a part of the health care team and help patients while still being able to have the best of both worlds. Having the best of home life and the best of career life. Your schedule, your pay, and the fact that you’re not on call like a physician makes it a lot easier with what’s going on at home. There’s really not a lot of projects to bring home, work doesn’t usually come home with you. Once you leave work, you’re done.

What advice would you offer someone considering this career?

I went to school with people that had never worked in a pharmacy and just didn’t really know what the pharmacy atmosphere was like. Some people love it and some people would never want to do it. It’s really just a personality thing. So, I would work as a technician in a pharmacy, either retail or hospital. There’s a lot of difference between a Walgreen’s and a hospital pharmacy, and I would work in both before I’d ever think about being a pharmacist.

How much time off do you get/take?

It’s weird because the hospital has this earned time off system which means that my holiday time, my vacation time and all of my sick time is in one big bank. So, if I don’t get sick during the year and I don’t have to call in sick, I’ll get more days that I can take for vacation time. But I’d say at least two weeks, maybe three. Once you hit five years, you start earning more time off.

What is a common misconception people have about what you do?

That all it is is counting pills and entering in a prescription. That’s all a lot of people think a pharmacist does.

What are your goals/dreams for the future?

My goal is to specialize in one area, like all the different floors and units I talked about earlier. My goal is to find an area that I love and to specialize in that and then become a decentralized pharmacist. A decentralized pharmacist just means they’re out of that central area, where all the drugs are stored and dispensing occurs, and they’ll work on the floor with the doctors and nurses directly.

What else would you like people to know about what you do?

Just that there’s a lot of things behind-the-scenes things that goes on in a pharmacist’s head, things that we’re thinking about, things that we’re looking out for when we’re looking at a patient and their prescriptions.  I think it’s a really common misconception that a pharmacist is just told what to do by the physician and they just do it. There’s a lot of evaluating whether or not it’s appropriate and then helping the patient monitor their side effects and make sure that they’re educated in all the things that they need to be aware of so that if this medication has a bad side effect or causes something that’s not supposed to happen, they can tell their physician and get it corrected.