Dropout Docs: Bay Area Doctors Quit Medicine to Work for Digital Health Startups

By Christina Farr
KQED, July 17, 2015

New data provided exclusively to KQED shows that Bay Area-based medical students have among the very lowest rates of applying to residency programs after graduation compared to the rest of the country. Rather than pursuing a career in traditional medicine, many of these doctors-in-training are drawn to entrepreneurship.

Bay Area-based medical students from Stanford and UCSF have among the very lowest rates of pursuing residency programs after graduation compared to the rest of the country. Stanford ranked 117th among 123 U.S. medical schools with just 65 percent of students going on to residencies in 2011, according to Doximity, a physician-network that generates data for the U.S. News Best Hospitals rankings. UCSF is 98th on the list, with 79 percent of its graduating students going on to residency. (Some students may have opted to apply to residency after taking a few years off. The 2011 figures haven’t yet been updated to reflect that.)

“We’ve seen that many of these Bay Area-based medical students are drawn to startup opportunities — it used to be biotech, and now it’s more often digital health,” said Jeff Tangney, CEO of Doximity. Tangney said many of the top digital health companies are more than willing to hire new grads straight out of medical school, who lack years of clinical experience.

Tangney said dropout doctors are well-positioned for a career in digital health as they have an insider’s view of the industry — and ideas about how to fix it.

Many of the students at the top Bay Area medical schools, Stanford and UCSF, are exposed to entrepreneurial thinking during the course of their education, which can be a major draw.

Other dropout docs said they felt pushed out of medicine, due to the lack of career opportunities or earning potential. Family practitioners, who serve at the front lines of health care, are paid the least.

Recent studies have also shown rising levels of discontent among primary care doctors. Nearly half of 7,200 doctors who responded to a Mayo Clinic survey in 2012 said they felt a lack of enthusiasm about medicine or cynicism about it. A decade ago, one quarter of doctors reported feeling burnt out.

“I loved working with patients but I looked around me and realized that I didn’t want the jobs of anybody who had ‘succeeded’ as a clinician,” said Rebecca Coelius, who graduated with an MD from UCSF.

http://ww2.kqed.org/futureofyou/2015/07/17/increasingly-young-bay-area-d…

Of medical school graduates in 2001, one-fifth of those graduating from UCSF and one-third from Stanford did not proceed into residency training for clinical medicine. Many of them instead were drawn into entrepreneurship, especially digital health.

Over half a century ago, as students at UCSF School of Medicine, my twin and I learned early on not discuss our intent to become general practitioners (as family physicians were then known). UCSF was above producing LMDs (local medical doctors – the source of all the screwed up cases that the specialists at UCSF had to bail out). Fast forwarding, at our 50th class reunion a couple of years ago, we were shown the utopian edifices and superstars representing the epitome of the medical-industrial complex.

In the last half century I was dedicated to primary care and, during the past couple of decades, to advancing health care justice through advocacy for a single payer national health program. Boy, did I feel out of place at our UCSF 50th reunion.

Stanford was “the other school” in the bay area. When I was a student, there was a feeling that UCSF was training specialized clinicians whereas Stanford was positioning their students to cater to the elite carriage trade. That is, in my view, Stanford was even worse than UCSF in glorifying the prestige and income in medicine, and apparently it remains so today based on the numbers that are moving into entrepreneurial ventures.

Under a well designed single payer system, primary care would be expanded, and the rewards for specialists would be based not on wealth acquisition but on the satisfaction of being a team member that protects and enhances the health of our patients. The medical school admissions committees at UCSF and Stanford apparently are not filtering out those whose career goals are business success in the industrial side of the medical-industrial equation.

So a single payer system would not only reform the financing infrastructure, it would also reorient the health care delivery system in a direction that would attract students who are truly dedicated to the healing arts. The selection process should continue to grant entry to the majority who are so oriented, but it should filter out those who see medical school as an opening to join the exclusive club of the one-percenters.