Monday, May 26, 2008

Doctor, Lawyer, Engineering Chief

Let me state the obvious: the world we live in is highly complex. No one person can hope to understand everything in the world around us. Once upon a time the elements of daily living were fairly simple and understood by all. Take two sticks and rub together--voila! fire. The contents of a cooking pot were also fairly simple--dig up vegetables, add to pot. Catch a chicken roosting somewhere--add to pot. Find a cow, milk it and drink. Catch a disease, die.

Today's complexity exists in every single element of living. Try reading a food label today and see if you can recognize even half of what is on the label. Ditto for the labels on over the counter supplements and drugs. Or prescription drugs.

In this type of complex society the role of experts has become doubly important. We look to these experts for the understanding that we do not have ourselves. It's their job to investigate all the minutae out there and report back to us in a way we can understand. For frum Jews these experts are even more necessary. We not only need the basic information and knowledge that others do, but we need the more specific knowledge that allows us to see how things fit in with halachic observance.

A stove is not a stove today; the structure and components of that fairly simple cooking appliance have all kinds of implications for shabbos and yom tov use. Yes, a rav is going to make a ruling about how the stove can be used, or even which stove can be used. But last time I investigated, Engineering 101 is not a required subject when studying for smicha. For that psak to take place and to have any meaning that rav is going to need to consult an engineer, and a frum engineer at that--one who has some idea about how his field impacts frum observance.

Want to know about food additives? Want to know the ins and outs of keeping fully kosher today? Again, a rav gives a psak, but last time I looked Chemistry 101 and Manufacturing 101 and a whole slew of 101s is not part of getting smicha. Time to find a frum chemist, a frum biologist etc.

Have a medical issue? Are there frumkeit issues involved in it? There's that rav again, and he is going to need a whole slew of doctors to consult with. Frum doctors.

So where are we going to get all those engineers and chemists and biologists and doctors from? From where will we draw on the frum experts necessary? It was once ubiquitous that Jewish and doctor went together. Not so today. What are our frum boys and girls majoring in? Most are not going into the highly technical fields nor the scientific fields. Going to medical school or dental school is not seen by many as being a comfortable fit with learning after high school and/or during college and afterwards, nor for marrying young and beginning a family right away. Those who are looking for a boy with earning capacity want it now, not later. The cachet, for many in the frum community, has worn off of "My son the doctor." And there has always been a resistance to saying "My daughter the doctor." Attaining a PhD is also looked at this way--too much time involved in getting it, requiring too much concentration that some in the frum community want put elsewhere.

We are going to start a new world on Planet X. What types of expertise do we have to make sure are present so that our new world functions at 100%? The list of jobs and specialists would be in the hundreds today, maybe in the thousands. Certainly pharmacists and dentists and doctors and scientists of all stripes would be on the list. Now make that a new frum world on Planet X. Maybe you would get the same list from frum Jews and maybe you wouldn't. The rabbanim in charge of that new world might think to include scientists and then maybe not. Or they might say: "We'll need one doctor and one engineer and one chemist etc," not the way to get a complete picture in these fields.

Unless we encourage our best and our brightest to broaden their horizons when it comes to careers, to go outside of the business and psychology fields, we are going to cause a shortage of frum professionals in other areas needed so rabbanim can give a psak that is based on real knowledge of how things work today. And here is the funny strange part. There are still more MO young people going into the fields of science and technology then there are in the RW world. Soon enough this is going to put the RW into the position of having to go to the MO in order to paskin on any scientific or technical areas. Since they'd rather chew nails then do so, they'll give psak based on their "deep" understanding of the halacha without reference to the actual science and technology involved. And then you'll be back to fire--rub two sticks together.

Ever wonder what would have happened to the Rambam had he lived today instead of in his own time period? Would he be encouraged to become a doctor? Would he be seen as contributing something vital to Yiddishkite or would he be seen only as being "bitul Torah"? Would someone tell him that being a doctor is "bad for shidduchim"?

28 comments:

Anonymous said...

You could also add that the education that our young people are getting starting from elementary school and going up through college for some of them is not deep or broad enough to get them into science programs or the best of the graduate programs. This is true for the boys of the right especially. For many of them all they want is the piece of paper that says they have a college degree. They're not interested in the actual education that goes with that degree. To voluntarily put themselves into having to go to school for at least 3 years after college is something they see as unnecessary.

Anonymous said...

You have that part about girls and being doctors right. I was told my whole life to forget about medical school, that really frum girls didn't become doctors, that I'd never get married if people heard me talk about medical school. So I lied to my parents about my college major. They thought I was getting all the scinece courses because I was in speech therapy. And I applied and was accepted to medical school. And I met my husband in medical school. His family still wonders if I am frum enough and my family still thinks I'm crazy. Too bad. When they have a question about medicine though they call us. You can't win.

Anonymous said...

Maybe I'm just not seeing them, but there are more rabbi/doctor combinations in the older generation then in mine. I'm thinking of people like the Twersky family and lots of others. When I was making my decision of what to major in it was more that you had to choose one or the other but you sure couldn't have both.

What do you make of the fact that law school seems to be the exception to the don't go to graduate school in something important rule?

Anonymous said...

At least in my community it's considered frummer to be a lawyer then to be a doctor. My shul hasn't got one doctor or dentist in it but has 7 lawyers. And loads of accountants. They are the most holy of all.

Lion of Zion said...

the main reason frum jews don't become scientists, doctors, engineers, etc. is that it simply isn't worth it and there are easier and quicker (and often more stable) ways to make more money.

and this isn't a "frum" phenomenon. our non-jewish neighbors also don't won't these jobs, which are fast being filled by immigrants. just one anecdote to illustrate this: last week i was at a graduation for a pharmacy school. 3 PhDs were awarded, 2 of them to immigrants; about 50 MSs were awarded--EVERY SINGLE ONE to an immigrant.

Lion of Zion said...

(disclaimer: i did not intend for that to be a nativist comment)

ProfK said...

Lion,
That immigrants are graduating in droves from pharmacy school and medical school says a lot in their favor. They are taking advantage of the opportunities offered here in their new country. And presumably if they are really immigrants, rather than foreigners who only came to study here, then they are our non Jewish neighbors. It also says a lot for their brightness.

Sigh, does it all really have to boil down to money? Doctors hardly starve to death, and neither do pharmacists or highly trained scientists in the various disciplines. And all lawyers and accountants are not wealthy. My point was that Klal needs people who are highly trained in the medical and scientific fields and who will be knowledgeable about how their fields and halacha may interact. We don't need everybody to become a doctor or scientist; we do, however, need some of our own to do so.

Lion of Zion said...
This comment has been removed by the author.
Lion of Zion said...

"if they are really immigrants, rather than foreigners who only came to study here"

i guess i don't know if all are actually immigrants and foreign students, but i hope they stay. i think immigration is a good thing, in part because our economic future rests on the brain industries.

"Sigh, does it all really have to boil down to money?"

yes

"Doctors hardly starve to death"

they don't. but they are also no longer getting paid commensurate for the expertise and education investment (both in time and $). unless you are going into a few hot fields or you are one of the few hot shots that can open a cash-only practice, medicine is not a good choice. (i honestly can't believe how little my pediatrician gets reimbursed from the insurance company.)

as far as scientists, the education can be just as long and nearly as demanding as for an MD--with even less chance of a pay-off. especially if we are talking about academic positions (i don't know anything about commercial scientists). you can spend 10 years on that PhD (maybe or maybe not funded), and then end up with an adjunt-teaching position at some jr college in arkansas.

i'll let you know how pharmacists do

ProfK said...

Lion, PhD's in the sciences from accredited universities don't end up adjuncting in Arkansas unless they "smoked" their way through school and have only a hazy recollection of ever having been there.. Not in the sciences. There is such a shortage of these people that they have no problem finding full time positions. In addition, industry is looking for them. Also, the public school system will and does pay a huge amount to get such people in.(How would you like to work 9 months a year, get mega benefits, free medical insurance for the rest of your life and a great pension? Plus a salary.) And if your 10 year figure doesn't begin from the first day of college then it is way too long. We have family and friends who have their PhDs in the various sciences and nobody took that long.

As to pharmacists, we happen to know five who are frum. Two worked for large drugstore franchises and made very decent salaries, plus excellent benefits. They bought houses, paid full tuition for their kids, sent them to college and even saved up for retirement. One bought an apartment in Florida and "commutes" between there and the house in SI. Another is preparing to retire next year and bought an apartment in Israel long ago that they are going to. The third owns his own drug store and judging by the tzedaka he gives just locally,by the house and cars he owns, by the trips they take, business is booming. The fourth has his own drugstore or I should say had it. The location was prime. One of the chain drug stores paid him an arm, 14 legs and at least two major organs to buy him out. The fifth is a young man in his 30s. He makes enough to have bought a house, keep a car and take vacations out of New York. He's fully self-supporting and his parents--our friends--don't do more than buy him a birthday present. How typical they are I can't say.

Anonymous said...

If you insist that the only fit job for a PhD physicist is in academia, one can easily end up at a small teaching school outside the big metropolitan areas. However, jobs in industry are plentiful (even for particle physicists) and starting salaries are around $100K (plus good benefits) for a freshly minted PhD. The average PhD is now 6 years after a BS, but that, in part, reflects that people are generally supported by the department in grad school in the sciences. People who are sufficiently motivated and have the sense to find an advisor who gets his students out still finish in 4.

Anonymous said...

The really frum attitude towards doctors is kind of strange. My husband is a doctor and shares a practice with 5 other doctors. Two of them are not Jewish and one of the frum doctors has a very goyish sounding last name. The practice overlaps an area where you have lots of very RW frum jews. The women invariably want to make appointments with the non Jewish doctors or with the one who sounds not Jewish. One got very upset when only the "Jewish" doctors were available. She told the nurse that it was ossur for a Jewish man to be touching her. And if that's the attitude it's no wonder that frum boys are discouraged from going into medicine.

Lion of Zion said...

MIKE S:

i don't know if you caught the comment i left you a few posts back, but i checked and you were right. there is no boy scout camp any more. "lack of interest"

Lion of Zion said...

PROFK and MIKE S:

ok, you caught me. my knowledge of academia is not based on the sciences, but rather history. and there it is pretty much as i described it (at least as of 5 years ago).

Lion of Zion said...

ZAHAVA:

"She told the nurse that it was ossur for a Jewish man to be touching her."

i commented a few posts back about women calling 911 rather than hatzalah for this reason.

Anonymous said...

But if we carry this out to its logical conclusion then frum women also can't go to the dentist if he is male (and female dentists are extremely rare). In a hospital setting they can't have a male xray technician or a male nurse or a male phlebotomist or a male anything. And the reverse would have to be true also. Men could not be treated by a female doctor, their nurses would have to be all male and so would any technicians in a hospital or office setting.

If anything this would support the argument that more of our children need to go into these fields so we can provide separate sex practitioners. Yes, frum women as doctors.

Is there an actual halachah that says that you cannot be treated by someone of the opposite sex who is Jewish for medical/dental purposes? Or is this another case where we are stretching tsnius to cover something that isn't really about tsnius? Are we really going to say that it's more tsniusdik to have a non Jewish male doctor touch a woman then a Jewish male?

ProfK said...

Lion,
"(i honestly can't believe how little my pediatrician gets reimbursed from the insurance company.)"

Our insurance company requires a co-pay for doctor visits. That co-pay has steadily risen to $20 per visit. If the doctor gets only another $20 from the insurance, then he was paid $40 for my visit. Appointments are scheduled in doctor's offices for from one every ten minutes to one every 15 minutes (specialists may be an exception to this scheduling rule, but they are also reimbursed at much higher rates.) At only 4 patients per hour and at the low reimbursement rate, that is $160 per hour. At 5 to 6 patients per hour, that is $200 to $240 an hour. Expenses for their office staff are deductible against income. Give those doctors only 20 hours of office hours a week and they are making $3200 a week to $4800 a week. Hospital visits are reimbursed at a higher rate than office visits. Add that income in as well. Even if you slashed that income in half, which is not the norm, that doctor would make $85,200 per year, not counting hospital visits and not counting procedures that bill at a higher rate of reimbursement. Without slashing the amount, that doctor would be making $170,400, again without hospital visits and procedures that bill higher.

Now add in that some doctors will charge patients for the difference between what the insurance company pays and what their charge is for a visit. Some doctors expect cash payment up front at their designated price and the insurance company reimburses the patient at whatever rate they will pay instead of the doctor.

Doctors don't make a lot of money? Compared to whom?

Anonymous said...

Plenty of regular doctors out there who don't submit to insurance companies for you. They will fill out your insurance forms after you have paid them and then you have to submit them what they are asking and you get to wait to be paid back whatever the insurance company will give you.

ProfK said...

Lion, any particular reason your blog got closed to all but invited readers?

Anonymous said...

Our rav holds that there is no issur of a woman being touched by a male doctor or medical assistant of any kind, whether frum or not frum, Jewish or not Jewish. He holds the same way for a man being touched by a woman.

He does say that if the person being touched knows that that touch would bring about forbidden thoughts or desires that they should go to someone who is their own sex. Where such a choice is not available and when it is an issue of p'kuach nefesh then any practitioner is allowed.

But then our shul is MO and the RW seem to be practicing a different branch of religion.

Lion of Zion said...

PROFK:

you are completely not factoring in the extremely high overhead. it doesn't matter that it is deductable, it still has to be paid out.

and again, even if the more poorly-paid doctor nets what seems like a lot of $, it is not commensurate to what he has invested in time and $. he has $200k in loans to pay back and what seems like a high salary may not really be compensating for all those years that he was not working or being paid subpar as a resident. and you can't put a price on all the missed time with family. (this might be another reasons frum people don't go into medicine. there is a much more pressure now to be fruitful earlier and in greater numbers, which is not compatible with medical training.)

"Now add in that some doctors will charge patients for the difference between what the insurance company pays and what their charge is for a visit."

i don't think they are allowed to do that. if they have a contract with an insurance company they must accept the stated reimursement + copay as payment.

but to get back to the post:yes, there is wide-range of salary for lawyers, MBAs, computer nerds, etc. but people who can get into even a mediocre medical school can probably get into one of the better law schools, graduate earlier (to say nothing of not even needing a BA or difficult undergrad requirements) and get a good job (these will not be the lawyers making $50k a year)

ALLEN:

"Our rav holds that there is no issur of a woman being touched by a male doctor . . "

don't ask me for a citation, but iirc this is for situations where the touching occurs in a professional capacity, in which case such touching lacks any element of derekh hibba

Anonymous said...

Lion, you've never been in Law school if you think you get more time then in medical school to see your family. And the first few years of practice 80 hour weeks aren't even considered unusual. Actually the years until you make partner if you do you are working those hours. If you aren't working them then you aren't in a firm where you are making any real money either. My brother in law is an opthalmologist and he sees his family a lot more than I do. My cousin is a CPA for a big firm and he travels for them around 40-50 days a year--that's almost 10 weeks he is not at home during the week. And then there are the huge extra hours at the end of every quarter. There is no real rule that you can state about the hours doctors work or how they fit in family time.

concernedjewgirl said...

Sorry,
I’m chiming in a bit late. I am a female in a scientific field. It is rare to see other frum Jewish women in a science based field. The most common question I get upon a person finding out what I do outside of the house is “are you a baletchuva”? It just so happens to be that I am. Isn’t it interesting though that frum Jews associate some professions from outside their own realm. I have a few friends that are frum from birth that are also scientists, they are even rarer.

queeniesmom said...

It starts before the Shidduch. My neighbors daughter was an honors/AP student in HS who was planning on going to medical school. She goes to Israel for 1 year then another, comes back saying medical school is inappropriate, this from a girl who won awards for research projects and wanted to go into research. She's now married, has 2 children and supporting a husband in kollel. There is discord between the parents about supporting them. The grandparents help but this is also causing major discord. Instead of making a contribution to society, this girl and her famil;y are now caught in a downward poverty cycle. For what reason?!

Anonymous said...

When they presented my wife to me as a possible shidduch the shadchan told my parents that she worked in a drugstore. Well, yeah, she does--she is a pharmacist with a graduate degree in pharmacology. After we were engaged I asked my mother in law why they gave out the information that way. She threw the question back to me and asked what my reaction would have been if I had been told my wife was a pharmacist. Honestly, I don't know. I don't know if my parents would have liked the idea, not knowing the girl. I'm not sure how I would have reacted either. Once I met my wife what she did didn't make a difference because I liked her as a person. A good reason for not prejudging people based on what they do.

Anonymous said...

Just a question for Lion and all those who think that going into science or medicine is not good because of the time involved. How much time does a guy learning full time spend at home with his family? If that's his job, and he works at it 6-1/2 days a week then when is he home? Yes I include Shabbat because when he goes away to daven all morning and then spends the afternoon at a shiur and more davening and then learning Motzoai Shabbat then he isn't home either. So he goes away early in the morning, comes home to grab some supper and then either goes away for night seder or he sits with a chavrusa and learns in his home. But he is not on call for his family. Learning boys "work" longer hours then doctors do. They work longer hours then most people do. If family time is the issue for not going into the sciences then we shouldn't be sending the boys into learning either. And if it's the money, then they don't earn much either.

Lion of Zion said...

AVI:

i guess i'm coming from a different background, but i just don't understand what was the problem with her being a pharmacist. that she's smarter? has more education? (although a minor correction: a PharmD is not a graduate degree.) makes more $?

btw, i happen to know a lot of pharmacy chicks, and they all rock. (and now a post on sexist attitudes in our daily language :) )

Lion of Zion said...

robbie,

"you've never been in Law school"

correct.

"if you think you get more time then in medical school to see your family."

i stated my observations of what i saw of friends in med and law schools and what they described. maybe i'm wrong and my friends are the outlyers.

"the first few years of practice 80 hour weeks aren't even considered unusual."

what do you think a resident works? (except that he works for a pittance). and shabbat/haggim are not necessarily family time either.

and i don't think you can compare the investment


also, even if you are correct that laws school is as difficult as med school, med students are working their buts off much earlier. lsats aside, the workload to get into law school is much easier than med school. you can't compare the pre-med curriculum with the traditional pre-law majors. in some cases people skip college altogether and get into law school with a BTS (PROFK: another reason law school is more popualar?). i also know people at rutgers and johns hopkins law who got in with a BTS (although i don't know if these are considered good schools and how BTS affects job prospects)