Doctors today: Young, broke and human

Doctors today: Young, broke and human

“Oh, you’re my doctor? A woman?”

Who do you picture walking through the exam room door at your new doctor’s office? Is it the Norman Rockwell depiction of an older, jolly looking male? After residency I was alarmed at how many patients commented on my age and gender:

“How old are you, 12?” or, “Oh, you’re my doctor? A woman?”

This got me thinking about misconceptions people have about doctors, and I thought I could share a few things many people may not know about their favorite neighborhood doctor.

1. We are not as rich as you think. It’s true that doctors make a salary that is well above the national average. However, after about 10 to 15 years of education and training, making little to no money, we find ourselves in hundreds of thousands of dollars in debt. It can take about double the amount of time originally invested to repay a debt, which can end up costing more than twice as much due to accrued interest. I tell people all the time, don’t become a doctor if you are trying to be rich. Become a doctor because you can’t see yourself doing anything else and you are willing to put in the sacrifice.

2. We exist in female form. While 70% of physicians in the U.S. are male, the number of females entering the medical field continues to grow. Not only do females have to jump through the same hoops as their male colleagues when it comes to medical training, they may even have a slight edge. A study done by the University of Montreal showed that female doctors score higher on quality and care measures and are more likely to follow evidenced-based guidelines. Another study showed that female physicians tend to show more empathy and are better listeners. (This is not meant to bash male physicians. There are very talented male physicians practicing medicine as well.)

3. We are young. According to the Association of American Medical Colleges, of the active physicians in the U.S. in 2012, about 60% were under the age of 54. With baby boomers retiring, someone has to take over the roles of older doctors (who by the way, were at some point young too). Physicians fresh out of residency have had several thousands of hours of experience in addition to seeing several thousands of patients. While more experience is an advantage, so is knowing the latest health guidelines. A study published in the Annals of Internal Medicine showed that younger physicians are more likely to order necessary tests and appropriately counsel patients on preventive health than their more experienced colleagues.

4. We know more than medical websites. It’s wonderful when people want to be informed about their health. There is however, a lot of false medical information on the Internet. Doctors learn the information presented online at an advanced level and take it a step further by applying that information to each individual. A cough in Mr. A who smokes, may be related to something completely different than a cough in Mrs. C who may have other health problems or medications.

5. We are human. Doctors have a lot of responsibilities placed on their shoulders, which is why becoming a physician is not easy; we are dealing with human lives after all. That being said, doctors don’t always have all the answers either. It’s called the “practice” of medicine for a reason. Sometimes we have to try a few things and rule some things out, which may require a few tests, additional appointments or even referrals to other physicians.

The stone age has passed

Regardless of our age, gender, or student loan debt, doctors have all taken an oath. An oath promising to value and respect human life, do no harm, maintain confidentiality and ultimately do what is best for patients and our community.

So the next time a young doctor walks into the room, give her the benefit of the doubt. She may be 20-something, driving a 2000 Toyota, with half of her paycheck paying off student loan debt. If you look hard enough you may see the “age lines” she and the next generation of young doctors acquired through the many sleepless nights and delayed gratification invested in taking care of you and your loved ones.

Aunna Pourang is a family physician who practices integrative medicine.  She is the author of the upcoming book, Meditate Don’t Medicate: A 14-Day Journey of Letting Go and Finding Yourself.  She can be reached at her self-titled site, Dr. Aunna Pourang, MD.

Image credit: Shutterstock.com

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  • QQQ

    I thought this was interesting

    If you want to read articles, read “why doctors don’t get
    rich” and “why doctors are poor, and computer geeks are rich”. These
    articles are from money managers by Michael Zhuang and Karen Cheong and
    they explain why medical doctors are poorest of high income earners and
    are financially struggling!

    ————————————————————————-

    Many of them are woefully financially illiterate. I cannot understand
    why people who are supposed to be clever can be so inadequately informed
    in areas of managing their finances.
    -Robert Kiyosaki-, author of “Rich Dad, Poor Dad”

    “Physicians have a significantly low propensity to accumulate substantial wealth.”
    – Thomas Stanley-, author of The Millionaire Next Door

  • John C. Key MD

    No one should get a gender preference at a medical facility. All are professionals, nurses, docs, techs alike. I was seen by my first opposite-sex physician way back in 1972, didn’t blink then and haven’t since. Get a grip people.

    • Thomas D Guastavino

      Not to open a can of worms, but there were gender preferences in 1972. It was called affirmative action.

    • Patient Kit

      Plenty of women prefer a female OB/GYN. I happen to have a male GYN oncologist, who I think is an awesome doc and who I trust with my life. But I think it’s very understandable why many women prefer a female OB/GYN.

      • John C. Key MD

        Of course they should, and should select the provider of their choice in a private setting. But if they go to an ER or other impersonal group situation they should expect to waive that choice.

        • Patient Kit

          I can see having no choice of what doctor sees you in the ER because it is an emergency situation (or should be an emergency) and a busy ER needs it’s full staff functioning. Even in the ER, I think exceptions need to be made. For example, for rape victims and women who won’t undress for a man who is not their husband because of religious beliefs.

          I disagree that patient choice should only be available in private practice settings, especially when we’re talking about longterm doctor-patient relationships, not one-time ER visits. I’m sure that the excellent teaching hospital-based Women’s Center where I currently receive my care will accommodate women who are not comfortable seeing male GYNs. My sister works as a psychotherapist (MSW, not MD) for HHC, the public hospital system here in NYC. I know for a fact that they consider patients’ personal preferences when assigning new cases. And they get choice regardless of insurance status. Patients are also free to request a change of therapist if they don’t like the one they are seeing. I’m sure that’s true at my hospital’s Women’s Center too.

          Surely, you’re not saying that only patients who go to private practice doctors should have any say about who treats them?

      • querywoman

        My own past with female ob/gyns has left me despising them. I prefer a man.
        Some women, like my deceased mama, do not want another woman touching their sexual organs.
        Most female family practitioners and internists are okay with me.
        A female internist told me in the early 1990s that OB/gyn is a very male-dominated profession.
        Women are starting to dominate the OB/gyn profession. Perhaps with newer training, their attitudes are changing. I do not care to go to a female ob/gyn to find out.

        • Patient Kit

          I’ve been lucky to have both excellent female GYNs and male GYNs in my life. I have no personal gender preference myself for my GYN but I totally understand why many women do either way. My one notorious bad GYN experience was a female GYN — the one who told me while I was in the stirrups that I probably had ovarian cancer and that if I voted for Obama, I’d get what I deserved. Needless to say, she’s not my doc anymore. I moved on to my current awesome male GYN oncologist. That one bad experience is no reason to avoid all female GYNs though. I care more about their skills, experience, compassion and communication style than their gender.

          Right now, for a couple years following my surgery, I have to have four pelvic exams a year (every 3 months). Since I’m. being treated at a teaching hospital, in addistion to my attending GYN ONC doing an exam, one of the residents working with him (both genders) often does an exam too. That means 8 pelvic exams a year, two each visit, one by my doc and one by a resident. I’ve gotten used to it. It comes with the territory of getting such excellent cancer care at an academic med center while on Medicaid. By the communication and people skills he has with patients, I think he must be an excellent teacher. I’m happy to contribute, in my small way, to the development of new docs who I can only hope will turn out to be as good as my doc.

  • Patient Kit

    I can understand why male patients might, for example, prefer to see a male urologist and I don’t see that choice as discrimination against female doctors. I think the gender comfort zone in areas like urology, GYN and psychology is very understandable and I think it’s a different issue than thinking a doctor is inferior because of their gender. Surely, doctors who choose to specialize in these fields — male GYNs and female urologists — must expect a certain amount of gender preference issues from patients.

    • Ladyimacbeth

      Yeah, I think it’s perfectly understandable. When I had to have the full head to toe skin cancer screening I specifically opted for a woman. I just went with what I was most comfortable with.

  • Rebecca Blanchard

    I think the only time I was startled by the doctor who entered the room was the first time I was treated by someone younger than myself. (And my mother quipped “Wait until they’re younger than your kids!) It was more a startling realization that I was getting older, not so much for a young doctor who treated me (at a walk-in clinic).
    As for GYN exams, well, I find that a bit uncomfortable no matter what the gender of the doctor is.

    • Patient Kit

      I agree with you about the age of our doctors. When we’re younger, all of our doctors are older than us. Then, at some point, we reach an age at which many of our doctors are suddenly younger than us. I’m in my fifties now and my favorite doc is 40. Some people never get used to that shift. LOL!, my mom is 90 and she still seems shocked that all of her docs are younger than her (even though almost everyone in the world is younger than her and most people really don’t want a doctor who is 100 treating them). Perception and perspective are funny things.

  • FEDUP MD

    So of course if someone does not want, say, African-Americans involved in their care, that’s OK then?

    • EmilyAnon

      If a patient were to verbalize their prejudice, then of course that is not OK. But how would you know the motives of a patient if they made a silent choice. You can’t just assume that because a patient picked a female doctor over male, picked a young doctor over old, picked an Asian doctor over Black, that their motive was based on deliberate exclusion of another group.

      • FEDUP MD

        In this example the patient is not being silent about it, is he?

        • EmilyAnon

          Nothing in my previous post would challenge that.

    • Ed

      Your question is clearly a “red herring” and you know it! You folks preach this whole gender neutral approach for expediency and profit alone while simultaneously practicing employment discrimination against male providers when it suits you. All completely legal of course, which I completely support because I want my mother, wife, and daughter to receive healthcare in an environment their completely comfortable in. The irony and hypocrisy in this is the author, like many female providers, likely insists on same gender OB/GYN care while criticizing male patients when they have the audacity to question or object to a female provider for their gender specific healthcare. Apparently, what’s good for the gander is clearly not good for the goose unless it serves a providers self-interest.

      • FEDUP MD

        I am not really sure what your point is as related to this article, as you seem to make a lot of assumptions. The author is stating that the patient seemed surprised that she was a young woman. I can tell you as a young female physician it gets old when patients would be surprised that “the doctor” was not a gray haired older white man, just as my African American colleagues are sometimes subject to the same response. People have a stereotype of who “the doctor” is which the author is pointing out, is not based in reality or numbers anymore.
        As far as choosing a physician, I would presume if this were a nonemergent situation, the patient would have investigated the physician he was making the appointment with and selected according to his preferences, including gender, if desired. If it is an emergent situation, then he is stuck with whoever is there. I ran into this a few times as a very young looking attending in a busy ED. I would sometimes be asked if they could see someone “older.” I explained that I was the only one on duty so if they wanted another opinion they could go to a neighboring hospital, because I was the one there that day.

        I am also not sure why you would assume the author would want a female OB Gyn. I can’t say that is very prevalent among female physicians, in my experience. I have had babies delivered by male and by female OBs. I think we realize it’s just a job to them, same as us in other specialties.

        • FEDUP MD

          Oh, and sometimes I have male teenaged patients who ask to see my male colleagues in follow up, and I get female teenaged patients for the same reason from them. These are all in outpatient clinic, so no emergency. No big deal. But, if you are seeing me in the hospital, I am the only one there. It’s either me or you go to another hospital.

          The whole “complete patient choice” leads to situations like in the NICU where the parents insisted no African-Americans care for their child, and the hospital complied by moving around nurses to make this happen. When the nurses found out, it hit the papers, as you can imagine. So it’s not really a red herring. It really happens.

          • Ed

            The author states she was “alarmed by how many patients commented on her age and gender” which clearly illustrates those patients were unable to research her prior to their first meeting. You’re correct about my assumptions but generally speaking, I think it’s entirely understandable patients might be uncomfortable with an inexperienced young physician and male patients doubly so with a female, depending on the nature of their illness or injury. We’re in complete agreement on emergent situations and the only one available. However, you automatically give her a pass by assuming she’s an ER doc and the only one available. A lot of folks don’t get to pick from a huge pool of physicians based on insurance limitations and/or scheduling constraints. Why it may be just a job to you, it’s our one and only body and you don’t get a free pass simply because of the initials at the end of your name. Finally, you raised the racial discrimination card, not the author. Racial discrimination is illegal and reprehensible in any form but it’s perfectly legal and acceptable for a patient to reject a physician because of their age or gender; the two are not comparable.

          • FEDUP MD

            Please explain in detail why it is reprehensible to judge someone on their race but not gender, as a matter of course.

            If it is the trauma angle, I have worked with WW2 and Vietnam vets with PTSD, especially those tortured as POWs, who get nervous around people of Asian descent. Is it OK for them to do the same as you suggest about gender? If not, please explain why gender is so different from race.

          • Ed

            No disrespect intended but really? A significant percentage of female patients will only see female physicians for their gynecological care; are you arguing they shouldn’t have that choice? POW’s are absolutely well within their legal rights to discriminate against Asian providers for their healthcare. How is their POW experience any less traumatic than a female rape victim refusing to see a male ER doc? The bottom-line is patients get to pick who participates in their healthcare, even for
            reasons you might consider discriminatory, and there is nothing you can do about it.

          • Mandy Jeddeloh Flory

            I do not think the author was saying men do not have the right to object to female doctors. Her point was the misconception that at times female doctors walk in the room and the patient is thrown that you are
            a female. I am a female physcian I cannot tell you how many times I have been called a nurse, even after correcting the patient. My male counterparts do not seem to have this same experience.

          • FEDUP MD

            If the patient did not research the doctor they were making a nonemergent appointment with, to be frank, that is on the patient. If they don’t want a female physician, they can ask when making the appointment if the physician is female and request another physician if they want, even if they don’t have the resources to investigate more than that. Not wanting a female physician but taking no steps to prevent that, then expressing that rudely when she comes in the door is a failure of personal responsibility. If insurance is limiting the pool, that is between the patient and their insurer, and not the physician’s fault. Taking that out on the physician is also rude. And again, if the patient has scheduling constraints, that is also not an excuse to be rude.
            It’s not Burger King. You can’t have it 100% your way. If you don’t want a female physician, take steps to make that happen and be empowered. But if you can only come on Thursdays at 3, and the only one with available spots is a woman, then you can take it or leave it. If your insurance only covers a female physician, lobby them otherwise. But showing up and then saying you don’t want a female physician

          • Ed

            Generally, as I indicated earlier, I agree with you but that doesn’t change the fact that both male and female physicians will continue to experience surprised patients (who obviously didn’t do their homework). What’s a patient, clearly uncomfortable for a myriad of reasons, supposed to do? “Can’t have it 100% your way.” As much as we spend for healthcare, I’m going to have it 100% my way every time or I’m going somewhere else. The days of Americans entering paternalistic medical facilities where we’re treated like inmates in the county jail are over.

          • FEDUP MD

            I don’t disagree about going elsewhere. But I have many patients who insist on having it their way but still want to stay. Like the ones who insisted they wanted to see only me that day e, not one of my partners, while my nurse explained that I was in the OR having my baby via c-section at that moment. Or the ones who were angry they had to reschedule because I was in the hospital with my ill son, or in the hospital myself because of a car accident.

          • Ed

            You can’t fix stupid; sincerely, my sympathies!

  • Ladyimacbeth

    The funny thing is that I had built it up in my mind and made it much bigger deal than it was. I had this vision of having to stand there without a stitch on while someone sitting on a rolling stool wheeled around me scrutinizing every square inch. Needless to say, it wasn’t quite like that. So, in the future I don’t think I would care too much who did it.

    • Patient Kit

      LOL, I haven’t had one (yet) but that’s kind of how I imagine a head-to-toe derm exam. In my experience, many medical procedures are not as bad as we expect them to be. My first colonoscopy comes to mind. People avoid them like the plague but it really wasn’t that bad. And humans seem to have the capacity to get used to almost anything. I’m sure there are medical procedures way worse than my very vivid imagination though that people have to suffer through.

      • Ladyimacbeth

        Yeah, I thought I would have to drop the sheet & stand there naked as a jay bird. Needless to say, I put that off for a while until my internist really got on my case about it. If you have to do it it’s not a big deal at all. They looked at my body in sections with drapes, so I got to pretend to have some modesty.

  • querywoman

    It’s not my business to ask a doctor about finances. If you are a recently licensed doctor and not making the money that you hope to make someday, you should be in an Income Based Repayment plan for you student loan.
    I am currently in an IBR plan.

  • Ladyimacbeth

    Sometimes patient preferences can backfire on them. I had a patient who demanded that I draw her blood because I was a nurse, and she didn’t want a CNA doing it. What she didn’t know was that it was my first week as a nurse, and the CNA had been drawing blood for years. The phrase be careful what you wish for comes to mind.

  • Eric W Thompson

    Remember, this is an equal opportunity society. If a patient can choose a provider by gender, they can do so by race and religion also. One Black male told me he would only see Asian doctors as they get the highest scores. You either allow patients preference; or you don’t.

    • EmilyAnon

      If you took away patient choice, I wonder how that would work. Would the patient be assigned a doctor or would they pick a name out of a hat.

      • Eric W Thompson

        Not sure. In the VA, we usually assign a new doctor, no questions asked. Whether it is a woman desiring a female doctor or whatever. Saves us from any charges of discrimination like what happened recently in Milwaukee. And why should a patient have to see a doctor he or she is uncomfortable with? I happen to have a female primary care provider. It works.

    • Ed

      “You either allow patients preference; or you don’t.”

      Are you implying that providers can deny a patient their legal right to choose who their providers are?

    • Suzi Q 38

      This is reality.
      Patient preference has been alive and well for decades.
      Patients go where they feel most comfortable.

      • Eric W Thompson

        That is exactly how it should be.

  • SteveCaley

    Recommend on the list – vulnerable, and manipulated. No fish jumps in the boat without the hook – and 20something and optimistic surrenders to 30something single mom working two jobs in a white coat.

  • Eric W Thompson

    You may not, others do. By law it is the same.

    • Ladyimacbeth

      Well, I think if people cannot understand the difference they’re being silly. I would be more comfortable being undressed in a women’s locker room, than a men’s locker room. Is that being discriminatory against men?

      • EmilyAnon

        Brace yourself, LadyM, that could be a litmus test (or punishment) for those accused of gender prejudice.

        • Ladyimacbeth

          Ha, you’re right. It may be coming.

          I have been trying to picture a gender discrimination case brought because a patient declined to be naked in front of a physician of the opposite sex. “Your honor, this patient would not let me see her naked, but she let a female physician take a peek.” (or vice versa). Yeah, I don’t think that case would go very far.

          Luckily most health professionals are sensitive to the embarrassment patients feel and try to make sure patients are as comfortable as possible. Those who would get offended over a patient preferring a physician of the same sex (particularly when it comes to invasive stuff) have serious issues.

          • Ed

            It’s a well established law called BFOQ (bona fide occupational qualifications) which allow patients and employers to discriminate based upon gender.

          • Eric W Thompson

            True. But everyone is different. I don’t care that I have a female doctor. Many would think it silly that you may prefer a female. Many do not want someone of a different race or religion to care for them. Everyone has their own set of what makes them uncomfortable. All are equal under the law. You may think they are silly. They may think the same about you. That is why a patient should be able to change providers no questions asked.

  • FEDUP MD

    No, I think I make it clear below that I have no problem with patients wanting to see a certain gender, or ethnicity, in a nonemergent situation. I certainly have teen patients far more comfortable with same gender and I transfer or accept in clinic as desired. That said,your preferences are your own, and should be kept so. Openly stating you don’t want a fill-in-the-blank doctor to someone who meets that description, like the patient in this example seems to imply very baldly, is insulting and not a way to start a doctor-patient relationship with open communication. As this title notes, we’re human too, and opening with an insult is not a good way to form a relationship. And if this is done in an emergent setting, well, that is who you are stuck with.

    • FEDUP MD

      Also, it was only about 50 years ago there were separate facilities for different races in this country, including locker rooms.

      • Bill98

        So, you equate separation by gender with segregation by race? Sexual attraction, sexual assault, and basic human modesty, are why we separate by gender for intimate situations. No such fundamental argument can be made for segregation by race. I truly hope that you realize this, and were just desperate to counter my argument.

        As for how patients should vocalize their preference, some ways are better than others. But, when folks are stressed, taken by surprise, in pain, etc., they don’t always do so in a polite fashion. This is especially true when their objections are met with scorn, and the usual “we’re all professionals”. So, under those circumstances, the patient might not consider the feelings of the others involved.

        But then, your feelings really aren’t the point. This isn’t about you, it’s about the patients. That you continue to argue this from the perspective of the medical professionals just reinforces my previous comment about empathy.

        • FEDUP MD

          If you read the title of the article it’s “Young, broke, and human.” The article is not addressing situations where clearly a patient is requesting a same gender physician for intimate care. It is addressing the situation where the assumption is that “the doctor” is a man, and the implicit assumption that if their expectation is not met that it is somehow inferior. As noted above, I have no problem with transferring (or accepting) patients in a nonacute setting due to gender preference. But having my competence questioned on the basis of my gender is something that has openly happened multiple times, and I think if you ask other female physicians you may hear the same. And the expectation that

          • FEDUP MD

            we sit, smile, and nod and not be insulted by that is not a reasonable human reaction, since the title of the article is emphasizing our humanity.

            And yes, obviously gender is different from race. However, it is important to realize that male privilege, just like white privilege, does exist and can be hard to see if you are on the receiving end of it. The fact that it is acceptable to openly question a female physician on her competence due to her gender is mind boggling to me in this day and age.

            I would recommend you round in the hospital with me someday. You can have a team where I will introduce myself as the attending physician in charge, we will have female residents and interns, and a male med student hiding in the back. Despite clearly delineating

          • FEDUP MD

            our roles, it is not uncommon the male med student is identified as the attending or the “doctor” leading a team of nurses. Trust me, it can get old, and there is not a female physician out there who can say this doesn’t happen to them.

          • Ed

            No where does the article infer that these patients questioned her competence due to her gender; that is strictly your interpretation.

    • Ed

      The patient expressed surprise that the physician was either young and/or female; how do you expect them to react? Exactly how is a patient supposed to express to a physician that their uncomfortable without openly saying so; is that not open communication? And if their not going to be that particular patients physician, tell me why I care about a relationship that is effectively over anyway?

      • FEDUP MD

        Because generally 1) why would someone be surprised that a physician was young and/or female? The numbers as stated in this article bear out that it is likely that a random physician will be one or both. Sure, if someone is old this is understandable based on their experience but coming from young people, it’s not uncommon and surprising. 2) Generally we have basic rules governing how people interact in our society, and violation of them is considered being rude. I guess you could go around being rude to anyone you’ll never meet again but it doesn’t really grease the wheels of society well. I mean, I take time out of my day to say please and thank you and talk to waiters and service people I’ll never see again. I guess you could consider it a waste of time but

        • Ed

          I think we generally agree on these issues much more than our respective comments indicate! What’s missing is the context of the author’s interaction with her patients; you and I are filling in those details based upon our read and neither is correct. The only rude comment cited IMO is “how old are you 12?” That’s certainly uncalled for as is your assumption that saying please and thank you is a waste of time.

          • FEDUP MD

            I suspect the author at least takes the comments as an insult, considering how she groups it with the age comment. I seriously doubt that many male physicians walk in the door to hear, “oh, my doctor is a man?” unless they are an OB GYN.

            Seeing as many female physicians have similar stories, especially re: repeatedly introducing themselves as physicians and then being continually called nurse, I don’t think she is being overly sensitive.

  • querywoman

    Later, the doctor should make more money. I am on disability. I have an IBR on a student loan.
    I could take a disability forgiveness, but but then I couldn’t get a loan.
    I knew that it would capitalize eventually and that the IRS would issue me a forgiven debt statement.
    I have worked for the IRS.
    I just researched IRS law. I discovered that, if my total debt was more than the amount of the loan before it defaulted, I am probably exempt from paying taxes on it.
    However, let’s say a doctor owes a $200,000 student loan and it is eventually forgiven. Taxes are usually 10 percent of income. So the doctor might owe $20,000 tax. The IRS will give you a payment plan, and you’ll end up paying a lot less for your education.

  • Ed

    Here is the bottom-line; patients can simply say no and we don’t have to explain our rationale to anyone. Providers cannot touch or even be present in the exam room with a patient without their informed consent; just one of the well kept secrets of paternalistic medicine!

    • Eric W Thompson

      Of course it is a choice. But if he rejects the doctor he will have to go elsewhere. AND pay. I always tell the patients they are free to get care wherever they want, but the VA will not pay for it. No one at any health care facility could force a patient to pay. Neither can the patient force the facility to give care.

  • querywoman

    I understand, but you do have to think it out. Of course, with the IBR you can always make higher payments.
    I just now discovered the IRS section about debt forgiveness.
    I’ll have to check again to see if things like a home mortgage and the cost of a practice are covered in the debt total of exceeding a forgiveness loan.
    Nevertheless, if you owe $40,000 taxes when you get a forgiven debt statement instead of $400,000 on a student loan, you’ll still end up paying less.
    And if you’ve become ill or unable to work and have little money by then, the IRS might put you in a, “currently not collectible,” status.
    The IRS usually doesn’t prosecute unless fraud is involved, mostly hiding money.
    A guy won a million somewhere and failed to pay income tax and got some time in the federal slammer. Do you feel sorry for him?
    If you do get a private practice, please be careful about paying your quarterly payroll taxes. Then you will have a better chance of dealing with them if you need it later down the road.
    Always contact the IRS if you have a problem.

  • FEDUP MD

    I don’t get mammograms because I am not old enough.

    I wouldn’t have a problem with a male mammographer, however, personally.

  • EmilyAnon

    “How old are you, 12?”

    One bright spot in your dilemma of looking too young is that this condition will clear up on its own.

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