6 specialties docs say are medicine's biggest 'dumping grounds'
Industry Buzz
It's the ER. I'm either wrong, and have created more work for you by you now having to write a consult note about why I'm wrong. Or I'm right, and have now created not only more work for you, but more work that needs to be done ASAP.
—@DadBods96 in r/medicine
We primary care providers either don’t know anything or think we know it all. We either refer too early or too late, and either for nothing or for something annoyingly difficult to diagnose.
—@terracottatilefish in r/medicine
Across medicine, few roles are spared from scrutiny—physicians in every specialty juggle clinical pressure, administrative overload, and, often, a surprising lack of respect from both peers and patients.
That tension came into sharp focus in a recent Reddit thread in r/medicine asking: “What’s the most maligned specialty in medicine and why?” This question prompted candid, sometimes biting responses from physicians across disciplines.
From the ER to primary care and beyond, their answers reveal a profession grappling with perception as much as practice—starting with two specialties that many say bear the brunt of it.
Emergency medicine
When it comes to who has it worse, the Reddit threat had a few clear winners. Among them, emergency medicine.
“It’s the ER. It’s not close,” writes doctor on Reddit @Hippo-Crates. “We had the weirdest thread when Covid was really bad talking about how people wouldn’t complain about the ER again. Didn’t last long.”
User @passwordistako concurs. “Most maligned is ED and it’s not even close. I do not work in ED and I would rather go back to making coffee than do it, as the general public treated me with more respect when I made coffee and delivered pizza than ED get from their own colleagues, let alone the general public."
"It's the ER. I'm either wrong, and have created more work for you by you now having to write a consult note about why I'm wrong. Or I'm right, and have now created not only more work for you, but more work that needs to be done ASAP," writes user and ER doc @DadBods96.
Family medicine and primary care
Family medicine, internal medicine, and primary care is described across the thread as an administrative default and dumping ground.
Reddit user and primary care physician @flexible-dogma writes: "The whiplash from specialists between 'PCPs are super docs that can clearly manage any medical condition under the sun and thus I don't need to accept their referrals if I don't feel like it' followed shortly by 'hey PCP, can you plz be my scribe and enter orders for these 8 million labs for me' is head spinning."
"We primary care providers either don’t know anything or think we know it all,” writes doctor @terracottatilefish. We either refer too early or too late, and either for nothing or for something annoyingly difficult to diagnose. . our poor work-life balance is our fault and we also need to be more available to our patients who work and message outside regular business hours."
"I would say primary care (IM/FM) mainly because it has become the default administrative dumping ground for anything anyone does not want to deal with. FMLA, disability, service letters, secretarial work for specialists," writes @PeriKardium.
Radiology
Radiologist @DrThirdOpinion writes, “We just look at pictures. Computers can do our jobs already. Clinician history and context are meaningless. A pixel is a pixel, and every surgeon is actually double boarded in surgery AND radiology. We never ever touch patients either. Just put a needle near a CT scanner or a US probe and the tumor or fluid will attract the needle right towards it.”
Related: These 7 specialties may be obsolete in the next decadeAnesthesiology
"Everyone thinks we are lazy, nobody understands what we do, everyone blames everything on us, everyone expects us to be everywhere all at once the moment they want our help with something and cannot understand that if I'm in a room doing anesthesia I cannot also be in another room doing anesthesia," writes Reddit user @casapantalones.
Pathology
Reddit user @CourageKind thinks it must be pathology, writing, “I mean, if I had a dollar for every time someone tried to convince me not to do pathology because I ‘was so good with patients, it would be a waste,” I could have paid off my med school loans pretty… quick.”
Honorable mentions
Beyond the usual suspects, a handful of less frequently cited specialties chimed in with their own sharply worded takes on what it means to be misunderstood in medicine.
“Psychiatry. We’re not real doctors. And anyway we’re just pathologizing variations in thoughts and behavior. There’s nothing real there. And if there were, it’s not medical. And we won’t take a patient with a systolic blood pressure of 130 or a sodium of 133. Anything not to treat patients. Which we can’t, because again, not-doctors treating not-pathology. Poorly! Anyway no one ever gets better. Obviously,” writes user @PokeTheVeil.
User @Neurogenesi5 writes: "Otolaryngology Head and Neck Surgery - I'm a complex airway reconstructive surgeon and my patients just want their ears cleaned. 'Sir your subglottis is 2mm. I don't have time to clean your ears before this awake tracheostomy."
Reddit user @OTN writes that radiation oncology is the most maligned because “all we do is push the button,” with the sarcastic caveat that “we don’t even push the button… we have people for that.”