Read as Dr. Goldstein gets JobShadowed about his career as a Bariatric Surgeon.  You can find Dr. Goldstein on his website www.drgoldstein.com and on his Twitter feed in the sidebar of this interview.  

What do you do for a living?

I am a bariatric surgeon.

How would you describe what you do?

I perform operations that allow obese patients to achieve weight loss.

What does your work entail?

I evaluate patients that have been unsuccessful achieving long term weight loss by non-surgical means and determine whether or not they would be appropriate candidates for weight loss surgery. If I deem them appropriate candidates, I help prepare them properly for surgery, minimizing as many potential risks as possible, and then perform the operation. I also assist them with their postoperative care following the surgery.

What’s a typical work week like?

Two days per week I evaluate patients in the office and provide their preoperative and postoperative care. The remaining three days per week are spent performing operations and procedures.

How did you get started?

I decided to attend medical school after completing four years of undergraduate college because I was very interested in science, helping people, and running my own business. I felt that being a physician allowed me to achieve all three of those goals. During medical school, I took a strong interest in the surgical specialties because I felt they allowed me to physically treat disease, using my hands, rather than the more cerebral medical specialties. As I completed my 5 years of residency training in general surgery I realized I had an ability to perform minimally invasive, or laparoscopic surgery, with a certain degree of comfort and therefore decided to enroll in an additional year of training in a minimally invasive and bariatric surgery fellowship. Following the fellowship I entered the private practice of minimally invasive and bariatric surgery.

What do you like about what you do?

I find it very rewarding to help people using the skills I’ve developed over the many years of my training. I gives me a sense of accomplishment to see the great success patients can achieve with weight loss surgery, knowing that I helped them get there. I also find operating to be fun!

What do you dislike?

Unfortunately, dealing with health insurance companies can be quite challenging. They can make it difficult to help patients at times because their rules regarding who can and cannot undergo the operations are quite strict. Also, as a surgeon you are expected to take a certain number of nights and weekends “on call”, which means you have to be available to deal with problems that may arise during these “off hour” periods. Lastly, the amount of money insurance companies pay the surgeon for his/her work can vary and the physician has little control over how much they are paid for a given operation.

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

For the most part, the health insurance companies pay the surgeon for the work he/she does. Sometimes patients do not have health insurance and pay for it themselves, but this is less common. How much money do Bariatric Surgeons make? The salary of a bariatric surgeon can vary depending on how many operations they perform per week. I would estimate that the average salary of the average bariatric surgeon can range from $250k to $500k, depending on whether they are employed by a hospital or are in private practice (run their own business).

How much money did/do you make starting out?

When you first come out of training, you will likely be employed by a private group or hospital system, as nowadays it is very difficult to simply open your own practice. As a first year employee you can expect to make somewhere in the $200k range.

What education, schooling, or skills are needed to do this?

You must go to a four year college or university, followed by four years of medical school (although there are some combined college and medical school programs that will allow you to finish faster than eight years), followed by a general surgical residency which could range from five to seven years depending on whether or not you take the option of doing a couple of years of medical research during your residency training. Then you would ideally enter a bariatric surgery fellowship, which typically is one or two years long. You do not have to do a fellowship, but the odds of you getting the position you desire without one are lower.

What is most challenging about what you do?

Depending on how you structure your practice, and how many partners you have to share the “on call” days with, the hours can be demanding. Be prepared to work hard as a surgeon. What is most rewarding? When a patient stands up at a seminar in front of a room full of people and says, “Dr. Goldstein changed my life”.

What advice would you offer someone considering this career?

I would strongly recommend that before even entering medical school you spend a day or two shadowing a bariatric surgeon to really understand what the lifestyle is all about. Becoming a surgeon is a choice that requires years of training and sacrifice of personal time before you achieve the ultimate goal of practicing surgery on your own.

How much time off do you get/take?

I personally take six weeks off per year. As a surgeon in private practice, you only make money when you operate, so the more time you take off, the less you make.

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

Two common misconceptions are: 1. All surgeons are rich – remember surgeons many times have medical school loans and/or college loans to repay, in addition to their business and personal expenses, so they don’t necessarily take home all the money they make; and 2. Surgeons just need to know how to operate – surgeons have to have a broad knowledge of medicine so that they can make the appropriate diagnosis before they commit someone to an operation.

What are your goals/dreams for the future?

To be able to provide for my family and give my children advantages in life that I did not have. Also, to be able to serve my community as a respected member of society who contributes to the welfare of my fellow men and women.

What else would you like people to know about your job/career?

Medicine is constantly evolving. Be prepared to deal with the fact that the way medicine is when you enter medical school may not be the way medicine is when you finish your fellowship.