I’m a high school senior interested in health care. Should I go to med school?

Where will the next generation of health care leaders come from?

Thirty years ago, if you had ambitions of playing an important role in this field, you went to medical school. Today, the best route to leadership is anyone’s guess.

Becoming a physician means grinding through 10 to 15 years of college, medical school, residency, and additional specialty training. Once upon a time, that all but guaranteed you a substantial income, a huge amount of prestige, and all the skills needed to climb as high as your hard work could take you.

Today, the path ahead is anything but clear for young people like me — I’m a high school senior — with a keen interest in health care.

Last summer I traveled 2,000 miles from home to do an internship in a genetic medicine practice. Although I had thought the experience would crystallize my career choice, it actually made it less clear.

I see four huge forces affecting the health care sphere. It’s possible to make a good argument for any one of them as the most important path to leadership in this field.

Genetic and precision medicine. The cost for testing an individual’s genome continues to drop rapidly, opening the door to medical approaches that are more effective and can start miles further down the road than traditional approaches.

Technology and big data. The ability to track the health of a given individual or population has increased dramatically with more universal information technology and electronic medical records. The accrual of big data can let engineers seek out patterns and correlations in disease and treatment that will likely change the way we think about the economics and incentives of health care.

Government policy and regulation. This fall showed the first signs that the Affordable Care Act may crumble. Insurance companies are pulling out of more markets while health care costs are soaring. And all bets are off if Donald Trump carries out his promise to dismantle Obamacare on day one of his presidency. Is the way forward more government involvement or less? Either way, government at all levels will play an immense role in the future of the biggest industry in America.

Entrepreneurship and new business models. Just as companies like Amazon and Uber have completely restructured the retail and local transportation industries, it’s possible that Silicon Valley will rethink and reengineer the delivery of health care services. The venture capital industry is focusing huge amounts of money on health care, increasing the probability that the way we receive medical treatment will change as much as, or even more than, the way we buy books.

Physicians aren’t necessarily equipped to excel in any of the new disciplines. For the most part, they’re not geneticists, and they’re clearly not software engineers, legislators, or natural entrepreneurs.

In one survey of doctors, a stunning 90 percent advised young people not to go into medicine as a career. Despite the looming shortage of physicians, who wants to spend 15 years studying and preparing for a career in which the current practitioners are waving their arms and saying, “STAY AWAY!”?

(Editor’s note: If you have advice for the author, share it with her here.) 

How should I, or the thousands of other young people with an interest in health care, decide how, or even if, to aim for this field? I certainly don’t have the answers, but here’s the plan I’ve come up with:

1. Gain as much knowledge as I can. No one should run blindly down this path. A medical degree is no longer a ticket to security in 21st century America. Young people must learn everything they can about the health care environment today — the economics, the technology, the political climate, and more — rather than just grinding away in premed classes at college. That means research, reading, Googling and, above all, thinking.
2. Talk to as many people as possible in as many parts of the health care universe as possible. There is no substitute for the perspective and advice of people who are active in the field. But keep in mind that “the field” is getting broader. Thanks to my internship experience, I can make a more intelligent decision today than I could have before doing it. That’s why I am continuing to interact with people across all the frontiers of health care.
3. Stay flexible. I don’t want to find myself wedded to one idea, whether that’s becoming a physician or a programmer or a congresswoman, when I still have a huge amount to learn.
4. Try to understand myself better. It’s hard, at age 17, to say I know I’d be a great doctor or a great entrepreneur, even if I were to conclude that a certain pathway is the right one to achieve my maximum potential in health care.
5. Think of college as the place to explore possibilities in health care rather than as a check box on the way to becoming a doctor or anything else.

The next few years will reveal a great deal about the evolution of America’s health care system. Perhaps there will be better and clearer paths to follow for young people like me. In the meantime, the best we can do is keep learning, keep thinking, and keep our options open.

Carlisle Maney is a senior at Littleton High School in Littleton, Colo.

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