I've worked in ER/Critical Care for the last 15 years of my life, and I'm almost finished with my degree in software engineering. I've gotten a lot of flack from people, because I'm leaving a "caring" field and pursuing "living a life in front of a computer" or "making a better mouse trap".

So, I've had quite a long chance to think these issues through. And, I've thought a lot about medicine and health care as well as it's limitations in terms of being rewarding.

One of the biggest problems that I have with either nursing or medicine, is that to get into the industry, it's tall barrier to entry. But after you're in, it's hard to get kicked out. You pretty much have to molest someone, recklessly kill someone or be on drugs to get booted out of the profession. And, that leads to a large set of problems. There are personality disorders in health care that simply would not be tolerated in the business world. I've seen people yell at each other, physically assault each other, throw dirty scalpels and charts. What other industry would tolerate that without involving the authorities?

Another problem that I see this: as an individual committed to growth and learning, is that there is no financial reward for becoming better at my job. It essentially becomes a volume business, not a quality business. If I am phenomenal at starting IV's or phenomenal at diagnosis or perform great life saving feats requiring inhuman feats of physical endurance--my bank account doesn't look any prettier. As a nurse, I'm rewarded for hours worked and more to the point for overtime worked. This produces nurses who work tons of overtime, especially during nursing shortages like we have now. And on the medical side, doctors get reimbursed by diagnosis or procedure, not by quality of work done. So, the doctors who make the most money are those who see the most patients, or who perform the most procedures on patients. In fact, if I'm not mistaken the highest paid doctors tend to be those who perform generally needless procedures: dermatologists and plastic surgeons.

But, as an entrepreneur, I get to make things and build things. Perhaps I don't save a life every day I go to work, but I can build something that can make thousands or hopefully millions of people's lives a tiny bit better, and that's pretty rewarding. Imagine how many people's lives have been improved because of Google. How many people now can earn a living because they are proficient at the Microsoft Office suite of applications? I know that I certainly consider my life to be qualitatively better because of innovative technology like the internet, cell phones, computers, better monitors, better user input devices, web applications like Gmail, Twitter, Hacker News, Slashdot, etc... How much financial benefit do you think that web apps like Ebay or Craigslist have created for the nation if not the world? How many people have been reunited with old friends because of Facebook or MySpace?

Those products don't get made without startups and entrepreneurs. Those products all help people. And, the best part of all... If I can make a product that a lot of people find benefit in, I get financially rewarded for the benefit that I can bring to other people.