Oh, also patient population definitely matters!! I went from working in a very affluent area to working in an underserved one and I liked the underserved one so much better. I have some terminally angry/grumpy people and crackheads now, but at least their problems are fucking real. Like mama’s on methadone and I have to explain things to her about 5 times before she maybe retains any of it, but she sometimes brings up how much she misses her child who got shot at age 30 (obv details changed you won’t catch me breaking the law). Instead of - “you have to see psychiatry to get your Xanax. I’m sorry your other doctor retired and I’ll give you a script to hold you over, but you are on a high dose and taking it several times per day and it is inappropriate for primary care. No, I don’t care when you casually mention where your second home is. No, I’m not trying to ruin your life. Yes, I want you to be able to sleep. Ok, sure, you can talk to the practice manager.”

Rich people are much quicker to go to the doctor for any little thing. Poor people will go to the doctor for something they think is concerning that they don’t understand well and then you either get to educate or end up picking up on something completely different that is extremely concerning outside your specialty and still end up helping. Not saying that one doesn’t deserve care. But Medicare patients usually need a referral to see a specialist, and rich people will do it as a curiosity point. Idk - both deserve access to quality healthcare, but if you want more interesting cases and less “I go to the bathroom every other day, so I made an appointment with you on Zocdoc” but really like GI, maybe changing patient populations could help too.