A Doctor’s Modest Proposal

One M.D. has a novel solution to warnings of an impending physician shortage: Embrace the shortage and become, in her words, "a rare commodity":

"Why would anyone in their right mind want to go into medicine now? Until something is done to corral the HMO and government administrators (who are expensive and time-consuming annoyances); until the pay for family practice and general practice doctors is made equal to that of general pediatricians and general internists; until there are special courts for malpractice complaints instead of the current lawyer-stealing-from-doctor tort system; and until we aren’t having to cope daily with the tragic stories of people who cannot afford medications and of people who are being dumped off insurance when they are sick, I’m advising my bright young patients to look elsewhere for an occupation.

"I think we should be allowed to become a rare commodity. Maybe then we will be paid enough and respected enough to make the profession worth doing again" (source).

After my second spit-take at the line suggesting that doctors aren’t compensated enough in money and respect for their services, I got to thinking.

In some ways, I can see this physician’s point. Given their long years of expensive training, the malpractice coverage they must pay, and the risks entailed with running a business (especially one where they are beholden to insurance companies to cough up payments in a timely manner) the dazzling salaries doctors reportedly make do seem less-glittering. And, of course, it is specialization that pays the most. General practice and teaching doctors do not make dazzling salaries. I can also concede that respect for doctors flies out the window when it’s time to start looking around for a scapegoat for a tragedy, whether or not an individual doctor could have done anything differently.

Still.

Advising that physicians allow themselves to become a "rare commodity" will only mean that patients, those whom doctors are supposed to serve, will only receive worse care as the insurance companies ration out treatment options ever more thinly to meet the increased demand. And, as the physicians left in the field grow ever more gray, who will replace them? Will it take a decade-plus to train the new physicians once the potential doctors and early-retiree doctors decide to come back from their "strike"?

All in all, a silly proposal for a serious problem.

(Nod to Kevin, M.D., for the links.)

6 thoughts on “A Doctor’s Modest Proposal”

  1. If the doctors want to do something about high medical malpractice costs, they need to do what lawyers do: SELF-POLICE.
    Right now there are medical boards and the like, but they seem to do very, very little to get rid of incompetent doctors. I would think that the good doctors would be eager to get rid of the bad ones so that their premiums would drop, but apparently that’s not sporting or something.

  2. Another factor to consider is that some states are attempting to limit a doctor’s freedom of conscience and religion by mandating that the doctor performs abortions and prescribes contraception.

  3. There is always a red flag that goes up in my mind whenever people mention money as a reason not be charitable.
    Unfortunately, what the physician proposes is an entirely logical and natural conclusion in a society that already has legalized the killing of millions of unborn and the starving of the elderly and incapacitated all for the sake of money (sometimes referenced as “poverty”, “convenience” or “financial burden”).
    It is not like doctors take an oath to protect life at all costs anymore. So why not deprive the poor of medical assistance? We all know that only the wealthy can afford “rare commodities.”
    So let’s see, by embracing the culture of death and advocating a society loosely based on eugenics, not only have we NOT succeeded in eradicating poverty (by not allowing the poor to reproduce — because we want their babies dead, you know) but we are moving rapidly to another extreme where the concept of “poor” expands to include the majority of the population.
    It kind of reminds me of Communist China when they killed all the bourgeoisie, including the skilled doctors. All that were left were just dumb young interns with their fingers up their nose. Needless to say, this compounded the suffering of the Chinese people. A society thousands of years older than Christianity, and in a decade they were reduced practically to the stone age.
    Which also makes me wonder: it is all the rage today to cynically disparage religion and religious movements by saying something uninformed like “too many people have been killed already in the name of God.” But if you look at the greatest tragedies of the last century, which were also the greatest tragedies of the human history, they were all SECULAR movements that sent mankind to the brink.
    Yet to this day, secular movements do not have any negative stigma associated with them.

  4. It’s unlikely that malpractice claims and awards (and/or settlements) have much to do with incompetence in the profession. Most of the problem is that medicine is by nature something less than an exact science – and our society can’t deal with that – and our civil justice system requires docs to pay for it.
    If – as is the case in some states/localities especially – docs can’t make a go of it, the main solution is malpractice reform.

  5. As a doctor and Hippocratic Oath sayer, I know that most of the time supply and demand will beat out my ideals. I don’t know what why the next generation is reluctant to become docs. Are they less charitable? Are the income or other factors a big disincentive?
    I would not try to talk anyone out of becoming a doctor. (Unless their motivations were selfish or otherwise wrongly placed.) I love it. I have loved caring for people in this way since I worked as an orderly in a nursing home. One of my original motivations for pursuing medicine was that every time I mentioned I wanted to be a doctor, the nuns would pat me on the head. The nuns gave head pats to two vocations: priests and doctors. Maybe the doctor shortage is secondary to the nun shortage.
    BTW it is hard work. I would not go into medicine thinking it is easy, emotionally, mentally, or physically.

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