I do not comment often about health care. In fact, I state quite often I am an Economics 101 illiterate. I do, however, appreciate and listen to conservatives who study the issue like Godfather blogger Hugh Hewitt. The Don Hewitt posted a provocative piece from a retired physician on his website today. The posting sounds a sort of Clarion call to the non medical community, exhorting them to wake up now and defeat public health care or face the consequences of employing amateur physicians-a scary thought. I posted the entire piece below because of its compelling nature:
I’m an Internal Medicine sub-specialist in Infectious Diseases retired from Academic Medicine, now in medical publishing (at the rip ole age of early 40’s). I have been listening to your show each evening. Thank you for focusing exclusively on health care reform. My upfront disclaimer on what I’ve “done to fix things”: I have contributed to Docs4patientcare, but I have gone above & beyond the call of duty by announcing on my Facebook that you are doing an excellent job with your interviews, and telling everybody to listen to your show. Yay for me.
You have done well so far in airing the current problems that physicians have with Medicare (& Medicaid) reimbursements. One of your surgeon callers adequately described that an in-house level III consult is worth $70 (of which overhead & taxes take ?), and few physicians can be motivated to get up at 2 a.m. & drive to the hospital, stay for half the night, for roughly $35, no matter how altruistic.
To play devil’s advocate, I’d like to point out what my liberal non-physician friends say when the cuts in reimbursements are discussed: “Well, if your income of $185K goes down to $150K, then you’re still making $80K more than I am, so I think you can survive…” (From a strictly philosophical position, there are so many things wrong with this statement that I don’t know where to begin.) But, let’s focus on the pragmatic. Average Joe doesn’t understand the debt to income ratio incurred by physicians (with debt taking many forms, not only financial). And society has done a great job of stigmatizing physicians as being money-grubbing entrepreneurs who don’t give a damn about patients, such that Average Joe actually feels almost liberated when reimbursements are cut.
I want to point out that current medical students today incur more than $125,000 for 4 years of med school (if they go to a cheap state school). This figure does not include college. The repayment schedule for my debt ($100K, because I graduated in the 1990’s) is $700/month and extends until I’m 65 years old. As a subspecialist physician, I trained for 14 years to do what I do (4 college 4 med school 4 med/peds residency 2 fellowship). While my friends and neighbors were becoming teachers and loan officers and hair stylists and restaurateurs and claims adjusters, I was going to school learning how to take care of old folks, babies, and AIDS patients. Not only did I incur debt, but concurrently, I deferred income for almost a decade. So, while my friends were buying homes and having babies, again, I was learning to take care of AIDS patients.
All of this was my choice, and I do not regret that choice. But let me be clear: medical students will not continue to make these sacrifices for peanuts. They will not. And the Americans who now sit idly by, watching politicians abscond with their health care—all for ideology, will one day wake up to a health care system run by nurse practitioners & physician assistants because they are cheap. And I don’t say that to disparage NPs & PAs. But a Master’s degree does not rival 14 years of training to understand complex disease. And If you’ve got bacteria growing in your blood or you’re having a heart attack, you don’t want “adequate” care. You want fantastic care—that only 14 years of training gets you. In no other profession—not teaching, not law enforcement, not journalism—are people expected to make these kinds of sacrifices—financial, familial, emotional, intellectual. No other profession. If you want future doctors, you’d better invest in them, because no person is going to go through all this for minimal salary. They’d be stupid to do that. And medical students might be a lot of things, but they aren’t stupid.
Thank you for calling attention to these matters,
CM
PS: as one final shocker, I’d like to tell you the salary I had a subspecialty trained Academic ID doc. As Assist Professor, my salary was $90,000/year, for which I was expected to teach, conduct research, & provide patient care. I worked 80-100 hrs/week. My NP who was employed at my HIV clinic, who worked 3 full days/week, was salaried at $80,000.










A FEW THOUGHTS CONCERNING TIGER WOODS
I play golf. I love golfers. I love professional golfers because they often embody all the characteristics we admire in gentlemanly athletes. Many professional golfers are men's men. Unlike strong men from contact sports, golfers exhibit gracious, kindly dispositions. Women like that in a man. So, indeed packaged in the golfer comes the complete man's man.
Then there is Tiger Woods, a golfer out of sync. One must admit he possesses an athletic adroitness second to none in the game. Yet, his surly disposition undoubtedly thwarts our attempts to fully embrace him as a member of the gentleman's club. We simply don't like the guy. That's why we always enthusiastically cheered for Phil Mickelson every time he and Tiger went head to head. Mickleson incarnates a personality we expect to witness in a prototypical golf champion. He always smiles even when the chips are down. We think he loves life.
Tiger Woods certainly is not the first golfer we merely tolerated. Long ago another champion named Ben Hogan captured our respect while shunning our affections. Hogan, however, developed his public aloofness through natural tragedy. His father committed suicide right before his eyes. Such a cataclysmic event would completely emotionally emasculate a lesser man. And, Hogan overcame his public introversion through another tragedy. A near fatal car wreck offered Hogan the chance to smell the roses.
Today's endorsements and hero worship catapults us to a new level. We admire those who live in million dollar homes, wear $20,000 Rolex watches, and drive custom made Escalades. We live our lives vicariously through their public display of opulence. Affability and graciousness matter little in our postmodern media saturated society. Even men's men from the most gentlemanly sport on earth sometimes fail to grasp the transcendent qualities needed for clean leaving. The women, however many there may be, in Tiger's sordid life, cleverly entered a relationship with him knowing full well the consequences and financial rewards. Gold diggers no doubt, who live in a shadow world. Fame and fortune possesses a tremendous penchant for impairing a sane man, jerking his chain, and taking him to a moral abyss where he formerly dare not go. Sometimes a person like Tiger must hit the proverbial bottom before he can look up and see a blue sky. Hopefully, like Ben Hogan, God may use Wood's tragedy to save his soul.
Nevertheless, we who create these modern idols must shoulder some responsibility for outcomes. Last year I published a piece in the same vein commenting on Barry Bond's disappointing us with his use of steroids. One need only substitute Bonds with Woods to see the big picture:
Posted by jeffreymark at 12:18 PM in Commentary, Golf, Sports | Permalink | Comments (0) | TrackBack (0)