Sunday, August 30, 2009

My Confession

I have a confession to make. Please don't think less of me after you read it. I'm just being honest with my readers and also making a point about the health care debate. Ready? Here it goes: medicine for me is not a calling. There. I've said it. Do you think I'm less of a doctor now that you know the truth? Don't get me wrong. I love my job. It's a very honorable field and we do good things for our fellow human being. But it is not a religious experience.

The reason I brought this up is because of several articles I've read recently. First there is the opinion piece in the Wall Street Journal by Dr. Ronald Dworkin, an anesthesiologist. He says that to the current generation of upper middle class professionals, a career satisfies an interest and the income sustains them once the interest inevitably subsides.

Then there is this comment to Dr. Dworkin's editorial by a Mr. Thomas Elmo. Mr. Elmo rebuts, "You don't become a teacher, policeman, fireman, minister or doctor if you DON'T think it is a calling." I wondered if that is truly how the public sees doctors, that we are doing this work because it is our "calling" and thus undeserving of higher compensation?

I will bet that 99.999% of people doing their jobs are not in it because of some "calling." Unless one is going into ministry, nearly everybody has an economic or personal reason for making a certain career. Maybe the profession runs in the family. Or somebody wants to make a bucket load of money. Or maybe they were inspired by a mentor. But very few people actually hear a calling, despite what Mr. Elmo says. In fact, other than priests and nuns, the list of people who heard a calling probably starts with Jesus and ends with Martin Luther King, Jr., with Gandhi, Mother Teresa, and Joan of Arc somewhere in there.

I can honestly say I never heard a voice telling me to go into medicine. My father is a physician, as was his father. My brother went into medicine too; it's what we know. Is that any different from the auto plant worker who's children follow them into the factory? Or the lawyer whose children join the same law group? Or the politician whose entire clan gravitates toward the same profession? Do you think President Obama heard a calling to become the POTUS? If so should he work for minimal wage or free since that is his destiny? What about the members of Congress? They like to think they're there to make the country a better place and do what's right for the citizens. Would they be so high-minded if they made less? The truth--they give themselves raises and private jets every chance they get, budget deficit be damned.

Other professionals like lawyers aren't ashamed to say they do it for the money. So why are doctors held to a higher standard? Is it so wrong to say medicine gives me a nice income to support my family and make a nice living? By saying doctors should be completely altruistic it gives opponents an excuse to lower doctors' reimbursements in the name of holding down health care costs. But some doctors are already making less than their local plumbers on an hourly rate. Plumbers (just to use as an example) don't have to answer calls in the middle of the night. They don't work weekends. They don't have to shell out tens of thousands of dollars for malpractice insurance (when was the last time you sued your plumber?). They want cash on the spot, no freebies from these guys. And they didn't go through at least eight years of higher education after high school before even starting residencies. Yet this health care debate revolves around cutting Medicare reimbursements even lower. If the public option based on Medicare rates gets passed, we'll see who really is in medicine because of a calling.

So to wrap up this tirade. I like my job. I like my income. I don't think I'm less of a doctor because I'm not working at the free clinic every day. To those who think doctors shouldn't mind making less money because the work is their destiny, I say come walk in my shoes. Try working 60-70 hours a week, practically nonexistent family time, and the threat of a malpractice lawsuit hanging over your head with every patient you see. Then you can tell me how little income you'd be willing to work for.

1 comment:

  1. Amen brother. As soon as I can Im getting out of INDUSTRIAL MEDICINE.