I finally ran across the eloquent essay by Dr. Jeffrey Singer; see “How Government Killed the Medical Profession” in the tweet below.
As you can see, I called this required reading for resident physicians and medical students, although it could be enlightening and possibly career-saving for high school students and college undergraduates as well.
Learners are guaranteed to get the party line that Dr. Singer decries. Geezer teachers like me give a less articulate version of his perspective (littered with curse words as needed) almost every day–when we’re not galloping on the treadmill our hospitals and clinics have installed for us.
Dr. Singer is one of a vanishing breed, a doctor who has a wealth of institutional memory wherein is stored a timeline on the economic and political evolution of our health care delivery system in America.
Doctors are beleaguered, burdened with increasing regulatory pressures, and on the precipice of losing our identity as professionals. The most recent indicator for the latter is the historic formation of a union by doctors in Oregon, something I never thought any group of physicians would do:
This evolution of the view of the practice of medicine as a profession to a trade, or as Dr. George Dawson has pointed out, of doctors being treated as production workers rather than knowledge workers, has been coming for a long time.
I rattle on about this to residents and medical students, who understandably don’t have time to focus on it because they have piled up a huge load of student loan debt which they have to repay.
Financially and psychologically, they can’t afford to think too much about Singer’s perspective. The question I can read on their faces is “What can I do about it now?”
Hey, the student loan debt crisis has been in the news a lot these days.
The CNN special on the high cost of college was enough to make many students question its value in today’s world. In this kind of environment, how do your persuade them to embark on a career in medicine, especially if doctors are increasingly being treated like widget workers?
Sometimes I feel like those of us who are trying to call attention to where the practice of medicine is going are a lot like the Cooper Union students protesting the college’s decision to charge tuition for the first time in its 150 year existence. They occupied the President’s offices for months but were unable to turn back the tide.
Debates, petitions, protest marches, sign-carrying, sit-ins (and now “die-ins” in response to recent controversial grand jury decisions regarding police killing unarmed African American males) are the American way. But geezers can’t persuade young folks to speak up. Organizations like Change Board Recertification and Physicians for Certification Change can’t get doctors united in great enough numbers to influence powerful certification boards.
I think that may be what my trainees are waiting to hear from me.