The doctor is (not) in

WASHINGTON — If you are frustrated by wait times to see your doctor, the cost of health insurance and prescription drugs, just wait until there may be no doctor to see.

NBC News recently broadcast a story about how fewer young people are entering the medical profession. The network cited a report from the Association of American Medical Colleges that “projected a shortage of 42,600 to 121,300 physicians by 2030, up from its 2017 projected shortage of 40,800 to 104,900 doctors.”

Only part of it has to do with the high cost of medical school and lengthy residencies. I asked my longtime family physician, Dr. John Curry, now retired, for his opinion. Dr. Curry holds MD and Ph.D. degrees, but quit medicine for reasons he explained to me in an email.

“The explanation for the exodus is very simple: Over the 40 years I had my medical office, that which is described as ‘the Practice of Medicine’ underwent a profound and ‘fundamental change’: In 1974, ‘Medicine’ was a transaction between patients (who needed diagnosis, treatment, and/or prevention) and physicians (who belonged to an exclusive class of professionals who worked under the demanding — and almost religious — mores of the Hippocratic Oath). Although we had the inevitable sprinkling of charlatans, exploiters and drunks, the typical physician put the patient’s interests ahead of his own; everyone who needed care received it; and in dealing with the poor, ‘fees’ could be embarrassingly small.

“In 2018, ‘Medicine’ is a nationwide system of financial obfuscation, in which the ruling denizens are huge corporate entities that control scores of hospitals, or health insurance for millions of ‘subscribers,’ or pharmaceutical benefits, or psychiatric benefits, or physical therapy, or a hundred other niche ‘benefits’ for millions of people, who are paying exorbitant ‘premiums’ to support thousands of ‘vendors’, and have no idea what they are paying for.

“And this entire ‘system’ is run by an endless network of interconnected computer programs, which are continually being ‘upgraded’, or swapped out for newer, more complex systems that always promise (but never deliver) ‘better medical care.’ And, needless to say, NO ONE HAS ANY IDEA WHAT ANYTHING COSTS! 1/8Clearly it costs A LOT, because a few new billionaires are generated every year.3/8

“Meanwhile, the interests of patients (which used to be the main driver of medical care) have been replaced by concern for the bottom line. And physicians, who used to be the substance of medical care, now find themselves no more than compliant (and replaceable) cogs in the machinery. 1/8’Get me two more instrument sterilizers, another MRI, 12 ward nurses, two ENTs and another hospitalist!’3/8

“Becoming a physician no longer has the appeal of joining a profession in which one can expect to do a lot of good in the world, advance scientific knowledge, have a lifestyle that balances work and family and earn a better-than-average living. If those are your aims, you would do better to become a funeral director.”

I’d add one other element: the over-involvement of government in medical care, when it should be doing more to promote good health, including a “to the moon” program to cure diseases such as Alzheimer’s and cancer. If it did, there would be less need for care because fewer people would get sick.

Dr. Curry says one of the major battles he fought was with government bureaucrats who often second-guessed him on his charges for a growing list of Medicare patients. The government wanted him to charge less in many cases, but he still had to pay high rates for office rental and malpractice insurance, thanks to lawyers who often sued doctors and won excessively high judgments from sympathetic jurors.

The problems inherent in the American medical industry are well-known, but solutions are rarely applied, thanks to lobbyists and the politicians they support with their campaign dollars. It’s enough to make a person sick.

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Readers may email Cal Thomas at tcaeditors@tribpub.com.

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