Oh, So It’s My Fault? by Pat Conrad MD

The first week of 2018, and I’m already weary of the same old misinformed, deceitful “journalist” claims about the medical profession and health care in general.

Writer Christian Barnard op-eds in the Washington Examiner that, “Thanks to doctors, there aren’t enough doctors.”  While shaking his fist at the future, Barnard presents not a single new fact or thought from the past.  “[Doctors] limit the supply of doctors to keep salaries high, and use legislation to shut out competition from other medical professions.” (And he repeats the usual cry about the U.S. lagging behind other developed nations in quality measures.)

The distillate is that doctors are bad.  They tried to limit their own supply over a century ago, tried to kill managed care, and too many of them want to get rich as unnecessary specialists.

Is Barnard truly ignorant, or simply dishonest in pushing an accepted party line?  He claims, “The thin supply of physicians drives up costs. U.S. physicians make twice as much as the average developed-world physician.”  But he is applying the basic economic principle to an artificial context that ignores economics.  Costs are far more a function of price inflation (caused by government interference/entitlements), premium spikes (government-Big Insurance cronyism), counterproductive administrative overhead (government, Big Insurance, hospital corporations), and defensive medicine (hug a lawyer).  If greedy doctors are to blame for cost increases, then how could he explain the success of DPC?  A rhetorical question of course, because truly market-driven medicine will not enter into Barnard’s (third) worldview.  He cries about physicians lobbying in favor of capping Medicare funds for residency slots in 1997.  Barnard does not have the imagination or honesty to question why it’s up to the federal government to fund residency slots in the first place, and how this invited AMA corruption.

Another thing Barnard can’t grasp is that greedy doctors, including evil specialists, can’t really set their own costs as he imagines.  Most have to work within price caps established by the parties he ignores, thus having to see more and more to make their obscene profits.  If docs were truly able to jack up prices they way he implies, they would lobby like hell for fewer medical school slots, double current prices, and work half as hard.

In the same breath, this unoriginal parrot complains about the lack of primary care doctors, and how doctors “restrict the scopes of practice of nurse practitioners, midwives, physician assistants, and other mid-level healthcare professionals.”  So while this clearly overpaid scribe whines that doctors make too much, he wants more docs, who he will seek to pay on a socialized medicine scale, while putting them in competition with LELT’s.

The whole thing is one more appeal for lower cost, limited access, government-run everything.  Nothing new here.  And when Mr. Barnard develops acute urinary retention from an overly large prostate, unfixable by a primary care tech in the clinic, may he enjoy his ER wait for an overworked, underpaid urologist.

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  6 comments for “Oh, So It’s My Fault? by Pat Conrad MD

  1. Brooke
    January 10, 2018 at 8:03 pm

    I am a physician and was very frustrated by Mr. Barnard’s article. I think one large area that continues to be overlooked is the doctor’s own costs!! No country in the world requires its doctors to pay as much for their own education (with very high interest rates) as the United States. Please let us not continue to discuss further cutting payments for doctors who often graduate $300,000+ in debt and do not start making any money until after at least 7-10 years of post college training. I spent medical school and residency living paycheck to paycheck while having to study and work late nights at the hospital. So excuse me for not wanting to go into primary care. If I did I would actually not be able to to survive and raise a family on the salary most PCPs make with my loan debt.

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    • Kurt
      January 13, 2018 at 4:22 pm

      Ditto, run off and specialize and your happiness will increase. I now am of the attitude that
      no female should go into primary care unless they don’t intend to get married and raise a
      family. If one tries a full practice with call and trying to keep up with the electronified
      B#ll$h*t they will have no time to be around to raise kids. I’ve seen more FP females leave for
      scheduled hours and no call. Guess what? They’ll be competing with the LELTs and be paid like the
      LELTs at the same low level. Talk about a waste of education!
      If one is going to sacrifice family, they should get paid the bucks they deserve (like the lady Ob’s).

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  2. Kurt
    January 10, 2018 at 1:43 pm

    Wasn’t Barnard that guy who did the 1st heart transplant in South Africa in 1967.
    I bet it’s a nom de plume! (That Barnard is deceased mind you.)

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  3. Perry
    January 8, 2018 at 8:13 am

    More bunkum from pinheads who don’t know what they are talking about.

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  4. Sir Hakum of Hugo
    January 8, 2018 at 7:58 am

    Teamster’s Union or bust.

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  5. Thomas Guastavino
    January 8, 2018 at 6:25 am

    At this point it does not matter what outsiders think. We as physicians have to protect ourselves from whatever misguided health reform measures may be thrown at us.

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