This article sheds light on a ‘physician stereotype’ that has been getting less and less true, although the momentum and the hate on docs for being “rich @**holes” (as my attending once said) shows no sign of giving way. I agree that pay for physicians “has remained flat or declined in recent years,” but that statement alone does not give the full picture. It doesn’t take inflation into account. It doesn’t take the rising cost of medical school into account ($90,000/yr + 8% interest). No one talks about these numbers. The real numbers. Always underestimated, always taken from less expensive schools, during less expensive years past. But from my school, some graduates had/will have $400,000 plus in debt AFTER residency. And that’s with sticking to a planned, conservative budget. How old are you after residency? Thirty years old if they went back to back to back with their schooling, and got every application accepted and passed every test. The first time. It’s absurd to think that physicians do it for the money. All physicians, on some level, do it because they want to help people.
The amount of debt, and delay in getting into the workforce, are shackles on the dreams of young physicians. What? How? Young physicians still get to practice medicine, don’t they? Sure, but what else can they do? Required to see four patients every hour, having to rush, no time to build rapport, 2/3rds of their time spent with the EMR, prior authorizations delaying care and hurting patients, decreasing patient satisfaction scores compound the moral injury that is inflicted day after day. They want to care, but how can they? I’ve heard it referred to as indentured servitude. It’s not like they can join Doctors Without Borders and work pro bono (can they?). It’s not like they have a choice. They have to pay their debt. I debt incurrent for wanting to help people.
With that being said, I cannot ignore the fact that some medical schools have started implementing free tuition. This is AMAZING and will go a long way to improve the lives of future physicians. But it’s not enough. Free medical school tuition is only a small step. There are still thousands of freshly minted physicians who graduate each year, and don’t have a job. And it’s not because they’re not qualified or competent physicians, it’s because there aren’t enough RESIDENCY spots. There are plenty of qualified pre-meds competing to get into medical school. There won’t be a shortage of med students any time soon. Physicians are aging, working less, and retiring sooner. If we want more physicians, if we want physicians to have better work-life balance so they can better care for their patients, and if we want physicians to take ‘healthcare’ back from corporations and start practicing medicine again, then we need more residency programs.
How do we get more residency programs? Where could we possibly get the funding? What if the AMA could spare a bit of the 20 mill they spend each year lobbying? Or have they been putting that money to good use? Maybe hospitals could pay their CEOs less, and instead pay a few more residents the $60,000 a year they expect to get for actually caring for patients.
“According to one study published last fall, from 2005 to 2015, mean annual compensation for major nonprofit medical center CEOs increased 93 percent, from $1.6 million to $3.1 million.” That’s 12 times more than an attending physician. I’m just asking for a few more residents!
I’ve been at hospitals where each resident had 5 patients, and hospitals where each resident had 25 patients. The difference I saw was in the quality of care received. It’s not that the busy residents were bad, or harming patients in any way, but the residents with fewer patients, had time to care, and to show it to the patient.
And do we realllllyyyy need this much admin anyway?
“Between 1975 and 2010, the number of U.S. physicians grew 150 percent, in keeping with the nation’s population. Meanwhile, the number of healthcare administrators increased 3,200 percent. The cost of that administrative burden today accounts, conservatively, for 20 to 30 percent of our healthcare spending.”
And to top it off…
“…despite spending about twice what other high-income nations do on healthcare, our life expectancy has declined for the first time in 100 years.”
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