Like a lot of you, I’m feeling a little tired after the last two months of winter. Along with a bigger than average flu pandemic, and the annual cold weather circus of COPD flares and mothers needing back-to-school notes for pink-eyed urchins, I packed in a few extra hours. No that’s not a complaint, just a recognition that filling the 24/7 schedules for small town and rural ER’s can be challenging. The doctor shortage you may have heard about is real, and a lot of the regulars on whom our ER’s depend are themselves full-time local primary care docs who moonlight on evenings and weekends. For many of them, it’s a combination of wanting to support their local hospital and community, and also needing to supplement their shriveling private practice profit margins.
Which is why I thought this story was an absolute laugh riot. Seems the author Matthew Yglesias has pinpointed the trouble with high health care costs: doctors make too much. He specifically wants more patients on Medicare as a way to pay doctors less. Leaving aside questions regarding the proper compensation for moronic pseudo-journalists, Mr. Y both admits that Medicare’s “uncapped commitment …is a big challenge”, and declares that expanding the program is the only way to control costs. Of course the shortfalls in physician numbers that would result from a general lowering of physician incomes would be offset by – TAAADAAAHHH – more NP’s and PA’s aka LELT’s.
Ordinarily I get pretty angry over an ignoramus third-party making value judgements regarding my worth. But it’s late and I’ll save the philosophical counter-attack for another day. I’m of more practical bent tonight: it is already routinely tough to staff small, ER’s with competent physicians who are willing to do the work at odd hours. So to all the do-gooder journalists and compassion merchants I say, “bring it on.” Let’s see what happens when the average doc no longer finds it worthwhile to put in those extra hours.Tweet