Will Good Doctors Be There When You Are Most in Need?

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Oil pressure. Photo by darkday/Flickr

Oil pressure. Photo by darkday/Flickr

Yes, some doctors do make good money and they should. But the erroneous idea that all doctors are rich is simply untrue. As the middle class in this country becomes extinct, great resentment is being misdirected at people who have dedicated themselves to years of education and lifetimes of work.

Apparently it’s just fine for the insurance companies to skirt anti-trust laws. Maybe it’s time for doctors to organize and unionize so they can fight the government and the insurance mafia and claw back the dignity and compensation they have sweated to earn. Good doctors have paid the price.

Santa Fe, New Mexico, 07 July 2015
By Dr. James Goldberg, Author of The American Medical Money Machine: The Destruction of Healthcare in America and the Rise of Medical Tourism

Practicing Medicine Today is Not Worth the Pressure

We are humans. Like machines we break, and at one time or another during our lives most of us will become a medical patient. Many people, approximately half according to recent statistics, have one kind of resentment about their doctors or another. Not enough time with their doctors, waiting too long to get an appointment, the doctor is distracted during office visits by filling out (mandatory) records for the government… the list goes on.

Well, medicine is hell for many physicians. If they can afford to, they are leaving medicine. What’s more, many young students are not going into medicine because there are no rewards. Nurse Practioner staff are stepping-in with a fraction of a fraction of doctoral medical education. They are being substituted for doctors in the treatment of you and your family.

Why? Because they cost a fraction of what a doctor is paid. According to CBS News, the cost of becoming a doctor has soared and average salaries are declining.

To be sure, pay is still high, with doctors accounting for the preponderance of six-figure positions in the country, according to government data. But it also takes between 11 and 14 years of higher education to become a physician. That means the typical doctor doesn’t earn a full-time salary until 10 years after the typical college graduate starts making money.

That lost decade of work costs a cool half-million dollars, if you assume this individual could have earned just $50,000 annually, and the typical medical school candidate is smart and successful enough to earn considerably more. Add in the time and cost it takes to pay off medical school debt and a dissatisfied physician may well consider pursuing medicine a $1 million mistake. (This assumes the average $166,750 medical school debt takes 30 years to repay at 7.5 percent interest—a total cost of $419,738.)

That does not include specialist training which takes years longer and substantially more debt!

Think Docs are Rich? Think Again.

In the 1940s, doctors were on the rise and held a highly-esteemed position in American society. Because of their influence, doctors made nearly three times the salary of an average worker. Nearly all physicians were in private, solo practices and patients paid cash for care. Those requiring hospital care were separated into two groups, wealthier patients who could afford private rooms and the less affluent charity patients who were treated in mass. But those days are long gone.

I realize that some of you think that doctors are rich but the reality is that many medical students are forced to go into substantial student debt to pay for their education. Failure to pay back these loans may result in medical licenses being revoked, passports suspended and other punishments reserved for people who have given their lives to treat the sick and heal the suffering.

Yes, some doctors do make good money and they should. But the erroneous idea that all doctors are rich is simply untrue. As the middle class in this country becomes extinct, great resentment is being misdirected at people who have dedicated themselves to years of education and lifetimes of work.

This Forbes article from 2013 will help shed some detailed light on the comparative pay rates of doctors in the US and in the rest of the world.

Few doctors, today, enter medicine as a way to make bags of money! The public displeasure and resentment over physician (excuse me, provider) pay should be tempered by the realization that doctors have little recourse when it comes to fighting for equal pay. Unions aren’t entirely practical, and doctors have long been discouraged from unionizing. There are three basic types of physician classes:

Independent Private Practitioners. If they join together to set fees and negotiate with payors, it would look like collusion to the government where they might be trying to set up a minimum fee schedule, which would be an anti-trust violation.

Employee Physicians. Doctors employed by a hospital can unionize (the United Salaried Physicians and Dentists Union is an example) as long as they are actual employees (W-2 salary). But legal battles have pointed to an issue that staff doctors are “supervisors” and so they they must be excluded.

Physicians in Training. Interns, residents and fellows are a special sub-set of salaried physicians. They are deemed the same as “apprentices” in terms of union categorization.

Basically, physicians who are hospital employees may unionize. Physicians in training may have an enforceable right to unionize under the National Labor Relations Act. But independent physicians who try to unionize will likely violate anti-trust laws.

This structure helps to explain why doctors have been crushed and bruised by the greed driven by the American medical money machine. Sure, there are some bad doctors just like there are bad car mechanics. But we know the source of the broken system is not found in the vast majority of those attempting to practice good medicine.

No Help from the AMA

The American Medical Association (AMA), who has historically been the champion for doctors, sold doctors down the river. They have essentially become a lobbying arm for the medical industry whose goal is to keep doctors firmly in check. Only 25 percent of US physicians are represented by the AMA, and a good portion of those are students. In the 1950s, AMA membership was more than 75 percent of all US Physicians.

Why pay yearly dues to an organization that’s not going to bat for you when it matters? The AMA betrayed our doctors and it is right and fitting for them to be shamed and pushed aside.

Apparently it’s just fine for the insurance companies to skirt anti-trust laws. Maybe it’s time for doctors to organize and unionize so they can fight the government and the insurance mafia and claw back the dignity and compensation they have sweated to earn.

Most people forget that to become a skilled physician, let alone a specialist, is not a job choice—it’s a life choice and a damn hard one at that. Nights, weekends, decreasing reimbursement, tightened government regulation and often, angry patients who, thanks to the Internet, often feel that they are more knowledgeable than their doctors are.

Added stressors on top include the corporate takeover of medicine where the big money boys have marginalized the importance of doctors in favor of raking in more money than at any other time in history.

Providers? Isn’t that Term a Racial Microagression?

The corporatization of medicine and its leading proponents, health insurance providers soon to number about 3-4 companies of substantial size, have emasculated doctors shamelessly. Doctors are now called providers. This is happening while the behemoth insurance cartel and big pharma becomes insanely rich, by charging you more money and whipping your doctor for having dedicated his or her life for the purpose of helping you to stay healthy or to fix you when you are sick.

Should a person who once enjoyed the highest level of respect be paid well for their efforts? I think so. But thanks to very high Federal and State tax rates, a good deal of the money earned by even a well-paid physician is sent to the IRS, high tax rates that cut deeply into income for which your doctor has probably paid a very dear price!

Still the populace is resentful. The only problem is, they are directing their anger at the wrong source.

Misdirected Hostility

Last December, doctors had a 65 percent favorable Gallup Poll rating when it comes to ethics and honesty. That’s 5 percent lower than nurses’ approval ratings! That stat means that 35 percent of people think doctors are unethical and dishonest.

As insurance premiums and deductible rise, many people are misinformed and are blaming their doctors. But the true source of the healthcare woes is the government and the insurance/pharma/hospital industry mafia.

Many US-trained doctors enter a world hostile to their very existence—a workplace suppressed by one layer of administrative or regulatory pressure after another. No wonder many are in a bad mood. I’m in a bad mood just thinking about the injustices many of my physician friends are suffering.

Here’s the irony: As patients, you are the ones who will one day be lying on a table, putting your life in the hands of this special breed of professional. Pray that they will be there when you or your family needs them most.

Doctors trained in foreign countries, where the quality of medical training is not even slightly comparable to our training, are moving in. Go to any hospital and see how many of these less-expensive foreign trained doctors roam the halls.

Western medicine has achieved many miraculous things. Treating doctors with the respect and dignity they deserve is not one of them. The next time you feel angry with your doctor, remember the price they have paid to save your life.

Walk in Their Shoes

A crushing tale of defeat is related in “The darker side of being a doctor,” a personal account of a physician who decides to quit practicing medicine because it was detrimental to her health.

To quote the author directly, “I no longer believe it was weakness or selfishness that led me to abandon clinical practice. I believe it was self-preservation. I knew I didn’t have the stamina and single-mindedness to try to provide high-quality, compassionate care within the existing environment. Perhaps, due to temperament or timing, I was less immune than others to the stresses of practicing medicine in a health care system that often seemed blind to humanness, both mine and my patients’.”

Blogger Joanne Intile who wrote the piece for KevinMD.com ends with this sage suggestion for the next time you see your doctor: “I would urge you to take a moment to let them know how much you appreciate their perseverance, dedication, and talent.”

We echo that idea!