A Couple Things to Think About...

You can not turn on the television and flip to any news channel without at least seeing something related to the current healthcare system of the United States. It is the single most discussed issue in politics right now... and with President Obama's recent signing of the Bill into law, everyone from Bill O to high school teachers feel their obligation to tell everyone exactly what they think about it. And until now, I have not seen a professional in the field of medicine discuss their feelings about it. I've had light conversations with doctors before, and the handful that I spoke to were all in complete favor of "universal healthcare." I have a few questions of my own though... what exactly does this healthcare bill mean for this field of work today, and down the road; how will salaries be affected, if they are? What exactly do doctors think they owe the public, if anything at all? Is there a line to be drawn between politics and medicine, and who decides?

The first place I decided to look for answers was in my book, Better. Of course, Dr. Gawande had much light to shed on a couple of these questions, under his "doing right" virtue. He himself briefly mentioned his stance on the issue, with the generic "universal healthcare for all" response, note however, that this book was published sometime in 2007, quite before the current debates. Regardless, he had a chapter, "What Doctors Owe," where he discussed the issue of malpractice lawsuits. He heavily explored the touchy subject of whether or not doctors actually owe anything to society. He spoke with a few other men in the field, who told him that a doctor was simply "a business man, nothing more, nothing less." That he was comparable to an accountant, or an electrician. He provided service in exchange for pay. The idea that doctors are burdened with some sort of extra, moral obligation to society sounded outlandish to this man.

In a time where some medical procedures cost upwards of tens of thousands of dollars, has doctoring been reduced to a business transaction, devoid of any humanity? Why does it cost so much? Is this simply those in charge jacking up the price tag simply because they can? Frequently, I mention the importance I place on the money I will make in the future. From the looks of it, I seem similar to the doctor Gawande interviewed, careless about the human side of the work, and I do not want to be that way. I made my decision to enter this field originally simply because I wanted to help society in anyway I could, if I was solely chasing the money, I guarantee you there are ways that I could earn bigger paychecks, but I do not want to pursue in those routes.

So, assuming this bill lasts into the future (this is a pretty big assumption considering the intense opposition) and serious restructuring of this sector of the economy is undertaken, what does this mean for doctors in particular? I've heard almost two, almost polar opposite, answers to this question, dependent on the political view of the answerer. I've heard that this may increase the number of people insured, which in turn would increase the demand for doctors. I've also heard that the new insurance policies are going to drastically reduce physicians' salaries because they directly benefit from high insurance costs... I can't really tell you who I believe. If the latter is the case, I will find myself having to choose between money and the other reasons I choose to pursue medicine.

Just a couple things to think about...