I’m sitting outside of Club Isabella waiting for a friend. There are six medical students at a near by table enjoying food, friendship, and a moment away from their daily stress. What do they talk about? They joke and laugh about doctors and classes, routines and procedures, and their daily grind. They are an interesting group. Two are women. Four appear to be of Asian descent. One, a tall thin white guy with his baseball cap on backwards, appears to have been delivered to us from Central Casting. They wave and shout to their friends walking by. They are incredibly normal.
I find this terribly reassuring. At 56, I am looking at the people who will be caring for me 20 years from now. They are bright, engaged, and sound like they are actually enjoying their work. This is important. If all of this work, time, and effort is just to get a title, a job, and a paycheck, they will never be fulfilled. And they probably won’t be very good at the practice of medicine. One can only hope that their discussions of cadavers (over dinner!) is a precursor of great careers.
This concerns me, the general happiness of physicians, because so much is changing in the practice of medicine. Many previously independent doctors are now, in 2011, employees of the major hospitals. Some have adjusted to this change. Some doctors embraced this. Many, however, have not. Being an employee, even a highly compensated one, is not the same as being your own boss. There is a certain freedom in being an independent business owner. And other doctors, like radiologists, have seen specialty treated like a commodity.
I’m not ready to have my health dependent upon the lowest bidder.
Our young doc-to-be’s at the next table have not experienced any of this. There is no transition for them. Medicine will be a corporate enterprise for them, complete with signing bonuses and holiday pay.
How will this impact the way they practice medicine? For one, they will have been initiated, from day one, into a system that allocates a specific number of minutes per patient. They will be instructed in profitability. They will always know the origins of their income. And once you are in this system, how hard is it to change employers? If, or when, the government becomes the major or single payer of health care, would these doctors even notice?
Hard to say.
We face a looming shortage of primary care physicians and gerontologists. I didn’t ask any of the future docs what they wanted to practice. I only wonder if their future employers will bother to ask.
Unfortunately, neither medical school nor nursing school prepares you for how the real world really is. And who knows, in the 5-8 more years it may take them to become actual doctors, this way of payment, employer, may all be changed.
Oh, and one more thing, I think you have the title backwards. The future to me is far scarier than the present. One reason why I am glad I am almost done.
Holly did raise a poignant point. The future is far scarier than the present, provided we get through the 10th Anniversary of 911 and the Republican Nominating Process. Obama, of course, is worried about his upcoming backbone replacement surgery.
My present doctors are far more human than corporate and none of them have more than one boat.
As an aside, how is the New Club Isabella and were you waiting for a female friend from central casting?
Club Isabella was a bit on the trendy side for me. The room is beautiful, but I had a bit of a time finding something that I really wanted to eat. I was waiting for a male client/friend. His girlfriend joined us a little later. Gorgeous, European and an entrepreneur. SHE could have come from Central Casting. By the way, did you click on the link for “waiting for a friend”?
Its like you read my mind! You appear to know a lot about this, like you wrote the book in it or something. I think that you could do with some pics to drive the message home a little bit, but other than that, this is magnificent blog. An excellent read. I will definitely be back.
Wonderful article, wonderful site theme, maintain the good work
Can I simply say what a relief to discover someone who really knows what theyre talking about on the internet.
I really liked the article, and the very cool blog
You have really interesting blog, keep up posting such informative posts!