March 3, 2008 - 10:00 pm
USA Today ran a front-page feature Tuesday headlined “Shortage of surgeons pinches U.S. hospitals.”
The problem promises to be particularly severe in rural areas as the Baby Boom generation — including boomer doctors — retire over the next dozen years, the newspaper reported.
Some blame the decision of U.S. medical schools to place tight caps on enrollments in the 1980s and ’90s, out of fear that managed health care, among other factors, was about to create a glut of doctors.
Indeed, U.S. medical schools have now reversed course, admitting 17,800 students — the largest entering class ever — in 2007.
So, because it takes three to seven years to train a doctor, the medical students now in the pipeline should start alleviating the problem by 2011 or 2012, right?
Maybe. One problem is that those new doctors will typically enter the market carrying $150,000 to $250,000 in debt for their educations. Because doctors are by definition smart enough to understand “compounding interest,” they’ll want to pay off those bills as quickly as possible, which can mean choosing specialties and locales that offer the best chance of good pay. Doing appendectomies in the Black Hills or the Ozarks — or in Tonopah — don’t make the top of that list.
But there are other problems. Dr. David Lingle, working at Shore Memorial Hospital on the Chesapeake in eastern Virginia, worries, “Nobody will want to sign up for this job anymore.”
James King, president of the American Academy of Family Physicians, agrees. Some of his physician friends are telling their children to avoid medical school “because of all the hassles,” the family doctor from Selmer, Tenn., told USA Today. “They say it’s not worth the headaches anymore.”
Outside the military, there aren’t many careers that require training as lengthy, intense and expensive as that of a doctor, only to “reward” the successful graduate by throwing him into an environment where his career can be imperiled by an unhappy outcome not of his making.
On top of that, doctors today often find themselves sharing their paychecks with rafts of employees who aren’t nurses or medical specialists, but whose sole job is instead to negotiate with insurance companies claiming the right to overrule the doctor’s expertise, telling him what he can and cannot do if he expects to get paid.
And paid what? Today, a new surgeon can still expect to make $165,000 per year, climbing to somewhere between $220,000 and $300,000 after five years, according to Josef Fischer, chairman of surgery at Beth Israel Deaconess Medical Center in Boston.
With the government medical welfare “insurance” schemes promising ever more benefits as they hemorrhage cash, expect reimbursements to doctors to continue dropping, even as leading Democrats call — in essence — for doctors to be turned into government employees.
Can today’s new doctors still expect to make $200,000? And what would be the combined tax rate on a new member of the “greedy rich” making and investing that kind of money under a President Obama or a President Clinton?
“Are the best and the brightest going into medicine like they once did?” asks Dr. Fischer. “The answer is no. They are becoming investment bankers, attorneys and captains of industry because the American way — how prestigious things are — depends on the money.”
But it’s not just the prestige.
Bankers and attorneys rarely work round-the-clock shifts, liable to be hauled into court and ruined if they make a mistake in their 36th hour with only three hours sleep. They even get to go fishing occasionally, without worrying about being paged to deal with a gunshot or a traumatic amputation.
At the very least, “Good Samaritan Laws” should be expanded to limit the liability of physicians who agree to visit emergency rooms late at night, or anywhere else they confront a chaotic environment where a detailed work-up isn’t an option.
Doctors get paid a lot because of the value society puts on their skills, and the fact that not every kid has what it takes to become a competent surgeon.
Yet these are precisely the people who Democrats say should have their measly $800 tax rebate seized, because “they’re the greedy rich and they don’t need it.”
Under this idea of leveling and “social justice,” doctors don’t end up making that much more than carpenters and house painters.
If that sounds like a better system to you, feel free to schedule your next surgery in Moscow.