Archive for the ‘Blog’ Category
Doctors put a lot of effort into their schooling. For some of them, those with the most over-achieving parents, it could start as early as before school. Some parents believe in the system so much that they could move just to get their children into the right kindergarten. For some this schooling comes easy. For most it involves hard work. Long-distance schooling is not so different than being an endurance athlete. Just instead of the heart and legs the organs taking part are the brain and ass. You have to sit down and study. And that only gets you into med school. Here you suddenly have to show some people skills. If you just happen to want to get into a good residency you can’t just be some kind of brainiac with no life. You have to be good with people. You have to understand the system. You have to talk your way through interviews. And then come the patients. For some, even after two decades of hard work, the patients could be an unpleasant surprise. For others they can form a challenge too great to surmount. But most do. And then more than two decades after embarking on this journey, it continues. Fellowship. A fancy word to describe advanced training and more education. And then what? What now? Now comes real life. And real work. And real responsibility. And real liability. Now comes the challenge. Now you have to live that great life you were hoping for. You have to pay off those college debts and do well for yourself.
So how much is all this worth? How much should a doctor make after all this schooling? Is it enough to pay them so they could pay their debts and live comfortably? Should they be paid according to their responsibility? To what they really are? To what we want them to be?
You know, in Russia in the communist days many doctors would have these signs hanging up in their offices, behind the doctor, in a visible spot, not to be missed by the patients. These signs would read “A hungry doctor doesn’t remember medicine”. This was basically a call for bribes. A patient who saw that sign knew that she should bring a chicken or some soup or an envelope filled with what little cash she had stashed so her doctor would magically be able to treat her. That is one extreme.
On the other side are the corrupt. These are the few (?) that give the rest of us a bad reputation that can kill a lifetime of progress. These people abuse their power. They cheat. The perform unnecessary procedures. They steal. These people should never have become doctors. But their egos took them wherever they wanted to go. Imaging putting your life in the hands of a cardiologist. You are experiencing chest pain. They say you need a stent. Who are you to argue, right? So you get a stent. The procedure goes well. You go home. You need to take a few more pills now, but that is okay. It IS you heart, right? But what if that stent should not have been left there in the first place? What if your good doctor put it there so he could make a buck? We all know these things happen.
So. Should doctors make just enough to get by or should they be driving fancy cars and living in mansions? Okay. Most of you are saying. Neither. They should be making a decent sum. I get that. Something to reflect the investment and to keep them straight. But how much is that? What is the price tag of responsibility for a life? What is the price tag for missing some childhood frolicking and sitting at home studying for the finals instead?
In Israel there are doctor strikes going on these days. Hundreds of doctors have abandoned their posts in the hospital wards and have taken to the streets demanding more money. Fair and square. More money and less work. For some this is appalling. More money?! Shouldn’t these people be taking care of me because they want to? Shouldn’t they be here because it is a calling to be a physician? But what if they are hungry? What if they can’t concentrate on your health because they see their friends leading easier, less stressful and more lucrative lives? What if the best of students and the most compasionate of people don’t go into medical school any more? What if they just say “Hey. I don’t need all this stress, investment, responsibility. Let me be anything else I choose”. What about that?
And then there is the good of the people. In the US healthcare reforms are on the verge of being implemented. Doctors will start getting paid less for procedures, more for keeping their patients out of the hospitals. For many this will mean a significant drop in salary. On the other hand, having a healthcare system that is unsustainable also does not make sense, does it?
So how much money should a doctor make? In the US, for instance, some internists make $150,000 a year. Sounds about right, no? They could be left with perhaps $100,000 net after tax deduction, health and all that. A lot of money. Perhaps if they don’t have children to put through medical school that is a lot of money. Think about it.
