What a sad story. Doctors in Nigeria are on strike. Patients die and no care is given, because they want to be paid the same as doctors in "government" hospitals. They currently earn about $700/month. http://english.aljazeera.net/video/africa/2011/03/201132154530341529.html
All doctors, and I'm certain these Nigerian doctors, respect the "Oath" to treat patients, and realize that patients are the number one priority for a physician. How could they not? Patients, that are suffering, are vulnerable, and hurting are difficult to ignore. To deny their patients care, I believe reflects on the work environment of these physicians. Giving up a fundamental obligation would only be done if the pressures are too great.
A host of pressures will effect U.S. doctors as health care reform takes hold, and the pressure "to earn" increases. Will that happen? Certainly. ObamaCare, or something like it is coming down the pike and I don't think the Republicans will stop this freight train. Even the American people believe something needs to be done and so do many doctors. One group that is not mentioned much during this debate are the doctors, and I believe that portends trouble for physicians.
Insurance companies are discussed frequently because they take too big a share of the health care dollar. Pharmaceutical companies are also mentioned for the same reason. Why are the doctors not mentioned-- aren't they are the driving force in the health care system?
The reason is that they are a small group, and they don't have enough political might to affect the deliberative process. Doctors in the U.S. pledge themselves to the welfare of the patient, and the politicians will surely take advantage of that promise in the "new" system. What are they going to do anyway, leave medicine?
But how will these health care delivery changes affect the function of physicians? I worry. Will it make them lean a bit more to doing a procedure that could wait for a test of time? Will it make them order an additional CAT scan on the machine they have invested in? Will they order another lab test from the lab they own a share in? Probably, and why, because earning a living is a potent motivator. Witness Nigeria.
I believe that this challenge ahead--income versus service--for the medical profession is as great as it has ever been. There will be no place for the Mercedes, the "mansions," and the elaborate life styles in the future. Physicians will be "public servants" in the real sense, or they will leave the profession. This will not happen in a short time, but in the future, the forces of control will change medicine from a "lucrative profession" to a field of giving. To avoid disappointment, young trainees need to hear and understand this message.
The premeds currently in college will realize these changes in their 40s, as the pressures of college age children, lifestyle, and retirement begin to enter their horizon. The majority of them will not have the "loose change" available to assuage their fears of "downsizing." Plainly, there will not be as much profit in the future for physicians and they will have to decide whether they will become public servants or leave medicine.
Don't be alarmed by these predictions. These days, I predict, lie 10 or 20 years in the future. But they will come. Unfortunately, when they do, the public will have to develop a keen sense of their medical care to survive as long as they can at a reasonable price.
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