I had an article published on a well known blog: http://www.kevinmd.com/blog/2015/08/why-this-physician-still-loves-medicine.html
What I Still Love About Medicine?
From every direction, the practice
of medicine in the U.S. is under attack. If one were to believe the headlines,
the American healthcare system is populated by insensitive, selfie shooting, medicare-medicaid
cheating, inefficient, and ineffective physicians grappling with an over
regulating government, predatory insurance companies more concerned about
profits than the health of their customers, and a legal system that more often
confuses a bad medical outcome with actual malpractice. Morale in medicine may never have been lower
among physicians than it is currently. Studies have demonstrated that few
physicians are positive about the future of their profession, and the majority
do not recommend medicine as a career choice for young people or their
children.
I have always wanted to be a
physician. It has always seemed that it was the “family business”. With a Grandparent, uncles, cousins and a
father in healthcare, did I exercise “free will” when I accepted admission to a
6-yr medical program at the age of 18?
One could argue, maybe not!
However, on the eve of starting medical school I affirmed for myself
that it was what I wanted to pursue. I
have never looked back on that choice with regret despite the ups and downs of
this noble profession. To answer my
self-imposed question, what I love about medicine are the unique opportunities
it has given me. Caring for others, educating trainees, a collegial bond, and
the intellectual challenges have sustained me through difficult times.
As a physician we have a unique responsibility
and a privilege. It is called the “doctor-patient relationship.” I have
always viewed this privilege as earned through years of hard work. Inherent in
our profession is the acknowledgment that those we care for are suffering. The Latin
root “patiens,” from “patior,” is to suffer or bear. I can’t stand it when some
try to use the term client in its place.
My automobile mechanic has clients. I have patients. We share an
intimacy of information and emotion with patients that few other professions
allow. Other than maybe members of the clergy, no one else is privy to the
closely held secrets, pains and distress of our patients. We often have the ability and need to heal
not just the body but also the spirit of our patients. At the end of the day, it is just one
doctor-one patient linked together in a sacred relationship. I don’t think any
other field would provide the same opportunity. The more we give, the more we
get.
Sadly, the pressures on physicians
are increasing while economic reimbursement is decreasing. The amount of debt accrued by medical
students is astounding. In as study by the AAMC, it was noted that the median
educational debt of all students was $180,000. Including interest payments, the
total repayment could approach half a million dollars. Considering the length
of time in post graduate training as a resident or fellow varying from 3 to 7
yrs. earning a modest income while working long hours, the “opportunity cost”
of not being able to earn a higher income and start saving for retirement is a
real economic hardship. Medicine has
attracted the “best and the brightest” historically. Given falling
reimbursements, increased debt and outside pressures, people contemplating a
career in medicine may not make the equation that the personal rewards that a
medical career can give balance against the decreased economic benefits. That will be a regrettable day that is
probably already here. To “save”
medicine, society will have to absorb the cost of medical education in some
manner as it did the cost of postgraduate training with Medicare. Those that choose the profession in the
future may actually be more dedicated and value the non-monetary reimbursements
more than the financial. Hopefully they
will be just as capable.
Gary B. Nackman, M.D.
Owner, NJ VeinCare, LLC
Clifton, NJ
Clinical Associate Professor
Dept. of Surgery
Rutgers-Robert Wood Johnson Medical School
New Brunswick, NJ