Where will future doctors come from?

Thomas Sowell wrote on this today. It is good to see this question asked in the mainstream media. It is a question I have asked and written about before on this site and a discussion I have had with many of you in person. Last year I attended a meeting to review a new product. About 30 of my Ob/Gyn colleagues sat through several hours of powerpoint presentations and discussions. The last lecture was by a lawyer working for the company sponsoring the event. There is no medicine without lawyers anymore. Actually, there is just about nothing without lawyers anymore but I digress. The conversation was interesting and eventually he asked how many of us in the room had parents who were doctors. About 40-50% of the hands went up. Then he asked the obvious next question. "How many of us would want our children to become doctors?" Not one hand went up. It was one of those indelible moments of reality and sadness to all attending of what our once noble profession was becoming.

I know many of my colleagues would agree with Dr. Sowell while some do see it differently. However, I would add this bit of thought. When you are sick or scared or need health advice would you prefer a shepherd or a sheep? For my part, I want someone who is a take charge person. One who exudes confidence, will go to bat for me with those that would obstruct my care and go the extra mile to make me and my family feel safe. I call those type of physicians shepherds. Shepherds do not want to go through 8 years of postgraduate education, 4-6 years of residency and fellowship training, costing them hundreds of thousands of dollars and leaving them in substantial debt ,spending the entire decade of their 20's in labs and libraries and lost hours and screwing up a normal social life.....Only to discover upon completion of their training that they will now have their salary, their decisions, their ability to plan their schedules and prescibe medicines all determined by an employer, an insurer, a government, a hospital and their lawyers. To be told what you can and cannot do confirms they are and will only ever be sheep. So, as the reality of what the future will be like reaches those eager premed students, the shepherd personality, the capable decison maker, the person who would take responsibility for their decisions, will not choose medicine.

Medicine will no longer be a profession but might still be a good "job". It will not be cost effective or individualized as it will be left in the hands of those incapable of taking charge. Natural selection and a training environment that emasculates decision making will lead to doctors incapable of making even a simple decision without consultations, extensive use of testing modalities and one size fits all protocols. (Ah, protocols....sound familiar?). This is where we are already and the future does not look brighter if trends in Washington continue. As Dennis Prager likes to say, "The bigger the government, the smaller the citizen." Anyway, I encourage you to read Dr. Sowell's piece linked below. Thanks, Dr.F