The Change in Physicians

The NY Times recounts the change of physician's political views in Maine as more and more practice at what could be called "jobs" and no longer as sole practitioners. The new physician is driven by getting better hours, lower stress, benefits, no overhead, and just a job. This in many ways is being accelerated by the mass infusion of women into medicine, where the balance is tipped to more than 50% women now entering the field.

It has been changing from a profession to a job. We saw that almost a century ago in engineering where companies brought the profession in-house and then fifty years ago as teachers became employees and no longer professionals as unions took over. Now the trend to employee status is taking over the field of medicine. Soon the MD will be akin to the PhD engineer at some corporation, both employees, cogs in the wheels of a changed society.

Yet the engineers still spin out as entrepreneurs, what will be the equivalent for the physician who seeks to retain a profession rather than a job?

For example the article states:

...a 51-year-old orthopedic surgeon... is the kind of doctor who has changed ...She trained at Harvard, but after her first son was born she began rethinking 18-hour workdays. “My husband used to drive my son to the hospital so that I could nurse him,” she said. “I decided that I really wanted to be a good surgeon, but also wanted to raise healthy, well-adjusted kids I would actually see.” So she went to work for a hospital, sees health care as a universal right and believes profit-making businesses should have no role in either insuring people or providing their care. She said she was involved with the Maine Medical Association, for the most part, to increase patients’ access to care. 

 But this also is the ACO model that the new health care plan fosters. So what can we expect? Physicians with jobs all belonging to unions, and dominated by women who want to work no more than 40 hours per week. Ah, we have seen that tale already, the Public School system. We know where that goes.

Imagine if lawyers wanted the same. Just 40 hours per week, just a job. They could also all work for the Government and when we need one they get assigned by that good old GS5 in the belly of the beast. Just imaging where Madoff or DSK would be now?

As the article continues:

Even in Texas, where three-quarters of doctors said last year that they opposed the new health law, doctors who did not have their own practices were twice as likely as those who owned a practice to support the overhaul, as were female doctors. 

 Frankly why did they enter medicine in the first place. Just to get a job? If we think things are bad now just wait!