The Falling-Down Professions

While I doubt the great majority of people are going to feel sorry for doctors and lawyers after reading the linked article, I am impressed that it holds the number 1 spot in the most read articles at the New York Times(nytimes.com). The article accurately portrays the great erosion of a sense of satisfaction many individuals in these fields now face in the U.S.

In healthcare the causes are many: the bias towards sensationalism in the media (which distorts the fact that most MDs are bright and caring by focusing on the few that aren't), the insurance companies which demand excessive documentation and then throw out every 3rd or 4th claim for payment submitted by physicians (or so it is said),the rise of consumerism with its attendant demands, the fact that every patient is a potential litigant, the ratio of severe vs. trivial pathology seen in the U.S. (vs. the developing world), the incessant decrease in reimbursement rates which do not allow patients the time they wish to have with their doctors etc...

I was at a dinner recently with 4 doctors--every single one of which was looking for a way to get out of the practice of medicine. In other places I have visited and worked in such as the Far East, the Middle East, and Africa--doctors are accorded much more respect than here. Even though a well--off doctor in say, Jos, Nigeria may only make $500/month I would venture to say that such an indivdual, treated as a professional, is happier in many ways than many of my colleagues here...
I often wonder if the general public realizes how demoralized doctors are here and how many of the brightest minds are now going into alternate fields...

So now who’s going to cheer up the doctors?

As of 2006, nearly 60 percent of doctors polled by the American College of Physician Executives said they had considered getting out of medicine because of low morale, and nearly 70 percent knew someone who already had.
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OR at least, it is not all about money. The pay is still good (sometimes very good), and the in-laws aren’t exactly complaining. Still, something is missing, say many doctors, lawyers and career experts: the old sense of purpose, of respect, of living at the center of American society and embodying its definition of “success.”

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One doctor responding to the American College of Physician Executives survey wrote: “I find it necessary about once every month or two to stay in bed for 24 to 48 hours. I do this on short notice when I get the feeling I might punch somebody.”

Increasing workloads and paperwork might be tolerable if the old feeling of authority were still the same, doctors said. But patients who once might have revered them for their knowledge and skill often arrive at the office armed with a sense of personal expertise, gleaned from a few hours on www.WebMD.com, doctors said, not to mention a disdain for the medical system in general.
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“What irritates me the most is the use of the term ‘provider,’” said Dr. Brian A. Meltzer, an internist in Pennington, N.J., who now practices pro bono on the side, but works full time for Johnson & Johnson’s venture capital division. “We didn’t go to provider school.”
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And then there is, yes, the money issue. Or rather, money envy. Associates at major New York firms often start at $150,000 to $180,000, said Bill Coleman, the chief compensation officer at Salary.com, a company that tracks income statistics. Partners at the country’s biggest 100 firms took home an average of $1.2 million in 2006, according to American Lawyer.

Hardly small sums, but for many senior investment bankers, bonuses and salaries this year will average $2.25 million to $2.75 million, according to Options Group, an executive search and consulting firm.

Doctors rarely approach such heights. While income varies widely, a typical physician might earn $150,00 to $300,000, according to Salary.com data. A surgeon might make $250,000 to $400,000; hot-shot surgeons can earn $750,000 a year, and superstars over a million dollars.
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This star-system mentality is particularly attractive to college students, many of whom were reared with the ’80s philosophy that every child was a potential superstar, Mr. Coleman said. And they want immediate rewards — not exactly the mentality that will fuel a student through years of medical school, a residency and additional training for a specialty.