From Doc R.:
Hugh,I listen to your show on pod cast, so I was unable to comment last night. An issue which you did not mention, but is critical to the situation is the accelerating doctor shortage. I am a senior physician executive who spent 31 years in the Air Force and completed my career as commander at ______ Medical Center….I am currently Sr. VP for Medical Affairs at a small hospital system in ___.The major problem with every effort to “fix” health care is that they focus on controlling the price that the consumer pays. No one ever takes into consideration the cost of producing that care. This will have a major and increasing impact on the way forward.Currently, the US is short of physicians and is not producing them at a rate of replacement. Add to that the fact that a 30 year old physician is a completely different animal than a 50 year old physician. Most “old” physicians came into the profession at the time it was considered a calling. Yes, they were compensated (monetarily and otherwise) very well. But for that, they accepted 100 hour work weeks and being on call for months at a time. It was part of the social contract and they just accepted it as part of the life of a physician.The current crop of physicians do not have the same work ethic. Similar to other members of their generation, these docs expect to “have a life.” They are unwilling to work the same hours as their elders – at any price. Additionally, 50% of most medical school graduates are women who statistically have a much shorter career. You can see that every time one of the old guys retires, you need more than one new graduate to cover the load.The proposed changes that are ahead will undoubtedly encourage many of the old docs that there is no point in working beyond the point that they can retire. Yes, the fact that many of them have been hurt badly in the crash will keep some at work. But not a day longer than they have to. Then it will be harder for all of us to find a physician to take care of us.Rationing is on its way.Dr. R.