Perspective/Observations

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cfdavid

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So, we all realize that part of this forum is designed so that we can vent frustrations, kick around ideas etc. To some extent, however, our field seems wrought with the "Woe is me" attitude.

Fellowships: Some lament that our field is "dead" when the perception is that a fellowship is necessary or even highly desired.

What surgical specialty do you see which isn't "suffering" from the same "problem"? How many Gen Surg residents are sticking with Gen Surg? Even in the subspecialties like Ortho and Urology, the residents who I know are MOSTLY "thinking" that a fellowship is either desireable or necessary.

Point? This is not a unique phenomenon of our field. It's important to keep that in mind.

Mid-level enchroachment: Look at "trends" in our society. Look at the numbers of women seeking more "natural" forms of birthing, increasingly incorporating mid-wives to the exclusion of an OB/GYN. Look at the RATES in which the DNP will effect OTHER medical professions than CRNA's are effecting anesthesiology today. So, again, these issues are almost universal.

Interchangeability: Do patients really give a sh.t who takes out their gallbladder or kidney stone? Sure, our field has become a bit commoditized (perhaps an understatement) but so are some other fields. Think of the OB who may or may not be the one delivering the baby. What about the urologist who saw you in the ED but his/her partner will be doing the lithotripsy/stenting. Point? Interchangeability is NOT unique to anesthesia, nor is the commoditization of medicine. These are trends in society, frankly.

Not too long ago a CPA was lamenting to ME that in the "old days" his clients showed some loyalty. They would stick by him and value their RELATIONSHIP. Today, he says? If another CPA offers $50.00 discount on his/her tax returns, 80% of his clients will seriously consider terminating the "relationship".

A lot of what we bitch about w/r/t medicine are really societal trends. Look at the growth of online brokerage accounts. Other than private equity, who's willing to pay a premium (of any significance) to the average financial "advisor"? Not many.

Just a few thoughts designed to reign in some of the gloom and doom.
 
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