Touchdown said:
Do social workers require 8 years of school and then 3-5 years of training before they can work? I dont think so, if you are going to pay someone the same amount of money for a job that takes only 4-6 years of training and one that takes 10+ years then a lot of people would be turned away from the profession (not all and certainly not me but enough that its going to hurt especially with the baby boomers reaching their golden years.) Also, it call more doctors to the research side of profession (as it will be private and certainly pay better) further decresing the amount of physicians.
As for your belief that doctors deserve to be treated like any other profession, well we are just going have to disagree. There is a reason that since Ancient Greece doctors have been held in high regards, if you dont have your health then you cant do anything and docs are the ones that cure that (hopefully.) It is in society's interest to place these indviduals in high regard and reward them with a good salary (especially given the years of training required) in order to attract the best and brightest to the profession (on top of those of us who are called regardless.) Canada is seriously considering moving towards our system of health (God help them) and Europe is a mess for the most part; there is a reason that the most risky and difficult procedures are done here in the US its because we have attracted the greatest talent.
I am not advocating our current system is perfect, in fact it has some serious issues of its own (which we all know and I dont need to rehash) I just think that socialism isnt the answer either. I dont know what is, what I do know is if we change to socialism it will be extremely difficult to change when that new third way is discovered (history says any country that stops socialism has a painful, severe depression following such a change) so in the interm I say stay with the system we have now instead of staring from scratch. Lets try to make constant strives within the system to fix its problems, who knows we might even discover that third way.
Finally I agree that the AMA goal is to protect a doctor's personal interests, but I dont have a problem with it. For one thing, someones got to be in congress argueing for our views. What I dont agree with is that the AMA puts the interest of the doctors above the patient because a vast majoritiy of docs would never let them, but clearly you have point of view due to your view of socialist medicine which we have allready established a disagreement on as to weither or not it is effective so Im not going to argue this point any further.
PS. its finally nice to have a debate about this, everyone seems to have their canned answer for interviews and dont care outside of that. Its nice to see another person who actually has an opinion on the subject and is thinking about this issue that will certainly be resovled sometime in our professional lifetime.
by similar status i meant social status or regard rather than economic position. i doubt doctors would be paid the same as social workers, but their lower financial rewards relative to costs (education debt and forgone wages) would give them a status more akin to social workers than they have now. i was just trying to make an extreme concession that their social status would be lowered, and then state that i am okay with that. a subset of the bright folks that medicine attracts are the altruistic. medicine is such a unique job that i don't think bright and altruistic people have too many other options that are both intellectually and emotionally satisfying. no doubt we would lose folks who are bright but not too altruistic (interested in medicine for the money and status), but i'd wager those are the folks that are most likely to drop out of medicine and do research or business in our current system anyway. i sat in on an ms1 class, in which the physician instructor (primary care for 30 years) told us his litmus test of whether a med student will actually like practicing medicine is if they really enjoy and care about seeing their patients feel better. the intellectual challenge, money, and status isn't enough in the long-run, i guess.
yeah, i think medicine is a job. it's a very unique job, that can have some awesome intrinsic rewards for those who enter it for particular reasons, but everybody's going to find various things they don't like about it (as they would other jobs). i think
that's why doctors get paid a lot of money, lobbying aside.
i'm definitely not advocating socialism. i'm not into communism or socialism, never mind the avatar. but i do think socialized medicine makes sense, because i believe everybody has a right to health care and the market isn't solving and i don't expect it to solve our problem of equity in allocation. we've been trying piecemeal solutions like medicare, medicaid, hmos, and drgs since the 1960s, and now we have this unwieldy system of different sectors providing different quality medical care to different groups of people, with a good number of people falling through the cracks altogether and getting no care. insurance companies are happier with it as long as they keep making profits off of healthy folks with jobs and exclude those with no money and/or health risks, and many doctors are happier with it to the extent that it protects their professional autonomy and bolsters their salaries, and so both groups lobby through organizations like the ama to keep the system going, conceding government patch-ups here or there that don't fundamentally push the system toward greater-equity-but-less-pay-and-profits and chastising those patch-ups that do. i think it's time for a fundamental restructuring, and massachussets may be on to something.
i don't think most doctors would put their own economic interests before their patient's well-being, but with policy decisions the issue is doctors' interests versus the health of those in the population as a whole. doctors who enter boutique medicine (see fewer, but wealthier patients) or don't believe health care is a basic right can be very good with their patients, but the practice or policy decisions they support can have negative health consequences for patients that aren't theirs and they don't see. the invisibility of this makes it easier for them to support their practice or policy decisions in good conscience. so that's what i mean by that. but we're all guilty of this to some extent. i could go schindler here and start yelling "i could have seen a patient in the time i took me to write this email! i could have done more!" ok, time for bed. i've enjoyed this discussion with you.
