Doctor Needed….Under
Control
S.Q. Lapius was trying
to snooze, but I could see no purpose in allowing him to do that so close to
bedtime. I rattled the paper and was greeted with a snore. Then I
threw back my head and started to roar with laughter. He cocked an eye at
me. “My sleeping amuses you, Harry?” he muttered impatiently.
“Not really, S.Q.” I
said. “It was merely the position of articles in the last issue of
Internal Medicine news. On top is another surreptitious attack on doctors
by Dr. Edwards, Assistant Secretary Of Health for the Department of Health
Education and Welfare (HEW). The say, ‘We are now questioning very
seriously whether it is appropriate for the federal government to bear so
substantial a share of the cost of preparing individuals for careers that offer
about the highest earning power in our society.’”
“What do you expect from
federally funded secretaries, even if they are doctors? In any case,”
Lapius, trying again to doze off, “What’s so funny?”
“What’s funny,” I said in
a loud voice, “is that the headline right underneath reads, ‘SUICIDE RATE OF
MD’S HIGHEST OF THE PROFESSIONS.’”
“Of course,” said
Lapius. “With friends and colleagues like Drs. Edwards and Altman to lead
us, suicide is about the only way out. Congress ought to pass a law that
anyone who has not seen a patient for five years should not be permitted to
flaunt the M.D. degree. They should be stripped of their shingles, the
caduceus ripped from their shirt collars, and their diplomas should be returned
to the fuzzy sheep from which they came. They are upset because the
government has subsidized the medical schools to the tune of 3 ½ billion
dollars in the last ten years, or 350 million a year. They are afraid
that we will have too many doctors by 1985 if the number of foreign graduates
licensed in the United States grows at the same rate as in the past.
Their solution? To cut down the number of American graduates. What
a time bomb. We will soon be dependent on foreign graduates to supply us
with medical services. This is like the army depending on Russia to
supply it with guns. The sensible solution, it seems, would be to
restrict the number of foreign graduates and open the doors of the medical
schools to Americans.”
“You read the article?”
“Not only read it but
anticipated it. The government subsidizes about $20,000 of the $25,000
that it costs yearly to train a medical student. Now they want to take
the money from the medical schools and use it for loans to medical students
instead.”
“Doesn’t sound like a
bad idea,” I said, sorry now that I had awakened Lapius. He was building
up steam.
“Well it is a bad
idea. The subsidy to the medical schools should continue. Otherwise
the quality of education will diminish and the future of the profession will be
jeopardized. I’ll never understand this continuing attack on the medical
profession, or the foolish notion that we can best serve the country by
destroying the standard of excellence that has served so well in the past.”
“But the loans to the
students is a good idea,” I said lamely.
“Of course. But
there is a catch. The government will vacate the indebtedness of the
student if the student who borrowed money, will, upon graduation, serve in
areas that need physicians.”
I was becoming annoyed
with Lapius. His conservative approach had a distinctly antipopulist
ring. “That’s not a bad trade, Simon,” I said. “After all, a free
education for a few years of service.”
“Think about it though,
Harry. This will be foist only upon the poor students. I think it
would be more equitable for the government to set up clinics in the areas of
doctor shortage and ask ALL medical school graduates to serve a year --.”
“That’s ridiculous,
Simon. The government has always filled what it considers the national need
by bribery. They populated the west with homesteaders. They
subsidized the railroads, truckers and airlines to serve the national
purpose. If they need doctors in underserved areas what’s wrong with a
little incentive to attract the doctors?”
Lapius grunted.
“Does that mean you agree with me?” I asked.
“I think you’ve made a
good argument, but I’m too tired to debate it.”
I guess it was the first
time I had ever had that concession from Lapius but I might be right about
something. It was quite a victory.
“However,” he continued,
“my point is that the government shouldn’t support the students at the expense
of the medical schools. It should do both. However, it doesn’t
really matter what I think or what you think. The die is cast. Did you
finish reading the article?”
“No, not yet,” I said.
“Then listen to the last
quote from Dr. Stuart H. Altman, PH.D, Assistant Secretary For Planning And
Evaluation of HEW.” Then Lapius brushed off his remarkable memory,
focused his eyes on a point on the ceiling to sharpen his concentration, and
quoted, as if reading, ‘We are moving towards a controlled medical system in
which it will be necessary to offer financial incentives to encourage potential
physicians to enter medicine despite federal controls on the practicing
physician’.’”
I followed the
text. Lapius hadn’t missed a word. “And that, Harry, is why the
suicide rate amongst physicians is the highest of the professions.”