Letter from a Doctor

To Hugh Hewitt. Excerpt:

You have done well so far in airing the current problems that physicians have with Medicare (& Medicaid) reimbursements. One of your surgeon callers adequately described that an in-house level III consult is worth $70 (of which overhead & taxes take ?), and few physicians can be motivated to get up at 2 a.m. & drive to the hospital, stay for half the night, for roughly $35, no matter how altruistic.

To play devil’s advocate, I’d like to point out what my liberal non-physician friends say when the cuts in reimbursements are discussed: “Well, if your income of $185K goes down to $150K, then you’re still making $80K more than I am, so I think you can survive…” (From a strictly philosophical position, there are so many things wrong with this statement that I don’t know where to begin.) But, let’s focus on the pragmatic. Average Joe doesn’t understand the debt to income ratio incurred by physicians (with debt taking many forms, not only financial). And society has done a great job of stigmatizing physicians as being money-grubbing entrepreneurs who don’t give a damn about patients, such that Average Joe actually feels almost liberated when reimbursements are cut.

I want to point out that current medical students today incur more than $125,000 for 4 years of med school (if they go to a cheap state school). This figure does not include college. The repayment schedule for my debt ($100K, because I graduated in the 1990’s) is $700/month and extends until I’m 65 years old. As a subspecialist physician, I trained for 14 years to do what I do (4 college 4 med school 4 med/peds residency 2 fellowship). While my friends and neighbors were becoming teachers and loan officers and hair stylists and restaurateurs and claims adjusters, I was going to school learning how to take care of old folks, babies, and AIDS patients. Not only did I incur debt, but concurrently, I deferred income for almost a decade. So, while my friends were buying homes and having babies, again, I was learning to take care of AIDS patients.

All of this was my choice, and I do not regret that choice. But let me be clear: medical students will not continue to make these sacrifices for peanuts. They will not.