We’ve come to a sorry pass in American medicine when physicians are willing to spend a lot of money to attend conferences—not to learn how to become better physicians, but to find a way out of the pit of clinical practice.
Few of us have the charisma (or chutzpah) to make a living in medical show business, like Sanjay Gupta or Mehmet Oz. But apparently any physician today can be clever enough to secure a comfortable nonclinical niche where the specter of The Joint Commission never lurks.
I came home recently to find a glossy brochure in my mailbox, inviting me (for a mere $1,295) to attend a two-day meeting with the principal aim to help me stop taking care of patients. This conference promised contact with recruiters and employers who would put me out of my misery as a clinical physician. In case I didn’t know I was miserable, the brochure pointed out that switching to a non-clinical career has “more financial potential” than clinical medicine. It suggested sympathetically that I might be among the many physicians who don’t enjoy going to work any more, and want to eliminate the “stress and time commitments” of patient care.
People in Washington DC would do well to take a good look at this brochure, just in case they were wondering why Medicare patients have trouble finding doctors. The panel of experts speaking at the conference includes a host of former internists and family physicians, all happy to explain how they fled the tiresome business of seeing patients for their new careers as consultants, entrepreneurs, business executives, motivational speakers, and expert witnesses. One emergency physician on the expert panel left the ER to become a “Master Sherpa Coach”, whatever that is.
It’s no wonder why so many physicians are getting progressively unhappier. In the past ten years, inflation-adjusted physician fees have declined by 25%, and at present aren’t even keeping pace with inflation. The non-elected Independent Payment Advisory Board, created by the Affordable Care Act, has the sweeping power to mandate even more pay cuts to physicians, and doesn’t even include a practicing doctor among its members. The overhead costs of running a medical practice continue to rise, and there is no relief in sight to reduce the crippling cost of malpractice insurance in many states. Documentation requirements (thanks to the Centers for Medicare and Medicaid Services and The Joint Commission) and penalties for noncompliance grow more threatening every year.
Why wouldn’t an enterprising physician look for a way out of this trap?