Today as part of a program I am involved with at school I went to a screening of "Bad Blood: A Cautionary Tale". It is a documentary about how Hep A, B, C and HIV virus got into the blood supply (and blood products), infecting thousands of hemophiliacs (and others) who used these products.
The movie had me in tears. I had known that this problem existed (having worked in the HIV community) but had no idea before watching this documentary how long it took the government and drug companies to react. Had more attention been paid and had the drug companies been willing to pay more to make their products safer, thousands of infetions and deaths could have been prevented.
It is a fear of mine that our society's obsession with money will keep me from being all I want to be as a doctor. My compassion is for people and I hope to spend my life serving the underserved (be they underserved in terms of employment, insurance or something else). However, I will have a family to care for, bills to pay and loan payments to make (Medical school is EXPENSIVE). So, while I may wish to spend my time really getting to know my patients and helping them the best way I can by including both treatment and preventative education in my visits the question is: Will I be able to afford to do this?
Most people don't realize this but when doctors bill insurance companies for their patients' visits they do not bill for their time, they bill for a diagnosis. This means a doctor who diagnoses hypertension (high blood pressure) and spends one minute writing a prescription and one who spends an hour going over diet and exercise options, get paid the same amount of money for that visit!! And many in this country don't even have health insurance so that is a whole issue in itself.
Yes, there are government and private funded clinics for the uninsured but there are few compared to the number of for profit hospitals and offices in our country. Not only that, doctors who work in these clinics are paid less (by necessity) than those who work in other places. And yet, these doctors are still responsible to make at least 10 years of loan payments. Medical school is expensive whether you attend a state or private school (as an in-state student I will be about $230,000 in debt by the time I graduate, not including interest assesed while I am in school). Costs vary from state to state but the point is that doctors owe the government for their education and they have to pay it back and support their families at the same time.
I am still determined to be the best doctor I can once I graduate school. I don't know if I will find work in a government sponsored or private setting but I will find ways to treat my patients with the respect they deserve. If I can't afford to give a patient a whole hour, I will give them the time I can and address their needs in the best way I know how. I am determined not to simply write prescriptions and send people on their way. I want my patients to feel as if they have a doctor who truely cares abou them. Most of all, I will do my part to help change the system. I will be honest, I don't know enough about the Health Care Bill and am determined to find out more about it so I can make my own judgements on its good and bad aspects. If there is a petition I can sign or somewhere I can speak out for patient rights I will do it. Sure, I will still have to pay my loans and support my family but I will not let my need for money compromise who I am as a person or as a physician.
Yes, it sounds idealistic, but I hold onto the thought that if one person is dedicated to their passion, they can make a difference.