[kyouens]

I'm also a physician. I am generally satisfied with my work, but I do feel distressed by what feels to me like erosion of the social contract between doctors and society that flourished during the second half of the twentieth century. It sounds like we agree that some of that erosion has occurred because of nakedly self-serving political action by medical professional societies.

When I made the decision to become a physician twenty years ago, I thought medicine was my calling. I believed that the personal sacrifices one makes to be a physician--and there are many--would be rewarded with professional pride, the respect of my community, the gratitude of my patients, and a secure and well-paid living. I have gotten a little wiser, I think. I make a good living, my work is interesting, and I still think medicine is a great career. But times have changed, and I no longer consider medicine a calling for which one should be willing to sacrifice one's personal well-being. I find myself defending my profession on the internet a little more than I'd anticipated :)

Those who control the business of medicine take economic advantage of the patient-first mindset of our medical tradition, and it cheapens what we do, both literally and figuratively. It is for that reason that, despite its many flaws, I do think organized medicine does have redeeming qualities. It gives physicians at least some voice in politics, where they would otherwise have none at all. Maybe one day health care reform will right the ship.

[killjoywashere]

Don't get me wrong, we have a great gig. A fellowship director once expressed shock that I would advice my kids to go into medicine. I asked him "Have you looked for another job? I had a job before this, and had to look for another before I got an acceptance letter, married with two kids. Have you looked at the job market? What other job pays half as much, is half as satisfying, or gives you half as many further opportunities?" His reply: "Yeah, I mean, when you put it that way..."

Well, what other way are you going to put it?!

I'm all for organized medicine. But I favor PSR and MSF. They represent the ideals of the modern liberal social order. The AMA needs to be starved off the face of the earth.