W. G. Thompson
Of all the pronouncements by politicians and editorialists about government medicine, I have found only one person who has expressed the concerns of physicians. This exception was Angus MacDonald in the December issue of The St. Croix Review. Please allow me to expand upon his identification of a serious problem.
It would be impossible to have statistics about future events. I will base my assumptions on 32 years of private practice and my own attitudes. Mr. MacDonald tells of five physicians who changed jobs ahead of the problem. Five is a tiny number compared to the many doctors of near-retirement age who may quit as the government takes over. Younger men and women will follow suit as they become aware of government interfering in both medical and business decisions. A number of other physicians will look elsewhere when they find their income is determined by socialism but their office expenses continue to be capitalistic.
There will also be discontent as a number of physicians will find themselves having demands made by "I have my rights and I am a taxpayer" attitudes.
Who will take up the slack? The obvious answer is nurse practitioners and physician assistants. There are two thoughts about this. First, fully-trained physicians make errors in ideal care. How will these ancillary healthcare people, as good as many are, do with only five percent of the training?
Another source of medical care is by foreign physicians. The few I've met have all seemed quite capable. Two points are worth bringing up. Americans converse partly with slang and idioms. How well can foreign physicians communicate? Secondly is the concern, maybe groundless, of how Middle East doctors will relate to American women.
A much more serious problem looms in the future. It takes excellent grades in some difficult areas (think organic chemistry) to be accepted to medical school. Will young men and women, most of whom can handle any college curriculum, desire a career as a government employee when the sky is the limit as to income in a number of other fields?
Will there be a reduction in the quality of applicants to medical school? Will the quality of physicians decline as medical schools reach deeper into the list of applicants to fill their classes?
There are many sides to the problem of medical care supply and financing. Smart people need to work on the many choices, but should not exclude the physicians.
W. G. Thompson, M. D.