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To be or not to be- A doctor- That is the quandry

The 21st century will be defined as that of technology, as was the 20th century defined as that of medicine. Times change, and so do the career paths that the brightest young students choose. For many reasons the option of medicine has been on the decline among graduating US college students, and the medical workforce is now dependent on foreign medical students, desperate to escape their economic hardships at home, who will willingly jump through multiple hurdles to end up working for some large hospital corporation at rates most US graduates would conveniently ignore. But how and why did the once noble profession of medicine, a profession that every US parent wanted their child to enter, fall off the map of ambition. There are many reasons and just a few of those will be delineated below

The medical profession is the only profession that has seen a progressive decline in its real income over the last twenty years, due in large part to the never ending cost cutting practices of the for profit insurance companies. Without making this essay a diatribe on the unethical practices of this sector of society, what cannot be denied is the fact that their wealthy executives have made vast profits from the US healthcare sector, while simultaneously refusing to pay physicians for the clinical services they rendered. One might ask why the profession did not fight back, and while being an obvious and very good question, the simple answer lies in the lack of strong political leadership that doctors have had to endure over the last two decades. The insurance industry have their sticky fingers in just about every pie of human existence, which gives them a major negotiating advantage with the government, in terms of introducing legislation hostile to the medical profession. In contrast doctors are ill organized and only a few either see, or have the stomach for a full on lobbying/legal battle to protect their interests.

Medicine at some point in the not so far distant past occupied a place of respect within US society. Sadly no more. This can be partly explained by the ultimately unproductive and excessive litigation that this nation of lawyers has perpetrated on the men and women who have dedicated their lives to saving lives. The same cannot be said of most attorneys whose raison d’etre is solely their own financial enrichment. Healthcare is a complex ecosystem that deals with equally complex human problems, and the excessive litigation that has plagued the US is a corrosive and selfish force that has been proven to do nothing to elevate healthcare standards. There are just as many complications/deaths now as there were twenty years ago, the only difference is that now there are many more lawyers willing to suck the life blood out of the system. This self serving conduct is one of the factors that has led to an increase in the insurance premiums that doctors are now forced to pay, and is without question the principal reason that a large percentage of OB-GYN doctors have abandoned medicine. A tragic state of affairs motivated by nothing but money.

There are off course more constructive formats in which to address the emotional, psychological and financial needs of medically injured patients, and these can be seen successfully working in Europe, where there exists an understanding that an overly punitive and expensive medical malpractice system benefits nobody but the prosecuting lawyer. I would suggest that if Obamacare really wanted to reduce costs, it would have given serious consideration to incorporating these models of malpractice sanity into their nascent form of medical dispensation.

Is it any wonder that US students are heading for the valleys of silicon, where fortunes are being made, frivolous litigation is on life support and one does not need to spend over $300,000 and 12 years of education before being able to make a livable salary. The majority of the future medical workplace will be women, working part time, with the result that clinical services will be rationed and patient care will bear the brunt.

The influx of non-English speaking doctors will increase to meet the demand and the profession of medicine will slip down the social rankings, making it a career path for those students that have cruised through college in the middle lane, albeit with good hearts and naïve intentions. The top tier groups will choose the computing and engineering sciences as stepping stones, on the way to the burgeoning tech industry which shows no signs of abating.

The cost benefit analysis that every American family makes when choosing what career path down which to send their progeny, plays a pivotal role in the higher educational business that makes billions for those institutions that promise bags of gold at the end of the graduation rainbow. The hard truth, however, is that vast sums of money are spent for an education that in many instances fail in their mission to generate the expected return on investment. It would be an enlightening experiment if higher education, as in Europe, were made free to the public and the purse strings loosened by the government, considering that personal taxes in the US are now on a par with those of the average European. Now that would require some political steroid induced muscle, which I seriously doubt will materialize considering the US is on the brink of election season.

The message therefore to the bright eyed and brilliant minded youngsters of today, is set your academic compass west, pack your hard drives and head out to the valley of silicon, where even those with marginal ambition will thrive.

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