Monday, July 6, 2009

"I just want to help people"

This is the classic line you're supposed to recite when you announce you're going to med school, and I have to admit, it's caused me to squirt coffee through my nose upon hearing it on a number of occasions. Does anybody really become a doctor with the sole or even primary motivation of helping people anymore? Maybe. It's kind of hard to believe, given the starry-eyed reverence and huge paycheck that comes with being a doctor in our culture. On the other hand, I do have a couple of friends who slogged through law school only to take relatively low-paying jobs with non-profits and NGOs, so maybe I should back off the cynicism.

But whatever may be true of the individual people who go into the medical profession, it is certainly not true of the industry as a whole that its sole or even primary goal is to help people. In fact, helping people appears to be very low on its list of priorities. This is evidenced by the fact that the industry is currently spending $1.4 million a day, every day, to lobby congress on health care legislation. And this effort involves paying a lot of money to a lot of insiders who know how to work the system on behalf of the highest bidder. Because heaven forbid they be required to offer real care to real people, in a way that limits their ability to make giant profits while leaving the poor and disenfranchised people of the world to die. No, that would be the course of action taken by a group of people who honestly cared about people and wanted to help them.


  1. There are a lot of cheaper and less time-consuming ways to become a person who helps people. Hopefully it's part of a person's reason though because I want my doctor to care.

  2. Expecting the medical industry to care about their patients? Why, that's communism! I mean socialism! Wait... Oh hell, they're the same anyway. It's both!


  3. I often wonder if doctors forget their pledge to do no harm. It seems that they want the status and the money that comes with medicine without taking seriously the health of the patient. The commodification of healthcare remains one of the worst crimes of capitalism.

  4. I've always liked this analogy: becoming a doctor because you want to help people is like becoming a lawyer because you care about justice. But now that you point out that people can and do go to law school with the goal of being an advocate, I'm reminded that some (like my old college roommate) become doctors and spend a lot of time volunteering in neighborhood clinics and taking their turns with doctors without borders and other groups. So maybe that's a good test for the authenticity (a favorite topic!) of their motivational claims.

  5. Anonymous7/18/2009

    As a medical professional that does a good amount of volunteer work, I take offense to your statements. I have spent the last year in an emergency department because, believe it or not, I love helping people. It's the "worst" place to work in a hospital, by all accounts, because we see the most SAGA, and Medicaid patients, which leads to an overflow of patients and a lack of resources with which to provide for them. Often these patients exhibit drug seeking, and many of them arrive weekly, if not more often, simply because it costs them nothing to do so. They don't even pay their copays, but we can't refuse them care, even the ones that owe us obscene amounts of money due to their weekly visits for "chronic back pain" or "ETOH intoxication".

    In any system that provides healthcare to everyone, three things have consistently been proven. Everyone pays more taxes to provide for said insurance, wait times increase, and governments regulate what treatments patients can and can't receive, regardless of whether a doctor deems it neccesary. In a government run system, your needs will be triaged. Expensive treatments for rare forms of cancer will be deemed too expensive by the state, as they have been in England and Canada, leading people to come to the United States for treatment. You will have to wait months to see a specialist, so that brain tumor we just found on your MRI will have to stay unchecked until we can schedule a sit-down with a neurologist. And the healthcare that many people receive from their employer for a small fee (not everyone, but many) will dissapear, instead replaced by an 8-10 percent tax increase. The reason that doctors lobby is not to corrupt the system, but because there are those that are lobbying against them, and they must defend what they believe to be in the best interest of their patients.

    Lastly, healthcare is not a right. For something to be a right, it must not infringe on the rights of others. To mandate healthcare forces providers, nurses, and all tertiary health professionals to be your servants. They must provide for you because the government says so. Take whatever industry you work in. Now imagine the government has given every citizen a voucher for your services, and they may now have them for free, and you cannot refuse to serve them. I believe you would be upset as well.

    I believe the government should force all businesses to provide working Americans with healthcare. They should regulate the industry, ensuring that companies do not gouge consumers. A minimum plan would have to be in place that allowed for coverage of a spouse and children for a reasonable price. All children under the age of 18 should be provided government insurance if their parents are not employed, as it is through no fault of theirs that their parent cannot find employment. Disaster insurance would be provided by the government for patients that had exceptionally large bills, reducing insurer's losses and ensuring that policies would be sustainable. Elderly and disabled Americans would be provided for under current Medicare and Medicaid systems. Essentially, you contribute to society, you get insurance, period. In this country, no one should get a free ride; it is hard work that has made this nation great. If you want to be lazy, pack your bags and move up north, Canada would love you.

    I'm sure this is tl;dr for you, but I felt I had to shine a different light on the issue. Work in a hospital for a while, and you learn that most doctors genuinely are in it to help people. Really help them. In a way giving them food and shelter simply can't. Until you've saved a few lives, you just can't understand. And most of them will tell you, they could've made a fortune in finance if they wanted money. And they'd have to deal with a lot less digital disempactions, GI bleeds, and batshit insanity, as well as finishing school when they were 24 instead of finishing fellowship at 31. Please avoid bashing on people you've never known, and never tried to understand.

  6. Anonymous7/24/2009

    The vast majority of people graduating from med school these days (and in fact, in the last 20 years) aren't treated with starry-eyed reverence, nor are there "huge paychecks" coming their way.

    Most of the revenue they earn is eaten up by malpractice premiums, and the staff they must employ to recover payment from insurance companies that will do any number of things to avoid paying a legitimate claim. Let's also not forget the medical school loans. It's not uncommon for doctors to graduate with hundreds of thousands of dollars in loans.

    The reverence they receive is often in the form of patients demanding tests and prescriptions, because, "I didn't come here for you to do nothing!" The patients that aren't complaining about the care they receive are refusing to pay their $20 co-pay because they're out of work, While they sit in the waiting room and drink their venti Starbucks latte.

    But a lot of docs stay in the game because, after they've waded through all the BS, at the end of the day they helped people.

    Don't buy into the demonization of the providers. The system does suck. And it sucks royally, but for the most part, it's not because of the doctors.

    Think if you will, of the image of the "welfare queen".'s a fantastically emotional opportunity for righteous indignation, but it's not really the true story.