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Medical Students, Specialty Practice, And More Money

With medical students graduating, on average, with almost $160,000 of debt, it’s a major reason why they’re choosing more lucrative specialty practice, which can offer salaries multiple times more than those of primary care fields.

In this clip from The Vanishing Oath, medical economist Amitabh Chandra, Professor of Public Policy at the Harvard Kennedy School of Government, discusses that influence, which contributes to a drastic decline of primary care residency slots being filled by American medical graduates.

Of course, it’s not only money. Primary care practice has a litany of obstacles that can contribute to rapid physician burnout, compounded by the fact that good primary care role models are largely absent from academic settings.

But there’s no denying that the salary disparity is an influential factor, and for many students, often a deciding one.

A video excerpt from The Vanishing Oath, a film directed by Ryan Flesher, M.D.:

*This blog post was originally published at*

Physician Burnout Isn’t New

Dr. Wes and Kevin, M.D. have both written reviews of the documentary film “The Vanishing Oath.” I started the process rolling of trying to get the film shown locally. No date yet, but looks like it will happen before the year is out. 

This is not a new phenomenon in medicine (or any profession). Dr. Robert Goldwyn wrote a nice essay on the some of the issues that can lead to burnout, though not once did he mention burnout specifically. The title says much:

“I Bargained on Working Hard as a Surgeon, Not Working Hard to Be Able to Work Hard as a Surgeon”

The preceding title is a quote from a letter written by a resident in the last year of his training (S. A. Teitlebaum, August 20, 1994). It reflects the gloom besetting the young in particular but certainly not them exclusively. We all are uneasy about our futures, professionally and economically. Bandied in the corridors at a national meeting was a dismal figure: 1:100,000, the presumed proper ratio, as determined by Health Maintenance Organizations, of plastic surgeons to population. That 1 million Americans need only 10 plastic surgeons seems wrong and idiotic to me, but it makes good economic sense to health providers and insurance companies. Their coffers swell as they collect the same or higher premiums while curtailing what they provide. Read more »

*This blog post was originally published at Suture for a Living*

Medical Malpractice: Perspectives From A Doctor And A Lawyer

Medical malpractice is a major issue that divides doctors and lawyers — with patients often left in the middle. I wrote last year in USA Today that reform is sorely needed, mainly to help injured patients be compensated more quickly and fairly than they currently are:

Researchers from the New England Journal of Medicine found that nearly one in six cases involving patients injured from medical errors received no payment. For patients who did receive compensation, they waited an average of five years before their case was decided, with one-third of claims requiring six years or more to resolve. These are long waits for patients and their families, who are forced to endure the uncertainty of whether they will be compensated or not.

And with 54 cents of every dollar injured patients receive used to pay legal and administrative fees, the overhead costs clearly do not justify this level of inefficiency.

In this video excerpt from The Vanishing Oath, a film directed by Ryan Flesher, M.D., perspectives from both sides are given, and it’s easy to see why this contentious issue isn’t going to be resolved anytime soon:

*This blog post was originally published at*

How The System Affects Our Doctors: A Must-See Documentary

Yesterday a much-anticipated package arrived in the mail containing a documentary film directed (and acted) by a young emergency room physician, Ryan Flesher, M.D., and produced by a former clinical social worker, Nancy Pando, L.I.C.S.W. The film is called “The Vanishing Oath.”

As background, the film is a 3-year project born in 2007 just before the great U.S. healthcare reform debate began. Over 200 hours of interviews were conducted to explore a simple question:

Why Dr. Flesher had grown to hate medicine. Read more »

*This blog post was originally published at Dr. Wes*

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