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Old 02-04-2022, 02:22 PM   #4
Socratic Monologue
"Honestly, I believe it is a rare person any more who wants to go into the medical field to actually and truly help people. Most, if they were honest, would admit that this is where the money is and that is what they are after. Any that survive to remain in the field long enough to get into management, well, they likely lost much of their humanity along the way."

I would speculate that you don't actually know any physicians?

Backing up a ways: Here's a neat rhetorical trick (I taught a college course in informal logic; I remember a bunch of cool tricks). Tell (print) a story -- true, of course -- "Three doctors under investigation for overprescribing drugs after accepting pharmaceutical company gifts" and a while later another one "Drug distributor fined $13 million for illegal kickbacks" and a couple more of the same sort. Then print the (true) statistic that "In 2015, 48% of physicians accepted some sort of payment or gift from the drug or medical equipment industry."

The inferential part of our lizard brain takes this all to mean that half of doctors overprescribe drugs to me and get paid extra for it. When a person is primed to accept some conclusion, they'll accept it without formal reasoning intervening (because it doesn't look like an incorrect inference). (Good book on this subject: Kahneman's 'Thinking Fast and Slow'.)

People are also primed to unconsciously infer some conclusion in virtue of their overall interpretive paradigm. When some guy gets busted and the cops find a bunch of half dead snakes in his basement, I see an outlier; PETA sees confirmation of what they already knew. This works both ways, so to speak; NPR doesn't have to convince me of much in the same way that Fox doesn't haven't to convince their viewers of much.

But the inference isn't true of course; all sort of kickbacks are illegal and are prosecuted -- anything involving Medicare and Medicaid, and they make an easy path for malpractice lawsuits (which, by the way, is one main driver of high testing and prescribing rates; docs cover their butts by doing everything medically possible even if a long shot). Most (88%) of these gifts are for lunch, which doctors can afford to buy on their own, and are in exchange for listening to a sales pitch. The average yearly amount per doctor is $200 -- chump change.

So, back to the point. My wife is an MD, clinical and admin. We've been together since before med school. We hang out with MDs (and PAs and NPs); our families spend holidays together, and go up north together, and help each other move, those sort of things.

As for the quoted claim, it doesn't square with reality. At all. Not one bit. All the MDs I know -- ER docs mostly, but GPs and surgeons too -- are much more caring and concerned and compassionate and thoughtful in one day than I am all month. Based on what they see sometimes, they should have PTSD, but they just make the best of it and keep helping. And though I only have N=1 on this, the move to admin work can be made out of a goal to make a bigger positive difference to patients than one can make just doing clinical work.

Physicians have a high risk of suicide (40% above the general population for men, 130% more for women). This is not because the money isn't what they expected. It isn't because they got a crummy lunch from a drug rep. It is because they are deeply caring people doing an often impossible job under pressure from all sides, including from meritless commentary on their motivations.

Anyone sick of "this COVID fiasco" should (1) get fully vaccinated, (2) wear a mask properly at all times in public, (3) stand six feet apart when in public, and (4) get out of the way and let those people who are trying to help, help.