Doctors Earn a Lot, Part 2

The best justification of our income lies in what we do:  we save lives, relieve suffering, and comfort the afflicted. Most of the time. I look on medicine as a noble, humanitarian calling, perhaps the noblest. Patients acknowledge this. So what’s the problem?

It’s that humanitarians shouldn’t make a lot of money. Few laymen believe clergymen, nurses, social workers, paramedics, teachers, policemen, or firemen are overpaid. They are less certain about doctors, but it doesn’t upset them if they have good insurance and enough money. Those without it rarely speak out or appear in the waiting room.

What are we doing about those who can’t afford us? Some doctors volunteer an afternoon or two. A few genuine humanitarians work full-time with the poor at an unacceptable salary. Most of us do little.

That statement produces an avalanche of disagreement. Poverty is no barrier in their practice, a chorus of doctors insists, but it is. Few doctors would refuse a patient who pleads for charity, but this doesn’t happen often.

Why don’t the needy call? They don’t hesitate to consult clergymen, social workers et al. I believe it’s because we are so powerful and prosperous and (ironically) because no influential group objects to this. In the debate over caring for the uninsured, no one wants doctors to shoulder the burden. Repeated cuts from insurers, Medicare, and Medicaid have had minimal effect on our income. Whatever changes occur in the years ahead, there’s no chance a physician’s income will come to equal that of, say, a teacher.

Doctors enjoy the best of both worlds. We care for the afflicted. For this we are widely admired and well paid. Sacrifices are expected - but only of our time and mental health. It’s hard to feel guilty because almost no one wants us to feel guilty.