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.
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