Paying a Doctor

I had the opportunity to read an article early this morning while waiting for labs to come back.  This is my last day working in this particular hospital, owing to a change in venue and a new job.  I will post the link here below and I encourage you to read this.  Dr Megan Lewis, from rural Colorado, gives a good example - with my sense of humor.

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Although this blog (linked above) is not new, it was funny and insightful.  I didn't get mad because I feel this is the collective work of all the apathy of the physicians out there.  'They' were so busy with 'medicine' that the business of 'business' went unnoticed.  Congress decided to act for them and enacted a law that every year tries to decrease physicians' salaries.  I find it humorous (not humorus) that a Congress of non-physicians and many trial lawyers know better how to pay/run/ direct a medical clinic than the doctor who is there, with boots on the ground.  If there are anymore people out there who get their salary and job ability limited to such a degree by the government, please let me know!

I did want to say that with me now switching jobs, I have found life to be exciting.  The places where I work/worked have been very sad that I am leaving.  It is nice, in an odd way, to be missed.  There was a patient last night that I drained a couple of liters off from around her lung, who really wanted to follow me out to the midwest, where I am heading.  I have had many nurses tell me they wish I were staying, and I would be, if it were up to them.  I am glad to have worked with such great nurses and house staff (those who support the doctors).

Lastly, I wanted to comment on how a doctor is paid.  I hold my biases close, as do most people, but this is a thought I have mulled over many a time while driving my two hour commute to work.  I have invested ten years AFTER college to help save peoples' lives.  I know that there are others who did it in seven, but I chose to do it a longer and more in depth way, including teaching.  I missed out on earning a living wage during that time because I needed to study and not work a second job.  Ten years of compound interest have already put me well behind the eight ball.  I feel I would pay to have someone equally skilled to treat my family pretty much what they ask for, sometimes.  The patients I interact with agree with me.  What I see is the difference is the ATTITUDE of the physician that makes the difference in the perceived value of care and level of skill.  Those physicians who behave like Dr House, are not well liked.  As a consequence, the perception that their income is too high is easily justified.  I choose to be humble, likable, friendly and treat my patients like family.  My patients have not complained about my level of care, skill or cost.  I think that the whole patient care package needs to be viewed when the issue of cost comes up.  Am I a rushed waiter, throwing food at people or am I a Health Care Consultant, taking time and energy to partner with my patients in managing their health?  I choose the latter, and with it, claim the right to charge for it.

Please let me know your thoughts!  I would love comments.
Michael Chipman (after being up way too late, working one last 24 hour shift)

The Value of Education

  I write this after finishing my tenth year of "post graduate education."  I have been in school for a really long time.  I have a bachelor's degree.  I spent four years in medical school plus added a year for teaching in a Fellowship.  I then did a traditional internship plus three years of residency and added on a second residency/Fellowship.  That is a lot of school.  Was it worth it?
  The value of education is difficult to determine.  I sacrificed many hundreds of thousands of dollars to become more educated than other physicians.  I have received intangible benefits from doing so.  The question seems to boil down to money versus experience. 
  I must confess that I never do anything simple, and am shocked to find that I look down on those who do.  I feel those individuals who do a "shorter" residency or "faster" degree to save time in order to earn money are somehow not as "pure" as me.  Myself, and those like me, spent a longer time, delving in deeper and grasping a different yet somehow nebulous concept.  The family physicians who work with me in the Emergency Department feel they are my equal, while when the bad stuff rolls in, their lack of training is obvious.  The nurse anesthatist who tries to tell me how to manage an airway backs away from the unstable, vomiting drunk with bullet wounds.  I am shocked to find a small amount of pride in me when I do something that others would rather not handle. 
  I sometimes feel like I took the long road and others might mock me for not jumping in and bringing in the big bucks.  Yet, when that extra area of specialty is needed, I feel vindicated. 
  For example, my daughter came down with a fever and pain in her ears when we were flying home from a job interview.  She refused to drink Tylenol and was miserable.  I was able to take her in my arms, use osteopathic manipulation and not only break the fever but drain her ears.  I bet she doesn't regret me spending extra time getting good at that. 
  Another example, I delivered a baby - backwards and almost completely dead - and saved her life.  She is doing very well now!  I have seen her family many times (but not her) and they always express their gratitude.  I spent an extra year learning how to manage that more than just a paragraph in the book. 
  Other people may be able to manage what I do, but the fear factor from being unprepared is key.  The nurses tell me that they would rather have me on when the bad stuff rolls in than anyone else.  I am again shocked to find a little swelling of pride with that. 
  I do NOT regret my extra time in studying and love what I do.  I like using my hands, my head and my smiling personality to help people in their process of healing.  What I have invested in my education has helped people live, live more comfortably, and suffer less iatrogenic (doctor inflicted) harm.  I think my path to where I am has helped me become the doctor I would like to see.  And for that, I am well pleased.