When you start with the premise that a price is too high (or too low) the resulting reasoning is bound to be sloppy and fraught with bias.
This article is no exception. It is embarrassing to read this article, because it is full of small, emotionally-potent morsels for those who don't like doctor salaries being high. It's as if the article were read as ASMR but the excitement is instead induced by those potent "the price is bad" morsels.
The truth is that not all doctors make even $200K and many struggle for years to pay back their med school loans once they finally are able to earn a salary after years and years of training.
But it's only by a slight of hand that we are even focusing on doctor salaries instead of the broader issue of the cost/benefit offered by the healthcare system as a whole.
Doctors combine a form of scientific authority with both social and moral authority. They have scarce knowledge, they judge whether or not we deserve workers comp, a paid sick day, a sticker to park in a coveted parking spot, permission to take a pill that takes the pain away, etc. They tell us which of our symptoms we are to blame for vs which we can blame on others, and they offer us hope when our loved ones are at death's door.
This makes doctors the closest thing modern, mainstream (secularized) culture has to priests and priestesses. The status held by doctors goes far beyond any financial rewards.
We must ask ourselves the difficult question of why we (as a society) need the absolution and authority offered by doctors. Why can't we just (as the article suggests) make pragmatic decisions that would lower the bar for entry into the profession?
To do this, we must appreciate that there is a uniquely American view of health that differs from the view held in many other places. Health is something we deserve. Health is understood as something that can be restored or improved through science. Disease is understood in a way that is analogous to "evil forces" that can be successfully eradicated from the body. The social and psychological aspect of disease is minimized, and the physicalization of mental health challenges is nearly completely denied.
Death too is treated differently. Death must always have one cause, and the implication is that were it not for that cause life would have gone on much longer.
In such a view, it is only through the perfect knowledge and/or perfect technical performance that we can overcome disease and stave off death, so doctors must be close to perfect. This is why the bar is set so high for entry into the profession. Those who are selected into the profession are typically very highly skilled. Medicine is among the most popular career plan for college freshmen, but only a small percentage manage to be admitted into medical school. The rest wash out either because they don't want to work that hard or because they can't make the grades.
This pressure on perfect outcomes (and all the fallacies the notion entails) results in expensive malpractice insurance and far too many costly interventions that have little chance of significantly benefitting the patient.
A massive amount of lifetime healthcare spending occurs in the last two months of a person's life. The author seemingly blames this on doctor salaries. This is false. The problem is that patients and their families expect the 80 year old with pneumonia to miraculously recover and live to be 100. The fact is, when an 80 year old gets very sick and ends up hospitalized, it's quite likely that a cancer or two might be discovered, as well as all sorts of other impending problems. But the family still thinks of the person as a healthy 80 year old. Most of the cost of our healthcare system comes from this adjustment process during which we flush money on useless tests and interventions, all to help a patient and family adjust to the reality of old age and impending death.
Yes, there are some docs who profit from largely elective and arguably wasteful surgeries, but many of those are also the optional "lifestyle" surgeries that the public demands most (arterial stents, plastic surgeries, many cosmetic derm treatments, etc.).
This article is no exception. It is embarrassing to read this article, because it is full of small, emotionally-potent morsels for those who don't like doctor salaries being high. It's as if the article were read as ASMR but the excitement is instead induced by those potent "the price is bad" morsels.
The truth is that not all doctors make even $200K and many struggle for years to pay back their med school loans once they finally are able to earn a salary after years and years of training.
But it's only by a slight of hand that we are even focusing on doctor salaries instead of the broader issue of the cost/benefit offered by the healthcare system as a whole.
Doctors combine a form of scientific authority with both social and moral authority. They have scarce knowledge, they judge whether or not we deserve workers comp, a paid sick day, a sticker to park in a coveted parking spot, permission to take a pill that takes the pain away, etc. They tell us which of our symptoms we are to blame for vs which we can blame on others, and they offer us hope when our loved ones are at death's door.
This makes doctors the closest thing modern, mainstream (secularized) culture has to priests and priestesses. The status held by doctors goes far beyond any financial rewards.
We must ask ourselves the difficult question of why we (as a society) need the absolution and authority offered by doctors. Why can't we just (as the article suggests) make pragmatic decisions that would lower the bar for entry into the profession?
To do this, we must appreciate that there is a uniquely American view of health that differs from the view held in many other places. Health is something we deserve. Health is understood as something that can be restored or improved through science. Disease is understood in a way that is analogous to "evil forces" that can be successfully eradicated from the body. The social and psychological aspect of disease is minimized, and the physicalization of mental health challenges is nearly completely denied.
Death too is treated differently. Death must always have one cause, and the implication is that were it not for that cause life would have gone on much longer.
In such a view, it is only through the perfect knowledge and/or perfect technical performance that we can overcome disease and stave off death, so doctors must be close to perfect. This is why the bar is set so high for entry into the profession. Those who are selected into the profession are typically very highly skilled. Medicine is among the most popular career plan for college freshmen, but only a small percentage manage to be admitted into medical school. The rest wash out either because they don't want to work that hard or because they can't make the grades.
This pressure on perfect outcomes (and all the fallacies the notion entails) results in expensive malpractice insurance and far too many costly interventions that have little chance of significantly benefitting the patient.
A massive amount of lifetime healthcare spending occurs in the last two months of a person's life. The author seemingly blames this on doctor salaries. This is false. The problem is that patients and their families expect the 80 year old with pneumonia to miraculously recover and live to be 100. The fact is, when an 80 year old gets very sick and ends up hospitalized, it's quite likely that a cancer or two might be discovered, as well as all sorts of other impending problems. But the family still thinks of the person as a healthy 80 year old. Most of the cost of our healthcare system comes from this adjustment process during which we flush money on useless tests and interventions, all to help a patient and family adjust to the reality of old age and impending death.
Yes, there are some docs who profit from largely elective and arguably wasteful surgeries, but many of those are also the optional "lifestyle" surgeries that the public demands most (arterial stents, plastic surgeries, many cosmetic derm treatments, etc.).