Medicine as a Profession Is Imperiled


Many American physicians are wondering whether they still can be physicians. “We physicians have lost control of our profession, our patients’ safety, and our ability to freely practice patient-centered Hippocratic medicine in the United States,” writes San Antonio ophthalmologist Kristin Held, M.D., in the winter issue of the Journal of American Physicians and Surgeons. Dr. Held is president of the Association of American Physicians and Surgeons (AAPS).

In 1984, a semester’s tuition at the University of Texas Medical School at San Antonio, one of the lowest-cost schools in the nation, was $300. In 2018-2019, tuition was $19,783. According to the Association of American Medical Colleges (AAMC), the average cost for one-year tuition, fees, and health insurance at a public medical school was $37,556 for in-state students. The median student medical school debt was $194,000 in 2018.

Encumbered with such debt, young physicians are no longer free to set up practice on their own. The AMA reported that 47.4% of practicing physicians were employed, and only 45.9% owned their own practices in 2018.

Many young physicians are leaving medicine before they start, and are being replaced by midlevel “providers,” nurse anesthetists, nurse practitioners, optometrists, and a never-ending cascade of “eligible clinicians” promoted to physician by politicians, bureaucrats, and private-equity corporations. Physicians, unlike these “physician extenders,” are subjected to never-ending, costly certification requirements. Sometimes the only work they can find is part-time and unpredictable. And while their costs keep going up, payment keeps going down.

A rapid-fire succession of new government rules has turned physicians into glorified data-entry clerks to benefit third-party payers. Medicare for All is the next step in destroying patient-centered medicine in favor of serving the “system.”

Dr. Held writes that to preserve the profession of medicine and the patient-physician relationship, “It’s time to opt out of government-corporate-medical-industrial complex-run medicine.” As a cataract surgeon, she faced a daunting challenge in declaring her “Medical Independence Day.”

Physicians need to work together for solutions that preserve individual freedom, common sense, compassion, and respect for life, she concludes.

The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.

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