10 December 2012

Money and medicine, introduction

From a well-written Business Week article on concierge medicine [emphasis mine]:
The [Affordable Care Act] will enable 30 million previously uninsured people to get coverage through an expansion of Medicaid. They’ll need primary care, but it’s not yet clear who will give it to them. By 2020, the Association of American Medical Colleges estimates, there will be 45,000 fewer primary-care doctors than the U.S. needs. “For the last 13 years, very few students have been going into it,” says Patrick Dowling, chairman of the department of family medicine at the University of California-Los Angeles’s David Geffen School of Medicine. “What motivates medical school students is income, just like everyone else.”  
What's supposed to set physicians apart from other professions is a deeply-held code of ethics, which demands that one place the patient's interests ahead of one's own. If Prof. Dowling is correct that income truly is what motivates medical students, "just like everyone else," then this code of ethics no longer applies. Medicine is simply a business, its physicians no different from financiers and salesmen. It appears that Prof. Dowling has ceased to believe in his profession.

In my next posts, I will explore money and medicine. What motivates medical students, if not income? Why, when our country spends the most (per person, in absolute expenditure, and as share of GDP) on health care in the world, is America's health so lackluster? Where does the money go? How can the system be improved? What will the Affordable Care Act do to medicine? I also invite you to write a comment about what topics might interest you.