I cringe when attendings, fellows or even co-residents openly criticize other specialties in front of nurses. Do we ever hear nurses openly criticizing other nurses to MDs? We have a lot to learn from nurses. Their unity is unparalleled. Despite the fact that we arrogantly consider ourselves among the most talented and accomplished in the medical field, it is our hubris that is becoming our downfall. The reality is that it's the nurses and midlevels who are much more intelligent and are able to get what they want from government and media---they're able to advance their fields and keep the best interests of their trainees all while minimizing their training. The end result is that they're successfully doing what is best for their field. The leadership of nurses is truly something to marvel at. They fight government leaders and hospital administrators to be on equal footing as physicians-- NP's only require 700 hrs of clinical training, an online Master's and they are able to call themselves equivalent to physicians, are able prescribe medications, and make $110,000+ while practicing without MD supervision in some states. Imagine all they need is less than 10 weeks worth of a medical residency to be considered "equivalent" to MD. Our leaders have failed us..
NPs and midlevels are now doing "residencies" in almost every field, they are even being trained to do colonoscopies while a GI doctor has to undergo 4 years of pre-med hell, 1-2 gap year, 4 years of med school hell, 3 years of residency hell and then 3 years of fellowship hell before he/she can legally do a colonoscopy. At the same time that the nurses are successfully spouting that they are the true care takers of patients and that their care often yields equivalent outcomes to physicians, nurses have the ability to unionize--they are legally able to just stop what they're doing, quit seeing patients and go on strikes demanding more money and less work all while getting sympathy from government, patients and media for all their "patient advocacy." Just check out the power that nurses yield in NY, they don't even drawn their patient's blood work, instead residents are forced to draw own labs that they order. MDs cannot even legally unionize to fight for their rights and even if we could imagine how that would be portrayed in the media. Greedy doctors stop seeing patients for more money.
Our field has been pimped out to government (comprised mostly of lawyers including malpractice lawyers), hospital administrators, mid-levels, insurance industries, pharma, and media. We are getting screwed every which way in all in the name of money, with everyone portraying a physician's salary as the main driver of health care costs when the reality is majority of the profit is going to our handlers. On top of all this, our training keeps becoming longer and more rigorous in the name of patient care and education when in reality everyone that has been through the process knows that residents are just cheap labor to operate their money-printing hospitals 24 hours a day, 7 days a week, 365 days a year. These administrators are destroying job markets by overtraining residents just to keep their supply of cheap labor in hand--just look at the job markets for radiology, pathology, nephrology, and cardiology. And now radiation oncology is headed in that same direction. Many residents and fellows in these fields have to do extra fellowships before they can find legitimate jobs due to over-saturation--once again, residents & fellows are cheap labor for hospitals so it is an incentive for them to over-train without any regard for future job prospects of their trainees. In the end, because the supply will outpace demand, we end up losing our bargaining power as these physicians are stuck in $300,000+ debt and years of sacrifice that they will end up taking any job they can get even if it means taking a pay cut to do so--win/win situation for hospital administrations. It's a sick game being played by hospitals...There are even talks now of making residents pay "tuition" for residency. No other trainee in any other field has to go through the years of education and training and sacrifice that we have to go through before we are considered "competent."
Private practice is in the process of becoming non-existent with reimbursement models being developed to pay more to hospitals to provide "coordinated" care instead of solo providers, many private practices are getting bought out by hospitals as a result because they can't stay afloat. You will likely be a mere employee to a CEO with a MBA who is making multi-million dollars while talking about ways to minimize your salary. You will be forced to work harder for less. When compared to the leadership of nurses it becomes quite clear that our leaders do not actually represent their trainees and nor do they have our best interests in mind.
Every single field is under attack from all fronts. New York Times has had a targeted campaign, publishing weekly articles criticizing physicians and their income--often times they target cardiologists and dermatologists, other times its surgeons, urologists, radiologists, even medical and radiation oncologists aren't spared. The comment sections are pretty scary with the public railing against doctors, some even praise nurses for being the true heroes. The nursing PR campaign and propaganda has been extremely effective.
My humble request to all medical students, trainees and even attendings is that regardless of how disgruntled you may get about another physician's care or the amount of money they are making compared to you, please do NOT openly criticize other fields or their reimbursement in front of patients, nurses or midlevels. You are destroying your own field by doing so. Instead of saying that radiology or dermatology needs to earn less, we all need to unite and say that the lower earning specialities such as primary care, pediatrics or infectious disease, need to be earning MORE. Do not fall under the trap of advocating the decrease of another field's salary because that is exactly what they want to hear. They want to decrease salary for EVERYONE, you really think by decreasing radiology's salary they'll instead increase family medicine's salary? That money will go to the administrators or be used to hire NPs and midlevels insteady of paying the salary of a full MD--what is cheaper for a hospital administrator hiring 5 anesthesiologists or hiring 1 anesthesiologists to oversee 4 CRNAs? The goal of the administration, government and insurance industry is to minimize expenses and salary across the board for MDs, not increase it. As physicians, let's change our tone. We need to stay united and fight back at all fronts if we want to keep our autonomy and position as leaders in the field. Divide and conquer is their tactic.
Thank you for listening, have a good night and God bless America....
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Please STOP criticizing other doctors & fields in front of nurses
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