Which Fight Is More Important?

One of those typical feel good articles came out again. This time it was in USA Today and it goes on about the good fight and how things need to change. Blah, blah, blah. I get so tired of these pieces quoting the same people about how the pharmaceutical industry has so much influence upon my life that I can't do anything anymore under my own volition. Personally, I ridicule the idiots in that industry more than anyone. I do spoof ads, stupid pharmaceutical tricks, and even videos about how they market their products. It's fun. The thing is that I don't think they are as entirely evil as these people say they are in the piece I am referring to (it was copped by the Associated Press). The pharmaceutical industry is just an easy target. In fact, this article really doesn't say anything new that we haven't seen before. It is so formulaic. I will prove it by pulling out key sentences and quotes and then I want you to apply these same sentences in a different way.

• deceiving the public, manipulating doctors and putting profits before patients
• "The influence that the [Blank], the for-profits, are having on every aspect of medicine ... is so blatant now you'd have to be deaf, blind and dumb not to see it"
• "We have just allowed them to take over, and it's our fault, the whole medical community."
• We should all get together and say, 'Enough!"'
• "[Blank] will always face criticism and at times deserve it but our companies remain committed to listening to and learning from parties with divergent points of views."
• "There is no industry far and away that has been more generous than the [Blank]
• But [Blank] analyst XYZ Securities said [Blank] will find ways to adapt to new rules
• Influence prescribing patterns

Now switch this article around. Grab a few Harvard professors, you always need their quotes, and make [Blank] be the managed care industry. That is the real story and the biggest reason the cost of medicine in this country is out of control. The real doctors in the trenches of medicine know that. We hate them more. And we should all get together and say, "Enough".

Two Percent

Check out Rita Rubin's piece at the USA Today as she discusses the results of a medical student survey. Only 2% of 1,177 respondents to a survey of students at 11 U.S. medical schools said they planned to pursue careers in general internal medicine. This came from a JAMA study. The worst part about it was that the respondents were fourth-year medical students. They had been through the school grinder and obviously realized the downfalls of primary care. What downfalls? How about student loan debt coupled with the fact that internists are one of the lowest paid physician specialties. I am proud to say that they are right up there with us family docs. By the way, why the study only looks at those going into internal medicine is a little weird because last time I checked, FPs counted as PCPs well. Hmmm. Anyway, here is a little nugget not mentioned. The study did say that 23% were going to go into IM but only 2% were not going to specialize. Hence, their results. The beauty of this is that those 2% can specialize at any time and many will. Most likely there will be LESS than 2% doing primary care! How lovely. Maybe those in charge of the specialty of internal medicine should do what the people in charge of family medicine do? You know, trap them into the specialty and then have no options to sub specialize once you are through. Once a family doc, always a family doc.....until you prematurely die. Okay, that last statement was a little bitter and I am sorry. Overwhelmed with trying to find more cerumen to clean. Gotta pay the bills, you know.