Who or What is Killing the Medical Profession?

A colleague commented recently that 'competition among doctors
within the profession is killing the profession". I' d like to disagree and
comment on this further.

What is the Problem Is Not

The problem is _not_ "competition among doctors" that is killing the
medical profession. Competition in a market among the providers of
goods and services is what drives innovation, continually lowers
costs and drives the production and, ultimately, the availability of
quality goods and services.

This is only true, however, when a market is relatively free and
unregulated. Witness the market for computers, ipods, cell phones,
TV' s and other electronics, and the remarkable innovation and
availability of increasingly higher quality, lower cost goods
available to a continually expanding pool of consumers.

What _is_ killing the medical profession is the replacement of
healthy competition in a free market with self- destructive, and
market-destructive, competition in a _highly regulated_ market, as
well as all the layers of the government and bureaucratic
regulations which add ridiculous, unnecessary exorbitant costs and
inefficiencies to the provision of health care services while
simultaneously and _negatively_ impacting on quality and
availability.

Providing health care in such a market is like playing with a deck
of cards stacked against you by monopolistic government and 3rd
party regulators who _continually_ set prices and drop
reimbursements arbitraily and reflexively _by fiat_in response to
voter demands, political expediency, snowballing government budgets,
pressure group politics, corporate employer needs, etc, and
completely _unrelated_ to medical market forces such as input costs,
business expenses, employee salaries (including increasing cost of
providing mandated employee health insurance), and the availability
and demand for specific services.

What the Problem Is

The root of the problem leading to the destruction of the medical
profession is NOT the unchecked ambition and competitive spirit
with our colleagues. This is the same spirit which drives many of
us to continue to learn and grow professionally, mastering ever -
expanding, ever -evolving bodies of scientific knowledge…learning
and implementing new technologies and procedures, all the while
improving, prolonging and saving the lives of our patients.

The sense of moral ambitiousness which drives many doctors in their
thirst for continually improving their own knowledge and skills is
not the vice from which such doctors suffer. Rather, it is a
_profound virtue_ and one that such doctors who possess it should
take pride in.

In other areas of society, this type of ambition, self-improvement
of knowledge and skills and personal competitiveness would be
rewarded handsomely.

The problem is not with the competitive spirit, ambition and other
virtues that doctors possess.

The problem lies with a society - and an increasingly government-run
and bureaucratic -run and regulated health care system which fails
to justly recognize and reward doctors for that spirit and that
seeks to _punish_ them_ for_ their _virtue-

or at least expects doctors to be driven and satisfied by the
spiritual rewards for their work, while eschewing or denying them
the proper material rewards for it which they have rightly earned.

Is it not _odd _that the more medical science and technology has
progressed, the more frequently physicians are denounced in the
media as dangerous, greedy exploiters of medically- ignorant and
vulnerable patients?

Is it not _strange_ that, rather than being viewed as the advocates,
champions, guardians and protectors of a patient's health, this role
has been expropriated by "progressive", "idealistic", populist
politicians, legions of Medicare and insurance bureaucrats and
crusading trial attorneys who piously vow to protect patients from
being "victimized" by money- hungry, greedy, exploitative doctors
allegedly seeking to fleece and defraud patients, insurance
companies and Medicare by foisting unnecessary medical procedures
and tests on the poor, the sick, the vulnerable and the medically
ignorant?"

What explains this apparent paradox?