Yes. I have two friends who are physicians who have retired at 50 and 52. One of them knows a cardiologist and OBGYN couple who retired at the ages of 40 and 42 and took less lucrative jobs at pharmaceutical companies. People don’t seem to understand that, in the balance, there aren’t a lot of reasons to be a doctor anymore. Note that they give up more money for less money — because this is not the main priority for most physicians.

They — and many doctors they know — are leaving medicine or wish they could because every appealing motive has disappeared: time with the patient, which most doctors treasure; autonomy, which is usually high on the list for doctors — and probably should be given that they know the most about their field; the addition of difficult EMR systems; and most of all, creating a system which makes doctors into nothing more than front end workers at a fast food chain. Doctors have been hijacked by corporations: what sense does it make to replace educated, intelligent, and experienced people who have put in the frontline work with less intelligent people who have none of the education and experience? It makes no sense to replace doctors with corporate types. What intelligent person would choose this? I imagine that, in this context, anybody who could get into medical school would be smart enough to choose something else. Add to that the generally negative attitude that both the public and news outlets have for physicians and the situation becomes especially difficult. Check out Rebekah Barnard (family practice) who has harsh words for NPR’s constant negativity towards physicians in her writing.

I believe that currently, people choose medicine in part because they don’t know what is coming to them: the public has a very distorted sense of what it means to be a doctor. This choice has been followed, in the last few years, with rising suicide levels in physicians such that their suicides exceed that of the general population by percentage. This is consistent with a group that doesn’t know what they signed up for and are then shocked and dismayed when they realize it, often in their thirties. Because the commitment has been so great, it seems like a dead end: they can’t even declare bankruptcy on loans (which average about 180K/med student in the US!!!) They’re stuck.

I’ve worked with hospital bed flow and capacity on a chronic, daily basis in the past, within the last decade. I can assure any American that most hospitals are at or above capacity on most days of the colder months, even before COVID 19, and not just due to the flu or just infections. There are plenty of others that also need vents on an emergency basis: bad heart attacks, strokes, car accidents, etc. The profession has been hemorrhaging doctors, especially in frontline areas (family and adult medicine, ER, hospitalists and critical care) for years now due to corporate intrusion. Many hospitals refuse to pay for a critical care doctor and instead force already overworked hospitalists or even outpatient doctors to carry these critical patients. Critical care doctors are tough to find for a long list of obvious and easy to understand reasons. Another acquaintance of mine worked this way for years until he retired at 46 and took a job at a corporation for less money. It was worth it, he told me. Money doesn’t matter as much as quality, and he no longer had any, even at the age of 46. This is pathetic. BTW, it is also pre-COVID.

I worry as much about the aftermath of healthcare in the next decade or so as this disaster. This disaster will have fall out for many years, if only because doctors already at the edge will now be pushed over. If nothing else, forcing doctors to choose between whose life to save because Trump didn’t invoke the Defense Production Act to mobilize supplies presents true moral injury: doctors, who vow to NOT do harm, forced to do it because of the government’s lack of moral response. Now, due to political malfeasance, doctors are forced to choose who will live. They will feel this forced moral injury deeply.

If they’re still alive, that is.

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She/Her: Distort lies until they amplify truth. CryBaby: As loud as necessary.

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