Doctor Shortage, Needed: A Documentary on “The Doctor in America”

Q: What’s on your mind these days?

A: A television documentary or a movie documentary on the “Doctor in America.”

Q: Why?

A: American doctors need to respond to Michael Moore’s “Sicko, ” to comment on Muslim physicians’ involvement in British terrorist attacks, and to state their positions on health reform. The public needs to know how doctors feel about these issues.

We need to counter “Sicko.” The major media admit Moore is slanted and polemic. But most agree with him the American health system is unfair, it’s the HMOs’ fault, and we need a “free” government-run system to straighten it out.

Q: What’s wrong with that?

A: Every issue has two sides. The American system is a product of our culture –dependence on market forces, thirst for innovation, desires for choice, and access to American medical technologies.

Moore doesn’t mention problems of single-payer systems. People are suffering or dying while waiting to receive treatment for serious illnesses, single-payer systems ration services to control costs, and most don’t offcr quick access to MRIs, CAT Scans, cancer drugs, coronary stents or bypasses, kidney dialysis, treatment for terminal disease like brain cancer. In most, you may wait for months to specialists. Furthermore, foreign trained doctors are flooding into America to practice.

Have you ever heard of Americans going to Canada, the United Kingdom, or France for treatment? I haven’t.

Q: What’s wrong with foreign-trained doctors coming to America?

A: Nothing. The AMA says foreign citizens or Americans graduates of foreign medical schools (about 20% of the total) account for 229,000 of the 902,000 physicians practicing in the U.S. That’s 25% compared to 42% of foreign-graduates practicing in the U.K.

Q: So what’s your problem?

A: The problem with physicians linked to terrorism is psychological. It paints Muslim physicians with a broad brush as potential terrorists, as persons to be treated with suspicion among fellow workers and patients.

I believe Khaled Hamid, a St.Louis-based asthma and allergy specialist, who said of physician-links to terrorism,” We’re hurt as Muslims and as physicians who believe life is sacred and must be protected.”

Q: Are foreign physicians practicing in America potential terrorists?

A: I see absolutely no evidence of that. But I do know that two of the eight British physician terrorists did apply for U.S. entry. Look, he U.S. gets the cream of the foreign medical school crop, many of these doctors become physician leaders in America, and they are more rapidly assimilated than in other countries..

Q: Any other problems?

A: Yes, the public needs to know the U.S. has a tremendous doctor shortage – 50,000 by 2010 and 200,000 by 2020.

Q: Any other beefs?

A: Yes. Through HMOs restrictions, government regulation, and systematic lowering of reimbursement rates, we’re making the profession of medicine unattractive to bright Americans. We need at least 12 more medical schools to produce the requisite number of American-born doctors; and we can’t make up the deficit through physician assistants, nurse practitioners, or retail clinics.

Q: I still don’t see the need for a documentary.

A: The American people need to know from doctors their opinions about the physician shortage, the need for foreign-trained doctors to fill the gap, the cost of third-party intervention, and doctors’ stands on reforms and who and what contributes to the so-called “health care crisis.” The AMA is about the launch a campaign on reform issues, but we need other voices too.

Q: What would the documentary contain? What would it explain?

A: It would contain interviews with various representatives of the American medical community: academics, leaders of big multispecialty groups, high tech specialists, but most of all, primary care physicians in the trenches, many of whom are dying on the vine, retiring, failing economically, quitting independent practice, and going to work for hospitals and HMOs. It would explain most Americans are satisfied with their care and most of its urgent care facilities and those who staff them are first-rate.

Q: And what would the American people learn from such a documentary?

A: They would learn there’s a doctor morale crisis bordering on despair, that doctors aren’t happy with the status quo; that doctors have good ideas on how to make the system better, and that they have the patients’ best interests at heart. The problem with the current political debate – whether we ought to have a government-run or consumer-driven system – is that the politicians rarely present doctors’ points of view. For God’s sake, doctors are a big part of what health care is all about. Let’s hear from them.