As a social media engaged physician, I too often find myself cringing when chancing upon doctor-bashing articles and comments. To be honest, I no longer read them. It’s frustrating and, yes, sometimes infuriating to read misinformation that has somehow spun out of control.
Part of the reason for the exasperation is due to the insurmountable and overwhelming volume of information on the internet—it’s simply not feasible to fight each article and respond to each cruel comment. And what would that accomplish anyway? It’s easy for people to “hide” behind the internet—it’s not as realistic to actually say out loud some of what I've read people stating while sitting behind the safety of their computers.
But doctors are humans, too. And most of us have a great sense of ethics and dedication to our profession and patients. This is partly what drives us to this profession. We have all taken an oath to “do no harm,” and we live by that.
So rather than idly reading the misinformation and myth, I will strive to provide my perspective on some of this misrepresentation and shed light on the truth as best I can in this two-part article. For part one, here are some of the most discouraging, false stereotypes created about physicians.
Doctors Are Wealthy
Why did I decide to pursue medicine as a career? Well, first of all, like most other doctors, I fancied science and math growing up—I excelled at these subjects and was a geek of sorts (at least more than I’d let on). I also knew whatever path I’d choose would be a humanitarian one. I felt a sense of satisfaction serving others, whether while teaching as an organic chemistry teaching assistant for three years in college, volunteering at a teen clinic in our community clinic, or serving as a liaison between the student body and our campus health clinic. It was all personally rewarding. You may argue that perhaps there is also something selfish in the feeling of the satisfaction we receive in return for wanting to help others. That may be partially true. Yet whatever the case, this is the path I chose.
But never in my decision making did I think to myself, “I want to be rich.” This is one of the most frustratingly untrue doctor myths. If money was on my mind when deciding on a future career, then I would have chosen business and would strive for a CEO corporate position. My student loans would be cut to a minute fraction of what they are. Needless to say, I will be paying off my student loans for decades to come.
In fact, as I mentioned in a recent podcast, doctors are clueless when it comes to money. It’s not what drives us, contrary to myth. We opt for a minimum of 11 years of extra schooling past high school, carrying well over half a million dollars in debt by then. In the process, we sacrifice our youth—while our peers are out socializing, pursuing their hobbies, starting a family, and living life, we have our head stuck in a book for over a decade. We are often in our thirties when we finally start earning an income. When I finally started to earn instead of pay, I was working 100 hour work weeks as a resident, with not much more than minimum wage earnings.
Who in their right mind wants to do this, you may ask? Only someone crazy enough to enjoy the near-torture we endure until we finally finish years navigating a hierarchy and ranking structure akin to the military.
Believe me, no amount of money is worth all of this effort…unless this is truly your calling. And believe me when i say that most of us are certainly not “rich.”
Doctors Are In Cahoots With the Pharmaceutical Industry
While it’s true that those of us in healthcare depend heavily on the pharmaceutical industry to produce necessary life-saving medications, it’s really a love/hate relationship. If you recall my prior episode on costly medical tests that are typically unnecessary, I mentioned that healthcare is a business in this country. If we retain this model, we need to be ready to accept that there’s a huge financial incentive that drives this pharma segment of the system as well. The drug manufacturing companies are therefore given the opportunity to charge whatever they fancy for their drugs. We, the people living in the U.S., are all passively allowing it to happen by electing government officials who encourage this unethical dilemma.
With that being said, most doctors in the trenches get exceedingly frustrated, knowing that patients cannot always afford their medications due to high cost. It’s outrageous to see a patient with leukemia whose survival is dependent on a pill that costs $13,000 a month. What doctor doesn’t feel frustrated when their asthmatic patients can’t afford to pay for that inhaler that will keep them from losing their breath? Or how about that outrageous life-saving Epi-Pen pharma fiasco? Like patients, doctors felt the pain of that one, too.
Thankfully, there are now generics for many ailments. And believe me, most of us practicing doctors purposefully select generics for everything unless we've no other choice. Like my colleagues, I cringe every time I am forced to select a brand when a generic doesn’t exist.
Many of us also refuse to dispense any “samples,” another tactic to entrap the patient. I have to admit, I have lost a patient or two in my career because of it, believe it or not. Patients cannot afford the prescriptions that their insurance plans will not cover and really sometimes depend on samples to get by. But by dispensing them, I’d be encouraging these pharma games and I am not about to compromise my ethics.
As with many of my colleagues, I refuse any contact with the pharmaceutical reps who visit the clinic in hopes of “educating” doctors about their new, outrageously priced, and often unnecessary drugs when generics are easily available at a fraction of the cost. Interestingly, I have never seen an unattractive pharma rep. This is not a coincidence. They are top-notch sales people who can sell anything.
But guess how they bypass the doctor in order to capture the consumer? Through ads on television. Nearly daily in my office, patients inquire about a medication commercial they saw on TV. The pharma’s are quite savvy at manipulation of our healthcare system.
Do they bring “free” lunch for the staff? This depends on the medical group’s stance on the level of pharma involvement at their sites. My staff knows to refrain from mentioning their presence, or to even “sneak” a plate for me. No thank you. These lunches are purposefully designed to place pressure on employers and doctors who have to “sign off” on them, because the staff gets a “free lunch.” In exchange, they occupy our precious clinic time in order to give their biased, rehearsed sales pitches about their assigned drug. Most of them do not have any medical degree or experience other than in sales.
The new Physician Payments Sunshine Act now requires transparency of the monetary value of these lunches. The cost of these lunches gets reported on an individual doctor basis and is publicly made available. So if that one lunch cost $300 and three doctors sign for them, then each one of those doctors gets $100 added to their tally report.
Let’s face it, though—there really is no “free lunch.” And believe me when I tell you that many doctors agree with these sentiments. But I’d like to make clear, that whether we do accept these controversial lunches or not, we are certainly nowhere near being “in cahoots” with the pharmas. While we all depend on the pharmas to produce life-saving drugs, in my personal opinion regulation to some degree is a must here. We need to remove the presence of pharmas in the clinical setting and remove their presence on television advertisements. Healthcare may be a business, but we are dealing with human life; it’s not an airline or supermarket.
How long will we allow this to go on? It’s time that we place pressure on our elected officials to start making ethical decisions to represent us. Just my two cents.
Tune in next time to read the remainder of these spun-out-of-control myths about doctors as we continue our discussion on this hot topic.
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
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