-By A. Joseph Layon, MD, FACP.
This article was written in response to Doctor Moeller’s Post: An Open Letter to Washington, D.C. From a Physician on the Front Lines
With interest, I read and re-read Matthew Moeller’s Open Letter. My son, a first year medical student at Drexel University in Philadelphia, commented that this missive was being discussed by his colleagues in a tone of moral righteousness. Interesting.
I know, I remember, what it was like to realize that the way to live an authentic life was to engage in providing health care for our people. I remember debt, struggle, and 120 work-weeks. All of this, I remember.
And I remember being a third year medical student at The University of California, Davis – Sacramento Medical Center. My professors, between patients on rounds, arguing how disastrous the health care system was becoming, how it was better in the “old days”, how they / we were suffering, how no one really understood what we had to go through. Well, you get the idea.
While I understand, empathize and remember much of what Doctor Moeller says in his piece, and while he is – in my view on the mark in much of what he writes – I think he misses several points that are worth comment:
1. Medical School Debt: As a member of the Faculty Senate at the University of Florida I once got into a running argument related to the lack of breadth our undergraduates exhibited prior to their entry into professional school; lack of knowledge of history, language, and cultures other than their own. Medical training is expensive. In the not so distant past, a huge portion of this expense – certainly in the State of California where I was both an undergraduate and graduate student – was funded through tax revenue. This was done not to be nice to our medical students, but because education was considered a social investment. Proportionally, the monies in education have decreased (see Christopher Newfield, Unmaking the Public University – The Forty-Year Assault on the Middle Class, 2008, Harvard University Press), resulting in a grand portion of the debt saddling Doctor Moeller. Nowhere in Doctor Moeller’s missive do I find any comment upon this. The very policies that many in our profession cling to – physicians being, oddly to my mind given our work, frequently conservative and in the Republican or Libertarian camps – i.e., anti-taxation policies, put our medical students – and undergraduates, and graduates – at risk. These policies put our future at risk. Doctor Moeller rightly notes his difficulties; but Matt, what about the broader picture ? This isn’t just a medical student issue. Continue reading