The real problem with our health care system: Female doctors ...

... now there's a Women's Bioethics Blog equivalent headline equivalent of those "Free Beer" postings on college campus bulletin boards. I only wish it was as facetious a headline.

What am I referring to? Why, an article in the April 28, 2008 issue of Businessweek, which you can hopefully read online here (although you may need a subscription). The take-home message: the looming shortage of doctors in the United States, estimated to be a deficit of 50-100K physicians by 2020, may be partially a result of the fact that female doctors work less than their male counterparts. They also see fewer patients, take time off to have children, and have the nerve to ask to work flexible schedules so they can actually nurture those kids they so unwisely produced. Thank god we've still got a couple of upstanding men who can pick up the slack. As one anonymously courageous male internist from New York so righteously complained: "The young women in our practice are always looking to get out of being on-call ... The rest of us have to pick up the slack."

On the plus side, women are more likely to go into understaffed, low-pay specialties like family practice, pediatrics and obstetrics. 

So who's at fault here I wonder? Could it be those selfish women who want: 1) to provide high quality and attentive preventive care, something our current system neglects; and 2) make sure that their kids aren't raised by Sesame Street and Nintendo? Or, could it be the current system that rewards those men (and women) who: 1) enter high paying and lucrative specialties; and 2) only see their kids on weekends during court-ordered and -supervised visits? Guess we'll have to choose ...

Paging Dr. Welby

I used to wish I'd been good enough at math and science to go to medical school. Not any more. See, I'd have wanted to take care of whole families, the range of their problems, over a long time (until one of us died or moved away, I guess). Now I'm all grown up, and I know some primary-care docs who are willing to share something of what their professional lives are like ... and I am glad I didn't go that route. (Though I still resent Mr. Savinelli for saying that girls just aren't good at math, which has played a way bigger role in my life than it probably should.)

Anyway: what brings me here today is yet another report of how the best and brightest medical students are choosing specialties that are as far away from primary care -- and, not incidentally, from sick people -- as they can. This article in the NYT highlights the competition to get into dermatology and plastic surgery, which are apparently the current "it" specialties. Good hours, patients who can pay, and few patients dying on you. Pretty sweet.

Social justice issues? Well, we the taxpayers pay for the bulk of medical education in this country. Unfortunately, we're not turning out anywhere near the number of GPs we need ... especially as the population grays. Also, while most of us probably wouldn't begrudge the desire for a normal family life, isn't it in the nature of the professions to put your clients first? If a career in medicine is primarily about money and status, not caring for sick people, what does that mean for the profession? And what does it mean for the rest of us?