Anyway, now I can read about the medical profession without actually putting anyone in danger. Routine Miracles is the latest title I found at the library. It's not a memoir, but a collection of essays and chapters in which he examines the astonishing advances which have been made in the last 25 years. And in which he examines the widespread negativity and dissatisfaction within the medical profession and amongst the students and interns he works with on a daily basis. According to Dr. Fisher, we are living in a time when the health professions should be filled with excitement, pride, thankfulness, and reward, due to the "miraculous" tools which have been developed and which are saving lives which would have been lost only 5 or 10 years ago. He examines cardiac advances, intrauterine fetal surgery, HIV drugs, corneal transplants and many more. But regardless of these advanced treatments and techniques, the medical community is still downtrodden and pesimistic.
Dr. Fisher attributes this to 4 primary factors, not necessarily in this order of importance:
- The high costs of medical training: apparently it's not unusual for a new physician to begin his/her practice facing six-figure debts from medical school and advance training. After spending 8-12 years, or more, in post high school education, the new MD can then face $100,000 to $200,000 in school loans.
- The tradition of medical school teachers and older physicians to berate, criticize, and belittle their students. Dr. Fisher asked one of this classes, "Has anyone been told you are the best, better than the faculty?" No hands go up. "Has anyone here been told you are worse than students in the past, that you are not diligent, devoted, or hardworking?" 80% of the hands go up. He compares this to a football coach telling his team that they are the worst players he's ever had, and then wondering why the team is despondent.
- The health insurance industry. This subject comes up over and over throughout the book, and states studies in which 92% of physicians identify insurance companies as their #1 problem, 7% identify insurance companies as a major problem, and 1% feel insurance companies are not a problem. He feels very strongly that the control insurance companies have over the medical profession is limiting advancement and decreasing the routine miracles we are coming to expect.
- The pharmaceutical industry. The need for profit with the drug industry is creating some interesting situations. For instance, Dr. Fisher states that there are now 12 drugs for erectile disfunction, while research for malaria prevention and treatment has diminished. Why? Market share. American men have the dollars and interest in ED drugs, while malaria occurs mostly in poor, 3rd world countries where the Return on Investment in very, very low.