The Florida urologist who posted the announcement on his office door this week asking all supporters of President Obama's health care reform bill to seek medical care elsewhere caused quite a stir. As a primary care physician, I think his actions were both unethical and immoral, and I hope the Florida State Medical Board, the American Urological Association, and even the American Medical Association become involved with reprimanding his actions. I am not sure this doctor, who is obviously angry at President Obama for passing health care reform, but chose to channel his anger in a very childish and ineffective way, should be practicing medicine.
Whatever happens to Dr. Jack Cassell, it's important that we not lose sight of important fact of medical training: the federal government provides enormous financial support for medical residents. So this doctor, who is now in his late 50's, was a medical student once, a process that takes four years. And after, that he completed five or six years of residency training in urology. Chances are pretty good that the federal government contributed large sums of money during the five to six years of this man's residency training to help make him the urologist he is today. Hopefully his operating room skills are more polished than his social and political ones.
How does the federal government play a role in financing medical training? Training medical students and doctors is an expensive, labor-intensive process, though one that our society recognizes as not only necessary, but also worthwhile. Direct and indirect costs of training residents add up to about $150,000 annually for each of the more than 22,000 doctors in training. Medicare, a federal government program, contributes a whopping $9 billion annually to hospital-based residency training programs.
Why does the government contribute to medical education and training? Our society recognizes the ongoing need for well-trained, compassionate physicians who will provide top-notch medical care. Just like our public school system, our federal highway system, and local public transportation systems, government steps in to fund ways to improve our lives and to make sure that academic medical institutions continue to train new physicians.
Once physicians complete their training, they may opt for a lot less government funding of their pay. Many private physicians exclude Medicaid patients from their practices because the low Medicaid reimbursement rates are not attractive to physicians who closely watch their bottom lines. Private-practice physicians are more likely to take on Medicare patients both in their out patient practices and in their hospital duties. The Medicare system offers better physician reimbursement, and since many of the Americans who need to see doctors are aged 65 and older, any physician who cares for adult patients would most likely need to accept Medicare patients to keep his or her practice running. Dr. Jack Cassell seems to have forgotten how President Obama and the Floridians who voted for the president continue to support his practice, even if they do support health care reform.
Dr. Cassell's angry backlash against Americans who support health care reform was both unethical and immoral, in my opinion. But it was also extremely short-sighted. Any one who pays taxes, whether Democrat, Republican, or Independent, helped provide Dr. Cassell with his training in urology and most likely helps his practice run now. Folks like Dr. Cassell need to find better outlets for their anger while keeping their office doors open to all who seek medical care. Any American-trained physician could truthfully be called 'Dr. Government', and we all need to repay our debt to society by caring for any one who needs it, regardless of political affiliation.
This post does not necessarily represent the views of PSR.