Majority of American M.D.s Want to Work as Salaried Employees

Less than a week ago, I wrote about a new survey of American physicians which found that a majority of them support single-payer socialized medicine. That was shocking enough. Now, another national survey has come to light which also confirms that we are a long way from the days of Marcus Welby, M.D. and the traditional, independent, self-employed family doctor who made house calls.

According to an article at MDLinx, “More than two-thirds of physicians said they would prefer to be paid a salary instead of being paid by fee-for-service, according to results of a recent survey.”

Think about that: A majority of today’s generation of doctors is willing – actually “would prefer” – to work as wage earning employees for a large organization like the federal government (for example, the Veterans Administration) or for a non-government entity like a large, government-regulated managed care organization.

As recently as several decades ago, American doctors were considered a strong and unassailable bastion of independent-minded, pro-capitalist, free market-oriented professionals who abhorred centralized government control and preferred working for themselves or in small group practices. Now they appear to be comfortable with the emerging statist collective model of working for a paycheck by pleasing and kowtowing to the big boss.

This new attitude, which suggests that doctors are OK with giving up their independence and being cogs in a large bureaucratic organization in exchange for a regular paycheck, is perfectly in sync with doctors’ reported preferences for socialized medicine. MDLinx:

The survey, The Nation’s Pulse: The Texas Medical Center’s Consumer & Physician Survey, found that only one in three physicians is currently paid entirely by salary; the remainder are paid in various combinations of salary and fee-for-service. The survey included 452 physicians throughout the nation (241 in primary care and 211 specialists), all of whom spend at least 50% of their time in patient care.

This new trend is being celebrated by the Medical Establishment, which is construing the new attitude of physicians as being more efficient and compatible with the “cost-cutting” (translation: rationing) future that looms with the imminent full-scale adoption of socialized medicine that must keep costs down – at all costs. Fee-for-service, the opposite of working for a salary, has lately been associated by big medicine spin doctors with inefficiency, conflicts of interest, excessive compensation, and other ills as defined by the new collectivist-minded powers-that-be in American politics and medicine

A recent article in the influential Journal of the American Medical Association, titled “Business Model–Related Conflict of Interests in Medicine – Problems and Potential Solutions,” adds a patina of academic and intellectual legitimacy to this new collectivist orientation. Among the “solutions,” according to the article’s authors, is for physicians to give up working on their own and instead work for a large boss – a huge corporation or, eventually, the government – that will guarantee them a regular salary.

This is how it works in socialist countries like England since the imposition of socialized medicine – the NHS or National Health Service – in the UK in 1948. All doctors there work as salaried employees for the state. As a result, the quality of care in the UK is abysmal and totalitarian in the way that it treats citizens. (For a case history of that, see any of the eight articles about the case of British baby Charlie Gard that I wrote for American Thinker this past summer linked from my archive page here.) In full-blown communist countries like Cuba, doctors also work for and represent the totalitarian enforcement arm of the state, with draconian results.

It’s ironic, because recent experiments in the United States in what is called direct care that have been gaining some ground in the face of abominations like Obamacare have pointed to the success of a very different model – one that relies on small-scale, self-employed medical practices that treat patients on an individualized, personal, one-to-one cash payment basis apart from the dictates of big insurance and big government mandates. The work of a successful practitioner of this model of medical care, Wichita, Kansas primary care doctor Josh Umbehr, M.D., has been brought to national attention since 2012 by Fox News and talk radio host Sean Hannity. Umbehr’s practice is called AtlasMD. A 2016 article in the Wichita Business Journal is one of many that has highlighted his work.

Umbehr says the direct care movement has generated some momentum in recent years, and the goal is to continue to push that in the weeks and months ahead. He founded the Wichita direct-care medical practice six years ago as a way to bypass insurance companies. He advocates for health insurance to cover catastrophic events, however.

Umbehr says his model helps to lower health care costs by eliminating red tape and administrative overhead. Health care prices, he says, also are more transparent.

At Atlas, patients pay a monthly membership fee — from $10 to $100 per month. Members have access to doctors in person, by phone or through social media channels.

The membership also gives patients access to diagnostic procedures, such as bone scans or pulmonary function tests, at no additional charge. Atlas has 2,200 members.

Josh Umbehr, M.D. of Wichita, Kansas

The cost effectiveness of the direct care model, sometimes called concierge medicine, compared with conventional insurance or government-controlled medicine (like Medicare, Medicaid, the VA, etc.) is substantial and actually mind-boggling.

Why a majority of American physicians would throw in their lot with the concepts of single-payer and working as wage slaves for a big organization is not easy for an observer to understand. Until one recognizes that medical education, like everything else in the West, has been a target of socialist/communist propaganda since the 1960s. The results of this “long march” towards radical historical revisionism; the denigration of independence, freedom, and the free market; and the adoption of political correctness and “social justice” are now bearing fruit as a critical mass in the transformation of society has been achieved.

It is as much against the interests of physicians to believe in the preference of being, in effect, wage slaves as it is for them to embrace single-payer socialized medicine. But that’s the way it is today – and as a result the future for everyone – them and us – looks very bleak.

Peter Barry Chowka has reported on health care, with an emphasis on alternative medicine, since 1972. Between 1992-’94 he was an advisor to the National Institutes of Health. His new Web site is Follow Peter on Twitter.

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