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The Assault on the Medical Profession

It used to be that two cereal-box tops The Assault on the Medical Professionand a quarter would get you a Flash Gordon secret decoder ring. Nowadays, the same will get you the word “Doctor” in front of your name. It reminds me of a scene from an old sitcom called Fernwood Tonight in which a man is having a heart attack and everyone yells for a doctor. When the “Doctor” comes running out from the audience, he has no idea what to do. It’s because, he says, he is a botanist.

I have always said that if somebody puts the word “Doctor” before his or her name on a sign or business card, it indicates that this person is not a medical doctor (or as one of my partners puts it, not an R.D. or Real Doctor). Conversely, when I first came to town, my medical colleagues cautioned me against telling contractors that I was a physician lest I incur the ‘medical tax’ – doctors are routinely up-charged since “they can afford it.”

Oh, and early in my medical career (not that I’m that old, mind you) I would inwardly feel slighted if I were not addressed as Doctor. But over time, I found that in most situations it is far less complicated not to let on that you’re a physician – you know, solicitations for different causes, spontaneous curb-side consults, etc. But heaven forbid if you don’t call a psychologist, or a chiropractor, or an optometrist “Doctor Jones”.

More ominous, however, than the mere name game is constant legislation to allow pseudo-professionals to perform beyond their scope-of-practice. Here in Florida it is a perpetual battle. So now there is a bill coming up for debate that would allow optometrists (sorry, “Board Certified Optometric Physicians”) to inject medications into the eye. Yes, intravitreal injections for the treatment of wet age-related macular degeneration. After all, pharmacists are now allowed to give flu shots, so a “shot in the eye” is no different, right.

Now, many insiders don’t really think that optometrists really want to specifically perform intravitreal injections, what with all the hassles associated with a sterile procedure like that. But perhaps they would be willing to settle for something less invasive like, say, laser vision correction – lasers are, after all, “just lights”.

If experts are correct about the failure of medical training programs to keep pace with the future needs of this country for physicians, then perhaps this is the shape of things to come. And when we are older and joking about getting our “pipes” cleaned out, it won’t be by a cardiothoracic surgeon but by a plumber.

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