The field of medicine is sick. Here’s how we can fix it
Physicians consistently rank among the most respected professionals, and in pop culture they are heralded as superheroes, heartthrobs and savvy intellectuals. America loves doctors, but the grim trajectory of medicine is eroding everything we’ve come to believe.
A series of dissimilar challenges are actively intertwining to rapidly degrade excellence in medicine. We face a critical shortage of doctors that is set to wreak havoc on one’s ability to access care, and the serpentine squeeze of politicization is destroying objectivity in medicine and public health. If we do not change course rapidly and address some hard truths, the quality of American health care will face great setbacks.
When I entered medical school, I aspired to be an exceptional physician both in the operating room and at the bedside; a source of confidence, uplifting to patients in times of great distress, and an objective authority that could make a difference in others’ lives. I fulfilled that dream and have practiced as a urologist and surgeon for more than 30 years. During this time, I have served as a medical missionary in India, several parts of Africa, Nicaragua and Haiti, and as chief of staff of a 1,000-bed Level I trauma center.
Today, demand for doctors is outpacing new additions to the workforce. Several factors contribute to this, but none more concerning than Washington’s lack of support for physicians and the growing pipeline of medical students moving into research or administrative roles upon graduation.
Persistent cuts to the reimbursement rate doctors receive for seeing Medicare patients are driving early retirements, hollowing out access to care in rural communities and fueling oligopolistic market concentration. Increasing difficulty for independent physicians to keep their doors open has forced the closure of private practices and energized the growth of large hospitals and health systems. Unfortunately, all of this is leading to higher costs and worse care for patients.
As for the next generation of doctors, a troubling trend has emerged: Medical students are lacking interest in serving as clinicians. A recent report found that more than half of medical students viewed their education as a stepping stone to careers in health care that do not involve directly treating patients. Cohorts are swelling with students who have no intention of ever seeing patients in their medical careers.
Medical schools’ primary obligation is to cultivate clinicians capable of meeting the burgeoning demands of health care. Engineering admissions standards to reward and penalize candidates based on racial considerations, and rewriting curriculums to comply with faddish, political narratives at odds with objective science are degrading the quality of practitioners.
Medicine and the health of our nation are set to suffer if we allow politics to compromise our mandate to treat patients to the best of our abilities. Medical schools across the nation have capitulated to cultural pressures to advance diversity, equity and inclusion (DEI) policies out of fear they may face backlash or lose accreditation. As a member of Congress, I have spearheaded pushback to this momentum with promising success, but greater action is desperately needed.
As a physician practicing in North Carolina, I uniquely understand the damage racial discrimination has done to the credibility of health care in the Black community. The field of medicine is open to all and certainly benefits from a more diverse professional makeup. However, I believe adjusting admissions standards and coercing prospective medical students to adhere to certain political ideologies or beliefs to increase diversity is shockingly discriminatory and degrades the aptitude and prowess of physicians entering the workforce.
Health care in the United States is at inflection point. We are moving toward a future in which care is consolidated among corporate giants and bolstered by a workforce cultivated by racial considerations that is forged under the influence of evolving political ideology. America must swiftly reverse course, because when life is on the line, nothing else matters.
Gregory F. Murphy, M.D., represents North Carolina’s 3rd District and is a member of the Ways and Means Health Subcommittee.
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