Dr. Rob thinks so:
I think that this is a fundamental problem in our system. For policy makers to understand what is wrong with the system, they must be able to hear it from those most affected by the deficiencies in the system. The problem is that those people who are in the most distress are exactly those who cannot afford to take the time to put forth their voice. In general, the “physicians” who populate the committees, task forces, and advisory panels are at best only practicing part-time. A friend of mine (who works in DC) says that often physicians on these panels introduce themselves as “recovering physicians,” with a chortle from the committee in response.
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In the final analysis large scale organized medicine fails in our charge to them to fight the bureaucracy because they too, became bureaucracies; once they fell into the same mind set, they failed to see our complaint. The people attracted to these activities are by nature people who believe in centralized solutions to problems, people who believe that crafting the right policy will solve the insoluble, people who believe in commities, rules, policies, and credentials rather than ability, moral commitment, common sense, personal responsibility and character as the solution to problems.
Further exacerbating that dissonance in the natural attraction of national NGO’s and governmental positions for those with statist philosophies, is the simple fact that independent self-sufficient practitioners make a huge financial sacrifice to participate. Those who with herd mentalities who have already joined one or another collective (VA, state employment, etc) usually can serve, travel expenses paid, with not financial cost to themselves. So they can go and talk for free, and talk, and talk, and talk. . .
Dr. Rob hits the nail on the head.
It’s just like jury duty – over half the jury was geriatric, and i didn’t try that hard to get out of it, being in a academic medicine at the time, and not taking a financial hit for hangin’ out in lower manhattan.
but if i was where i am now? forget it, i’d lose like $1000/day in gross revenue. if i was stuck for a week or two that’s almost my whole profit for a month!
i used to serve on a committee of our state medical society, and quickly learned how useless that was – the next youngest committee member was at least 35 years older than me, and all issues were “tabled”. Seems that for some, committees & meetings are a disruption to their job, and for others, such diversions ARE their jobs.
One cannot both run a practice effectively AND be politically active, just sadly impossible.
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