Kevin, M.D. - Medical Weblog

It will never be done "no strings attatched" The string is the only point of doing it. Here it is working at a community health center. That is no different from aggreeing to serve the military for 4 years of med school paid for.

Why does this something for nothing fantasy persist?
 

That's a pretty big string attached. That locks these young doctors into employed positions at clinics dependent on subsidizes from the federal government.

Raising payment to a reasonable level to allow private practice to survive would be "no strings attached".
 

Other than any tax implications, isn't this just an indirect way of raising the salary by $25K for the first three years. Nothing earth-shattering about the fact that raising the offered salary will help in the recruitment of employees.
 

Making the economic climate favorable for a physician to practice independently in the affected community is precisely the LAST thing these clinics want.

If that doctor found he/she LIKED the community and set up shop there, it would put the clinic out of business.

Government entities do not put themselves out of business.

There is some phony-baloney MBA-type administrator who would have to get a real job. There's some nurse-administrator who would have to go back to actually treating patients.

As such, I have seen many cases of physicians who were deliberately made miserable by the administrators. They went out of their way to antagonize the doctors. They wanted the doc to get pissed-off and leave at the end of the contract.

One doc, a personal friend, actually liked his community. By fortunate accident, rural underserved community was very close to major city. Live in nice area, commute to impoverished area, family's happy, kids in good schools, patients served. Everyone wins.

Shortly afterward, friend tells me he's leaving. Was made clear to him, the clinic administration would go out of their way to make his life miserable if he stayed. They'd all be out of their jobs.

I couldn't believe his story.....until I heard the same thing from other docs in similar situations.
 

All of the silliness of our institutions, public and private begin to make sense once one realizes that organizations never make decisions, only individuals do that and each and every one is making what he thinks is the best decision for him personally.