ABOUT THE BOOK
As my late friend, Charles Krauthammer, MD, often mentions in his book, Things That Matter, “Medicine is a very satisfying field” Surgery is even more satisfying than other areas of medicine because it is so ‘hands on.’ The surgeon-patient relationship is extremely close. Almost all surgical patients do well and are extremely grateful. This makes the work very rewarding.
However, things can go wrong, and medicine can become stressful at times. When I interviewed for a thoracic surgical residency at the University of Alabama with Dr. John Kirklin, a legendary heart surgeon, he told me, “Cardiac surgery had the highest highs and the lowest lows.” Truer words have never been spoken. The occasional bad outcome can be very distressing even if it does not result in malpractice litigation.
The cost of medical education is rising exponentially, and the time required for training continues to increase. There are four years of expensive medical school after college. Then residency and fellowship training can extend from three to ten years. In the surgical fields, it is rarely less than five years. Due to changes in reimbursement and a rise in the number of employed physicians in practice, the financial rewards are diminishing.
Although physicians only receive about 20 percent of health care spending, costs continue to rise nearing 20 percent of the gross domestic product. More and better diagnostic procedures arrive almost every day. There are also better medications and innovative new surgical procedures such as the use of robots. Generally, this improves care, but it always drives up costs.
In this book, I will discuss all these factors in detail. I will also relate some of the personal stories that have made my last fifty years interesting and largely enjoyable. I will make some suggestions for improving the health care delivery system in our country. Finally, I will make some simple suggestions that would make all us Americans healthy again.
