Doctors: Over-worked, Under-paid Political Scapegoats

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Appeared in the Saint John Telegraph-Journal and the New Brunswick Telegraph-Journal

Clashes between doctors and the politician-managers of medicare race across the nation like a plague, with the latest outbreak in New Brunswick. This raises a question – can doctors be the over-worked, under-paid, stressed-out victims of an arrogant, closed-minded, uncaring employer?

The surprising answer is yes. So are nurses.

Across Canada, doctors and nurses are taking sporadic job action, demanding more money or perhaps enough time to sleep or get in some vacation. Doctors and nurses don''t like to strike. These often desperate job actions merely reveal the bizarre pay rates that afflict our government-run system.

Here''s a silly-sounding question. Who earns more per hour: an experienced teacher with an undergraduate degree, an autoworker with a high school diploma, or your family doctor? Everyone has read newspaper stories about the obscene earnings of some doctors, and some do inflate their billings. But even family doctor''s pay seems high, averaging $210,000 across Canada.

About half goes to expenses – office rent, receptionist, nurse, medical equipment, etc. Even after that, doctors earn a pretty penny. But, there''s reason for that. Doctors work a lot harder and longer than the rest of us – about 40 per cent more hours than the average worker.

Nor do family physicians, working out of their own offices, get the plethora of benefits – like extended medical coverage – most workers and families take for granted. They have to fund their own pension and if they get sick, they just stop earning, unless they''ve ponied up for an insurance plan.

So again I ask: Who earns more money on an hourly basis: a teacher, autoworker, or family doctor? Once benefits are factored in, a family doctor earns about the same as a teacher in most provinces or an autoworker. Many family doctors earn much less.

Yet, doctors face stressful life-and-death responsibilities everyday. They typically endure over a decade of advanced education and training. While most of us are out earning money in our 20s and early 30s, doctors are building up massive student loans. As interns, they face hours of work and hardship that would drive any union member to the international human rights tribunal. It''s shocking how little doctors earn after all this and how many hours they still work.

Why do people become doctors? Anyone who can get through medical school could instead become a high-priced lawyer, or software engineer, or MBA, or whatever -- and graduate earlier, earn money earlier, and earn more money.

The reason is simple. Despite all the public abuse directed at doctors – note Premier Bernard Lord''s comment: Do they want to take the patients of New Brunswick hostage? Is that their objective? – most doctors become physicians because they have a genuine commitment to medicine.

That''s why doctors, and nurses too, have become victims of Canada''s government-run medicare system. Governments know they can attack the earnings of doctors and nurses because of health workers'' reluctance to take their patients hostage. Doctors and nurses have been under siege for more than a decade. Their real earnings have tumbled.

Governments expect health workers to give in quietly. Now, that many are saying no, governments'' response has been: But, you should be giving in. Think of your patients.

Yet, governments quickly surrender to power groups that have no hesitation in flexing their muscle. Unionized hospital workers – who themselves are not health care professionals – earn 10 to 20 per cent more than people doing the same job in the private sector.

Not surprisingly, unions fund the scare tactics against modest reforms to the health system which, for example, would allow private facilities to provide some health care services. That doesn''t violate the rules of medicare. Government would still set the rates for procedures and pay the bills, but it would break government''s monopoly power to dictate doctors'' and nurses'' pay.

Obviously, this wouldn''t solve even a significant portion medicare''s problems. Comprehensive reform is needed to free the system from the heavy hand of government''s slow strangulation. There are lots of possible reforms around, from allowing private clinics to the creation of individual, but government-funded, medical savings accounts.

Reform does not mean the creation of a system that would leave Canadians without taxpayer-funded medical care. But, the fact that government pays for something, doesn''t mean government must run it, and reward whoever has the most political clout rather than those who do the valuable work. Without reform, we may soon have hospitals full of well-paid janitors and maintenance workers but empty of doctors and nurses.

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