Thursday, May 15, 2008

Medical students, physician debt - Of Doctors, Debt, and Time

I see by today’s May 15 Wall Street Journal that the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University will award full scholarships to all entering medical students to cover the $43,500 tuition but not the estimated $21,800 for living expenses, fees, equipment, and books.

The school is starting a five-year program to train physician investigators for academic careers. Medical student interest in academic careers has been flat for a decade, hovering around 15%, but dropped to 9.4% in 2007.

The program also addresses the problem of the high cost of medical education, which is $140,000 on average. Other medical schools – the University of South Florida and Yale – are also moving to address the problem of education debt.

Buried in the WSJ report is this statement, “Academic careers are very demanding in terms of time. Some students feel those kinds of demands would be difficult for them to meet while also trying to obtain some sense of work-life balance.”

I find this comment interesting because doctor critics too often ignore the whole concept of time spent becoming a functioning doctor – 11 to 16 years depending on specialty. time expended in seeing this 25 patients answering those 50 phone calls, and filling out those endless forms in the course of day.
Maybe those young doctors flocking to hospital employment and those 8 hour days and 40 hour weeks have it right – time is fleeting, life is short, and family relationships are sweet.

In any event, the words of Peter F. Drucker (1909-2006) come to mind.

“Time is a unique resource. Of the other major resources, money is actually quite plentiful. We long ago should have learned that is the demand for capital, rather the supply thereof that sets the limits of economic growth. People – the third limiting resources – one cannot hire, through one can rarely hire enough good people. But one cannot rent, hire, buy, or otherwise obtain more time.

The supply of time is totally inelast6ic. No matter how high the demand, the supply will never go up. There are no prices for it, and no marginal utility curve for it. Moreover, time is totally perishable and cannot be stored. Yesterday’s time is gone forever and will never come back. Time, therefore is in exceedingly short supply.

Time is totally irreplaceable. Everything requires time.

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