MASH WAS 2 fine television show, but it lacked a certain honesty as a medical doctors’ It is not contrary to the tenets of the Medical Profession Act for a physician to have a keen intellect, but it is usually unnecessary and most frequently absent. Despite their esteemed position in society, they are simply skilled tradesmen. It is demeaning to be a patient. Pyjamas are no substitute for formal attire, and reost ailments arrive with a variety of indignities. The Doctor walks like an emperor into this milieu, with a personal superiority created only by the situation, not necessarily any earned respect. Unfortunately, man: doctors feel that this artificial primacy travels with them «then they leave the hospital or the waiting room of their offices. Most of them get thumped in business, politics and — judging from divorce statistics — in private life as well. As a result, I never find it sur- prising to see the B.C. Medical Association making an abject fool of itself in public. Their legions are wandering around these days telling us how badly done by they are. They are demanding a new contract and one is under negotiation. The govern- ment has made certain offers. Responding to widespread criti- cism about health care, the gov- ernment has wisely empanelled a royal cornmission. The long over- due, thoughtful investigation could achieve for health what Barry Sullivan’s commission did for education. Most areas of medicine — par- ticularly the specialities —- have all the intellectual stimulation of a procession line in Detroit. There is a tedious sameness to the daily parade of patients. Perhaps it requires a certain dimness between the ears to suffer through each day. The general practitioners, the most accomplished specialists and the public health doctors have the best deal. Their lives are filled with variety and challenge. The best evidence of the BCMA lack of smarts is not only the cumbersome size of its executive, but the fact that they all seem to want to go to every meeting. Besieged cabinet ministers find it impossible to negotiate with two dozen bodies. ake There have been at least two celebrated doctors’ strikes in North America: one in Saskatchewan and the other in San Francisco. The curious aspect about them is that the death rate dropped when doc- tors failed to go to work. Coin- cidence? Canada’s medicare scheme was opposed by the Canadian Medical Association when it was first an- nounced. It was bitterly described as socialism. Now, it is the doctors who man the political barricades to defend this guaranteed income producer. Paul Hellyer’s latest book, Damn the Torpedoes is about unification of the armed forces, but one chapter covers the 1960s medicare debate. Hellyer said he warned his cabinet colleagues about the flaws in the system. He said he proposed an elegantly A Place To Go When You're Pregnant And Need Support: BIRTHRIGHT Call 987-7313 © Free Pregnancy Test © 225 loncsle in Vancouver Cail Worth ¥xxesuver 687-7223 bargaining attempt. simple program, where every citi- zen could go to a doctor of choice, but would have to pay his own medical bills up to a limit of two per cent of annual income. A per- son making $30,000 would pay the first $600 of medical bills each year. Someone earning $100,000 would pay the first $2,000. “*We could have avoided the necessity of governments setting fees for services, under which the worst of doctors are overpaid and the best and most skilied of specialists are vastly under- compensated,’’ Hellyer said. Some of the medicare flaws are: © Medical competency is unrelated to income. © Doctors control the frequency of patient visits, which is why doubl- ing the number of doctors ina community will have no impact on average medical income, and the relative health of the population will be unchanged. ' © There is no incentive for doctors to join worthy causes or to utilize other forms of getting their names known, © Doctors are encouraged to make as much use of hospitals as possi- ble, to shift as much of the burden of overhead onto the public purse. I was once advised that a Ger- man proverb observes: ‘‘A young doctor means a new graveyard.’’ aa Physicians are conducting a powerful advertising campaign over the airwaves this year. It’s a scare campaign that talks about everything except their own salaries, It slams the government for overcrowded hospitals, waiting lists, ambulance services and many other things. But what is the principal issue? Their own salaries, of course. They remain the highest paid profession in our society and the government recognizes that an in- crease is in order. The latest offer, the BCMA complains, is lower than the overhead increases the membership must absorb. There is no shortage of doctors. Supply and demand considera- tions demonstrate no serious prob- lems. Conversely, there is an acute shortage of surgical nurses. This is where emergency atten- tion must be applied: salaries, working conditions and whatever else is necessary. We don’t hear the BCMA advising us that acute-care nurses concerns are greater than their own. Finally, for the past several years, doctors have had the right to opt out of medicare. Not one in B.C. has done so. Why? It is always threatened. In such an event, the doctor would charge you or me for the visit and we would submit the receipt to the medica! plan for payment. Com- pensation would only be at a fee schedule jevel. 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