Memo from the Editor

In June, I suggested in this memo that healthcare costs might not be as high if insurance company executives didn't have multimillion-dollar compensation packages. Robert Whelan, a resident who finished his training at Wake Forest University in June, e-mailed me with his own perspective on the costs of healthcare and what's in it for young physicians. I'd like to share those thoughts with you.

"In medical school I spent easily 80 hours/wk in classes or studying. I completed a preliminary year in general surgery the year before the 80 hour/wk work rule took effect. Not one week had less than 120 hours of hospital responsibilities; most were between 125 and 135 hours. Our general surgery residency program boasted a 100 percent divorce rate among its residents before graduation. The three years of my anesthesiology residency has required approximately 80 hours a week of hospital and homework.

"As I graduate, I have approximately $170,000 in student debt from my medical school training alone. Before attending medical school, I worked full time and had nearly completed my MBA. That business background gives me a clear appreciation of what a different financial situation I'd be in now had I applied 80 to 90 hours a week over the last eight years to a career in health care administration.

"While I do not regret my choices, it will be increasingly difficult to expect talented individuals to make this sacrifice in the future, especially given the financial uncertainties that accompany life as a physician."

Many experts predict a shortage of physicians by 2020; judging by recruiting efforts, there's already one in primary care. So Dr. Whelan's fears may certainly prove true. Yet in 2004 we asked doctors-the people who know exactly what practicing in today's climate entails-whether they'd recommend the profession to their children. Six in 10 said Yes. The American people can only hope that fathers and mothers continue to hold medicine out as a worthy-and worthwhile-profession. And that their children listen to them.