BLOG: Of doctors and pilots

Read more blog posts by John A. Hovanesian, MD, FACS

When I grew up in the early 1970s, I remember considering different professional careers. Among the most desirable were becoming a doctor, a lawyer, an engineer and a pilot.

These were the most respected and best paid mainstream career choices. I chose to be a physician because I loved science and loved helping people, but I always thought about becoming a pilot as well. Aviation offered an extremely respected place in society, highly technical skill, great pay and a reasonable workweek.

But in the years since, something very interesting has happened. The airline industry has devalued pilots, reducing their pay through predatory contracts and threatening negotiation, withdrawing retirement benefits, which has left many tenured pilots in financial challenges, and treating pilots generally as skilled technicians rather than respected professionals. Sadly, I think society’s view of pilots has echoed this sentiment. Most kids today probably do not view aviation as a respected career path the way we did a generation ago.

Medicine is now in danger of repeating this pattern. Insurance companies are already beginning to offer predatory contracts for reduced reimbursement in exchange for a “narrow network” of guaranteed patient volume. Giant medical groups are forming, purchasing primary care doctors’ practices like commodities, seeking to gain control of as much market share as possible. And I wonder whether society’s respected view of physicians has already been eroded.

But there is a difference between pilots and doctors. The supply of new doctors, especially in fields like ours, is still limited, yet the aging population is growing. Clearly the supply-demand curve favors us. Unlike pilots who remain ever more faceless, locked behind a heavy flight deck door, we physicians directly serve our patients, face to face with a relationship that develops over many years. Unlike pilots, we form a bond with the ones we serve, driven by our personality and our genuine care for our patients. This just can’t be commoditized.

As physicians, we have great value and, therefore, great leverage against those who would attempt to devalue our place in society. We must always remember this when we face the challenges to our autonomy and our compensation that lie ahead. Unlike pilots, whose profession has, sadly and unfairly, become relegated to the class of highly skilled technician by their own industry, we must remember the reasons that most of us went to medical school — to use our aptitude in science to help other people — and never lose sight of what we are worth.