Written by Jack McGowan

A PROSPECTIVE PRE-MED STUDENT SPEAKS OUT

For the past few years, I have spent much of my free time outside of high school and my two part-time jobs immersing myself in the field of medicine, as I have dreamt of becoming a doctor for as long as I can remember.

In fact, when I was discovered to have Type 1 diabetes in November of 2019, the diagnosis did not devastate me nor deter me from my conviction for my chosen career path. It was as if my childhood fascination with the inner workings of the human body had eerily served as a form of foreshadowing, allowing me to swiftly bypass the Kübler-Ross stages that I should have experienced as a freshman in high school when I found out I had developed a life-altering chronic illness.

I simultaneously found myself at both the “bargaining” and “acceptance” phases shortly after my diagnosis, and have continued to practice these two virtues in my daily approach to life.

There was no denying what was going on: it was clearly irrefutable that, seemingly overnight, my once precisely functioning pancreas had to be replaced by crude approximations of self-administered exogenous insulin to manage the wild fluctuations in my blood sugar. Instead of wallowing in self-pity about my body’s betrayal, I was able to pivot my mindset to appreciate the complexity and precision of God’s handiwork. Most of us take for granted how remarkably efficient the human body is when it works well.

I was more irate and angry at the COVID-19 pandemic and the way it was being managed than I was at the diabetes itself and how it had turned my world upside down. Anger is one of those emotions that can be all-consuming, and I made a conscious decision not to let it become a dominating factor in my life.

I HAVE experienced feeling depressed and discouraged, but surprisingly, the sadness and melancholy that enveloped me had nothing to do with my diagnosis or the pandemic. The despondency I felt was a direct result of discovering the current state of the medical profession. It was “perfect” timing (insert sarcastic tone), I might add, as I had just gone through the arduous task of completing and submitting 11 college applications as a prospective pre-med student.

I will never forget the moment that I started questioning my dream of becoming a doctor. I was working on an article for Physician Outlook Magazine (where I had been volunteering as a content intern). I was assigned to write about Dr. Luke Lin, an inspiring ER doctor who was the cover artist for Volume 6. After reaching out to him, I wanted to learn more about Emergency Medicine. I have been shadowing an Orthopedic Surgeon, and although I love the Operating Room and the idea of being able to restore patients with musculoskeletal issues to normal function, I was also attracted to the field of Emergency Medicine, as it is more diverse and requires a broader base of medical knowledge and has that “adrenaline appeal” for me.

During my research, I came across an Emergency Room Reddit post that included a link to a YouTube video titled “The Harsh Future of ER Doctors,” which was sobering. It described the plight of “Bernard,” an ER doctor with extensive training (4 years of undergraduate education, 4 years of medical school, and a 3-5 year residency/fellowship) who suddenly finds himself JOBLESS. I couldn’t believe that what I was watching could possibly be happening, and I started doing some deeper research. I interviewed Dr. Mitch Li, founder of Take Medicine Back, PBLLC, which is an advocacy organization that provides education and advocacy to the public regarding the corporate takeover of modern medicine. This corporatization has led to the financial exploitation of patients and the erosion of trust between healthcare providers and patients.

I learned about the growing trend of private equity firms “buying up” Emergency Medicine training programs with profit-making as the primary goal, with little to no regard for the ethical and moral obligations that make medicine the trusted and respected career that it is (or rather was). These programs essentially skimp on training and education, choosing instead to “fast-track” doctors with a goal of making the most money in the least amount of time.

I know that healthcare is a business, and I can understand that businesses must employ basic economic strategies to survive and thrive, but I cannot support nor turn a blind eye to the predatory practices that for-profit private equity firms are sneaking into the business of medicine. These PE firms are allowing young, undertrained Physician Assistants and Nurse Practitioners to literally “practice” medicine unsupervised as if they were doctors, which undermines the integrity of both the specialty and the position. Physicians being trained at these PE-backed emergency medicine programs are often poorly prepared, as the programs are not designed to create quality doctors. Simply put, PE firms “pump out” doctors as if they were being mass produced in a factory to make as much money in as little time as possible. This may work for manufacturers producing tangible products, but it has no place in medical education and in patient care.

There are two victims of this criminal practice: unsuspecting patients who are being financially exploited while getting substandard care, as well as the physicians who are being short-changed in their education and training. The trend is not just affecting ER doctors; these profit-driven investment firms are swooping in to purchase and “run” Dermatology, Plastic Surgery, and Radiology groups.

I am often asked if doing this research affected my plans to pursue medicine as a career. Did I still want to be a doctor? The answer is a resounding “yes.” When I myself became a patient as a freshman in high school, lost in an unfamiliar new world of Type 1 diabetes, it was my physicians who guided me through the dark tunnel towards the light. I personally experienced the importance of well-trained care teams who put ME, the patient, not profits, as the top priority. My care team at the Children’s Hospital of Philadelphia is physician-led and includes endocrinologists, nurses, nutritionists, and pediatric residents. They have made an incredible difference in my life, and I plan to do the same for many other people’s lives. I am so grateful that, as I am embarking on this long journey, I am doing so with my eyes wide open, and with connections to and knowledge of grass-roots groups that are dedicated to maintaining the integrity of a profession that is rooted in a pledge to “Primum No Nocere.” Part of “Doing No Harm” is to continue to educate myself about the dark and dangerous side of medicine, and to advocate for much-needed transparency and change.