NATIONALIZED MEDICINE,  just like nationalized compulsory schooling, is likely to be much more favorable to female workers than to male. In general, working for the government, which provides security and does not require initiative, is more attractive to women.

In fact, the new law adopted by Congress last weekend equates doctors, who are more likely to be men, with nurses, who are more likely to be women. As the blogger Dr.Rich notes:

And here’s how the new law defines Primary Care Practitioners:

The term ‘primary care practitioner’ means an individual who —

(I) is a physician (as described in section 1861(r)(1)) who has a primary specialty designation of family medicine, internal medicine, geriatric medicine, or pediatric medicine; or

(II) is a nurse practitioner, clinical nurse specialist, or physician assistant (as those terms are defined in 9 section 1861(aa)(5))

And so … DrRich must report that the real “fix” your political leaders have envisioned for the PCP shortage has been to declare you and nurse practitioners to be functionally (and legally) equivalent. This, DrRich submits, is all you need to know.

Having painstakingly reduced you unfortunate practitioners of primary care medicine to tools of the state – whose job is to follow the guidelines and place chits on the checklists which are handed down from on high, and to fill out the electronic forms which are designed not to advance patient care but to convenience the healthcare accountants who will thereby judge your “quality” – it is only natural for the central authority to eventually notice that you really don’t need all that training to do the kind of job they have invented for you. Nurses – who can be “trained up” much more rapidly than you, who will work for much less money than you, and who (they think) will be much less recalcitrant about following handed-down directives than you – will fill the gap. And you, doctor, can go pound salt.

C.S. writes:

In my medical school class in the 1950’s, there were only five females. One of them eventually became a general surgeon; could out cuss the most seasoned sailor (my apologies to the men of the sea); smoked cigars; and unbeknownst to me represented the harbinger of things to come. A couple of the others were what I now know to be closet lesbians. 

I recently had a conversation with a “nurse practitioner” who is an acquaintance. I was appalled when she informed me that she had very little oversight of her daily ministrations to her patients. In fact, according to her, only about 10% of her charts are reviewed by a physician. Furthermore, she remarked that Obamacare would benefit nurse practitioners. She also can prescribe narcotics with the exception of, I believe, class 5 narcotics. She then began to berate a general surgeon whom she works with, saying that he was extremely “biased” against obese people. I tried to inform her that there was some rationale behind this: to wit, obese people in an operative setting are at greater risk of complications both intra-operatively and post-operatively. This did not seem to phase her continued dislike of this particular physician. This indicates to me that there is a huge hole in the training of these people, particularly the females. These females bring an emotional attitude to the table which has no place in the “practice” of medicine. 

With the advent of Obamacare, the disaster has begun!

Laura writes:

With managed care, the nurse practitioner has already become a greater force and she is the wave of the future. There is a place for nurse practitioners, but too often they become cheap replacements for physicians.

It’s interesting that you mention the emotional attitude of women in medicine. The empathy of women is well-suited to genuine nursing, but it is less appropriate to the work of physician, which requires detachment. Generally, with the entry of many women into medicine, this emotionalism has been welcomed, even to the point of creating a defensive posture in male physicians. The touchy-feely approach seems more common.

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