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Lessons from the road

Some of my recent weekends have been spent re-visiting the small number of medical schools to which I’ve been admitted.  Schools invariably have a “gimmick” or two to try to differentiate themselves from others despite the fact that much of what they’re selling you on is essentially the same, but fortunately there were enough legitimate differences to make the choice of Sorta Urban Medical School (SUMS, situated in Region Near A Lake [RNAL]) an easy one.

There were two interesting things I picked up on from these visits that were unrelated to the issue of choosing a medical school.  The first is political.  I’ve heard it mentioned that medical students tend to be more politically “conservative” than their counterparts at law schools or PhD programs.  Maybe this was true in decades past, but I definitely did not find that to be the case among the current/prospective students or the faculty that I met at any of the schools I visited.  Granted, there are giant sample size and omitted variable bias issues at play here, but a left-leaning libertarian (I guess that’s what I am for the time being?)  like myself would not be part of the mainstream at any school I saw… forget about full-blown conservatives.

The second was a piece of unexpectedly relevant wisdom dispensed by a cab driver.  It turned out that the most time and cost-effective way to get from the Canadian hinterlands to the medical schools of Regional Near A Lake involve connecting through New York City.  A late inbound flight at one of the area’s three airports meant having to take a cab part of the way to the other airport from which my next flight was leaving (note to self:  bad idea).  The cabbie was a stereotypical fast-talking business-minded Indian immigrant.  He immigrated in his youth, got an engineering degree, but drove a cab to make ends meet.  Time went on, he ended up buying a cab and medallion, than another.

What stuck with me was something he mentioned in the context of dealing with city regulation.  He showed me a picture (while driving…) of himself shaking hands with Mayor Bloomberg.  He said that when the city met with cab drivers to discuss taxi policy (?), they didn’t actually meet with the drivers.  They met with the owners.  Apparently most NYC taxis are owned by large fleets, but when it comes time for them to deal with the city, even the smallest owners, such as my driver, are included.  Not the employees.

“You see, I own my cab, not like the other drivers.  They’re employees!  The city doesn’t talk to them.  But an owner… if you’re an owner, they talk to you.” In other words, if you’re an owner, you get a seat at the table.

I’ve mentioned earlier my belief that physician ownership of medical practices is ideal, for a variety of reasons.  Here’s one more.  As it is, much of the public (and probably most elected representatives) see physicians and hospitals as having identical interests (financial or otherwise), when that is definitely not always the case.  The machinations surrounding the recent US health reform bill definitely show that the administration was talking to the hospitals… not so much to the doctors.

“If you’re an owner, they talk to you.”  As more and more physicians head into hospital-owned practice, this is something to ponder.

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