Expert: JM Starkman, MD - 6/4/2009

Question
So I keep worrying about the socialization of medicine.  What will this mean for someone who is about to enter residency for anesthesiology next year?

Answer
Important question!  I believe the increased socialization of medicine really asks all of us if we want to either join up with a government-controlled system (mostly Medicare) or seek a means to operate independently from that system.

Socialized systems, whether they are medical or other state planned, financed and owned, all have similar things in common--least of which is that when they inevitably crash they leave their dependents destitute. We may become such dependents.

You are beginning an anesthesiology residency and we'll eventually see you practicing around 2013.  Evaluate what your free-market vs. government options will be.  Almost all anesthesiology groups are highly dependent on government and third party (insurance) money for their cash-flow and hence their existence.............will you want to join up with a group like that in 2013?  Plastic surgery and dentists offices are good places to make a living providing free-market, cash-based payments for anesthesia services---but will take a while to get up and running business-wise.  Your anesthesia residency does not include the business skills needed to quickly jump into this after training and that is about all the options you have free-market-related in anesthesia.  

Knowledge is power--here are some things you should do now:

Join the American Association of Physicians and Surgeons  (AAPSonline.org)
Join the Cato Institute as a beginning sponsor ($50)
Read:   Code Blue: Healthcare in Crisis, by Edward Annis, MD

Both organizations have gargantuan amounts of knowledge pertinent to your question about which most residency directors have not yet dreamed.