"But you're walking away from your dream!"
"Think about all of the years of hard work you have invested."
"What will you do instead?"
These are common reactions people have when they hear about a surgeon walking away from medicine. It's hard to imagine a surgeon would ever do such a thing. But the past few years may have changed that commitment to medicine for many.
My peers and I have invested nearly a decade to become surgeons. We've spent years in the classroom and hospital rotations, taking various standardized tests, and interviewing for competitive training positions around the country for the privilege of standing in the operating room -- a humbling opportunity to serve patients from all walks of life. This is why it's so disheartening to witness healthcare workers across the country, including residents, walk away from medicine. They are just too frustrated by the challenges of a healthcare system that is crippling surgeons and other doctors from providing effective care.
Now, a looming to surgical care threatens to make matters worse.
My Experience in Surgical Training
I went into medicine because I wanted to have a positive impact on people's lives, and I chose to pursue a career in surgery because I loved the immediacy of improving patients' health in critical situations.
I distinctly remember the first time I witnessed a patient wake up from a kidney transplant. The patient, a mother in her sixties, had been on dialysis for years. When I told her that her kidneys were functioning again -- that she would no longer need to travel every other day to the hospital for dialysis -- her expression was priceless. "I have my life back," she said, with gratitude for the chance of an improved quality of life. That encounter, and many more, inspired me to become a surgeon.
Medicine is by no means a conventional field. While many of my college classmates are now 5 or 6 years into their careers, my decade-long training after school has just begun. Stepping foot into the hospital as newly minted physicians in 2020 was a rocky start. My co-residents and I began our program just months into the pandemic when elective surgical practice was nearly halted. The vast majority of admissions to the hospital were from complications of COVID-19, impacting our ability to gain the broad knowledge classically acquired in the junior years of surgical training.
On top of this, we've continuously faced staffing and equipment and drug shortages, along with pressures from the staggering rise in medical inflation.
The Impact of Looming Medicare Cuts
The challenges that impact patients and their care just keep coming. The latest? The impending sky-high Medicare cuts for the surgical field.
While I'm pleased to see that Congress recently aimed at lowering the cost of prescription drugs for seniors, there is much more that needs to be done. It's alarming to hear that CMS is planning to make significant cuts to Medicare payments for surgical care starting January 1, 2023.
These misguided cuts will force surgeons to do more with less, promising a bleaker future for myself and my peers.
With fewer resources, more senior surgeons will have less time to spend with residents like me. I've had amazing role models during my training so far. But these cuts threaten future surgeons' access to the sound mentorship and necessary resources needed to adequately build the next generation of healthcare providers.
On top of this, these cuts will exacerbate the burnout that surgeons across the country already face, leading more surgeons to close their practices and walk away from medicine toward an early retirement. Put simply, there will be fewer surgeons to care for patients. We will be left with a vicious spiral that jeopardizes the stability of our healthcare system.
I am particularly concerned about the consequences of physician shortages on patients living in underserved areas, where there is already a scarcity of surgeons, anesthesiologists, and operating room staff. I can speak to that by the virtue of my training at the highest volume safety-net hospitals in Brooklyn. Additional cuts to the bedrock -- Medicare -- on which such systems rely will lead to delays in care, worsening patient outcomes, and eventually, increasing the cost of care with patients walking through our doors with more advanced disease down the road.
Year-after-year proposed cuts by CMS underscore the need for long-term reform to the broader Medicare payment system.
Without congressional action, the cuts to surgical budgets, staffing, and services will hit seniors in my area and many other regions harshly. Now, more than ever, we must support the type of thoughtful, responsible healthcare policies that ensure capable, wide-ranging surgical options for patients and their families across New York and the rest of the country.
is a surgical resident at Downstate Health Sciences University in Brooklyn, New York. He is in his third year of a seven-year program.