Re “UC sets poor example for med students” (Viewpoints, Feb. 2): As a recent UC Davis residency graduate I want to assure the three medical students that you are receiving a medical education far better than you realize or appreciate. During my residency at UC Davis I provided medical care, both inpatient and outpatient, to fully insured patients, partially insured patients, indigent patients and undocumented patients, and the outstanding quality of the care delivered never deviated based on their ability to pay.
A large number of these patients provided no revenue to the University Medical Center yet consumed millions of dollars in resources. As exemplified by the hundreds of hospitals and emergency rooms that have closed in recent years due to insolvency, it should be obvious that negative cash flow is unsustainable and ultimately results in less availability of health care to everyone.
The commentary also criticizes UC Davis for embarking on the construction of a new emergency department. Let me assure you that the construction of this building is essential to the continued care of the ever growing number of patients who visit the ER. When I practiced in the UC Davis ER two years ago it was common to treat patients on gurneys in the corridors of the hospital or allow them to languish for hours in the waiting room for lack of space in the emergency room. This is not ideal patient care.
You further criticize the provision of bonuses to UC Davis Medical Center executives. It is important for you to understand that in all large, complex institutions it requires financial incentives to recruit and maintain the required managerial talent to guide and oversee the operation of the organization. Failure to competitively compensate the executives could compromise the very existence of the institution.
My message to you, doctors in training, is that although we would all like to learn and work in an ivory tower atmosphere, immune from the economic realities of the world, this does not represent an ideal medical education. To practice medicine without regard to economic realities has played a major role in the health care mess that we are currently battling on a local and a national level. You need to learn medicine through didactic training and clinical practice, and you also must be well aware that you are practicing medicine in an environment where resources are indeed limited and the sooner you embrace this notion the sooner you will be able to effectively practice medicine in the real world.