You’ve probably noticed folks in the medical field going through progressively greater contortions to make ends meet, let alone get ahead. Logistical acrobatics get even more frantic with the approach of a tidal-wave of unknowns such as PPACA; tough as it may be to navigate our current choppy waters, it can seem impossible to chart a course for the next few years when even the politicians who pushed through nearly three thousand pages of new rules for our profession don’t know how things will be implemented.
One response to such an environment is to seek a different, friendlier playing field. (No, I’m not talking about leaving medicine, although some folks have gone that route, and quite a few others are making contingency plans to do so in case things get even uglier.)
The field of “medical tourism” is an example of this: leaving one’s own country for diagnosis and/or treatment abroad because, even with the costs of travel and lodging, getting cosmetic surgery in Country X costs substantially less than it does at home. In some instances, the sought-after health care isn’t even available at home (experimental treatments, for instance). Of course, if you’re a healthcare provider looking to set up a base of operations in another country, there’s a whole lot of due diligence ahead of you — part of which includes making sure your host country won’t make your professional life just as difficult as the one you left.
On another doctors’ website I frequent, a closer-to-home option has been discussed from time to time, not entirely in jest. I think part of the inspiration was from the never-ending quest to increase popular access to gambling. Recognizing that lots of folks would rather not drive or fly a few hours to the nearest municipality where gambling is legal, some enterprising souls have established small cruise lines whose sole purpose is to head out into international waters, at which point onboard casinos proceed to function without legal hassles which would be in effect back on shore.
I think it speaks to just how excessively our profession has been squeezed, that there are more than a few docs who eagerly snap to attention when hearing about the concept of a medical cruise line.
Whether it’s a massive ship with representation from every subspecialty out there (surgical suites, sleep labs, rehab units, etc.) or smaller, single-specialty craft (such as for radiology, with sections of the ship ranging from diagnostic mammo to radiation oncology), there are more than a few details which would have to be worked out before concluding that such an approach would be economically viable.
It seems to me that a profession with practitioners so eager for such pie-in-the-sky rescues from their day-to-day realities has got to be in serious trouble — so much so that the sources of their woes (such as policymakers who continue to inflict those woes on a regular basis) can’t possibly be unaware of such low morale. Unless it’s willful ignorance.