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Today’s primary source is William A. Dunnagan, “Why I Stopped Being a Family Doctor,” Look, 21 Aug. 1956, 35-37. It’s a goodie! His rationale: not “abreast” of medical developments, (2) not enough “home life,” (3) unpaid bills and charity “patients,” and (4) health insurance. 1/
His solutions included doctors in pairs, medical coverage, and higher insurance reimbursements for “charity patients”; preparing students interested in being GPs with realism; better media depictions of physicians, tempering lay expectations. 2/
Choice quotes: “In leaving general practice, I am, of course, only solving my own individual problem. The real problem is profession wide, and finding a solution is just as important to the communities who want and need doctors as it is to the doctors themselves. 3/
I am convinced that there is a solution, but if the public must change its ideas and adapt its attitudes to new developments. Too many people are victims of the popular myth that a doctor is a hybrid of saint and superman: indefatigable, generous and nerveless. 4/
This conception, nurtured by popular fiction, radio, television, and movies, is long overdue for the scrap heap.” (36) The article concludes: “I do not feel that I am deserting a sinking ship. I consider that I am shifting my efforts and abilities to allocate my hours 5/
regulating my working and sleeping time. I will have enough time to live, study, rest, and recuperate from physical and mental exhaustion. This is the only way, I feel, to be the good, steady, cheerful, confident and cautious doctor I want to be to all my patients.” (37) 6/
There’s much to unpack: the weight of Golden Age expectations and gender roles, political economy of post-WWII US medicine, tensions between GPs and specialists, patient consumerism, work-life balance in medicine, etc. BTW, he became a radiologist. #physicianburnout #histmed 7/
There are apparently additional photos, which never made it into the Look print article, which are housed at Library of Congress. Images of Dunnagan treating patients, moving out of his office, spending time with family, etc.
And for non-historians following me, this source is **super** typical for this era. We don't need to buy into the master narrative of the rise of managed care in 1980s as source of all woes. It's a much messier, complex, and tricky past.
TL;DR: physician emotions and healthcare business have much more complex and braided relationship. @CoherenceMed @AdamRodmanMD @ColinWestMDPhD @agnesjuliet @gabrieldane @jbullockruns @MillieQED @CFCCovid @VictorDzau @DocsWith @alexnmold @ariannahuff @abbyellin @KellyODonn
@GeorgeAumoithe @gabrielwinant @downstatedoctor @MedHistoryMan @drjessigold @NatsforDocs @drbreenheroes
