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MANY DOCTORS FLEEING THEIR FEVERISH FIELD

Frustrated with a sagging public image and the uncertain future of medicine, many Utah physicians are retiring early and choosing other professions.

From his perspective as the director of the Salt Lake Clinic - and as a father of two medical students - Dr. Richard R. Price sees a disturbing trend away from a profession that has given him immense satisfaction over the years.Since the controversy over health costs has exploded on the national scene, Price has accepted the early retirements of more than 15 doctors who are "giving up 10 years early." One young physician decided to quit medicine entirely, opting to become an auto mechanic. The clinic employs 90 doctors.

Even as his sons question their decision to become doctors, Price is concerned that eventually the rewards of medicine will be destroyed by overregulation by government and insurance companies. Talented young people will choose other occupations.

Price is unimpressed with reforms recommended in the recent legislative session. While health care was a hot issue at the beginning of the session, most bills were referred to committees for further study. Nothing substantial was passed, he said.

"The doctor is being left out of the loop in the reforms," he said. "Republicans and Democrats alike talk about changes, but they obviously have a shallow understanding of the problems. They need to talk with the practicing doctors who are on the firing line - not just the administrators."

He concedes that physicians are partially to blame for the lack of communication. "When you work 16 to 18 hours a day, it's hard to find time to get a different perspective in the media. We need to improve that; break down barriers."

When Price began medical school in 1956, physicians were respected. But now, most of the public believes doctors are in medicine for the fast buck.

"There are a few physicians who are greedy folks. There are bad apples in all professions. But by the time you invest 10 to 12 years of medical training, the person who is motivated primarily by greed is weeded out."

His sons are in medicine for the right reasons - to help people. But the altruistic motives are diminished as the public points the finger at doctor for rising health costs.

Today, doctors can't ask: "What can I do to best help this patient?" Instead, permission must be granted by insurance companies. The bottom line becomes, "What will an insurance company approve of? Price, a surgeon, recently hired an employee who does nothing but call insurance companies full-time and ask for permission to perform recommended surgeries.

There is no question that access to health care is a big problem in America. "If young mothers are afraid to call a doctor when their baby is sick because it costs too much, then something is terribly wrong."

But society must put a limit on what constitutes "basic care."

"All Americans want Ferrari medicine at Ford prices - and that's just not possible," said Price.

For instance, should doctors give everyone a liver transplant, even if the survival rate is only 5 percent? Price suggests the standard should be: What health care can result in the greatest amount of good for the least amount of money.

"For an idealistic physician who wants to do everything possible to help a patient, these are agonizing questions. But the monkey needs to be taken off the doctor's backs. It's a question of ethics for society.

"Unless some answers are provided soon, doctors will lose the personal satisfaction of healing in the midst of controversy and politics. And if you lose that, you lose the quality in our health system."