Monday, January 12, 2009

Come Be a GI Doc, and one last thought on Gupta

The NY Times today has a quick piece about the coming shortage of gastroenterologists, which will lead to delays in screening colonoscopies. Medicine residents of the US, here is your future! Upsides: your income will be among the highest of internal medicine subspecialties (along with cardiologists and pulmonary-critical care docs), but typically with a less brutal schedule, as there are fewer middle-of-the-night GI emergencies. Downsides: scoping patients day-after-day has got to be one of the less exciting jobs in medicine, and managing GI bleeders can be raise-the-hair-on-the-back-of-your-neck scary.

As those residents who decide on pursuing GI instead of pulmonology like to say, "take shit over spit."

As for Gupta, I've just re-watched the 17-minute showdown between Gupta and Michael Moore on Larry King Live (I just love juxtaposing a serious topic with the words "Larry King"). To me it's a case study in making mountains out of molehills. On every major point Gupta not only concedes the general accuracy of Moore's facts, but states that he agrees with his overall bleak assessment of the US healthcare system! This is not the rhetoric of an apologist for the system, as some have alleged. They spend a few minutes going round each other on whether Cuba spends $229 or $251 annually on health care per person; they might as well debate about the number of angels that can dance on the head of a pin, as that wouldn't be any less relevant to the real issue at hand. They do have a scrape about the use of the term "free healthcare," with Gupta making the point that countries like France and the UK, despite having universal health care, still have to pay for their system in some way so it's a bit of a misnomer to call it "free," but Moore just won't concede the point even though he's wrong.

The one time when Gupta does go astray (and it's a biggie) is when he defends his choice of interviewing Paul Keckley as a "healthcare expert" to discuss Sicko. Gupta says that Keckley's only affiliation is with Vanderbilt University--but this is clearly wrong. The entire explanation is covered by Media Matters here, the gist of which is that Keckley is affiliated with Deloitte & Touche USA LLP (not just Vandy), and that Keckley personally has made contributions to Republican politicians. This isn't mentioned in the original three-minute piece that aired in Wolf Blitzer's "Situation Room" (snicker), and Gupta--wrongly--stands his ground on Larry King.

How Gupta ends up finding a Republican-connected "expert" to interview is the subject for another day, but my point is that's the rub, not whether or not Gupta was smug and arrogant (he doesn't seem so to me) and did a mugging on Sicko. A superficial analysis that missed the forest for the trees? Yes. A hatchet job? No.

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