Enmity is a feeling of hatred or hostility towards something. Natural man has enmity towards God. Romans 8:7: "The carnal mind is enmity against God." James 4:4: "Do you not know that friendship with the world is enmity with God?" It is difficult to believe, but people who have not accepted Christ as their savior are actually enemies of God. Romans 5:10: "For if when we were enemies we were reconciled to God through the death of His Son, much more, having been reconciled, we shall be saved by His life." Colossians 1:21: "And you, who once were alienated and enemies in your mind by wicked works, yet now He has reconciled..." It is not surprising that enmity and enemy sound so much alike, as they both originate from the Latin inimicus.
The Bible also tells us that God has wrath. This is an unpleasant notion, but the Word of God is clear on that subject. Romans 1:18 states, "For the wrath of God is revealed from heaven against all ungodliness and unrighteousness of men..." Jesus Himself said in Luke 12:4-5, "My friends, do not be afraid of those who kill the body, and after that have no more that they can do. But I will show you whom you should fear: Fear Him, who after He has killed, has power to cast you into hell; yes, I say to you, fear Him!" These are the very words of Christ. And if we believe the words of Jesus, and if there is a Supreme Being with wrath, we should be fearful of Him. Yet man finds this intolerable, that there should be a Person who is greater than him, of whom he should be afraid. How does man resolve the problem of being the enemy of a God, all-powerful and all-knowing, who is capable of great wrath?
The first way is to deny He even exists, and the atheist solves his problem right there. You can't be an enemy of someone who does not exist, and there is no need to fear the wrath of an imaginary entity. This, then, allows you to live in any manner you wish, without worry of any temporal or eternal consequences. This is a group of people who are not believers in Christ or God or the Spirit, and threats from the Bible do not have any relevance for them.
The second way to deal with this is to remake Him into the image that we desire. We claim that God exists, but that He does not have any wrath. Many look upon the Old Testament as just that, "Old", and see a God capable of all manner of wrath and destruction, but have replaced Him with the image of a completely kind and loving Father who would never be angry with anyone. Some have looked upon the Old Testament God as a frightful, judging Being, and He has now been superseded by His Son Jesus, the gentle Lamb of God who is all-loving.
There are several problems with this viewpoint. First of all, it goes against what Jesus Himself said in Luke 12, Secondly, it ignores the full divinity of Christ, who is indeed the Lamb of God but also the Lion of the Tribe of Judah (Revelations 5:5). When Jesus returns, He will bring judgment upon the world. In fact, Jesus tells us in John 5:22, "For the Father judges no one, but has committed all judgment to the Son." Thirdly, although Jesus was meek and loving, He never condoned sin and was capable of great anger when the need arose, as in the temple with the moneychangers. Lastly, Jesus is the Word Incarnate, and the Word itself is a two-edged sword (Hebrews 4:12), with the good news of the Gospel and the frightful news of pending judgment.
Those who deny the existence of a God with wrath or a do not believe in a wrathful God are making a serious error. The first group is free to make up any moral system they desire, and the second is free to disobey God's moral system; both are free of any consequences. They are inappropriately not fearful of God's wrath. We certainly see this playing out daily in our lives. The people who would dismember a child in the womb and sell its body parts are not afraid of God. The lawmakers who pass laws that violate God's natural order for man and wife, and the judges that approve, are not afraid of God. The leaders of our country who pass laws for our healthcare by lying to us, bearing false witness, are not afraid of God.
Even on an individual level, we know people who claim to believe in God, but are sinning and unafraid of God's wrath. We are afraid to confront them, afraid to upset them, afraid that we will not seem loving, but our fear of these things should pale in comparison to the fear of God that they do not have. If we love them , we would speak to them of their sin so that they would avoid His judgment and wrath.
There is a third way to resolve the problem of being an enemy of a God with wrath, and that is to be reconciled with Him. This is done through faith in His Son Jesus Christ. Those who do will be spared His eternal wrath, and can rest peacefully in that promise. There will still be painful things to deal with: chastening for disobedience, pruning for sanctification, and spiritual warfare, but we need not be afraid of these things or God Himself. Our loving God sustains us through these.
There are some Christians, who are reconciled to Him, who still carry an unhealthy fear of Him, worried that the slightest misstep will result in punishment; they often interpret any bad thing that happens to them as an expression of God's wrath. The are inappropriately afraid of God's wrath. The best way I know to overcome this is by repeatedly reading the Word and His promises to look after us, to care for us, and to comfort us. If Psalm 23 tells us that because of our Lord we "will fear no evil", then how much less do we need to fear that same Lord who is perfectly good?
Those who do not believe in God have every reason to be afraid of His eternal wrath. Those who believe in God but do not believe he is capable of wrath will stand before Him in judgment and there will not be an opportunity to offer excuses for disobedience. Only those who in humility confess their faith in Christ Jesus as well as confess their sins have nothing to be afraid of.
And I'm afraid that's about all I have to say on the matter.
Tuesday, July 28, 2015
Tuesday, July 21, 2015
Doveryai, no Proveryai
I have just finished a tremendous biography of Charles Ponzi, of the eponymous "Ponzi Scheme." He began his project in 1920 in Boston, promising to give people a 50% return on their investments in 45 days. He actually had a notion of how he might do that, using the difference in values of currency in other countries and their exchange rates in postage, but soon after accepting investment monies he realized it wasn't workable, and so he paid off the early investors with money coming in from new investors. His first investor only put in a few hundred dollars, but soon he was taking in $10,000 a week, then $100,000 a week, and then a million dollars a week. People trusted him with their money, in some cases their life's savings, and when it all fell apart they were wiped out.
One of my earlier articles described the difference between truth and belief, terms that are frequently misused. In summary, a thing that is true cannot be untrue at the same time; this violates the law of non-contradiction. A true thing must be true for all people. A belief, however, can be correct or incorrect. You may believe something to be true that is not, or believe something that is not true that is. Your belief, however, does not change the fact that something is true or not.
"Trust" is a belief. If we trust someone or some thing, it means that we hold a belief that person or thing is true or reliable. If I trust you, I believe you to be reliable; it does not guarantee that you are in fact reliable. Trust is a vital and essential property for any relationship to succeed. We have to have trust in the grocer that our food is unspoiled, trust in the pharmacist that our medicines are correct, and trust in our banker that our money will not be stolen. The Bible has many, many verses on love, but I would submit that trust is a predicate for love's fulfillment. It is possible to love someone that you do not trust, even love your enemies, but love in its fullest sense requires trust.
Another pair of words that are commonly misused, or at least used in only their negative sense, are prejudice and discrimination. "Prejudice" actually means to "pre-judge", and in many cases this is also an essential practice. In fact, it may even be life-saving. I confess that I am prejudiced about rattlesnakes. If I see a rattlesnake, I may pre-judge it to be highly dangerous and likely to strike me, based on what I know about rattlesnakes. It is not feasible for me to get to know each and every rattlesnake, to determine if every single one is nasty or if some like to have their bellies rubbed. I therefore pass judgment rather quickly, and this saves time and prevents envenomation. To discriminate means to "divide" or "separate". This is also a necessary part of life. I chose to marry a human, not some other species. I discriminated on the basis of sex, and chose to only marry a woman. In fact, I discriminated against all other women by choosing only one, eliminating the legions of other women that I could have chosen. Well, maybe not that many. A few. A couple of them. (In fact, it was my wife that discriminated and chose me from all the other men.)
Trust and mistrust, prejudice and discrimination, are therefore essential parts of daily living. I trust my airplane mechanic to make sure that all the parts on my 1993 plane are still in working order. I am prejudiced against every single grizzly bear. And I discriminate against many fruits (wishing Eve had done the same). Prejudice and discrimination are wrong when they are done unfairly.
It is when someone violates our trust that our foundations in our relationship with that person are shaken. We judge someone to be reliable, we trust them to do something for us, and they let us down. Now our trust is broken, our belief in their reliability is shaken, and we must determine if this is a single event or if it requires us to define them as untrustworthy. Do we become prejudiced against them, and assume that we must now "pre-judge" their future reliability, and do we discriminate against them, separating them from the people that we do trust?
The Bible give us some direction. First, as Christians we are to love them. If we have a problem with them, we are to take it to them. If they still do not see the error of their ways, we are to take other Christians with us to discuss the matter. If they repent, we are to forgive them. If they reject us, we are then entitled to mark them as untrustworthy, meaning judge them as untrustworthy, and discriminate against them. We are still obliged to love them and forgive them, but it does not mean that we do not see the truth about them.
In the 1980's, Ronald Reagan had many negotiations with the leader of the Soviet Union, Mikhail Gorbachev. Reagan frequently appropriated and used a Russian proverb when dealing with Gorbachev, "doveryai, no proverai", meaning "trust, but verify", and it was through Reagan that this phrase actually entered modern discourse. However, I would submit that this is a false proverb. If you have to verify that someone is truthful or reliable, you can not really trust them. An accurate belief of trust does not require verification.
Many of us are too trusting, and will be shaken time and again when we find our beliefs to be untrue. Many others are incapable of trusting, and will never be able to have fulfilling relationships or even successful lives because at some level a basic level of trust is a requirement to function in society. Only the recluse or hermit has one person that they can trust, themselves--to some extent.
There are some lessons for the Christian here that are essential if we are to deal with our fellow man. First, we are to ardently strive in advance to determine if someone is worthy of our trust. The Ponzi investors were looking for something that would make them rich quick, and they failed to assess the man or his methods to correctly decide if he merited their trust. The Bible warns us in Psalms 118:8, "It is better to put trust in the Lord than confidence in men." Secondly, none of us are perfect, and others will let us down from time to time. We must not rush to judgment, nor become incorrectly prejudiced against them, or unnecessarily discriminate against them. We are to continue to love them and forgive them. Yet nowhere are we to be commanded to be fools. We must use our God-given wisdom to evaluate and discern how to proceed. As mentioned earlier, love in its fullest sense requires trust; to love those we do not trust we must trust in God.
Thirdly, we must always strive to ensure that no one ever has any doubt to trust us, and it is sobering to ask yourself, "Have I ever done something that would cause another person not to trust me?" Fourth, the hermit or recluse, and even ourselves, must be careful about trusting in one's self. We learn in Proverbs 3:5 to "Trust in the Lord with all your heart, and lean not on your own understanding." Finally, there are three persons that are perfectly and always trustworthy, the Father, Son, and Spirit. There never needs to be any verification of their reliability. In fact, not trusting in them will result in spending eternity with Satan, the most untrustworthy being of all. You don't have to trust me on this, just His Word. And I don't care how cute your pet rattlesnake is, I don't trust him.
One of my earlier articles described the difference between truth and belief, terms that are frequently misused. In summary, a thing that is true cannot be untrue at the same time; this violates the law of non-contradiction. A true thing must be true for all people. A belief, however, can be correct or incorrect. You may believe something to be true that is not, or believe something that is not true that is. Your belief, however, does not change the fact that something is true or not.
"Trust" is a belief. If we trust someone or some thing, it means that we hold a belief that person or thing is true or reliable. If I trust you, I believe you to be reliable; it does not guarantee that you are in fact reliable. Trust is a vital and essential property for any relationship to succeed. We have to have trust in the grocer that our food is unspoiled, trust in the pharmacist that our medicines are correct, and trust in our banker that our money will not be stolen. The Bible has many, many verses on love, but I would submit that trust is a predicate for love's fulfillment. It is possible to love someone that you do not trust, even love your enemies, but love in its fullest sense requires trust.
Another pair of words that are commonly misused, or at least used in only their negative sense, are prejudice and discrimination. "Prejudice" actually means to "pre-judge", and in many cases this is also an essential practice. In fact, it may even be life-saving. I confess that I am prejudiced about rattlesnakes. If I see a rattlesnake, I may pre-judge it to be highly dangerous and likely to strike me, based on what I know about rattlesnakes. It is not feasible for me to get to know each and every rattlesnake, to determine if every single one is nasty or if some like to have their bellies rubbed. I therefore pass judgment rather quickly, and this saves time and prevents envenomation. To discriminate means to "divide" or "separate". This is also a necessary part of life. I chose to marry a human, not some other species. I discriminated on the basis of sex, and chose to only marry a woman. In fact, I discriminated against all other women by choosing only one, eliminating the legions of other women that I could have chosen. Well, maybe not that many. A few. A couple of them. (In fact, it was my wife that discriminated and chose me from all the other men.)
Trust and mistrust, prejudice and discrimination, are therefore essential parts of daily living. I trust my airplane mechanic to make sure that all the parts on my 1993 plane are still in working order. I am prejudiced against every single grizzly bear. And I discriminate against many fruits (wishing Eve had done the same). Prejudice and discrimination are wrong when they are done unfairly.
It is when someone violates our trust that our foundations in our relationship with that person are shaken. We judge someone to be reliable, we trust them to do something for us, and they let us down. Now our trust is broken, our belief in their reliability is shaken, and we must determine if this is a single event or if it requires us to define them as untrustworthy. Do we become prejudiced against them, and assume that we must now "pre-judge" their future reliability, and do we discriminate against them, separating them from the people that we do trust?
The Bible give us some direction. First, as Christians we are to love them. If we have a problem with them, we are to take it to them. If they still do not see the error of their ways, we are to take other Christians with us to discuss the matter. If they repent, we are to forgive them. If they reject us, we are then entitled to mark them as untrustworthy, meaning judge them as untrustworthy, and discriminate against them. We are still obliged to love them and forgive them, but it does not mean that we do not see the truth about them.
In the 1980's, Ronald Reagan had many negotiations with the leader of the Soviet Union, Mikhail Gorbachev. Reagan frequently appropriated and used a Russian proverb when dealing with Gorbachev, "doveryai, no proverai", meaning "trust, but verify", and it was through Reagan that this phrase actually entered modern discourse. However, I would submit that this is a false proverb. If you have to verify that someone is truthful or reliable, you can not really trust them. An accurate belief of trust does not require verification.
Many of us are too trusting, and will be shaken time and again when we find our beliefs to be untrue. Many others are incapable of trusting, and will never be able to have fulfilling relationships or even successful lives because at some level a basic level of trust is a requirement to function in society. Only the recluse or hermit has one person that they can trust, themselves--to some extent.
There are some lessons for the Christian here that are essential if we are to deal with our fellow man. First, we are to ardently strive in advance to determine if someone is worthy of our trust. The Ponzi investors were looking for something that would make them rich quick, and they failed to assess the man or his methods to correctly decide if he merited their trust. The Bible warns us in Psalms 118:8, "It is better to put trust in the Lord than confidence in men." Secondly, none of us are perfect, and others will let us down from time to time. We must not rush to judgment, nor become incorrectly prejudiced against them, or unnecessarily discriminate against them. We are to continue to love them and forgive them. Yet nowhere are we to be commanded to be fools. We must use our God-given wisdom to evaluate and discern how to proceed. As mentioned earlier, love in its fullest sense requires trust; to love those we do not trust we must trust in God.
Thirdly, we must always strive to ensure that no one ever has any doubt to trust us, and it is sobering to ask yourself, "Have I ever done something that would cause another person not to trust me?" Fourth, the hermit or recluse, and even ourselves, must be careful about trusting in one's self. We learn in Proverbs 3:5 to "Trust in the Lord with all your heart, and lean not on your own understanding." Finally, there are three persons that are perfectly and always trustworthy, the Father, Son, and Spirit. There never needs to be any verification of their reliability. In fact, not trusting in them will result in spending eternity with Satan, the most untrustworthy being of all. You don't have to trust me on this, just His Word. And I don't care how cute your pet rattlesnake is, I don't trust him.
Wednesday, July 15, 2015
Picking and Choosing
One of life's most important duties is made in the choosing of people. Choosing the right person for the job, our friendship, and our other associates is so crucial, yet so often it is done with less deliberation than it requires. Sometimes, the choosing is done carelessly or even randomly. Choosing the leaders of our country is so important that the consequences of choosing poorly can be catastrophic for our nation; we have seen in recent weeks the results of choosing Supreme Court justices who do not much believe in the Constitution.
Other than choosing to follow Christ, there is no more important choice to be made in this earthly existence than the person we marry. A key choice to be made is where to worship, and under whose direction. Many people, especially young people, would be much better served if they chose their friends carefully, for often times our close associates have more influence on us than we would like to admit.
In the Bible, there are several instances where people were carefully chosen for their duties. In Judges chapter 7, we are told of instructions God gave to Gideon as he prepared his army to attack the Midianites. God felt that it was important to demonstrate His divine providence by having Gideon obtain victory in circumstances that would be otherwise impossible. He did not want Gideon winning the battle with a large number of men. In verse 2, "The Lord said to Gideon, 'The people with you are too many for me to give the Midianites into their hand, lest Israel boast over me, saying "'My own hand has saved me.'" First, God told Gideon to dismiss anyone who was afraid, and promptly 22,000 up and left, leaving 10,00 behind. Then He told Gideon to send his men down by the water, and told him to separate the men by the way that they drank the water, and he retained only the 300 men that brought the water to their mouths by their hands. And with only those 300 carefully chosen men, Gideon and his small army defeated the Midianites.
In Luke chapter 6, verse 12, we hear about Christ praying all night before a decision about choosing people: "In those days He went out to the mountain to pray, and all night He continued in prayer to God. And when day came, He called His disciples, and chose from them twelve, whom He named apostles." We can see by studying our Savior how important it is to choose people carefully, and consult God when we do so.
As a physician, I can assure you that it is extremely important when you need treatment to choose your doctor carefully. Likewise, it is critical that we choose the correct people to become doctors and train in the art and science of medicine. There are many who resent physicians, claiming they are paid too much and have undeserved prestige. However, the fundamental laws of economics, rewards and penalties, costs and benefits, play a role in who becomes a physician. When a profession becomes unattractive financially or burdened by regulation, fewer people desire to expend the costs to enter that profession. We have seen an unbelievable decline in people who want to train in my own specialty, Cardiac Surgery, over the last few decades.
When I applied for a residency in heart surgery, it was a highly sought after specialty, and you pretty much needed to be near the top of your class to get a training spot. Shortly after I entered private practice, and Medicare reimbursement began to be cut drastically, we began to see a sharp fall in the people who would be willing to spend four years in college, four years in medical school, and eight years in residency to be an open heart surgeon. In 1997, the number of applicants still exceeded the number of training positions, although the number of those positions had been reduced. At that time, there were 176 people in America who wanted to train in the 143 slots available. Currently, because so few people want to be a heart surgeon nowadays, the number of training slots has been reduced to 102, but only 80 people applied for those positions in 2012; only 80 people in a country of 300 million wanted to be a heart surgeon. As the residency programs still need to fill their positions in a time of declining demand, the quality of the trainees declines. Last year saw the highest failure rate on the Thoracic Surgery Board Examinations ever.
Likewise, we see entire medical school classes graduating where no one wants to go into General Surgery. It has become obvious to the residency programs that the quality of those entering such training has also diminished. Up to one-third of doctors graduating from General Surgery training are felt to need remedial training. When the number of people applying to train in General or Cardiac Surgery plummets, the residency directors can 't be picky about who they let in any more.
Even if you think that health care is a right and there should be a nationalized health care system providing care to Americans that they do not individually have to pay for, and that physicians should be paid much less because they are over-valued, you cannot force people at gunpoint to exchange valuable years of their lives and hundreds of thousands of dollars in educational debt to become doctors and not see commensurate rewards. And this leads to a severe shortage in qualified applicants.
I am not writing this to whine or to seek pity. I have had a good career that is clearly over half-way over; I am trying to address the problems the patients of the future will face with their doctors. You may feel that doctors are overpaid and over-valued by society. But with increasing regulations, paperwork and other governmental burdens, compounded by declining reimbursements, we see that the number and quality of physicians in some specialties is falling off a cliff. You may want to pick your doctor carefully, but you need to be aware of the "pool" of applicants from whence he came.
Now we come to the real tectonic shift in the grounds for choosing who will be a doctor. When I applied for medical school, only one in seven applicants was accepted, and at my particular medical school, it was one in twelve. One of the tests we all had to take was the MCAT, Medical Colleges Admissions Test, sort of like an SAT for aspiring physicians. Not only did we have to have decent grades, we had to score well on this test. We were tested on the knowledge we had acquired as undergraduates that we would need to succeed in medical school and as practicing doctors. We were tested on biology, anatomy, chemistry, physics, and biochemistry. It was an exceedingly rigorous examination, designed to select only those with an aptitude for learning the intricacies of the human body and its diseases. In medical school, we would later learn every muscle, tendon, nerve and bone in the body. We would learn every single chemical reaction and hormone, and the derangements of these functions as they caused illness.
The powers that be have now decided that a new test is needed to choose the doctors of tomorrow. The new MCAT will test medical school applicants with questions designed to test their knowledge of "psychology, sociology, and the biological foundations of behavior." There will be a review of "social inequality, class consciousness, racial and ethnic identity, 'institutional racism and discrimination', and 'power, privilege, and prestige'".
The MCAT's are going to qualify these people to become doctors not on their knowledge of all things medical, but by testing for their comprehension of "social inequality", "class consciousness", and so forth. I don't know about you, but when I go to the doctor, I could not care less about their views on such matters. I want them to have a deep and full understanding of how my illness needs to be diagnosed and treated. I really am not interested in how much you know about "institutional racism and discrimination", I want to know how much you know about curing my thyroid problem or my cancer. If I am seeing you as a patient and you are a surgeon, when you walk into the examining room I will wonder if you were one of the one in three who had to do remedial training before you were released to perform surgery without supervision, and who cares what your views are on "power, privilege, and prestige"?
God is sovereign over all, and yet we are allowed to make choices. He has shown us in His Bible the importance of picking and choosing wisely. Ironically, those who choose who will be a doctor today will likely one day in advancing age be patients who will need the utmost of skill and knowledge to diagnose and treat their illnesses, and will they then regret their choices? Those who vote for leaders that create the unwelcome environment in which physicians practice will also be receiving care from doctors that were poorly qualified applicants who were some of the few available for positions where there was not much competition. Unfortunately, almost all of us at one time will need healing services delivered by those chosen not for their aptitude for medicine but for their politically correct social beliefs. As a physician and Christian, my counsel to you would to be to pray to never get sick.
Other than choosing to follow Christ, there is no more important choice to be made in this earthly existence than the person we marry. A key choice to be made is where to worship, and under whose direction. Many people, especially young people, would be much better served if they chose their friends carefully, for often times our close associates have more influence on us than we would like to admit.
In the Bible, there are several instances where people were carefully chosen for their duties. In Judges chapter 7, we are told of instructions God gave to Gideon as he prepared his army to attack the Midianites. God felt that it was important to demonstrate His divine providence by having Gideon obtain victory in circumstances that would be otherwise impossible. He did not want Gideon winning the battle with a large number of men. In verse 2, "The Lord said to Gideon, 'The people with you are too many for me to give the Midianites into their hand, lest Israel boast over me, saying "'My own hand has saved me.'" First, God told Gideon to dismiss anyone who was afraid, and promptly 22,000 up and left, leaving 10,00 behind. Then He told Gideon to send his men down by the water, and told him to separate the men by the way that they drank the water, and he retained only the 300 men that brought the water to their mouths by their hands. And with only those 300 carefully chosen men, Gideon and his small army defeated the Midianites.
In Luke chapter 6, verse 12, we hear about Christ praying all night before a decision about choosing people: "In those days He went out to the mountain to pray, and all night He continued in prayer to God. And when day came, He called His disciples, and chose from them twelve, whom He named apostles." We can see by studying our Savior how important it is to choose people carefully, and consult God when we do so.
As a physician, I can assure you that it is extremely important when you need treatment to choose your doctor carefully. Likewise, it is critical that we choose the correct people to become doctors and train in the art and science of medicine. There are many who resent physicians, claiming they are paid too much and have undeserved prestige. However, the fundamental laws of economics, rewards and penalties, costs and benefits, play a role in who becomes a physician. When a profession becomes unattractive financially or burdened by regulation, fewer people desire to expend the costs to enter that profession. We have seen an unbelievable decline in people who want to train in my own specialty, Cardiac Surgery, over the last few decades.
When I applied for a residency in heart surgery, it was a highly sought after specialty, and you pretty much needed to be near the top of your class to get a training spot. Shortly after I entered private practice, and Medicare reimbursement began to be cut drastically, we began to see a sharp fall in the people who would be willing to spend four years in college, four years in medical school, and eight years in residency to be an open heart surgeon. In 1997, the number of applicants still exceeded the number of training positions, although the number of those positions had been reduced. At that time, there were 176 people in America who wanted to train in the 143 slots available. Currently, because so few people want to be a heart surgeon nowadays, the number of training slots has been reduced to 102, but only 80 people applied for those positions in 2012; only 80 people in a country of 300 million wanted to be a heart surgeon. As the residency programs still need to fill their positions in a time of declining demand, the quality of the trainees declines. Last year saw the highest failure rate on the Thoracic Surgery Board Examinations ever.
Likewise, we see entire medical school classes graduating where no one wants to go into General Surgery. It has become obvious to the residency programs that the quality of those entering such training has also diminished. Up to one-third of doctors graduating from General Surgery training are felt to need remedial training. When the number of people applying to train in General or Cardiac Surgery plummets, the residency directors can 't be picky about who they let in any more.
Even if you think that health care is a right and there should be a nationalized health care system providing care to Americans that they do not individually have to pay for, and that physicians should be paid much less because they are over-valued, you cannot force people at gunpoint to exchange valuable years of their lives and hundreds of thousands of dollars in educational debt to become doctors and not see commensurate rewards. And this leads to a severe shortage in qualified applicants.
I am not writing this to whine or to seek pity. I have had a good career that is clearly over half-way over; I am trying to address the problems the patients of the future will face with their doctors. You may feel that doctors are overpaid and over-valued by society. But with increasing regulations, paperwork and other governmental burdens, compounded by declining reimbursements, we see that the number and quality of physicians in some specialties is falling off a cliff. You may want to pick your doctor carefully, but you need to be aware of the "pool" of applicants from whence he came.
Now we come to the real tectonic shift in the grounds for choosing who will be a doctor. When I applied for medical school, only one in seven applicants was accepted, and at my particular medical school, it was one in twelve. One of the tests we all had to take was the MCAT, Medical Colleges Admissions Test, sort of like an SAT for aspiring physicians. Not only did we have to have decent grades, we had to score well on this test. We were tested on the knowledge we had acquired as undergraduates that we would need to succeed in medical school and as practicing doctors. We were tested on biology, anatomy, chemistry, physics, and biochemistry. It was an exceedingly rigorous examination, designed to select only those with an aptitude for learning the intricacies of the human body and its diseases. In medical school, we would later learn every muscle, tendon, nerve and bone in the body. We would learn every single chemical reaction and hormone, and the derangements of these functions as they caused illness.
The powers that be have now decided that a new test is needed to choose the doctors of tomorrow. The new MCAT will test medical school applicants with questions designed to test their knowledge of "psychology, sociology, and the biological foundations of behavior." There will be a review of "social inequality, class consciousness, racial and ethnic identity, 'institutional racism and discrimination', and 'power, privilege, and prestige'".
The MCAT's are going to qualify these people to become doctors not on their knowledge of all things medical, but by testing for their comprehension of "social inequality", "class consciousness", and so forth. I don't know about you, but when I go to the doctor, I could not care less about their views on such matters. I want them to have a deep and full understanding of how my illness needs to be diagnosed and treated. I really am not interested in how much you know about "institutional racism and discrimination", I want to know how much you know about curing my thyroid problem or my cancer. If I am seeing you as a patient and you are a surgeon, when you walk into the examining room I will wonder if you were one of the one in three who had to do remedial training before you were released to perform surgery without supervision, and who cares what your views are on "power, privilege, and prestige"?
God is sovereign over all, and yet we are allowed to make choices. He has shown us in His Bible the importance of picking and choosing wisely. Ironically, those who choose who will be a doctor today will likely one day in advancing age be patients who will need the utmost of skill and knowledge to diagnose and treat their illnesses, and will they then regret their choices? Those who vote for leaders that create the unwelcome environment in which physicians practice will also be receiving care from doctors that were poorly qualified applicants who were some of the few available for positions where there was not much competition. Unfortunately, almost all of us at one time will need healing services delivered by those chosen not for their aptitude for medicine but for their politically correct social beliefs. As a physician and Christian, my counsel to you would to be to pray to never get sick.
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