To see ouserlves as others see us!"
Robert Burns To a Louse 
Why Things Never Change
Eugene A. Stead, Jr. (Click for printer friendly variant)
The American medical schools have never been interested in producing enough doctors at a reasonable cost to service the needs of our people. Many persons are aware of this fact and each year one or more major conferences are held to suggest changes in the present system. The conference publishes a lengthy report which is rarely read and nothing happens. Why?
The members attending the conference are opposed to change. Let us look at the people who attend the meetings and write reports. They all have one thing in common. They can afford to go to a major city, stay at the best hotels and spend several pleasant evenings with their wives. (Remember I am 93 years old.) The institutions which employ them pay for travel, lodging, meals and after dinner entertainment.
I once had a friend who asked these professional meeting professionals who did their work when they were away from home. They said they had never been asked this question. On reflection they all agreed that the persons that covered their time away from home were the same persons who did the work when they were at home.
About one third of the members of the conference are public minded citizens who know that all is not well and hope that the conference will solve one or more important problems/ They do not attempt to force any change that is opposed by the doctors. After all the MD has spent more years in school and has invested more money in education than any other segment of our society. Education is accepted as a magic tool which makes men wise. The report of the conference in the end protects the medical schools and their professors. Medicine remains an elitist profession with little interest in universal medical coverage.
The doctors that care for the majority of patients rarely attend these meetings. They are at home caring for the people. Doctors are not the best business men and only a few practices structure their work so that natural leaders can become active on the national scene. When they are away from home, no one pays for their time. They are effective and admired in the small area that they touch, but no one picks up the check when they go to national conferences.
We do have national foundations that specialize in medical matters. Unfortunately executives of these foundations are babied by the medical professionals who attend to the needs of people who give away money. These individuals are well respected in their world and completely shielded from the real world.
The Institute of Medicine is peopled with doctors who see very few patients. The members all have titles that recognize their membership in foundations, medical schools or industry. Practicing doctors,as members of the IOM are rare. The result is that the Institute of Medicine supports the status quo.