Roblimo's Journal: Doctors Are Not Immune to the Recession

One of my wife's friends is a doctor's wife -- who is now on an austerity budget because, she says, her husband's pediatric practice now sees an average of seven patients per day, down from an average of thirty patients per day a year ago. He's laying off two more of his office staff people this week, and this is not his first layoff. The reason? My wife's friend says it's because many of her husband's patients' parents have lost their jobs and health insurance and can no longer afford to take their kids to a doctor for minor illnesses or regular checkups. And if something happens to their children that makes medical care necessary rather than optional, these newly-impoverished families seek out public health clinics or go to the local emergency rooms, and will only call their old pediatrician as a last resort.

This situation is not necessarily typical in the doctor business. We are speaking here about a Spanish-speaking (bi-lingual) pediatrician in Sarasota, Florida, one of the cities in the U.S. that is in a true depression, not a mere recession. We're also talking about a doctor who caters heavily to Spanish-speaking residents, a group whose members have historically depended more on the now-moribund construction industry for income than most others, and because of this is now experiencing an extraordinarily high rate of unemployment -- by some estimates as high as 40% or 50%.

And even Hispanic families here whose members still have jobs are feeling pinched. Many of them are facing reduced hours and, even if that's not a factor, feel obliged to help unemployed relatives. There has long been a local, truth-based stereotype of Mexican and Central American families packing four people into a one-bedroom apartment and six or eight into a two-bedroom place. Now families are doubling up, so that crowding is worse than ever.

An Anglo with a steady job or some kind of entitlement income (Social Security or an old-fashioned defined pension) may turn up his or her nose at the idea of so many people living in so little space, especially if the nose-turner is living alone in 1000 square feet or is part of a family of four that lives in a 2000 or 3000 square foot suburban house. The complacent love to sneer at those less well-off than themselves. I don't know why this is, but it is a habit among many in this part of the world.

But how many of the sneerers have taken in their laid-off relatives? Or send substantial part of their incomes to relatives in Mexico or Michigan or other places where the economy is even more depressed than it is here? Some, I'm sure, but not a huge percentage.

We can also sneer at families whose adults may be illegal immigrants, and point out that a Spanish-speaking pediatrician here probably has plenty of illegals -- or their "anchor baby" children -- among his patients. Still, when these children don't go to doctors as often as they should, the doctor's income drops, and employment in his office drops, and the risk of those children carrying commicable diseases goes up. And fine, yes, we can send all those families back to Mexico or Guatemala or which means the pediatrician will have even fewer patients and may eventually be forced to close his practice entirely, which means everyone who works for him becomes jobless and our already-high local commercial property vacancy rate will increase by one more unit.

I'm sure other doctors are also feeling pinched. From what I hear, mostly second-hand and third-hand, plastic surgeons and those who specialize in Lasik eye surgery and other optional procedures are also seeing their practices shrink, and more people are tryig to stick with their family doctors or internists instead of going to pricier specialists either because, now uninsured, they are paying for treatment out of their own pockets or because (my wife is in this second group) they can't afford the risk of their insurance company failing to pay all or part of a specialist's fee.

What's the point here? Nothing, really, except to point out that even businesses once considered recession-proof aren't. Gambling was once considered recession-proof but casino revenues are now way down from where they were a year or two ago. And the medical sector was once considered even more recession-proof than the gaming industry. But this no longer seems to be so. We don't have many doctors standing on street corners yet, holding their medical bags and signs that say, "Will Cure You for Food," but I have one relative and more than a few friends who have lost more humble jobs in the medical field (phlebotomy, lab techs, receptionists, etc.) and are now having a rough time feeding their families.

What should we do about all this? Unleash the now-discredited free market so it can work its so-called magic? Use more government subsidies or job-creation programs to put money in ordinary citizens' pockets? I have no idea. But I hope someone has one. Soon.

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Read more of my essays and see some of my videos at Roblimo.com