As It Was … But Not Now
A Memoir
by
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This is the story of a boy educated in the public schools of the rural South who was transformed into a physician by Harvard, Vanderbilt, and London’s Hammersmith Hospital. Afterwards, NIH and Baylor College of Medicine provided him an environment to study the vagaries of academic medicine in America’s changing ‘health-care’ industry.
Today, students are being taught medicine in an environment where the daily media enumerate crimes being committed in medicine’s domain: falsifying diagnostic codes to increase reimbursement; billing for unnecessary laboratory tests; unnecessary surgery; and corporate offers to doctors to hospitalize people.
Tax-exempt “teaching and research hospitals” are using their tax-derived profits to advertise their contributions to unrelated tax-exempt organizations. Medical school faculties, although salaried by tax money, now compete with their graduates in the private practice of medicine.
Other forces are reshaping ‘health care’ in the USA: method of payment for service, volumes of new regulations, new drugs, expensive diagnostic procedures, and greater use of non-MD personnel to provide primary care. This perpetual conflict continues to change American medicine’s manners, customs, traditions, and principles. It has also raised pertinent questions.
Is the social setting based on this new morality appropriate for medical education? Is your medical school a business or a place of learning? Is it a community of scholars? Is it a part of a university or is it a vocational school? Is your faculty’s ‘precept and example’ suitable for developing ‘humane’ physicians and surgeons?
Ten years ago I featured a question asked by the founder of American scientific medicine, William Welch: Is medical education’s mission to increase the earning capacity of the profession or is it to improve the public welfare and to advance medical knowledge?
Perhaps, my memoir will offer insights in answering Dr. Welch.
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About the Book
In 1923 in Andalusia, Alabama, twenty-odd miles north of the Florida line, a physician was born. It’s a place deep in the piney woods that was an area of sand beds, sand roads, and sandspurs. In As It Was … But Not Now, Dr. Joseph Merrill tells his story that began in that little town more than ninety years ago.
In this memoir, Merrill recalls a boy educated in the public schools of the rural South who was transformed into a physician. NIH and Baylor College of Medicine provided him an environment to study the vagaries of academic medicine in America’s changing health care industry.
Filled with anecdotes and stories from his youth to his college days in medical school to his career as a physician, Merrill offers a look at the life of a doctor and the ebb and flow of the practice of medicine.
About the Author
Joseph Merrill is a ninety-one-year-old physician who attended Harvard, Vanderbilt, and London’s Hammersmith Hospital. Merrill worked at NIH and Baylor College of Medicine. He currently lives in Houston, Texas.