Locums and Lunacy

I've been trying to tell you that there's a Big Business scam raking in BEAUCOUP bucks, making a mess and dumping it on Obamacare.  Here's the scam.
Places - ESPECIALLY THE  WITHHELD, dig - pretend to be hiring doctors.  They post ads.  They collect resumes.  They whine and say that nobody's applying. 
They take these "unfillable" positions and BUNDLE THEM AND SELL THEM to BIG national physician enrollment firms doing "locum tenens" work.  If "your primary care doctor" is changing every six months, that's probably because they use locum tenens warm-bodies to fill the slots.  The locum tenens docs are cheaper - they are on "contract" and have no benefits - not even HEALTHCARE, for God's sake!  And if they don't zip the lip, and complain - they get walked off the premises - problem solved for management.  Henry Ford would be impressed!

Presto!  The WITHHELD gets a 30% discount over hiring someone; everyone gets bonuses.  The WITHHELD gets a guy or gal who's spent the last six months in Vermont or West Virginia; and after this shift, will move on to North Dakota or Nevada.  There are even some "trailer-parks" for the locums.  Campesino medicine, you betcha!  Move along, now, boys, move along!  Locums work is considered to be valuable for newly-divorced doctors who are single moms.  If you can get everyone into a Winnebago, and they're out of diapers, it's Partridge Family Time! (Or Joad family, or Dr. Snopes MD)  No ties to the local medical community; and no 'problems.'

Who owns the physicians?  Well, it's the big national locums companies, of course.  The whole racket probably moves a billion dollars a year through it, and with that sort of money comes friends - Federal friends and local friends.  Some physician becomes incontrollably independent, or just can't keep their yap shut, or goes to some liberal social awareness meeting against the hospital - zam!  That's it for you!  Once you work for locums companies, your "professional references" come from those companies.  Patients don't care for you?  Too bad - bye!  Maybe that's why the suicide rates are up for MD's.  As if anyone cares.
Everyone wins - even the patients; they get death benefits and a burial at the cemetery of their choice.  Box'em up, boys, this is for-profit medical care.

Best of all - answer all the complaints with "Obamacare!"  Now, this slick system's been in place for a dozen years, building and building - and the cost of medical care hasn't been plummeting along with it.  So the next whizbang techo-revolution that's coming to deal with the "pending doctor shortage," remember that it's a PLANNED pending doctor shortage - including at the WITHHELD.  Increased patient autonomy, freedom of choice, app-based self-diagnosis and self-treatment - remember, that's all they have in Guyana and Zimbabwe.  The vast majority of people never will see a doctor in their life.  And maybe, maybe that's the future for you, too.  Do you feel lucky to be an American, modeling our future on Turkish and Kenyan medical care?  I used to think we did things the other way around, were a beacon to the rest of the world.  Oh, well.