Two Americas Reaches the Doctors

Democrats and Republicans Aren’t Just Divided. They Live in Different Worlds. wsj.com I avoid political opinions on my blog but sometimes they are a chance to think an issue through.   Usually the WSJ boots me as an inferior non-subscriber but they let me look at this one on FB where an assigned FB Friend must have either posted it or commented on it. There have been a couple of popular books on this. Charles Murray's Coming Apart analyzed a 50 year trajectory of separation having to do less with political identification but more with economic circumstances. He was rather condescending to the underachievers, as I might anticipate from other writings that suggest colleges are too often attended by students not academically qualified to be there, but noted that economic distress also clustered with divorce, housing instability, educational underperformance, and jeopardized health that filtered over generations. Most of the analyzed 1960-2010 span did not have political divide as part of the cluster. Robert Putnam's Our Kids looks at similar data in a more sympathetic way. The economically stressed were looked at as displaced rather than as underachievers, but with the same bimodal result as the WSW article, complete with political division and with isolation of each group from the other. It's really a megatrend. In his book Tailspin Steven Brill notes that historically public officials anticipated this possibility decades ago and even debated protections to those who would be predictably displaced but those got sidetracked in the name of expediency.  And as America divides with a political, social, and economic intersectionality, one group does not readily cross over to the other.  Economic data from the WSJ indicates that prosperity follows Democrats while those displaced from their traditional niche default as Republicans.  The divisions are not equal by any measure, nor is the hostility equal. Doctors puzzle me a little in this framework.  Sermo has largely devolved into a right wing echo chamber though the physicians I would suspect are more personable in person than on an unedited screen.  They don't seem to be at the top of the medical food chain, often bitter posting individuals who never were granted the Hebrew chayn, which is best English translation may be grace.  They all have university educations, mostly high income, public respect, and mostly secure lives.  Yet they come across as pounced upon by the forces they cannot control, be it the government, the insurers, bosses who are less accomplished than themselves.  The optimism seems absent as does the joy that taking care of patients once created for them.  The divide in general may be economic.  The divide among the doctors may be one of perceived trajectory as well as whether the daily work brings gratification in sufficient amounts to overcome the annoyances.  They do good work but it does not seem to them to be its own reward.  Since the divide involves prosperous professions, it should include the sense of loss of security or future prospects as part of the intersectionality.  I don't detect that same bitterness from the senior physicians, either at work or at professional meetings.  Just as we don't seem to cross categories based on prosperity or struggle, we don't cross them based on personal bitterness or satisfaction either.  Irrespective of professional or economic circumstances, if you perceive yourself as trampled, you probably are.  It may challenge the medical workplace for some time to come.