Volunteer? -You mean work for free!?

Politicians and hospital administrators asked doctors to help during the COVID crisis. Most have agreed. They do a day’s work and get paid a day’s wage. Some work for free.

There is another forced labor participation movement from US history class-the draft.

The draft ended in the 1970s. Now a time of crisis is used to compel doctors to “give back” and “step up for humanity.”

On February 21st, 1970, the Gates Commission presented its findings to President Richard Nixon. They detailed how the military could function with all volunteers.

Conscription was the way of life. When you hit age 18, you were a phone call away from deployment.

The principle of force went against American values. How do we have a free country but force service? It seemed contradictory.

Richard Nixon wanted to end the draft. Some powerful generals disagreed. The Gates Commission gathered those for and against an all-volunteer army.

One of the most powerful voices for an all-volunteer army was an economist. He had a fascinating debate with General William Westmoreland. Westmoreland wanted to preserve the draft.

The debate revolved around mercenaries and slaves. A mercenary is someone that works only for money. A slave works by force.

As he recounted in his memoir,

“In the course of his [General Westmoreland’s] testimony, he made the statement that he did not want to command an army of mercenaries. I stopped him and said, ‘General, would you rather command an army of slaves?’ He drew himself up and said, ‘I don’t like to hear our patriotic draftees referred to as slaves.’ I replied, ‘I don’t like to hear our patriotic volunteers referred to as mercenaries.’ But I went on to say, ‘If they are mercenaries, then I, sir, am a mercenary professor, and you, sir, are a mercenary general; we are served by mercenary physicians, we use a mercenary lawyer, and we get our meat from a mercenary butcher.’ That was the last that we heard from the general about mercenaries.”

Physicians now face a similar situation. Some have more free time with the canceling of elective care. Anything that can wait must wait.

Some exploitative hospital systems see this as an opportunity to guilt doctors into “helping.”

They are General Westmoreland’s. They praise the doctor’s service and willingness to “help out.” They don’t mention the doctors are slaves. Guilted into working for free.

Some Doctors must “volunteer”. For most this means volunteer to pick up a shift and get paid appropriately. Some are asked to work for free.

Others have been “reassigned.”

If a hospital is paying a full salary and there is no work for the doctor, then having them assist where needed is reasonable. This is assuming adequate PPE and compensation for the work and risk.

Some doctors are struggling to pay their staff. Some are defaulting due to a lack of clinical revenue. Working for free is not an option.

Doctors spent four years after college and many years in residency to gain knowledge. This knowledge is critical for treating COVID patients.

Working for free is disrespectful to their degree. It is disrespectful to their family that waits at home while they work. It is disrespectful to their parents that worked hard to help get them a good education. It is disrespectful to the hundreds of thousands of dollars in debt that it took to gain that knowledge.

The guilt trip is extreme.

“You took the Hippocratic Oath, you must help.” This line has come surprisingly from fellow physicians.

The Hippocratic Oath is that ancient text that prays to Greek gods. The text that swears to not use a pessary for abortion. The same text that says to never do surgery.

Doctors must agree to a ridiculous outdated oath. So, they must now risk their health and their family’s health and work for free.

Doctors are rich, they say. They can help in times of need.

Are we mercenaries if we want compensation for our work?

As the economist said to the general. If we are mercenaries then the politicians that ask us to “help out” are mercenaries. The hospital administrators that courageously work from home are mercenaries.

Doctors want to help. This is what we trained to do. We must be compensated for our training. We must be compensated for the level of risk. We have a family waiting at home for us.

Imagine the outcry if firefighters were asked to work for free during a disaster. There would be protests and marches. For good reason. Doctors would take part in the protest.

Instead at a time when doctors are most in need we here about “volunteering”.

Doctors and other hospital staff are facing pay cuts. Earned compensation and bonuses are delayed.

The added financial stress affects a doctor’s ability to provide the best care at work. We need our doctors focused on saving people from the virus. We don’t want them worried about their next paycheck.

To all hospital administrators and politicians out there. Ask doctors if they will volunteer to pick up a shift. Do not ask us to volunteer.

Do you want an army of doctor slaves? You will get what you pay for.

The MDpreneur is a physician with an MBA. You can read more articles here or follow on twitter.