Reason for never being released

I have heard that it was deemed to be too dark for the American public, that they would lose faith in their physicians. As good as the book is, it's really not that great of a movie (at least the version I saw that had a horrible buzzing in the background the entire time).

I am an MD (Internist.) The Book was written by an IM Doc like Me who went crazy from his year at BBI took a year off and became a Shrink (LOL). MANY things are still relevant.

Everyone wants the NPC (no patient care) specialties (Anesthesiology aka "Gas" Dermatology, Radiology) and I have known MANY residents-very Good residents- who went back to square one with a new residency to NOT do Primary Care. This is not because of the brutality of the residencies (which are somewhat more Humane these days) but because being an Attending (full Bird Physician) sucks in these fields in terms of reimbursement, paperwork hassles and overall quality of life issues.

The "Gomers" and also "Gorks" (God only really knows)-Brain Dead Vegetables (!) are FAR more numerous than in 1973 when ole Sam Shem did HIS Internship.

Also notice, that, at least in the Book, (and I never Saw the Movie) the ones like The Fat Man and their Evil Chief "The Leggo" who "stayed" in Internal Medicine overwhelmingly did Fellowships in their cases in GI and Renal, respectively. Cardiology is a grueling five years past residency, but VERY Lucrative!!

The Major Difference is that Reimbursements for MDs have gone wayyy down and the HMOs severely rationed tests that can be ordered. Now, I will admit there were and in some cases still are excesses in my profession, particularly in the case of Surgical Specialists, Interventional Radiologists, and some outright corruption, but no matter how bad WE are, I guarantee that the CEOs of pharmaceutical companies and health insurance companies are much Worse, both for physicians and the welfare of the patient.

Surgical residencies are still sort of the Top Guns SEALS Marines etc. Brutal call schedule, weeding out folks even in the Fourth Year, but beaucoup respect and Big Bucks.

The Nurse as Sex Symbol thing is mostly Dead ))-;, their average age is like in the late Forties, mostly because there's noone Under them to replace them-it's an unpopular career now, except a few male nurses and Filipinos imported in. The Inner City places?? DON'T ASK! I've worked in a Few. It's sort of like the Stew...er..Flight Attendants in Pan Am days vs now

They didn't even show the Fierce Competition in Calculus Organic Chemistry and later Gross Anatomy prior to the residency. Not in the book and too Nerdy for most.

Not complaining, just sayin'. And make sure you don't overeat smoke too much share needles so you can at least be healthy until YOUR "Gomer" days.

Having read the book and watched the movie, all I can say is that much of the amusing dialogue will go right over the head of the average viewer. There is a whole lot of 'inside jokes' that medical people will appreciate, but the layman will not. I have shown the movie to friends, some of whom fall asleep while trying to watch it. Others get up and do something else while the movie is playing. All demonstrative of their inability to understand what's going on, on screen. OTOH, those who work with me in the e.r. understand everything perfectly. In the 40 years since I read the book, some things have changed, but the general routine of finding ways to make money on the insured patients has not changed a bit. It's more difficult, but I still see many rich physicians who have mastered how to do this. One key way is to hire a master billing person, who is worth their weight in gold. Indeed, a person who knows how to bill the insurance companies for maximum reimbursement will often be found to make six figure salaries while their employing physician group buys building after building, expanding their coverage of area to several counties, and hires their own specialists in every conceivable specialty, keeping all referrals 'in house', that means in their own company to keep every insurance dollar for themselves, not the other doctors or hospitals. Really good ones run their own urgent care centers as well.

That said, I doubt that the general public would enjoy this movie. They 1. wouldn't want to know what really goes on 'behind the scenes' in the medical profession (and no doctor will tell his patients that this movie is accurate, for fear of being, oh, sued?), and 2. won't understand a lot of the terminology. And that, I believe, is why the movie wasn't released to theaters back when it was made, especially since the AIDS epidemic was occuring right when it was made.

Enjoy the movie. Pass it around to your friends. This is what medical care in America is really like. It's a view 'behind the curtain' that no one wants to see, because they really want to believe that physicians are all brilliant, caring people who will save their lives and the lives of their relatives. All for a fee, of course.