"Doctors coin money when they do procedures but family medicine doesn't have any procedures"
About this Quote
David Jones is putting a thumb on the scale of American medicine’s most awkward truth: the system pays handsomely for doing things to bodies, not for thinking, listening, and preventing problems before they become billable crises. The line is blunt on purpose. “Coin money” carries a whiff of profiteering, like revenue is being minted out of pain, while “doesn’t have any procedures” reduces family medicine to an undervalued service role in a marketplace that only respects tangible interventions.
The intent reads less like an attack on individual specialists and more like a diagnosis of incentives. In fee-for-service medicine, a colonoscopy, stent, or injection has a clean code, a measurable unit, a reimbursable “product.” Family medicine’s core work is messier: sorting vague symptoms, managing multiple chronic conditions, negotiating behavior change, catching cancer early because you noticed a small shift in a patient’s story. That’s labor, but it’s not legible to a billing system built like a vending machine.
The subtext is professional frustration and a warning. When you underpay primary care, you don’t just insult a field; you reshape the whole pipeline. Students chase higher-paying procedural specialties, primary care clinics thin out, access gets worse, and patients end up in ERs or specialist offices for issues that could’ve been handled upstream. Jones’s sentence works because it’s economically literal and morally charged at the same time: a quick jab that exposes how “value” gets defined when reimbursement becomes destiny.
The intent reads less like an attack on individual specialists and more like a diagnosis of incentives. In fee-for-service medicine, a colonoscopy, stent, or injection has a clean code, a measurable unit, a reimbursable “product.” Family medicine’s core work is messier: sorting vague symptoms, managing multiple chronic conditions, negotiating behavior change, catching cancer early because you noticed a small shift in a patient’s story. That’s labor, but it’s not legible to a billing system built like a vending machine.
The subtext is professional frustration and a warning. When you underpay primary care, you don’t just insult a field; you reshape the whole pipeline. Students chase higher-paying procedural specialties, primary care clinics thin out, access gets worse, and patients end up in ERs or specialist offices for issues that could’ve been handled upstream. Jones’s sentence works because it’s economically literal and morally charged at the same time: a quick jab that exposes how “value” gets defined when reimbursement becomes destiny.
Quote Details
| Topic | Doctor |
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