Daily Inspiration Quote by Richard Dooling

A novelist doesn’t need an MD to diagnose what’s sick here: incentives. Dooling’s line is built like a punchline with a scalpel edge - a blunt contrast between the reimbursed drama of intervention and the unreimbursed intimacy of talking. The pacemaker stands in for the whole American faith in doing something measurable, billable, heroic. “Counsel you” is quieter, harder to code, and harder to sell to a system that treats time like overhead and hardware like value.

The intent isn’t to dunk on doctors; it’s to expose the machinery that pushes them. By phrasing it as “I get paid” twice, he makes the speaker sound less like a healer than a worker following an algorithm. That repetition is the subtext: moral choices get distorted when the financial signal is louder than the clinical one. The quote also smuggles in a darker truth about end-of-life care: it’s not just medically complex, it’s emotionally and politically loaded. A pacemaker is a decision that can be defended in a chart. A conversation about dying forces everyone - patient, family, clinician - to admit what the chart can’t contain.

Contextually, the line sits inside decades of Medicare reimbursement structures that historically rewarded procedures more than time-intensive counseling, especially before newer billing codes tried to address advance care planning. Dooling’s cynicism lands because it reframes “choice” in healthcare as something pre-shaped by what the system will recognize as legitimate work. The result is a culture where technology gets the microphone and mortality gets put on hold.