Koop prescribes hard work

C. Everett Koop, the former U.S. Surgeon General under Ronald Reagan, had a message of professional pride for more than 300 physicians, nursing students and faculty, and other University affiliates.

“For years, when magazines took polls on the most-admired profession, medicine was always number one,” he told his audience during his April 24 talk at the Nursing School. “Now doctors are number 17. Do you know who’s first?”

“Nurses,” blurted at least 20 audience members.

“No, I didn’t say who should be first,” Koop said, prompting laughter and a smattering of applause. “Pharmacists have been first for nine years. Why does their job merit more respect than yours?”

This drop in public admiration of physicians, Koop said, is a result of physicians’ diminished professionalism, which in turn accounts for part of the current health care crisis.

Koop, who began his medical career as a resident at Pennsylvania Hospital before teaching and practicing pediatrics at Penn for more than 30 years and serving as the surgeon-in-chief at the Children’s Hospital of Philadelphia from 1948 to 1981, entitled his talk “The Right To Health Care: Has the Time Come?”

In the first three minutes of his talk, he answered his own question: No, it has not.

Then he elaborated.

“Health care is not free, like freedom of speech or freedom of religion,” Koop said. “If somebody has a right to health care, somebody else has an obligation to pay for it.” Citing polling data, he said that most Americans don’t want to pay for other people’s health care.

Koop also looked to the Constitution. “What we call constitutional rights, the rights in our Bill of Rights, are things government cannot take away from us, not things the government must give us.”

He said establishing a right to health care for all Americans would raise more thorny questions. For instance, would the right cover only American citizens? What about legal residents or undocumented immigrants?

And then there’s the question of how much health care is enough.

“Would we want to cover a coronary bypass for a healthy 50-year-old?” Koop asked. “Yes, of course. How about for a frail 84-year-old? Well, I’m not so sure. How about for a healthy 84-year-old like the one who’s now talking to you?”

Koop, who didn’t look a day over 60 in his blue three-piece suit and bright red bow tie, paused to let his admission sink in.

And he had more to say about his personal connection to health care debates.

“I used to be quadriplegic,” he said. “In 1986, had I lived in the United Kingdom with their right to health care, I would have been nine years too old to qualify for the surgery that restored my health.”

Koop concluded by saying that the answer to today’s health care crisis has to come from medical professionals.

“People in medical professions should work till the job is done, not by the hour,” he said. “I was only paid for about 30 percent of the surgery I performed during my career. There needs to be a revitalized ethic of self-sacrifice in the medical professions.”

When Koop finished answering the audience’s polite questions — no one objected to being lectured on the value of long hours and lower pay — 500 underadmired present and future medical professionals gave their former Surgeon General a resounding standing ovation.


Originally published on May 3, 2001