White Coat, Same Boat

Written by Ian Goldstein / Illustrated by Stefan Sirucek

Recently, I went to the dermatologist, and she told me how little she was being paid: “Ian, if you saw how much I was making, you would be shocked — shocked!” She then checked my back for moles, and I left.

This illustration was inspired by the idea that many doctors and patients are often in the same boat: struggling to navigate the health insurance industry with limited time and resources. In 2025, The Guardian spoke with doctors about how the broken system of delays of vital medications are killing patients. The article states:

“There’s good evidence that these kinds of delays literally kill people,” said Dr Ed Weisbart, former chief medical officer for Express Scripts, one of the largest prescription benefits managers in the US. “For some people, this isn’t just an inconvenience and an annoyance and an aggravation.

“It’s a death sentence, and the only reason the insurance companies do that is to maximize their profits. The fact that they might be killing you is not in the equation of what they care about.”

The stakes are high for all of us. This piece by The Journal goes more in depth on how doctors are suffering too:

Dr. Alan Nguyen: I have to put out maybe 30 minutes to an hour or so three times a week. I work in a very large office, so we have a prior authorization department that sends in most of the information when the insurance requests it. But I have previously worked in offices where the doctor does not have a lot of resources and can't hire all the staff to do that, so they end up doing the majority of it and the paperwork becomes very time-consuming.

I’m rooting for my dermatologist. I’m rooting for ALL dermatologists (except the asshole ones).

For this Substack, we’d love to hear from more doctors directly, so if you’re reading this, and you’re a doctor, reach out!

Written by Ian Goldstein and illustrated by Stefan Sirucek