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Old 05-28-2009, 02:20 PM
 
Location: Portland, Oregon
7,090 posts, read 7,244,247 times
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Medical costs are spiraling, but doctors pay (and they work harder then I ever could for it) is not as much of problem. A good amount is uninsured patients (Uninsured are costly for all, report finds - Health care- msnbc.com), a good amount is litigation, a good amount is those fancy new expensive machines (PET scans, MRI's easily cost 1.5 million+), and a good amount is the massive back office needed to deal with billing. I do it for a living so I see a good number of the expenses going in and out, if you cut a docs pay to make it even more frustrating and badly compensated...you're going to see a big drop in the quality of doctors as those who could make a good living doing other things will do just that.
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Old 05-28-2009, 02:24 PM
 
Location: Midwest Coast
1,170 posts, read 2,416,587 times
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Quote:
Originally Posted by CosmicWizard View Post
vdy1985 wrote:
I don't know about you, but I want my doctor to be the smartest and the most competent... that is more important to me than them being nice (though that would be a plus, and to be honest all my experiences with physicians have been very positive).
Are you assuming that being nice and being competent are mutually exclusive? Rather than having to choose one or the other, as a prospective patient of a doctor I WANT BOTH?
Not saying that at all, in fact if you see in the ( ), I added that my doctors have been competent and compassionate.
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Old 05-28-2009, 02:27 PM
 
Location: Sandpoint, Idaho
2,118 posts, read 3,143,056 times
Reputation: 1990
Quote:
Originally Posted by vdy1985 View Post
Uh what? The AMA has very little political clout. Hence, the stranglehold on healthcare by the Insurance lobby and Big Pharma. Insurance companies with all their red tape have taken the fun out of doctoring, and the income, hence they work more and more hours just to maintain the same income they did in the past. And finally, only 30-40% of practicing physicians are a part of the AMA.
AMA's political and regulatory clout is substantial as is its influence on state medical boards. The big four, the AMA, Big Pharma (with their devious undermining of the credibility of medical research) Slashdot | More Fake Journals From Elsevier , the insurance lobby, and the trial lawyer guild are REALLY hard to differentiate in the sense of fighting for the patient.

Why not try a multi-tiered system like Singapore's? They have a wide range of medical service providers, not all of whom have the high-end training as in the US. Again, the university faculty analogy is useful. The vast majority of high end research is done by a fairly short-list of faculty within a short-list of schools. Yet the focus on public or perish is pointless at the mid-tier or blow schools. Those students need basic yet rigorous intellectual development.
Medical services also serve the elite at the expense of a worn out middle class.

Of course, the usual response is, "don;t you want the know you have the best trained physician servicing your family?" My response. One, no, actually I do not. What I do want is someone who can address the needs I have. As a father of three, the vast number of visits to the hospital and to the clinic have been for fairly basic things. On the occasions I need a Mercedes I'll rent one, but for 98% of my driving a Civic will do just fine.

Two, I have lived in a number of countries, and quite frankly the care received overseas has been much better than the care received in the US.

Leave the hardcore cases for the elite hospitals and revamp the provision of medical services to the other 90% of the population and cases that brings back the humanity into treatment. The "Airport Security" model of hassle coupled with indignity and a touch of incompetence by neglect is just an ugly model.

Quote:
Originally Posted by vdy1985 View Post
And there is no medical tourism to Canada. Canada outlaws private practice. And if you look at the wealthy from other countries, they are coming here to get treated.
1) Not True. Perhaps limited at this point Canadian Healthcare International but...there is more to come... A cure for Canada : Dr. Brian Day

2) Your statement on the wealthy is exactly the point. For the vast majority of Americans earning less than $150K a year, simpler forms of healthcare is needed, not high end or discretionary treatments. In many aspects of life beyond medicine, the human welfare services have become "tournaments," where the top performers get a extraordinary percentage of the spoils. That British royalty and pop-stars get their treatment in the US is an embarrassing defense of the economic dimensions of medical care in the US. How on earth can you not see this?

The fact that it is expected that 12 million US medical tourists expected by 2012 is a red flag if there ever is one.

Isn't amazing to note see Canada drooling over the prospect of American patients at a time when Canadian healthcare is seen as bloated?

The problems here are of course aspects of class. I would suspect that the average income of the medical tourist is going to be fairly high, probably middle to upper middle class...wealthy and knowledgeable enough to jet to a foreign hospital but not rich enough to get the platinum class treatment in the US which few can afford.

Quote:
Originally Posted by vdy1985 View Post
And it is there fault that the US is so obese? I think not. Despite being so unhealthy, medicine has increased life expentancy and quality to life to the highest age ever. Get your facts straight before you try to slander a profession and the people who took great sacrifice to learn the art of medicine. Like some balanced posters have said, there are crappy people in every profession. Let's leave it at that.
Greater life expectancy (measured at birth) has more to do with economic well-being and education than the provision of healthcare in the US. And BTW, I would not not crow too much about US stats on healthcare. The US numbers are quite poor.

This is not an attack on medical services per se (I did quite clearly point out the angels & gentlemen in the field), but on the exorbitant costs and poor services offered by US providers. They stink. You might want to pay closer attention, instead of not hear what the client base is screaming out to deaf ears. The stats, $ figures, trends in costs and medical tourism, and boatloads of anecdotal experiences are pretty darn clear to see, so being defensive is a rather futile enterprise.

Look, dirty laundry is one thing. I agree, every profession has it. But when ranks are closed and leaving so many high and dry with extracting ever higher rents, can you or any other medical professional really truly be surprised at the growing call for socialised medicine? Wake up before democracy does its thing at makes the necessary reforms for you.
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Old 05-28-2009, 02:31 PM
 
Location: Wherabouts Unknown!
7,527 posts, read 11,397,326 times
Reputation: 8414
subsound wrote:
you're going to see a big drop in the quality of doctors as those who could make a good living doing other things will do just that.
This is just an assumption that may or may not happen. I'm betting that it would not happen. My assumption is that a new class of service oriented doctors would emerge to take the place of those whose primary concern is to make a good living. ( $100K is still a very good living! ) If the main concern of a doctor is to make a good living, then I hope they DO indeed leave the world of medicine and go to other professions.
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Old 05-28-2009, 02:38 PM
 
Location: Sandpoint, Idaho
2,118 posts, read 3,143,056 times
Reputation: 1990
Quote:
Originally Posted by subsound View Post
Medical costs are spiraling, but doctors pay (and they work harder then I ever could for it) is not as much of problem. A good amount is uninsured patients (Uninsured are costly for all, report finds - Health care- msnbc.com), a good amount is litigation, a good amount is those fancy new expensive machines (PET scans, MRI's easily cost 1.5 million+), and a good amount is the massive back office needed to deal with billing. I do it for a living so I see a good number of the expenses going in and out, if you cut a docs pay to make it even more frustrating and badly compensated...you're going to see a big drop in the quality of doctors as those who could make a good living doing other things will do just that.
I agree, wholesale cutting of doctor pay on its own will not help. And I really do not blame good doctors out there, just like I would not blame the many good teachers in bad schools. But like these bad schools, the problem is institutional. The rules of the game are now fully aligned against the average patient. While doctors are worn out, they should not once for a second dismiss the sheer terror and frustration felt by the end user...not while they are making the coin they make and while many patients get a combo of the arrogance and expense. Simply immoral.

It reminds me of the airline industry in the US. The US used to be synonymous with friendly travel. Now it is inhumane both at the airport and on the plane. Think not? Try flying Emirates or Singapore Airlines. Not first-class, mind you, where the treatment is quite wonderful or even business, but when you are in crammed into cattle cars and attended to (or not) by people who are almost as miserable as you.

This is America, we can do better!
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Old 05-28-2009, 02:39 PM
 
5,748 posts, read 7,329,804 times
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Quote:
Originally Posted by cjma79 View Post
A great majority of the people that go to med school is because of the money.
I disagree. I think a great majority go into medicine for the prestige. By the time a doctor pays his (or her) student loans and malpractice insurance, there isn't enough left to make it about the money. He'd have been better off training to be an electrician.
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Old 05-28-2009, 02:44 PM
 
1,257 posts, read 2,724,859 times
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Quote:
Originally Posted by CosmicWizard View Post
subsound wrote:[indent][ $100K is still a very good living! ) .
100K for a doctor is not a very good living. First, need to pay taxes/ss/med care fee. After that, malpractice insurance and disability insurance (~3-5K per month for a surgeon, if hands shake or eye has some problem, the career is finished). After that, 1-2 k per month for education loan. On top of that, 24 hr on call for at least two weeks per month. Then the first wife tends to leave because the doctor was never at home. Then there is a child support after divorce. Then all the friends think they are rich and expect a very good gift... Tough life.
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Old 05-28-2009, 02:52 PM
 
1,257 posts, read 2,724,859 times
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Quote:
Originally Posted by formercalifornian View Post
I disagree. I think a great majority go into medicine for the prestige. By the time a doctor pays his (or her) student loans and malpractice insurance, there isn't enough left to make it about the money. He'd have been better off training to be an electrician.
You are absolutely right. My husband is a surgeon. He goes into medicine for the prestige. We live in a nice house (~300K) because we can get loan easily. But education loan, business loan, mortgage, taxes, and insurances... never end. I learn to live by myself, do everything by myself because he has to deal with patients' call all the time. Last year, when I have to put our dog down, he wanted to come but there is an emergency. The patient has no insurance. He knows that he wouldn't be paid for service and he knows he had to there for the patient, not for me and not for our dog. The whole incidence hurt our relationship very much. I am still wondering whether I can ever count on him. I wish he is an electrician. I would rather rent and have someone there when I need him the most.
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Old 05-28-2009, 03:17 PM
 
Location: Wherabouts Unknown!
7,527 posts, read 11,397,326 times
Reputation: 8414
Sandpointian wrote:
The rules of the game are now fully aligned against the average patient. While doctors are worn out, they should not once for a second dismiss the sheer terror and frustration felt by the end user...not while they are making the coin they make and while many patients get a combo of the arrogance and expense. Simply immoral.
Very well stated!
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Old 05-28-2009, 05:44 PM
 
2,742 posts, read 5,045,387 times
Reputation: 488
Quote:
Originally Posted by CosmicWizard View Post
I'm actually quite sane! IMO, medicine is already in a self destruct mode.
It wouldn't have to be 20 years. I wrote: the taxpayers would pay for med school in exchange for perhaps 20 years of service
Who said it was in a destructive mode?

Quote:
I totally disagree. Very few doctors I have ever know would have the courage to leave the country. Also I'm betting that a new kind of doctor would emerge to take the place of the few doctors who flee because of financial reasons. The new doctors would be people who valued service and medicine primarily, and monetary gain only secondarily ( not there there is anything wrong with chasing the almighty dollar. Medicine just ain't the place for it. )
This is funny we are going to bet the future health of the country on your little gambling game. Right now we have a large % of foreign doctors coming to this country. I am sorry is not going to work, with all of the FMG (Foreign Medical Graduates) and all of the AMG (American Medical Graduate) we still have a shortage, imagine when we implement your ideas.

Quote:
I don't have any proposals for that. This thread is about doctors and medicine.
I see, so only this services not others.
Quote:
I wouldn't advise that. Do your own research and form your own conclusions. I simply shared my opinion.
I don't get it, are you talking about changing our health system with your opinion but then we can't question your opinion?
Quote:
That is not what I had in mind. I hope you'll forgive my inability to communicate my intention with clarity. I think it would be great if doctors genuinely, from the heart, socialized with their patients.
Yeah, but that didn't sound like your first intentions.

Quote:
Sometimes yes, but as a matter of protocol ...IT SUCKS!
If for the protection of the patient and doctor.
Quote:
Becasue they're scared of the lawyers, eh?
Because it serves a purpose, for example, to be honest the first Pt that died in my arms was in Kings County Hosp. I was a student doing my first rotation, and that one was the one of the most painful (the other was doing Peds) after this one, you start to feel less and less with each other. You just can't take home your job, you would go crazy. Is better for the PT and doctors health to be cold.
Quote:
Just wear regular clothes like everone else. Dress comfortably with a clean shirt and pants. Jeans and a T shirt would be fine with me. BTW what doctors wear is not really a big issue with me. The white coat thing is just a minor annoyance.
The white coat is for protection (body fluids from patients, bacteria, virus, etc) so that a doctor can take out the coat and have relative clean clothes when he gets home and dont get family infected with patients disease.


Quote:
You really scared me with the Cuba socialism comment. I'm looking for a place to hide now.
Well, if the government controls medicine the way you are saying then it would be like Cuba, what do you want me to say. I have family in Cuba and they dont have a good health care plan,
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