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Old 10-20-2010, 10:25 PM
 
10,720 posts, read 17,358,953 times
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Quote:
Originally Posted by hawkeye2009 View Post
The study in Pennsylvania that showed NO DIFFERENCE among US and foriegn grads evaluated physicians who were all from US RESIDENICES in three clinical diagnosis perameters. I would expect no difference among physicians (foriegn or not) who trained in US residencies, as everything you learn that is relevent in medicine is during your residency.

Medical News: Public Data on Doctors Poor Proxy for Performance - in Public Health & Policy, General Professional Issues from MedPage Today
All doctors in the United States are required to do residency in the United States. A foreign trained doctor cannot practice in the United States without having completed a residency in the United States first. This is pretty basic. How are you a physician? This is not some new rule either. This has been existence for the last 40 years at least. If you are going to pretend to be a physician, at least do your homework, go to this site

http://www.acgme.org/acWebsite/home/home.asp (broken link)
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Old 10-21-2010, 12:15 AM
 
10,720 posts, read 17,358,953 times
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Quote:
Originally Posted by rodomonte View Post
Exactly. My primary care provider ordered a complete blood panel the first time I saw him. It turned out not a single parameter was outside the normal range, yet he wanted me to come in for an office visit to discuss the results. I told his nurse I would not come in since everything was normal.
It is routine to discuss lab results with the patient in a follow-up visit regardless of what the results are. Lab results can be in the normal range but be high normal or low normal which could indicate a trend given a certain family history such as your glucose or blood pressure. If following up with your physician is too arduous for you then why even see one? If all you want is a set of labs, go to an urgent care. They will require you pay them a standard cash fee ($80-$100), they will run labs for you and fax it to you without asking you to follow up. Seeing a physician is not for everyone. It's only for those people who want to be properly evaluated and have the patience to do so.


Quote:
My urologist was about to give me a prostate biopsy in his office since my PSA was an unusually high 0.3. I found out I could get it in a hospital under general anesthetic instead. He certaintly didn't give me all the options.
That is because the risks associated with general anesthesia far outweigh the risks of getting a prostate biopsy in an office setting. Prostate biopsies are routinely done in the office and takes less than 15 minutes. He didn't offer that option because the standard of care is to perform it in the office. General anesthesia has complications of its own and most insurance will not cover a huge hospital bill just to get a procedure that is routinely done in the office in less than 20 minutes. Without trying to sound rude, asking to get a prostate biopsy under general anesthesia is similar to asking to be under general anesthesia for 1 cm laceration sutured. People are awake for far worse things like getting a central line placed.

Last edited by azriverfan.; 10-21-2010 at 12:31 AM..
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Old 10-21-2010, 02:08 AM
 
11,961 posts, read 12,783,756 times
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Quote:
Originally Posted by JetJockey View Post
I've seen A LOT of doctors, since I have a rare genetic disorder so I'd like to think I have a good grasp on how Doctors treat their patients. In my experience, I want a Doctor that's quick, gets ***** done, and doesn't take crap from the insurance company. I don't care where they grew up or what they look like and I certainly don't care about their 'bedside manner'. I'm not there to have a warm, loving conversation... I'm there because I'm sick and I want to be well. Period.

My current doctor is AMAZING. He is foreign (Indian), he doesn't beat around the bush and when he wants something done (a test, an MRI etc.) he badgers someone until they okay it. I appreciate that He has been more helpful in the past 3 weeks that he's been my PCP than my last one was for the past 2 years.

I guess it comes down to personal preference though.
Not everyone has tolerance for Hugh Laurie style medicine. I suspect there's some significant cultural differences going on with the OP & this general relationship of foreign docs in rural communities. I think it safe to say that sensitivity training given to missionaries abroad would be useful to these foreign doc's working in America.
I prefer professionalism over feel good too, however, I did see instances in teaching hospitals that were bothersome. I've seen foreign residents showing up with less than stellar motives. They struck me as in it for prestige and $$$$. The docs you refer to who go to bat for you are worth their weight in gold no matter where they hail. Stonybrook university has a pretty decent vetting process and I've noticed the lesser performing students got shuffled to less demanding specialties like physical therapy, radiology, or lab technicians so their coursework wouldn't go to complete waste.
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Old 10-21-2010, 08:06 AM
 
18,617 posts, read 12,057,646 times
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Quote:
Originally Posted by azriverfan. View Post
All doctors in the United States are required to do residency in the United States. A foreign trained doctor cannot practice in the United States without having completed a residency in the United States first. This is pretty basic. How are you a physician? This is not some new rule either. This has been existence for the last 40 years at least. If you are going to pretend to be a physician, at least do your homework, go to this site

ACGME | Accreditation Council for Graduate Medical Education (http://www.acgme.org/acWebsite/home/home.asp - broken link)

You don't even need to do a residency to practice medicine in the US.

Most hosptials and facilities have requirements of both residency training in your area of specialty as well as board certification. However, your liscence allows you to practice "medicine and surgery" (read it). I hope you remember that you got your liscence after completing NBME III? Ever "moonlight" in an ER during your residency? Was that "practicing medicine"? Different states have different requirements. Some "require" one year of residency training, but not even completion of a residency.

"Pretend to be a physician"? I think you are just sore becuse you are a FMG. We have already been down that road before. I trained in a residency that was ranked in the top three for my specialty and turned down residencies at MGH, Hopkins and Penn. Beyond your foreign medical school, where was your residency ranked?

If you are a physician, you know that the worst medicine in the US is practiced in the states with the highest density of FMGs. New Jersey, Florida, and Illinois are renowned for low quality care. Is it just a coincidence that these states have the highest percentage of FMGs? I think not. I can tell you as well from insurance reviews for a major insurer that a disproportionate number of medical errors and billing fraud that I look into is comitted by FMGs.

What do you suppose is the percentage of department chairs across the country who are FMGs? Is that a coincidence?

Last edited by hawkeye2009; 10-21-2010 at 08:18 AM..
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Old 10-21-2010, 08:18 AM
 
2,086 posts, read 2,162,884 times
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I hear ya. I have never had a good foreign doctor.
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Old 10-21-2010, 08:54 AM
 
Location: TX
1,098 posts, read 1,579,315 times
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Quote:
Originally Posted by harborlady View Post
... Stonybrook university has a pretty decent vetting process and I've noticed the lesser performing students got shuffled to less demanding specialties like physical therapy, radiology, or lab technicians so their coursework wouldn't go to complete waste.
I hope I'm just misunderstanding you here. Radiology is a competitive specialty that isn't easy to match into. Lifestyle for a radiologist might be considered less demanding than some other specialties, however the typical applicant for a radiology residency slot is definitely not going to be a "lesser performing student". (If you meant radiology tech then ignore all of this)
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Old 10-21-2010, 11:17 AM
 
Location: Up in the air
19,126 posts, read 26,546,096 times
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Quote:
Originally Posted by harborlady View Post
Not everyone has tolerance for Hugh Laurie style medicine. I suspect there's some significant cultural differences going on with the OP & this general relationship of foreign docs in rural communities. I think it safe to say that sensitivity training given to missionaries abroad would be useful to these foreign doc's working in America.
I prefer professionalism over feel good too, however, I did see instances in teaching hospitals that were bothersome. I've seen foreign residents showing up with less than stellar motives. They struck me as in it for prestige and $$$$. The docs you refer to who go to bat for you are worth their weight in gold no matter where they hail. Stonybrook university has a pretty decent vetting process and I've noticed the lesser performing students got shuffled to less demanding specialties like physical therapy, radiology, or lab technicians so their coursework wouldn't go to complete waste.
I had an organ removed due to a 'mistake' at a teaching hospital, so I've experienced bad medicine first hand.

If you want a feel good doctor, go for it. I've had enough of those... from my experience they simply don't have the cajones (if you will) to stand up for their patients in times of need. They don't have the urgency that other doctors have and I prefer not to deal with them.

I had a 'feel good' doctor that I fought with for nearly 2 years to get a simple MRI done... swapped doctors and he had it approved and scheduled within a week. The MRI wasn't frivolous either, it had been a yearly occurrence since I was 11 years old, so for over a decade I've been getting one done once a year due to some chronic problems. She didn't have the forcefulness to get stuff done in a timely manner.

Like I said, it's personal preference.
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Old 10-21-2010, 08:24 PM
 
10,720 posts, read 17,358,953 times
Reputation: 9919
Quote:
Originally Posted by hawkeye2009 View Post
You don't even need to do a residency to practice medicine in the US.

Most hosptials and facilities have requirements of both residency training in your area of specialty as well as board certification. However, your liscence allows you to practice "medicine and surgery" (read it). I hope you remember that you got your liscence after completing NBME III? Ever "moonlight" in an ER during your residency? Was that "practicing medicine"? Different states have different requirements. Some "require" one year of residency training, but not even completion of a residency.
You don't have to complete a residency but you are required to complete an internship at a U.S. program so you are required to train in the United States to practice here. And that is a moot point since it's extremely rare for a physician to choose to practice without completing residency. You are backtracking because you did not know that physicians are required to complete training in the United States. You were embarrassing yourself by telling people to see physicians who did residency in the United States as if people could see a physician who didn't do residency in the United States. Furthermore, physicians (M.D.'s) take the USMLE not the NBME. LOL!! Like I said, if you are going to pretend to be a physician, you might want to learn the basics.

Quote:
"Pretend to be a physician"? I think you are just sore becuse you are a FMG. We have already been down that road before. I trained in a residency that was ranked in the top three for my specialty and turned down residencies at MGH, Hopkins and Penn. Beyond your foreign medical school, where was your residency ranked?
Previously, you claimed to have trained at Iowa in their M.D./PhD program in neurosurgery. In this thread, you claimed you trained at Washington University at St. Louis. And we also proved that your program wasn't top 3 let alone top 25 in your field.Are you so ashamed of Iowa that you had to lie and say you went to Wash U? I'm sorry you were unable to do residency at a top program but Iowa is a fine program nonetheless. Unlike you I didn't go to Iowa, I went to UCSF for medical school, and Stanford for residency.

What type of physician are you really? Are you an internist? I don't know of many neurosurgeons who work in a clinic with 135 physicians, usually primary care doctors like internists work in large groups like that. LOL if you are going to lie and claim you are a neurosurgeon, you should realize they typically work in small groups since they are so rare. You also claimed you had a "brother" who was an internist in a large group in Tennessee, I'm guessing that's you? You also do chart reviews for insurance companies, which again is typically done by primary care doctors. I don't know of any neurosurgeon who has the time (or desire) to do chart reviews let alone post on City Data. There is nothing wrong with being an internist, we need more of those so I'm glad you are giving back to the community.

Quote:
What do you suppose is the percentage of department chairs across the country who are FMGs? Is that a coincidence?
And you don't think politics have anything to do with who becomes department chairs? It's widely known that both FMG's and DO's are often discriminated against from academic programs so how are you going to expect them to suddenly become chair of a department.

Last edited by azriverfan.; 10-21-2010 at 09:25 PM..
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Old 10-21-2010, 09:19 PM
 
10,720 posts, read 17,358,953 times
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Default hawkeye contradicts his earlier statement

Hawkeye stated he turned down Wash U
Quote:
Originally Posted by hawkeye2009 View Post
Wowser- a little testy.

1. I am older than you and applied for med school when the admission standards were tougher
2. I turned down Yale, UCSF, Northwestern, and Wash U to attend Iowa at the MDPhD program.
21% Medicare reimbursement cut goes into effect April 1st

Now on page 2 of this thread, Hawkeye tells us he went to Wash U in St. Louis for his medical training

Quote:
Originally Posted by hawkeye2009 View Post
It is a little tricky to navigate the waters. Just because somebody looks "foriegn", they may have great training. A guy I used to work with was Phillipine, but lived in the US since age 3. We went to Univ of Chicago undergrad, then Wash U in St. Louis (a very good training program) for everything. We thought it was funny when he got the "foriegn doctor" treatment, as he was and is a very, very good physician.
I don't like my foreign doctors

Hawkeye is obviously not telling the truth about his credentials.
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Old 10-21-2010, 09:25 PM
 
277 posts, read 136,404 times
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Quote:
Originally Posted by rodomonte View Post
I am stuck in a small town where most of the doctors are foreign. The only ones that take Medicare here are foreign. I saw my third foreign doctor today. He didn't introduce himself. He left without saying anything. All three just up and leave without saying anything. No bedside manner whatsoever. They only spend about 10 minutes per visit with me. They don't really volunteer any information. One said he would do a digital prostate exam the next time I saw him, then refused to do it. A neighbor also sees him and he wouldn't give him one either.

There is a huge difference between American and foreign doctors. Don't get me wrong. They are very smart, but they are very poor communicators. My goal is to move to a large city where I can find an American doctor.

Maybe I should complain to the medical board and ask them to give foreign doctors some sensitivity training in how to treat patients. No, that would be discriminatory. They will have to give all doctors this training.
Here is something you might want to consider: who are you getting the best diagnosis & care from? Does it matter if the doctor only spends 10 minutes with you? Because, in case you haven't heard, that is the going rate for an exam nowadays & it has been for years...seriously, for years now. This is nothing new. And you expect it to get better in the big city? Good luck with that.
I suspect you're whining just to be heard. Here's a tip: get to your appointment early, you'll be surprised how often they take you before your scheduled time (happens to me all the time). Also, if you have questions, ASK THEM. Don't expect your doc to be a mind reader. Oh & on that note, while you may have questions, keep in mind that yes, your doc is super busy so don't take up their time unnecessarily (lots of people do that...it's that whole "it's all about me & no one else mentality").
I've had doctors who aren't very bedside manner but hey, that's how the balls roll sometimes. Get over it & be grateful that A. you have insurance & a doctor (I assume) & B. you're still talking which means you're not on life support. Ain't life grand?!
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