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View Poll Results: Where do talented new doctors tend to establish themselves?
Near affluent, metropolitan areas where they can more rapidly recoup their investment 21 77.78%
Equally distributed and available most places 6 22.22%
Voters: 27. You may not vote on this poll

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Old 05-24-2014, 03:19 PM
 
14,266 posts, read 24,016,895 times
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Quote:
Originally Posted by StressedOutNYer View Post
There is a difference between being pessimistic and being realistic. I belong to the "hope for the best but plan for the worst" camp, myself.

ETA: To get back to the original topic, I don't want to be seen by some rookie MD -- no matter how bright or innovating his/her thinking may be. Because I have multiple conditions which affect each other in various ways, I want a doctor with as much experience as possible and who is established in his/her profession.

With me, I like going to the same doctors when I need care. Otherwise, I spend a good hour plus giving the full medical history. And in the large institutions, you give the history to the ER doctor, the doctors on the floor, the specialists .... all at a time when you feel truly miserable. Also, you run into doctors who want to change all your medications, treatments, etc. which really messes up the continuity of care.

People who are fortunate to not have a chronic condition do not understand it.
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Old 05-25-2014, 09:12 AM
mlb
 
Location: North Monterey County
3,194 posts, read 2,862,863 times
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My mother adored her physician who was in his 80's when she was.

He was a quack.

She had knee surgery and he failed to adjust her coumadin postoperatively. She suffered a debilitating stroke that put her into assisted living.

Age and experience do not equal competence.

Give me a teaching hospital anytime. I've worked them - and currently live close to one. I've kept my GYN for over 20 years because he's "teachable". I don't have any chronic illnesses - thank god - but I do have issues that I need addressed - that are not common in the population. Only he understands my concern for this. Other doctors are offputting about this issue and do not have the level of concern I require.

Oftentimes you can receive much more up-to-date therapies and care via university hospitals. Most doctors who have been in practice for many years - are NOT up to date on meds or therapies. Neither do they have the time nor take the time to research them.

Same with dental care. When I lived in San Francisco - the University of the Pacific Dental school had a clinic downtown. Best Dental Care Ever. And at a sliding scale. I hope to be in proximity to a dental school as well when I retire.
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Old 05-25-2014, 11:36 AM
 
Location: Glenbogle
730 posts, read 1,028,761 times
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Quote:
Originally Posted by mlb View Post
Age and experience do not equal competence.

Give me a teaching hospital anytime. I've worked them - and currently live close to one. I've kept my GYN for over 20 years because he's "teachable". I don't have any chronic illnesses - thank god - but I do have issues that I need addressed - that are not common in the population. Only he understands my concern for this. Other doctors are offputting about this issue and do not have the level of concern I require.

Oftentimes you can receive much more up-to-date therapies and care via university hospitals. Most doctors who have been in practice for many years - are NOT up to date on meds or therapies. Neither do they have the time nor take the time to research them.
I don't think you can generalize in either direction about the age/experience factor. In my own experience, the older more experienced MDs have been the ones MOST competent and MOST up to the mark on the newest methods, therapies and meds. The ones who have screwed up the most have been, without exception, the younger (thirties) doctors. And in one case, the mistake made by the younger doctor would literally have cost me my life, had I not been uneasy enough about the diagnosis to insist that the biopsy be reviewed by the SENIOR pathologist at the lab instead of accepting the report which found "no evidence of abnormal cells present."

Turns out that abnormal cells were present, the result of a condition so rare that it is only found in about 1% of patients with that particular (and quite aggressive) cancer. The pathologist who initially did the work was one who had never seen those cells outside of a textbook; the senior pathologist (older and more experienced), however, had... and recognized them for what they were.

Had I not followed my gut instinct and insisted on having a more experienced pair of eyes take a second look, I would not be here writing this.
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Old 05-25-2014, 01:26 PM
 
Location: State of Being
35,885 posts, read 67,205,825 times
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Quote:
Originally Posted by theoldnorthstate View Post
Fail ER, no anxiety disorder.

As North Carolinians which is a state of extremes, my sister and I were discussing retirement locations and she favors going back into the homeland mountains believing that the quality of specialists if needed would sort themselves out in a normal distribution. And I having seen how hard the kids work to become doctors of specialty wonder if these same young doctors would want to have retirees, lower income people, and the occasional wealthy second home person as their client base thereby paying off debt and building wealth more slowly. Where as I was thinking the better ones would want to be near research or well known teaching/medical areas (e.g. Duke, Wake Forest, etc) where they could be financially rewarded sooner and challenged by the research or learning environment.

But I can see where your geographical environment might cause you to read my question from your perspective.
From firsthand experience, this is my thought . . .

Some of the best docs are not into the money . . . they choose a practice where they can make a good living but also combine quality of life with it.

In the Boone area, I have found some outstanding docs. We are convinced hubby's new cardiologist saved his life, as the docs in Charlotte (Sanger Clinic, so we are talking well respected) were just not interested in pursuing options. Out of desperation, we heard of a doc with impeccable credentials in Boone and immediately he got hubby into Duke. It took going into a small rural community to get the treatment he had not received for 5 years from a respected clinic in a metropolitan area.

Why did this doc move to a small town? Quality of life.

I think it is so individual as to why docs choose to practice some place . . . some go "back home," some want to make the big bucks as quickly as possible, some want to be close to a large teaching hospital, some want a community where they can raise their kids in a certain lifestyle . . .

Years ago, my next door neighbor was an orthopaedic surgeon and was originally from Pennsylvania. I asked him why he chose to move to NC and he said - you want the TRUTH or a politically correct answer?

I wanted the truth.

He loved golf and had dreamed of playing on a Donald Ross golf course -- so he looked up all the courses Ross designed, pin pointed them on a map and then researched to find what communities nearby were recruiting new docs.

True story.
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Old 05-25-2014, 02:44 PM
GLS
 
1,985 posts, read 4,849,660 times
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Quote:
Originally Posted by mlb View Post
Give me a teaching hospital anytime................
I certainly agree with you that teaching hospitals typically have excellent resources and a dedication to be on the forefront of new medical knowledge. However, you reminded me of our "inside joke" during my residency.

I told all my friends and relatives, "Whatever you do, don't get admitted on July 1st. It is the most dangerous day of the year when the newly minted interns arrive."
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Old 05-25-2014, 02:46 PM
 
5,399 posts, read 6,545,752 times
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Quote:
Originally Posted by GLS View Post
I certainly agree with you that teaching hospitals typically have excellent resources and a dedication to be on the forefront of new medical knowledge. However, you reminded me of our "inside joke" during my residency.

I told all my friends and relatives, "Whatever you do, don't get admitted on July 1st. It is the most dangerous day of the year when the newly minted interns arrive."
That is exactly what my sister said yesterday! minds think alike I guess
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Old 05-25-2014, 03:56 PM
 
14,266 posts, read 24,016,895 times
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Quote:
Originally Posted by anifani821 View Post
Why did this doc move to a small town? Quality of life.

I think it is so individual as to why docs choose to practice some place . . . some go "back home," some want to make the big bucks as quickly as possible, some want to be close to a large teaching hospital, some want a community where they can raise their kids in a certain lifestyle . . .

Years ago, my next door neighbor was an orthopaedic surgeon and was originally from Pennsylvania. I asked him why he chose to move to NC and he said - you want the TRUTH or a politically correct answer?

I wanted the truth.

He loved golf and had dreamed of playing on a Donald Ross golf course -- so he looked up all the courses Ross designed, pin pointed them on a map and then researched to find what communities nearby were recruiting new docs.

True story.

I worked at a hospital in a resort area in VA. One of the major reasons why a number of doctors moved to the rural area was that they really liked to slower lifestyle as well as the opportunity to practice medicine as they wanted to. They are going to make the money wherever they decide to practice.

Do realize that a doctor in a small town is a big deal. And small towns welcome doctors that decide to practice in their community.

In a large city, the doctor is just another doctor.
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Old 05-25-2014, 04:36 PM
 
5,399 posts, read 6,545,752 times
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You have all helped with my concern. and I was getting it backwards. the specialist can be wherever as long as you have a good GP who can get you to whatever specialist you need.

My intention was to return to the town where I was born but being a small mountain resort town in a remote area, medical coverage was a problem. So the town fathers/mothers went after some doctors and I just read that they have closed the deal on bringing in two family practice doctors (one fresh from 3 years of residencies and one mid careerish) and an experienced dentist. Know the town built the medical facilities and expect deals were made but I am happy with the idea that my small little town will have medical access and technology means to get patients access to specialized care if needed.

And yes, the young doctor did cite small town life and living on the lake as a good place to raise his young children.

So on with the plan to go home
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Old 05-25-2014, 05:10 PM
 
Location: Ponte Vedra Beach FL
14,628 posts, read 17,947,745 times
Reputation: 6717
IMO - people who aren't doctors are totally incompetent to judge doctors. They simply base their opinions on whether things worked out ok -or didn't. Which - in many many cases - is not a good barometer of a doctor's competence. RObyn
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Old 05-27-2014, 12:15 PM
 
12,825 posts, read 20,160,725 times
Reputation: 10910
They are sure not coming to the SF Bay Area unless they are foreigners. I suspect the American ones are heading for the sticks. Or not becoming doctors at all.

Not that I have something against foreign doctors. If that is the way things are going I'll deal.

One other thing I see is, private practices are becoming a thing of the past. Most docs are joining the large corporate groups.

What a shame.
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