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1. Those "millions with healthcare insurance" are just new Medicaid patients. Many physicians already do not accept Medicaid patients. Our multi-specialty clinic will not accept "Obamacare" patients when they are rolled out, nor will any clinic in our city.
2. Adding 40 million potential patients would require-
a. 80,000 new physicians
b. reimbursement for those patients that would allow them to keep thier doors open
c. increased emergency rooms and hospital facilities
d. 80,000 new residency slots (Obamacare CUTS funding for residency slots. Therefore, we will have FEWER PHYSICIANS due to Obamacare!)
3. Medical schools and residencies are not mom and pop stands.
a. They require funding from the state and federal governments, as well as residency positions to which those graduates can be sent for training.
b. Obamacare CUTS THE NUMBER OF RESIDENCY SLOTS, thus reducing the number of physicians.
c. any increased number of medical students would require more staff physicians and infrastructure to train them.
Gee............... one would have thought the libs would have thought this out a little earlier!
Of course not, the whole idea came from the cult leader and his partners and according to them Obama is always right so it must be good right. lol
You didn't even mention all the illegal immigrants that are coming in to the country. Oh I forgot, they renamed them unregistered Democrats didn't they... something like that.
Yes there are specialists making 300-600k. Sometimes more if they own their own surgery centers. Go ahead. Become a neurosurgeon. You will be close to 40 years old by the time your practice is up and running. Along with 250k in school loans. Last I heard. A prominent residency training program had a 120% divorce rate. Yep. Neurosurgery is a long training process. So long the medical residents get divorce even 2 times while in training.
Being on call has to be one PIA. Yep, all that training, the hours, the responsibility but hey begrudge them because liberals think it fair to take from them to give to welfare leaches who can't go to work. Liberals sense of fairness is crap!
Nurse practitioners can do about 80 % of what a general practitioner can do. Since much of the increased demand will be in primary care, it will be fine.
You realize there is a movement in the nursing community demanding independent practice for NPs. In fact starting in 2015. Almost all advance nursing degrees will have the title "doctor" in front of them.
And guess what. If NPs can do 80% of what primary care docs can do. Than why is there a push for independent practice along with equal billing and pay.
Think about that. You want NPs with less training thinking they can do 80% of what primary car docs can do yet demanding 100% of pay as primary care docs.
So are we going to save any money by having mid levels making as much as MDs with less training. And how will malpractice carriers handle NPs in independent practice.
You realize there is a movement in the nursing community demanding independent practice for NPs. In fact starting in 2015. Almost all advance nursing degrees will have the title "doctor" in from of them.
And guess what. If NPs can do 80% of what primary care docs can do. Than why is there a push for independent practice along with equal billing and pay.
Think about that. You want NPs with less training thinking they can do 80% of what primary car docs can do yet demanding 100% of pay as primary care docs.
So are we going to save any money by having mid levels making as much as MDs with less training. And how will malpractice carriers handle NPs in independent practice.
That is scary. Although most nurses are pretty good, there are a few that I would run away as fast as I could. Most are exhausted from the long and crazy hours and the work loads. Malpractice, if we think it is bad now, watch out. You better hope your life is not the one your family is suing for.
But hey as long as you are not going to get sick until the baby boomers have passed on then no worries lol. <sarcasm> The again, all the illegal immigrants uh hum I mean unregistered democrats will take their place.
lol, I thought maybe a liberal was waking up. I just got my taxes due and want to get sick. I now have no choice I have to lay someone off. Oh I can hear you all attack and say I am wrong but it is what it is. I tried to keep them but it doesn't make sense anymore. Thanks you sickening liberals. The employee thanks you too.
Let the attacks begin but I don't fricken care anymore!
Quote:
Originally Posted by urbanlife78
It is good to know you have time to spend all of Thursday on City-Data while your "business" fails and you are forced to lay off employees all while blaming it on Obama.
Oh and thank you fuselage for giving a great answer for this thread.
Quote:
Originally Posted by petch751
why the hell should I work to pay for lazy ass leaches. They are all greedy pigs always got hands out wanting what is not theirs pigs. And you expect me to feel sorry for them F### no, I don't. Tell them to keep the fricken legs closed. I am tired of supporting baby producers. Of course the men need to keep it in their pants if they don't want to pay for the consequences. Oh that is right, we are the fools who pay for their sorry asses. Feel sorry for them, no, they disgust me.
Tell them to WORK! instead of leaching off others. Not worth a thing, can do a thing, it's toooo harrrd. Is telling a lazy ass leach sucking money off other people racist? oh my, i am surprised word has not been added to the pc list.
Food stamp asses are not worth this ****.
I got a LIBERAL in my sites. gone!!!
I'm sure I will too after posting that these no good for nothing suck off everyone else doesn't deserve any respect.
Do you have any employees or not? First you say you will have to lay someone off; in your next post you say you refuse to work to pay for 'lazy ass leaches'.
Do you have any employees or not? First you say you will have to lay someone off; in your next post you say you refuse to work to pay for 'lazy ass leaches'.
So which is it?
Both! also one less employee now, pink slip going out tomorrow. . Oooh I get it, you think all business owners sit on the beach lol.
And for the welfare leaches you pay for them.
Obama is hitting up billionaire row while tax payers pay for it... I'm not too thrilled about that either.
That is scary. Although most nurses are pretty good, there are a few that I would run away as fast as I could. Most are exhausted from the long and crazy hours and the work loads. Malpractice, if we think it is bad now, watch out. You better hope your life is not the one your family is suing for.
But hey as long as you are not going to get sick until the baby boomers have passed on then no worries lol. <sarcasm> The again, all the illegal immigrants uh hum I mean unregistered democrats will take their place.
I have nothing against NPs. I know quite a few of them. Many of them, especially the experienced ones are quite good at what they do. But many people without the full medical school training experience will always have "gaps" in their medical knowledge. What happens with those gaps. It causes them to order more tests and consult more specialist for further workup. Exactly what we are trying not to do when saving health care dollars.
Can certain NPs "fill those lack of knowledge gaps" through experience and "on the job" learning. Absolutely.
The real issue is how long will it take "one the job" to acquire that knowledge that's taught in med school and residency training. The other issue is some mid levels may not fully fill those missing gaps no matter how long they are out in practice.
AARP (of all organizations, as they endorsed Obamacare and the addition of 40 million new patients to healthcare roles) is lamenting the future shortage of physicians.
Gee............ this was all pretty obvious to anyone with half a brain-
1. cutting $750 billion from medicare will result in fewer residency slots
2. cutting $750 billion from medicare will result in reduced reimbursement
3. adding 40 million "new patients' will require MANY more providers
4. It takes about 8-10 years to "grow" new providers
5. With reduced reimbursement, fewer students will want to go to med school, go into debt $350K, and be unable to repay debt
6. Finding physicians who will take all the new medicaid patients will be difficult
7. Adding 40 million "new patients" will cost far more than anyone (including the CBO) thought
The road to disaster is paved with good intentions. Like most liberal policies, the "plan" is a far cry from reality and usually fails miserably. Not to worry.............. there will be another plan that will make things even worse.
Tell me again............................. how much did AARP get for endorsing Obamacare?
If there is no excuse for ignorance than why did you post this drivel of an "informed" opnion???
NP's and PA's have been fighting for over twenty years to have their scope of practice recognised nation wide and their training and education compensated at the market level.
NP's and PA's have traditionally practised where GP's would not practise due to lack of financial reward, isolated area or traditionally under represented populations.
Did you have a break with reality or is the taste of Obama so bad, that you are more than willing to get on this board and lie??
Incidentally, the projected shortage is of Primary Physicians and has only marginally to do with Obamacare.
Rather, the problem has to do with a very large aging population that, necessarily, demands more primary care physicians.
Next, only 2% of medical students express any interest in becoming primary physicians - for a variety of reasons ranging from disproportionate burn-out rates, longer work hours than most subspecialties, lower compensation than most subspecialties, incredible bureaucracy with obtaining insurance approval for absolutely everything, etc. All of these issues make this profession very undesirable.
If you were to spend many years and tons of money to get a degree, would you rather work in a field that potentially pays you $400,000 a year or one that pays you $75,000? Exactly!
The affordable care act certainly adds to the problem because it adds an even higher demand on this particular field. And yes, I think everybody knows that an increase in demand needs to be met with an increase in supply.
Unfortunately, outrageous costs of obtaining an M.D. make it absolutely impractical to pursue the general practitioner track. This, however, is NOT an issue caused by "Obamacare" - it is a systemic fault in our educational system.
It seems the solution would be to increase reimbursement to primary care doctors and decrease the bureaucratic nonsense.
Quote:
Originally Posted by MTAtech
So, what's the point? Rather have millions without health care access?
I have faith in the free market. Medical schools will accept more applicants and graduate more doctors.
That is being done, but there is still a problem. See below.
Quote:
Originally Posted by tablemtn
As I'm sure you know, the AMA cartel explicitly and openly limits the number of new entrants into US medicals schools each year. MCAT medians have gone up over the years, which seems to indicate that students who would have made it into medical school in decades past are now being declined the opportunity.
Perhaps the solution would involve loosening the AMA's grip, no?
The AMA has nothing to do with the number of medical school admissions. As hawkeye pointed out, the bottleneck is residency slots. There are not enough slots for graduates as it is. Residents actually do get paid a salary. That means those positions have to be funded.
"This situation is only going to worsen. Due to the pending doctor shortage, the Association of American Medical Colleges (AAMC) has called for a 30% increase in medical school enrollment, or 5,000 more doctors each year. College universities have responded to this demand, with 18 new medical schools currently in the process of opening.
The increase in the number of medical students would lead to an increase in residency positions as well, right?
Wrong.
Since 2001, the number of first year residency positions has increased by 3,000, compared to a whopping increase of 6,500 applicants. The slow growth in residency positions is likely due to a 15 year freeze in Medicare support. The current federal budget problems make lifting the freeze unlikely in the near future."
About 1100 students did not match and only about half of those found slots after the match.
"Congress recently reintroduced bills that would add 15,000 Medicare-financed residency positions over five years, emphasize training in community or outpatient settings, and set aside new training spots for specialties where there are identified shortages, such as primary and geriatric care.
The AAMC also supports the bill. "Right now, there are about 26,000 people [medical school graduates] and a similar number of residency slots," says Atul Grover, the organization's chief public policy officer. "But starting in 2016, that will begin to change, with more medical school graduates, and without a corresponding growth in residencies, there will be a wider gap." The AAMC [Association of American Medical Colleges] estimates that it will cost about $9 billion to close this gap."
Note that the AMA supports increasing the number of residency slots.
Quote:
Originally Posted by ellemint
Nurse practitioners can do about 80 % of what a general practitioner can do. Since much of the increased demand will be in primary care, it will be fine.
Midlevel providers can help, but their level of training is not the same as a physician. It would be a mistake to try to use them as substitutes for doctors. Because of their less extensive training, many end up ordering tests that are unnecessary and referring to specialists conditions that could and should be treated by primary care doctors.
Also, many patients will enter the system who have not seen a doctor in some time. That will mean people will be identified who should see specialists, for everything from cataract surgery to colonoscopies.
Our politicians would do well to listen to doctors actually in practice to find out what real solutions to the health care problem in the US will entail.
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