Are there still lifestyle specialties besides derm?

[DetectiveAlonzo]

The flip side of that is that one can work for 15 years and then get the f... out. I have seen job offers out there that are too good to be true... 350k+ for 12 (10 hrs) shift/month... unbelievable!

for NOW my guy. Those wages aren't gonna be here in 5 years. There are always bubbles about to be burst and cycles that will come to an end. EM is slowly on its way. CMG are coming in.

Also, those hospitals will have you SLAVING for that dough.

---

Members don't see this ad.

 

[TooMuchResearch]

Every displaced orbital fracture should get an optho consult to rule out ocular entrapment, proptosis and increased intraocular pressure.

The fact that you don't know this makes me wonder why you wrote the rest of that post.

Not from our ED. Call ENT for concern for entrapment and proptosis since they fix the bones. Immediate evaluation for the possibility of increased IOP isn't ophtho's job.

Again, that's just how my hospital operates. If yours needs an emergent ophtho consult from the ED, that's fine, but that's not what we do.

 

[lymphocyte]

.

 

[akwho]

Not from our ED. Call ENT for concern for entrapment and proptosis since they fix the bones. Immediate evaluation for the possibility of increased IOP isn't ophtho's job.

Again, that's just how my hospital operates. If yours needs an emergent ophtho consult from the ED, that's fine, but that's not what we do.

As long as somebody is looking/testing.

 

[Summerlax2016]

JESUS CHRIST EM IS NOT A ****ING LIFESTYLE SPECIALTY!

Have you SEEN an EM shift?

They are the number one burnout specialty!

Reason they only work 40 hours is because they NEED the time off.

It's the difference like doing HIIT cardio vs. a daily walk.

There's a main reason these guys end up doing urgent care seeing sniffles and colds from 9-5 in their late 40s and 50s.

Circadian rhythm is shot, cardiac episodes are super high, etc.

Longevity is not there.

Sooner people understand this, the sooner they will stop thinking EM has a great lifestyle.

Unless you WANT to be used up, chewed, and spit out by all of your homeless patients (love them btw), frequent fliers, gang bangers (love these guys too), and pillseekers.

You gotta LOVE the people you are dealing with or else you will be on here bitching about how you hate EM lol

Me posting this is based on what the doctors who work in the ER have told me. Obviously you're mileage may very, the location, size of the hospital, patient demographic, and who you're coworkers are will play a role. But that being said, multiple doctors working in the ER were a different specialty and switched. There is good and bad in everything, personally I love EM and the fact that I can have a life outside the hospital is an huge bonus.

 

[DetectiveAlonzo]

Me posting this is based on what the doctors who work in the ER have told me. Obviously you're mileage may very, the location, size of the hospital, patient demographic, and who you're coworkers are will play a role. But that being said, multiple doctors working in the ER were a different specialty and switched. There is good and bad in everything, personally I love EM and the fact that I can have a life outside the hospital is an huge bonus.

Your experience will differ. Trust me on that.

Go pull 4 over-nighters in a row at an ER and let us know if you even have enough energy and time outside of the hospital to "enjoy" your life.

You do not know what you even like about EM yet. All people and pre-meds see is the "life" outside of the hospital.

EM is about discharge or admit, and moving the "meat" through the hospital.

You have to see EVERYTHING and EVERYONE. No matter how minute or big the situation is. ALL the while making sure you can balance the burden and mental exhaustion of 3-4 patients at once while making your hospital admin folks happy and kissing ass and NOT wasting valuable resources and just getting a CT on everybody and then passing them on to other docs.

No no nooooo..

Such is life.

You are another cog in the wheel. You are an employee. You are replaceable if you do not do your job and do it with passion, and with amazing precision and efficiency.

It is NOT easy and there is a reason why they ONLY work 3-4 shifts a week and why they can only practice until mid 40s and transition to something else.

There is high turnover.

FWIW... there are a few 60 year olds I've worked with at our local ED and they take a HUGE paycut to work only daytime.. and i mean "Should have stuck to IM" pay.

One guy is moving to an urgent care soon cause he simply can't do it anymore and doesn't like the patients.

Me.. personally? I enjoy the gang bangers, the psych patients, and the drug seekers. We seem to connect. Whatever that means lolol

Take it for what it is y'all. This money will not be here by the time y'all graduate.

Thanks to that doucher Obama.

If you guys LOVE what you do though, the money will come.

Beleeee dat.

 

[DetectiveAlonzo]

Please don't post this kind of nonsense.
It's not constructive and false.
For clarification, Anesthesia isn't really a lifestyle field, and it never was.
It was a "ROAD" specialty because it paid well and when you're off, you're off. No clinic and no after hours calls when not on call is very appealing to a lot of people. But you're really working for the surgeon and the system, so you're not taking Friday afternoon off to chaperone the class trip or get 18 holes in before the weekend tournament. You're a cog in the wheel and you aren't going to get a lot of glory or even many pats on the back for a good save or a job well done. How stressful it is depends on what you're doing and how you manage critical events. It still pays well and the sky isn't falling. I work 20-25% more than our CRNAs and I make nearly 3x their income, though with benefits it's probably 2-2.5x. And I'm not even in private practice where I could make much more.
The field has a lot of variability in workload, income, management, etc. but it's still a good choice for people who take the time to understand what it's really about and what challenges exist, and how to try to insulate yourself from them.
It can still be a good field. Though, like all higher paying fields, it has farther to fall as socialized medicine marches ahead.



--
Il Destriero

Look Il destriero I love you and look up to you doc.

But you cannot tell me that situation will be here in 5-10 years for folks like myself and other med students.

We will not be the old-school gas docs weaing rolexes while in surgery kicking back and read the New York Times.

You said it at then end, it is falling and will continue to fall.

The new generation will simply be overlords for CRNAs and most likely WILL be working side by side and fixing their mistakes with OUR license on the line while the AANA and their nursing committees make more pushes into the system and get bigger wins.

BUT IF YOU LOVE IT.... then do you.

I love the physiology and MAY consider gas but I'm certainly realistic unlike a majority of these pre-meds and med students who haven't worked a damn day in their lives and realize that to make more, you gotta work more.

 

[IlDestriero]

I still think the biggest threat to anesthesia is who is in the White House and universal care for all, not CRNAs or management companies.


--
Il Destriero

 

[vendtex]

I still think the biggest threat to anesthesia is who is in the White House and universal care for all, not CRNAs or management companies.


--
Il Destriero

Not just a threat to anesthesia.


Sent from my iPhone using Tapatalk

 

[benjamin94559]

The best lifestyle in medicine is one where you are doing what you enjoy.

I love gen surg and could not see myself doing anything else. If I ever had to do derm, you would find out what a self-thoracotomy looks like.

So like seppuku but more manly because you have to cut through bone?

 

[Psai]

Your experience will differ. Trust me on that.

Go pull 4 over-nighters in a row at an ER and let us know if you even have enough energy and time outside of the hospital to "enjoy" your life.

You do not know what you even like about EM yet. All people and pre-meds see is the "life" outside of the hospital.

EM is about discharge or admit, and moving the "meat" through the hospital.

You have to see EVERYTHING and EVERYONE. No matter how minute or big the situation is. ALL the while making sure you can balance the burden and mental exhaustion of 3-4 patients at once while making your hospital admin folks happy and kissing ass and NOT wasting valuable resources and just getting a CT on everybody and then passing them on to other docs.

No no nooooo..

Such is life.

You are another cog in the wheel. You are an employee. You are replaceable if you do not do your job and do it with passion, and with amazing precision and efficiency.

It is NOT easy and there is a reason why they ONLY work 3-4 shifts a week and why they can only practice until mid 40s and transition to something else.

There is high turnover.

FWIW... there are a few 60 year olds I've worked with at our local ED and they take a HUGE paycut to work only daytime.. and i mean "Should have stuck to IM" pay.

One guy is moving to an urgent care soon cause he simply can't do it anymore and doesn't like the patients.

Me.. personally? I enjoy the gang bangers, the psych patients, and the drug seekers. We seem to connect. Whatever that means lolol

Take it for what it is y'all. This money will not be here by the time y'all graduate.

Thanks to that doucher Obama.

If you guys LOVE what you do though, the money will come.

Beleeee dat.

Em is pretty awesome but incredibly tiring. Also I hate stank feet

 

[InternistDO]

Me posting this is based on what the doctors who work in the ER have told me. Obviously you're mileage may very, the location, size of the hospital, patient demographic, and who you're coworkers are will play a role. But that being said, multiple doctors working in the ER were a different specialty and switched. There is good and bad in everything, personally I love EM and the fact that I can have a life outside the hospital is an huge bonus.

I'm not saying you're completely wrong, but I will say if you've never actually worked in an emergency setting before (something like nursing, teching, or urban EMS--scribing doesn't really count), you really can't say you love EM. The downsides of working in an ED aren't really something you'd see as a shadowing student or casual ambulance volunteer, which is how I think most pre-meds have exposure to the field.

Working 3-4 shifts a week in EM also isn't as good a lifestyle as people think it is.

Maybe this doesn't describe you, but just something to think about.

 

[SurfingDoctor]

I still think the biggest threat to anesthesia is who is in the White House and universal care for all, not CRNAs or management companies.


--
Il Destriero

Not to derail this thread further, but I'm curious how universal care for all is a threat to anesthesia? A threat to the profession or a threat to the salary?

 

[DetectiveAlonzo]

I still think the biggest threat to anesthesia is who is in the White House and universal care for all, not CRNAs or management companies.


--
Il Destriero

They are the biggest threat to medicine IN GENERAL.

That douchetard Obama messed everything up.

Time to move to Canada. They got some good offers up there from what I've been told. You make ~ what you see here and little to less call or stress.

Imagine all that Tim Horton's eh?

 

[W19]

Not to derail this thread further, but I'm curious how universal care for all is a threat to anesthesia? A threat to the profession or a threat to the salary?

Is that a serious question coming from a physician?

 

[OnePunchBiopsy]

So like seppuku but more manly because you have to cut through bone?

I'd like to think it would be more manly simply because it's me doing it.

 

[SurfingDoctor]

Is that a serious question coming from a physician?

Yep. It was a serious question.

 

[DetectiveAlonzo]

Is that a serious question coming from a physician?

In his defense, most physicians know jack **** of how they get paid and the business side of things.

I don't blame him.

 

[SurfingDoctor]

In his defense, most physicians know jack **** of how they get paid and the business side of things.

I don't blame him.

I know exactly how I get paid. For children, it's Medicaid. But Medicaid is a safety net to insure children have coverage. So increased coverage is a good thing for children and the profession, but it doesn't pay more. Hence the clarification of the statement.

 

[W19]

I know exactly how I get paid. For children, it's Medicaid. But Medicaid is a safety net to insure children have coverage. So increased coverage is a good thing for children and the profession, but it doesn't pay more. Hence the clarification of the statement.

Now I see... As a pediatrician, you probably don't have the 'high' salary that most other specialties have. Most people in here, whether they want to admit or not, are seeing things from a monetary and lifestyle standpoint for the most part.

 

[smq123]

In his defense, most physicians know jack **** of how they get paid and the business side of things.

I don't blame him.

Out of curiosity, do you know how physicians get paid? Do you run an office or own your own practice?

 

[DetectiveAlonzo]

I know exactly how I get paid. For children, it's Medicaid. But Medicaid is a safety net to insure children have coverage. So increased coverage is a good thing for children and the profession, but it doesn't pay more. Hence the clarification of the statement.

ahhhhh I see.

 

[DetectiveAlonzo]

Out of curiosity, do you know how physicians get paid? Do you run an office or own your own practice?

Not yet! Have friends and family that own their own practices, however.

I have a good sense of RVUs and the government sanctioning and effect that goes into said RVUs and the way certain ICD codes influence billing though.

I'm just a lowly med student so please ignore me.

 

[SurfingDoctor]

ahhhhh see yeah hence why many docs don't take medicaid. Is what it is.

Well every children's hospital in the US would be closed if that was the case. I don't know, that sounds bad for the profession to me.

 

[DetectiveAlonzo]

Well every children's hospital in the US would be closed if that was the case. I don't know, that sounds bad for the profession to me.

Well given the fact that hospitals overcharge for everything and try to milk medicaid and medicare as much as they can.

They are trying to suck that government teet dry.

 

[SurfingDoctor]

Now I see... As a pediatrician, you probably don't have the 'high' salary that most other specialties have. Most people in here, whether they want to admit or not, are seeing things from a monetary and lifestyle standpoint for the most part.

Oh I figured that. But it is more honest just to state that.

 

[DetectiveAlonzo]

Oh I figured that. But it is more honest just to state that.

Key thing is that you enjoy what you do. I applaud that.

 

[SurfingDoctor]

Well given the fact that hospitals overcharge for everything and try to milk medicaid and medicare as much as they can.

They are trying to suck that government teet dry.

Ha. Okay.

 

[IlDestriero]

Not to derail this thread further, but I'm curious how universal care for all is a threat to anesthesia? A threat to the profession or a threat to the salary?

It's a threat to the profession and to the salary.
Universal health care will be Medicare for all. Private insurance will pay 3 or more times what Medicare will pay for the same work. Anesthesia is currently severely penalized with Medicare patients. Income disparity within the field is often directly related to payor mix. That's the future for the other specialties as well btw. They won't be getting 70%+ of private rates any more. It's too expensive, they'll be getting 1/3 as well. When/if the private insurance plans go away, income will drop dramatically in the specialty and NOBODY wants to do a high risk, high stress job, with frequent call, for CRNA pay. So who will do it for that? CRNAs.
What's the real bottom? It's hard to say. Maybe $250? I won't be doing high risk kids for $250, I'll be retiring early. Or moving to Canada.
There could be a 2 tiered system of private hospitals and the government system here. The survivors there will be the major academic systems with deep pockets/Kaiser/etc that can merge or contract and survive the shake up and emerge as the private alternative system for those that can afford private insurance. How will the government be able to do this without buying up trillions of dollars of hospitals, etc? Easy. A bankrupt hospital isn't worth anything. There are tons of hospitals struggling to keep the lights on and the doors open now. Start slashing their facility fees and they'll go for nothing. A business that is in the red with no hope of ever turning a profit has no value, but communities will still need medical services. Then it's NHS time, rationing, wait lists, etc. Fortunately for me, all that will take time, and I'll be done. But I'll have to be part of the test group for the new medical reality in my golden years and my hip or knee replacement might take a while to schedule.
Obamacare is a Trojan horse.


--
Il Destriero

 

[SurfingDoctor]

It's a threat to the profession and to the salary.
Universal health care will be Medicare for all. Private insurance will pay 3 or more times what Medicare will pay for the same work. Anesthesia is currently severely penalized with Medicare patients. Income disparity within the field is often directly related to payor mix. That's the future for the other specialties as well btw. They won't be getting 70%+ of private rates any more. It's too expensive, they'll be getting 1/3 as well. When/if the private insurance plans go away, income will drop dramatically in the specialty and NOBODY wants to do a high risk, high stress job, with frequent call, for CRNA pay. So who will do it for that? CRNAs.
What's the real bottom? It's hard to say. Maybe $250? I won't be doing high risk kids for $250, I'll be retiring early. Or moving to Canada.
There could be a 2 tiered system of private hospitals and the government system here. The survivors there will be the major academic systems with deep pockets/Kaiser/etc that can merge or contract and survive the shake up and emerge as the private alternative system for those that can afford private insurance. How will the government be able to do this without buying up trillions of dollars of hospitals, etc? Easy. A bankrupt hospital isn't worth anything. There are tons of hospitals struggling to keep the lights on and the doors open now. Start slashing their facility fees and they'll go for nothing. A business that is in the red with no hope of ever turning a profit has no value, but communities will still need medical services. Then it's NHS time, rationing, wait lists, etc. Fortunately for me, all that will take time, and I'll be done. But I'll have to be part of the test group for the new medical reality in my golden years and my hip or knee replacement might take a while to schedule.
Obamacare is a Trojan horse.


--
Il Destriero

Medicine as a general profession is interesting. Pretty much everything you stated is already the reality for pediatrics, hence every pediatrician I know firmly believes in a single payer system. Can't have it both ways though. We've tried that since the passing of Medicare, having a mixture of public and private insurance. The fact that the US pays more than every other country only to be ranked 37th in outcomes shows that the current system isn't working out too well. As a profession in general, we are doing poorly.

 

[DetectiveAlonzo]

It's a threat to the profession and to the salary.
Universal health care will be Medicare for all. Private insurance will pay 3 or more times what Medicare will pay for the same work. Anesthesia is currently severely penalized with Medicare patients. Income disparity within the field is often directly related to payor mix. That's the future for the other specialties as well btw. They won't be getting 70%+ of private rates any more. It's too expensive, they'll be getting 1/3 as well. When/if the private insurance plans go away, income will drop dramatically in the specialty and NOBODY wants to do a high risk, high stress job, with frequent call, for CRNA pay. So who will do it for that? CRNAs.
What's the real bottom? It's hard to say. Maybe $250? I won't be doing high risk kids for $250, I'll be retiring early. Or moving to Canada.
There could be a 2 tiered system of private hospitals and the government system here. The survivors there will be the major academic systems with deep pockets/Kaiser/etc that can merge or contract and survive the shake up and emerge as the private alternative system for those that can afford private insurance. How will the government be able to do this without buying up trillions of dollars of hospitals, etc? Easy. A bankrupt hospital isn't worth anything. There are tons of hospitals struggling to keep the lights on and the doors open now. Start slashing their facility fees and they'll go for nothing. A business that is in the red with no hope of ever turning a profit has no value, but communities will still need medical services. Then it's NHS time, rationing, wait lists, etc. Fortunately for me, all that will take time, and I'll be done. But I'll have to be part of the test group for the new medical reality in my golden years and my hip or knee replacement might take a while to schedule.
Obamacare is a Trojan horse.


--
Il Destriero

The GOD HAS SPOKEN!

 

[Stagg737]

Now I see... As a pediatrician, you probably don't have the 'high' salary that most other specialties have. Most people in here, whether they want to admit or not, are seeing things from a monetary and lifestyle standpoint for the most part.

It's more than just that, although that's certainly a major consideration. Part of it is the loss of autonomy with increased government regulations. It's having to deal with government more regularly, which can be just as ridiculous or worse than insurance companies, and even worse having to deal with both at times. Loss of autonomy is another issue and the opportunities to practice privately are becoming more scarce thanks to the ACA and government take-over. Plus, it may be a bit of the slippery slope fallacy, but to a lot of people think once we start moving towards a universal or single payer system it's hard to stop that train, and to a certain extent I agree. We're moving farther from a system where a physician can make what they want out of their career and more to the "cog in a machine" controlled by the gov. and employers that so many people here talk about.

 

[smq123]

Not yet! Have friends and family that own their own practices, however.

I have a good sense of RVUs and the government sanctioning and effect that goes into said RVUs and the way certain ICD codes influence billing though.

I'm just a lowly med student so please ignore me.

No need to apologize or be self-effacing. I was genuinely curious; I know some people who were certified coders or who were practice managers, but then went back to medical school or PA school. Just wondering!

It's a threat to the profession and to the salary.
Universal health care will be Medicare for all. Private insurance will pay 3 or more times what Medicare will pay for the same work. Anesthesia is currently severely penalized with Medicare patients. Income disparity within the field is often directly related to payor mix. That's the future for the other specialties as well btw. They won't be getting 70%+ of private rates any more. It's too expensive, they'll be getting 1/3 as well. When/if the private insurance plans go away, income will drop dramatically in the specialty and NOBODY wants to do a high risk, high stress job, with frequent call, for CRNA pay. So who will do it for that? CRNAs.

So, I don't think it's fair to demonize Obamacare for the private insurance companies going away....because, at least in states like Florida, the private insurance companies made out like bandits because of Obamacare. People were forced to buy crappy insurance plans that they wouldn't normally otherwise buy. (cough cough, HUMANA, cough cough)

As a primary care person, I don't fear Obamacare the way that the specialists do. But the private insurance companies make my job harder. They don't really increase my revenue because they take up so many resources. I would need fewer people to process my referrals if I didn't have to have a group for Cigna, a group for Humana, a group for the Blues, a group for Aetna. I could get through my paperwork faster if I didn't have prior auths for so many different medications because Cigna will cover something that BCBS won't, etc. Patients could get through registration faster because we wouldn't have to verify their insurance coverage before each and every visit (and have to do a PCP change so often).

 

[smq123]

It's having to deal with government more regularly, which can be just as ridiculous or worse than insurance companies

Meh. It depends.

 

[VA Hopeful Dr]

Look Il destriero I love you and look up to you doc.

But you cannot tell me that situation will be here in 5-10 years for folks like myself and other med students.

We will not be the old-school gas docs weaing rolexes while in surgery kicking back and read the New York Times.

You said it at then end, it is falling and will continue to fall.

The new generation will simply be overlords for CRNAs and most likely WILL be working side by side and fixing their mistakes with OUR license on the line while the AANA and their nursing committees make more pushes into the system and get bigger wins.

BUT IF YOU LOVE IT.... then do you.

I love the physiology and MAY consider gas but I'm certainly realistic unlike a majority of these pre-meds and med students who haven't worked a damn day in their lives and realize that to make more, you gotta work more.

All true, but when I came here in 2004 the anesthesia forum was very doom and gloom re: CRNA and reimbursements. They're still doing OK 12 years later.

 

[SurfingDoctor]

As a primary care person, I don't fear Obamacare the way that the specialists do. But the private insurance companies make my job harder. They don't really increase my revenue because they take up so many resources. I would need fewer people to process my referrals if I didn't have to have a group for Cigna, a group for Humana, a group for the Blues, a group for Aetna. I could get through my paperwork faster if I didn't have prior auths for so many different medications because Cigna will cover something that BCBS won't, etc. Patients could get through registration faster because we wouldn't have to verify their insurance coverage before each and every visit (and have to do a PCP change so often).

I'm a specialist, and I don't fear the ACA or expansion of it. But I do worry it doesn't address the real issues of this whole thread, money, cost and outcomes. The fact that higher education is so expensive in this country I feel is a major driving force behind these threads. You got a lot of debt from education and you want money to pay it off, I get that. But this perpetuates a never ending cycle which is the state of current healthcare. Couple this with the cost of malpractice insurance, the cost of malpractice claims that go to court (unless your state has tort reform), you need money to pay for those things. But that money comes from consumers. Now it would be nice if the consumers were all rich and covered those costs, but that is not reality. So you create an insurance system of both private and public coverage. Sure, it still favors the well to do, but you get more cost coverage. The problem is, that not everyone is covered, but when they get sick, they become consumers, consumers who can't pay (private insurance isn't going to help people who have no money). Well it is illegal to let people just up and die if you can help them (which it should be), so in order to offset their lack of pay, you charge higher on the people who can. But insurance companies need to make a profit, so they increase premiums. Add into the fact, that charges are based on what you do, not what you get out of it (ie outcomes), you charge more to private insurance companies because you need the money to pay off your debt, support your lifestyle, your practice, etc. But that needs to come from somewhere and it is the well-insured consumers who have money that provide support for that. But that is a small fraction of the total insured consumers who seek care, so you need a public option and so and so. Outcome becomes irrelevant in this system. It all ends up being a result of transferring money from one party to the next at higher costs because each party wants more than what they are putting in.

This may seem like a rambling mess, because it is. That is US healthcare, a rambling mess. The discussion of "public versus private insurance" or "money plus lifestyle" are just distractions that don't fix or help a system that is broken on many levels. I don't think there is a quick answer, but I do know that 36th other countries do it better than us.

 

[VA Hopeful Dr]

Medicine as a general profession is interesting. Pretty much everything you stated is already the reality for pediatrics, hence every pediatrician I know firmly believes in a single payer system. Can't have it both ways though. We've tried that since the passing of Medicare, having a mixture of public and private insurance. The fact that the US pays more than every other country only to be ranked 37th in outcomes shows that the current system isn't working out too well. As a profession in general, we are doing poorly.

Oh c'mon now, you and I both know its not medicine's fault that health is so bad. Plus, you and I also both know the markers they use for get that 37th aren't all that good.

What we pay a lot for is not waiting 8 months for elective surgery (or really any super long waits), or getting to a BMI of 70 and still getting that same elective surgery. We also, unfortunately, pay to subsidize other countries' healthcare pretty often.

Edit: Just saw your longer post, will address later.

 

[OnePunchBiopsy]

All true, but when I came here in 2004 the anesthesia forum was very doom and gloom re: CRNA and reimbursements. They're still doing OK 12 years later.

Agreed. The team-based anesthesia model works both ways IMO, how is it a "team" without physicians and nurses? Plus I think the "anesthesia-home" model only works with physicians involved.

 

[SurfingDoctor]

Oh c'mon now, you and I both know its not medicine's fault that health is so bad. Plus, you and I also both know the markers they use for get that 37th aren't all that good.

What we pay a lot for is not waiting 8 months for elective surgery (or really any super long waits), or getting to a BMI of 70 and still getting that same elective surgery. We also, unfortunately, pay to subsidize other countries' healthcare pretty often.

Edit: Just saw your longer post, will address later.

Okay. Pick another metric. How about infant mortality rate? The US is 38th, right between Brunei and Belarus. Sure you can find most faults with every measurement, however if it is reproducible across multiple measurements, it is hard to say that there isn't some truth to it.

I'm not saying it is medicine's fault. The fault is multi layers deep. However the arguments of "public versus private" and "money versus lifestyle" don't address the problems. They just ignore them.

Edit:
The 2015 statistics put US infant mortality rate 57th lowest in the world, right between Croatia and Serbia. But we beat them in gold medals in Rio, so there's that.

 

[FiveOClock]

The two-tiered medical care system will really suck for poor people and the middle class. Entire specialities (think optho, derm, ortho, etc) will be mostly closed off access wise with only a few doctors willing to take terrible pay. The rest will migrate to the private system, probably make a lot less but also work a lot less.

 

[PhillyMed777]

Man this thread is toxic...

I.e. it's my kind of thread.

I mean, who doesn't like a nice toxic puss filled negative thread after a long day of being abused on Obgyn like I was today?
Better yet, what would sdn be without these threads? Probably mad boring

 

[username456789]

Okay. Pick another metric. How about infant mortality rate? The US is 38th, right between Brunei and Belarus. Sure you can find most faults with every measurement, however if it is reproducible across multiple measurements, it is hard to say that there isn't some truth to it.

I'm not saying it is medicine's fault. The fault is multi layers deep. However the arguments of "public versus private" and "money versus lifestyle" don't address the problems. They just ignore them.

Edit:
The 2015 statistics put US infant mortality rate 57th lowest in the world, right between Croatia and Serbia. But we beat them in gold medals in Rio, so there's that.

Infant mortality is a terrible metric if you actually want to glean meaning.

We actually try to save babies who are severely ill and not all of those infants survive, whereas in many countries the babies never make it that far and are not part of the statistics.

If you truly believe our OB and infant care is inferior to these third world countries, I have a bridge to sell you.

 

[Rekt]

I.e. it's my kind of thread.

I mean, who doesn't like a nice toxic puss filled negative thread after a long day of being abused on Obgyn like I was today?
Better yet, what would sdn be without these threads? Probably mad boring

Exactly. I get enough nonsense from school. I need some ridiculous **** from these forums intermittently to keep me sane

 

[Foot Fetish]

Official song of this thread:

"I've done did a lot of sh1t just to live this here lifestyle"

-Young Thug

 

[Stagg737]

The two-tiered medical care system will really suck for poor people and the middle class. Entire specialities (think optho, derm, ortho, etc) will be mostly closed off access wise with only a few doctors willing to take terrible pay. The rest will migrate to the private system, probably make a lot less but also work a lot less.

That's not necessarily universal though, it completely depends on how much the public tier insurance covers (usually not much) and how expensive the private tier's premiums are (in the U.S. I'm sure they'd get milked for every penny). The point of two-tiered systems isn't to provide comprehensive coverage to everyone which has two pluses. It provide basic preventative needs to everyone thus creating a system where major issues can be caught and prevented before the condition gets too costly and spirals out of control as well as driving down costs of private plans which no longer have to focus on paying for the basic services. So basically like getting medicaid with wrap-around insurance. The goal in most cases is NOT to cover specialist services like ophtho, ortho, plastics, etc, It's to create a system where less individuals are in need of those services, or at least the more complicated and expensive aspects which may occur in those fields.

 

[IlDestriero]

Infant mortality is a terrible metric if you actually want to glean meaning.

We actually try to save babies who are severely ill and not all of those infants survive, whereas in many countries the babies never make it that far and are not part of the statistics.

If you truly believe our OB and infant care is inferior to these third world countries, I have a bridge to sell you.

I wonder how many 24 week preemies survive in Belarus?


--
Il Destriero

 

[username456789]

I wonder how many 24 week preemies survive in Belarus?


--
Il Destriero

We'll never know

 

[deleted245139]

Your experience will differ. Trust me on that.

Go pull 4 over-nighters in a row at an ER and let us know if you even have enough energy and time outside of the hospital to "enjoy" your life.

You do not know what you even like about EM yet. All people and pre-meds see is the "life" outside of the hospital.

EM is about discharge or admit, and moving the "meat" through the hospital.

You have to see EVERYTHING and EVERYONE. No matter how minute or big the situation is. ALL the while making sure you can balance the burden and mental exhaustion of 3-4 patients at once while making your hospital admin folks happy and kissing ass and NOT wasting valuable resources and just getting a CT on everybody and then passing them on to other docs.

No no nooooo..

Such is life.

You are another cog in the wheel. You are an employee. You are replaceable if you do not do your job and do it with passion, and with amazing precision and efficiency.

It is NOT easy and there is a reason why they ONLY work 3-4 shifts a week and why they can only practice until mid 40s and transition to something else.

There is high turnover.

FWIW... there are a few 60 year olds I've worked with at our local ED and they take a HUGE paycut to work only daytime.. and i mean "Should have stuck to IM" pay.

One guy is moving to an urgent care soon cause he simply can't do it anymore and doesn't like the patients.

Me.. personally? I enjoy the gang bangers, the psych patients, and the drug seekers. We seem to connect. Whatever that means lolol

Take it for what it is y'all. This money will not be here by the time y'all graduate.

Thanks to that doucher Obama.

If you guys LOVE what you do though, the money will come.

Beleeee dat.

Cool. So... How long have you been a practicing EM doc? I only ask because you seem to really know the ins and outs...

 

[SurfingDoctor]

Infant mortality is a terrible metric if you actually want to glean meaning.

We actually try to save babies who are severely ill and not all of those infants survive, whereas in many countries the babies never make it that far and are not part of the statistics.

If you truly believe our OB and infant care is inferior to these third world countries, I have a bridge to sell you.

So France is killing babies left and right and Botswana is trying to save them all? But then if they weren't trying to save babies and letting them die, wouldn't the mortality rate be higher? You do realize that effort to save a baby doesn't matter if the baby dies.

 

[VA Hopeful Dr]

Okay. Pick another metric. How about infant mortality rate? The US is 38th, right between Brunei and Belarus. Sure you can find most faults with every measurement, however if it is reproducible across multiple measurements, it is hard to say that there isn't some truth to it.

I'm not saying it is medicine's fault. The fault is multi layers deep. However the arguments of "public versus private" and "money versus lifestyle" don't address the problems. They just ignore them.

Edit:
The 2015 statistics put US infant mortality rate 57th lowest in the world, right between Croatia and Serbia. But we beat them in gold medals in Rio, so there's that.

http://www.skepticalob.com/2014/10/finally-a-comprehensive-analysis-of-us-infant-mortality.html

Try again