"Surgeons make $50,000 to $150,000 for a few hours of work"

[naus]

Here's a New York Times commentator today getting the highest number of recommendations on an article about lowering health care costs:

http://opinionator.blogs.nytimes.com/2011/08/02/slashing-the-price-of-health-with-common-sense/

#3: "I am amazed that no one talks about reducing the cost of health care by paying surgeons and other specialists a reasonable amount for their work. Granted physicians are highly skilled and intelligent people, but lets get real. No one deserves to be paid $50,000 or $100,000 for a few hours of work . . . even for 8 hours of work on a demanding operation. Plus, the exorbitant costs of medical testing and special procedures is ridiculous. When we look at the itemized hospital bills and see how much the various services cost, it is legalized robbery. The medical professionals and insurance companies work in cahoots to rip off the patients and the public."​

Unbelievable. Just unbelievable. We are really failing in educating our patients about the economics of health care and how much we actually get paid for the hours we put in. We should also have cleaner bills in the future, instead of being forced to jack up our bill just so that we will be reimbursed 20% of it.

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[climbguy]

this kind of bullsh*t is why everyone thinks doctors are greedy and overpaid. Some ***** who doesn't know what he is talking about spouting nonsense about the profession. Oh yeah, and we all should be paid "a reasonable amount" for the work we do. What is that exactly? What is a reasonable amount to make for some one who worked anywhere from 11 to 15+ years of their lives training to do a job, acquiring enormous debt along the way, and let's not forget the liability incurred during medical practice. So what exactly should a "reasonable" wage be?? When did America stop being a culture in which we value hard work, education, and reward people who put that time and effort in to accomplishing something, particularly while providing a service to the rest of soceity?

 

[bronx43]

I think he's mistaking surgeons with NBA players.

 

[ozzi22]

"Then do your own f***ing surgery."

couldn't have said it better

 

[Fah-Q]

Unfortunately, this kind of ignorance is not isolated to *****s on blogs. It just so happens that our President said something equally stupid during the healthcare reform debate.

http://www.youtube.com/watch?v=SG56B2et4M8

 

[ozzi22]

Unfortunately, this kind of ignorance is not isolated to *****s on blogs. It just so happens that our President said something equally stupid during the healthcare reform debate.

http://www.youtube.com/watch?v=SG56B2et4M8

i can't believe he said that

 

[goooooober]

Unfortunately, this kind of ignorance is not isolated to *****s on blogs. It just so happens that our President said something equally stupid during the healthcare reform debate.

http://www.youtube.com/watch?v=SG56B2et4M8

WAIT! ARE YOU TELLING ME THAT I WILL NOT BE MAKING 50 Gs PER AMPUTATION?

If that is true, my high school guidance counselor was WAY off, and I need a new plan for the kids' college funds, maybe stripping (veins that is).

 

[DoctwoB]

Unfortunately, this kind of ignorance is not isolated to *****s on blogs. It just so happens that our President said something equally stupid during the healthcare reform debate.

http://www.youtube.com/watch?v=SG56B2et4M8

Brb. switching career path to vascular.

 

[geauxg8rs]

Don't you guys fly to work in private jets and blow your nose with 100 dollar bills?

 

[Maybeknot]

Unfortunately, this kind of ignorance is not isolated to *****s on blogs. It just so happens that our President said something equally stupid during the healthcare reform debate.

http://www.youtube.com/watch?v=SG56B2et4M8

This just makes me sad. President Obama doesn't know jack about health care-- but thinks he does. He truly thinks that one of the major factors in the cost of health care is the greed of doctors. Doesn't he have physicians on his staff advising him about these matters, or is there just complete cognitive consonance in the White House? "Yes, sir. Pediatricians can treat recurrent tonsillitis with allergy pills. Yes, sir. Doctors are intentionally not managing diabetes so they can make $30k on amputations."

I try to forward these youtube videos to my resident friends who are big Obama backers. Their response is usually, "well, he might be wrong about that, but he has a point...." *sigh* Somehow, political inclinations seem to trump career preservation.

 

[MossPoh]

That is more of an advisor issue taking things out of context. It was taken from the story a few years back involving uninsured amputees getting huge bills in the mail. Whoever gave him that information failed to distinguish between how much the total bill was versus actual reimbursement for the surgeon....amongst many other things. Obama doesn't believe he knows a lot about it. Presidents get fed a lot of the information and then select a team to create and execute the plan based on the information given. People whine about the guy not solving all the problems, but it is the "executive branch" for a reason. Legislators need to get off their arse, stop petty ideology party bs and actually write some frigging legislation.

 

[Fah-Q]

Legislators need to get off their arse, stop petty ideology party bs and actually write some frigging legislation.

No, they don't. Congress has written plenty of legislation and most of it is absolutely useless at best, and harmful to the country at worst. Do you realize that this congress is going to run a $1.6 trillion budget deficit just this year alone? The ENTIRE national budget in 1996 was $1.6 trillion.

I would love for Congress to just go home.

 

[The Angriest Bird]

The ultimate failure is that "money" has been such a taboo throughout medical education, starting with medical school, ending with residency/fellowship. Everyone who dares to touch the topic is instantly labeled as "greedy" or "don't care about patient". No other profession is like this.

We are all grown-up mature adults who have families to support, not to mention the six-figure loans. Doctors, attendings, medical school teachers, need to learn how to talk about medical economics, including their own incomes, in a professional and matter-of-fact way. A robust profession is one that does the job and demands appropriate compensation, and I don't know why some people would like to make medicine the exception.

 

[DrNick Riviera]

Something even worse is how we are at times forced to increase the cost of medical care by allowing reimbursement strategies guide medical decision making. I'll admit I am early in training, but something that has irked me over the last few days is when I'm told that a pt "isn't meeting criteria" to get his day paid for. So I end up having to start a guy who is eating and drinking fine on some piddly 50cc/h mIVF so that he meets input criteria. What a waste...

 

[SLUser11]

Something even worse is how we are at times forced to increase the cost of medical care by allowing reimbursement strategies guide medical decision making. I'll admit I am early in training, but something that has irked me over the last few days is when I'm told that a pt "isn't meeting criteria" to get his day paid for. So I end up having to start a guy who is eating and drinking fine on some piddly 50cc/h mIVF so that he meets input criteria. What a waste...

While we all do similar things from time to time, I'd be careful how transparent you are about it, because it's technically medicare fraud. And, some of the people who are in charge of those criteria decisions aren't working on the same team as you.

As for physician reimbursement, I am particularly aware of its importance now, as I'm in my last year of training and my family and I are barely skimming by on credit cards and feeling suffocated by educational and private debt.

However, the truth is that physicians could do more to change their public perception. When I walk through the doctor parking lot, I see a lot more mercedes/Lexus/BMWs than anywhere else. I have yet to meet a busy private practice doctor that isn't visibly wealthy. When the public sees this, they don't have much sympathy for our declining reimbursement.

 

[bronx43]

However, the truth is that physicians could do more to change their public perception. When I walk through the doctor parking lot, I see a lot more mercedes/Lexus/BMWs than anywhere else. I have yet to meet a busy private practice doctor that isn't visibly wealthy. When the public sees this, they don't have much sympathy for our declining reimbursement.

At one of our affiliate hospitals, there is a parking garage right by the main hospital entrance, where there is a small 4-5 car lot outside of the garage gate. There are some ridiculous cars parked there at all hours of the day/night. We're not even talking about BMWs and MBs, as those are the lower end cars that park there. Imagine patients or any regular person walking by day after day and seeing Aston Martins and Maseratis parked under a big sign that says "Trauma Surgeons only."

 

[Fah-Q]

The ultimate failure is that "money" has been such a taboo throughout medical education, starting with medical school, ending with residency/fellowship. Everyone who dares to touch the topic is instantly labeled as "greedy" or "don't care about patient". No other profession is like this.

We are all grown-up mature adults who have families to support, not to mention the six-figure loans. Doctors, attendings, medical school teachers, need to learn how to talk about medical economics, including their own incomes, in a professional and matter-of-fact way. A robust profession is one that does the job and demands appropriate compensation, and I don't know why some people would like to make medicine the exception.

Well said. We have to get away from this idea that all physicians should sacrifice themselves for their patients.

 

[45408]

At one of our affiliate hospitals, there is a parking garage right by the main hospital entrance, where there is a small 4-5 car lot outside of the garage gate. There are some ridiculous cars parked there at all hours of the day/night. We're not even talking about BMWs and MBs, as those are the lower end cars that park there. Imagine patients or any regular person walking by day after day and seeing Aston Martins and Maseratis parked under a big sign that says "Trauma Surgeons only."

LOL, our trauma surgeons have vehicles like a mid-90s Suburban, a Prius, and one of them walks to work every day. The nicest vehicles I've seen are a Lotus Elise and several Mercedes. I was pulling out of the lot with a few of our faculty a few days ago, and my staff were driving vehicles like a Ford Escape and a RAV4.

I want to park a jacked up Jeep Wrangler on mud tires in my spot

 

[JaggerPlate]

When did America stop being a culture in which we value hard work, education, and reward people who put that time and effort in to accomplishing something, particularly while providing a service to the rest of soceity?

November, 2008.

 

[badasshairday]

However, the truth is that physicians could do more to change their public perception. When I walk through the doctor parking lot, I see a lot more mercedes/Lexus/BMWs than anywhere else. I have yet to meet a busy private practice doctor that isn't visibly wealthy. When the public sees this, they don't have much sympathy for our declining reimbursement.

How so? Drive to work in beaters? I've done that all my life so far, and will be doing so for several more years. I want some nice things in life some day.

 

[bronx43]

How so? Drive to work in beaters? I've done that all my life so far, and will be doing so for several more years. I want some nice things in life some day.

Well, therein lies the catch. The public is either ignorant of or simply doesn't care about the plights of doctors. Therefore, as long as physicians appear wealthy, there will be no public sympathy for governmental cuts.
There's absolutely nothing wrong with working hard and buying toys. Just don't expect the proletariat to back you up in the voting booth.

 

[bronx43]

November, 2008.

Oh give me a break. I don't exactly support what Obama has or hasn't done in the past three years, but the quagmire the country is in goes FAR beyond what a single, relatively moderate president did.

 

[Fah-Q]

Well, therein lies the catch. The public is either ignorant of or simply doesn't care about the plights of doctors. Therefore, as long as physicians appear wealthy, there will be no public sympathy for governmental cuts.
There's absolutely nothing wrong with working hard and buying toys. Just don't expect the proletariat to back you up in the voting booth.

The public won't care until they realize the federal government has been lying to them for decades. Medicare will go bankrupt or will cut reimbursement so much that very few physicians will accept it any longer. Ditto for the new middle-class entitlement that Obamacare created.

The government will blame physicians for the contraction in access to healthcare that is coming. Physicians will rightly blame the government. I'm not sure who the public will side with but I'm going to venture a guess that it will not be us (especially amongst those who believe the government has the answer for everything).

 

[bronx43]

The public won't care until they realize the federal government has been lying to them for decades. Medicare will go bankrupt or will cut reimbursement so much that very few physicians will accept it any longer. Ditto for the new middle-class entitlement that Obamacare created.

The government will blame physicians for the contraction in access to healthcare that is coming. Physicians will rightly blame the government. I'm not sure who the public will side with but I'm going to venture a guess that it will not be us (especially amongst those who believe the government has the answer for everything).

Medicare going bankrupt is basically the apocalypse scenario for American health care and health care providers. At that point, it isn't even about who or what accepts Medicare - it'll simply be systemic collapse on all levels. This is precisely why I see no other way out for the steroid-induced bubble that the health care has become over the past half century. Especially with the the increasing trend in corporatization, I fully expect a good portion of MDs to lose their jobs, especially those providing services with low cost effectiveness. Everything will trend downmarket.

 

[plauto]

you guys are so apocalyptic...if the government does not pay you anymore for your services, guess what, the patients will. People get sick and will need doctors. You'll get paid cash, no insurance or medicare/medicaid BS to deal with.
By the way, this is the way it works in many countries with socialized health care. Hospitals are free, doctors' visits are not, unless you want to wait months to see the underpaid/overworked doc at the free hospital...

 

[bronx43]

you guys are so apocalyptic...if the government does not pay you anymore for your services, guess what, the patients will. People get sick and will need doctors. You'll get paid cash, no insurance or medicare/medicaid BS to deal with.
By the way, this is the way it works in many countries with socialized health care. Hospitals are free, doctors' visits are not, unless you want to wait months to see the underpaid/overworked doc at the free hospital...

Heh, I'm afraid it doesn't exactly work like that. Keep in mind that when I use the word apocalyptic, I don't mean that the entire field of medicine will become useless, or that most doctors will be jobless. I mean it in the sense that the current health care infrastructure is unsustainable, and the amount of care currently offered has to be drastically decreased. That isn't a guess or an opinion. It's simple laws of nature. You can't spend this amount of money on health care and expect growth or even maintenance in other sectors. Therefore, when the health care bubble does pop via dissolution of Medicare, you will be left with this massive infrastructure without the market support from the government, which adds around 800 billion a year. And this isn't even factoring the fact that Medicare going "bankrupt" signifies FAR bigger problems with American finances and economy than simply a federal program going broke.
Now, the breakdown of entitlement programs may not be as drastic as them folding overnight, but the basic logistics are inevitable. Health care services will have to be drastically cut. When that happens, physicians will be left with a much smaller pie from which to divide. And such a contractionary market, everything will trend downmarket like I said - cost-effectiveness will be just as important (if not more important) as quality of care. And given the increasing trend of corporatization, many providers offering upmarket services will likely lose their jobs.

 

[plauto]

Heh, I'm afraid it doesn't exactly work like that. Keep in mind that when I use the word apocalyptic, I don't mean that the entire field of medicine will become useless, or that most doctors will be jobless. I mean it in the sense that the current health care infrastructure is unsustainable, and the amount of care currently offered has to be drastically decreased. That isn't a guess or an opinion. It's simple laws of nature. You can't spend this amount of money on health care and expect growth or even maintenance in other sectors. Therefore, when the health care bubble does pop via dissolution of Medicare, you will be left with this massive infrastructure without the market support from the government, which adds around 800 billion a year. And this isn't even factoring the fact that Medicare going "bankrupt" signifies FAR bigger problems with American finances and economy than simply a federal program going broke.
Now, the breakdown of entitlement programs may not be as drastic as them folding overnight, but the basic logistics are inevitable. Health care services will have to be drastically cut. When that happens, physicians will be left with a much smaller pie from which to divide. And such a contractionary market, everything will trend downmarket like I said - cost-effectiveness will be just as important (if not more important) as quality of care. And given the increasing trend of corporatization, many providers offering upmarket services will likely lose their jobs.

I disagree with that. The dude on disability will have to choose between buying an iphone or coming to see you. We are an extremely rich country. There will be just a direct relationship between you and the patient, just like most other developed countries in the world without private insurance.

 

[bronx43]

I disagree with that. The dude on disability will have to choose between buying an iphone or coming to see you. We are an extremely rich country. There will be just a direct relationship between you and the patient, just like most other developed countries in the world without private insurance.

Haha, ok. So, the dude on disability will spend the whopping $200 he would have on an iphone on a 4-day hospital stay or appendectomy.

 

[Radonkulous]

I disagree with that. The dude on disability will have to choose between buying an iphone or coming to see you. We are an extremely rich country. There will be just a direct relationship between you and the patient, just like most other developed countries in the world without private insurance.

What country do you live in, because where I live the top 1% control 40% of the wealth. I don't think the rest of us are as "rich" as them.

 

[bronx43]

What country do you live in, because where I live the top 1% control 40% of the wealth. I don't think the rest of us are as "rich" as them.

Haha, I mean, there's really nothing more to talk to him about. This is basically like trying to explain to an equities trader how CHF works.

 

[JaggerPlate]

1. I was joking

Oh give me a break. I don't exactly support what Obama has or hasn't done in the past three years

2. LOL

but the quagmire the country is in goes FAR beyond what a single, relatively moderate president did.

3. LOL

but the quagmire the country is in goes FAR beyond what a single president did.

4. Unless, of course, that President is Bush.

 

[plauto]

Haha, I mean, there's really nothing more to talk to him about. This is basically like trying to explain to an equities trader how CHF works.

hey Einstein, hold your horses there....I was thinking mostly about office care. As medical students, we see most of the care happening in hospitals, whereas in real life it happens in the office. Insurance should only cover major things like hospitalization. Just like car insurance....if a light bulb in your car goes, you just walk into the store an buy a new one, you don't put a claim through you car ins company, right?
Every day I am in the clinic I hear patients complaining about their $20 or $30 copay while talking on their brand new iPhone. Is that going to cover surgery? No. But it will definitely cover their office copay....

 

[LucidSplash]

hey Einstein, hold your horses there....I was thinking mostly about office care. As medical students, we see most of the care happening in hospitals, whereas in real life it happens in the office. Insurance should only cover major things like hospitalization. Just like car insurance....if a light bulb in your car goes, you just walk into the store an buy a new one, you don't put a claim through you car ins company, right?
Every day I am in the clinic I hear patients complaining about their $20 or $30 copay while talking on their brand new iPhone. Is that going to cover surgery? No. But it will definitely cover their office copay....

Actually, the fees for surgery typically include all postoperative care within a 90-day window, including office visits. So yes, what you are talking about MIGHT have that kind of effect of PCPs, but it is unlikely to work out the way you describe for the rest of medicine.

 

[plauto]

Actually, the fees for surgery typically include all postoperative care within a 90-day window, including office visits. So yes, what you are talking about MIGHT have that kind of effect of PCPs, but it is unlikely to work out the way you describe for the rest of medicine.

I wasn' t really talking about post-op visits. I actually think that what I am saying applies to the rest of medicine except for surgery.

 

[palma]

Here's a New York Times commentator today getting the highest number of recommendations on an article about lowering health care costs:

http://opinionator.blogs.nytimes.com/2011/08/02/slashing-the-price-of-health-with-common-sense/

#3: "I am amazed that no one talks about reducing the cost of health care by paying surgeons and other specialists a reasonable amount for their work. Granted physicians are highly skilled and intelligent people, but lets get real. No one deserves to be paid $50,000 or $100,000 for a few hours of work . . . even for 8 hours of work on a demanding operation. Plus, the exorbitant costs of medical testing and special procedures is ridiculous. When we look at the itemized hospital bills and see how much the various services cost, it is legalized robbery. The medical professionals and insurance companies work in cahoots to rip off the patients and the public."​

Unbelievable. Just unbelievable. We are really failing in educating our patients about the economics of health care and how much we actually get paid for the hours we put in. We should also have cleaner bills in the future, instead of being forced to jack up our bill just so that we will be reimbursed 20% of it.

Still 20% of 50k for 8 hours would be balla no? Sorry, I am Canadian and don't fully understand how billing in the US works. The guy did not mention anything about the overhead a surgeon has to pay? Although, up here surgeons as far as I know don't pay any.

 

[palma]

Here's a New York Times commentator today getting the highest number of recommendations on an article about lowering health care costs:

http://opinionator.blogs.nytimes.com/2011/08/02/slashing-the-price-of-health-with-common-sense/

#3: "I am amazed that no one talks about reducing the cost of health care by paying surgeons and other specialists a reasonable amount for their work. Granted physicians are highly skilled and intelligent people, but lets get real. No one deserves to be paid $50,000 or $100,000 for a few hours of work . . . even for 8 hours of work on a demanding operation. Plus, the exorbitant costs of medical testing and special procedures is ridiculous. When we look at the itemized hospital bills and see how much the various services cost, it is legalized robbery. The medical professionals and insurance companies work in cahoots to rip off the patients and the public."​

Unbelievable. Just unbelievable. We are really failing in educating our patients about the economics of health care and how much we actually get paid for the hours we put in. We should also have cleaner bills in the future, instead of being forced to jack up our bill just so that we will be reimbursed 20% of it.

Still 20% of 50k for 8 hours would be balla no? Sorry, I am Canadian and don't fully understand how billing in the US works. The guy did not mention anything about the overhead a surgeon has to pay? Up here surgeons as far as I know don't pay any.

 

[opr8n]

I really dont think people see the apacolypse of medicare coming. Doctors are goin to lose money on those patients.

Let me give you an example of a solo surgeon i work with who is in private practice. He brings in $600k A year from billing. His fixed operating costs are almost $300,000, so he pays himself $300K a year. 2/3 of his patinets are medicare, when medicare cuts payments by 1/3, we will instantly lose $133K which lowers his salary to $166K b/c his FOC dont change! Now keep in mind this is a hard working 60-90 h/w guy. I mean whats the point? He is there later than me most nights.

Whats really goion to happen is that no surgeons will be self employed, everyone will soon be a hospital employee as thats the only way to keep a solid salary, but then the man will be watching you even more, and you will have more people overe your head to answer to.

 

[bronx43]

I really dont think people see the apacolypse of medicare coming. Doctors are goin to lose money on those patients.

Let me give you an example of a solo surgeon i work with who is in private practice. He brings in $600k A year from billing. His fixed operating costs are almost $300,000, so he pays himself $300K a year. 2/3 of his patinets are medicare, when medicare cuts payments by 1/3, we will instantly lose $133K which lowers his salary to $166K b/c his FOC dont change! Now keep in mind this is a hard working 60-90 h/w guy. I mean whats the point? He is there later than me most nights.

Whats really goion to happen is that no surgeons will be self employed, everyone will soon be a hospital employee as thats the only way to keep a solid salary, but then the man will be watching you even more, and you will have more people overe your head to answer to.

Yes, that will be the trend, as I've been saying ad nauseum. And the kicker to being employed is that your job security is only as stable as the market allows. Especially in the world of surgery, the vast majority of patients won't have the disposable income to pay for procedures not covered by third party payers. Should such organizations ever get the political or market leeway to remove coverage for certain services, then providers offering said services will be SOL. And you won't be kept on the payroll for a reduced output - you'll simply be fired.

 

[Slack3r]

Yes, that will be the trend, as I've been saying ad nauseum. And the kicker to being employed is that your job security is only as stable as the market allows. Especially in the world of surgery, the vast majority of patients won't have the disposable income to pay for procedures not covered by third party payers. Should such organizations ever get the political or market leeway to remove coverage for certain services, then providers offering said services will be SOL. And you won't be kept on the payroll for a reduced output - you'll simply be fired.

I think there will be severe rationing before they actually let Medicare fail. Health spending is not unsustainable. Entitlement spending, at its current levels, is.

 

[SocialistMD]

The public is either ignorant of or simply doesn't care about the plights of doctors.

That is because the plight of the public is worse than the plight of the physician. People tend to have little sympathy for those better off than themselves.

 

[RadOncDoc21]

I just saw the Obama link and although I do believe he has a lot to learn about health care and the physician's role, I think he meant to say we need to do more as far as preventive care goes. Either he wanted to "relate" to the crowd or he misunderstood, but either way I can not put all of the country's crisis on one man especially when we have a congress looking to slash everything but taxes.

Let's face it, most people in the US think all doctors are rich including the broke, overworked resident, unfortunately it takes a good 10-15 years of added education and debt to finally get what you put in. I do believe we as physicians need to learn more about the business side of medicine because that is where the money is. Most of the cost of healthcare covers administration and let's not forget the $20,000/year cancer drugs that are out there. Pharmaceutical companies and CEO of health insurance companies have been making a killing over the past 30 years. These things have been going on prior to Obama and will continue far after he is gone, so I can neither give him credit or blame him for what continues to go on in this country.

-R

 

[yellowfinGuy]

I think he's mistaking surgeons with NBA players.

or Jay-z and west trashing and destroying a Maybach just for a video

 

[Butler]

or Jay-z and west trashing and destroying a Maybach just for a video

Funny how Movie stars and Athletes are payed huge salaries and yet they are immortalized by the public. But Oh God, a doctor, who spent 15+ years of education and training, driving a BMW might as well be Lucifer incarnate. The ignorance of the general public is astounding.

 

[womp]

Funny how Movie stars and Athletes are payed huge salaries and yet they are immortalized by the public. But Oh God, a doctor, who spent 15+ years of education and training, driving a BMW might as well be Lucifer incarnate. The ignorance of the general public is astounding.

Most people project. The average American works in a cubicle for 44 hrs a week and spends probably no less than 1/3rd of those 44 hrs surfing the Internet, scrolling through Facebook or chatting on gmail. He then goes home and watches 36 hours of a TV a week. This is the baseline.

He's not going to be imagining the doctor once pulled countless allnighters studying for a shelf exam post call, or is late for an appointment because another patient just coded at the hospital, or had to put off having children because of residency working 80+ hrs a week.

Even if you tell him how long and rigorous medical school and residency was, he'll just reflect on his own experiences and work ethic in college and extrapolate from there. He may even conclude that since he learned nothing from school, that the doctor didn't either and had been in school way too long (this is the nurse practitioner's argument).

He's also concluding that if he made $200k a year, he would be on the golf course everyday and chillin', and therefore every doctor is on the golf course and joyriding in his BMW, and that's why the doctor was late for his appointment.

 

[Osteoimperfecta]

I don't know if anyone else has noticed that the push for paying less for procedures and more for 'prevention' is from both parties. The abandonment of the plight of physicians is also bipartisan. Hell, the bush administration flipped us the finger on malpractice reform, and even almost slashed medicare reimbursements to physicians (not hospitals) by monumental proportions. What does this mean? Personally, I think it simply means we ought to be politically neutral in our effort to prevent the assault politicians are going to launch on us, and I don't see either party offering us free lunch any time soon. I must say though, Obama has a unique distaste for the physician workforce which I have not seen in any other president.

 

[bedrock]

I don't know if anyone else has noticed that the push for paying less for procedures and more for 'prevention' is from both parties. The abandonment of the plight of physicians is also bipartisan. Hell, the bush administration flipped us the finger on malpractice reform, and even almost slashed medicare reimbursements to physicians (not hospitals) by monumental proportions. What does this mean? Personally, I think it simply means we ought to be politically neutral in our effort to prevent the assault politicians are going to launch on us, and I don't see either party offering us free lunch any time soon. I must say though, Obama has a unique distaste for the physician workforce which I have not seen in any other president.

Agreed. I tried to believe in the guy, but I'm voting for whoever runs against him in the next election and we should convince other physicians to do the same.

 

[basupran]

Then everyone would be driving without headlights. The average person is much more likely to pay $500 for a pair of designer glasses than they would $100 for a prescription medication.

hey Einstein, hold your horses there....I was thinking mostly about office care. As medical students, we see most of the care happening in hospitals, whereas in real life it happens in the office. Insurance should only cover major things like hospitalization. Just like car insurance....if a light bulb in your car goes, you just walk into the store an buy a new one, you don't put a claim through you car ins company, right?
Every day I am in the clinic I hear patients complaining about their $20 or $30 copay while talking on their brand new iPhone. Is that going to cover surgery? No. But it will definitely cover their office copay....

 

[PharmaTope]

you guys are so apocalyptic...if the government does not pay you anymore for your services, guess what, the patients will. People get sick and will need doctors. You'll get paid cash, no insurance or medicare/medicaid BS to deal with.
By the way, this is the way it works in many countries with socialized health care. Hospitals are free, doctors' visits are not, unless you want to wait months to see the underpaid/overworked doc at the free hospital...

maybe you havent been walking around in this country. people do not like to pay for anything. people argue about 1 dollar copays on prescriptions that cost 800 dollars but pay for their cigarettes and lotto tickets without hesitation. now you think they going to pay cash for physician visits?

most people who lack insurance do not even go see a physician unless an emergency happens. ive seen people who havent been in 10+ years. this is not a rare thing, this is rather common to be honest. people will go the free route.

 

[PharmaTope]

Most people project. The average American works in a cubicle for 44 hrs a week and spends probably no less than 1/3rd of those 44 hrs surfing the Internet, scrolling through Facebook or chatting on gmail. He then goes home and watches 36 hours of a TV a week. This is the baseline.

He's not going to be imagining the doctor once pulled countless allnighters studying for a shelf exam post call, or is late for an appointment because another patient just coded at the hospital, or had to put off having children because of residency working 80+ hrs a week.

Even if you tell him how long and rigorous medical school and residency was, he'll just reflect on his own experiences and work ethic in college and extrapolate from there. He may even conclude that since he learned nothing from school, that the doctor didn't either and had been in school way too long (this is the nurse practitioner's argument).

He's also concluding that if he made $200k a year, he would be on the golf course everyday and chillin', and therefore every doctor is on the golf course and joyriding in his BMW, and that's why the doctor was late for his appointment.

that is true. i couldnt imagine doing 40-44 a week sitting on facebook and crap. i dont know how people do that without fear of losing their job. i would avoid all that web crap like the plague personally.

 

[45408]

Most people project. The average American works in a cubicle for 44 hrs a week and spends probably no less than 1/3rd of those 44 hrs surfing the Internet, scrolling through Facebook or chatting on gmail. He then goes home and watches 36 hours of a TV a week. This is the baseline.

He's not going to be imagining the doctor once pulled countless allnighters studying for a shelf exam post call, or is late for an appointment because another patient just coded at the hospital, or had to put off having children because of residency working 80+ hrs a week.

Even if you tell him how long and rigorous medical school and residency was, he'll just reflect on his own experiences and work ethic in college and extrapolate from there. He may even conclude that since he learned nothing from school, that the doctor didn't either and had been in school way too long (this is the nurse practitioner's argument).

He's also concluding that if he made $200k a year, he would be on the golf course everyday and chillin', and therefore every doctor is on the golf course and joyriding in his BMW, and that's why the doctor was late for his appointment.

this is signature-worthy material