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Insight into being a Doctor in America

Discussion in 'Politics & Religion' started by Obamanation, Apr 25, 2013.

  1. earlpearl

    earlpearl Well-Known Member

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    #21
    Okay mr stubborn.

    The guy in the story is a rural doc. That is 10% of the physician population (serving 20% of the population). At 10% he is more of an exception than the rule.

    He is a GP. They earn less, and he is in a rural area. He probably earns a good bit less than most docs. More exception rather than the norm.

    He is a single practitioner, a dying breed. It also means he has to personally foot the bill of the technology. I've pointed out...his decision makes sense on that basis. And then as is clearly stated, he is older with less years to practice. Assuming there is "some cost savings" with electronic records.. he doesn't have the time ahead of him to benefit from that payback.

    Think of this, the technology is newer with less providers. Its probably way more expensive for installation than it might be in several years (as with all new technology). Not only does the guy have less time to make back the investment cost of the technology but in the medium number of years his depreciated first generation technology will probably somewhat outdated.

    Its simply not a good investment decision for this guy.

    But he is a minority of docs.

    Your generalization and rants against health care and then the administration aren't merited in this case.


    There are so many issues to debate in health care. Its too bad the right wing went anti Obama and nuclear against Obama Care. The far bigger issue are total costs. The above info graphic speaks to that issue. ObamaCare really didn't attack this head on....and nobody is. Not the GOP, not conservatives, not dems.

    Here are some issues:

    Health care/person costs 60% more than the 3 next most expensive nations and more than twice what it is around the world. Over 1/2 of that expense is picked up by private costs, not the gov.

    Those enormous costs come out of your pocket. We pay tons more for procedures, tons more for medication. Do you have insurance coverage through an employer?? If they are like all employers they are increasing your costs. That has been going on for a long time.

    Not for profit hospitals are sucking up a lot of cash and they don't pay taxes. Hey they aren't not for profits if they buy gauze for a $1.00/box and charge you $70 for it in a hospital stay. Our drug costs are way way higher than the costs around the world.

    As for the doc in the story. Its an interesting story. If I were in his shoes I'd probably do the same. But its a unique story representing the minority of docs....not the "health care of America"
     
    earlpearl, Apr 29, 2013 IP
  2. Obamanation

    Obamanation Well-Known Member

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    #22
    Nothing new in your post there Earl. Just because three young doctors working in a practice together are more able to absorb the cost of new regulations doesn't change the fact that GPs make about 150k a year after medical school.

    Also, just because GPs make up a small portion of doctors does not change the fact that they are the first point of contact for every ailment outside of emergencies, regardless of whether we are talking about Medicare or private insurance. What we wind up with are people who are horribly underpaid for the amount of schooling they have received, who were already over burdened based on the patient to doctor load, who are now saddled with 40mn new patients to support without any possibility to increase their earnings. You think that is a winning formula to drive people toward being a general practitioner?

    To put it in perspective, the top life guard in the OC makes $225k a year, with a full pension after 20 years of sitting on the beach and driving the jeep around. No college degree required, nor should there be.

    By the way, Im glad to see we both agree that ObamaCare does nothing to address this enormous problem. In fact, ObamaCare exacerbates the problem. What intelligent person would knowingly decide to become a general practitioner now? You would have to be a saint, or extremely stupid.

    Once you digest these facts, the light bulb should go on in your head as to why ObamaCare was so unpopular, and why it remains so to this very day.

    If you want to tackle the cost of healthcare in this country, you need to make people pay for their own health care, like they did only a few decades ago. When people pay for the products they consume, they shop the product. They complain about bad service. Insurance companies, government or private, are a large part of the problem.
     
    Obamanation, Apr 29, 2013 IP
  3. earlpearl

    earlpearl Well-Known Member

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    #23
    Currently about 50% of docs have installed electronic records. If you have stats on installations on by GP's show them. My friend is a GP with electronic records. I have no idea if his group practise includes just GP's or a variety of specialties. Installation is moving forward at a reasonable pace.

    All you have done is taken a story about 1 guy, who is nearing the end of his practice and who doesn't make as much as most docs. He doesn't like the program. That is one guy.

    Its not a reason behind a national program. Its a single guy for whom things don't work out.

    Right wingers take a policy and these days attack anything done by Obama and paint it as the worst crime in humanity. Then they look for a constituency and blow out a lot of overwrought verbiage.

    If you are unhappy with health care deal with the overall cost situation. Read the infographic above and deal with it, rather than building a case on some older doc, operating on his own, living in a rural area and earning less than most docs, to try and build your case.

    Meanwhile about 50% of docs have installed electronic records to date.

    You probably like the fact that the 10 "not for profit" had operating profits of aggregate $3.5 billion and paid ZERO taxes. You probably like the fact that proscribed medicine in America costs 2, 3, 4,5 times as much as anywhere else in the world and that the same hospitals referenced above take cost items like a box of gauze that costs them $1 and charge hospital patients over $70.

    That $70 bucks is either paid by private insurance, possibly something like medicare OR you pay for it out of pocket.

    Those are rip off problems. They are worthy of being attacked.
     
    earlpearl, Apr 30, 2013 IP
  4. Corwin

    Corwin Well-Known Member

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    #24
    What I want to know is, is sharing my medical information electronically mandatory?

    What if I like it that my doctor, who's been practicing medicine for over 25 years, keeps my medical records in hand-written forms organized by color-coded folders?

    In 2004 I went to get a life insurance policy. I was required to take a blood test. In the release form it was spelled out that the results of my blood test will be placed in a national databank, and I needed to sign that form to release my results to the Feds. I refused to take the blood test or sign that form. The insurance company did a hilarious dance of "we take your privacy very seriously, we are using your case as an example of how to handle privacy, we hold your information in strictest confidence - now sign the freakin' form!" I didn't get the policy.

    It seems that each time the government wants to invade our privacy, it's "for your own good".
     
    Corwin, Apr 30, 2013 IP
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  5. Obamanation

    Obamanation Well-Known Member

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    #25
    Congratulations! That is exactly the action more people need to be taking.

    I just changed out my children's health insurance company. They got a new doctor with the new company, and they had 20 pages of long form information gathering, on which was the question, "Are there any guns in the house". The response, written over the checkbox yes/no, was "Go fuck yourself".

    If I had to guess, I'd say 80% of the form was information gathering for some insurance company actuary to build a profile of the children and assign risk. I left much of it blank. If there is something my doctor wants to know, he can ask himself, at which point he is legally bound to Doctor/Patient confidentiality, and can be sued for disclosing the information.

    I know first hand, based on the business I am in, that nothing that goes over a wire is private. Nothing. When you get that warm fuzzy feeling because you see that "secure connection" icon in the corner of your browser, just be aware that your secure connection may be setup directly to a man in the middle server who collects your information and passes it along. Smart phones are especially prone to this kind of attack.

    Even without first hand knowledge, a little common sense should tell you that any company you supply information to is subject to hacking and employee information theft. There are examples in the news on a daily basis.

    @Earlpearl: You seem to want to talk about electronic records keeping, rather than the well documented average wage for GPs. I can't say I blame you. Not only is it embarrassing, it flies in the face of your narrative of how the doctor from this news article is somehow an anomaly. Have you looked at the data on GlassDoor yet?
     
    Obamanation, Apr 30, 2013 IP
  6. earlpearl

    earlpearl Well-Known Member

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    #26
    O-nation: you keep trying to push a false argument. I've acknowledged several times the difficulties new docs, and specifically GP's could face. I see it as a two fold issue. Huge costs for education on top of incomes that are less than the rest of the medical industry. It is not a new issue. It is made more severe by the incredible increases in medical education in the US.

    Meanwhile foreign born and trained docs are entering the US at an increasing rate. They love the income. In most of the rest of the world medical education is underwritten by the state.

    Maybe we should be underwriting medical education.

    You, OTOH wanted to cut the salaries of higher paid government employees, the overwhelming majority of those employees in that salary range would have been docs.

    You wanted to cut docs salaries. Now you are whining about docs not making enough money. Give me a break o-nation. you don't care about any of these issues....you just enjoy mouthing off about right wing issues
     
    earlpearl, Apr 30, 2013 IP
  7. earlpearl

    earlpearl Well-Known Member

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    #27
    hm....google has incredible volumes of information on you. If you use a gmail acct they probably know your make and model of a mobile phone, let alone what you tend to search on, your interests, and tendencies. Facebook has huge volumes of personal information. All sorts of private businesses have enormous volumes of private information on you.

    ...and yes the US govt let alone states have information on you also. Its clearly a big issue for many folks.
    I don't care if the US knows my blood type. We are far far far from Russia, China or some other despotic nation that limits individuals.
     
    earlpearl, Apr 30, 2013 IP
  8. Obamanation

    Obamanation Well-Known Member

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    #28
    So your argument here is, since Google is invading your privacy, why not let the Federal and State governments do the same?


    I have no Google account, no Facebook, and no Twitter account under my own name. My PC is setup on a VM, which means every time I power the VM off, all the days activity gets erased with it. Cookies. Login IDs, everything. I used to be a diligent Tor browser user, but I really hate Firefox, so I've been lax. I'm swapping over to a small VPN company for my browsing.

    My information is my own, and I like it that way. Like you, I have the option to not use the services of people who insist on invading my privacy. It wasn't that long ago when such invasions of privacy were considered blatantly illegal.

    Regarding doctor pay vs. cost of education, why am I not surprised that your solution involves new government spending. Is there nothing that government spending can't fix? Riddle me this. How is new government spending going to bring GP pay from ~150k to the ~250k it is in Australia? Answer? It won't. The cost of education in the US is a whole different mess the liberals have created, and the associated debt bubble may well send us to 3rd world status. It has nothing to do with why our GPs make so little.
     
    Obamanation, Apr 30, 2013 IP
  9. earlpearl

    earlpearl Well-Known Member

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    #29
    O-nation: in order to attack the current administration you take the story of one older deeply unusual doctor operating as a single practitioner in a rural area...and claim that is the situation of all doctors across the land. Then you blame the govt and its medical practices.

    Maybe you should pay attention to what is going on in Australia. It appears that the Australian government is overwhelmingly underwriting the incomes of GP's in rural areas. Clearly a big govt program:

    http://www.theaustralian.com.au/nat...-shortage-a-myth/story-fn59nokw-1226588021207

    From the article: Australia has a big government program to support docs in rural areas. Here is what this Australian medicare program paid out:


    In 2011-12, the commonwealth government paid out $6.7 billion to GPs billing on Medicare and for GP incentive programs, up from $6.2bn in 2006-07.
    The 2011-12 payment amounted to an average of $317,000 for each of the 21,119 full-time-equivalent GPs billing on Medicare in 2011-12.

    I see you like big government programs that underwrite docs. Maybe you would suggest the same thing for the US since you love it in Australia. Meanwhile if you are so sad and worried about the incomes of docs why did you propose to cut the incomes of all the docs that service vets?

    Do you hate veterans??

     
    earlpearl, Apr 30, 2013 IP
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  10. Obamanation

    Obamanation Well-Known Member

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    #30
    @Earlpearl: The US government DOES do the same thing, only slightly differently. The pay tables for Medicare are based on desirability of the place to live. AKA Rural docs get more from Medicare. Since medicare basically sets the pay rate, it has the same effect. I would have to find the information to find out exactly what our medicare payment program is, but I suspect it is much the equivalent. There are probably just more hands in the pot due to regulations, which push down what the doctor actually takes home.
     
    Obamanation, Apr 30, 2013 IP
  11. earlpearl

    earlpearl Well-Known Member

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    #31
    o-nation: do you have multiple personalities?? you like how big govt works in australia and how it compensates docs. You hate docs who take care of vets and want to cut their pay. You also are happy to see how a doc can earn more in Australia than the US.

    I see your pattern here. Its a lot like how you, the NRA, and al quada are all for the same things, as shown in the thread about gun legislation.

    You are like al quada. You like what hurts america.
     
    earlpearl, Apr 30, 2013 IP
  12. Corwin

    Corwin Well-Known Member

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    #32
    Nice to know I'm not alone in thinking this way!

    EXACTLY!

    Anything I tell my doctor is bound by Doctor/Patient confidentiality. Anything I tell an insurance company can be bought and sold.

    I have a custom version of Android on my phone (CM7), I use a firewall for apps that don't need access, and rather than use a strange WiFi connection (which is just asking for trouble) I use mobile data.

    My doctor, a GP in the Boston suburbs - after 25+ years serving the community he's closing shop this year. Not just because he doesn't want to pay for the electronic record keeping (to be fair, he never told me he can't afford it) but in his own words "when government gets involved in medicine they screw everything up".
     
    Corwin, Apr 30, 2013 IP
  13. Corwin

    Corwin Well-Known Member

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    #33
    There's a difference between Google having your private information verses the government.

    Google doesn't have arrest and subpoena powers.
     
    Corwin, May 1, 2013 IP
  14. Obamanation

    Obamanation Well-Known Member

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    #34
    Good point, though you don't want Google having your information either.


    If it is the government you are concerned about, you should be aware that the government, our government, employs large private companies to hack private networks and private company's data. China has been doing the same for decades, so we are actually a bit behind the ball here, but to deny such programs exist defies common sense. Talk to a few people at DefCon and you'll find that nearly every last one of them works for a government contractor.

    On a private basis, I think of all the genius' who post their lives on facebook, only to later lose a job for posting something their would be future employer finds objectionable. Twitter, same deal. Companies who collect and aggregate your data are also huge targets for identity thieves, who make their living off of such data.

    Seriously, the only truly safe move is to try and prevent the existence of such data to an extent that is reasonable. I'm not going to live in a closet, but I'm also not headed down to a whore house in Haiti to have unprotected sex (from an information standpoint), like many people seem to be willing to do.
     
    Obamanation, May 1, 2013 IP
  15. thesickearth

    thesickearth Active Member

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    #35
    And what would be their options, out of curiosity? Everyone will become an investment banker? Professional athletes? Do you think $150 K a year jobs grow on the trees?
     
    thesickearth, May 10, 2013 IP
  16. Obamanation

    Obamanation Well-Known Member

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    #36
    Their options? Specialize. Work for a hospital that offers profit sharing. Move to a different country, as the doctor in the article did. Whatever you do, don't become a primary care physician. It doesn't pencil out.


    If you haven't gone through the process, I'd go to law school. Demand for attorneys with all the big government we have is only going up. Start a firm with your pals and you can be doing a million a year before age 30 in California. Go work for a big firm, then run for political office and feed off the system that way.

    Investment banking, mortgage banking, and the rest pay pretty well (a lot more than 150k) if you have good math skills.

    Whatever you do, don't start your own business, unless you want to be buried under a mountain of paperwork and legislation from the city, county,state, and federal government, work five times as hard for half the pay, only to be called a wart on the ass of society.

    My personal favorite is the professorial path. This is a path for career college students who never want to grow up. Tenure, high six digit salaries, special treatment, respect. Its beautiful. We can be a nation of Attorneys, bankers, politicians, government workers, college professors, students, and people on welfare. Its really the American dream.

    By the way, you probably didn't know this, but at 150k salary, your take home is 100k, because the government considers you rich.
     
    Obamanation, May 10, 2013 IP
  17. Corwin

    Corwin Well-Known Member

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    #37
    And with 100K take-home, a family can raise no more than two kids, live middle-class, and send their kids to a decent college. decent=they can't be doctors or lawyers.
     
    Corwin, May 11, 2013 IP