Medical Practice Growing After Refusing Health Insurance

[OYMWA]

Re: Medical Practice Growing After Refusing Health Insurance

@TLK

See this is always my concern. Why is that medical school so damn expensive. It’s almost like, oh because you are going to make millions later, we gonna charge you a million to educate you. They should start with or education system. Bring that cost down, and it will transform into lower service charges for health care

Oh..there is another factor. Malpractice insurance. The culture of suing for slightest of causes is also contributing to the problem. It forces the doctors to cover all their bases when you go in to see them. They will order all the tests, regardless of necessity, so they don’t get sued later. As soon as you get lawyers involved in any relationship, its all downhill.

[OYMWA]

Re: Medical Practice Growing After Refusing Health Insurance

@Muzna

Agree.
At the very least their should be some sort of “tiered” system where the potential income is taken into account when you are studying…
So it you are going to do nothing but a family practice you pay less to become a dr whereas if you plan to become a surgeon then you pay more. (And maybe it does end up that way in the long-run but I think the difference should be significantly greater between the two.)

Isnt that the case now? Someone studying Family Medicine or Internal Medicine pays less than the ones that go on and specialize.

[Southie]

Re: Medical Practice Growing After Refusing Health Insurance

Obama care crap? Which allows those who didn’t have insurance before to now have insurance? Which didn’t go far enough for most. Cause universal care is what it is about.

The fit for you wrt Obamacare may not be perfect. But is is an improvement over the previous sysyem. When if u lost ur job uu we out of luck.

Also hospitals I hear charge MORE those without insurance when they need surgery etc.

And not everyone gets a flat amount to get health care. Those on a salary of 30k with a.famiky of 4 do need Healthcare. Insurance for most at is useless till u need jt.

As a nation we need to work for everyone’s benefit.

[ehl-e-chamman]

Re: Medical Practice Growing After Refusing Health Insurance

@OneYourMomWarnedAbt

Oh..there is another factor. Malpractice insurance. The culture of suing for slightest of causes is also contributing to the problem. It forces the doctors to cover all their bases when you go in to see them. They will order all the tests, regardless of necessity, so they don’t get sued later. As soon as you get lawyers involved in any relationship, its all downhill.

that plus scores of patients that come in looking for zebras (thanks to idiotic shows like house or the doctors) … demanding all kinds of unnecessary workup … and are not happy if/when denied … which is then reflected in patient satisfaction surveys … which leads to lower pres ganey scores for the physician … resulting in hospital administration (v often with no medical training) breathing down the neck of physicians to do better or face replacement.
for many physicians its just not worth the time/hassle/harassment from EVERYONE to do the right thing.
Those that choose to fight the system … face persecution … both subtle and obvious. I tell you guys … i get home from my ER shifts as though returning from a battle! absolute mental, physical and emotional exhaustion … and i know i am not alone … all my colleagues feel the same way.

in addition to addressing the issues of the education system and the health care system … it is equally if not more important to get rid of/reduce this sense of entitlement/abuse of the system that exists (flourishes) currently.

[Pisiform]

Re: Medical Practice Growing After Refusing Health Insurance

@ehl-e-chamman

that plus scores of patients that come in looking for zebras (thanks to idiotic shows like house or the doctors) … demanding all kinds of unnecessary workup … and are not happy if/when denied … which is then reflected in patient satisfaction surveys … which leads to lower pres ganey scores for the physician … resulting in hospital administration (v often with no medical training) breathing down the neck of physicians to do better or face replacement.
for many physicians its just not worth the time/hassle/harassment from EVERYONE to do the right thing.
Those that choose to fight the system … face persecution … both subtle and obvious. I tell you guys …** i get home from my ER shifts as though returning from a battle! absolute mental, physical and emotional exhaustion … and i know i am not alone … all my colleagues feel the same way.
**
in addition to addressing the issues of the education system and the health care system … it is equally if not more important to get rid of/reduce this sense of entitlement/abuse of the system that exists (flourishes) currently.

I heard that a lot from ER docs. I was very excited about EM but but now considering how many docs burn out in this specialty, I am thinking something more relaxed

[shaasavera]

Re: Medical Practice Growing After Refusing Health Insurance

@ehl-e-chamman

that plus scores of patients that come in looking for zebras (thanks to idiotic shows like house or the doctors) … demanding all kinds of unnecessary workup … and are not happy if/when denied … which is then reflected in patient satisfaction surveys … which leads to lower pres ganey scores for the physician … resulting in hospital administration (v often with no medical training) breathing down the neck of physicians to do better or face replacement.
for many physicians its just not worth the time/hassle/harassment from EVERYONE to do the right thing.
Those that choose to fight the system … face persecution … both subtle and obvious. I tell you guys … i get home from my ER shifts as though returning from a battle! absolute mental, physical and emotional exhaustion … and i know i am not alone … all my colleagues feel the same way.

in addition to addressing the issues of the education system and the health care system … it is equally if not more important to get rid of/reduce this sense of entitlement/abuse of the system that exists (flourishes) currently.

It must be quite tough considering the number of frivolous law suits around medical litigation in the US and generally in the West.
In India and Pakistan people are not as demanding and trust the doctor to make the right decision. Tv shows and the internet make people think of the worse scenario and that inspires them to do what you say. It’s definitely not easy and I admire ED doctors for their skill and making tough decisions. so on behalf of your patients thank you for your hard work.

[ehl-e-chamman]

Re: Medical Practice Growing After Refusing Health Insurance

@Pisiform

I heard that a lot from ER docs. I was very excited about EM but but now considering how many docs burn out in this specialty, I am thinking something more relaxed

hmm … ER doc burnout rate is about 3x the rest.
However, there is genuine satisfaction there too … nothing beats the high of delivering that baby or reviving that arrest or catching/calling in that stroke or discovering and initiating treatment for that illness that would’ve taken months in primary care setting to even discover … shrug
ER is ER … its sad, frustrating and exhilarating all at once. you have to have the right personality for it.

PLUS there is flexibility in ER that most other dept just dont have … ideal for anyone with a young family.

whats more relaxed? pathology? anything with a clinic is subject to the same frustartions that we’ve all been highlighting.

[shaasavera]

Re: Medical Practice Growing After Refusing Health Insurance

@Pisiform

I myself didn’t have insurance for good two years. And I didn’t see a doctor for a regular checkup. What if I have gotten sick seriously, the ER and hospital visit would have drained me without insurance. Our lawmakers are douchebags, they just want to keep their sponsors like hospital systems, big pharma happy. If they really want to cut down medical cost I can think of several things on top of my mind

As Pcg said, ER visit are expensive and we should get rid of ER as a tool for routine health care for the poor. But what can the poor people do. When they have no health insurance, they would obviously walk into the ER with a cold, pneumonia etc. ER physicians are mainly trained to handle sudden problems like MVA, stroke and I think they must be limited to that. But nowadays, a grandma with arthritis walks into the ER. Since these non-emergent uninsured people flood the ER, who ends up paying for their visit .. tax payers and hence rise in the medical cost. Best thing would be to open free clinics for poor in those areas where poor people are most (they are not evenly distributed) and it should be a part of federal tax.

Also we should get rid of the profit mindedness from some doctors. I have come across few surgeons and (most of them desis) who would perform a procedure like colonoscopy and other things even though the patients doesn’t have symptoms they require the procedure. They just do it so they could make more money and not always think whats in the interest of the patient. Doctors who are employed by the hospital are paid a fixed amount and so in-house surgeon do surgeries and procedures if it is required (best interest) to the patient and not just because they can make few bucks.

Many of the folks practice defensive medicine. its just sad but they have to cover their asses don’t they because even though we know its useless to do this test, we would still run it just to cover protect ourselves from getting sued by a lunatic and ruining our life. This climate where patient can easily sue doctor for whatever should be eliminated …

I could go on and on but I have an exam tomorrow sigh

It is ridiculous how much degrees especially medical degrees cost in the US. Quarter of a million for a medical degree is crazy. In most countries it is 30-40 000.

Maybe after the US the best place to be a doctor is Australia. Health care system is quite good as well. We have universal coverage by medicare. All Australian residents get free treatment at public hospitals and subsidised treatment for optometrist, dental care, physio, Dietician, psychologists etc. Medicare is funded by income tax which i think is 1.5% or 2.5% if you have high income and no private insurance. Medicare pays benefit for doctor/specialist fees/investigations/surgical procedures. If you have chronic diseases patients get rebate on allied health services. 85% of standard specialists fee is paid by medicare. If a specialist charges more than a standard fee then that gap will have to be paid by the patient but then a patient will go to someone who charges reasonable amount. There is also option for private insurance for additional benefits.

I don’t see why the US system can’t be like this. Maybe doctors would earn a bit less initially but if the crazy course fees are slashed to 30 000 like in most developed countries why would it matter? In long term you can still earn as much.
In Scotland university education including medical education is paid by the government and is free. It’s an unnecessary stress in the mind of US students.

I don’t understand why many people are resistant to universal healthcare in the US. The affluent and rich people get access to all facilities but those who cannot afford it do not. A country is judged on how it treats its most unfortunate. More well being among citizens leads to less crime. A healthy society is better than a few healthy individuals. What’s the point of having world class medical facilities and doctors when only a fraction of a population can access it when they need it?

I live in Australia and all the desi doctors help each other. One of my relatives is a doctor and most of the patients are Indian or Pakistani and they go out of the way to make sure they get referrals to specialists and specialists subsidise payments for them. Lot of them go out of the way for their patients for no extra cost.
With so many desi doctors in US there should be more solidarity to help out each other’s community.

I think going across the border to Canada gives more reasonable results. Socialised medicine is not even that bad as media in the US makes it out to be. Maybe UK and European countries don’t pay doctors that well but countries like Australia have a good balance between both sides. Medicare is 1.5-2.5% of taxes. Imagine how many billions is wasted on overseas adventures. Without good health quality of life is significantly reduced. Anyone could be in a situation where someone could need ongoing healthcare because of some illness. It is unfortunate that even those on decent salaries can get bankrupt paying these costs. A wealthy country like the US shouldn’t have issues with health. Is it about doctors fees? Doctors in Australia earn a decent amount (without crazy course fees) and the public has access to good health. Both access to public and private health insurance like there is in Australia should be available.

Canada’s system is quite decent and i hear some US patients go to Canada.

Healthcare: Perspective from an American expat living in Canada

Canadian Doctor Gives U.S. Senator A Clinic On Public Health Care

86% of Canadians are satisfied with their healthcare system. 10% of their GDP compared to 15% of US's GDP.

if the US had a strong system of generalists or GPs who were universally accessible to all with insurance lot of general complaints like colds, arthritis, asthma check up, pap smears, headaches etc wouldn’t need to go to an ER.
I like your idea of a free clinic for poor people. I’m sure it will be appreciated. We have PBS (Pharmaceutical benefits scheme) which subsidises medications otherwise we’d be paying crazy rates.

Good luck for your exam.

[shaasavera]

Re: Medical Practice Growing After Refusing Health Insurance

@ehl-e-chamman

hmm … ER doc burnout rate is about 3x the rest.
However, there is genuine satisfaction there too … nothing beats the high of delivering that baby or reviving that arrest or catching/calling in that stroke or discovering and initiating treatment for that illness that would’ve taken months in primary care setting to even discover … shrug
ER is ER … its sad, frustrating and exhilarating all at once. you have to have the right personality for it.

PLUS there is flexibility in ER that most other dept just dont have … ideal for anyone with a young family.

whats more relaxed? pathology? anything with a clinic is subject to the same frustartions that we’ve all been highlighting.

I agree it is more exciting which is why i guess most medical shows are centred around an ER rather than other departments.

[shaasavera]

Re: Medical Practice Growing After Refusing Health Insurance

@OneYourMomWarnedAbt

Isnt that the case now? Someone studying Family Medicine or Internal Medicine pays less than the ones that go on and specialize.

I think everyone pays the same. I doubt most people know which area they want to go into initially. People always change their minds. There may even be some family doctors who are very popular who may earn more than a not so popular specialist. What i don’t understand is why are US medical degrees so much expensive than ones in India, Pakistan, Australia, UK, Europe? I understand US has the best medical facilities and doctors but 200 000 for a medical degree. Isn’t that a bit crazy? Scotland has free medical education for students and quality of healthcare is just as good. Maybe they get taxed a bit more but i think the US can afford slashing their defence budget in favour of the health budget.

Why doesn’t better medical facilities and doctors translate to better satisfaction? It’s not the fault of the doctors but the system itself.

Australia is ranked 4th in healthcare and 2nd in physician salaries. So best of both worlds for both sides. US ranks highest on quality but low on access, efficiency and equity. Other countries can learn quality care from the US and the US, if it wants to, can learn about access, efficiency and equity from other countries.
(U.S. Healthcare Ranked Dead Last Compared To 10 Other Countries)

http://www.forbes.com/sites/theapothecary/2013/05/28/are-u-s-doctors-paid-too-much/
There’s nothing wrong with universal healthcare it’s just that Obama is not doing it right because of pressure groups. I think Americans deserve better healthcare and on the same level as other developed countries.

[OYMWA]

Re: Medical Practice Growing After Refusing Health Insurance

@ehl-e-chamman

that plus scores of patients that come in looking for zebras (thanks to idiotic shows like house or the doctors) … demanding all kinds of unnecessary workup … and are not happy if/when denied … which is then reflected in patient satisfaction surveys … which leads to lower pres ganey scores for the physician … resulting in hospital administration (v often with no medical training) breathing down the neck of physicians to do better or face replacement.
for many physicians its just not worth the time/hassle/harassment from EVERYONE to do the right thing.
Those that choose to fight the system … face persecution … both subtle and obvious. I tell you guys … i get home from my ER shifts as though returning from a battle! absolute mental, physical and emotional exhaustion … and i know i am not alone … all my colleagues feel the same way.

in addition to addressing the issues of the education system and the health care system … it is equally if not more important to get rid of/reduce this sense of entitlement/abuse of the system that exists (flourishes) currently.

whats zebras?

[ehl-e-chamman]

Re: Medical Practice Growing After Refusing Health Insurance

@OneYourMomWarnedAbt

whats zebras?

euphemism for a rare/exotic condition with low prevalence.

[shaasavera]

Re: Medical Practice Growing After Refusing Health Insurance

@ehl-e-chamman

euphemism for a rare/exotic condition with low prevalence.

compared to horses i guess. Common things happening more commonly. Now if it was a unicorn that would be unheard of.

Good location. Great series by Enid Blyton. Sorry that was off topic but had to appreciate your taste in books.

[eastern11]

Re: Medical Practice Growing After Refusing Health Insurance

Still everyone in the US wants to become a doctor or marry their daughter/ son to one and once they do, they turn up their noses at the rest of the other “common folk”!

[ehl-e-chamman]

Re: Medical Practice Growing After Refusing Health Insurance

@shaasavera Thank you!
@eastern11 … im sorry i didnt follow your train of thought. how does marrying a doctor in USA contribute to the exorbitant cost of healthcare in USA?

[diwana]

Re: Medical Practice Growing After Refusing Health Insurance

@khattichic

It’s doctors costs too…

Please prove what you said.

Doctors cost is not whatsoever contributing to overall high cost of healthcare in US.

And do not be defensive (or even offensive), you are talking out of no knowledge of the topic when one reads your posts.