Tired of Corporate America

[jl lin]

OP. Read my reply above.

We do what we can, but we are going to see even more shake downs and drops in best practices in healthcare in coming years. People will essentially be getting a lot less and charged a lot more.

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[jl lin]

Anecdotes != data. Fact of the matter is, medicine provides higher salary and job security than many other fields. Growth in field is projected at 18% in coming decade. These are statistics one can look up rather than relying in malcontents on SDN.

Here's a hunt: happy doctors don't spend their time venting on SDN.

No offense BH, but you totally missed the point, and reality is what it is. Better to face it.

Also, I won't get into a pizzing war with you or anyone else, but I am reasonably sure over the years I have worked, befriended, and interacted with more physicians than you. It's the nature of my work. While many are not saying their lives/jobs are utter hell; they are not so quick to see and share about the glory as they once were.

As things keep changing for the worse in healthcare, people are getting less and less, I'll just say, thrilled, with medicine. It's really a lot of docs--not just a few here and there. A lot of it doesn't have so much to do with patients per se--dealing with patients and such. It seems that it has to do with insurance and reimbursement issues--and I hear a LOT about the time-consuming, ridiculous (and growing) regulations and idiotic paperwork that is required to stay afloat. This ends up sucking up so much time, they can't interact with their patients as they would like to be able to interact with them. They often can't even get home at a decent hour working in private practice, b/c of these regulations and excessive paperwork. Most physicians, pretty near all of them, can't survive in private practice anymore.
Mostly, they still may love seeing patients and helping them, but the growing weight of all the other stuff is taking a toll on them. I expect that probably in the next 5 years or more, med school apps will drop off again--especially since the sheer cost of medical education is becoming more and more unbearable. It almost seems inevitable.

 

[PreMedBeauty]

Relative to other fields is fine in the abstract, but when you are actually navigating your way through a bad job market in your chosen specialty it's really not going to be much solace to say, "well at least it better than" law, finance or whatever. Put another way --You don't care how many sharks there are out there waiting to rip you apart -- anything more than one isn't meaningfully worse...As you are getting torn apart by one shark you aren't going to say, "gee at least I've got it a lot better than that guy over there being eaten by twice as many sharks." Bad is bad. There is no relative.

I'm not trying to be negative or scare anyone. I'm just reporting back from the trenches that regardless of what propaganda you might have heard in pre-allo, there are fields and geographic regions that aren't universally offering guaranteed jobs for life. You can absolutely be struggling to find that right position. Or keep it.

I can barely read your posts. I'm done with this thread as well. All I have to say is that my doctor said the opposite. Also, considering that you were a lawyer. LOL

 

[ridethecliche]

OP. Read my reply above.

We do what we can, but we are going to see even more shake downs and drops in best practices in healthcare in coming years. People will essentially be getting a lot less and charged a lot more.

People keep saying this rhetoric, but there's no data to show it. Our system needs a gigantic bloody overhaul. For all the fear mongering that happens, the system in the Netherlands, England, Canada, etc. are great. Those systems also value education and aren't trying to rip people off and profit from those that will work to aid society after they graduate. People have private insurance over there if they want to pay more and want more prompt service, but I'd argue that american consumers are misguided as hell. Consumers here want more care NOW for non-life threatening and quality of life things to a degree which I think is unreasonable.

There are a few PCP groups I've worked with and been seen at where you can come in the same day or have space made for you if something is truly urgent. I took the short cut to the OR that way and circumvented the ER when I had acute appendicitis. But most systems aren't designed that well.

The biggest loss here is time spent with the PCP, i.e. a patients guide to health/medicine. If you can't build a rapport and trust with a patient, why would they listen to you. That's incredibly short sighted. I see NP's etc bridging that gap and this is why care teams are pivotal. Our current system is incredibly inequitable. That's the thing that needs the most change.

I can barely read your posts. I'm done with this thread as well. All I have to say is that my doctor said the opposite. Also, considering that you were a lawyer. LOL

Not sure what your credentials are but regardless, it's your loss.

Your doctor isn't paid to tell you the truth. There is a lot of stuff happening that people are terrified of. I know tons of residents that love what they do and others that are just toughing it out. Some of the attendings are nervous too. It would be better if there was any sort of system in place that people actually believed in to make changes, but no one has the balls to do that in this country. That's the worst part.

 

[ehwhatsupdoc]

No offense BH, but you totally missed the point, and reality is what it is. Better to face it.

Also, I won't get into a pizzing war with you or anyone else, but I am reasonably sure over the years I have worked, befriended, and interacted with more physicians than you. It's the nature of my work. While many are not saying, their lives/jobs are utter hell; they are not so quick to see and share they glory as they once were.

As things keep changing for the worse in healthcare, people are getting less and less, I'll just say, thrilled, with medicine. It's really a lot of docs--not just a few here and there. A lot of it doesn't have so much to do with patients per se--dealing with patients and such. It seems that it has to do with insurance and reimbursement issues--and I hear a LOT about the time-consuming, ridiculous (and growing) regulations and idiotic paperwork that is required to stay afloat. This ends up sucking up so much time, they can't interact with their patients as they would like to be able to interact with them. They often can't even get home at a decent hour working in private practice, b/c of these regulations and excessive paperwork. Most physicians, pretty near all of them, can't survive in private practice anymore.
Mostly, they still may love seeing patients and helping them, but the growing weight of all the other stuff is taking a toll on them. I expect that probably in the next 5 years or more, med school apps will drop off again--especially since the sheer cost of medical education is becoming more and more unbearable. It almost seems inevitable.

I also foresee a drop in applications too, especially with the economy strengthening. People will start flocking to finance, engineering, law, and computer science again. But I wouldn't be so negative as others are about the growing level of paperwork and bureaucracy you have to deal with. Once a system is in place where electronic medical records are shared all over and everyone has acceptable health insurance, there will be new computer software/algorithms that will make the paperwork seamless. I think this is just the growing pains during the transition.

 

[Dr.Sticks]

The corporate American culture is a major reason I am staying away from office type jobs..
Sitting at a computer, where I have no excitement, or actually problem solving that has a real physical affect eill drive me nuts.
Good luck escaping the rat race dude! What sucks now though is school is much more pricey, and doctor jobs aren't as abundant as they were before. So yeah, good luck.

 

[Dr.Sticks]

Oh while you guys are on the health care system, I believe in a switch to co concierge medicine.
Insurance that way will only be needed for major things, a doctors visit won't cost you an arm and a leg.
Another thing that need to stop though is the "sue" everyone mentality.

Law suits are a big problem, drive costs up,

 

[jl lin]

error

 

[jl lin]

I also foresee a drop in applications too, especially with the economy strengthening. People will start flocking to finance, engineering, law, and computer science again. But I wouldn't be so negative as others are about the growing level of paperwork and bureaucracy you have to deal with. Once a system is in place where electronic medical records are shared all over and everyone has acceptable health insurance, there will be new computer software/algorithms that will make the paperwork seamless. I think this is just the growing pains during the transition.

This has been going on for over 20 years, and still, it's never seamless. And the issues go beyond that. Ask a number of primary care physicians, but they aren't alone in dealing with this kind of thing. And there is really no such thing as a purely paperless system in healthcare. LOL. You can try; but there are always hardcopies and then some.

 

[Law2Doc]

I can barely read your posts. I'm done with this thread as well. All I have to say is that my doctor said the opposite. Also, considering that you were a lawyer. LOL

How close is your doctor to the job search phase of his career? It makes a difference. Until you are established and a partner with your own patient base you are much more likely to have no job security. And if you are an employee (ie not a partner in a practice) without your own patient base, any glut of residency graduates will mean there are people willing to work cheaper than you and take your job to get their foot in the door. Right now fields like pathology, radiology and cardiology are feeling this hit. Other specialties are likely to join this group as reimbursement cuts outpace growth, and the partner model gets replaced with an employee/hospital model.

Also, FYI having been a lawyer gives me BETTER insight because I've actually worked with failing medical practices (doing bankruptcy and restructurings) so I've actually seen people laid off and cast aside first hand. I've also worked with partnerships "firing" partners. Lots of doctors like to pretend it doesn't happen, can't happen to them or maybe haven't seen it personally, but the lawyer always gets to see the bad stuff.

Again, I'm not saying medicine is a bad career choice. I'm saying go into it with your eyes wide open and don't be lulled by some premeds' false notions of invariable high pay and impenetrable job security. you might wake up to learn you have incurred a lot of debt and invested a ton of time training for that perfect job you can't even find or keep.

 

[Nasrudin]

EMR's don't decrease paperwork--documentation--they increase it. Similar to the Braess paradox which describes how building a new highway actually increases traffic. Healthcare personnel spend more time clicking away on their computers and less time talking to patients than they ever did with paper charts.

 

[QofQuimica]

EMR's don't decrease paperwork--documentation--they increase it. Similar to the Braess paradox which describes how building a new highway actually increases traffic. Healthcare personnel spend more time clicking away on their computers and less time talking to patients than they ever did with paper charts.

Sad but true. I use an Ipad mini with a keyboard case myself. At least I can sit at the foot of the patient's bed with it and type away while we're chatting, instead of sitting in a computer room or worse, hauling a portable computer around with me from room to room. And the mini fits nicely in my white coat pocket.