AMA speaks out

[SteinUmStein]

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http://www.nytimes.com/2009/06/11/us/politics/11health.html?_r=1&hp

A nice reminder that the medical community does not live in a vacuum. An organization that is very familiar to all of us, the AMA, sent a letter to Congress stating their official opposition to a government-sponsored insurance plan. As potential future physicians, this is an incredibly relevant topic.

If private insurers are pushed out of the market, the group said, “the corresponding surge in public plan participation would likely lead to an explosion of costs that would need to be absorbed by taxpayers.”

While not the political behemoth it once was, the association probably has more influence than any other group in the health care industry.

Thoughts? What does everyone think about the fact that an organization of 250,000 physicians has immense power over the future of health care in this country of 300 million? How much of a voice should physicians have in this process?

 

[dw2158]

wow. just wow. i don't want to get flamed and/or start some crazy political talk on this thread, so i'll just stick with wow.

 

[Narmerguy]

Well I feel a lot better that no matter what outcome that the physicians will attempt to insert some sort of opinion into the debate. However, I feel that their interests are of too little importance to the powers that be when attempting to "satisfy the masses." This is a good step in the right direction. Personally I don't like the idea of being forced to see patients by the government. I support some sort of public coverage effort but forcing physicians to accept whatever they decide (though this will likely happen in some form anyway even if it's just under the table arm twisting) doesn't sit well with me.

 

[ngkats]

Well I feel a lot better that no matter what outcome that the physicians will attempt to insert some sort of opinion into the debate. However, I feel that their interests are of too little importance to the powers that be when attempting to "satisfy the masses." This is a good step in the right direction. Personally I don't like the idea of being forced to see patients by the government. I support some sort of public coverage effort but forcing physicians to accept whatever they decide (though this will likely happen in some form anyway even if it's just under the table arm twisting) doesn't sit well with me.

In regards to the bolded portion above, I think everyone can agree. For some reason it seems that the physician's voice--largely due, in my opinion, to public mistrust and the belief that physicians will only act in their own and exclusive interest--has dramatically softened.

It is quite surprising how willing the public is for massive changes in the way health care is delivered without too much concern for the opinion of those delivering it. And again, I think mistrust of physicians by the public is part of the problem here. Mistrust because...

...physician compensation is an inevitable part of this debate. Regardless of facts, it seems, to me at least, that most people believe doctors get paid far too much and their compensation should only and always decrease. Perhaps it is the extremely high costs of health care that convinces people doctors walk away with a pocket full of cash after a $1500 MRI.

Educating the public is crucial here. And that's what the AMA has done a piss-poor job of. This letter to Congress is a crucial step--irrespective of the opinion expressed in it--to positing meaning and increasing volume in the physician voice. Educating the public is another crucial step.

Without this education, I feel like reducing physician compensation will at least be a large p.r. portion of a public health care push. Regardless of whether decreasing phsycian compensation will actually lower costs substantially, making it an integral part of health care reform is a tidbit of information that the public can easily understand.

 

[TimeGate]

I agree. I think we are seeing similar developments in the financial industry where the government has intervened or at least tried to intervene in executive pay. People assume (sometimes rightly) that these people are paid for no reason, but most of time, these executives are hard workers that have immense responsiblity. Its hard for the public to see that when the public has never experienced the pressures of a ceo or cfo...i believe healthcare might take a frightningly similar path

 

[itsallthesame]

the doctor i live with is the single hardest working person i've ever met. she makes crap, has tons of debt and the pager goes off at least once every night. if someone needs an emergent operation, she is legally and ethically required to perform it before they pay. her hospital can not legally forcibly collect payment afterwards if the patient decides not to pay (like a car loan company can), and her hospital must accept any amount that an insurance company or the us gov't choses as compensation.

medicine is the ONLY profession in this country where the provider can be forced to provide a service before pay. try walking into a grocery store while starving to death and claiming a banana. you'll get sent to an ER or jail. homeless? without any clothing? don't go to jc penny. you can't just pick a house.

sure, there's affordable housing, food stamps, etc. but the grocery store gets it's money for food stamps. you still have to pay a fee up front to get affordable housing. the contractors who build projects get paid, and can unionize to set their fee. but if a doctor mentions to another doctor that X HMO doesn't pay enough and that they should consider not accepting it... she just committed a crime.

the idea that doctors shouldn't have a hand in designing american medical care is a joke. not only are they the one best trained to design health care systems, but they are the ones slaving over delivery. the ones training harder than any other profession, etc. and the ones who deserve to be rewarded for that. not shoved under a rug, not allowed to associate to discuss compensation, blamed for health care problems, and forced to over perform procedures just to almost come close to keeping their income steady.

not to mention that a national health care program will decrease quality of care and increase costs. if you don't believe me, go to your local county hospital. ask when the last time someone got fired because they didn't work as hard as they could, aka a little lazy. lazy employees = wasted money.

 

[Excelsius]

I agree. I think we are seeing similar developments in the financial industry where the government has intervened or at least tried to intervene in executive pay. People assume (sometimes rightly) that these people are paid for no reason, but most of time, these executives are hard workers that have immense responsiblity. Its hard for the public to see that when the public has never experienced the pressures of a ceo or cfo...i believe healthcare might take a frightningly similar path

The financial market and the healthcare industry are two very separate things. First of all, CEOs are the very same people who brought this country down by exploiting toxic assets on a national level. It affected everybody. Doctors cannot do this. Second, after these "hard working" CEOs and others in similar work environment worked hard to bring the country down, they kneeled before the congress and begged for money. They got it. So now they are operating with public money. What do you expect? Of course there are going to be caps on compensation. There better be a cap. Those bums that screwed the country over should be stripped of their wealth instead of getting bonuses. There is nothing intelligent about what they did and it strikes a nerve to compensate them. Once they pay back all the money they usurped from the taxpayers, their compensation caps will be lifted. This has nothing to do with the healthcare industry.

 

[IndianVercetti]

I know I'm a bit behind on the political basis behind this, but can someone just briefly summarize why universal public health insurance is generally disfavored by physicians? What are the repercussions to doctors?

 

[tiedyeddog]

I know I'm a bit behind on the political basis behind this, but can someone just briefly summarize why universal public health insurance is generally disfavored by physicians? What are the repercussions to doctors?

Government will control compensation (They already do for the most part but the fear is compensation will lower.)

 

[Decicco]

Three cheers for the AMA. I'd like to not be a government employee, if at all possible.

Government will control compensation (They already do for the most part but the fear is compensation will lower.)

Also, the government would politicize what treatments and procedures are available or (more likely) not available to patients. This has less to do with rationing and more to do with lobbying.

 

[kami333]

Personally, I fear the AMA (and healthcare industry in general) has missed the boat.

By not speaking up (well, they did but they should have been shouting) and changing earlier, and only promising to change things now that the "threat" of UHC is on the table, I think all the public sees now are ulterior motives.

 

[ayushman80]

If anyone wants to learn more about the subject, "Who Killed Healthcare" is an excellent book. Goes into a great deal about what the state of the system is, how it got that way, and the right way to fix it.

 

[Decicco]

If anyone wants to learn more about the subject, "Who Killed Healthcare" is an excellent book. Goes into a great deal about what the state of the system is, how it got that way, and the right way to fix it.

I also recommend this book, it is excellent. If you want to get a head start on the notorious "health care policy" questions in interviews, you should buy this book (it helped me alot)!

 

[aphios5]

You know, I'm surprised that there hasn't been more discussion of reinsurance. What is reinsurance, you ask? Why let me tell you:

In the context of our national healthcare debate, reinsurance would entail having the federal government insure private insurance companies against their high-risk groups, thus enabling insurance companies to ease up on premium rates for the rest of us average Joe Schmoes.

It's sort of a mix of private and federal coverage, but definitely not a new idea. It's actually been around for a while, but it would be nice to teach that old dog a new trick or two, especially in this day and age of confusion.

Want to learn more? Katherine Swartz, a professor at the Harvard School of Public Health, is the author of Reinsuring Health: Why More Middle-Class People Are Uninsured and What Government Can Do (Russell Sage Foundation Press, 2006).

Go to your local library and get informed on this often forgotten option. It'd be nice get some other perspectives on the subject as I haven't really heard anything negative about it yet.

Ciao.

 

[aphios5]

This should be obvious, but how do potentially lower insurance premiums figure into the debate of this thread?

If more people are able to afford private health insurance premiums, more people will be able to afford health insurance, which means less people left uninsured, which means more people are actually visiting their doctors, which means more preventive care is being provided, which affords more opportunity to catch chronic diseases and the like earlier, which means better health outcomes for patients and a decreased cost to the insurance company over the lifespan of a policyholder, so on and so forth, yadda yadda.....👍

 

[Stixman28]

http://blog.healthcareforamericanow...e-ama-takes-mere-hours-to-reverse-themselves/


"Today's New York Times story creates a false impression about the AMA's position on a public plan option in health care reform legislation. The AMA opposes any public plan that forces physicians to participate, expands the fiscally-challenged Medicare program or pays Medicare rates, but the AMA is willing to consider other variations of the public plan that are currently under discussion in Congress. This includes a federally chartered co-op health plan or a level playing field option for all plans. The AMA is working to achieve meaningful health reform this year and is ready to stand behind legislation that includes coverage options that work for patients and physicians."

 

[Mysterion]

This should be obvious, but how do potentially lower insurance premiums figure into the debate of this thread?

If more people are able to afford private health insurance premiums, more people will be able to afford health insurance, which means less people left uninsured, which means more people are actually visiting their doctors, which means more preventive care is being provided, which affords more opportunity to catch chronic diseases and the like earlier, which means better health outcomes for patients and a decreased cost to the insurance company over the lifespan of a policyholder, so on and so forth, yadda yadda.....👍

With lower insurance premiums though, the amount of people to be insured would rise and thus the costs incurred by the insuring company would rise in order to cover the new members. I think that this would work out like the sub prime mortgage crisis in a way because the amount of cost assumed by the company (due to insurance claims in this case) would likely be higher due to all the newly insured than the amount coming in from the low premiums.

Now if you're talking about lower premiums with much stricter restrictions on what procedures are covered, that could definitely be a good idea and may work out for both sides, but are the patients will to compromise on that.

 

[dw2158]

http://blog.healthcareforamericanow...-ama-takes-mere-hours-to-reverse-themselves/:


“Today's New York Times story creates a false impression about the AMA's position on a public plan option in health care reform legislation. The AMA opposes any public plan that forces physicians to participate, expands the fiscally-challenged Medicare program or pays Medicare rates, but the AMA is willing to consider other variations of the public plan that are currently under discussion in Congress. This includes a federally chartered co-op health plan or a level playing field option for all plans. The AMA is working to achieve meaningful health reform this year and is ready to stand behind legislation that includes coverage options that work for patients and physicians.”

i think the AMA just threw down.

 

[aphios5]

With lower insurance premiums though, the amount of people to be insured would rise and thus the costs incurred by the insuring company would rise in order to cover the new members. I think that this would work out like the sub prime mortgage crisis in a way because the amount of cost assumed by the company (due to insurance claims in this case) would likely be higher due to all the newly insured than the amount coming in from the low premiums.

Now if you're talking about lower premiums with much stricter restrictions on what procedures are covered, that could definitely be a good idea and may work out for both sides, but are the patients will to compromise on that.

Your latter point is taken very well, indeed, the author ascribes: "Government reinsurance shifts the burden of risk....reducing premiums and creating incentive to manage medical care." She goes on to state that it creates affordability - but no free lunch.

In all of her positive thought regarding the subject, the author is still very honest in noting that the actual cost of reinsurance remains to be seen. In terms of a final analysis, there are many bullet points and variables to take into consideration.....

Thanks!

 

[ngkats]

http://blog.healthcareforamericanow...-ama-takes-mere-hours-to-reverse-themselves/:


“Today's New York Times story creates a false impression about the AMA's position on a public plan option in health care reform legislation. The AMA opposes any public plan that forces physicians to participate, expands the fiscally-challenged Medicare program or pays Medicare rates, but the AMA is willing to consider other variations of the public plan that are currently under discussion in Congress. This includes a federally chartered co-op health plan or a level playing field option for all plans. The AMA is working to achieve meaningful health reform this year and is ready to stand behind legislation that includes coverage options that work for patients and physicians.”

Wait, who wrote this? Is it directly from the AMA?

 

[BTC]

I know I'm a bit behind on the political basis behind this, but can someone just briefly summarize why universal public health insurance is generally disfavored by physicians? What are the repercussions to doctors?

Many physicians currently treat medicare and medicaid patients at a loss. Obama's plan will expand this system to the entire population and then mandate that physicians be required to treat these people. I don't think doctors like being told who they have to treat.

I wholeheartedly agree that healthcare needs reform but this system looks like a camoflaged single payer health system. Many say, 'great, we could use one of those,' but other countries which have those have additional things like subsidized medical education.

And while Obama takes on healthcare, what excatly has he done to reform the financial system?

 

[tiedyeddog]

If anyone wants to learn more about the subject, "Who Killed Healthcare" is an excellent book. Goes into a great deal about what the state of the system is, how it got that way, and the right way to fix it.

Thanks for the book suggestion! I'll order and read it soon, sounds like a good read.

 

[ngkats]

Check out the comments section on the nytimes article. I haven't read the whole first page yet (they are over 700 comments total...), but numbers 2-4 are classic example in what I was talking about in my previous post. Any resistance by doctors to a national plan, and laymen reflexively assume doctors are just being "greedy."

http://community.nytimes.com/article/comments/2009/06/11/us/politics/11health.html

Here are some highlights of the reaction to the article:

"To be expected. Get a group of docs together and what do they talk about: money, money, money, and 'Oh yeah I found a new way of doing X that I'd like to brag about.' It'll be a happy day when we hand these jokers a 40% pay cut to bring them down to international norms."

Here's another:

"Of course the AMA and its members would oppose a government-sponsored plan. The current system that allows its members a year out of residency to earn an average of $150,000 to $200,000, with the prospect of seeing that rise to upwards of $$300,000 to $500,000 in less than 10 years is too much to give up. If you think Wall Street is the last place where pure greed exists, think again."

(the education the public point I made in my previous post, really applies to this second comment.)

 

[Stixman28]

Wait, who wrote this? Is it directly from the AMA?

Apparently, i fixed the link above, and here's another, Marc Ambinder is quite reputable:

AMA: We're Open To Some Public Plans
http://politics.theatlantic.com/2009/06/ama_were_open_to_some_public_plans.php

A friend of mine works for the health care for america now ppl, so he's always quick to find this stuff.

Ill toss in a thought too. this 'reversal' i've read may have been spurred on by the fact that no one want to oppose obama, he's just too damn popular. Anyway to look like you're agreeing with him ppl think will help their interests in the long run.

 

[womp]

Check out the comments section on the nytimes article. I haven't read the whole first page yet (they are over 700 comments total...), but numbers 2-4 are classic example in what I was talking about in my previous post. Any resistance by doctors to a national plan, and laymen reflexively assume doctors are just being "greedy."

http://community.nytimes.com/article/comments/2009/06/11/us/politics/11health.html

Here are some highlights of the reaction to the article:

"To be expected. Get a group of docs together and what do they talk about: money, money, money, and 'Oh yeah I found a new way of doing X that I'd like to brag about.' It'll be a happy day when we hand these jokers a 40% pay cut to bring them down to international norms."

Here's another:

"Of course the AMA and its members would oppose a government-sponsored plan. The current system that allows its members a year out of residency to earn an average of $150,000 to $200,000, with the prospect of seeing that rise to upwards of $$300,000 to $500,000 in less than 10 years is too much to give up. If you think Wall Street is the last place where pure greed exists, think again."

(the education the public point I made in my previous post, really applies to this second comment.)

It's like an angry mob. There's nothing to be gained when doctors side with the insurers, only the wrath of the dimwitted masses.

More comments from the New York Times (only about 1 out of 20 comments supported the doctors):

"Let's not forget another one: the exorbitant income of medical doctors, each of which is essentially a self-regulated franchisee protected by the monopoly of the AMA. Under ANY semblance of a competitive system, US physicians will pocket a lot less $$ -- and will live more like the public servants they actually are than like instant profiteers they currently are permitted to be. Please don't cry to me about the many years of schooling, student loan debt, long hours, stress, pleasures foregone while in training, attracting only the best, etc. etc. etc. Certain other professions can claim the same, without the compensation."

"The AMA has the best scam ever. It can prey with impunity on the sick and the poor for profit while wearing the mask of compassion and uttering false concern for its victims. The perfect parasite. What it fails to accept is the fact that the host is dying."

"Doctors have now joined the ranks of lawyers and politicians in their greed. Anyone who has ever gotten sick can plainly see that the private insurance system does not work. For a physicians' group such as AMA to NOT endorse a public option diminishes the group's importance. What a farce!"

"Doctors are and have for a long time been the most selfish segment of our economic community."

"a lot of the rest of us worked hard as undergradates (in my case, two different undergraduate degrees while raising two children alone) got high marks, took GRE's, had misery in graduate school and what? should be rewarded for what? Being smart? Ok, in that case I guess I should gripe because I didn't get more money throughout my life in my chosen field which just unfortunately was not medicine. Big deal. Get over yourself."

"Boo to the AMA! The same organization that spends millions each year to lobby against Advanced Practice Nurses in this country. The AMA does not care about increasing access to health care. What they care about is money and making sure that only physician providers are getting reimbursement."

"It's so sad to see that health care is about the doctors, and the insurance companies, and maybe the hospital administrators. But it really isn't about the patient anymore. The only purpose of a patient is to provide money for the above named parties whose survial is at stake here. They'll have to face rationing: each will have to settle for a smaller piece of the pie. So sad."

"This is nothing new from AMA. It is a UNION run by the Doctors for the only benefit of the Doctors just like any other union. If the medical profession is opened up to cheap labor from foreign countries just as software programming is, then we would not have these cost escalations."



If the comments above represent the majority of Americans' views, then this country is definitely heading down, down, down.

Of all the comments, only this one spoke some sense:

"The eminent surgeon who performed my 5 hour triple bypass surgery was paid $2300, the negotiated fee with my health insurer. (She has 28 years of education) My real estate agent was paid 6%, of the $300K ($18,000) for the 3 hours it took to sell my house. (She has 12 years of education)."

 

[usermike8500]

"To be expected. Get a group of docs together and what do they talk about: money, money, money, and 'Oh yeah I found a new way of doing X that I'd like to brag about.' It'll be a happy day when we hand these jokers a 40% pay cut to bring them down to international norms."

Relax future doctors. If our salaries are brought down to international norms, there are other ways to make money. Take Dr. Kono Hitoshi in Japan for example:

"If somebody comes in with a cut less than 6 square inches, Kono gets 450 yen, or about $4.30, to sew it up.

"It's extremely cheap," he says.

Kono is forced to look for other ways to make a yen. He has four vending machines in the waiting room. In a part of Tokyo with free street parking, he charges $4 an hour to park at his clinic.

The upside is that virtually no one in Japan goes broke because of medical expenses."

here's the link:
http://www.npr.org/templates/story/story.php?storyId=89626309


*okay, I know I've been posting this too much. I just like the article. I'm thinking about getting several vending machines that sell bouncy balls and sticky hand toys in order to pay back my loans once healthcare nationalization takes place.

 

[womp]

Relax future doctors. If our salaries are brought down to international norms, there are other ways to make money. Take Dr. Kono Hitoshi in Japan for example:

"If somebody comes in with a cut less than 6 square inches, Kono gets 450 yen, or about $4.30, to sew it up.

"It's extremely cheap," he says.

Kono is forced to look for other ways to make a yen. He has four vending machines in the waiting room. In a part of Tokyo with free street parking, he charges $4 an hour to park at his clinic.

That's ridiculous that the reimbursement is only $4.30 to sew someone up in Japan and hospital stays are $10 a night, while a taxi ride from the international airport to Tokyo proper is $300 (30,000 yen). A Japanese person makes more money being a taxi driver than a doctor.

Let's not be Japan. They've been in a recession for two decades now.

 

[Excelsius]

That's ridiculous that the reimbursement is only $4.30 to sew someone up in Japan and hospital stays are $10 a night, while a taxi ride from the international airport to Tokyo proper is $300 (30,000 yen). A Japanese person makes more money being a taxi driver than a doctor.

Let's not be Japan. They've been in a recession for two decades now.

"I think our system is pretty good, pretty good, but no system is perfect," he says. "But 50 percent of hospitals are in financial deficit now."

That is not sustainable and I don't think will last long.

Also this:

- Hospital doctor = ¥en 14.1 million = US $134,817 / year (April 2008 Rates)

- Doctor with own clinic = ¥en 25.3 million = US $243,632 / year

- Doctor working at clinic = ¥en 14.0 million = US $134,817 / year

(http://mdsalaries.blogspot.com/2008/04/doctor-incomes-in-japan.html)

Those are doctor salaries in Japan. Compare that to their average income for the country of $30K. The conclusion here is that doctors are always going to be well taken care off. The minute it becomes uncomfortable to lead a doctor's life, you are going to have a crisis in the country as no one will want to become one. I think the profession is safe even on the global level. Salary fluctuations can happen here and there, but not to a very significant degree.

 

[aliziry]

http://student.pnhp.org/content/what_about_physician_salaries.php

 

[womp]

http://student.pnhp.org/content/what_about_physician_salaries.php

That's under a single-payer system though... not an expanded Medicare system. I highly doubt most physicians will see equal compensation under an expanded Medicare hybrid system.

 

[ngkats]

Nm

 

[NoMoreAMCAS]

AMA sounds like it's being very logical. I'm happy to see my future colleagues are a lot more like me than i thought. I figured most of them would be completely illogical hippies calling for health care for all, no matter the consequences.

 

[ngkats]

AMA sounds like it's being very logical. I'm happy to see my future colleagues are a lot more like me than i thought. I figured most of them would be completely illogical hippies calling for health care for all, no matter the consequences.

Just so you know, calling those who disagree with you "hippies" will automatically discredit your opinion, regardless of whether it's reasonable or not.

 

[NoMoreAMCAS]

Personally, I fear the AMA (and healthcare industry in general) has missed the boat.

By not speaking up (well, they did but they should have been shouting) and changing earlier, and only promising to change things now that the "threat" of UHC is on the table, I think all the public sees now are ulterior motives.

Such as keeping taxes from shooting through the roof for every american? Like mentioned in the article.

 

[NoMoreAMCAS]

Just so you know, calling those who disagree with you "hippies" will automatically discredit your opinion, regardless of whether it's reasonable or not.

Bummer.

 

[Bacchus]

**** the doctors! But, I'll watch Christiano Ronaldo kick a ball around for about an hour to the tune of $130,000,000. Or, I'll watch the Yankee's who spend ten's of millions on players' salaries each year.

 

[FIREitUP]

the doctor i live with is the single hardest working person i've ever met. she makes crap, has tons of debt and the pager goes off at least once every night. if someone needs an emergent operation, she is legally and ethically required to perform it before they pay. her hospital can not legally forcibly collect payment afterwards if the patient decides not to pay (like a car loan company can), and her hospital must accept any amount that an insurance company or the us gov't choses as compensation.

medicine is the ONLY profession in this country where the provider can be forced to provide a service before pay. try walking into a grocery store while starving to death and claiming a banana. you'll get sent to an ER or jail. homeless? without any clothing? don't go to jc penny. you can't just pick a house.

sure, there's affordable housing, food stamps, etc. but the grocery store gets it's money for food stamps. you still have to pay a fee up front to get affordable housing. the contractors who build projects get paid, and can unionize to set their fee. but if a doctor mentions to another doctor that X HMO doesn't pay enough and that they should consider not accepting it... she just committed a crime.

the idea that doctors shouldn't have a hand in designing american medical care is a joke. not only are they the one best trained to design health care systems, but they are the ones slaving over delivery. the ones training harder than any other profession, etc. and the ones who deserve to be rewarded for that. not shoved under a rug, not allowed to associate to discuss compensation, blamed for health care problems, and forced to over perform procedures just to almost come close to keeping their income steady.

not to mention that a national health care program will decrease quality of care and increase costs. if you don't believe me, go to your local county hospital. ask when the last time someone got fired because they didn't work as hard as they could, aka a little lazy. lazy employees = wasted money.

i suggest you go look at how much we pay per capita for medical care versus other countries. I also suggest you look at the disparity in life expectancies on the basis of wealth in america. I don't think you understand that 30% of healthcare costs are administrative, i.e., to deny you care. This change is necessary for this country to thrive.

 

[Charles_Carmichael]

It's scary what the general public thinks about doctors. I really feel like we need to educate them on the path to becoming a doctor (and the sacrifices involved) and that not every doctor owns a mansion and is driving around in Lamborghinis. What can we do to make the average person understand all this? Shouldn't we be putting in some effort towards improving the image of the doctor to one that's more realistic than what the lay person tends to assume?

 

[Bacchus]

It's scary what the general public thinks about doctors. I really feel like we need to educate them on the path to becoming a doctor (and the sacrifices involved) and that not every doctor owns a mansion and is driving around in Lamborghinis. What can we do to make the average person understand all this? Shouldn't we be putting in some effort towards improving the image of the doctor to one that's more realistic than what the lay person tends to assume?

You can lead the campaign. You'll give up in less than 2 weeks, I bet.

 

[Charles_Carmichael]

You can lead the campaign. You'll give up in less than 2 weeks, I bet.

Hah. You'll definitely win that bet. It's still discouraging to see what a low opinion of physicians people can have.

 

[witness23]

?

i thought public had a pretty high opinion of doctors. especially in comparison to other careers.

 

[Col Kurtz]

AMA sounds like it's being very logical. I'm happy to see my future colleagues are a lot more like me than i thought. I figured most of them would be completely illogical hippies calling for health care for all, no matter the consequences.

So, you take the position that not everyone should have access to health care? Nice. This is the reason that the public has a negative view of doctors.

 

[Narmerguy]

So, you take the position that not everyone should have access to health care? Nice. This is the reason that the public has a negative view of doctors.

Come on now, don't cherry pick his post. He said that we shouldn't throw health care to everyone no matter the cost. I don't think there are many physicians or future physicians who wouldn't want to see more people covered but the cost of insuring them needs to be considered as well.

 

[Narmerguy]

?

i thought public had a pretty high opinion of doctors. especially in comparison to other careers.

Well if the general opinion towards premeds is any indicator...not that it isn't ever rightfully so and not that all of these premeds that digust others ultimately become doctors. Nonetheless, from the very beginning many people (at least at the college level) have a pretty harsh view of what will eventually become doctors.

 

[Col Kurtz]

Come on now, don't cherry pick his post. He said that we shouldn't throw health care to everyone no matter the cost. I don't think there are many physicians or future physicians who wouldn't want to see more people covered but the cost of insuring them needs to be considered as well.

Yes, I agree it was cherry picking. though i disagree with him often, i think NoMoreAmcas generally has thoughful posts. BUT let's be honest, if we use "cost" as an over riding factor in whether someone receives health care or not, then there will be many people who do not receive it. Since you two demand a pragmatic approach, then you must be willing to debate whether it is right to deny health care based on whether the pt can afford it.

Also when I hear a future physician complain that he doesn't want his taxes to go up or his pay cut so that more people can have access to something that every person needs, I find it a little disturbing. That is the definition of greed and I think it is well within reason to question whether that person has the capacity for compassion that the profession demands.

 

[niranjan162]

Yes, I agree it was cherry picking. though i disagree with him often, i think NoMoreAmcas generally has thoughful posts. BUT let's be honest, if we use "cost" as an over riding factor in whether someone receives health care or not, then there will be many people who do not receive it. Since you two demand a pragmatic approach, then you must be willing to debate whether it is right to deny health care based on whether the pt can afford it.

Also when I hear a future physician complain that he doesn't want his taxes to go up or his pay cut so that more people can have access to something that every person needs, I find it a little disturbing. That is the definition of greed and I think it is well within reason to question whether that person has the capacity for compassion that the profession demands.

There is no other factor. Why do u think everyone is making a big deal about the healthcare system now? Because people are getting so fat and irresponsible thats its costing more to treat them.

Your idealism isnt gonna pay for johnny tripple bypass so he can go back to mcdonalds in a few weeks.

Caring about your salary and how the government pisses away your money is not greed. Doctors fight to keep their salaries STAGNANT, not even for raises, but just to keep them from going down. That doesnt sound like greed to me. get a clue.

 

[niranjan162]

?

i thought public had a pretty high opinion of doctors. especially in comparison to other careers.

this is in the past. Doctors are seen as part of the system thats trying to screw them over. The hospital the insurance company and the doctor are all lumped into one group by the public and when they dont get what they want they blame the face (doctor) rather than the nameless company or hospital.

 

[Bacchus]

Yes, I agree it was cherry picking. though i disagree with him often, i think NoMoreAmcas generally has thoughful posts. BUT let's be honest, if we use "cost" as an over riding factor in whether someone receives health care or not, then there will be many people who do not receive it. Since you two demand a pragmatic approach, then you must be willing to debate whether it is right to deny health care based on whether the pt can afford it.

Also when I hear a future physician complain that he doesn't want his taxes to go up or his pay cut so that more people can have access to something that every person needs, I find it a little disturbing. That is the definition of greed and I think it is well within reason to question whether that person has the capacity for compassion that the profession demands.

It is not greed. We want to make a living. And, besides committing to an underserved area or our military, it can be hard. With the amount of debt we willingly take on, the time we "waste" of our prime youth, and the bull**** that we put up with, I would hardly say this is greed. If you subsidize my medical education with no catch (years of indebted "servitude") then perhaps you can cut my salary. Cutting physician salary is not going to solve any problems but will create more, most definitely.

 

[yoman786]

Perhaps the best idea I could think of to bridge this problem, to move past the fact that physicians are going to be hurt by some form of national health care option, would be that within that same bill that creates such a national health care option, to also limit malpractice and free doctors from frivilous malpractice suits and from massive payments and high rates of insurance. I am from Illinois, where no cap exists, and where doctors find it more feasible to either enter another line of work or move in order to avoid the possibility of losing a thriving practice to one mistake. I feel if this situtation were corrected, then possibly the loss of a small amount of yearly income could be handled

And perhaps we should all remember at its heart medicine is a altrustic way of life. We willingly give of ourselves and place strangers, patients, above our own happiness at times. While we deserve to be compenstated for this, for our sacrifices, we should take a step back and realize that maybe this is another sacrifice being asked of us. This is assuming of course that the pay cut is fair, and yet even as I type this I think of how much it will cost us as students to attend medical school, 250k-300k, and the cost of educating a medical student, averaged around a million if I remember last. Perhaps if we were to know more specifics, perhaps what amount of a cut is being promised, then we could properly discuss what it would mean and whether it is resonable for its benefits.

As for outreach, I think shows like Hopkins or ER helped, they allowed people to see the tough, albiet in the case of ER fictionalized, lives doctors can lead. I feel that perhaps some form of new special that takes a serious look at the sacrifices that we are willing to make and what the truth is for our compenstation levels, that would be an ideal vechicle in order to educate the public and raise the status of the doctor from the villians we appear to have become.

All I know is, despite all of this, I still would like to attend medical school and become a doctor. I have made the decision to give of myself and work towards saving lives, towards the public good, towards my fellow man. My dream is simply that some medical school, preferably in my state, understands this from how I present myself to them, and allows me admission. Even if it would mean a pay cut

 

[niranjan162]

Perhaps the best idea I could think of to bridge this problem, to move past the fact that physicians are going to be hurt by some form of national health care option, would be that within that same bill that creates such a national health care option, to also limit malpractice and free doctors from frivilous malpractice suits and from massive payments and high rates of insurance. I am from Illinois, where no cap exists, and where doctors find it more feasible to either enter another line of work or move in order to avoid the possibility of losing a thriving practice to one mistake. I feel if this situtation were corrected, then possibly the loss of a small amount of yearly income could be handled

And perhaps we should all remember at its heart medicine is a altrustic way of life. We willingly give of ourselves and place strangers, patients, above our own happiness at times. While we deserve to be compenstated for this, for our sacrifices, we should take a step back and realize that maybe this is another sacrifice being asked of us. This is assuming of course that the pay cut is fair, and yet even as I type this I think of how much it will cost us as students to attend medical school, 250k-300k, and the cost of educating a medical student, averaged around a million if I remember last. Perhaps if we were to know more specifics, perhaps what amount of a cut is being promised, then we could properly discuss what it would mean and whether it is resonable for its benefits.

As for outreach, I think shows like Hopkins or ER helped, they allowed people to see the tough, albiet in the case of ER fictionalized, lives doctors can lead. I feel that perhaps some form of new special that takes a serious look at the sacrifices that we are willing to make and what the truth is for our compenstation levels, that would be an ideal vechicle in order to educate the public and raise the status of the doctor from the villians we appear to have become.

All I know is, despite all of this, I still would like to attend medical school and become a doctor. I have made the decision to give of myself and work towards saving lives, towards the public good, towards my fellow man. My dream is simply that some medical school, preferably in my state, understands this from how I present myself to them, and allows me admission. Even if it would mean a pay cut

Thats stupid. How many people are you gonna be able to help when the pay cuts (that you were ok with) come in that run ur practice outta business? ZERO.

Why do you think that doctors dont want to take on new medicare patients? Medicare patients already have enough trouble getting doctors now lets increase this population by about 40 million (even though we cant afford those who are already on it).

FP's are closing their doors and less and less med students go into those fields cuz they know the pay/hour isnt worth it.