BBC: Obama warns doctors over reforms

[Knyteguy]

Advertisement - Members don't see this ad

US President Barack Obama has told a meeting of doctors that spiralling healthcare costs could bankrupt the American economy.

The US could "go the way of General Motors" unless the health system is reformed, Mr Obama said at the American Medical Association's annual meeting.

Full story with video

Same stuff we've been reading pretty much. It worries me going into my first year of college as a pre-med. Physicians deserve to be paid what they do, in my very honest, and even unbiased opinion. We trust physicians to save our lives, diagnose problems, and even to have their emotional support when needed. How many average joe jobs have that responsibility?

I'm very curious how much high end private medical insurance companies are making per year. If the US could really go the way of GM (ahem, "too large to fail"), I very highly doubt it's singly due to employee health insurance.

I sincerely hope I'll be able to pay my student loans from med school. How about free med school for doctors? That'd be a start at least if they want to potentially cut salary like I would expect.

Looks like socialism. “From each according to hisability, to each according to his needs.”

 

[VneZonyDostupa]

Full story with video

Same stuff we've been reading pretty much. It worries me going into my first year of college as a pre-med. Physicians deserve to be paid what they do, in my very honest, and even unbiased opinion. We trust physicians to save our lives, diagnose problems, and even to have their emotional support when needed. How many average joe jobs have that responsibility?

The statement "they deserve what they are currently earning" is a bit naive, considering how wide-ranging physician salaries are, even within the same specialty. How much should a GP earn to you? A cardiologist? Emergency doc? Do you think that a physcian's job is more important than a soldier's? What about a police officers? Both of those people are entrusted with the lives of others, they solve problems, and often provide some sort of emotional support to either comrades or victims, yet they earn a mere pittance compared to the average primary care doc, and even less so when compared to many specialists.

Why can't you be content with earning maybe 10-20% less (hypothetically), and knowing that everyone will have access to basic healthcare? The average GP would still clear $140,000.

I sincerely hope I'll be able to pay my student loans from med school.

No policy has been suggested here, in DC, or in any newspaper that would prevent you from doing this, even if you work as a primary care doc in a public hospital. Irrational fear isn't a good way to live your life. It makes you jittery.

 

[Knyteguy]

The statement "they deserve what they are currently earning" is a bit naive, considering how wide-ranging physician salaries are, even within the same specialty. How much should a GP earn to you? A cardiologist? Emergency doc? Do you think that a physcian's job is more important than a soldier's? What about a police officers? Both of those people are entrusted with the lives of others, they solve problems, and often provide some sort of emotional support to either comrades or victims, yet they earn a mere pittance compared to the average primary care doc, and even less so when compared to many specialists.

Why can't you be content with earning maybe 10-20% less (hypothetically), and knowing that everyone will have access to basic healthcare? The average GP would still clear $140,000.

Granted I suppose. It would put US docs under Canadian docs though, who average just under $190,000 USD equivalent a year. We could lose some very talented physicians due to chasing money. Altruism is very rare, some say even impossible to extents.

Definitely not more important than the careers you listed. No doubt as important though. I also don't see soldiers, or policeman, fireman etc. going to 8 years + residency + fellowship in the case of specialists. As far as I know, the longest military job training there is, is Navy nuclear field, at 2 years "A-school". They pull $100k a year once out of enlistment as a nuclear engineer. And police academy is what, 6 months? $50,000 a year isn't too shabby for that amount of training time IMO. Don't get me wrong, I highly respect said careers, I may even go into the service after med school.

No policy has been suggested here, in DC, or in any newspaper that would prevent you from doing this, even if you work as a primary care doc in a public hospital. Irrational fear isn't a good way to live your life. It makes you jittery.

I mean I think the state should pay it if they wanna go all the way here. I guess I am a little worried, it's a lot of money to be indebted. I would absolutely hate for 8 years of schooling to be a bad financial investment. I don't really see this happening in the US, but look at Japan. The AMA isn't exactly helping the way I see it either.

 

[MegaProjectile]

The statement "they deserve what they are currently earning" is a bit naive, considering how wide-ranging physician salaries are, even within the same specialty. How much should a GP earn to you? A cardiologist? Emergency doc? Do you think that a physcian's job is more important than a soldier's? What about a police officers? Both of those people are entrusted with the lives of others, they solve problems, and often provide some sort of emotional support to either comrades or victims, yet they earn a mere pittance compared to the average primary care doc, and even less so when compared to many specialists.

Why can't you be content with earning maybe 10-20% less (hypothetically), and knowing that everyone will have access to basic healthcare? The average GP would still clear $140,000.



No policy has been suggested here, in DC, or in any newspaper that would prevent you from doing this, even if you work as a primary care doc in a public hospital. Irrational fear isn't a good way to live your life. It makes you jittery.

Very interesting thing to say for a future medical student. Do soldiers/cops take out 200k+ loans to attain their future careers? Even in Europe that has free healthcare, med school is free/miniscule for most citizens. Yes, $140,000 is a good pay but when you considers the years of study(4+4+3), overhead, malpractice insurance(which is ridiculously low in Europe vs US), and tuition cost, you'll find out that we are geting the short end of the stick. Even add the fact most US docs work the longest hours.

You can't have the milk without the cow. If you want to start dictating pay , better make sure that the baggages that come with (tort reform and tuition caps) are also included. You can't promise the country free healthcare and tend still expect them to sue their doctors for multi-million dollar jackpots.

 

[VneZonyDostupa]

Definitely not more important than the careers you listed. No doubt as important though. I also don't see soldiers, or policeman, fireman etc. going to 8 years + residency + fellowship in the case of specialists. As far as I know, the longest military job training there is, is Navy nuclear field, at 2 years "A-school". They pull $100k a year once out of enlistment as a nuclear engineer. And police academy is what, 6 months? $50,000 a year isn't too shabby for that amount of training time IMO.

Given, but the average doctor doesn't risk being shot, blown-up, or otherwise disabled on an typical day at work.

I mean I think the state should pay it if they wanna go all the way here. I guess I am a little worried, it's a lot of money to be indebted. I would absolutely hate for 8 years of schooling to be a bad financial investment. I don't really see this happening in the US, but look at Japan. The AMA isn't exactly helping the way I see it either.

Choosing a career in medicine will never be a bad financial investment. If it becomes hard to repay debt in the United States (which will never happen, as the AMA will throw a ****-fit), you have a degree and advanced training that allows you to work in many, many fields with varying degrees of compensation and time comittment. Not a bad deal, if you ask me, as I sit here with my worthless BS in genetics.

 

[VneZonyDostupa]

Very interesting thing to say for a future medical student. Do soldiers/cops take out 200k+ loans to attain their future careers? Even in Europe that has free healthcare, med school is free/miniscule for most citizens. Yes, $140,000 is a good pay but when you considers the years of study(4+4+3), overhead, malpractice insurance(which is ridiculously low in Europe vs US), and tuition cost, you'll find out that we are geting the short end of the stick. Even add the fact most US docs work the longest hours.

The debt is considered an opportunity cost. If the opportunity cost of practicing medicine is too great for you, leave. It's that simple. I, personally, know that living within my means will allow me to pay off that debt, while enjoying a wonderful career.

 

[NeuroChaos]

I sincerely hope I'll be able to pay my student loans from med school. How about free med school for doctors? That'd be a start at least if they want to potentially cut salary like I would expect.

Looks like socialism. “From each according to hisability, to each according to his needs.”

I am not sure about free medical education. Yes, medical education is expensive, but I would rather see the billions of dollars go towards improving our health care system than save me 200K in debt. Physicians will be able to pay off their debts one way or another; if we really have extra money in our budget, we should spend it on areas (ex. health care) that effect a larger group of population and not just benefit the already privileged subgroup of future docs.

 

[MedSchoolPlz]

Any thought's on Mr. Obama's approach to medical malpractice? I believe in the speech he said something roughly to the effect "I do not support caps on malpractice suits because I feel that an individual aught to be able to sue in the event of wrongful injury."

In my own opinion, and yes-- I'm not an economist or a physician-- the audience rightfully bood him. We all know that medical malpractice is one of the leading contributers to the painfully high cost of healthcare in the U.S. Mr. Obama even hinted around the issue when he referenced a doctor who "spent 20 % of his day doing paperwork" and when he spoke about doctors ordering frivolous MRIs and CT scans to protect themselves from lawsuits. Yet, for some reason, he doesn't believe that the approach should involve capping malpractice suits.

I understand the notion that more emphasis on preventative care will hopefully lead to less need for risky procedures, and hence, fewer medical lawsuits. It seems though, that this sort of approach takes a roundabout way of getting to the issue, without fully addressing one of the key problems facing healthcare. Although, given that Mr. Obama is himself a lawyer, as are the vast majority of politicians, I feel that it's unlikely that there will be a cap. The senseless state of medical malpractice seems doomed to continue.

Mr. Obama got so many things right, but I'm afraid this point was a bit off.

 

[ANF1986]

VneZonyDostupa does have a point. In addition a career as a physician offers unrivaled job security. Barring any large judgements or marks on your record which would preclude you from holding a medical license, you will almost certainly NEVER be without work. I would never advocate price fixing of any kind as a libertarian, I believe that the market should be allowed to set the rates for physicians, but I do not see a tremendous problem with losing 10% off of a 250-350k/yr salary, knowing that that job will ALWAYS be there. For instance, I was just offered a job with only my undergrad degree in hand at the moment, with a 100k/yr salary, in medical device sales, but because of the instability in that market(as well as other reasons), have decided to turn it down and continue with my post-bac for med school.

 

[nick_carraway]

Any thought's on Mr. Obama's approach to medical malpractice? I believe in the speech he said something roughly to the effect "I do not support caps on malpractice suits because I feel that an individual aught to be able to sue in the event of wrongful injury."

The issue is that in our society, we exact punishment and reparations with money. Limits will of course be placed on individual settlement or judgments, but I don't believe it's the federal government's place to determine what is fair and what is unfair in the future.

 

[NeuroChaos]

Any thought's on Mr. Obama's approach to medical malpractice? I believe in the speech he said something roughly to the effect "I do not support caps on malpractice suits because I feel that an individual aught to be able to sue in the event of wrongful injury."

In my own opinion, and yes-- I'm not an economist or a physician-- the audience rightfully bood him. We all know that medical malpractice is one of the leading contributers to the painfully high cost of healthcare in the U.S. Mr. Obama even hinted around the issue when he referenced a doctor who "spent 20 % of his day doing paperwork" and when he spoke about doctors ordering frivolous MRIs and CT scans to protect themselves from lawsuits. Yet, for some reason, he doesn't believe that the approach should involve capping malpractice suits.

I understand the notion that more emphasis on preventative care will hopefully lead to less need for risky procedures, and hence, fewer medical lawsuits. It seems though, that this sort of approach takes a roundabout way of getting to the issue, without fully addressing one of the key problems facing healthcare. Although, given that Mr. Obama is himself a lawyer, as are the vast majority of politicians, I feel that it's unlikely that there will be a cap. The senseless state of medical malpractice seems doomed to continue.

Mr. Obama got so many things right, but I'm afraid this point was a bit off.

The freedoms that our constitution so beautifully grants us as American citizens won't be upheld if AMA starts putting limits on what we can and cannot fight for.

 

[ChubbyChaser]

VneZonyDostupa does have a point. In addition a career as a physician offers unrivaled job security. Barring any large judgements or marks on your record which would preclude you from holding a medical license, you will almost certainly NEVER be without work. I would never advocate price fixing of any kind as a libertarian, I believe that the market should be allowed to set the rates for physicians, but I do not see a tremendous problem with losing 10% off of a 250-350k/yr salary, knowing that that job will ALWAYS be there. For instance, I was just offered a job with only my undergrad degree in hand at the moment, with a 100k/yr salary, in medical device sales, but because of the instability in that market(as well as other reasons), have decided to turn it down and continue with my post-bac for med school.

Yes...i want my salary to decline for the good of humanity🙄...

No personally, i would like to spend that extra 10% and use it how i see fit and on what charities i want. I can spend my money better then the Government can.

 

[VneZonyDostupa]

I can spend my money better then the Government can.

I hear this so often, but see such little evidence for the claim among the populace. 🙄

 

[Col Kurtz]

VneZonyDostupa does have a point. In addition a career as a physician offers unrivaled job security. Barring any large judgements or marks on your record which would preclude you from holding a medical license, you will almost certainly NEVER be without work. I would never advocate price fixing of any kind as a libertarian, I believe that the market should be allowed to set the rates for physicians, but I do not see a tremendous problem with losing 10% off of a 250-350k/yr salary, knowing that that job will ALWAYS be there. For instance, I was just offered a job with only my undergrad degree in hand at the moment, with a 100k/yr salary, in medical device sales, but because of the instability in that market(as well as other reasons), have decided to turn it down and continue with my post-bac for med school.

Hmm...perhaps I should have put 10% (admittedly I thought about it) in some of my posts on the other threads eh? Maybe it would have softened some of the other people's comments a bit... 😉

 

[ChubbyChaser]

I hear this so often, but see such little evidence for the claim among the populace. 🙄

O yeah?? *insert witty smiley*

 

[BluntSurgeon]

I cannot believe that President Obama won't put any caps on malpractice lawsuits when they are perhaps the biggest problem that needs to be addressed. I think MedSchoolPlz put it very eloquently.

Perhaps the health care system needs to go way of the financial system, where everything just crumbles and goes to ****. I'm talking doctors quitting in massive numbers, NPs desperately trying (keyword: trying) to clean up the mess, and patients dying left and right... basically the medical apocalypse.

I think at that point people might start actually thinking of reform and policy that quickly and correctly addresses the real issues. Until then we will most likely just get more of the same beaurocrat self-serving circlejerk policy that really helps nobody.

 

[TMP-SMX]

I hear this so often, but see such little evidence for the claim among the populace. 🙄

It's pretty simple. When you start making money you will readily donate to charities to reduce your taxable income. It's a lot less overhead than if the feds made a similar program. Nobody likes losing their money to taxes.

 

[TMP-SMX]

I cannot believe that President Obama won't put any caps on malpractice lawsuits when they are perhaps the biggest problem that needs to be addressed. I think MedSchoolPlz put it very eloquently.

Perhaps the health care system needs to go way of the financial system, where everything just crumbles and goes to ****. I'm talking doctors quitting in massive numbers, NPs desperately trying (keyword: trying) to clean up the mess, and patients dying left and right... basically the medical apocalypse.

I think at that point people might start actually thinking of reform and policy that quickly and correctly addresses the real issues. Until then we will most likely just get more of the same beaurocrat self-serving circlejerk policy that really helps nobody.

That will go over well. People die if physicians don't do their duty. Not quite the same as the banking system. There is a financial net for people who can't pay their bills.

 

[BluntSurgeon]

That will go over well. People die if physicians don't do their duty. Not quite the same as the banking system. There is a financial net for people who can't pay their bills.

Yeah I know, but I mean it just seems like that's the way America works. Until the ship is literally sinking and half underwater, only then does our government actually step in and do what it should have done when the ship first sprung a leak.

But yea, I really doubt there will come a time where physicians quit in droves causing a huge shortage.

 

[ChubbyChaser]

Yeah I know, but I mean it just seems like that's the way America works. Until the ship is literally sinking and half underwater, only then does our government actually step in and do what it should have done when the ship first sprung a leak.

But yea, I really doubt there will come a time where physicians quit in droves causing a huge shortage.

Hmm...one could argue that the ship goes half way under because the govt tries to do too much.

 

[circulus vitios]

Any thought's on Mr. Obama's approach to medical malpractice? I believe in the speech he said something roughly to the effect "I do not support caps on malpractice suits because I feel that an individual aught to be able to sue in the event of wrongful injury."

What a surprise. An ex-lawyer wants no caps on malpractice suits so his lawyer buddies can get a bigger cut of the settlements.

The minimally invasive surgeon said there would be no scar, and I clearly have a 2 millimeter scar! I demand fifty million dollars for pain and suffering!

 

[nick_carraway]

What a surprise. An ex-lawyer wants no caps on malpractice suits so his lawyer buddies can get a bigger cut of the settlements.

The minimally invasive surgeon said there would be no scar, and I clearly have a 2 millimeter scar! I demand fifty million dollars for pain and suffering!

FWIW, it's difficult to find lawyers willing to take on most alleged malpractice cases because they are very difficult to win.

 

[BluntSurgeon]

Hmm...one could argue that the ship goes half way under because the govt tries to do too much.

Hm.. also a good point. I guess I should stop posting in these threads because at the end of the day I really have no idea what I am talking about.

Cliffs notes: if one of you intrepid politics-savvy people happens to figure out a way to unite physicians legally and in such a way that we have a voice, you can be damned sure that I will buy your newsletter and support the cause.

 

[ANF1986]

I hear this so often, but see such little evidence for the claim among the populace. 🙄

Our current system is too broken for charity to be able to absorb the uninsured. I believe 10% against 250-350k is small, thats IMO of course. I believe it pales if compared to the fact that MCARE/MCAID have not increased reimbursements since 2001. Effectively doctors who have a large percentage of patients covered under those plans have not had raises in 8 years. Put that against inflation (Dollar losing 50% of its value since 2001) and increases in the cost of living, and they are losing out on much more than 10% presently, even if it appears that their salaries haven't changed. I do not believe in price fixing what so ever, I was just speaking to the fact that losing that amount of income is relatively insignificant passed the 250k mark (assuming you are not over extended).

I believe Obama's intentions are genuine and that he thinks his solution will do a lot of good. Unfortunately I disagree with him. As a libertarian I dont believe that the government really does anything better than the private sector in a TRUE free market environment. I have said this in other threads so I apologize if I sound like a broken record. 1970s ERISA&HMO act, unfairly advantage the HMOs against the private insurers, cases inequities in the market. In addition, MCARE/MCAID artifically lower reimbursements below what the market would ordinarily dictate, further exacerbating the problems. Adding onto all of this, doctors are prohibited from advertising their prices to the public, making it impossible for the free market to function in healthcare, if consumers(patients) cannot effectively shop around for the best deals, "greedy" doctors can price gouge the **** out of people, as is surely being done in some instances.

Asserting that the free market has "failed" healthcare is patently UNTRUE. The free market has never been given an opportunity to improve healthcare. I would not agree with salary caps on physicians, but if the free market is given an opportunity to enter healthcare and the market decides to pay doctors less, I would have no problem with it. It's worth noting many charities had to close down and stop providing care because of the prohibitive cost of malpractice insurance, so for Obama to claim tort reform is unnecessary is offensive.

 

[ChubbyChaser]

Our current system is too broken for charity to be able to absorb the uninsured. I believe 10% against 250-350k is small, thats IMO of course. I believe it pales if compared to the fact that MCARE/MCAID have not increased reimbursements since 2001. Effectively doctors who have a large percentage of patients covered under those plans have not had raises in 8 years. Put that against inflation (Dollar losing 50% of its value since 2001) and increases in the cost of living, and they are losing out on much more than 10% presently, even if it appears that their salaries haven't changed. I do not believe in price fixing what so ever, I was just speaking to the fact that losing that amount of income is relatively insignificant passed the 250k mark (assuming you are not over extended).

I believe Obama's intentions are genuine and that he thinks his solution will do a lot of good. Unfortunately I disagree with him. As a libertarian I dont believe that the government really does anything better than the private sector in a TRUE free market environment. I have said this in other threads so I apologize if I sound like a broken record. 1970s ERISA&HMO act, unfairly advantage the HMOs against the private insurers, cases inequities in the market. In addition, MCARE/MCAID artifically lower reimbursements below what the market would ordinarily dictate, further exacerbating the problems. Adding onto all of this, doctors are prohibited from advertising their prices to the public, making it impossible for the free market to function in healthcare, if consumers(patients) cannot effectively shop around for the best deals, "greedy" doctors can price gouge the **** out of people, as is surely being done in some instances.

Asserting that the free market has "failed" healthcare is patently UNTRUE. The free market has never been given an opportunity to improve healthcare. I would not agree with salary caps on physicians, but if the free market is given an opportunity to enter healthcare and the market decides to pay doctors less, I would have no problem with it. It's worth noting many charities had to close down and stop providing care because of the prohibitive cost of malpractice insurance, so for Obama to claim tort reform is unnecessary is offensive.

Just playing devils advocate here....but in a true free market, you wouldnt really need a license to practice medicine...so no idea what effect that will have on physician salaries.

 

[Omni]

Right now, I kind of want to trust Obama on this. Like he said, healthcare was the root of the GM problem and will continue to be. If costs for healthcare increases, regardless of how much you get paid as a doctor, doctors will see less patients, and hence even less money.
There is a problem with having a lot of money when the economy is crap. Your money may not be worth anything

 

[usermike8500]

I sincerely hope I'll be able to pay my student loans from med school. How about free med school for doctors?

Even if you made half of what doctors currently make, you would still be able to pay back your loans. Honestly, I don't know how much sympathy the public will have for a physician who must pay back $150K in loans using part of his or her $250K/year salary. As a percentage of salary, medical school debt is no worse than that faced by most other starting professionals. For example, lets say a teacher who gets her masters in education has to pay back $30K in debt. With a salary of only $40K/year, her debt will be a greater burden than med school debt is to the starting physician.

If "high cost of education" is the only armor physicians have against ravenous politicians clawing at any means to cut healthcare costs, we as future physicians will need to get used to driving used Hyundai cars and living with our parents... not that there's anything wrong with that.

 

[Omni]

Even if you made half of what doctors currently make, you would still be able to pay back your loans. Honestly, I don't know how much sympathy the public will have for a physician who must pay back $150K in loans using part of his or her $250K/year salary. As a percentage of salary, medical school debt is no worse than that faced by most other starting professionals. For example, lets say a teacher who gets her masters in education has to pay back $30K in debt. With a salary of only $40K/year, her debt will be a greater burden than med school debt is to the starting physician.

If "high cost of education" is the only armor physicians have against ravenous politicians clawing at any means to cut healthcare costs, we as future physicians will need to get used to driving used Hyundai cars and living with our parents... not that there's anything wrong with that.

But keep in mind. Many companies will pay your way through getting a graduate degree. If you work for a company for a few years with an undergraduate degree, they will pay for your education to get a graduate degree. This happens a lot more often with schools, ITs, businesses, etc. etc. than it ever will happen with medicine (which is never).
And plus, teachers don't need to pay malpractice insurance. ANd on top of that, as soon as you graduate med school, you don't immiediatley start making 100k/year. You start out with a McDonald's yearly pay while putting in a few more times in hours.

 

[BTC]

Cliffs notes: if one of you intrepid politics-savvy people happens to figure out a way to unite physicians legally and in such a way that we have a voice, you can be damned sure that I will buy your newsletter and support the cause.

It's called the AMA.

Despite all the bad press, it appears to me that the AMA is engaging congress in developing workable healthcare reform that protects physician's interests.

 

[BlueElmo]

It's called the AMA.

Despite all the bad press, it appears to me that the AMA is engaging congress in developing workable healthcare reform that protects physician's interests.

Of course, which is why AMA is so dead set against government backed public health insurance system. AMA fears private insurers will run out of business, despite Obama's insistence this won't happen.
And remember, AMA is made up of doctors, so of course it will do anything to protect physicians' interests.

 

[usermike8500]

And plus, teachers don't need to pay malpractice insurance.

Malpractice insurance is already accounted for before a physician's salary is calculated. Therefore, it doesn't affect the debt/salary ratio. 🙂

Good point about employers paying graduate school tuition though. I've never met or known anyone who has actually gotten their education expenses paid for by an employer but I'm sure it happens somewhere... unlike physicians in which case it never happens.

 

[Climberak]

Dammit OP, stop copying me 😀.

http://forums.studentdoctor.net/showthread.php?t=637655

 

[Brigade4Radiant]

But keep in mind. Many companies will pay your way through getting a graduate degree. If you work for a company for a few years with an undergraduate degree, they will pay for your education to get a graduate degree. This happens a lot more often with schools, ITs, businesses, etc. etc. than it ever will happen with medicine (which is never).
And plus, teachers don't need to pay malpractice insurance. ANd on top of that, as soon as you graduate med school, you don't immiediatley start making 100k/year. You start out with a McDonald's yearly pay while putting in a few more times in hours.

Keep in mind that Vetstudents don't have companines to pay their tuition and they go in with nearly just as much debt as Medical students and make about 3 times less. Also what is this "The best and the brightest will leave medicine" crap comming from? What "Best and the Brightest?" the one's who have the highest board scores? Oh please there is little evidence that these people are great physicans its just the specialties that they go into.

Guess what guys Medschool admissions are competitive even D.O schools are pretty competitive. If you leave there are 4 other 3.7GPA, 32 MCAT students to take your place. Also medicine is pretty competitive in nations that have nationalized healthcare like Europe and other nations.

And free market on healthcare? Lol FMG would be taking nearly every spot and then you would have to deal with DNP programs that would crop nearly overnight.

 

[YouAreAwesome]

Even the almighty AMA has nothing on Obama's massive popularity.

 

[Sully21]

As a percentage of salary, medical school debt is no worse than that faced by most other starting professionals. For example, lets say a teacher who gets her masters in education has to pay back $30K in debt. With a salary of only $40K/year, her debt will be a greater burden than med school debt is to the starting physician.

You also want to consider that a teacher can start paying off loans right after undergrad - probably around the age of 22. Doctor's won't be able to start repaying loans until they get to their residency, and even then they are probably making just enough to contain the interest on the loans. they really don't have the power to pay back loans until they are through with their residency and possibly fellowship. Say you get done with undergrad at 22 - med school at 26 - residency at 29 - that's seven more years that you have been in school - living on a minimal budget - adding interest to loans- whereas the teacher has been making 40k a year for seven years. Not being able to start to work off debt until you are 30 is a consideration in itself

 

[unsung]

Any thought's on Mr. Obama's approach to medical malpractice? I believe in the speech he said something roughly to the effect "I do not support caps on malpractice suits because I feel that an individual aught to be able to sue in the event of wrongful injury."

In my own opinion, and yes-- I'm not an economist or a physician-- the audience rightfully bood him. We all know that medical malpractice is one of the leading contributers to the painfully high cost of healthcare in the U.S. Mr. Obama even hinted around the issue when he referenced a doctor who "spent 20 % of his day doing paperwork" and when he spoke about doctors ordering frivolous MRIs and CT scans to protect themselves from lawsuits. Yet, for some reason, he doesn't believe that the approach should involve capping malpractice suits.

I understand the notion that more emphasis on preventative care will hopefully lead to less need for risky procedures, and hence, fewer medical lawsuits. It seems though, that this sort of approach takes a roundabout way of getting to the issue, without fully addressing one of the key problems facing healthcare. Although, given that Mr. Obama is himself a lawyer, as are the vast majority of politicians, I feel that it's unlikely that there will be a cap. The senseless state of medical malpractice seems doomed to continue.

Mr. Obama got so many things right, but I'm afraid this point was a bit off.

Malpractice suits may contribute to healthcare costs, but I would hardly consider it the most significant contributor by any means.

You reference preventative care as a "roundabout" approach to solving the problem of rising healthcare costs in contrast with setting caps on malpractice suits.

But an obvious and important difference between the two options is not being stated, which is that preventative care actually reduces healthcare costs by way of a healthier population! The entire populace benefits. Aside from obvious quality of life improvements, there's also greater work productivity.

Emphasizing setting caps, otoh, only benefits one tiny sub-group of the population: physicians! And significantly, it directly fails to benefit (in fact hurts) the consumers of healthcare (i.e. patients)! Malpractice suits exist for a reason: To protect the consumer. Sure, some suits may be frivolous. But certainly a number of suits are completely legitimate, and those individuals deserve adequate compensation.

What is the price set for an individual who wrongfully lost a breast because the doctor operated on the wrong breast? Can anyone justify setting some arbitrary value on that physical, emotional, and quite personal suffering?

How about other areas of tort law? If a consumer uses an unsafe product made by a large company and is permanently injured, would people really support caps protecting the company which made the unsafe product? Really... who would?

Physicians providing healthcare (a service) should be no different. Just because we will work hard to get through long years of schooling and incur huge amounts of debt in the process does not absolve us of pressure and responsibility. Setting caps reduces responsibility to an extent. It may feel better, but what feels good is not necessarily what's moral.

 

[Bildo]

It seems in this issue that there are many problems and too little solutions, especially solutions that are viable for everyone.

The cost of healthcare is too high, that's for certain. Too many people are uninsured, which is true. Many physicians don't get reimbursed appropriate to their workload/training.

It's hard overcoming a bias towards one outlook, though, when I consider the fact that my mother (a physician) sees about twice the volume of patients as she did when she started and the income she makes is just about equal. Somebody mentioned that doctors have gotten essentially no raises in the last eight years...some have had to increase their workload just to maintain.

People often have to work terribly hard to make ends meet, that's true, but it doesn't make sense for people to continue to put in a huge amount of time an effort when they aren't rewarded commensurate to it.

You can say medical school is still highly competitive even despite the problems, and it's true. I hope most people going into medicine are doing so out of dedication and passion, but that doesn't mean its -fair- to arbitrarily decide that since people will always want to be doctors to help people that it's okay to lower their reimbursements because the majority will just grimace and bear it because they are doing what they want to do. Eventually an impasse will occur.
Would you go into medicine if your total annual salary would never be above 60k?
There are people who would say no. And probably people who wouldn't if they didn't think they'd ever make above 100k a year.

The reasoning that it's okay for doctors to submit themselves to torturous training, hours, and work schedules in the face of high debt and low profits is weak.

The problems with this issue is that, on the other hand, people who have devoted time and effort and their skills elsewhere shouldn't have to be faced with gigantic costs for health insurance and medical bills, just because the doctors would like a nice salary. People shouldn't have to fear scheduling an appointment or getting tests or flu shots because of the price tag.

I wish I knew what should be done.

 

[Bryson17]

Even if you made half of what doctors currently make, you would still be able to pay back your loans. Honestly, I don't know how much sympathy the public will have for a physician who must pay back $150K in loans using part of his or her $250K/year salary. As a percentage of salary, medical school debt is no worse than that faced by most other starting professionals. For example, lets say a teacher who gets her masters in education has to pay back $30K in debt. With a salary of only $40K/year, her debt will be a greater burden than med school debt is to the starting physician.

If "high cost of education" is the only armor physicians have against ravenous politicians clawing at any means to cut healthcare costs, we as future physicians will need to get used to driving used Hyundai cars and living with our parents... not that there's anything wrong with that.

What about a primary care physician, or someone in the rural areas? They're paying the big city debt (150+K) on little city incomes (120-140K/yr). Should there be loans specifically tailored to those practicing primary care or practicing in rural areas? Maybe these guys should get a little extra incentive to enter the field because that's where a big shortage is, and it's getting harder to be a primary care physician with all this debt. Give them loans with less interest backed by contributions from interest on loans that overpaid specialists pay back. Yes, I want to specialize, but I think specialists can take a percentage salary cut to help pay for primary care docs. That's how they get patients (customers) right?!?!

I also think we need to simplify things on the care side. Obama made an awesome point about how some people get a procedure when all they need is an adjustment in drugs. If we had a better history (i.e. universal electronic medical records), we'd have a better picture of the state of health of the patient. Then we wouldn't need to order tests that have alredy been done or would be obvious given the history. One of my textbooks said "the patient's medical diagnosis can almost always be attributed to the patient's history." Let's get the best histroy we can, and USE it.

 

[MegaProjectile]

The debt is considered an opportunity cost. If the opportunity cost of practicing medicine is too great for you, leave. It's that simple. I, personally, know that living within my means will allow me to pay off that debt, while enjoying a wonderful career.

It's not simple. You haven't started paying back your student loans, practicing defensive medicine or afraid of being sued each day, so your idealism is understandable but very wrong. Healthcare cost is always going up not down. Cutting physician salary is an easy way out but never solves the problem. The government has been cutting physician salary for the past 40 years........and healthcare still hasn't been fixed. Do you think you'll retain the 140k in the next 10 years? NO, you won't. However, the tuition will still be going up.

Will that stop students from pursuing medicine?No but it will drive students from primary care and into high paying specialties.The entire country is already paying the price for "opportunity cost" as only 2% of MD students are going into primary care while competitive students are trying to match into plastics, radiology, derm and uro.

 

[MegaProjectile]

What about a primary care physician, or someone in the rural areas? They're paying the big city debt (150+K) on little city incomes (120-140K/yr). Should there be loans specifically tailored to those practicing primary care or practicing in rural areas? Maybe these guys should get a little extra incentive to enter the field because that's where a big shortage is, and it's getting harder to be a primary care physician with all this debt. Give them loans with less interest backed by contributions from interest on loans that overpaid specialists pay back. Yes, I want to specialize, but I think specialists can take a percentage salary cut to help pay for primary care docs. That's how they get patients (customers) right?!?!

I also think we need to simplify things on the care side. Obama made an awesome point about how some people get a procedure when all they need is an adjustment in drugs. If we had a better history (i.e. universal electronic medical records), we'd have a better picture of the state of health of the patient. Then we wouldn't need to order tests that have alredy been done or would be obvious given the history. One of my textbooks said "the patient's medical diagnosis can almost always be attributed to the patient's history." Let's get the best histroy we can, and USE it.

I love Obama but he's a politician not a doctor. Even if we implement electronic history, it will only save money on ancillary costs(staff). Doctors will still order a CT scan for anyone that walks into a hospital with a headache to cover their ass for lawsuit. Have a chest pain ? Admit! It *might* be a precusor heart attack awaiting. In a country with an oversupply of lawyers, doctors will still be ordering unnecessary tests.

 

[Bacchus]

Medical malpract IS NOT a leading factor in the failure of our healthcare system. Payouts are more of a concern to specific doctors or hospitals, but in the grand scheme account for very little of the overall costs of healthcare to the country. The following website estimates malpractice costs of the system to 2%:
http://www.makethemaccountable.com/myth/RisingCostOfMedicalMalpracticeInsurance.htm

Their list of 7 things are cited and actually shed some light. Read it.

 

[Bryson17]

I love Obama but he's a politician not a doctor. Even if we implement electronic history, it will only save money on ancillary costs(staff). Doctors will still order a CT scan for anyone that walks into a hospital with a headache to cover their ass for lawsuit. Have a chest pain ? Admit! It *might* be a precusor heart attack awaiting. In a country with an oversupply of lawyers, doctors will still be ordering unnecessary tests.

Ya know, we just need to make a lot of these tests cheaper. Docs aren't going to stop ordering CT's, MRI's and chest x-rays, you're right. The thing is that patients come to the doctor find out what's wrong and how they can be fixed. Doctors don't want to miss something because the patient is usually there for a good reason, and they don't want to have to come back or go to the ER if it gets worse. Patients want their problem solved and docs want to solve it.

That leads me to the preventative care argument, but politicians act like this is so easy to implement. It's not like preventative care is a switch we can just turn on tomorrow by spending $100 billion. How can we implement preventative care? It may not be possible given the American attitude of 'don't fix it if it ain't broken'...

 

[ANF1986]

But an obvious and important difference between the two options is not being stated, which is that preventative care actually reduces healthcare costs by way of a healthier population! The entire populace benefits. Aside from obvious quality of life improvements, there's also greater work productivity.

Emphasizing setting caps, otoh, only benefits one tiny sub-group of the population: physicians! And significantly, it directly fails to benefit (in fact hurts) the consumers of healthcare (i.e. patients)! Malpractice suits exist for a reason: To protect the consumer. Sure, some suits may be frivolous. But certainly a number of suits are completely legitimate, and those individuals deserve adequate compensation.

How about other areas of tort law? If a consumer uses an unsafe product made by a large company and is permanently injured, would people really support caps protecting the company which made the unsafe product? Really... who would?

Physicians providing healthcare (a service) should be no different. Just because we will work hard to get through long years of schooling and incur huge amounts of debt in the process does not absolve us of pressure and responsibility. Setting caps reduces responsibility to an extent. It may feel better, but what feels good is not necessarily what's moral.

So let me get this straight. It's not 'immoral' to tax people who are healthy and then redistribute their money to people who aren't in the form of a nationalized healthcare system. Yet, it's immoral to demand tort reform at the same time to help attenuate the effect of lower salaries and higher tuition?

Preventative medicine for "everyone" sounds and feels good. But it comes at the cost of taxing people who may not want to participate, yet the government is talking about obligating these people to pay for those who cant afford it. That's immoral!... I dont buy into this notion of social responsibility, it's not what our country was founded on, and it's not written into the Constitution anywhere. If people want to donate their services via charity, then I am fine with it. This is actually how most of the poor were cared for in times past. If you read my earlier post, I show that the free market would go a long way to lowering costs.

 

[sarahl86]

Ya know, we just need to make a lot of these tests cheaper. Docs aren't going to stop ordering CT's, MRI's and chest x-rays, you're right. The thing is that patients come to the doctor find out what's wrong and how they can be fixed. Doctors don't want to miss something because the patient is usually there for a good reason, and they don't want to have to come back or go to the ER if it gets worse. Patients want their problem solved and docs want to solve it.

That leads me to the preventative care argument, but politicians act like this is so easy to implement. It's not like preventative care is a switch we can just turn on tomorrow by spending $100 billion. How can we implement preventative care? It may not be possible given the American attitude of 'don't fix it if it ain't broken'...

Ding ding ding!! We have a winner!

As Bacchus said, malpractice isn't the problem. You don't see the government going after GE for equipment costs or pharmaceutical companies for the ridiculous costs of their products. OF COURSE insurance is going to be high if they have to cover $200+/month for some newfangled medications or new gamma knife technologies when in some instances, the old standard would have been just as sufficient.

 

[Aladdin]

The statement "they deserve what they are currently earning" is a bit naive, considering how wide-ranging physician salaries are, even within the same specialty. How much should a GP earn to you? A cardiologist? Emergency doc? Do you think that a physcian's job is more important than a soldier's? What about a police officers? Both of those people are entrusted with the lives of others, they solve problems, and often provide some sort of emotional support to either comrades or victims, yet they earn a mere pittance compared to the average primary care doc, and even less so when compared to many specialists.

Why can't you be content with earning maybe 10-20% less (hypothetically), and knowing that everyone will have access to basic healthcare? The average GP would still clear $140,000.



No policy has been suggested here, in DC, or in any newspaper that would prevent you from doing this, even if you work as a primary care doc in a public hospital. Irrational fear isn't a good way to live your life. It makes you jittery.

This is a terrible argument: Policemen and soldiers are both paid immediately upon beginning training. Let me know when policemen or soldiers accrue $200K worth of debt at 7% interest rate and a decade of training, then we'll talk.

 

[atomi]

-

 

[atomi]

-

 

[MedStudentWanna]

FWIW, it's difficult to find lawyers willing to take on most alleged malpractice cases because they are very difficult to win.

That's how John Edwards made his millions.

 

[MedStudentWanna]

Even if you made half of what doctors currently make, you would still be able to pay back your loans. Honestly, I don't know how much sympathy the public will have for a physician who must pay back $150K in loans using part of his or her $250K/year salary. As a percentage of salary, medical school debt is no worse than that faced by most other starting professionals. For example, lets say a teacher who gets her masters in education has to pay back $30K in debt. With a salary of only $40K/year, her debt will be a greater burden than med school debt is to the starting physician.

If "high cost of education" is the only armor physicians have against ravenous politicians clawing at any means to cut healthcare costs, we as future physicians will need to get used to driving used Hyundai cars and living with our parents... not that there's anything wrong with that.

Where are you getting your figures, 1982? The average med school debt these days is $250K, not $150. Many go over $300 with interest. Second, your average of $250K salary is inaccurate for many fields, including primary care, which is where there's the most shortage. FM averages is only $120K. So you graduate after 12 years of education after high school, making $120K to pay $300K in loans and you say all's peachy keen?

The bottom line is, you have to give people a REASON to go into medicine, beyond helping people. And money is important. It's why people choose Derm or Radiology over things like Peds. Don't discount the influence of salary when you start off your life that much in the hole.

 

[MedStudentWanna]

Malpractice insurance is already accounted for before a physician's salary is calculated. Therefore, it doesn't affect the debt/salary ratio. 🙂

Once again this is not true. The average salaries you see on the Internet are before malpractice and taxes.