Being a Dr Sucks

[coprolalia]

I need to address a couple of your points and then will talk more about mine.

Projects in a city make up a portion of the larger city population. It can be considered that the larger population is who is being protected by police presence in the projects, even though the police is spending more of their effort in the projects. The bottom line: Joe MiddleClass lives in a low crime neighborhood, free to live out his life. I'm referring to poor cities versus rich cities. East Palo Alto (former murder capital of the US) hardly has the tax base for running a police force sufficient to keep crime low in their poor city. Neighboring cities actually contribute their police forces to keep crime low in EPA since they can't handle it on their own. This is to preserve the low crime environments for neighboring "rich" communities like Menlo Park, Palo Alto and the Stanford campus.

You're not disagreeing with me. You are making my point.

From a public policy perspective, I believe healthcare is held to similar standards. To assure minimum conditions for the low income community (i.e. keeping sufficient low income population happy so they'll actually work the jobs in your community that you don't want to do, and keep crime low) healthcare has to be made "available" and "accessible".

I don't understand what you mean by this. In the U.S., this access is already clearly "available" and "accessible". A routine check-up at a doctor's office is not expensive. But, the problem is, people don't want to go to the doctor until they perceive there is a problem. And, when they do have a problem, they go to the ER. And, when they go to the ER, they are charged a premium. There is no continuity of care. There is no good follow-up. And, the costs become astronomical.

How you fix that by continuing to hand out free healthcare in ER's is beyond me, which is what it sounds like you're proposing we continue to do.

So while you are correct that there are examples of bad apples that disrupt the system, present policies are based on the concept that this cost is worth dealing with since many more are supposedly helped. (and it's the police's role to get the addicts anyway).

You're wrong. Sick people don't endanger society except for the fact that they can't pay for their care - which is the problem. They certainly don't pose a threat to society, like a 20-year-old gang-banger who is getting ready to rob a liquor store because there are no cops around.

People have tried to get folks in for "preventive medicine." This is not a new concept. Most people do not seek care until they perceive they have a problem. This goes doubly-true for poor people. Often they just show up or are brought to the hospital, sometimes without even wanting to go. Our current system assumes they want care, and we're going to provide it to them, even if they can't pay for it.

I believe it's based on the adage that the masses need to be appeased for society to remain "stable". Therefore, the people who are well-off in society have a vested interest in preserving the status-quo stability, should be willing to "pay" for said stability. They benefit via the act of "doing good" as well as preserving this society for their children.

This is more the premise behind welfare. How this translates into healthcare, given the fact that people have repeatedly demonstrated they don't want care until they are really sick, I don't know. I'm all for public clinics where people can get preventive medicine checks at low (or even no) cost. They just don't use such a system. They go to the ER. And, until you repeal EMTALA and pull the teat out of their mouth, they're going to continue to abuse the system.

That being said, there really should be ways to filter out those bad apples. I believe certain countries (with socialized medicine no less) have policies in place to handle abusers.

It's easy. We're not doing it because (1) we fear being sued, and (2) many ivory tower physicians who teach us medicine believe a lot of stupid things like "everyone is entitled to healthcare" and "you shouldn't talk to drug reps" and a bunch of other stupid, idealistic stuff that only proves they are so insulated with their standard salaries, whether they see one patient or twenty in a day, that they don't even know the world really works.

I've asked my attendings. Most have no idea how much the treatments they propose cost. But, they do it under the guise of "academic" interest. That's fine, I suppose. Just don't pick up their bad habits. They have no real solutions to this problem because it doesn't really affect them.

And, I'd believe your "placating the masses" argument if I felt that sick people were really a threat to society. They're not, except when they can't pay for the million dollar care we give them, or still attempt to sue either way.

-copro

 

[chippedtoof]

You're not disagreeing with me. You are making my point.

I was clarifying that certain things that look like they benefit only individuals (e.g. joe blow in the projects getting police protection) serve the needs of a different population who may have to flip the bill. I was setting up the parallel to medicine, which you obviously disagree with.

A routine check-up at a doctor's office is not expensive. But, the problem is, people don't want to go to the doctor until they perceive there is a problem. And, when they do have a problem, they go to the ER. And, when they go to the ER, they are charged a premium. There is no continuity of care. There is no good follow-up. And, the costs become astronomical.

How you fix that by continuing to hand out free healthcare in ER's is beyond me, which is what it sounds like you're proposing we continue to do.

That's not my proposal. However, the cost to the system for a patient is not the cost of a check-up. It'll be more comparable to monthly insurance premiums (minus admin overhead), which most of this population cannot afford. So while I agree the usage pattern for health services is atrocious, the costs still make access an issue.

You're wrong. Sick people don't endanger society except for the fact that they can't pay for their care - which is the problem. They certainly don't pose a threat to society, like a 20-year-old gang-banger who is getting ready to rob a liquor store because there are no cops around.

You're mired in low level specifics. A large population of unsatisfied citizens will enact change, regardless of whether their unhappiness is due to being robbed or not getting health care for their poor grandmother. Change like higher taxes, more government services to pay for, socialized medicine, etc (it doesn't have to be la revolution). If I am interested in stopping that from happening, and I am, I'd shoot for keeping the masses happy with the status quo. Remember that unhappy masses will not vote the way you vote.

This is more the premise behind welfare. How this translates into healthcare, given the fact that people have repeatedly demonstrated they don't want care until they are really sick, I don't know. I'm all for public clinics where people can get preventive medicine checks at low (or even no) cost. They just don't use such a system. They go to the ER. And, until you repeal EMTALA and pull the teat out of their mouth, they're going to continue to abuse the system.

Based on this, are preventive medicine checks not utilized in countries with socialized medicine, a la England? How about the system in Japan? I'm going to assume that it is utilized, meaning good usage patterns can be implemented. I agree it is not implemented correctly today in the US.

 

[andwhat]

yep. it doesn't matter what you do, you will be over worked and under paid. the nurses make like 4-8x as much money per hour as we do and only work 12 hours at a time and are thought to be God's gift to the world.

Hospitalist medicine is laid back, and not at all burnout. Pays quite well also, in the $200-400 K range.
Once you get into Private Practice in Anesthesia, I am sure that it will get better. Residency sucks.
Anesthesiologists have way chill lifestyles.
You are everybody's subservient as a resident, this will never ever change. It is like some wicked tradition, or 3 year long gang initiation or something.

 

[Frikkynaknak]

"Coprolalia is involuntary swearing or the involuntary utterance of obscene words or socially inappropriate and derogatory remarks. Coprolalia comes from the Greek κόπρος (kopros) meaning "faeces" and λαλία (lalia) meaning "babbling, meaningless talk", from lalein, "to talk""

yea that sounds about right. all i need now is to learn how to add a gay smiley face at the end of my post like you

 

[radslooking]

The problem with this society is not too many safety nets, it is the lack of education and the wide spread ignorance.
Scandinavian countries and many European countries offer their citizens way more "safety nets" than the average American would ever dream of, but they don't have the wide spread abuse and complete lack of regard for others we have, why do you think that is the case?

i think it's pretty multifactorial. scandinavian countries are much more homogeneous, however...that usually cuts down on violence quite a bit.

 

[radslooking]

although life for docs may be harder when we have to negotiate treatment based on prices....(probably not as applicable to gas docs...tough to quote prices when they are sleepy), I would welcome the opportunity to prescribe over the counter zantac for 5$ versus 120$ month nexium which offers virtually no benefit for the garden variety mild-mod GERD patient. Just think how much money you could save alone on something like that. Multiply that times the innumerable amounts of garbage that we spend for little to no benefit and it would be far, far, far more efficient.

The mere act of people knowing prices would work wonders for this system.

 

[radslooking]

At the end of the year, you can see who's racking up huge charges compared to the patient's outcome. You'd probably wouldn't be surprised that some of the crappiest doctors result in some of the biggest charges for a variety of reasons. And, they often have worse outcomes. You identify these individuals and subject them to either additional training (in the form of CME, etc.), or dismissal from the hospital. We're talking about averages here, and we have the ability to identify trouble makers, from patients to care givers, but why we don't routinely do it - or, for those healthcare systems that do, why they don't use that information to effect change - is a mystery to me.

-copro

oh wow, would i love to see these stats. i had some ***** colleague blow about 30,000 dollars worth of tests on a patient last week who had a mini-mental of 17/30. Good work, douchebag. Mr. Dementia checked out last year. Get another echo on him, please!!!

 

[223634]

Just so it's clear, we aren't allowed to "unionize" because the Federal Trade Commission won't let us. Insurance companies are allowed to collectively bargain. We are not.

-copro

sooo... why are we not allowed to unionize?

 

[coprolalia]

sooo... why are we not allowed to unionize?

It's complicated. If you work directly for a hospital, and are paid exclusively as a hospital employee, you can. If you are a contracting entity or member of a private group, you can't.

This article provides a nice summary:

http://www.physiciansnews.com/law/497union.html

-copro

 

[Nuriko]

On this plus side, think about how much more of this **** we would have to deal with if we were ER docs... that was one MAJOR turnoff for me...

 

[FreshOffTheBoat]

got damn..alota greedy n heartless doctors in this thread...ur job is to SAVE LIVES ....not make judgments....leave that to the courts!!!!!!!![ex] who care if u hav save some gang-banger from a gunshot? ur job is to sav that person life...n courts [judge n jury] job to provide JUSTICE by the LAW....thas how american sysytem works...if not u mus hate america system...go to other country then ..not ur job to make judgments or say that person DON deserv to live..that person deserv to live so they butt can go to court n get charged n sentenced from their crimes!


n so what if sum woman hav 5 kids workin 15hours? mayb she was affected by her enviroment...mayb she not hav any resources for her to get help..maybe not good schools with good mentors...u peeople assume tooo much.

instead sayin these peeople don deserv the care u provid them...u shuld have the courts n law decide what they worthy of..n U sav their life...and to prevent such kinds of 'bad' peeople from coming to your care advocate comunity DEVELOPMENT programs ..u think life is so easy? american dream so easy....pft ...

 

[fakin' the funk]

got damn..alota greedy n heartless doctors in this thread...ur job is to SAVE LIVES ....not make judgments....leave that to the courts!!!!!!!![ex] who care if u hav save some gang-banger from a gunshot? ur job is to sav that person life...n courts [judge n jury] job to provide JUSTICE by the LAW....thas how american sysytem works...if not u mus hate america system...go to other country then ..not ur job to make judgments or say that person DON deserv to live..that person deserv to live so they butt can go to court n get charged n sentenced from their crimes!

I do hope your career in the Anesthesiology forum is a long and fruitful one.

 

[lane]

got damn..alota greedy n heartless doctors in this thread...ur job is to SAVE LIVES ....not make judgments....leave that to the courts!!!!!!!![ex] who care if u hav save some gang-banger from a gunshot? ur job is to sav that person life...n courts [judge n jury] job to provide JUSTICE by the LAW....thas how american sysytem works...if not u mus hate america system...go to other country then ..not ur job to make judgments or say that person DON deserv to live..that person deserv to live so they butt can go to court n get charged n sentenced from their crimes!


n so what if sum woman hav 5 kids workin 15hours? mayb she was affected by her enviroment...mayb she not hav any resources for her to get help..maybe not good schools with good mentors...u peeople assume tooo much.

instead sayin these peeople don deserv the care u provid them...u shuld have the courts n law decide what they worthy of..n U sav their life...and to prevent such kinds of 'bad' peeople from coming to your care advocate comunity DEVELOPMENT programs ..u think life is so easy? american dream so easy....pft ...

ironic for someone who posts the lyrics to MIA - paper planes in her blog...

 

[FreshOffTheBoat]

I do hope your career in the Anesthesiology forum is a long and fruitful one.

are u bein sarcastic or bein nice b/c i cant tell.

 

[FreshOffTheBoat]

ironic for someone who posts the lyrics to MIA - paper planes in her blog...

do u kno meanin behind song...she is touchin on the STEREOTYPES that peeople hav on immigrants..that all they wana do is 'take ur money' 'take ur job' 'kill/gang bang'... etc....i see u don kno notin bout analyzin music...

 

[OB1🤙]

You know you're getting old when you have no damn idea of whatever language it is these kids these days are using on the internets.

 

[lane]

do u kno meanin behind song...she is touchin on the STEREOTYPES that peeople hav on immigrants..that all they wana do is 'take ur money' 'take ur job' 'kill/gang bang'... etc....i see u don kno notin bout analyzin music...

but surely it's okay to take your time, energy, resources, education, and sacrifices (personal and financial) for granted without the willingness or ability (or both) to compensate you (even partially, if at all) for your efforts. maybe she could add a few more sounds effects, like a clock ticking or an infant's first words for all the things in life we miss while taking care of the drug seekers and gangbangers getting shot at 3am. oh wait, those are only stereotypes.

 

[FreshOffTheBoat]

but surely it's okay to take your time, energy, resources, education, and sacrifices (personal and financial) for granted without the willingness or ability (or both) to compensate you (even partially, if at all) for your efforts. maybe she could add a few more sounds effects, like a clock ticking or an infant's first words for all the things in life we miss while taking care of the drug seekers and gangbangers getting shot at 3am. oh wait, those are only stereotypes.

why u assume that they NOT gona compensate u or wuldnt if they could?.u think all immigrants want free rides? wana cause trouble? uhhhh no..here to make a life...but many gota start from BOTTOM n go up...many don come here with tons $$ in their pockets..they have to struggle. ...not evry1 has the opportunities handed on sum platter....heartless peeople u all are....


by the way..if u all happen to be republicans....i actually like republicanism n i wuld say many foreigners do...especially if one come from region where govt is too corruptive in nature..last thing u want is govt intruding....foreingers or many who struggle want to work and want to rise above circumstances but some get stuck in the system...n sum children get raised in bad environments...not bc they WANTED to but bc they family had to start at bottom n when u come into a new country you don always got $$$$$$ so you may not liv in best neighborhoods or go to adequate schools...or have available resources to help n guide u out of circumstances....if u not raised in a settin that shows or tells u that opportunities out in the world are realistic how u really gona believe they are available when their is nothin to prove it?


problem wit you guys is that u COMPLAIN but u hav no solutions but to hav peeople suffer MORE...sayin these peeople don "deserve" care from you or others provide does NOTHING progressive n just leave U complaining MORE. u all shuld advocate PROGRESSIVE measures instead of jus say "BOO HOO BEIN DR SUCKS BC I GOT TAKE CARE OF PEEOPLE I DON LIKE.... BUT I HAV NO SOLUTIONS BOUT THE ROOTS OF THE PROBLEMS SO IM GONA COMPLAIN FOREVER BC I KNO THE GOVT WONT LET ME LEAVE THEM DYING"

boo hoo cry me a river

 

[lane]

why u assume that they NOT gona compensate u or wuldnt if they could?.u think all immigrants want free rides? wana cause trouble? uhhhh no..here to make a life...but many gota start from BOTTOM n go up...many don come here with tons $$ in their pockets..they have to struggle. ...not evry1 has the opportunities handed on sum platter....heartless peeople u all are....


by the way..if u all happen to be republicans....i actually like republicanism n i wuld say many foreigners do...especially if one come from region where govt is too corruptive in nature..last thing u want is govt intruding....foreingers or many who struggle want to work and want to rise above circumstances but some get stuck in the system...n sum children get raised in bad environments...not bc they WANTED to but bc they family had to start at bottom n when u come into a new country you don always got $$$$$$ so you may not liv in best neighborhoods or go to adequate schools...or have available resources to help n guide u out of circumstances....if u not raised in a settin that shows or tells u that opportunities out in the world are realistic how u really gona believe they are available when their is nothin to prove it?


problem wit you guys is that u COMPLAIN but u hav no solutions but to hav peeople suffer MORE...sayin these peeople don "deserve" care from you or others provide does NOTHING progressive n just leave U complaining MORE. u all shuld advocate PROGRESSIVE measures instead of jus say "BOO HOO BEIN DR SUCKS BC I GOT TAKE CARE OF PEEOPLE I DON LIKE.... BUT I HAV NO SOLUTIONS BOUT THE ROOTS OF THE PROBLEMS SO IM GONA COMPLAIN FOREVER BC I KNO THE GOVT WONT LET ME LEAVE THEM DYING"

boo hoo cry me a river

huh?

 

[FreshOffTheBoat]

huh?

n a nutshell....stop bein a crybaby you insensitive greedy head. boo hoo cry me a river. u have no progressive solutions. u only wish to complain forever. u don wana address root issues...u just wana leave peoeple to die bc u dont like them. u hate american system. u should move to japan where every1 is japanese and you don have to worry about immigrants since you hate them so much.



[n i kno you read my previous post fine]

 

[VolatileNavyDoc]

You know you're getting old when you have no damn idea of whatever language it is these kids these days are using on the internets.

I think the last post was something about how foreingers don't (or maybe do) like corruptive republicanism. Beyond that, I'm at a bit of a loss.

 

[FreshOffTheBoat]

I think the last post was something about how foreingers don't (or maybe do) like corruptive republicanism. Beyond that, I'm at a bit of a loss.

lollll i said if anything many foreigners like republicanism especially if you come from a region that had a corruptive govt. so last thing you wuld want is a intruding govt. immigrants do not wana be dependent..they come to different country to leave hardhips of old country and live better economically.

the problem is not republicanism..the problem is republicans...the ideals of republicanism are good...but many [but not all] republicans [the peeople] are jus heartless


their are so many things that factor into this issue.


but yall some stubborn doctors who essentially wuld like to leave peeople dyin if given the opportunity. therefore i cant discuss rational things with such illogical peeople.

 

[Gern Blansten]

<looks around> Is there an interpreter in the house? <pats "freshofftheboat" on the head> We can't help you if we can't understand you.

 

[FreshOffTheBoat]

<looks around> Is there an interpreter in the house? <pats "freshofftheboat" on the head> We can't help you if we can't understand you.

oh hush u read jus fine! u kno what funny....their is research that if u can recognize even a few letters of word scrambled up u can STILL read it....n im sure yall hav seen it too...u guys undastand me jus fin...its jus ur rude it immigrants is all

 

[Monty Python]

oh hush u read jus fine! u kno what funny....their is research that if u can recognize even a few letters of word scrambled up u can STILL read it....n im sure yall hav seen it too...u guys undastand me jus fin...its jus ur rude it immigrants is all

If this isn't asking too much of you .... this is a professional forum. Would you kindly exert just a little bit more effort to post in complete sentences, using standard English (ie, in a professional manner)? Thank you.

 

[michaelrack]

I think the last post was something about how foreingers don't (or maybe do) like corruptive republicanism. Beyond that, I'm at a bit of a loss.

I think he is saying that foreigners are republicans who want welfare? Maybe he wants to elect a better tax collector for the welfare state?
http://www.perkel.com/politics/dole/tax.htm

 

[chocomorsel]

oh hush u read jus fine! u kno what funny....their is research that if u can recognize even a few letters of word scrambled up u can STILL read it....n im sure yall hav seen it too...u guys undastand me jus fin...its jus ur rude it immigrants is all

Thank God Trinity. Please Fresh of the Boat, type in complete sentences. It takes a lot more effort to understand what you are saying when you stop using necessary vowels and such. And what does your grammar have to do with being a foreigner? It's more texting grammar and and driving me and others nuts. I am a foreigner too and don't understand much of what you are typing.

 

[dejerine]

I really don't understand the people who absolutely refuse to accept any adverse comment on the profession. Doctors in England now are paid more than in America and those are Pakistani's my friend, who are not 400,000 in debt, with big monthly repays.

Of course, it is intelligent to examine one's surroundings and if one is not being treated fairly to say or do something about it. It doesn't mean you are a griper, it means you are taking care of number one, which is OKAY. If it were just us, perhaps we could do it, but when we get ourselves into such a circumstance we are asking the spouse and children also to donate their time and their parental influence to society. No society has the right to demand this of children. What is good for the parent is good for the kid. I think most of those saying "What a big griper you are" etc. are either unmarried, or cannot think of another life, and imagine they are Mother Theresa. I am glad Thomas Jefferson didn't think this way or we would have been speaking proper English, and paying taxes to the Anglican church. It is "physician heal thyself" because it is a cinch no one else is going to help those big rich doctors, or their children.

To say with great power comes great responsibility is a MOVIE line, and means nothing and no one saying that in a movie has ever made the contribution that a doctor does. What about the power to be a good parent. There is responsiblity to keep yourself healthy and in a good mood, something that managed care is not attaining. At least we have the residencies down to eighty hours a week, but it needs to be forty.

We can fulfil our great responsibility better if we have had a decent night's sleep, a little exercise, and know our children are happy.

With medicine being the fast track to immigration we certainly don't have to worry there is a shortage of docs, so let them move here, let them help us work a forty hour week, and take our moderate salary in exchange for a higher quality life.

What good are cars and chicks if you never get to have someone actually love you and someone you actually love.

To the "no one has any right to complain about anything" group, identification of problems is a fault, not a sign of mental acuity. And for those who say anyone who can conceive of any way to make things better means we want to leave people dying, take two running jumps and ........... (quote from JFK) Yes, you can work for a hospital, and I guess we all soon will have to. However, I dont' see it as a given that residency has to be so exhaustive in hours. Make it another six months or something if we really need the experience.

 

[Josh L.Ac.]

To paraphrase a quote I heard somewhere... I went into medicine for the same reason most people go into medicine: chicks, money, power, and chicks.

Peace.

...chicks, money, power, and chicks... i think you're talking about Bruce Wayne...heck you can even save people at night as Batman..👍..

Dr. Cox said it on Scrubs Season 1 Episode 15 "My Bed Banter & Beyond" when he was being interviewed by a psychologist:

http://www.tv.com/scrubs/my-bed-banter-and-beyond/episode/114341/recap.html?tag=overview;recap