biggest problem in US health care system?

[prettymonkey]

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Stony Brook asks you to identify the biggest problem facing the US health care system. I should have no problem with this essay seeing as I have an MPH... but that is actually making it more difficult. I could write a 30 page dissertation on this. They want like a page. How do I wrap up the biggest problem in the US health care system? I don't want to come off sounding like an idiot writing a paper for a class. But I probably will anyway.
How complicated a discussion are you guys going to get into in one page?

 

[LizzyM]

The biggest problem?



Obesity.



(only half jk)

 

[Inuranic]

Lizzy, let's keep the groaners to a minimum.

I wrote a similar essay for WVU - I went for the cliche and talked about insurance. Brief paragraph on why this is a problem, personal story illustrating the problem, wrap-up, and there's a page.

 

[PharmDFisher]

Stony Brook asks you to identify the biggest problem facing the US health care system. I should have no problem with this essay seeing as I have an MPH... but that is actually making it more difficult. I could write a 30 page dissertation on this. They want like a page. How do I wrap up the biggest problem in the US health care system? I don't want to come off sounding like an idiot writing a paper for a class. But I probably will anyway.
How complicated a discussion are you guys going to get into in one page?

just say cost, then go from malpractice insurance to real insurance to the actual cost of operation

 

[OCallag]

costs is a good response. i'd go with administrative costs, in particular.

 

[Law2Doc]

Stony Brook asks you to identify the biggest problem facing the US health care system.

I got this question on most interviews a few years back, so it isn't Stony Brook specific.

Healthcare costs and the underinsured seem to be obvious answers.
Things like obesity/cigarettes/cancer/heart disease are things which may ultimately be attacked with less ambiguous medical/social solutions.
Antibiotic resistant bugs, SARS, bird flu pose future armageddon-like concerns.

 

[lord_jeebus]

Greed

 

[Kikaku21]

The biggest problem is access.

There are 50 million people in this country with inadequate access to healthcare. But you'll never hear about that on SDN because there are so many CHILDREN here that are concerned about making as much money as possible. I love reading the stuff about socialized medicine, etc. Nobody is talking about what is best for patients. Its frightening.

 

[Law2Doc]

Nobody is talking about what is best for patients. Its frightening.

Um, every politician running for office is talking about what is best for patients (at least those who vote); often at the expense of physicians -- the very cogs that make this machine work. I wouldn't worry as much about patients -- they are one group that is currently being spoken for in the current healthcare battle. The real issue is which group gets screwed in an effort to make things best for patients -- the doctors, the insurance companies, the pharmaceutical indusry or the taxpayer (or most likely several of the above). Of these groups, the doctors are the weakest fighters. So you really need places like SDN to advocate the physician/future physician side of things, because frankly, this is the group that is most likely going to get trampled in someone's march to the whitehouse. Read last weekend's NYTimes article attacking physician salaries and it will give you a taste of where the discussion is going to go between now and the next election.

 

[LizzyM]

The biggest problem?



Obesity.



(only half jk)

I'm serious here. People do not take responsibility for themselves. They want to do as they please & get baled out by health care system which just means that they want everyone to chip in to pay for problems of their own making. The is evidenced not only by the rising proportion of obese and overweight adults in America but in the use of alcohol, cigarettes, drugs and risky sexual behavior.

Obesity is a risk factor for a wide variety of disabling conditions. Wipe out obesity and you reduce the number of heart attacks, hip and knee replacements, even breast cancer (associated with higher body weight after adjusting for height).

One of the problems of the health care system that leads to obesity and other preventable problems is that we are totally designed as a one-on-one system designed to treat problems when they arise rather than a system that identifies and prevents potential problems (pediatrics is an exception to this rule with most pediatricians doing a lot of anticipatory guidance and prevention including vaccines).

 

[PeepshowJohnny]

"Doc, why am I sick?"

"Well, your heart has failed partly because you didn't control your blood pressure by the diet and medications I put you on, and partly from that heart attack you had a few years ago because you didn't get your cholesterol under control. You didn't control your blood sugars when we diagnosed you with diabetes several years ago, which contributed to your heart problems. Also, it has ruined your vision, your kidneys are starting to fail, and its the cause of those shooting pains in your legs. You've continued to smoke for the 10 years you've been my patient and the pulmonary function tests we just got back show you've developed COPD as well."

Patient looks confused: "But other than that, why am I sick?"

 

[artaxerxes]

I'm serious here. People do not take responsibility for themselves. They want to do as they please & get baled out by health care system which just means that they want everyone to chip in to pay for problems of their own making. The is evidenced not only by the rising proportion of obese and overweight adults in America but in the use of alcohol, cigarettes, drugs and risky sexual behavior.

Obesity is a risk factor for a wide variety of disabling conditions. Wipe out obesity and you reduce the number of heart attacks, hip and knee replacements, even breast cancer (associated with higher body weight after adjusting for height).

One of the problems of the health care system that leads to obesity and other preventable problems is that we are totally designed as a one-on-one system designed to treat problems when they arise rather than a system that identifies and prevents potential problems (pediatrics is an exception to this rule with most pediatricians doing a lot of anticipatory guidance and prevention including vaccines).

the lack of personal responsibility and a sense of entitlement is the root of it. mind if I steal some of your material for interview and essays🙂

 

[TheRealMD]

A system more focused on treatment than prevention. You only get access to a doctor after you've had a heart attack, not 30 years earlier in your life when you decide McDonalds is good 3 times a day. But that really gets into lifestyle issues more than anything else.

 

[h0ck3ydo0od]

i dont see anything wrong with the current health system

 

[AnthonyNY]

oh man...

 

[PharmDFisher]

The biggest problem is access.

There are 50 million people in this country with inadequate access to healthcare. But you'll never hear about that on SDN because there are so many CHILDREN here that are concerned about making as much money as possible. I love reading the stuff about socialized medicine, etc. Nobody is talking about what is best for patients. Its frightening.

Best for patients? um ok best for patients is not socialized medicine. You hear about socialized medicine and how anyone can see the doctor at anytime with socialized medicine...well thats true, however like any system you come up with there are flaws. Right now you can see a doctor, poor rich or what not, makes no difference. It may not be the best doctor or the best hospital but you can still see them. Second with socialized medicine your eliminating compition, you talk about how doctors are in it for the money and what not, sure this is true, so you take away the one thing that brings new people to wanting to become doctors and what do you get? A shortage of doctors. There is no best system, but I'm tired of hearing how bad our system is... I'm sorry if I had a disease or had to have some kind of special surgery or even to just visit a doctor, I would much be in the United States and pay my bazillion dollars then to go to a country where doctors get paid the same for longer schooling.

 

[PharmDFisher]

Um, every politician running for office is talking about what is best for patients (at least those who vote); often at the expense of physicians -- the very cogs that make this machine work. I wouldn't worry as much about patients -- they are one group that is currently being spoken for in the current healthcare battle. The real issue is which group gets screwed in an effort to make things best for patients -- the doctors, the insurance companies, the pharmaceutical indusry or the taxpayer (or most likely several of the above). Of these groups, the doctors are the weakest fighters. So you really need places like SDN to advocate the physician/future physician side of things, because frankly, this is the group that is most likely going to get trampled in someone's march to the whitehouse. Read last weekend's NYTimes article attacking physician salaries and it will give you a taste of where the discussion is going to go between now and the next election.

read the newsweekly last month, puts down doctors like no tomorrow

 

[dannieloco]

i dont see anything wrong with the current health system

WHOA! haha you gotta be kidding me...

Go earn an MPH degree and you'll learn everything that is wrong with our Healthcare "Industry"..

Just glance over the bullets presented here..
http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=221624

 

[PharmDFisher]

I call bull$hit.

People either get sick now, or later. Preventing heart disease in a 40yo doesn't prevent him from getting cancer at 70. Reasonably valid analyses have shown that the majority of health care expenditures occur in the final year or two of a person's life. So we can either pay these costs when people are young, or when they're old. That doesn't change the ultimate expense. Eventually we will all get sick, and we will all die, and many (if not most) of us will not drop dead suddenly, we will linger. That costs money, no matter how old you are.

If you really want to save money, you have to spend less, which means treating less and letting more people die.

Um ok but if you manage to prevent the heart disease and he gets cancer at 70 your talking about managing cancer at 70.

Ok, Then you have getting heart disease, treating it and then getting cancer at 70 anyways... so that means you are spending more

 

[PharmDFisher]

i dont see anything wrong with the current health system

Actually I agree and disagree with this statement... I agree this is the best system but there is a problem, its called too many people complain about it.

 

[mikkey]

I agree with PharmD. Socialized med is not in the patient's best interest. That patient, ie you and me, have to wait 4 months for a simple doctor's appointment, and I am talking about family med here, not some super hot shot in like neurosurgery. I believe that the American system is a good base, but that insurers should stop trying to deny care all the time for experimental procedures and uncommon treatment options. The doc you saw the first time is a better judge of the situation than some office "doctor" who only looks at your file and can only see money.
I believe this is a good option in a time where basic and primary care doesn't cost all that much to the one patient (except if they are hospitalized) but where technology is becoming insanely expensive. I think that is where the money needs to go, in my mind.
And I hate that Stony Brook question!

 

[dannieloco]

I call bull$hit.

People either get sick now, or later. Preventing heart disease in a 40yo doesn't prevent him from getting cancer at 70. Reasonably valid analyses have shown that the majority of health care expenditures occur in the final year or two of a person's life. So we can either pay these costs when people are young, or when they're old. That doesn't change the ultimate expense. Eventually we will all get sick, and we will all die, and many (if not most) of us will not drop dead suddenly, we will linger. That costs money, no matter how old you are.

If you really want to save money, you have to spend less, which means treating less and letting more people die.

I dont know about that.. you're talking about illnesses that will eventually occur.. but what about diseases that are preventable, like Diabetes, Hyertension, and even obesity. All three are preventable and theyre all related, so why not invest in preventing illness instead of treating it after the fact. Heart Attacks are preventable too, most people get an attack because of their lifestyles, diets, and failure to prescreen themselves for possible risk.

I agree with "A system more focused on treatment than prevention. You only get access to a doctor after you've had a heart attack, not 30 years earlier in your life when you decide McDonalds is good 3 times a day. But that really gets into lifestyle issues more than anything else."

And.. letting people die, should NOT be an option for lowering healthcare costs in America..

 

[dannieloco]

Actually I agree and disagree with this statement... I agree this is the best system but there is a problem, its called too many people complain about it.

you're right too many people do complain about our system, but it's because other nation's spend 1/3 less per capita on healthcare than the US and have better health outcomes. We over-utilize resources/services on a patient to "prevent" malpractice accusations. Having 3 cat scans and an x-ray instead of only 1 cat, can hurt a persons health - all while raising the cost for treatment.

 

[PharmDFisher]

I agree with PharmD. Socialized med is not in the patient's best interest. That patient, ie you and me, have to wait 4 months for a simple doctor's appointment, and I am talking about family med here, not some super hot shot in like neurosurgery. I believe that the American system is a good base, but that insurers should stop trying to deny care all the time for experimental procedures and uncommon treatment options. The doc you saw the first time is a better judge of the situation than some office "doctor" who only looks at your file and can only see money.
I believe this is a good option in a time where basic and primary care doesn't cost all that much to the one patient (except if they are hospitalized) but where technology is becoming insanely expensive. I think that is where the money needs to go, in my mind.
And I hate that Stony Brook question!

Well theres more risk with uncommon treatments, which entales more risk of malpractice. Also the new technology isnt just the insurance companies fault, its the producers of the new technology.

 

[PharmDFisher]

you're right too many people do complain about our system, but it's because other nation's spend 1/3 less per capita on healthcare than the US and have better health outcomes. We over-utilize resources/services on a patient to "prevent" malpractice accusations. Having 3 cat scans and an x-ray instead of only 1 cat, can hurt a persons health - all while raising the cost for treatment.

Well to put it simple, we are capitalist, we want to make money and really don't want to lose money. And since malpractice lawsuits can be in the millions, it requires doctors to pay millions to cover these lawsuits. Which in turn makes doctors have to be paid more to cover the cost of schooling and insurance...

Ok, but how to fix the problem? I see the only way to make our system better is for there to be a government run malpractice insurer, not to be mistaken for regular insurance... At the end of the year the amount of money paid out to the malpractice suets would be completely divided among all doctors. This would probably drop individual insurance premiums by 10s of thousands each year. This would take out any profit to the malpractice insurance companies, and would leave a flat rate at the end. This would in tale alowing us to drop the cost of insurance its self when it comes to high risk procedures.

 

[LizzyM]

It is not just the cost of malpractice insurance (which is considerable) but it is the practice of "cover your ass" medicine that gets practiced in combination, at times, with an over-reliance on tests and an under-appreciation for the history and physical. Case in point: 45 year old white female with complaints suggestive of hypothyroidism. Primary care doctor orders makes a cursory examination of the thyroid gland. The doctor is thinking about a recent patient with thyroid cancer and worries that the patient may have an enlarged thyroid due to a tumor. The doctor orders the usual blood tests for hypothyroidism but also sends the patient for an ultrasound. The ultrasound shows a normal size thyroid (not enlarged) but it contains a small cyst. The doctor refers the patient to an endocrinologist who may be able to assess the cyst. The endocrinologist claims to be able to palpate the cyst but doesn't want to take a needle biopsy. Meanwhile the blood work comes back and is normal. But wait, the cyst is something we can't ignore! The endocrinolgist refers the patient to an interventional radiologist for a needle biopsy of the cyst. The interventionist says the cyst is so small that it is not palpable but it still needs to be checked out. The needle biopsy is evaluated by a pathologist and it indicates that there may be a problem but the only way to know for sure is to surgically remove the thyroid gland. The endocrinogist and the primary care doc refer the patient to a surgeon. The surgeon, an anesthesiologist and the pathologist work together, the gland is removed and the cyst is found to be BENIGN!

How much time and effort was spent on something that could have been avoided with a thorough exam and a wait to see the results of the blood work before moving on to the ultrasound.

Some of this new technology is finding a lot of "trouble" that is really no trouble at all and the work up of all those false positive findings is really a lot of money for no better health outcomes than if we'd left things alone.

 

[PharmDFisher]

It is not just the cost of malpractice insurance (which is considerable) but it is the practice of "cover your ass" medicine that gets practiced in combination, at times, with an over-reliance on tests and an under-appreciation for the history and physical. Case in point: 45 year old white female with complaints suggestive of hypothyroidism. Primary care doctor orders makes a cursory examination of the thyroid gland. The doctor is thinking about a recent patient with thyroid cancer and worries that the patient may have an enlarged thyroid due to a tumor. The doctor orders the usual blood tests for hypothyroidism but also sends the patient for an ultrasound. The ultrasound shows a normal size thyroid (not enlarged) but it contains a small cyst. The doctor refers the patient to an endocrinologist who may be able to assess the cyst. The endocrinologist claims to be able to palpate the cyst but doesn't want to take a needle biopsy. Meanwhile the blood work comes back and is normal. But wait, the cyst is something we can't ignore! The endocrinolgist refers the patient to an interventional radiologist for a needle biopsy of the cyst. The interventionist says the cyst is so small that it is not palpable but it still needs to be checked out. The needle biopsy is evaluated by a pathologist and it indicates that there may be a problem but the only way to know for sure is to surgically remove the thyroid gland. The endocrinogist and the primary care doc refer the patient to a surgeon. The surgeon, an anesthesiologist and the pathologist work together, the gland is removed and the cyst is found to be BENIGN!

How much time and effort was spent on something that could have been avoided with a thorough exam and a wait to see the results of the blood work before moving on to the ultrasound.

Some of this new technology is finding a lot of "trouble" that is really no trouble at all and the work up of all those false positive findings is really a lot of money for no better health outcomes than if we'd left things alone.

ok, but tell the same woman if it were cancer and it spread through her body, that there were tests that we could of performed that could of caught this in its early stages but we thought we could save some money by not doing them... yeah bad response

 

[LizzyM]

ok, but tell the same woman if it were cancer and it spread through her body, that there were tests that we could of performed that could of caught this in its early stages but we thought we could save some money by not doing them... yeah bad response

But the point is, a decent physical exam would have shown that the thyroid gland was essentially normal. Many people have non-palpable, benign cysts. We can work them all up in an attempt to catch the very, very rare thyroid cancers that occur in that age group but we are going to have to be willing to spend billions on care that doesn't improve anyone's quality of life, not to mention taking the time that very talented subspecialists could be directing toward patients with more serious problems. (As it is the wait time to see a specialist can be 6 weeks and another 6-8 weeks to get into an OR).

 

[Vera18]

Um, every politician running for office is talking about what is best for patients (at least those who vote); often at the expense of physicians -- the very cogs that make this machine work. I wouldn't worry as much about patients -- they are one group that is currently being spoken for in the current healthcare battle. The real issue is which group gets screwed in an effort to make things best for patients -- the doctors, the insurance companies, the pharmaceutical indusry or the taxpayer (or most likely several of the above). Of these groups, the doctors are the weakest fighters. So you really need places like SDN to advocate the physician/future physician side of things, because frankly, this is the group that is most likely going to get trampled in someone's march to the whitehouse. Read last weekend's NYTimes article attacking physician salaries and it will give you a taste of where the discussion is going to go between now and the next election.

You can't seriously be saying that doctors, insurance companies and pharmaceutical industries are being screwed. They're practically swimming in money, while poor americans are going without treatment. I saw a man, whose cleft palate prevented him from speaking for 50 years!! because he could not afford to be treated, on the news the other day. That's absurd. We are living in one of the richest countries in the world, yet so many americans can't even afford to visit to a family doctor.

And you're concerned with physicians' salaries. How benevolent.

 

[Beau Geste]

But the point is, a decent physical exam would have shown that the thyroid gland was essentially normal. Many people have non-palpable, benign cysts. We can work them all up in an attempt to catch the very, very rare thyroid cancers that occur in that age group but we are going to have to be willing to spend billions on care that doesn't improve anyone's quality of life, not to mention taking the time that very talented subspecialists could be directing toward patients with more serious problems. (As it is the wait time to see a specialist can be 6 weeks and another 6-8 weeks to get into an OR).

Benign tumors and cysts can still wreak havoc in addition to cancer and can behave the same way as cancerous tumors.

Even so, thyroid cancer or pre-cancer isn't as rare as you'd think. In fact, 5 immediate family members of mine have had 5 different kinds of thyroid cancer. My tumor was the size of a golf ball so it was kinda hard to say there wasn't anything there. The cancer itself was malignant, but contained within the thyroid, so didn't metastasize and considered benign compared to the rest of the body. Had they left it for later, even a few weeks, and my lymph nodes would have been in trouble. The entire time from initial palpitation to removal was about 3 weeks. That sucker grew fast.

I never had any lab tests but did have an ultrasound and biopsy. I shudder to think what may have happened if it was not treated aggressively. It always reminds me that not everything that seems less important is indeed less important. It was potentially very life-threatening. I was lucky. 30 years ago my father was not. He also had thyroid cancer which indeed metastasized to his lymph nodes. He underwent grueling chemo and has a nasty scar from collarbone to jawbone. He wasn't expected to live but but he grace of God made it through. His doctor was aggressive as well, and he'd be dead if the doctor wasn't.

I probably take exception to this line of conversation because I experienced it.

 

[Beau Geste]

You can't seriously be saying that doctors, insurance companies and pharmaceutical industries are being screwed. They're practically swimming in money, while poor americans are going without treatment. I saw a man, whose cleft palate prevented him from speaking for 50 years!! because he could not afford to be treated, on the news the other day. That's absurd. We are living in one of the richest countries in the world, yet so many americans can't even afford to visit to a family doctor.

And you're concerned with physicians' salaries. How benevolent.

That's because healthcare isn't a magical endowment - it's a service-oriented profession, where people work long hours and obtain lengthy educations and are compensated accordingly. I'm not too excited about insurance companies, but I definitely speak out when physicians are attacked for how much they make and when people think there is no responsibility on the patient in healthcare.

I'm a speech-language pathologist and I have a little girl with a cleft palate on my caseload at the moment. Her mother is on Public Aid, and they're paying for her cleft repair this Sept. Her lip has already been repaired. I'm sure you take pity on the guy with the cleft, but don't assume he wasn't able to get it repaired. Even though he can't speak, he can probably write or sign for communication.

From what I've seen, and I work with about 75% uninsured families, it's not access to healthcare (if they see me, they've already seen a doctor), it's the motivation by the parents to actually follow through with well-child visits and etc.

 

[adoggie]

I think the biggest problem is figuring out how to distribute the limited funds in the most cost effective way amongst all people, both young and old.

 

[coralfangs]

I think many people are aware of this "cover your ass" medicine. However, wouldn't such statements be looked negatively upon in our applications or during interviews?

It is not just the cost of malpractice insurance (which is considerable) but it is the practice of "cover your ass" medicine that gets practiced in combination, at times, with an over-reliance on tests and an under-appreciation for the history and physical. Case in point: 45 year old white female with complaints suggestive of hypothyroidism. Primary care doctor orders makes a cursory examination of the thyroid gland. The doctor is thinking about a recent patient with thyroid cancer and worries that the patient may have an enlarged thyroid due to a tumor. The doctor orders the usual blood tests for hypothyroidism but also sends the patient for an ultrasound. The ultrasound shows a normal size thyroid (not enlarged) but it contains a small cyst. The doctor refers the patient to an endocrinologist who may be able to assess the cyst. The endocrinologist claims to be able to palpate the cyst but doesn't want to take a needle biopsy. Meanwhile the blood work comes back and is normal. But wait, the cyst is something we can't ignore! The endocrinolgist refers the patient to an interventional radiologist for a needle biopsy of the cyst. The interventionist says the cyst is so small that it is not palpable but it still needs to be checked out. The needle biopsy is evaluated by a pathologist and it indicates that there may be a problem but the only way to know for sure is to surgically remove the thyroid gland. The endocrinogist and the primary care doc refer the patient to a surgeon. The surgeon, an anesthesiologist and the pathologist work together, the gland is removed and the cyst is found to be BENIGN!

How much time and effort was spent on something that could have been avoided with a thorough exam and a wait to see the results of the blood work before moving on to the ultrasound.

Some of this new technology is finding a lot of "trouble" that is really no trouble at all and the work up of all those false positive findings is really a lot of money for no better health outcomes than if we'd left things alone.

 

[Law2Doc]

And you're concerned with physicians' salaries. How benevolent.

When you borrow $200k and spend the next decade training, you can decide how benevolent I'm being. 🙄 There are many ways to pay for healthcare, but in my opinion slashing physician salaries is not the most desirable or effective route. But it is the most likely, of late.

 

[Vera18]

That's because healthcare isn't a magical endowment - it's a service-oriented profession, where people work long hours and obtain lengthy educations and are compensated accordingly. I'm not too excited about insurance companies, but I definitely speak out when physicians are attacked for how much they make and when people think there is no responsibility on the patient in healthcare.

I'm a speech-language pathologist and I have a little girl with a cleft palate on my caseload at the moment. Her mother is on Public Aid, and they're paying for her cleft repair this Sept. Her lip has already been repaired. I'm sure you take pity on the guy with the cleft, but don't assume he wasn't able to get it repaired. Even though he can't speak, he can probably write or sign for communication.

From what I've seen, and I work with about 75% uninsured families, it's not access to healthcare (if they see me, they've already seen a doctor), it's the motivation by the parents to actually follow through with well-child visits and etc.

I agree that patients need to take responsibility, but I still think that physicians are being 'compensated' more than enough.

 

[Beau Geste]

I agree that patients need to take responsibility, but I still think that physicians are being 'compensated' more than enough.

You can think whatever you want. But you can also be wrong.

P.S. I thought newbies had to post in the new-student forum for their first post?!

 

[Vera18]

When you borrow $200k and spend the next decade training, you can decide how benevolent I'm being. 🙄 There are many ways to pay for healthcare, but in my opinion slashing physician salaries is not the most desirable or effective route. But it is the most likely, of late.

I'd work for the minimum wage, if I had to. I can't think of anything better than being a doctor.

(of course, only after all my debt was paid off lol)

 

[Vera18]

You can think whatever you want. But you can also be wrong.

Ok

 

[Law2Doc]

I'd work for the minimum wage, if I had to. I can't think of anything better than being a doctor.

(of course, only after all my debt was paid off lol)

If you divide resident salary by resident hours I promise you you will be doing your share of working for minimum wage, long before your debt is paid off. This is a career of very delayed gratification. And the gratification is already less than it once was. Not sure why you would be a proponent of slicing it further.

 

[Beau Geste]

If you divide resident salary by resident hours I promise you you will be doing your share of working for minimum wage, long before your debt is paid off. This is a career of very delayed gratification. And the gratification is already less than it once was. Not sure why you would be a proponent of slicing it further.

Lol there's always a lot of "big talk" among pre-meds. I don't think I've ever heard a resident say "this is so much fun, I'd do it for the same pay as someone who works at Mickey D's!"

👎 for the whole idea

 

[Vera18]

You can think whatever you want. But you can also be wrong.

P.S. I thought newbies had to post in the new-student forum for their first post?!

I've done the 'first post' thing already.

 

[Vera18]

If you divide resident salary by resident hours I promise you you will be doing your share of working for minimum wage, long before your debt is paid off. This is a career of very delayed gratification. And the gratification is already less than it once was. Not sure why you would be a proponent of slicing it further.

So gratification = money in your eyes?

 

[Beau Geste]

I've done the 'first post' thing already.

Not in the new student forum though.

 

[Vera18]

Not in the new student forum though.

Otherwise I wouldn't be able to type here, so yeah.

 

[Beau Geste]

Otherwise I wouldn't be able to type here, so yeah.

Hmmm, your post history says otherwise.

And it also says you're 17. You have a lot of growing up to do young lady.

 

[Vera18]

Hmmm, your post history says otherwise.

And it also says you're 17. You have a lot of growing up to do young lady.

Don't attack me because of my age.

 

[Beau Geste]

Don't attack me because of my age.

It's not an attack. it's my opinion.

Don't attack us because we want to make a good living.

Get back to us after you graduate college and see how you feel about whatever career you go into and compensation for said career.

P.S. Do your parents know you're on the internet?

 

[Law2Doc]

So gratification = money in your eyes?

I think you are reading too much into the word. You don't go into medicine for the money. If you read my posts you would know I am one of the bigger proponents of this view.
That being said, we in a situation where some version of healthcare reform is about to happen, and where organizations are lobbying over various healthcare plans, and who will get the short straw. If you read the NY Times last week or are keeping up with the news, physician salaries have become a big target, notwithstanding that they only represent a small percentage of healthcare costs. So the physicians need to lobby for their interests, or they will get screwed by the more powerful insurance and pharmaceutical interests (they will anyway, but ought not go down without a fight).

I realize from another thread that you are only 17 and perhaps not up on income issues, but physician salaries have already declined 7+% over the last decade and incomes today are really not what they were in the past generation. Which is fine, but can be made not so fine with further reductions. You have to realize that many med students are borrowing $200k and then plan to train as residents and fellows for 3-8 years after med school before taking private practice jobs. So any salary you get after that is really taking into account the 7-12 years of income you have foregone. This means you pretty much have to earn a lot more than minimum wage to pay your bills and debt because you will have been broke for a while. Hardly sounds excessive to me.

 

[Daydreamer2008]

But the point is, a decent physical exam would have shown that the thyroid gland was essentially normal. Many people have non-palpable, benign cysts. We can work them all up in an attempt to catch the very, very rare thyroid cancers that occur in that age group but we are going to have to be willing to spend billions on care that doesn't improve anyone's quality of life, not to mention taking the time that very talented subspecialists could be directing toward patients with more serious problems. (As it is the wait time to see a specialist can be 6 weeks and another 6-8 weeks to get into an OR).

This discussion reminds me of someone, though it's a totally unrelated situation. Someone I know, who was 22 years old at the time, complains about neck pain. Her family has a history of thyroid problems so they do the usual work up to check for abnormalities. They checked usual thyroid hormones and such. Everything seemed fine and 2 years go by without finding out why she had neck pain. She thinks it is because she studies so much. Finally, after checking the calcitonin level in her blood, they realize it was a rare form of thyroid cancer called medullary cancer. By the time they removed the thyroid gland, it had metastasized to the nearby esophagus. She did not make it. Now I don't know much about endocrinology or details about the thyroid, but I don't know why it took 2 years to get the calcitonin work up done. If her cancer had not metastasized, she would be alive today.

 

[Beau Geste]

This discussion reminds me of someone, though it's a totally unrelated situation. Someone I know, who was 22 years old at the time, complains about neck pain. Her family has a history of thyroid problems so they do the usual work up to check for abnormalities. They checked usual thyroid hormones and such. Everything seemed fine and 2 years go by without finding out why she had neck pain. She thinks it is because she studies so much. Finally, after checking the calcitonin level in her blood, they realize it was a rare form of thyroid cancer called medullary cancer. By the time they removed the thyroid gland, it had metastasized to the nearby esophagus. She did not make it. Now I don't know much about endocrinology or details about the thyroid, but I don't know why it took 2 years to get the calcitonin work up done. If her cancer had not metastasized, she would be alive today.

That's the kind my dad had.