COULD you do it again?

[labst]

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I'm kind of surprised at how many people say they wouldn't or couldn't do it again. But I suppose another way of looking at it is that people are saying they wouldn't do twice the amount of schooling for the same pay off?

It's really amazing when you think about some of the FMG's who come over here, already doctors in their home country, and who do residency all over again.

That's not amazing at all. Please understand that when FMGs come to America to "retrain," they are under markedly different circumstances. They are coming from countries that are much less affluent in many cases than the U.S. A certain number of those FMGs aim to stay in America after training in order to live a better life. To sacrifice in order to live in America versus a second- or third-world country is not unremarkable. That's just common sense. We would all do it if we were in those circumstances and had the opportunity. It's why FMGs are willing to take ANY specialty (e.g., they're trained in Pathology, but they're here doing FM). A smaller number of FMGs want to train here and return home. But the cachet of having an American degree will earn them MUCH more money at home. That is why these people are willing to undergo this torture.

In contrast, Americans have no need for this. We can just get other jobs that, if we work hard, can pay off well. Of course, once we START medicine we have to continue because the incredible debt load basically makes us permanently impoverished if we do not finish residency training. But that's another story. But please do not talk as if FMGs are these marvelous humans who can endure much more than Americans.

 

[Southpaw]

MDs look at each other as competition because they can't unionize or unite. Since you and the other 5 surgeons in town can't unite on what you should charge for a lap appy, you view the rest as your competition.

This is the part I don't understand. What stands in the way of every general surgeon in town saying "Screw this, I should earn more than X amount of dollars for this surgery...I'm not going to accept insurance anymore.".....

Guys, this is how businesses run. This is how profit is made. Your local vet does the exact same type of business, just on animals. The large majority of their business is cash only. Is that person smarter than the general surgeon? As far as business goes, yep, they sure are.

 

[labst]

It has nothing to do with "smart." It has to do with guilt. From day one, physicians are indoctrinated to believe that you can't refuse to treat anyone. The way our medical system is set up, you offer every service to every patient. We provide care at a cost of hundreds of thousands of dollars to even complete bums and losers. A lot of younger physicians feel that turning down people "to make money" is wrong. Heck, I felt that way, too, until I saw how badly physicians were taking it "for the common good." Physicians are routinely used by society and forced to sacrifice themselves in every way, their personal life, their bodies (coming in sick, etc), and financially. Physicians make good money, but relative to how hard some of us work it's a rip-off. (Other physicians, however, in many of the lifestyle specialties, are the ones gaming the system. But that's because their specialties are designed to either avoid insurance or for other more complex reasons.)

The fact of the matter is that you have to be willing to tell someone to go drop dead if you want to win in this country. And I am all for that because the patients play the system excellently. Every resident knows what I'm talking about. We all have met the woman who paid for her breast implants out of pocket and now is here to have her gallbladder removed and is using Medicare. We've all seen the chumps who come in trying to get disability or claiming fibromyalgia. We all know the freqent fliers that everyone in the hospital is familiar with. We know the bums who come in and say "I feel suicidal, where's my room?" or come in with pain and tell you what narcotic of choice they prefer. If you love that stuff, continue to accept insurance. If you want control, tell them to bite it. At the very least, even if you have to keep dealing with that crap you'll get paid a lot more.