How much do we have to know about US healthcare system for interview?

sky778

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Hey,

How much do we have to know about US healthcare system? I am asking because I grew up in Canada and do not have the best knowledge in topics like this.

Any advice on books or other sources that you guys can recommend?

Thanks!!!!!!
 

Peach Newport

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Hey,

How much do we have to know about US healthcare system? I am asking because I grew up in Canada and do not have the best knowledge in topics like this.

Any advice on books or other sources that you guys can recommend?

Thanks!!!!!!
You should know the following:

1) There are two ways of establishing universal healthcare. First is a SINGLE PAYOR SYSTEM. This is when one party, typically the government, pays for peoples' healthcare with tax dollars. This system is seen in many areas of Europe, such as Britain's NHS. The second is an INDIVIDUAL MANDATE, where each person is required to purchase health insurance, and there are usually affordable plans out there. The Affordable Care Act (ACA/ Obamacare) is an example of an individual mandate.
2) Read up on the major provisions of the ACA. What do you think are the best parts of it? Where do you think it didn't go far enough.
3) Know why healthcare is a big issue in the USA (lack of transparency, unaffordable prices, lack of insurance oversight, excessive litigation, etc etc).
4) Know about the effects of each system on Physicians, and some examples of how they've played out in other countries.

Most likely, you won't be asked a lot about healthcare. I've been to 8 interviews and was never asked about healthcare policy, but I know many who have been. You want to make sure you can talk about it if asked. They don't expect you to be an expert, they just want to know that you've thought carefully about the important issues facing the medical profession, of which the healthcare system is a big one.
 

AlteredScale

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Hey,

How much do we have to know about US healthcare system? I am asking because I grew up in Canada and do not have the best knowledge in topics like this.

Any advice on books or other sources that you guys can recommend?

Thanks!!!!!!
There's some good discussions, articles, and videos on Medscape Ethics, Business, and healthy policy that help introduce you to what's going on in the field currently. It may help :)


Sent from my iPhone using SDN mobile
 
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sky778

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Thanks guys for the help :)
 
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It might be a small part of your interviews but not much. Just know some of the challenges in the US system and maybe be able to compare/contrast that with Canada.

Use caution to avoid coming across as critical of political things like Obamacare/ACA, as you never know if the person you're speaking with loves it.

Good luck
 
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sky778

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It might be a small part of your interviews but not much. Just know some of the challenges in the US system and maybe be able to compare/contrast that with Canada.

Use caution to avoid coming across as critical of political things like Obamacare/ACA, as you never know if the person you're speaking with loves it.

Good luck
Hey thanks for the feedback!
I kind of want people's view on this...what do you think are the benefits of having people buy healthcare plan from insurance companies as oppose to what the Canadian government does? I am formulating what I will be saying during the interview if topics relating to this come up and I kinda want to know what my fellow SDN people think :p
 

Instatewaiter

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Well it really depends on your politics. While a single, governmental payer makes it easier for a physician practice not to have to fight with different people, it also means there is a monopoly which has cons. First more beaurocracy. Second, as a monopoly they have price control so if the gov't arbitrarily wants to cut prices, your income as a physician can fall by 20% in a year. Because those who are pushing complete coverage don't want to admit that everyone's taxes would have to raise by 10% to get this, they will look for ways to cut costs. Because doctors have less lobbying power than hospital systems or pharma, it likely would mean physician incomes would be on the chopping block. A few years back certain specialties saw incomes drop by 20-30% in a year. Expect that healthcare wide.

Now that has implications farther sweeping than just the pocketbook of doctors. I can tell you for certain after going through medical school, residency and fellowship that without the significant monetary compensation, it would not be worth giving up your 20s and 30s. The opportunity cost would be higher in the circumstance. Therefore, we would see a drop in quality of applicants because they would know the compensation would not be there.


Or you know, rainbows and butterflies if you listen to a certain messy-haired politician.
 
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sky778

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Well it really depends on your politics. While a single, governmental payer makes it easier for a physician practice not to have to fight with different people, it also means there is a monopoly which has cons. First more beaurocracy. Second, as a monopoly they have price control so if the gov't arbitrarily wants to cut prices, your income as a physician can fall by 20% in a year. Because those who are pushing complete coverage don't want to admit that everyone's taxes would have to raise by 10% to get this, they will look for ways to cut costs. Because doctors have less lobbying power than hospital systems or pharma, it likely would mean physician incomes would be on the chopping block. A few years back certain specialties saw incomes drop by 20-30% in a year. Expect that healthcare wide.

Now that has implications farther sweeping than just the pocketbook of doctors. I can tell you for certain after going through medical school, residency and fellowship that without the significant monetary compensation, it would not be worth giving up your 20s and 30s. The opportunity cost would be higher in the circumstance. Therefore, we would see a drop in quality of applicants because they would know the compensation would not be there.


Or you know, rainbows and butterflies if you listen to a certain messy-haired politician.
Hmm that makes a lot of sense. Is there any other impacts on the quality of care that patients are getting under a single payer system? Other than the potential drop in quality of applicants? From my personal experience ( seeing a family doctor myself vs shadowing in the U.S.) I feel that my doctor spent significantly less time per patient compare to the U.S. doctors who I shadowed (seriously, my family doctors only sees me for 5 minutes on average). Is this also a result of the healthcare system?
 

Instatewaiter

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Hmm that makes a lot of sense. Is there any other impacts on the quality of care that patients are getting under a single payer system? Other than the potential drop in quality of applicants? From my personal experience ( seeing a family doctor myself vs shadowing in the U.S.) I feel that my doctor spent significantly less time per patient compare to the U.S. doctors who I shadowed (seriously, my family doctors only sees me for 5 minutes on average). Is this also a result of the healthcare system?
This is a result of many things- prices being cut over the last 20 years, more time spent dealing with non-medical BS (forms, paperwork, prior auths). Previously, doctors were paid much more for their time so they could see fewer patients and still make the same money. Now they are forced to see more patients in less time just to keep pace with how the gov't is cutting reimbursement
 
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CaffeinatedSquirrel

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You should know the following:

1) There are two ways of establishing universal healthcare. First is a SINGLE PAYOR SYSTEM. This is when one party, typically the government, pays for peoples' healthcare with tax dollars. This system is seen in many areas of Europe, such as Britain's NHS. The second is an INDIVIDUAL MANDATE, where each person is required to purchase health insurance, and there are usually affordable plans out there. The Affordable Care Act (ACA/ Obamacare) is an example of an individual mandate.
2) Read up on the major provisions of the ACA. What do you think are the best parts of it? Where do you think it didn't go far enough.
3) Know why healthcare is a big issue in the USA (lack of transparency, unaffordable prices, lack of insurance oversight, excessive litigation, etc etc).
4) Know about the effects of each system on Physicians, and some examples of how they've played out in other countries.

Most likely, you won't be asked a lot about healthcare. I've been to 8 interviews and was never asked about healthcare policy, but I know many who have been. You want to make sure you can talk about it if asked. They don't expect you to be an expert, they just want to know that you've thought carefully about the important issues facing the medical profession, of which the healthcare system is a big one.
Thanks for your helpful post! We like to reward people for being helpful members of the SDN community. Check your message inbox for an Amazon Gift Code!
 
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sky778

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This is a result of many things- prices being cut over the last 20 years, more time spent dealing with non-medical BS (forms, paperwork, prior auths). Previously, doctors were paid much more for their time so they could see fewer patients and still make the same money. Now they are forced to see more patients in less time just to keep pace with how the gov't is cutting reimbursement
Thanks for the reply and my apology for the late response!

Your point makes total sense but I feel like is there other incentive or reasons for why "non-universal healthcare" system tend to provide better medical service? Is it so much of being one thing or the other? Is it guarantee that universal healthcare results in less patient time which is related to less healthcare service quality?

Thank you again for all the inputs :)
 
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It might be a small part of your interviews but not much. Just know some of the challenges in the US system and maybe be able to compare/contrast that with Canada.

Use caution to avoid coming across as critical of political things like Obamacare/ACA, as you never know if the person you're speaking with loves it.

Good luck
That is a tricky one, I knew a few people who were very critical of ACA but you would never know it, some were pro ACA. Got to sound neutral to these things, even then everyone has a right to an opinion. Some other topics could get you in trouble though.
 
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That is a tricky one, I knew a few people who were very critical of ACA but you would never know it, some were pro ACA. Got to sound neutral to these things, even then everyone has a right to an opinion. Some other topics could get you in trouble though.
You might have a right to your opinion but some adcoms don't take kindly to those who disagree. It's always safer to if possible avoid coming across negatively on any major political topic, but you can/should be able to discuss pros and cons without taking a side.
 
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You might have a right to your opinion but some adcoms don't take kindly to those who disagree. It's always safer to if possible avoid coming across negatively on any major political topic, but you can/should be able to discuss pros and cons without taking a side.
You are right to a point but sometimes you might get stuck with a question as to what level of understanding you might know about certain healthcare issues, the adcom might want to know what you understand about issues like the ACA, not your personal feelings on the matter. Trying to sound as rational as possible will probably make a good impression.
 
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You are right to a point but sometimes you might get stuck with a question as to what level of understanding you might know about certain healthcare issues, the adcom might want to know what you understand about issues like the ACA, not your personal feelings on the matter. Trying to sound as rational as possible will probably make a good impression.
Yes, I'm all for sharing what you know and even discussing challenges faced on each side of an issue, but it is invaluable to discuss what you know in a balanced manner without letting onto your views when possible. I've been on various committees where questions were asked on things like assisted suicide, abortion rights, capital punishment, etc and right or wrong I've witnessed some committee members hold it against people who differed politically/religiously. Being knowledgeable but appearing neutral will rarely get you into trouble and often if done well people strongly on each side will assume you agree with them, which is a positive. It is absolutely possible to intelligently discuss the pros and cons of things like the ACA without letting on if you support it or not.

That said, if it involves ethics/professionalism then absolutely come down firm against cheating, stealing, etc. There is no gray area for instances involving cheating.
 
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Y'all are kidding, right? The OP is asking how much he or she needs to know about the US health system for an interview at a DO school? Very little. If you are asked a question about insurance or the new Healthcare act or what you think about differences between systems, the interviewers are looking for your ability to speak sensibly, logically, and briefly. It is very unlikely that anyone will expect you to have insights.