In response to Hard Truths: 10 Healthcare Myths--Physicians are underpaid. . .posted on devinmd.com.

Discussion in 'Family Medicine' started by jl lin, 09.23.14.

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  1. jl lin

    jl lin 7+ Year Member

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    http://www.kevinmd.com/blog/2014/09/hard-truths-dispelling-10-health-care-myths.html


    Here we go again. The long and short of this discussion is that Family Practice must inevitably become a dying area of practice; b/c this is economically what the market is demanding. But if you make that jump, then listen, how is it any more worthwhile for people to go the extra miles for IM or IM-Peds, for example? How will compensation for them be much better?

    And really, will there be enough NPs or PAs going into FP or Primary Care to make up for this? And will they REALLY be able to handle the many more complex cases--and there are so many complex cases and cases with co-morbid risk factors. As such, this makes use of NP or PA for these patients/clients a waste! And if NPs and PAs are taking on these kinds of cases, which there are more and more prevalent d/t advances in medical science/disease-understanding--and also the aging population, I cannot say I support tort reform anymore. Why? Well, I think there will be a lot of lawsuits when you push these more complex clients on to NPs and PAs--and in those cases, I say high damages will probably be justified--b/c in reality, the NPs and PAs are/will practicing far outside their scope of practice--based on education and supervised, clinical experiences and board standards!!!! But of course NP and PA penalties will be limited, b/c the government will be controlling this and limiting/capping their pay -outs. This is wrong!!! They shouldn't be taking on the kinds of clients to which I am referring--and such clients are a growing percentage of primary care today!
     
    Last edited: 09.23.14
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  3. styphon

    styphon Senior Member 10+ Year Member

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    Cue person posting the graphic of the placement of NP/PA newgrads

    Spoiler: its not majority primary care.
     
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  4. Blue Dog

    Blue Dog Avec caféine. SDN Advisor 10+ Year Member

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  5. jl lin

    jl lin 7+ Year Member

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    Thank you for that data. Forgive me for overlooking it elsewhere.

    Thing is, this particular physician is saying:

    "2. Physicians are underpaid. It pains me to say it, but given our current economy, most physicians are not underpaid. Some argue that, due to the cost and length of medical education or the demanding nature of their jobs, physicians’ salaries are unacceptably low, particularly in primary care. That might be true in some utopian society where education and work ethic always correlate nicely with compensation, but in this country, that simply isn’t the case in any industry. In less than a decade, annual salaries for primary care physicians and subspecialists will average $90,000 and $150,000, respectively — so plan accordingly."


    Dr. Collar is projecting ten years out--in light of all the changes in healthcare and the need to get costs under control. I can't see it; but that doesn't mean that in 5 years, there will not be more of a crank-out of FPNPs or PAs in this area. Also, are you not primarily referring to rural medicine? No one wants to deal with a "Chicken Little" scenario; but in light of the exorbitant costs associated with medical education, shouldn't people be concerned. I mean it would be different if there were some serious break on ME costs; but that doesn't at all seem likely. And from whence is this Dr. Collar pulling these figures?
     
  6. Blue Dog

    Blue Dog Avec caféine. SDN Advisor 10+ Year Member

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    Would you like me to use anatomical terminology, or colloquial? ;)
     
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  7. jl lin

    jl lin 7+ Year Member

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    ;)

    It's just so hard to see this kind of stuff when you are working hard to make you life work on this path. Personally, I would like more data as was posted by you above by those that make these harsh claims. :)
     
    Last edited: 09.24.14
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  8. styphon

    styphon Senior Member 10+ Year Member

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    People who make these claims are blind to what is currently happening, they think "no one can replace me with a PA!"

    A combination of poor foresight, egos and need to maintain hospital administration salary in the face of decreasing profits will cause trouble in the future.

    OBVIOUS EXAMPLE: Anaesthesia started heavily using CRNA's in this geographical area to increase income, and there are two colleges that pump them out. Much to anaethesia's surprise - hospitals started ditching anaethesia and staffing ONLY CRNAs!!!!

    SUBTLE EXAMPLE:The innercity hospital I worked at had GI do just EGD/colonoscopys. Paracentesis are done by an "ultrasound PA" and liver biopsies are sent to IR. PA/NP's saw GI consults (who did not provide any real help), but the hospital started discussing making a "PA proceduralist" who would only do "procedures". Can you guess what procedures they are?
     
  9. jl lin

    jl lin 7+ Year Member

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    So are you implying that people like me should just dump the idea of pursuing primary care, or even that people pursuing medicine should just quit and go to NP or PA school?

    Even as a pt, I would not want those procedures done by anyone but my GI doc. As for anesthesia, well, I have grilled the anesthesia dpt re my expectations when procedures have been planned for my family and me. They are put on alert, and they should be.

    What I originally suggested is that people should be careful with pushing too hard against limits on penalties for negligence and malpractice. They may cutting physicians throats and the pts along with them. And hospitals need even more accountability in this regard. I make it clear who I expect would be performing said procedures on my loved ones or me. Ultimately, this is a public safety issue. And when I see my PCP PHYSICIAN, that's the professional I expect/demand to see.

    I think media people don't want to explore and publicize this issue bc of the current political environment. It's beyond ridiculous.

    A line must be drawn, and it's up to physicians and those that truly care about pt safety, as well as some good lawyers and even pts, to draw that line and not budge from it.
     
    Last edited: 09.25.14
  10. styphon

    styphon Senior Member 10+ Year Member

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    No, I love family medicine, and encourage everyone to do it. I am implying that PA/NP creep occurs across the board, and likely will get worse in ALL fields as time marches on, how else can we support inflated admin salaries?
     
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  11. sazerac

    sazerac rye sense of humor 2+ Year Member

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    Results In 2012, nurse practitioners and physician assistants billed independently for more than 4 million procedures at our cutoff of 5000 paid claims per procedure. Most (54.8%) of these procedures were performed in the specialty area of dermatology.

    http://archderm.jamanetwork.com/article.aspx?articleid=1895673
     

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