Interview questions my friend was asked about healthcare, really tough!

[MissAmanda]

My friend got two questions that I am trying to collect information for. He had trouble answering them.

1. "Less and less medical students choose to go into primary care because of hectic schedules, high malpractice insurance costs, low reimbursements, and vast amounts of paperwork. How would you alleviate these problems?"

2. "If we were to adopt a universal health care model, how do you think doctors would be affected? Do you think they would be paid less? If so, what do you think should be done?

Any ideas? I have an interview on Friday at the same school. These are tough!

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[mimimi]

less vs. fewer. let me go ahead and be overly critical of the grammar used by your friend's interviewer.

 

[brianmartin]

2. "If we were to adopt a universal health care model, how do you think doctors would be affected? Do you think they would be paid less? If so, what do you think should be done?

Clearly doctors would be paid less because socialism automatically = lower pay. It is far better to have a lot of private companies competing to see who can reimburse lower. Plus, physican offices create jobs by hiring staff to handle the increased insurance paperwork. Also, young healthy people can opt out of the system because they are healthy anyway, no need for them to pay into the system because they aren't getting any benefit. The socialists would garnish physician wages because they don't believe physicians deserve good compensation. They want to run doctors into the ground and out of business.

 

[MissAmanda]

Clearly doctors would be paid less because socialism automatically = lower pay. It is far better to have a lot of private companies competing to see who can reimburse lower. Plus, physican offices create jobs by hiring staff to handle the increased insurance paperwork. Also, young healthy people can opt out of the system because they are healthy anyway, no need for them to pay into the system because they aren't getting any benefit. The socialists would garnish physician wages because they don't believe physicians deserve good compensation. They want to run doctors into the ground and out of business.

But universal health care doesn't necessarily mean single-payer or socialized medicine, it just means all are covered. So would docs still suffer if things like tax credits were used and money was saved else where (ie information technology, cutting admin costs)?

Also, what do you guys thinks about regulating the cost of malpractice insurance and passing legislation to curb lawsuits, to help doctors? or will those things not help so much?

I am trying to find a compromise with giving care to all and not burdening docs...

 

[airplanes]

Clearly doctors would be paid less because socialism automatically = lower pay. It is far better to have a lot of private companies competing to see who can reimburse lower. Plus, physican offices create jobs by hiring staff to handle the increased insurance paperwork. Also, young healthy people can opt out of the system because they are healthy anyway, no need for them to pay into the system because they aren't getting any benefit. The socialists would garnish physician wages because they don't believe physicians deserve good compensation. They want to run doctors into the ground and out of business.

why would running doctors to the ground be to the benefit of anyone?

Healthy people aren't buying out of the system because health care needs are unique. They have the potential to be very random, very sudden, very important and very expensive.

Physicians make less and less because precisely because they have to hire staff and devote more time and money into the maze of paperwork. Private insurers also turn a very large profit. Most of the inefficiency of the current health care system is tied up in overhead, while physician compensation is at an all time low.

I also think there is something inherently wrong about a for-profit health care system because the needs of the people are not the highest priority.

 

[airplanes]

But universal health care doesn't necessarily mean single-payer or socialized medicine, it just means all are covered. So would docs still suffer if things like tax credits were used and money was saved else where (ie information technology, cutting admin costs)?

Also, what do you guys thinks about regulating the cost of malpractice insurance and passing legislation to curb lawsuits, to help doctors? or will those things not help so much?

I am trying to find a compromise with giving care to all and not burdening docs...

I'm not sure if capping malpractice is really the long term answer. Most people who are true victims of malpractice never file, while many fraudulent claims do and get thrown out at a rate of over 60% last time I heard...This means the people who deserve compensation aren't getting it, doctors are paying sky high rates for insurance, insurers are settling with people who may or may not be deserving...and everyone is unhappy.

In my opinion, a universal health care system has many benefits, the most of which is the curtailing of health care spending. (lower administrative fees, negotiated prices for drugs, equipment, less paperwork, more people getting the early preventative care they need to offset more expensive procedures in the future, and the end of the 80/20 rule...where 80% of the healthy pay for the unhealthy and the uninsured when they come into ER's. We spend 2.5 times more per capita than the UK and 2 times more than France, and something like 1/6 of our population isn't even insured. That's just messed up.

Of course, physician salary would be lower, but in the UK...medical school is free, maybe that's something that could be adopted here?

Just my two cents.

 

[kac714]

maybe there could be something like the government will forgive or pay off loans if you work in primary care for x number of years? I know that a lot of law schools have programs like that for people who go into public interest law. if people arent going into primary care bc of lower salaries and high debt, this could help.

 

[Jtrenier]

Just saw this article at CNN:
http://www.cnn.com/2008/HEALTH/11/17/primary.care.doctors.study/index.html

I was asked a similar question in my interview, but it wasn't quite as detailed. The faculty interviewer asked me," If you were President Obama, how would you fix healthcare?" this was a little easier for me because I was able to take my experiences from public health and incorporate them into my answers: issues of access to healthcare, early detection and treatment, prevention vs. treament, access to healthy options (remember that even if people are insured, it doesn't mean that they will automatically go to the doctor, stop smoking, or choose to live a healthier lifestyle). Therefore, in your answer to universal healthcare remember that insuring everyone only goes so far. People must have access to parks, farmer's markets, healthy options, instead of just fast food joints (there's a real discrepancy here if you look at neighborhoods by socioeconomic status). Just remember that there is no easy solution for this complex problem and that we will need multiple experts from different fields working to solve our healthcare crisis.

 

[LittleRocker]

These questions piss me off. If I knew the answers I wouldn't be applying to med school, I'd be running for president.

 

[Jtrenier]

These questions piss me off. If I knew the answers I wouldn't be applying to med school, I'd be running for president.

Yes, but as future physicians, we will be expected/pressured to come up with these solutions.

 

[armybound]

I don't think they're ridiculously tough questions.

The first question is just asking how you'd lower costs and/or physician liability and/or bureaucracy. Hopefully your friend is aware of factors affecting cost of healthcare in the US.

As far as the second one goes, you'd just need to be able to hypothesize, right or wrong. I don't think the interviewer is looking for too much more than a general understanding of how our system compares to socialized systems.

 

[MissAmanda]

I don't think they're ridiculously tough questions.

The first question is just asking how you'd lower costs and/or physician liability and/or bureaucracy. Hopefully your friend is aware of factors affecting cost of healthcare in the US.

But how? If we were to lower liability, some would not get to file the malpractice suits they deserved, as someone mentioned above. If we were to adopt universal health care, but not the single-payer model, I don't think paperwork would actually decrease because the payment method would still be just as fragmented as it is now, but more b/c of tax credits for the poor, etc.

 

[MissAmanda]

Of course, physician salary would be lower, but in the UK...medical school is free, maybe that's something that could be adopted here?

This made me remember something ... the UK's NHS had the same problem with primary care doctors, and then they made some sort of reform in 2005 to help primary care docs, does anyone know what that was about?

 

[flip26]

I don't think they're ridiculously tough questions.

The first question is just asking how you'd lower costs and/or physician liability and/or bureaucracy. Hopefully your friend is aware of factors affecting cost of healthcare in the US.

As far as the second one goes, you'd just need to be able to hypothesize, right or wrong. I don't think the interviewer is looking for too much more than a general understanding of how our system compares to socialized systems.

I agree - these are not tough questions.

Armybound - big congrats on the acceptance!

 

[armybound]

But how? If we were to lower liability, some would not get to file the malpractice suits they deserved, as someone mentioned above. If we were to adopt universal health care, but not the single-payer model, I don't think paperwork would actually decrease because the payment method would still be just as fragmented as it is now, but more b/c of tax credits for the poor, etc.

Louisiana has a system in place for lowering malpractice payouts. Malpractice suits are reviewed by physicians to figure out if the complaint is justified. There are also possible caps on malpractice payouts, all of which decrease cost of healthcare by reducing "defensive medicine" and decreases malpractice insurance cost.
Lowering cost/bureaucracy is mostly aimed at insurance overhead. Streamlining the process somehow (single payer system?) could lower overhead and paperwork.
Electronic medical records and computerized provider order entry (CPOE) can be used to introduce decision support, decrease adverse drug events, improve therapeutic effectiveness, include best-of-care principles, decrease length of stay, and decrease overall cost.

There are just a few things off the top of my head. I'm almost positive an interviewer would have simply been happy with "We should look into ways of reducing insurance overhead, since it currently accounts for around 30% of all healthcare dollars spent, which is just wasted money! On top of that, there could be some legal/tort reform to help protect physicians and reduce malpractice insurance costs, while still providing fair compensation to patients injured by malpractice."

 

[copperfrog09]

It seems to me that both these questions are just a veiled attempt to see if the applicant has a basic understanding of how the health care system and the bureacracy works. Rather than necessarily WHAT your answer is, they want to know that you understand the problem you are addressing, such as the issues with the health care system and how and by what physician compensation is affected. Learn about these subjects, then come up with an answer you feel fits the framework.

 

[HeatherMD]

I want into primary care and come from a country with universal healthcare!

I would love these questions!