Is obamacare really bad for doctors?

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People need to stop smoking the dope politically speaking. As a nation, we are seriously screwed. This is the beginning of the end of a free republic, and the beginning of the end of a strong middle class--the potential for a great equalizer. And that doesn't even begin to address the level of corruption. People may need to re-think going for medicine if they don't have a rich daddy to pay for the education and loss of income in the years of that follow.

There's either an amazing level of corruption going on or people are just as lost as can be.

A perfect example of how someone can write a paragraph that says absolutely nothing.
 
I don't think patients will no longer be denied treatments. Sometimes you should deny treatments because cost-benefit isn't there.

Healthcare is a moving goalpost. You don't get everything at once. Will more people be able to get treatments they should be getting, pe cost-benefit? Yes. That's a good thing. Will every single person in the United States get the treatment they should be getting? Obviously not. And it doesn't seem to be the right criticism. That seems to be arguing that we're not doing enough.

It comes down to the fact that we are re-allocating money for healthcare costs to different age demographics. Anybody (regardless of age) who is denied a treatment or test that could potential help them will feel like we aren't doing enough (referencing your last sentence). A country north of us has a panel that simply says, "no"... And older people are usually the ones hearing it (for better or for worse).
 
A perfect example of how someone can write a paragraph that says absolutely nothing.


screw you.

it says it all. You have apparently said nothing about a "supposed" nothing comment yourself.

Typical hypocritical thinking.

It's over honey. Banging away on the middle class, small business initiatives, you name it; people are going to suffer like they never imagined.

If you don't see how much people will be screwed, stand back. Give it time. This is going to hurt everyone--even those that stand in line with their hands open.

This is what it will be. The very, very elite and protected, and then the rest of us--middle class that falls down into the masses with the poor, with little to no potential to get out.

And we as a nation will no longer be any sort of superpower in the world.

China is holding too many cards on us.

We are so very screwed as a people. And a big portion of our being screwed has to do with severe ignorance.

Freedom had a decent run for a while. It's been progressively whittled away for sometime now (pun intended), and as Franklin intimated a long time ago, the republic that we had, difficult as it was to keep, is essentially lost as Americans opted to go the way of Western European. And of Europose, they are in much of an economic bind as well.

I don't have to spell things out anymore than you have to spell you inane return comment.

But really, if you have an opposing position state it. Otherwise your comment has nothing at all to add. It's ad hominen, and lame at that. Stand proud.
 
screw you.

it says it all. You have apparently said nothing about a "supposed" nothing comment yourself.

Typical hypocritical thinking.

It's over honey. Banging away on the middle class, small business initiatives, you name it; people are going to suffer like they never imagined.

If you don't see how much people will be screwed, stand back. Give it time. This is going to hurt everyone--even those that stand in line with their hands open.

This is what it will be. The very, very elite and protected, and then the rest of us--middle class that falls down into the masses with the poor, with little to no potential to get out.

And we as a nation will no longer be any sort of superpower in the world.

China is holding too many cards on us.

We are so very screwed as a people. And a big portion of our being screwed has to do with severe ignorance.

Freedom had a decent run for a while. It's been progressively whittled away for sometime now (pun intended), and as Franklin intimated a long time ago, the republic that we had, difficult as it was to keep, is essentially lost as Americans opted to go the way of Western European. And of Europose, they are in much of an economic bind as well.

I don't have to spell things out anymore than you have to spell you inane return comment.

But really, if you have an opposing position state it. Otherwise your comment has nothing at all to add. It's ad hominen, and lame at that. Stand proud.

Any chance your name is Glenn Beck?

There is nothing to oppose because absolutely nothing you said is demonstrable or refutable.

(sent from my phone)
 
screw you.

it says it all. You have apparently said nothing about a "supposed" nothing.

Typical hypocritical thinking.

It's over honey. Banging away on the middle class, small business initiatives, you name it.

If you don't see how much people will be screwed, stand back. Give it time. This is going to hurt everyone--even those that stand in line with their hands open.

This is what it will be. The very, very elite and protect, and the rest of us--middle class that falls down into the masses with the poor, with little to no potential to get out.

And we will no longer be any sort of superpower in the world.

China is holding too many cards on us.

We are so very screwed as a people. And a big portion of our being screwed has to do with severe ignorance.

Freedom had a decent run for a while. It's been progressively whittled away for sometime now (pun intended), and as Franklin intimated a long time ago the republic that we had, difficult as it was to keep, is essentially lost as Americans opted to go all Western European. And of WE, they are in much of an economic bind as well.

I don't have to spell things out. Anymore than you have to spell you inane return comments.

So don't. If you have an opposing position state it. Otherwise you comment has nothing at all to add. It's ad hominen, and lame at that.

Despite an increasing wide-spread hysteria about the potential of the Chinese economy, it won't be surpassing us anytime soon.

For anyone interested, I thought this interview was pretty straightforward and informative:

http://www.npr.org/2012/10/28/163803396/whats-next-for-chinas-economy

Key point:

"China's economy has been driven primarily by very high investment. Every country that has had very high levels of investment for many years has run into the problems that, at some point, additional investment creates economic activity but it actually destroys wealth. The problem is if you bring investment levels down, you need something else to replace it. And that something else is normally consumption.

But it's extremely difficult consumption rates up quickly enough to replace declining investment rates. So we're going to see many years of much, much slower growth as China rebalances away from investment."
 
screw you.

it says it all. You have apparently said nothing about a "supposed" nothing comment yourself.

Typical hypocritical thinking.

It's over honey. Banging away on the middle class, small business initiatives, you name it; people are going to suffer like they never imagined.

If you don't see how much people will be screwed, stand back. Give it time. This is going to hurt everyone--even those that stand in line with their hands open.

This is what it will be. The very, very elite and protected, and then the rest of us--middle class that falls down into the masses with the poor, with little to no potential to get out.

And we as a nation will no longer be any sort of superpower in the world.

China is holding too many cards on us.

We are so very screwed as a people. And a big portion of our being screwed has to do with severe ignorance.

Freedom had a decent run for a while. It's been progressively whittled away for sometime now (pun intended), and as Franklin intimated a long time ago, the republic that we had, difficult as it was to keep, is essentially lost as Americans opted to go the way of Western European. And of Europose, they are in much of an economic bind as well.

I don't have to spell things out anymore than you have to spell you inane return comment.

But really, if you have an opposing position state it. Otherwise your comment has nothing at all to add. It's ad hominen, and lame at that. Stand proud.

You still didn't say anything.... thats kind of incredible.... I'm not even mad 😀

Sent from my DROID RAZR using SDN Mobile
 
screw you.

it says it all. You have apparently said nothing about a "supposed" nothing comment yourself.

Typical hypocritical thinking.

It's over honey. Banging away on the middle class, small business initiatives, you name it; people are going to suffer like they never imagined.

If you don't see how much people will be screwed, stand back. Give it time. This is going to hurt everyone--even those that stand in line with their hands open.

This is what it will be. The very, very elite and protected, and then the rest of us--middle class that falls down into the masses with the poor, with little to no potential to get out.

And we as a nation will no longer be any sort of superpower in the world.

China is holding too many cards on us.

We are so very screwed as a people. And a big portion of our being screwed has to do with severe ignorance.

Freedom had a decent run for a while. It's been progressively whittled away for sometime now (pun intended), and as Franklin intimated a long time ago, the republic that we had, difficult as it was to keep, is essentially lost as Americans opted to go the way of Western European. And of Europose, they are in much of an economic bind as well.

I don't have to spell things out anymore than you have to spell you inane return comment.

But really, if you have an opposing position state it. Otherwise your comment has nothing at all to add. It's ad hominen, and lame at that. Stand proud.

Do you just pick lines from fox news articles and string them together? For instance, how exactly is Obamacare going to "bang away on the middle class" and "screw us" as a people? Wtf does China have to do with any of this? How does it help the "very, very, elite and protected"? Last time I checked, they had some pretty good insurance plans before this law was signed.

You aren't really spelling things out very well in the first place....well maybe in your head.
 
Give it time. You WILL be crying into your soup. . .what's left of it.

Some people never get things until they are suffering and hurting--until they feel it full force.

Some people are insightful, study history, and they have historical data as well as intuitive insights--something only a relatively small percentage have in truth. That's why most people have difficulty with empathy until they suffer in a similar fashion. There are the few that feel and live it through others without having to fully go through it. There are those that learn well from history. IMHO a lot of Americans do not have this ability. Some of this is due to a major lack of knowledge and insight into history. The other factor is when people learn early on that's it's all about their immediate wants and needs, and they only attempt to relate to others in name or "face" only--for some political or influential gain. It's not real to them. They think they can relate; but they can't. B/c it's all about them and what they want and need. This is the oxymoronic BS about a lot of liberalism. It CLAIMS an understanding or empathy, but it's in name ONLY. It's not real. But people fall for the BS over and over again.

Time is also a great equalizer. Give it time ladies and gentlemen. You will see what a terrible path we have taken for not merely a few, but for MOST Americans. . . including the minorities.


BTW, a lot of FOX is BS. If you think there is a shortage of liberals over there, you are smoking something very strange. They are liberal and moderate heavy too.


calhob: res ipsa loquitur dude.
 
I anticipate Gut Shot will be here very soon providing the actual statistics (he/she has already done so in multiple different threads if you want to search).

That's sweet, but I'm not in the mood to play Whac-A-Mole with this topic. Somebody heard something 'bout Obamacare? It's gonna pay us tree fiddy and hour and make us do jumping jacks with our underpants on our heads? Awesome, sounds reputable, believe it.
 
Give it time. You WILL be crying into your soup. . .what's left of it.

Some people never get things until they are suffering and hurting--until they feel it full force.

Some people are insightful, study history, and they have historical data as well as intuitive insights--something only a relatively small percentage have in truth. That's why most people have difficulty with empathy until they suffer in a similar fashion. There are the few that feel and live it through others without having to fully go through it. There are those that learn well from history. IMHO a lot of Americans do not have this ability. Some of this is due to a major lack of knowledge and insight into history. The other factor is when people learn early on that's it's all about their immediate wants and needs, and they only attempt to relate to others in name or "face" only--for some political or influential gain. It's not real to them. They think they can relate; but they can't. B/c it's all about them and what they want and need. This is the oxymoronic BS about a lot of liberalism. It CLAIMS an understanding or empathy, but it's in name ONLY. It's not real. But people fall for the BS over and over again.

Time is also a great equalizer. Give it time ladies and gentlemen. You will see what a terrible path we have taken for not merely a few, but for MOST Americans. . . including the minorities.


BTW, a lot of FOX is BS. If you think there is a shortage of liberals over there, you are smoking something very strange. They are liberal and moderate heavy too.


calhob: res ipsa loquitur dude.

Ohhh I get it, you're taking advantage of the new Colorado law. It all makes sense now.

Blaze a fat one for me dude.
 
Give it time. You WILL be crying into your soup. . .what's left of it.

Some people never get things until they are suffering and hurting--until they feel it full force.

Some people are insightful, study history, and they have historical data as well as intuitive insights--something only a relatively small percentage have in truth. That's why most people have difficulty with empathy until they suffer in a similar fashion. There are the few that feel and live it through others without having to fully go through it. There are those that learn well from history. IMHO a lot of Americans do not have this ability. Some of this is due to a major lack of knowledge and insight into history. The other factor is when people learn early on that's it's all about their immediate wants and needs, and they only attempt to relate to others in name or "face" only--for some political or influential gain. It's not real to them. They think they can relate; but they can't. B/c it's all about them and what they want and need. This is the oxymoronic BS about a lot of liberalism. It CLAIMS an understanding or empathy, but it's in name ONLY. It's not real. But people fall for the BS over and over again.

Time is also a great equalizer. Give it time ladies and gentlemen. You will see what a terrible path we have taken for not merely a few, but for MOST Americans. . . including the minorities.


BTW, a lot of FOX is BS. If you think there is a shortage of liberals over there, you are smoking something very strange. They are liberal and moderate heavy too.


calhob: res ipsa loquitur dude.

seriously... GIVE EXAMPLES. Give a coherent mechanism. it is not enough to just keep shouting "DIS GUNNA SUCK SUMPIN FIERCE!" in 9 different ways. How are you not getting this?
 
As far as internal medicine goes- it'll probably lead to the better doctors opening their own practices and consequently leave less apt, but still good, doctors in medical institutions.
 
Give it time. You WILL be crying into your soup. . .what's left of it.

Some people never get things until they are suffering and hurting--until they feel it full force.

Some people are insightful, study history, and they have historical data as well as intuitive insights--something only a relatively small percentage have in truth. That's why most people have difficulty with empathy until they suffer in a similar fashion. There are the few that feel and live it through others without having to fully go through it. There are those that learn well from history. IMHO a lot of Americans do not have this ability. Some of this is due to a major lack of knowledge and insight into history. The other factor is when people learn early on that's it's all about their immediate wants and needs, and they only attempt to relate to others in name or "face" only--for some political or influential gain. It's not real to them. They think they can relate; but they can't. B/c it's all about them and what they want and need. This is the oxymoronic BS about a lot of liberalism. It CLAIMS an understanding or empathy, but it's in name ONLY. It's not real. But people fall for the BS over and over again.

Time is also a great equalizer. Give it time ladies and gentlemen. You will see what a terrible path we have taken for not merely a few, but for MOST Americans. . . including the minorities.


BTW, a lot of FOX is BS. If you think there is a shortage of liberals over there, you are smoking something very strange. They are liberal and moderate heavy too.


calhob: res ipsa loquitur dude.

At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.

After reading your last few posts this was the only thing that seemed appropriate to respond. One of my favorite movies.
 
At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.

After reading your last few posts this was the only thing that seemed appropriate to respond. One of my favorite movies.

jeremiahjohnson.gif



(what makes that better is, on a whim, I googled "beard approv" and google autofilled to "Beard approval gif". Awesome)
 
At no point in your rambling, incoherent response were you even close to anything that could be considered a rational thought. Everyone in this room is now dumber for having listened to it. I award you no points, and may God have mercy on your soul.

After reading your last few posts this was the only thing that seemed appropriate to respond. One of my favorite movies.


Oh for the sake of sanity. It's pretty simple. We, America, are ROYALLY SCREWED. Your so called victory translates to us being screwed, screwed, screwed.

Lame duck pres or not, taxes will increase, and not just on those making $200,000 per year! Debt will increase. Obamacare is totally unsustainable, and cuts and severe limitations for individuals in terms of what their insurance plans will mean will inevitably occur. At the same time, huge hikes in insurance coverage plans, private or government-controlled, are going to kill individuals and businesses,and even the ability to hire. The fear of that has influenced employment in terms of hiring since 2008. What do you think the hiring freezes have been about?

How much time do you have? BTW, everyone in America is dumber for having listened to those akin to the likes of you, and we are going to be reeling from the pain of it soon enough.

We are screwed economically.

We are screwed in maintaining any semblance of a free, Constitutional republic.(Ours, not some socialistically contrived one in which Obama would love to implement.)

We are looking at the essential undermining and extermination of the middle class, and such major overstepping of government as we have never heard of--and our forefathers are still turning over in their graves over the last four years worth of government expansion--as opposed to their beliefs, by far, in limited government.

I don't have time to teach you things you should have already learned in school or at home with your parents, and current issues, with which you should have had a balanced perspective--not one favoring your sense of limited entitlements, but those that affect the survival of freedom for an ENTIRE nation of people--not merely some groups' special interests.

It's time to start suing the American Public School Systems for not properly teaching students about our history, our Constitution and indispensable founding documents, as well as the safeguards built into the American Federal Government---safeguards that Obama, et al, have spit upon.

Things like true individual liberty, Federalism, the principled and intelligent foundations of the American revolution are all being supplanted by the progressives' force and treachery of federal sovereignty and the collective interests of liberal political theory and influence.

The real damage began when it was allowed to take hold in the school systems and post-secondary education. I mean it's been a steady pace since the 60's. Using the unions to help forge it forward was another part of the plan. Americans have been quite complacent, so to some very real degree, we deserve what we got on Tuesday, November 6th, 2012 as well as Tuesday, November 4th, 2008.

In growing horror, many of us have expected this. The real issues and concepts of the original American revolution have been lost to many or are barely existent to many, and are merely a passing term of history to most others.


Why in the world would you even think for a second that I would count your "points" as worthy of having?

Really? Indeed your perspective may be that of the following:



where "What have you done for me lately" isn't merely a Janet Jackson song, it's the indoctrination theme of the American public taught to them by the progressive government influence--just another vehicle of thought whereby people embrace being made slaves of entitlement, as they accept the fed as their only true god.

There is nothing remotely laudable or respect-worthy about anyone that holds fast to such beliefs in my book; b/c they have weakly, blindly, or perhaps even nefariously succumbed to the idea that loss of freedom, in the larger perspective of things is a good thing, not just for themselves, but for a whole of a nation and its individuals.

.What is the opposite of freedom? Think of it carefully for a moment. Furthermore, what is so grand about entitlements or alternative systems that makes either of them worthy of the loss of freedom associated with having them? And when a government starts taking from other people's freedom to fulfill a supposed entitlement to another, both groups of people had better beware. For as they had taken from the one, they can and will as easily take from the other--the one to whom they had previously given.
.

.
.

.What is irresponsible to a nation such as ours, that is, one that has gained hard-won freedom, is in giving government carte blanche in asserting dominance and overstepping its boundaries. Too many people have become too "OK" with more and bigger government, and they don't see or accept that allowing it, it, without exception means loss of freedom for people. Limited government was seen as absolutely necessary by our founders, and the reality of that principle HAS NOT CHANGED..
. .
.Human government ALWAYS amounts to force, and thus freedom necessitates vigilance in limiting government. Expanding government, particularly as this administration has and will continue to do, is most irresponsible, as it is the highest assault on freedom..
. .
"Government is not reason, it is not eloquence, it is force; like fire, a
troublesome servant and a fearful master. Never for a moment should it be left
to irresponsible action."
-- George Washington, in a speech of January 7, 1790..


Giving way to more and more government control is IRRESPONSIBLE ACTION.
 
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Supply and demand:

There's a lot more doctors retiring and more doctors working part time.

There's a lot of baby boomers aging.

In terms of physician salaries over the coming years realize that there's lot subject to change no one can really predict what's going to happen, but in my own opinion if you're not happy when you're making $200,000 then you're not going to be happy at 3,4,500 k and you're in medicine for the wrong reasons.
 
Supply and demand:

There's a lot more doctors retiring and more doctors working part time.

There's a lot of baby boomers aging.

In terms of physician salaries over the coming years realize that there's lot subject to change no one can really predict what's going to happen, but in my own opinion if you're not happy when you're making $200,000 then you're not going to be happy at 3,4,500 k and you're in medicine for the wrong reasons.

A supply that is becoming more easy to fill in many areas with advanced practice nurses and other midlevel providers. Universities everywhere are going hog wild getting nurses to sign-up for their advanced practice programs. And nowadays, so many of the very green nurses are moving right into these programs, which is even more dangerous, b/c they have barely any clinical experience to begin with. Years ago, at least people that went for these programs were those with strong full-time clinical experience over many years. Not so anymore, and the schools don't care one bit. They just keep building and expanding their programs. There is money to be made in many of these programs.

The political affiliations of nursing organizations with government entities are strong, and they believe more people will get covered by using the less expensive alternatives.

Enough people know that there will be tons more people to try and cover, and they believe a good solution is advanced practice nurses. This movement is very strong. Nurses shouldn't be hated over it; but you have to understand the political alliances and mentalities of those behind this push. They see the government will have this great influence on healthcare and their are needs and expenses that must be covered, and the advanced practice nurses fit their bottom line.

Beyond that, physicians, are going to be killing themselves trying to keep up with the new loads, changes, endless lists of government requirements for reimbursement. People have no idea what a nightmare this is going to become.

Before you risk misjudging people's intentions and motives for becoming physicians, stop and consider the reality. The investment in time, incredibly high cost of education,and the lost wages over many years (And no one ever starts at the top end figures after the education or residency/fellowship process.) requires some serious thought. People need to be wise and consider what the level of compensation is based on the overall investment, which becomes a big lifetime investment.

Of course no one should go into it for merely the money, but beyond those that do, people with the best of intentions need to count up the costs and see if the compensation is fair and comparable given the overall investment. The figure, then, is relative to many factors. For example, what does your investment of time each day, along with your desired investment of time with each patient mean to you? Docs are already complaining that they can't possibly make enough time with their patients as individuals in many instances. So where in all of that does the ideal of right intentions get lost--or having to stay hours on end night after night to meet all the paperwork, documentation, and other requirements, or in trying to stay away from the red when you have to address issues of overhead? If you work ED, what does that mean, again, in terms of time with patients (natural hazard of working in that area--or not, I guess, depending upon how you look at it)? What about forcing yourself day in and out, month in and out, year in and out and working shift rotations, which I speak from experience over many years, can be very hard on the body/health--or in having to work all kinds of holidays? Really, no job in medicine is 9a-5pm. There are those that come closer to it, but overall, nope. Such hours do not exist in medicine, and there are plenty of negatives that you have to be willing to endure, which are often quite unlike the many negatives of other kinds of work. I could, for example, accept the reality shock that comes with nursing a lot better than that which comes with medicine, b/c the limitations in both work and income are more clear cut. And there is a huge reality shock that comes in nursing. I personally believe it is only bigger in medicine. And the impact of it hits harder, b/c you have invested a boatload of time and money in the pursuit of it. If there isn't reasonable compensation, you'd have a handful of people doing it or staying in it--regardless of how much they loved medicine or helping people through medicine. There are too many negatives to not have proper financial compensation.

But the compensation will be limited, b/c the whole infrastructure of healthcare reimbursement systems will be predominantly government controlled. This will invariably mean overloads in care as well as denials in compensation or in treatment plans.

You keep believing that it won't matter. Eventually there won't be people going into medicine, b/c on the whole, it will not be worth it. It' won't just be a shortage based on those that retire compounded by the growing senior population. People will see that lack of reasonable compensation for the time invested, coupled with the inability to practice the kind of medicine and care that they had hoped to give to patients--compounded by incredible red-tape and strangulating government regulations.

In the future, especially under the forthcoming plan, you may well see primary care docs getting paid half of what you originally stated, and that may well be for working 80 hours per week.

Look at other countries with similar plans and see how this works. It's a different story when you live and work the reality, and then that reality changes to the point where you are working more hours and getting paid less.

That is what we are looking at in the future. Many in various fields in middle class America have already been looking at this reality--those that are lucky enough to have jobs. Most will be facing this growing reality as the economic growth continues to stagnate and we face the inevitable reality of inflation.
 
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It comes down to the fact that we are re-allocating money for healthcare costs to different age demographics. Anybody (regardless of age) who is denied a treatment or test that could potential help them will feel like we aren't doing enough (referencing your last sentence). A country north of us has a panel that simply says, "no"... And older people are usually the ones hearing it (for better or for worse).

We allocate resources already in healthcare. Doctors and payors deal with it everyday. Not sure what your point is. Older people don't get best and every treatment because they have the shortest life expectancy and the worst benefits-costs. Your post is also getting pretty close to death panel stupidity.

If you think older people should be getting more money for treatments, then I assume you are advocating to increase taxes.
 
I think many physicians will move towards "concierge medicine" to survive the changing healthcare landscape created by Obamacare.

Concierge Medicine also known as direct care, boutique medicine, and retainer-based medicine, concierge medicine is when a physician enters into a contract with a patient in which the patient pays an annual or monthly fee in exchange for enhanced care.

According to American Medical News, enhanced care can include:

“same-day or guaranteed next-day appointments, 24-hour physician availability, telephone and/or email consultations, limited waiting times, coordination of care with specialists (and) an à la carte menu of services that can be obtained for an additional fee.”

So, the rich (1%) will maintain access to the à la carte menu while the rest (%99) will have to wait in the buffet line. Change we can believe in. 🙄
 
I think many physicians will move towards "concierge medicine" to survive the changing healthcare landscape created by Obamacare.

Concierge Medicine also known as direct care, boutique medicine, and retainer-based medicine, concierge medicine is when a physician enters into a contract with a patient in which the patient pays an annual or monthly fee in exchange for enhanced care.

According to American Medical News, enhanced care can include:

“same-day or guaranteed next-day appointments, 24-hour physician availability, telephone and/or email consultations, limited waiting times, coordination of care with specialists (and) an à la carte menu of services that can be obtained for an additional fee.”

So, the rich (1%) will maintain access to the à la carte menu while the rest (%99) will have to wait in the buffet line. Change we can believe in. 🙄

Unfortunately this isn't a sustainable model. Not many people can afford paying a physician many thousands of dollars just for access. Insurance costs a similar price but provides way more coverage. Concierge medicine might be more TEMPTING, but it's simply not feasible for many physicians to do this kind of practice. Your target market is pretty small.
 
I think it will be good for medicine because it will attract people who are actually passionate about healing patients rather than people who are in it for profits.


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I think it will be good for medicine because it will attract people who are actually passionate about healing patients rather than people who are in it for profits.


Sent from my iPhone using SDN Mobile

Implies:

-high salaries mean you don't care about patients
-lowering salaries will cause you to actually care about patients
-medicine is an excellent way to get wealthy
-people going into medicine are incapable of doing other demanding careers that have a significantly higher salary ceiling
 
That's sweet, but I'm not in the mood to play Whac-A-Mole with this topic. Somebody heard something 'bout Obamacare? It's gonna pay us tree fiddy and hour and make us do jumping jacks with our underpants on our heads? Awesome, sounds reputable, believe it.

JK

On the contrary, primary care is the only sizable area where reimbursements are actually creeping upward. In very broad terms, it has been accepted by policymakers that we spend a great deal on procedure-based care given by specialists, and that a lot of that care isn't very good at increasing the quantity or quality of patient life. In the same vein, so to speak, the nation has a shortage of primary care providers, in part because they have been getting the financial shaft for some time.

Hence, we are currently on the front end of a fairly long, grinding shift in reimbursement policy, one that is going to reconstitute some financial incentives for young docs to choose primary care fields. I believe there will always be more money to be had as a specialist, but the return is going to be more modest than in years past.

To support this, check out the 2013 Medicare fee preview and note the biggest winners:

Family Medicine 7%
Geriatrics 4%
Internal Medicine 5%
Pediatrics 5%

Yay! I knew he'd come! :laugh:

:meanie:
 
I think it will be good for medicine because it will attract people who are actually passionate about healing patients rather than people who are in it for profits.

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I'm curious... Where is this large demographic of people that are attracted to medicine, not actually for "healing patients", but, rather, are "in it for profits"?

Also, is there some sort of study that indicates different patient health outcomes between people that are 100% "about healing patients" vs. 100% "in it for the profits" vs. (say) 50/50% "about healing patients and in it for the profits"?

Obviously wanting to "heal patients" is a valuable motivation to enter medicine; I know there is research that shows perhaps improved outcomes for patients that experience compassion/empathy from their physician -- but that can be easily feigned (volunteering in almost any ED for a length of time can prove that fact). I don't believe any investigations have been conducted on comparing outcomes of sincere "passion for healing patients" vis-a-vis feigned "passion for healing patients".

I could be wrong.
 
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I think many physicians will move towards "concierge medicine" to survive the changing healthcare landscape created by Obamacare.

Concierge Medicine also known as direct care, boutique medicine, and retainer-based medicine, concierge medicine is when a physician enters into a contract with a patient in which the patient pays an annual or monthly fee in exchange for enhanced care.

According to American Medical News, enhanced care can include:

“same-day or guaranteed next-day appointments, 24-hour physician availability, telephone and/or email consultations, limited waiting times, coordination of care with specialists (and) an à la carte menu of services that can be obtained for an additional fee.”

So, the rich (1%) will maintain access to the à la carte menu while the rest (%99) will have to wait in the buffet line. Change we can believe in. 🙄

Unfortunately this isn't a sustainable model. Not many people can afford paying a physician many thousands of dollars just for access. Insurance costs a similar price but provides way more coverage. Concierge medicine might be more TEMPTING, but it's simply not feasible for many physicians to do this kind of practice. Your target market is pretty small.

Unfortunately, some patients who wish to continue seeing their doctor won't have a choice—they will have to join their concierge practice.

With the ACA, the single practitioner will be hard pressed to survive without joining a group/hospital, or by transforming into a concierge model. Turning away patients who are unable to afford a retainer fee is going to be a difficult ethical choice for some doctors, but I'm sure some will in order to remain in practice.
 
I think it will be good for medicine because it will attract people who are actually passionate about healing patients rather than people who are in it for profits.


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Im starting to hate the word "healing"..... people use it like a buzzword and suck the meaning from it. Pre med over romanticism is a problem here....


It also implies that current doctors are not passionate about care (see how I didn't use the word healing?) Which... is like wrong and junk





Implies:

-high salaries mean you don't care about patients
-lowering salaries will cause you to actually care about patients
-medicine is an excellent way to get wealthy
-people going into medicine are incapable of doing other demanding careers that have a significantly higher salary ceiling



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I found an absolutely fantastic report on PPACA and how it will affect hospital reimbursements and physician reimbursements. Essentially, as far as Physician cuts go, it's mainly just imaging that will face cuts, while primary care will face increases. Hospitals and Physicians will also have to report on quality of care, and will have reimbursement rates effected by quality of care. It says that the HHS Secretary must come up with an implementation system about this in 2012, but I can't find online whether she has or not, and how it will be coordinated. Hospitals face further cuts for readmissions, and hospital acquired conditions. Hospitals also face Market basket reductions, which will result in a decreased reimbursement rate for hospitals. Now, reimbursements will still increase, just not at the same rate as they previously would have. However, the way the formula is designed, there may actually be some years where hospital reimbursement actually decreases over the previous year (similar to the SGR cuts to Physicians that Congress keeps delaying). These cuts have actually already gone into effect (started in 2010), and will continue to increase. This article explains it well.http://healthreformstat.com/2010/06/05/provider-reimbursement-–-reduction-in-market-basket-updates/

The other major cost cutting provision that people worry about are the IPAB boards. If health care spending exceeds projected Medicare growth, then the IPAB is authorized to come up with means on how to cut costs to get costs back in line with projected Medicare growth. For instance, if Medicare costs were only supposed to increase by 4% in 2017, but actually increased by 5%, then IPAB is authorized to find a way to get it down to 4%. Based on another article that I've read by the AMA, this isn't expected to be a problem until after 2020. Until then, costs are expected to stay in line with projected Medicare cost increases.

This is the report that explains this stuff. It's fantastic, and will answer many questions. It just focuses on how reimbursement will change. http://www.healthlawyers.org/Events/Programs/Materials/Documents/HCR10/barry_luband_lutz.pdf
 
Hmmm. What I find most anxiety invoking about this whole deal is that regardless of whether you think obamacare will lead to lower compensation for physicians, as a collective whole physicians have very little power to negotiate on this issue - an issue with outcomes that will have profound effects on their daily practice. Doctors need a strong and encompassing representative organization. Isn't it less than 20% of physicians that belong to the AMA now?
 
Hmmm. What I find most anxiety invoking about this whole deal is that regardless of whether you think obamacare will lead to lower compensation for physicians, as a collective whole physicians have very little power to negotiate on this issue - an issue with outcomes that will have profound effects on their daily practice. Doctors need a strong and encompassing representative organization. Isn't it less than 20% of physicians that belong to the AMA now?

This.

The AMA is pathetic in terms of legislation for physicians. The damn nursing union has more power than the AMA.
 
just something to think about discussing salaries... 200K in salary can really vary depending on what type of medicine you practice, location, etc... you have to take into account costs.

example: making 200k working for a hospital that pays for your employees, malpractice, etc...much different than practicing in a private office setting.
 
Hmmm. What I find most anxiety invoking about this whole deal is that regardless of whether you think obamacare will lead to lower compensation for physicians, as a collective whole physicians have very little power to negotiate on this issue - an issue with outcomes that will have profound effects on their daily practice. Doctors need a strong and encompassing representative organization. Isn't it less than 20% of physicians that belong to the AMA now?

Yeah, because the AMA leadership are self-serving pricks.
 
Unfortunately, some patients who wish to continue seeing their doctor won't have a choice—they will have to join their concierge practice.

With the ACA, the single practitioner will be hard pressed to survive without joining a group/hospital, or by transforming into a concierge model. Turning away patients who are unable to afford a retainer fee is going to be a difficult ethical choice for some doctors, but I'm sure some will in order to remain in practice.

You're missing the part where PCPs make more with the PPACA and would have even less of an incentive to go into concierge medicine than they do now.
 
implies:

-high salaries mean you don't care about patients
-lowering salaries will cause you to actually care about patients
-medicine is an excellent way to get wealthy
-people going into medicine are incapable of doing other demanding careers that have a significantly higher salary ceiling


4/4
 
I think it will be good for medicine because it will attract people who are actually passionate about healing patients rather than people who are in it for profits.


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I think it will be good for medicine because people will actually be able to afford health care. I dunno how many of you have actually been sick (like, ACTUALLY been SICK), but have you ever thought about what it would cost without insurance? I know I would be on my ass, way beyond bankrupt if I weren't insured, and quite frankly, we weren't all lucky enough to be born into families that are steadily employed or can afford health insurance. Obamacare may make a few doctors grumpy, but at the price of millions of people not having to worry about not being financially capable of becoming healthy.
 
That is a good point. I was lucky/thankful to have insurance as a kid and teen. If I didnt, I would had to either get no medicine or run to a place where they take people with no health insurance.
 
I think it will be good for medicine because people will actually be able to afford health care. I dunno how many of you have actually been sick (like, ACTUALLY been SICK), but have you ever thought about what it would cost without insurance? I know I would be on my ass, way beyond bankrupt if I weren't insured, and quite frankly, we weren't all lucky enough to be born into families that are steadily employed or can afford health insurance. Obamacare may make a few doctors grumpy, but at the price of millions of people not having to worry about not being financially capable of becoming healthy.

Seriously, the people on here worried about what $1000 pair of shoes to wear, or what watch, or suit to wear, I bet they have no idea of what people actually go through out there. They aren't even an MD yet and they know how to fix the system. There are definitely two schools of thought out there, much like the political parties, and I had a good talk about it during one of my interviews. And this was with a physician in support of my application. So people can say what they will, but at the end of the day, the type of doctor that views healthcare as a right is the doctor I wish I had and want to emulate.
 
Who said anything about a million bucks? With an average of ~170-200k, any significant cut in salary suddenly means we are making marginally more than most professionals while assuming way more debt. I could have just as soon done engineering (any one of several types) in UG and been making 70% of a doctors salary after only a few years.

Then why didn't you? If medicine wasn't compelling in and of itself to you, I think it rather shortsighted to enter the profession just for the income, when that appealing element is so vulnerable (as you yourself admitted it was). If you DO love medicine for its own sake, I see little substantial reason to be discouraged by your projected great salary reducing to a somewhat less but still great salary. The engineers are happy, and you're happy. I recognize our training is MUCH more intensive, but you know what? That's just the way it is. Life isn't always fair.
 
Im starting to hate the word "healing"..... people use it like a buzzword and suck the meaning from it. Pre med over romanticism is a problem here....

Who are you to ban which words I use?
 
I think it will be good for medicine because it will attract people who are actually passionate about healing patients rather than people who are in it for profits.


Sent from my iPhone using SDN Mobile


No offense, but really. . .this mentality again. It's so unrealistic--very far from what is reality.

Mostly medicine doesn't heal people. It may implement things that will help a person to heal, where otherwise, they may not have been able to do so--or it helps people manage illness with various treatments, and in the especially best model, IMHO, it helps prevent or limit illness.

Very few to no people are going into primary care, or the crazy and at times painful rock and roll of emergency medicine, for merely the bucks. Maybe this may be so for certain areas, like rads--although that is hard in its own way and right. Perhaps derm, but it is difficult to get into--and while there are some interesting things people can pick up on from derm--generally it would bore the pants off of me.
Anesthesia can get good bucks, but that is a whole other level of stress and pain in the azzness.
Critical care, also demanding and stressful.
Surgery, a VERY long and hard road post graduate education through fellowship---I have seen it beat the daylights out of people. You have to really want that very badly in my view.

It's a lot easier, though not perfectly easy, but relatively speaking, to get an MBA, specialize in the right kind of business or marketing, do the right kind of networking, and make some nice bucks. That too is a pain in its own way, but in my opinion, not nearly as much as the path and existence in medicine.

People just don't understand what a major hard, pain in the azz medicine is--getting into it, getting through it, getting through postgrad residency and fellowship, the early years of being an attending, and even thereafter. Pretty much it doesn't matter what flavor of it you go for--it's degrees and types of differences, but it's all a huge pain in the azz.

Don't get me wrong. It's the one kind of work that I aspire to more than any other. But I have been up close to it in critical care nursing and surgery for a long time--I don't even want to say how long. I have absolutely NO illusions about it.

My point is that there are a lot less expensive and less painful and time-consuming ways of making some decent bank.

In general, however not always, the sheer process should eliminate most fool-hearty people that think the glamour, praise, and money is this huge thing--and that allow such things to be their motivation. If the first part of the process doesn't get them, some way on the long road, it will catch most of those that really don't care about medicine--and at least hopefully those that don't really care about people.

But the reality of the other side is that burn out in caring for people is VERY real even for the best of practitioners.

Looking for reasonable compensation for all of it is not profit-sniffing and neither is about not caring about medicine or people.

This is one of the most annoying attitudes I come across, b/c if you have not worked directed in and around the field, you have no idea how wiped you can get my it. Dealing with very ill and/or extremely demanding, psychotic, or unrealistic patients and families--and difficult others within the field is overwhelmingly stressful after a while. The paperwork is ridiculous. The games to cover your but is unbelievable. No one in their right mind would go into this simply for the bucks. If they do, they won't be in it long--or they will go into sales or something else.

As a matter of fact, you would not believe how many docs I've know that have gone back to law school of all things.

BTW, those that work in medicine in pure volunteer or minimal income mode do not always have the same level of paperwork and management demands. There is a whole administrative and management end of medicine that goes beyond all the other things you must do.

So you are not adding things up correctly when you talk about those that are serving without pay or minimal pay. And how long are they doing it for.

What's more, those that give their lives purely for religious or altruistic reasons to such work have accepted a calling and committed themselves, for whatever time, if any at all, to that lifestyle. That's a whole other can of beans. I would not at all knock it. Most people that enroll in medical school programs are going as part of a calling. Thankfully at least a good many do donate their time and services to others here and abroad, just not full time. You are comparing apples and oranges.

Are you saying that all physicians should simply be called as mission-workers and only work in that manner? Really. A calling is a much different thing from choosing a profession.
 
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Seriously, the people on here worried about what $1000 pair of shoes to wear, or what watch, or suit to wear, I bet they have no idea of what people actually go through out there. They aren't even an MD yet and they know how to fix the system. There are definitely two schools of thought out there, much like the political parties, and I had a good talk about it during one of my interviews. And this was with a physician in support of my application. So people can say what they will, but at the end of the day, the type of doctor that views healthcare as a right is the doctor I wish I had and want to emulate.


OK, I'll bite. I've been in critical care nursing a LONG time. I have worked very closely with more residents, fellows, and attendings that you can shake a stick at.
It's BS what you are saying about the $1000 pairs of shoes. You have absolutely no idea, seriously. You don't.

I rightfully wish that everyone get excellent care and treatment. I don't believe the federal government should dictate how that goes down.

Beyond that you have LOADS of people, sadly, that don't give enough of a crap about their own health and well-being or their children's. Take care of them year in and out and bang your head against the wall enough times trying to get through.

You do the best that you can, but at some point, you have got to face reality and get real.

Forget this. I have to study.
 
Then why didn't you? If medicine wasn't compelling in and of itself to you, I think it rather shortsighted to enter the profession just for the income, when that appealing element is so vulnerable (as you yourself admitted it was). If you DO love medicine for its own sake, I see little substantial reason to be discouraged by your projected great salary reducing to a somewhat less but still great salary. The engineers are happy, and you're happy. I recognize our training is MUCH more intensive, but you know what? That's just the way it is. Life isn't always fair.

I think it rather shortsighted to read so superficially into what was said and misrepresent my post that way :shrug: I'm giving you the benefit of the doubt that you are being difficult and don't actually think I was saying I am doing it for the money.

Regardless of whatever pre-med idealism is present here, everyone has a cutoff. I didn't give my number in that post but just talked in terms of trends. But you have a number too. You wouldn't put your life on hold for ~10 years to get out and make 35k/year. Even if you think you would... you wouldnt. Much of the allure of medicine has to do with its popular romanticism and that is highly tied to the historical salary. The problem is that the application trail makes every pre-med deathly afraid to admit that they don't have purely altruistic and self-sacrificing goals at heart to the point that they actually seem to begin to believe it 👍

All the happy warm fuzzy feelings aside, there is a real life component to this that the average "straight from UG to medschool" student doesn't understand. It doesn't matter how badly you "just love to help people", if it gets to the point where you can't pay off your loans and support yourself you will reconsider as well. If medicine as a whole got capped <$100k regardless of specialty, and stayed that way for 5-6 years you would see application numbers plummet.
 
Who are you to ban which words I use?

I wasn't aware it was a ban. I was just noting a trend in the types of people who use it in particular contexts, and expressing personal feelings on the subject.

I shall take it as a compliment that you assumed my post had such authority that you considered it a ban. :laugh: Carry on citizen, use buzzwords rapidly diluting their meaning to your heart's content. You have my blessing 😉👍
 
OK, I'll bite. I've been in critical care nursing a LONG time. I have worked very closely with more residents, fellows, and attendings that you can shake a stick at.
It's BS what you are saying about the $1000 pairs of shoes. You have absolutely no idea, seriously. You don't.

I rightfully wish that everyone get excellent care and treatment. I don't believe the federal government should dictate how that goes down.

Beyond that you have LOADS of people, sadly, that don't give enough of a crap about their own health and well-being or their children's. Take care of them year in and out and bang your head against the wall enough times trying to get through.

You do the best that you can, but at some point, you have got to face reality and get real.

Forget this. I have to study.

Have you been in the fashion threads? So because some people are too lazy to take care of themselves you want to give up on other people who would but can't? I'm sorry you think the poor are lazy.

No offense, but really. . .this mentality again. It's so unrealistic--very far from what is reality.

Mostly medicine doesn't heal people. It may implement things that will help a person to heal, where otherwise, they may not have been able to do--or is helps people manage illness with various treatments, and in the especially best model, IMHO, it helps prevent or limit illness.

Very few to no people are going into primary care or the crazy and at times painful rock and roll of emergency medicine for merely the bucks. Maybe this may be so for certain only areas, like rads, although that is hard in its own way and right, derm, difficult to get into, and while there are some interesting things people can pick up on from derm, generally it would bore the pants off of me. Anesthesia can get good bucks, but that is a whole other level of stress and pain in the azzness. Critical care, also demanding and stressful. Surgery, a VERY long and hard road post graduate education through fellowship---I have seen it beat the daylights out of people. YOu have to really want that.

It's a lot easier, though not perfectly easy, but relatively speaking, to get an MBA, specialize in the right kind of business or marketing, do the right kind of networking, and make some nice bucks. That too is a pain in its own way, but in my opinion, not nearly as much as just about any path to medicine.

People just don't understand what a major hard, pain in the azz medicine is--getting into it, getting through it, getting through postgrad residency and fellowship, the early years of being an attending, and even thereafter. Pretty much it doesn't matter what flavor of it you go for--it's degrees and types of differences, but it's all a huge pain in the azz.

Don't get me wrong. It's the one kind of work that I aspire to more than any other. But I have been up close to it in critical care nursing and surgery for a long time--I don't even want to say how long, K. I have absolutely NO illusions about it.

My point is that there are a lot less expensive and less painful and time-consuming ways of making some decent bank. In general, however not always, the sheer process should eliminate most fool-hearty people that things its glamour, praise, and money. If the first part of the process doesn't get them, some way on the long road will catch most of those that really don't care about medicine--and at least hopefully those that don't really care about people.

But the reality of the other side is that burn out in caring for people is VERY real even for the best of practitioners.

Looking for reasonable compensation for all of it is not profit-sniffing and neither is about not caring about medicine or people.

This is one of the most annoying attitudes I come across, b/c if you have worked directed in and around the field, you have no idea how wiped you can get my it. Dealing with very ill and/or extremely demanding, psychotic, or unrealistic patients and families--and difficult others within the field is overwhelmingly stressful after a while. The paperwork is ridiculous. The games to cover your but is unbelievable. No one in their right mind would go into this simply for the bucks. If they do, they won't be in it long--or they will go into sales or something else.

As a matter of fact, you would not believe how many docs I've know that have gone back to law school of all things.

Seriously, what is your point? I'm glad you feel that way, but some do go in to it for the money and prestige. I'm glad you as a nurse somehow have all doctors and the healthcare system figured out.
 
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What the hell are you people talking about? I posted multiple articles that actually discuss how PPACA is going to affect Physician and hospital reimbursement in concrete terms, and you guys would rather babble on about some petty definition of what a real physician is? This stupid forum.
 
What the hell are you people talking about? I posted multiple articles that actually discuss how PPACA is going to affect Physician and hospital reimbursement in concrete terms, and you guys would rather babble on about some petty definition of what a real physician is? This stupid forum.

No one is saying it wouldn't affect reimbursement.
 
I don't think most peeps could afford 1000 dollar shoes for interviews. I know some use the logic "Well if you can afford plane tickets you can afford shoes!", but that's not true. Usually, a lot of peeps barely have enough $$ left for fancy stuff.

But, there are fashion topics for that kinda talk 😛

I don't think salaries are gonna be capped to a sub-6 figure salary in every field. At least, it's too early to tell. Peeps need to chill out 🙂
 
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