Is obamacare really bad for doctors?

[Doudline]

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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.

The physicians of MSF making less than a CNA's salary would like a word with you.

 

[jl lin]

I think it rather shortsighted to read so superficially into what was said and misrepresent my post that way 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.

Yup. I mean that is reality 👍

 

[SoulinNeed]

No one is saying it wouldn't affect reimbursement.

What are you talking about? I posted a few articles just a few posts above about how PPACA will impact Physicians in concrete terms, and people are just ignoring it, because they'd rather talk about some petty philosophical issues that are inconsequential.

This is why Physicians routinely get run over in legislative discussions by nurses/lawyers/etc. Instead of focusing on actual practical matters, they'd rather ignore the real issues and bicker among themselves on matters that are wholly inconsequential, while lacking any real knowledge on what the issue (in this case, PPACA) actually consists of.

People, focus. We are discussing PPACA (Obamacare) here. Not whether or not more money makes you a good Physician, what it takes to be a good physician, etc. I posted articles that actually assess the bill. Maybe. Now, just maybe, if we can actually discuss it, we can know what we're getting into in this field, and maybe find ways on letting our voices be heard to improve it.

 

[SpecterGT260]

The physicians of MSF making less than a CNA's salary would like a word with you.

🙄

I could explain why this is just irrelevant to the point I was making. Instead I'll let you think about it and I'll get back to you in the morning

Sent from my DROID RAZR using SDN Mobile

 

[jl lin]

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.



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.

First, stop putting words, in people's mouths, so to speak. It's not about calling poor people lazy. People are very complicated. How many people have you worked with from all walks of life over the last two decades? People's heads start to hurt after hitting the same wall over and over again. I don't give up on people, but I certainly understand how colleagues, physicians, and others get frustrated in dealing with these people--and the huge waste of time and money that comes from these people taking up space in clinical areas and places like the ED--especially when they could really care less about effective treatment. Don't you think that takes time and care away from other people that need help????????? It also sucks up money and resources in financial system that is already underwater.


I didn't say I had anything all figured out. I said I definitely have some legitimate perspective here, where as I'm not seeing any from your end.

It's nice to stand all new, with fuzzy ideals, while casting aspersions on other people, when you apparently have zip for a clue as to what really goes on in the real world of healthcare and medicine.

 

[jl lin]

What are you talking about? I posted a few articles just a few posts above about how PPACA will impact Physicians in concrete terms, and people are just ignoring it, because they'd rather talk about some petty philosophical issues that are inconsequential.

This is why Physicians routinely get run over in legislative discussions by nurses/lawyers/etc. Instead of focusing on actual practical matters, they'd rather ignore the real issues and bicker among themselves on matters that are wholly inconsequential, while lacking any real knowledge on what the issue (in this case, PPACA) actually consists of.

People, focus. We are discussing PPACA (Obamacare) here. Not whether or not more money makes you a good Physician, what it takes to be a good physician, etc. I posted articles that actually assess the bill. Maybe. Now, just maybe, if we can actually discuss it, we can know what we're getting into in this field, and maybe find ways on letting our voices be heard to improve it.

Souls, no one is even going to have a lot of the answers to how it will precisely roll out until January. No one really is getting it, and at this point, I doubt that those involved in developing it really get how it will rolls.

One thing is certain to me. Making it work will be costly, and very questionable in terms of how I count try efficacy. And let's face it. The federal government has crap for a track record when it comes to running things. Something this complex will likely implode at some point.

 

[Doudline]

🙄

I could explain why this is just irrelevant to the point I was making. Instead I'll let you think about it and I'll get back to you in the morning

Sent from my DROID RAZR using SDN Mobile

Of course you will!

 

[SoulinNeed]

Souls, no one is even going to have a lot of the answers to how it will precisely roll out until January. No one really is getting it, and at this point, I doubt that those involved in developing it really get how it will rolls.

One thing is certain to me. Making it work will be costly, and very questionable in terms of how I count try efficacy. And let's face it. The federal government has crap for a track record when it comes to running things. Something this complex will likely implode at some point.

Whatever. The point is that we should be discussing the actual bill. You may say that they don't know, but that's not totally accurate. The CSM has already rolled out how it will implement VPM (I posted the article about it on the last page). MB reimbursement cuts for hospitals were put in place in 2010, and imaging cuts were put in place in 2010, and these things will continue to grow. VPM for hospitals will also be implemented, and IPAB boards have already been heavily discussed. Pre-meds need to understand what they're getting into (for better or worse), and how it will impact the specific fields that they want to go into. Some will benefit, some will not, and others won't be affected.

I don't know what you mean by January. Are you talking about SGR? The fiscal cliff cuts? These are all separate things.

Either way, enough of this stuff from all of you. This debate has no real bearing in reality. If future Physicians don't have a real grasp of what's being passed, why, and how they can benefit from it (and there are real ways that this bill can benefit us), then we have no one to blame but ourselves when we get run over in the future.

I swear, as a former pre-law student, I sometimes think that as smart as med students are about the sciences, they are just as dumb about political matters, lol.

 

[Undhopeful]

It's not bad if you don't mind working for free (or close to it)

 

[jl lin]

Whatever. The point is that we should be discussing the actual bill. You may say that they don't know, but that's not totally accurate. The CSM has already rolled out how it will implement VPM (I posted the article about it on the last page). MB reimbursement cuts for hospitals were put in place in 2010, and imaging cuts were put in place in 2010, and these things will continue to grow. VPM for hospitals will also be implemented, and IPAB boards have already been heavily discussed. Pre-meds need to understand what they're getting into (for better or worse), and how it will impact the specific fields that they want to go into. Some will benefit, some will not, and others won't be affected.

I don't know what you mean by January. Are you talking about SGR? The fiscal cliff cuts? These are all separate things.

Either way, enough of this stuff from all of you. This debate has no real bearing in reality. If future Physicians don't have a real grasp of what's being passed, why, and how they can benefit from it (and there are real ways that this bill can benefit us), then we have no one to blame but ourselves when we get run over in the future.

I swear, as a former pre-law student, I sometimes think that as smart as med students are about the sciences, they are just as dumb about political matters, lol.

See below:
Yes, OK. Everyone has got it all figured out. LOL It doesn't take a genius to see how this will kill employers, job employment, and how it will be an utter nightmare to even attempt to implement.

 

[deleted303591]

I have medical conditions-type 1 diabetes (expensive) and a rare (very expensive) autoimmune disease.

Many of you have no idea how much healthcare costs for somebody with a chronic illness in the United States. The average cost for a diabetes related care for a diabetic (type 1 AND type 2 included) in the US for 2007 was $11,744.

I am not against the healthcare law, even if my care is rationed or forgone due to allocation of resources.

I manage to do well even when the odds are against me. I believe adequate patient education (particularly diabetes, it is widely available, in many forms) and reliable preventative medicine protocols have given me the ability to make decisions for myself and to be an informative patient.

My diabetes is complicated by my autoimmune disease, which effects digestion and many other bodily functions but I do completely fine. I do not need a $7000 insulin pump (type 1 diabetics typically get a new pump every four years in the US) with disposable items that cost $250 a month, a continuous glucose monitor that costs $1200 with sensors that cost $400 a month, or "designer" insulins that cost $300 a month (Believe it or not, Humalin/Novolin Regular and NPH work just fine and cost less than $100 a month!). Type 1 diabetics in the UK and in other parts of the world do just fine without these "toys" and "tools". Also, most developed countries have better outcomes for type 1 diabetics compared to those in the United States.

On the other hand, there are no established treatments for my rare and very expensive autoimmune disease. In fact, I just received an infusion treatment today at the hospital. I receive IgG (a type of immunoglobulin) every 2 to 3 weeks, and it costs $20,000-$30,000 each treatment. I have been receiving this treatment since the second quarter of the year, so you can just imagine how much this treatment has cost this year.

Anyways, I apologize for the ramble.

 

[calvnandhobbs68]

See below:
Yes, OK. Everyone has got it all figured out. LOL It doesn't take a genius to see how this will kill employers, job employment, and how it will be an utter nightmare to even attempt to implement.

This picture has all kinds of unequivalent things on it. CMS is not equivalent to the Hospital Value Based Purchasing Program. One of them is a department the other one is...a program. One of those bubbles literally just says "Medicaid expansion +16 million". All those diamonds are just taxes and cuts. Almost every department on there already existed.

 

[deleted303591]

See below:
Yes, OK. Everyone has got it all figured out. LOL It doesn't take a genius to see how this will kill employers, job employment, and how it will be an utter nightmare to even attempt to implement.

Looks like a flowchart an engineer/programmer created. I <3 engineering/programming flowcharts.

It is not as complicated as it looks. It is easy to understand once you know programming fundamentals.

It just takes time to go through the flowchart.

 

[TheWeeIceMan]

Man this thread is depressing. I'm going to go find some sand and bury my head in it.

 

[SoulinNeed]

See below:
Yes, OK. Everyone has got it all figured out. LOL It doesn't take a genius to see how this will kill employers, job employment, and how it will be an utter nightmare to even attempt to implement.

I don't even understand what you're talking about. Once again, if you would just look at these articles. This one clearly explains how MB cuts on hospital are implemented.
http://healthreformstat.com/2010/06/05/provider-reimbursement-–-reduction-in-market-basket-updates/

This one clearly explains how CMS will implement VPM measures.
http://www.ama-assn.org/amednews/2012/09/17/gvl10917.htm

And this one does a great job explaining the overall bill, and how it will be implemented, and how reimbursement will be affected. http://www.healthlawyers.org/Events/Programs/Materials/Documents/HCR10/barry_luband_lutz.pdf

Dude, I'm not trying to discuss whether PPACA is a good bill or not. It's here, and it's not going away, like it or not. My point is that we have to try to understand it. By posting that picture, it seems like you're just throwing in the towel, and going, "it's too complicated to understand."

We have to understand this thing. It's not going away.

 

[deleted303591]

See below:
Yes, OK. Everyone has got it all figured out. LOL It doesn't take a genius to see how this will kill employers, job employment, and how it will be an utter nightmare to even attempt to implement.

Well, our healthcare system is already a nightmare for people with chronic illness. Having universal healthcare is not the end of the world.

Advocacy for Patients with Chronic Illness is at the forefront at fighting unscrupulous denials and activities by health insurance companies. If you want to know what kind of hell people go through trying to get proper treatment for catastrophic diseases, I suggest you read "It's Too Hard to Be Sick in America" by Advocacy for Patients with Chronic Illness.

There is actually a story in there of a medical device that is a Humanitarian Use Device (Enterra, by Medtronic) that I have due to severe nausea and vomiting. It was approved by the FDA for compassionate use and < 4,000 people in the US are allowed to get this device implanted in a single year due to FDA law. In fact, the insurance company that I will be under next year, denies every single claim for Enterra. The ironic part is that Advocacy for Patients with Chronic Illness has done several appeals for this particular medical device (and sends the insurance company a textbook of clinical studies in the appeal) and they win 85-90% of the appeals with this insurance company. This tells you that the device is being denied way too often.

Their blog is very interesting and up to date regarding the healthcare system. http://advocacyforpatients.blogspot.com/

And, by the way, the bill is far from perfect. It was a compromise and a starting point for further healthcare legislation.

 

[SpecterGT260]

Of course you will!

yep 👍

So when I mentioned trends and likelihood, i.e. "as reimbursement goes down, fewer people..." naming a random group of people that actually do work for very little is just completely irrelevant and just plain doesn't contradict the initial statement in any way. It always confuses me how people like to throw out minor exceptions as if the world actually is just that black and white. 😕

 

[chemsmith]

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 🙂

Ah, the paradox of the 1000 dollar shoe: if it doesn't look like a 1000 dollar shoe, was it worth spending 1000 dollars on them? On the other hand, if it does look like an exquisite 1000 dollar pair of shoes, you will look like a douchebag at the interview.

 

[SpecterGT260]

My shoes were $40 and look awesome

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[notbobtrustme]

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.

http://www.jennhoffman.com/blog/wp-content/uploads/2011/09/Never-Go-Full-******.jpg

 

[Geebeejay]

Souls, no one is even going to have a lot of the answers to how it will precisely roll out until January. No one really is getting it, and at this point, I doubt that those involved in developing it really get how it will rolls.

One thing is certain to me. Making it work will be costly, and very questionable in terms of how I count try efficacy. And let's face it. The federal government has crap for a track record when it comes to running things. Something this complex will likely implode at some point.

Dude, your prophesies and conjecture sound like the ramblings of crazy pastors and senile elderly Christians preaching about the apocalypse and judgment day. Why don't you give it a rest, and wait to see what actually happens? According to you, it's beyond your control now anyway.

 

[Arbor Vitae]

Dude, your prophesies and conjecture sound like the ramblings of crazy pastors and senile elderly Christians preaching about the apocalypse and judgment day. Why don't you give it a rest, and wait to see what actually happens? According to you, it's beyond your control now anyway.

+1 i can't even understand his incoherent ramblings, seriously sounds like a homeless person

 

[calvnandhobbs68]

+1 i can't even understand his incoherent ramblings, seriously sounds like a homeless person

Just turn to Glenn Beck or Rush for a day and you'll see where people get this stuff from.

 

[wjs010]

I echo the sentiment that all of the premed romanticism of the ACA...to the guy who said "it's a good idea because lower pay will weed out the insincere doctors..." are you kidding me?

this idea that you aren't doing it right unless you are doing it for free needs to end...why can't you pre med pinheads just go look at how doctors are talking about it in the resident section? Of course there will always be insincere doctors that slip through the crack, but raising or lowering their salaries will not change how they work. However, for the good doctors who do bust their asses everyday, how do you think it's going to feel when the giant bureaucratic cockblock takes place in 2015? It's going to make many doctors unhappy. If you think you will be different...you're most likely wrong. There is nothing wrong with fantasizing about being a doctor, but don't look past the obvious fallacy that you are going to be better than all others because you " dont mind working for less money"

When we have a libertarian president in the future, hopefully ACA will be stopped., and common sense will be started.

 

[Doudline]

yep 👍

So when I mentioned trends and likelihood, i.e. "as reimbursement goes down, fewer people..." naming a random group of people that actually do work for very little is just completely irrelevant and just plain doesn't contradict the initial statement in any way. It always confuses me how people like to throw out minor exceptions as if the world actually is just that black and white. 😕

A silly answer for a silly argument.
What are you even suggesting, that physicians' salary should be high because... they believe it should be high and allegedly wouldn't work for less?

 

[circulus vitios]

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.

Don't you see? Making health insurance more affordable and more accessible to the middle class is actually hurting them. Open your eyes, sheeple! Fox Nation, out.

 

[KnuxNole]

Not caring about large salaries =/= doing it for free D:

I don't think anyone actually thinks that. You gotta be paid 😎

 

[Barcu]

I echo the sentiment that all of the premed romanticism of the ACA...to the guy who said "it's a good idea because lower pay will weed out the insincere doctors..." are you kidding me?

this idea that you aren't doing it right unless you are doing it for free needs to end...why can't you pre med pinheads just go look at how doctors are talking about it in the resident section? Of course there will always be insincere doctors that slip through the crack, but raising or lowering their salaries will not change how they work. However, for the good doctors who do bust their asses everyday, how do you think it's going to feel when the giant bureaucratic cockblock takes place in 2015? It's going to make many doctors unhappy. If you think you will be different...you're most likely wrong. There is nothing wrong with fantasizing about being a doctor, but don't look past the obvious fallacy that you are going to be better than all others because you " dont mind working for less money"

When we have a libertarian president in the future, hopefully ACA will be stopped., and common sense will be started.

I have come across more physicians who favor the ACA than who oppose it, though primary care and academic physicians are probably more likely to be in favor of the law, and that's who we have the most exposure to in med school.

The point is, physicians are pretty mixed about the ACA. While I agree with your point that idealism is very high on SDN, it's also unfair to say that the vast majority of doctors are up in arms about the healthcare law.

I think the biggest issue for current doctors is that they feel their current salary may be threatened. I think the fear is a bit overblown, but it's not completely unfounded. Med students and premeds today, on the other hand, may see the law much more favorably than current physicians because they entered med school knowing what the law entailed and that salaries may be lower (or higher if you are considering primary care).

You think people are naive for saying they will work for less. However, if you've never made a high salary, making 150,000 sounds great. And you will adapt to that once you begin practicing, so I don't think that all of this idealism is completely unfounded. Physicians now are so concerned because they are used to their current salaries.

Complaining about the state of healthcare is what all doctors do, and if it wasn't the ACA, it would be something else. Healthcare is a field that is always changing, and it always will be changing. Every doctor is going to lament the "good ol' days." But the newer physicians will adapt. And if premeds don't like the way the field is heading, then they can try and change it (very difficult) or look to another profession.

 

[KnuxNole]

I dunno, maybe I just haven't been surrounded by anyone who makes 6 figure salaries, but the idea of that in general seems shocking/unreal. I never imagined that it could be possible for me lol. 200K ---> 175K seems minimal. I can see people getting upset if it goes from 200K---> 60K, but how do we know that yet?

 

[SpecterGT260]

A silly answer for a silly argument.
What are you even suggesting, that physicians' salary should be high because... they believe it should be high and allegedly wouldn't work for less?

what are you defining as "high"? You seem to think that I am pushing for increasing pay when in reality I am responding to those who are calling for cutting wages.

It is really only your naivete that is continuing this argument 👍

 

[Geebeejay]

60k will not happen

 

[Gut Shot]

For anybody interested in a concise, readable digestion of how the PPACA will (presumably) affect reimbursement:
http://www.physiciansnews.com/2012/...ng-bust-at-the-healthcare-buffet-part-1-of-2/
http://www.physiciansnews.com/2012/...ing-bust-at-the-healthcare-buffet-conclusion/

It is understandable why practicing physicians are wetting themselves. As the above article points out, from 1995 to 2008 reimbursement eroded ~25%. Combine that with a looming overhaul of the health system, the annual SGR debacle, and unprecedented levels of educational debt, and it's easy to see why some people feel the rug is being pulled out from under us in slow motion.

 

[Dires]

For anybody interested in a concise, readable digestion of how the PPACA will (presumably) affect reimbursement:
http://www.physiciansnews.com/2012/...ng-bust-at-the-healthcare-buffet-part-1-of-2/
http://www.physiciansnews.com/2012/...ing-bust-at-the-healthcare-buffet-conclusion/

It is understandable why practicing physicians are wetting themselves. As the above article points out, from 1995 to 2008 reimbursement eroded ~25%. Combine that with a looming overhaul of the health system, the annual SGR debacle, and unprecedented levels of educational debt, and it's easy to see why some people feel the rug is being pulled out from under us in slow motion.

Epic post.

 

[SpecterGT260]

For anybody interested in a concise, readable digestion of how the PPACA will (presumably) affect reimbursement:
http://www.physiciansnews.com/2012/...ng-bust-at-the-healthcare-buffet-part-1-of-2/
http://www.physiciansnews.com/2012/...ing-bust-at-the-healthcare-buffet-conclusion/

It is understandable why practicing physicians are wetting themselves. As the above article points out, from 1995 to 2008 reimbursement eroded ~25%. Combine that with a looming overhaul of the health system, the annual SGR debacle, and unprecedented levels of educational debt, and it's easy to see why some people feel the rug is being pulled out from under us in slow motion.

No no no. Listen to the real world experience and wisdom of the pre med. Obviously you just don't care about your patients enough. Obviously 👎

Sent from my DROID RAZR using SDN Mobile

 

[wjs010]

i just dont think specialists should make <200k...that's just what i think.

 

[SoulinNeed]

For anybody interested in a concise, readable digestion of how the PPACA will (presumably) affect reimbursement:
http://www.physiciansnews.com/2012/...ng-bust-at-the-healthcare-buffet-part-1-of-2/
http://www.physiciansnews.com/2012/...ing-bust-at-the-healthcare-buffet-conclusion/

It is understandable why practicing physicians are wetting themselves. As the above article points out, from 1995 to 2008 reimbursement eroded ~25%. Combine that with a looming overhaul of the health system, the annual SGR debacle, and unprecedented levels of educational debt, and it's easy to see why some people feel the rug is being pulled out from under us in slow motion.

Like I said in my posts (which no one read, lol) Physicians are going to have to rely on quality measures to get Medicare bonuses, relying on more patients with private insurance (none of these reimbursement cuts apply to them), which should be easier with all of the people now being required to have private insurance. Physicians are also going to have to merge into large groups, and collectively try to negotiate fees with Hospitals.

The days of the solo-practictioner Physician are over.

 

[Geebeejay]

i just dont think specialists should make <200k...that's just what i think.

fair enough, but I think there are millions and millions of people with all different types of careers or career aspirations that think they deserve to and are entitled to make more money than they do. Life's tough, and times are tough.

 

[jl lin]

Dude, your prophesies and conjecture sound like the ramblings of crazy pastors and senile elderly Christians preaching about the apocalypse and judgment day. Why don't you give it a rest, and wait to see what actually happens? According to you, it's beyond your control now anyway.

You don't really have to wait. It's been spelled out in history. Pattern recognition mean anything to you?

Yes, let's just blow it all off--but like Benghazi, huh?

 

[jl lin]

fair enough, but I think there are millions and millions of people with all different types of careers or career aspirations that think they deserve to and are entitled to make more money than they do. Life's tough, and times are tough.

Hmmm, how much of a cut do you think any of your Congress people will be willing to take?

And do you think for a second that their healthcare package will look anything like most others? Do you think Pelosi's will?

LOL. Time to start brewing some coffee.

And what about those sports stars you love? How about all those in Hollywood that have worked to undermine liberty and opportunity in the name of "covering everyone?"

What world exactly do you live in?

It's whatever the market will bear, and now, the market is going to bear down hard. It has no where to go but down and out.

By the way. . .are those Hollywood stars worthy of all their figures compared with the work you have or will put in toward become and staying a physician?

People can make do without stars. They can't do without good physicians and good healthcare personnel. Yet you as a physician will be forced to care for more, with less, while receiving less. They won't--especially if politically they played their cards right--the politics of Hollywood is no different than the politics of anywhere else--and DC is like a mirror image.

 

[Arbor Vitae]

No no no. Listen to the real world experience and wisdom of the pre med. Obviously you just don't care about your patients enough. Obviously 👎

Sent from my DROID RAZR using SDN Mobile

i know right 😉

 

[Geebeejay]

Hmmm, how much of a cut do you think any of your Congress people will be willing to take?

And do you think for a second that their healthcare package will look anything like most others? Do you think Pelosi's will?

LOL. Time to start brewing some coffee.

And what about those sports stars you love? How about all those in Hollywood that have worked to undermine liberty and opportunity in the name of "covering everyone?"

What world exactly do you live in?

It's whatever the market will bear, and now, the market is going to bear down hard. It has no where to go but down and out.

By the way. . .are those Hollywood stars worthy of all their figures compared with the work you have or will put in toward become and staying a physician?

People can make do without stars. They can't do without good physicians and good healthcare personnel. Yet you as a physician will be forced to care for more, with less, while receiving less. They won't--especially if politically they played their cards right--the politics of Hollywood is no different than the politics of anywhere else--and DC is like a mirror image.

What in god's name are you talking about, and how does this have anything to do with my post that you responded to? And since when are "Hollywood stars" salaried workers? Are you just practicing typing at this point?

Whatever man, in about 3 years you can come back, and make a new post describing either how very right you were, or how very wrong you were with your outrageous rhetorical scenarios and baseless conjecture.

 

[Arbor Vitae]

Hmmm, how much of a cut do you think any of your Congress people will be willing to take?

And do you think for a second that their healthcare package will look anything like most others? Do you think Pelosi's will?

LOL. Time to start brewing some coffee.

And what about those sports stars you love? How about all those in Hollywood that have worked to undermine liberty and opportunity in the name of "covering everyone?"

What world exactly do you live in?

It's whatever the market will bear, and now, the market is going to bear down hard. It has no where to go but down and out.

By the way. . .are those Hollywood stars worthy of all their figures compared with the work you have or will put in toward become and staying a physician?

People can make do without stars. They can't do without good physicians and good healthcare personnel. Yet you as a physician will be forced to care for more, with less, while receiving less. They won't--especially if politically they played their cards right--the politics of Hollywood is no different than the politics of anywhere else--and DC is like a mirror image.

you are the craziest nurse I've ever came across.

 

[PikminOC]

Dis gunna suck sumpin fierce

 

[Arbor Vitae]

How do other countries make it work? Is it just that our taxes are too low or our government too inept?

 

[SpecterGT260]

i just dont think specialists should make <200k...that's just what i think.

What SHOULD they make then?

Sent from my DROID RAZR using SDN Mobile

 

[SpecterGT260]

How do other countries make it work? Is it just that our taxes are too low or our government too inept?

Other countries do a number of different things from enforcing proper "chain of care" and not allowing immediate specialist access without referral, some allow poorer quality of care and less rigorous training. Some places just don't have the "steak at a McDouble price" attitude that American patients have. Many countries don't have the litigation heavy culture we have. There are lots of things.

What is important is understanding that there is give and take for everything. Our system is far from perfect but so are the systems in other countries. You could very easy change one evil for another

Sent from my DROID RAZR using SDN Mobile

 

[PikminOC]

For anybody interested in a concise, readable digestion of how the PPACA will (presumably) affect reimbursement:
http://www.physiciansnews.com/2012/...ng-bust-at-the-healthcare-buffet-part-1-of-2/
http://www.physiciansnews.com/2012/...ing-bust-at-the-healthcare-buffet-conclusion/

It is understandable why practicing physicians are wetting themselves. As the above article points out, from 1995 to 2008 reimbursement eroded ~25%. Combine that with a looming overhaul of the health system, the annual SGR debacle, and unprecedented levels of educational debt, and it's easy to see why some people feel the rug is being pulled out from under us in slow motion.

Thank you for this link. Towards the end, it is mentioned that with less specialists, the public thinks there will be less unneeded procedures. That is counterintuitive to everything I have seen when it comes to NP/PA/etc. I have seen more tests run as fishing expeditions with them.

I have been employed by a hospital. It does suck bc there are few physician administrators, so you have to defend yourself to a nurse or SW who understands nothing about physician clinical care.

As an employee at the hospital, you are the hospital's whipping boy. They need you to cover a clinic 60 miles away? Go do it! If you aren't making enough revenue, they will increase your caseload, start doublebooking and other maneuvers that are not safe for patients. If there are NP's there or other ancillary staff, it is in your hospital contract that you have to collaborate with them. Their malpractice insurance also covers the hospital's best interest, not yours so they will settle a case you may have won if the malpractice pursued it. The decision is taken from you.

It is also very difficult to negotiate certain points on these 20 page employee contracts. They will just find a less difficult person to hire.

 

[PikminOC]

Hmmm, how much of a cut do you think any of your Congress people will be willing to take?

And do you think for a second that their healthcare package will look anything like most others? Do you think Pelosi's will?

LOL. Time to start brewing some coffee.

And what about those sports stars you love? How about all those in Hollywood that have worked to undermine liberty and opportunity in the name of "covering everyone?"

What world exactly do you live in?

It's whatever the market will bear, and now, the market is going to bear down hard. It has no where to go but down and out.

By the way. . .are those Hollywood stars worthy of all their figures compared with the work you have or will put in toward become and staying a physician?

People can make do without stars. They can't do without good physicians and good healthcare personnel. Yet you as a physician will be forced to care for more, with less, while receiving less. They won't--especially if politically they played their cards right--the politics of Hollywood is no different than the politics of anywhere else--and DC is like a mirror image.

You guys are coming very hard on this SDN poster.

Alot of things this person writes is very true.

Why don't the Hollywood stars like Eva Longoria and the like who are all for everyone being covered and free immigration into the US putting their money where their mouth is?

And regardless if a Hollywood star or sports star is salaried or not, physicians work their tukkuses off, take great responsibility upon themselves with their patient crises and illnesses and being one malpractice case away from losing everything they have worked for. Being a doc takes a toll on physician physical and mental well being and family/friend time. It is not a 9-5 job where you can "turn off" your mind to the problems and patients from the day.

While the public sees us as "bazillionaires" who work minimally, no one is out there complaining that the bazillionaire sports stars and movie stars etc make too much money.

Cut the lazy docs pay.

 

[jl lin]

What in god's name are you talking about, and how does this have anything to do with my post that you responded to? And since when are "Hollywood stars" salaried workers? Are you just practicing typing at this point?

Whatever man, in about 3 years you can come back, and make a new post describing either how very right you were, or how very wrong you were with your outrageous rhetorical scenarios and baseless conjecture.

Lovely, so now you are going to clam difference based on being a salaried worker. For the love. . .really?

You missed the point. Baseless, um, major employers have severely cut down hiring since after the last election. If you don't understand how OC is going to cost much more and how it's going to strain the corporations, hospitals, and various enterprises and businesses that provide open jobs, you need to read A LOT MORE.

It has nothing to do with conjecture. It's reality. Companies have closed off BIG TIME and it will only continue as this plan is being shoved down their throats. And let's not even get into the massive governmental regulations.

Reality can bite big time.

 

[jl lin]

you are the craziest nurse I've ever came across.

That's an idiotic statement. You know nothing about my nursing skills. But there are a lot of patients and families that have been grateful for them--as there have also been a lot of docs that have thanked me for them as well.

But continue with ad hominems. The sadness is in your failure to see that using them totally undermines you and any position you could make.