Is There A Doctor Shortage?

[DermViser]

Very interesting debate regarding whether or not there is a doctor shortage and all that entails. So at 27:46 - the host asks which specialties if he could cut (or least cut in huge numbers) he would. 30:44 - Ezekiel Emanuel (he is quite childish and insufferable throughout the entire video) lists the 2 specialties he thinks there are too many of in general - Anesthesiology and Radiology. All part of his overall goal to try to get the Primary Care to Specialist ratio away from the 30:70 ratio as it is now, along with changing payment methods to hospitals and providers (of course). Does he have a point?

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[BobbyB]

what is the current primary care to specialist ratio?

 

[PL198]

short answer: no.

Check out the access to care in other countries. I laugh when we hear about too few doctors in America, yet other countries people wait years for certain procedures. Sounds like the world is just convinced medicine should be walmart and you can walk in whenever you want and buy whatever you want with someone waiting to give it to you. Sorry, not gonna happen.

 

[DermViser]

what is the current primary care to specialist ratio?

30:70

 

[DermViser]

short answer: no.

Check out the access to care in other countries. I laugh when we hear about too few doctors in America, yet other countries people wait years for certain procedures. Sounds like the world is just convinced medicine should be walmart and you can walk in whenever you want and buy whatever you want with someone waiting to give it to you. Sorry, not gonna happen.

The ones who come here from other countries to this country for procedures are usually politicians and dignitaries who can pay out of pocket. Other countries also actively ration care as far as what their govt. plans will pay for. Obamacare's rationing will likely happen thru IPAB as far as what will or won't be covered (Obamacare exchange plans already do this in a way with very narrow networks).

 

[PL198]

The ones who come here from other countries to this country for procedures are usually politicians and dignitaries who can pay out of pocket. Other countries also actively ration care as far as what their govt. plans will pay for. Obamacare's rationing will likely happen thru IPAB as far as what will or won't be covered (Obamacare exchange plans already do this in a way with very narrow networks).

Agreed on all accounts, just think it's hilarious when people talk about a physician shortage in America, where here people have 10x the access to procedures that they do in other nations, it just might require paying a pretty penny.

People need to start looking at extensive procedures as what they are- extensive procedures. Not something you're entitled to just for being in bad health. If they did this, I wager people would maintain their health a lot better and less of those procedures would be required.

 

[db1210]

Fiji water, lol. What a scam.

Good point about Nephrologists providing some primary care to patients at 32:16. It may not be so much about the number of specialists, but more of what they actually do.

 

[PhillyMed777]

why is it that I find EE's voice so annoying?

Additions - I guess it's clear there's no shortage. This video gives some new ideas to me regarding which fields to pursue

 

[DermViser]

why is it that I find EE's voice so annoying?

Additions - I guess it's clear there's no shortage. This video gives some new ideas to me regarding which fields to pursue

It's bc he's stubborn, smarmy, and thinks he knows everything, and believes the healthcare system should work the way he sees fit (after taking full advantage of it himself - he's an Oncologist - although above that he's a political idealogue, which should scare any patient). As much as he wants to incentivitize, if you watch the video, you'll see that the things he's incentivizing for primary care to do (to keep patients out of the hospital) is making their jobs harder, not easier.

He also thinks all of Anesthesia can easily be done by CRNAs which shows he's a complete fool. He's a Harvard Med grad, but he's not common sense smart and doesn't know the real life practices of specialties - i.e. his comments about Ortho.

 

[PhillyMed777]

It's bc he's stubborn, smarmy, and thinks he knows everything, and believes the healthcare system should work the way he sees fit (after taking full advantage of it himself - he's an Oncologist - although above that he's a political idealogue, which should scare any patient). As much as he wants to incentivitize, if you watch the video, you'll see that the things he's incentivizing for primary care to do (to keep patients out of the hospital) is making their jobs harder, not easier.

He also thinks all of Anesthesia can easily be done by CRNAs which shows he's a complete fool. He's a Harvard Med grad, but he's not common sense smart and doesn't know the real life practices of specialties - i.e. his comments about Ortho.

He's unbelievably ready to pin costs on "doctor induced demand." He's also ready to swarm the system with NPs. And to top it off, his comments that attack urologists, ortho, radiologists, anesthesiologists are just...Wow. Some bold predictions like: in 2030, imaging will go to a central bank and it will be read by anyone pre-certified.

 

[PL198]

It's bc he's stubborn, smarmy, and thinks he knows everything, and believes the healthcare system should work the way he sees fit (after taking full advantage of it himself - he's an Oncologist - although above that he's a political idealogue, which should scare any patient). As much as he wants to incentivitize, if you watch the video, you'll see that the things he's incentivizing for primary care to do (to keep patients out of the hospital) is making their jobs harder, not easier.

He also thinks all of Anesthesia can easily be done by CRNAs which shows he's a complete fool. He's a Harvard Med grad, but he's not common sense smart and doesn't know the real life practices of specialties - i.e. his comments about Ortho.

I bet this is way more likely than the people from there actually having common sense. People from the highest academic institutions or intellectual performance of any kind tend to have no common sense, ie the average medical student. When you take a super high achieving subset of that same group, I bet most of them don't even understand the difference between common sense and being book smart.

 

[DermViser]

He's unbelievably ready to pin costs on "doctor induced demand." He's also ready to swarm the system with NPs. And to top it off, his comments that attack urologists, ortho, radiologists, anesthesiologists are just...Wow. Some bold predictions like: in 2030, imaging will go to a central bank and it will be read by anyone pre-certified.

and he's attacked Radiation Oncologists (proton beam tx), Urologists (DaVinci robot), etc.

Like I said. He lives in a complete utopia of how he believes the healthcare system should work. He thinks people should get care (no matter what the quality) from cheaper providers, but he's such a fool, he doesn't realize those cheaper providers are lobbying for equal reimbursement, thus negating any cost savings.

 

[DermViser]

I bet this is way more likely than the people from there actually having common sense. People from the highest academic institutions or intellectual performance of any kind tend to have no common sense, ie the average medical student. When you take a super high achieving subset of that same group, I bet most of them don't even understand the difference between common sense and being book smart.

It's call Ivory Tower syndrome, bc they're very insulated from everyone else with respect to life experiences and the real-life consequences of the things they espouse (which of course doesn't apply to them). If you look at the average Harvard Med School medical student - these usually are people who come from very affluent and well-to-do backgrounds themselves, and believe they have the right to bloviate about how healthcare should be run due to the fact they graduated from Harvard. For example, talking about the importance of primary care, yet having cut funding for their own primary care department:
http://www.thecrimson.com/article/2009/7/16/hms-suspends-funding-for-primary-care/.

See here: http://www.studentdoctor.net/2011/0...g-mission-for-harvard-medical-school-student/
"I had little formal exposure to my future health care colleagues throughout medical school; I had no idea, for example, what physician assistants did and how they trained. I only found out when one morning in my third year of medical school I asked a physician assistant joining us for morning rounds because I was curious and frankly, embarrassed by my ignorance."

I mean seriously? A third year Harvard medical student, not knowing what a PA does? Only in the People's Republic of Cambridge.

 

[BestDoctorEver]

Ezekiel Emanuel is a *****....

 

[RJGOP]

Ezekiel Emanuel is a *****....

Very interesting debate regarding whether or not there is a doctor shortage and all that entails. So at 27:46 - the host asks which specialties if he could cut (or least cut in huge numbers) he would. 30:44 - Ezekiel Emanuel (he is quite childish and insufferable throughout the entire video) lists the 2 specialties he thinks there are too many of in general - Anesthesiology and Radiology. All part of his overall goal to try to get the Primary Care to Specialist ratio away from the 30:70 ratio as it is now, along with changing payment methods to hospitals and providers (of course). Does he have a point?

They were discussing increasing the reimbursement for primary care, specifically FM (I assume), and how that could solve the problem. They're right that more people would go into Family medicine, but that would make it more and more competitive. Which in turn, would make other specialties less competitive, due to either lost or lower than average reimbursement. That would just create a never ending cycle. Further, they were discussing how many doctors will soon retire due to their age, but they failed to acknowledge all the residents, fellows and medical students whom will soon be entering the workforce.

 

[calvnandhobbs68]

and he's attacked Radiation Oncologists (proton beam tx), Urologists (DaVinci robot), etc.

Like I said. He lives in a complete utopia of how he believes the healthcare system should work. He thinks people should get care (no matter what the quality) from cheaper providers, but he's such a fool, he doesn't realize those cheaper providers are lobbying for equal reimbursement, thus negating any cost savings.

Whether proton beam treatments or Da Vinci robots do anything besides add extra costs to the system with dubious benefits over similar, cheaper treatments is actually something being actively debated among physicians themselves. Although it probably isn't fair to say that they don't provide any extra benefit, questioning whether they are worth the added cost is legitimate.

 

[ketosisevangelist]

and he's attacked Radiation Oncologists (proton beam tx), Urologists (DaVinci robot), etc.

Like I said. He lives in a complete utopia of how he believes the healthcare system should work. He thinks people should get care (no matter what the quality) from cheaper providers, but he's such a fool, he doesn't realize those cheaper providers are lobbying for equal reimbursement, thus negating any cost savings.

Guys like this have seats at the think tanks. These people have a special place in hell.

 

[RJGOP]

Ezekiel Emanuel is a *****....

I wouldn't say he's a *****, he's actually very smart. However, he has so many weird-ass ideas and notions of how medicine should be. His proposals and ideas also are typically impractical and have no validity whatsoever. So, no, he's not a *****, but he comes off that way, in addition to being an annoying prick.

Edit: I forgot to mention he's also the brother of the "dead fish."

 

[RJGOP]

and he's attacked Radiation Oncologists (proton beam tx), Urologists (DaVinci robot), etc.

Like I said. He lives in a complete utopia of how he believes the healthcare system should work. He thinks people should get care (no matter what the quality) from cheaper providers, but he's such a fool, he doesn't realize those cheaper providers are lobbying for equal reimbursement, thus negating any cost savings.

It's ridiculous, but you have to remember he's just an egg-head liberal loony who implements his crazy political ideas into everything, at the (what would be, rather) expense of others.

 

[ketosisevangelist]

I know you ppl are building the spaceship. I'm going to be very upset it I'm stranded here on this planet.

Please reconsider and inform me as to the whereabouts of the spaceport.

Thanks

 

[PL198]

Guys like this have seats at the think tanks. These people have a special place in hell.

When I'm in hell and he is too, I'm gonna kick his *ss

Can just imagine him now " violence is so barbaric."

 

[dadaddadaBATMAN]

I know you ppl are building the spaceship. I'm going to be very upset it I'm stranded here on this planet.

Please reconsider and inform me as to the whereabouts of the spaceport.

Thanks

If this is an oblique futurama reference, I'll take it

 

[DermViser]

It's ridiculous, but you have to remember he's just an egg-head liberal loony who implements his crazy political ideas into everything, at the (what would be, rather) expense of others.

That's what's scary. If you watch the thing from the beginning, he talks about how med school education should be changed, residency should be changed, the healthcare system, having PAs/NPs do more, etc. as if he has all the answers (not tort reform of course). You can't change those things and then not inherently change the front end: tuition costs, time costs, board exams, etc. to people going in.

 

[ketosisevangelist]

That's what's scary. If you watch the thing from the beginning, he talks about how med school education should be changed, residency should be changed, the healthcare system, having PAs/NPs do more, etc. as if he has all the answers (not tort reform of course). You can't change those things and then not inherently change the front end: tuition costs, time costs, board exams, etc. to people going in.

This month, I'll find and post his contact info. This dude is going to hear it from us.

I'll offer a $150 bounty for anyone with information about the prostitutes with whom he has laid in bed.

 

[DermViser]

This month, I'll find and post his contact info. This dude is going to hear it from us.

I'll offer a $150 bounty for anyone with information about the prostitutes with whom he has laid in bed.

Considering he's a dear Obama friend, I would watch your phones getting tapped.

 

[ketosisevangelist]

Considering he's a dear Obama friend, I would watch your phones getting tapped.

It's already tapped. I recite the list of 100 words that set off the PRISM system daily.

 

[DrOwnage]

Why the hell does it seem like the only publicly vocal and politically active physicians are the ones trying to literally F over the profession.

Yes, lets sit here and eliminate specialties from our profession with a grin on our face with a voice that sounds like it was meant to voice a homosexual porno.

I hope when this guy gets older and needs a general surgery that the anesthesiologist tea bags him while hes under. I don't understand the professionals that are willing to stigmatize the other professionals in the field who have undoubtedly assisted them in bringing care to their own patients indirectly.

P.S. I just hit 69 posts.... awwwright

 

[PL198]

What doesn't he want to change? Also his demeanor seems extremely unusual to me, like I'm betting there's a mental disorder that he falls squarely on the spectrum of.

 

[RJGOP]

What doesn't he want to change? Also his demeanor seems extremely unusual to me, like I'm betting there's a mental disorder that he falls squarely on the spectrum of.

It's called off the charts, crazy lunatic, liberalism.

 

[RJGOP]

Why the hell does it seem like the only publicly vocal and politically active physicians are the ones trying to literally F over the profession.

Yes, lets sit here and eliminate specialties from our profession with a grin on our face with a voice that sounds like it was meant to voice a homosexual porno.

I hope when this guy gets older and needs a general surgery that the anesthesiologist tea bags him while hes under. I don't understand the professionals that are willing to stigmatize the other professionals in the field who have undoubtedly assisted them in bringing care to their own patients indirectly.

P.S. I just hit 69 posts.... awwwright

It should be a CRNA. He thinks we don't need anesthesiologists. Let's see what he prefers when HE needs an operation.

 

[DermViser]

What doesn't he want to change? Also his demeanor seems extremely unusual to me, like I'm betting there's a mental disorder that he falls squarely on the spectrum of.

He's quite hilarious on interviews -- always trying to get in a word edgewise, never taking blame for anything and always blaming someone else (mainly Republicans for his bill going wrong) http://articles.philly.com/2012-08-...e-emanuel-staff-and-current-mayor-health-care

If it tells you anything, his father quit the AMA bc of it's initial campaign against Medicare, which is now coming to roost, bc back then physicians could charge anything they wanted and Medicare paid it in full (that was the deal LBJ made with the AMA to get support for Medicare).

 

[PL198]

It's called off the charts, crazy lunatic, liberalism.

I think he shows a lot of signs of asperger's honestly. He thinks everything is black and white is the best example I can think of. His overall demeanor just tells me something isn't medically sound, hard to describe.

 

[RJGOP]

I think he shows a lot of signs of asperger's honestly. He thinks everything is black and white is the best example I can think of. His overall demeanor just tells me something isn't medically sound, hard to describe.

Yeah, I mean he just seems like an extremely neurotic, socially inept, brilliant guy with absurd ideas. Could very well be Asperger's.

 

[DermViser]

I think he shows a lot of signs of asperger's honestly. He thinks everything is black and white is the best example I can think of. His overall demeanor just tells me something isn't medically sound, hard to describe.

Yeah, I mean he just seems like an extremely neurotic, socially inept, brilliant guy with absurd ideas. Could very well be Asperger's.

http://articles.philly.com/2012-08-...e-emanuel-staff-and-current-mayor-health-care
Once, first to finish a chemistry exam, Emanuel slapped his paper on the professor's desk, proclaiming the test terrible. The professor shot back, "Why don't you write your own?" Before the other students had finished, Emanuel returned with his improved version.

He didn't really want to be a doctor, he says, but his parents gave him little choice. He hated the hierarchical pedagogy of medical school and although his years as a breast cancer specialist were rewarding, he was frustrated by the country's broken health care system. So many avoidable problems were beyond a clinician's domain, he said. "I decided I'd rather work on changing the system."

Last year, after deciding to leave NIH, he considered several offers before picking Penn. Insiders, however, none of whom would speak on the record, said his arrogance limited his choices.

"He's not as good as he should be at recognizing when he should live and let live," says Keating, a law professor at the University of Southern California. He was in law school at Harvard in the early 1980s when Emanuel was in med school and earning a Ph.D. in political philosophy from Harvard. "It drove him crazy when people walked around with Walkmen because he thought it destroyed the public space. He would walk up to total strangers and chastise them, telling them they were supposed to be interacting."

 

[RJGOP]

http://articles.philly.com/2012-08-...e-emanuel-staff-and-current-mayor-health-care
Once, first to finish a chemistry exam, Emanuel slapped his paper on the professor's desk, proclaiming the test terrible. The professor shot back, "Why don't you write your own?" Before the other students had finished, Emanuel returned with his improved version.

He didn't really want to be a doctor, he says, but his parents gave him little choice. He hated the hierarchical pedagogy of medical school and although his years as a breast cancer specialist were rewarding, he was frustrated by the country's broken health care system. So many avoidable problems were beyond a clinician's domain, he said. "I decided I'd rather work on changing the system."

Last year, after deciding to leave NIH, he considered several offers before picking Penn. Insiders, however, none of whom would speak on the record, said his arrogance limited his choices.

"He's not as good as he should be at recognizing when he should live and let live," says Keating, a law professor at the University of Southern California. He was in law school at Harvard in the early 1980s when Emanuel was in med school and earning a Ph.D. in political philosophy from Harvard. "It drove him crazy when people walked around with Walkmen because he thought it destroyed the public space. He would walk up to total strangers and chastise them, telling them they were supposed to be interacting."

He's an interesting character to say the least.

 

[RJGOP]

http://articles.philly.com/2012-08-...e-emanuel-staff-and-current-mayor-health-care
Once, first to finish a chemistry exam, Emanuel slapped his paper on the professor's desk, proclaiming the test terrible. The professor shot back, "Why don't you write your own?" Before the other students had finished, Emanuel returned with his improved version.

He didn't really want to be a doctor, he says, but his parents gave him little choice. He hated the hierarchical pedagogy of medical school and although his years as a breast cancer specialist were rewarding, he was frustrated by the country's broken health care system. So many avoidable problems were beyond a clinician's domain, he said. "I decided I'd rather work on changing the system."

Last year, after deciding to leave NIH, he considered several offers before picking Penn. Insiders, however, none of whom would speak on the record, said his arrogance limited his choices.

"He's not as good as he should be at recognizing when he should live and let live," says Keating, a law professor at the University of Southern California. He was in law school at Harvard in the early 1980s when Emanuel was in med school and earning a Ph.D. in political philosophy from Harvard. "It drove him crazy when people walked around with Walkmen because he thought it destroyed the public space. He would walk up to total strangers and chastise them, telling them they were supposed to be interacting."

Lol, sounds like me in elementary school.

 

[PL198]

http://articles.philly.com/2012-08-...e-emanuel-staff-and-current-mayor-health-care
Once, first to finish a chemistry exam, Emanuel slapped his paper on the professor's desk, proclaiming the test terrible. The professor shot back, "Why don't you write your own?" Before the other students had finished, Emanuel returned with his improved version.

He didn't really want to be a doctor, he says, but his parents gave him little choice. He hated the hierarchical pedagogy of medical school and although his years as a breast cancer specialist were rewarding, he was frustrated by the country's broken health care system. So many avoidable problems were beyond a clinician's domain, he said. "I decided I'd rather work on changing the system."

Last year, after deciding to leave NIH, he considered several offers before picking Penn. Insiders, however, none of whom would speak on the record, said his arrogance limited his choices.

"He's not as good as he should be at recognizing when he should live and let live," says Keating, a law professor at the University of Southern California. He was in law school at Harvard in the early 1980s when Emanuel was in med school and earning a Ph.D. in political philosophy from Harvard. "It drove him crazy when people walked around with Walkmen because he thought it destroyed the public space. He would walk up to total strangers and chastise them, telling them they were supposed to be interacting."

It's perfect someone with the last name Keating would comment on him, because I compare EE to a character from the fountainhead called Ellsworth Toohey. There's also a character in that book called Keating. While EE and Toohey have different demeanors, they seem to have very similar motivations.

inb4 sh*tstorm, I'm a randian nutjob, etc etc etc.

 

[DermViser]

It's perfect someone with the last name Keating would comment on him, because I compare EE to a character from the fountainhead called Ellsworth Toohey. There's also a character in that book called Keating. While EE and Toohey have different demeanors, they seem to have very similar motivations.

inb4 sh*tstorm, I'm a randian nutjob, etc etc etc.

I was thinking more of the criminal Charles Keating: http://en.wikipedia.org/wiki/Charles_Keating

 

[PL198]

I was thinking more of the criminal Charles Keating: http://en.wikipedia.org/wiki/Charles_Keating

I have no idea why I just read that, but somehow he convinced Cincy to accept his naval service as credit and he had to take 6 months of classes before he could enter law school, even though he only was in school for 1 semester the first time. That dude is a boss, all crime aside .

 

[Mskincer]

http://articles.philly.com/2012-08-...e-emanuel-staff-and-current-mayor-health-care
Once, first to finish a chemistry exam, Emanuel slapped his paper on the professor's desk, proclaiming the test terrible. The professor shot back, "Why don't you write your own?" Before the other students had finished, Emanuel returned with his improved version.

"He's not as good as he should be at recognizing when he should live and let live," says Keating, a law professor at the University of Southern California. He was in law school at Harvard in the early 1980s when Emanuel was in med school and earning a Ph.D. in political philosophy from Harvard. "It drove him crazy when people walked around with Walkmen because he thought it destroyed the public space. He would walk up to total strangers and chastise them, telling them they were supposed to be interacting."

don't know who I would rather punch in the face, Ezekiel Emanuel or George Clooney?

 

[Spikebd]

He's a bit odd, but he had valid points in this video. I agree with him that we should be cautious when increasing residency spots. He also showed true concern for primary care compensation and how us current med students will struggle to pay back loans if we have to go into primary care. Though, I wouldn't place my hope in any government program designed to help primary care. Too risky.

This video has me concerned for future anesthesiologists and radiologists. This guy is a main author of Obamacare and he is no friend to those two specialties.

He had no idea what to say when the guy asked him a question about malpractice, he basically just said other people somehow decided to take it out of legislation. I think he was trying to cover something up and that's why he acted so squirmy while he replied to that question.

 

[DermViser]

He's a bit odd, but he had valid points in this video. I agree with him that we should be cautious when increasing residency spots. He also showed true concern for primary care compensation and how us current med students will struggle to pay back loans if we have to go into primary care. Though, I wouldn't place my hope in any government program designed to help primary care. Too risky.

This video has me concerned for future anesthesiologists and radiologists. This guy is a main author of Obamacare and he is no friend to those two specialties.

He had no idea what to say when the guy asked him a question about malpractice, he basically just said other people somehow decided to take it out of legislation. I think he was trying to cover something up and that's why he acted so squirmy while he replied to that question.

He could care less about your compensation. His goal is to tip the PC to specialty balance to 70 PC : 30 specialist (which would just increase specialist salaries a lot due to scarcity of people in those fields). He also wants PCs to essentially just be administrators over PAs and NPs who will charge less to the system (in theory). He believes that it's the monetary incentives that drive students to become specialists. He is no friend to specialists in general - hence his screed on: Urologists, Oncologists, Dermatology, Radiology, Anethesia, Ortho, etc.

 

[Spikebd]

He could care less about your compensation. His goal is to tip the PC to specialty balance to 70 PC : 30 specialist (which would just increase specialist salaries a lot due to scarcity of people in those fields). He also wants PCs to essentially just be administrators over PAs and NPs who will charge less to the system (in theory). He believes that it's the monetary incentives that drive students to become specialists. He is no friend to specialists in general - hence his screed on: Urologists, Oncologists, Dermatology, Radiology, Anethesia, Ortho, etc.

Yea that's nonsense, if we do that our health system will be no better than a 3rd world country. The scary thing is this is the guy writing the legislation. Brilliant guy, but unable to see another persons point of view.

 

[RJGOP]

Yea that's nonsense, if we do that our health system will be no better than a 3rd world country. The scary thing is this is the guy writing the legislation. Brilliant guy, but unable to see another persons point of view.

Whether or not he can see the view point of other people is irrelevant. It's whether his plan coincides with his politicial agenda. Everything is politicized. The best interest of doctors does not fall under his crazy political ideology.

 

[DermViser]

Yea that's nonsense, if we do that our health system will be no better than a 3rd world country. The scary thing is this is the guy writing the legislation. Brilliant guy, but unable to see another persons point of view.

Oh, he sees the other point of view. He just doesn't care. His #1 goal is his political agenda which is to revamp the system. http://articles.philly.com/2012-08-...e-emanuel-staff-and-current-mayor-health-care: He hated the hierarchical pedagogy of medical school and although his years as a breast cancer specialist were rewarding, he was frustrated by the country's broken health care system. So many avoidable problems were beyond a clinician's domain, he said. "I decided I'd rather work on changing the system."

He believes too much of medicine is specialty driven hence why he believes he can tell GI docs and Breast oncologists how to practice and gets angry that they don't follow guidelines to the letter (hence why he can feel he can comment on when a colonscopy should be done w/o knowing the patient's history). I forgot to add to list above -- Urologists, Oncologists, Dermatology, Radiology, Anesthesia, Orthopedics, and Gastroenterology, etc.

 

[PL198]

Oh, he sees the other point of view. He just doesn't care. His #1 goal is his political agenda which is to revamp the system. http://articles.philly.com/2012-08-...e-emanuel-staff-and-current-mayor-health-care: He hated the hierarchical pedagogy of medical school and although his years as a breast cancer specialist were rewarding, he was frustrated by the country's broken health care system. So many avoidable problems were beyond a clinician's domain, he said. "I decided I'd rather work on changing the system."

He believes too much of medicine is specialty driven hence why he believes he can tell GI docs and Breast oncologists how to practice and gets angry that they don't follow guidelines to the letter (hence why he can feel he can comment on when a colonscopy should be done w/o knowing the patient's history). I forgot to add to list above -- Urologists, Oncologists, Dermatology, Radiology, Anesthesia, Orthopedics, and Gastroenterology, etc.

I don't understand that at all. Like primary care medicine is for the most part, maintaining chronic disease that isn't severe, health maintenance and referring to the proper specialists, unless my view of primary care is really wrong. specialists are the people responsible for acute care, which is what our system is built to emphasize. this just brings us back to all the BS metrics that rate US medical system as poor, which I believe place a huge emphasis on chronic care which isn't even really reflective of the medical system itself. My view is still that the US has the best health-care system in the world.

 

[DermViser]

I don't understand that at all. Like primary care medicine is for the most part, maintaining chronic disease that isn't severe, health maintenance and referring to the proper specialists, unless my view of primary care is really wrong. specialists are the people responsible for acute care, which is what our system is built to emphasize. this just brings us back to all the BS metrics that rate US medical system as poor, which I believe place a huge emphasis on chronic care which isn't even really reflective of the medical system itself. My view is still that the US has the best health-care system in the world.

Apparently, he believes it's the job of docs to keep you out of the hospital. Just like a job of dentist is to keep u from getting new cavities. Oh wait... A PCP being responsible for outcomes of patients is nuts.

 

[PL198]

Apparently, he believes it's the job of docs to keep you out of the hospital. Just like a job of dentist is to keep u from getting new cavities. Oh wait... A PCP being responsible for outcomes of patients is nuts.

yeah I mean its obvious if people would meet with dentists more, and that if there were physically more dentists that would just have to force people to brush their teeth. because we all know that the only things preventing people from proper oral hygiene are a) inability to meet with a dentist b) concern about the number of dentists. it has absolutely nothing to do with their health maintenance quality or desire to have good teeth

not srs

 

[adenocard]

http://archderm.jamanetwork.com/art...utm_source=@jamaderm&utm_content=new_research

Scope of Physician Procedures Independently Billed by Mid-Level Providers in the Office Setting
Results In 2012, nurse practitioners and physician assistants billed independently for more than 4 million procedures at our cutoff of 5000 paid claims per procedure. Most (54.8%) of these procedures were performed in the specialty area of dermatology.

Conclusions and Relevance The findings of this study are relevant to safety and quality of care. Recently, the shortage of primary care clinicians has prompted discussion of widening the scope of practice for mid-level providers. It would be prudent to temper widening the scope of practice of mid-level providers by recognizing that mid-level providers are not solely limited to primary care, and may involve procedures for which they may not have formal training.

 

[DermViser]

http://archderm.jamanetwork.com/art...utm_source=@jamaderm&utm_content=new_research

From the President of the American Academy of Dermatology no less! "Finally Congress could consider amending the 1997 Balanced Budget Act to align it with its original intent, by restricting independent Medicare payment of mid-level providers to evaluation and management codes to enhance access to primary care. This action would concentrate mid-level providers in their area of training and greatest need." --- Excellent idea for the PA/NP community to put their money where their mouth is.