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Maybe it is time
- Thread starter pathstudent
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From the House of God. If you keep on doing stuff to people sooner or later you can really hurt them. If doctors are financially incetivized to do stuff to patients sooner or later a patient is going to have something done to them that was unnecessary but that will hurt them.
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Really? Do you do a poorer job on a patient that you know is uninsured than the one that has insurance?
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I heard just friday of a patient that had a blastoid mantle cell leukemia (i.e. a peripheral count of 60K with the t(11;14) translocation.)
The patient was uninsured as he was a self employed computer science person and was not given insurance by multiple entities. A local community practice oncologist treated him with hyper CVAD for free, but he was unable to get his definitive treatment of an allo-SCT due to his lack of insurance.. Now he is dead. So I think that the general populace feels much more for people like him than people like SLUsugar who busted their ass in medical school but now can't earn 500K a year and can only earn 300K a year.
A certain percentage of those uninsured patients that will now have insurance will survive, so I think the general voting populace will side with the patients rather than SLUsugar who busted his ass in H.S. to got to Stanford residence with the expectation of earning 500K a year.
It is time to deal with this people. What you expected isn't what is reality. Hopefully you picked you specialty because you enjoyed if. If you don't, drop out and go into something else.
The patient was uninsured as he was a self employed computer science person and was not given insurance by multiple entities. A local community practice oncologist treated him with hyper CVAD for free, but he was unable to get his definitive treatment of an allo-SCT due to his lack of insurance.. Now he is dead. So I think that the general populace feels much more for people like him than people like SLUsugar who busted their ass in medical school but now can't earn 500K a year and can only earn 300K a year.
A certain percentage of those uninsured patients that will now have insurance will survive, so I think the general voting populace will side with the patients rather than SLUsugar who busted his ass in H.S. to got to Stanford residence with the expectation of earning 500K a year.
It is time to deal with this people. What you expected isn't what is reality. Hopefully you picked you specialty because you enjoyed if. If you don't, drop out and go into something else.
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I heard just friday of a patient that had a blastoid mantle cell leukemia (i.e. a peripheral count of 60K with the t(11;14) translocation.)
The patient was uninsured as he was a self employed computer science person and was not given insurance by multiple entities. A local community practice oncologist treated him with hyper CVAD for free, but he was unable to get his definitive treatment of an allo-SCT due to his lack of insurance.. Now he is dead. So I think that the general populace feels much more for people like him than people like SLUsugar who busted their ass in medical school but now can't earn 500K a year and can only earn 300K a year.
A certain percentage of those uninsured patients that will now have insurance will survive, so I think the general voting populace will side with the patients rather than SLUsugar who busted his ass in H.S. to got to Stanford residency with the expectation of earning 500K a year.
It is time to deal with this people. What you expected isn't what is reality. Hopefully you picked you specialty because you enjoyed if. If you don't, drop out and go into something else.
The patient was uninsured as he was a self employed computer science person and was not given insurance by multiple entities. A local community practice oncologist treated him with hyper CVAD for free, but he was unable to get his definitive treatment of an allo-SCT due to his lack of insurance.. Now he is dead. So I think that the general populace feels much more for people like him than people like SLUsugar who busted their ass in medical school but now can't earn 500K a year and can only earn 300K a year.
A certain percentage of those uninsured patients that will now have insurance will survive, so I think the general voting populace will side with the patients rather than SLUsugar who busted his ass in H.S. to got to Stanford residency with the expectation of earning 500K a year.
It is time to deal with this people. What you expected isn't what is reality. Hopefully you picked you specialty because you enjoyed if. If you don't, drop out and go into something else.
Ahhhhh... The hardcore left --- always ruled by emotions and always the righteous ones, as if no one else in the world, other than themselves, did anything good for others...
No, I don't think it works that way. At least I've never seen docs make that kind of distinction.
It's the cumulative hassles that are weighed in comparison with compensation and future compensation. It's developing a shift-work, not-my-problem attitude that is associated with commoditized, over-regulated work everywhere.
Well said.
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Once again, you fail to understand the big picture here and have no sense of the real world as a practicing pathologists. NO ONE expects to earn 500K (including myself), and VERY few pathologists even get that close, so please get your facts straight. The point is that our specialty is already under-represented at AMA, which every day of the week is going to side with the other more fascinating (and lucrative) specialties like GI, neurosurg, etc. AMA frankly could care less about pathology. Once ObamaCare throws out the bundled $ pie for dividing, I'm concerned that typical and classic low-key path is going to just sit back and patiently wait while everyone else gets their cut (and perhaps takes a bit extra for tomorrow's lunch) while we are left fighting for scraps. Talk to folks like Ms. Jane Pine Wood (ASCP) and you'll see what I mean (on an aside, although I'm glad she's fighting on our behalf in gov't, 1 person can't do it all).
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My limited understanding of the health care overhaul is that it is essentially a cost control measure on national spending that had appeared to be going out of control. ( I hope we can agree on this point)
So I thought that we, as whole, should try to do something to fix it.
The best solution I think is rationing health care. We may or may not agree on this point.
I also think that covering uninsured is also part of cost control. we do not what these people to come through ER.
We want to do it right for less rather than for more. But our current system, we are incentivized to do more. Doing more leading to better outcome is another debate. Legal issue is another.
Although some group, like lawyers and maybe union members, are getting untouched, it seems to me that it is a global measure to reduce the spending.
Companies, like AT&T, Boeing, and caterpillars, are now responsible to some prescription drug coverage for their retirees. (Isn't that right?)
In this environment of shrinking resoruce, there are some of pathologists who think that we will get screwed by other power players, like our clinician colleagues, hospital admin, pharmaceutical industry, etc. This may be true. Good example would be urologists with their pod labs to recover their lost revenue(Lupron injection).
I think I am hearing most/loudest from pathologists who are private practice type who are vested, the entrepreneur type.
In my opinion, any investment is associated with risks. My medical degree is an investment (although safer than most but also very costly) that I made long time ago. I want this investment to pay off well. What that means, i don't know yet. But i know that i will have to wait longer to get that million dollar house that my wife wants. Heck, i would like to get rid of school loans first.
I think that we should do something to protect our investment. Some think that there won't be drastic change. Others predict that it will be worse. Do we know anything for sure? Is there anything we can do?
good luck to anyone who is looking for jobs btw. i accepted my current job around this time last year. sometimes you have to wait it out. many i knew decided to take a fellowship offer because didn't want to deal with anxiety. This might be another reason why so many stay in their training program as instructor. We pathologists, if i may make a general statements, prefer stability. We may disagree on that too.
So I thought that we, as whole, should try to do something to fix it.
The best solution I think is rationing health care. We may or may not agree on this point.
I also think that covering uninsured is also part of cost control. we do not what these people to come through ER.
We want to do it right for less rather than for more. But our current system, we are incentivized to do more. Doing more leading to better outcome is another debate. Legal issue is another.
Although some group, like lawyers and maybe union members, are getting untouched, it seems to me that it is a global measure to reduce the spending.
Companies, like AT&T, Boeing, and caterpillars, are now responsible to some prescription drug coverage for their retirees. (Isn't that right?)
In this environment of shrinking resoruce, there are some of pathologists who think that we will get screwed by other power players, like our clinician colleagues, hospital admin, pharmaceutical industry, etc. This may be true. Good example would be urologists with their pod labs to recover their lost revenue(Lupron injection).
I think I am hearing most/loudest from pathologists who are private practice type who are vested, the entrepreneur type.
In my opinion, any investment is associated with risks. My medical degree is an investment (although safer than most but also very costly) that I made long time ago. I want this investment to pay off well. What that means, i don't know yet. But i know that i will have to wait longer to get that million dollar house that my wife wants. Heck, i would like to get rid of school loans first.
I think that we should do something to protect our investment. Some think that there won't be drastic change. Others predict that it will be worse. Do we know anything for sure? Is there anything we can do?
good luck to anyone who is looking for jobs btw. i accepted my current job around this time last year. sometimes you have to wait it out. many i knew decided to take a fellowship offer because didn't want to deal with anxiety. This might be another reason why so many stay in their training program as instructor. We pathologists, if i may make a general statements, prefer stability. We may disagree on that too.
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When financial motivation becomes the primary driver behind administration of care, the other drivers of care become secondary priorities. Thus, you do things in order to make money. A procedure or patient that will make you more money becomes more important than one who will not, even if the former is more risky, of uncertain benefit, or has more questionable indications. In addition, when financial motivation becomes the primary driver the incentive is to do as many of these things as possible, which goes in hand with doing them as quickly as possible. While efficiency is increased, at times quality and care can suffer. There are other reasons also.
Note that there are similar problems when financial motivation is completely dissociated from the task at hand. Some hospitals are great examples of this - if your salary is the same no matter what you do or how effective you are, care can also suffer.
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We cannot all agree on this point. The bill is about expanding coverage, not controlling cost. It is made to appear deficit neutral or even to decrease the deficit by postponing various provisions and by assuming there will be long term savings by expanding coverage. There is little agreement what the ultimate cost or savings will be.
