Maybe it is time

[pathstudent]

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To accept the fact that we shouldn't get rich doing this. Even if private practice pathologists have their incomes slashed from 400 k to 225k that is still a great living and 4x the median income.

 

[pathstudent]

To accept the fact that we shouldn't get rich doing this. Even if private practice pathologists have their incomes slashed from 400 k to 225k that is still a great living and 4x the median income.

It is time to accept that the poor aren't accepting our bs anymore and we are now living in the era of wealth distribution. Obama is solely committed to reversing the Reagan revolution. Reagan redistributed wealth from the poor to the rich and now Obama is filtering it back

 

[Entgegen]

To accept the fact that we shouldn't get rich doing this. Even if private practice pathologists have their incomes slashed from 400 k to 225k that is still a great living and 4x the median income.

Not that I expected to ever really be "rich" from medicine (depending on your definition of the word), but why "shouldn't" we be, if that's what our income allows (allowed?) us to be? You make it sound as though there is something wrong with it.

 

[mcfaddens]

Obama is solely committed to reversing the Reagan revolution. Reagan redistributed wealth from the poor to the rich and now Obama is filtering it back

How does one redistribute wealth from the poor? That does not make any sense. The poor is poor, aka they have no wealth, how do you take something that does not exist? If you know how to take something that does not exist please let me know, Id like to get on this kind of action

 

[pathstudent]

Yeah it seems like pathology/medicine was a genteel profession where you were respected had a good living and had a country club membership. Then in the Due to the fed govt it became a way to get wealthy. Do you know that an 88305 paid nearly 90 dollars 15 years ago.

Well the country is now broke and 45 million people don't have insurance. Obama won an impossi le election and mow won a huge victory in what was considered impossible a month ago when Scott brown won.

Until the democrats are out of power wealth redistribution is our future like it r not

 

[pathstudent]

How does one redistribute wealth from the poor? That does not make any sense. The poor is poor, aka they have no wealth, how do you take something that does not exist? If you know how to take something that does not exist please let me know, Id like to get on this kind of action

By making the poor porrer and the rich richer. That us what has happened the lAst thirty years. The era od Reagan is over

 

[mcfaddens]

Oh I have a way better idea!!!!
Why don't we redistribute your computer from you rich guy to my hands, guess what you will get in return, the satisfaction that it was for the greater good. I think many on sdn would agree with this kind of redistribution.
On another note people keep posting on my thread its way better, more diversity of opinion.

 

[mcfaddens]

By making the poor porrer and the rich richer. That us what has happened the lAst thirty years. The era od Reagan is over

what is an era od? im lost

 

[mcfaddens]

pathstudent
no disrespect, im sure you love obama I can tell by looking at your avitar and if your game is stirring the pot with another viewpoint thats cool too, hey this is america right. but i would stray away from your total idolization of a particular viewpoint or an iconic leader, kind of reminds me of the nazi germany mentality.

 

[pathstudent]

The ironic part is that Obama will be worth a quarter billion dollars within ten years of his presidency and neither he nor his children nor their children will ever need to work again.

 

[Pingu]

To accept the fact that we shouldn't get rich doing this. Even if private practice pathologists have their incomes slashed from 400 k to 225k that is still a great living and 4x the median income.

225k after taxes IS a great living IF you haven't sacrificed 12+ years of your life and incurred hundreds of thousands of dollars in student loans OR if you aren't trying to live in a halfway decent neighborhood in a major metropolitan area.

I didn't choose to become a pathologist for the money. There are plenty of other ways for me (and just about anyone else) to make way more money than I do as a pathologist.

I just can't figure out what your overall argument is, though.

Do you somehow think that we as pathologists do not provide a valuable service? Why should our income be slashed in half while other professions with less education and training see their incomes increase?

The medicare reimbursement for the professional component on an 88305 is approximately $40. That's ridicuously cheap for the amount of expertise that goes into a diagnosis. $40 is a pedicure. $40 isn't even enough for a good steak. I can't even get my lawn mowed for $40.

Without pathology, the majority of medicine is essentially lost. A surgeon can biopsy as many moles or colon polyps as they want, but what the patient really wants to know is if it is cancer or not. And yet somehow no one knows what the heck a pathologist even is. That's pathetic.

What do you think the fair market value for our services should be? If a medical malpractice suit for a wrong diagnosis is hundreds of thousands of dollars, how much is a correct diagnosis really worth?

 

[mcfaddens]

225k after taxes IS a great living IF you haven't sacrificed 12+ years of your life and incurred hundreds of thousands of dollars in student loans OR if you aren't trying to live in a halfway decent neighborhood in a major metropolitan area.

I didn't choose to become a pathologist for the money. There are plenty of other ways for me (and just about anyone else) to make way more money than I do as a pathologist.

I just can't figure out what your overall argument is, though.

Do you somehow think that we as pathologists do not provide a valuable service? Why should our income be slashed in half while other professions with less education and training see their incomes increase?

The medicare reimbursement for the professional component on an 88305 is approximately $40. That's ridicuously cheap for the amount of expertise that goes into a diagnosis. $40 is a pedicure. $40 isn't even enough for a good steak. I can't even get my lawn mowed for $40.

Without pathology, the majority of medicine is essentially lost. A surgeon can biopsy as many moles or colon polyps as they want, but what the patient really wants to know is if it is cancer or not. And yet somehow no one knows what the heck a pathologist even is. That's pathetic.

What do you think the fair market value for our services should be? If a medical malpractice suit for a wrong diagnosis is hundreds of thousands of dollars, how much is a correct diagnosis really worth?

repost in the better original thread
thanks

 

[SkinPath]

The medicare reimbursement for the professional component on an 88305 is approximately $40. That's ridicuously cheap for the amount of expertise that goes into a diagnosis. $40 is a pedicure. $40 isn't even enough for a good steak. I can't even get my lawn mowed for $40.

Awesome, awesome post!!!

The liberals and progressives (as they'd like to call themselves) have always thought that it is bad for doctors to make money. But the lawyers (which most of them are) sure can. And actors and entertainers --- they too are mostly liberals and it is ok for them to make tons of money, simply by being born pretty!

 

[salt]

On another note people keep posting on my thread its way better, more diversity of opinion.

Nearly 25% of the posts in that thread are your own.

 

[salt]

And >75% of those are innane cheerleading continue-posts wherein you beg people to add more posts.

 

[Parts Unknown]

For me to stop posting my inane drivel in this forum.

Fixed.

 

[schrute]

Well the country is now broke and 45 million people don't have insurance. ...
Until the democrats are out of power wealth redistribution is our future like it r not

So...the country is broke, by your admission, and instead of objecting we should just accept it and move on...

I don't buy "inevitibility" as a principled position of support...like you're admitting the country is being financially run to the ground and you'd rather just get a free ride to the bottom than make a stand.

That's such a cop out...you have no principled argument to support the financial ruin of the country (other than speaking in terms of comparison to past presidents), just a complacent attitude to accept it.

 

[pathstudent]

I just can't figure out what your overall argument is, though.

Do you somehow think that we as pathologists do not provide a valuable service? Why should our income be slashed in half while other professions with less education and training see their incomes increase?

The medicare reimbursement for the professional component on an 88305 is approximately $40. That's ridicuously cheap for the amount of expertise that goes into a diagnosis. $40 is a pedicure. $40 isn't even enough for a good steak. I can't even get my lawn mowed for $40.

I guess you could opt out of medicare and try to negotiate with insurance companies to pay you 100 for an 88305. But hospital based pathologists kind of have to take it like it is unless your admin agrees not to admite medicare patients to the hospital. Even if you don't accept medicare, the federal govt has a law that you can only charge so much to a medicare patient.

The future will have to be a two tier system. Medicare-based hospitals and a handful of elite private ones where patients will pay 100 for PC on an 88305.

 

[LoaLoa]

To accept the fact that we shouldn't get rich doing this. Even if private practice pathologists have their incomes slashed from 400 k to 225k that is still a great living and 4x the median income.

Congratulations on this truly epic troll.

 

[path24]

I hope if path student ever makes 200+, they are sure to donate or not charge for all of that plus part. Put the money where his/her mouth is. What are the chances that happens????

 

[Nilf]

I guess you could opt out of medicare and try to negotiate with insurance companies to pay you 100 for an 88305. But hospital based pathologists kind of have to take it like it is unless your admin agrees not to admite medicare patients to the hospital. Even if you don't accept medicare, the federal govt has a law that you can only charge so much to a medicare patient.

The future will have to be a two tier system. Medicare-based hospitals and a handful of elite private ones where patients will pay 100 for PC on an 88305.

This is exactly what I am going to do.

 

[pathstudent]

This is exactly what I am going to do.

Well then no hospital based group will hire you nor any reference lab. And like I sort of explained you won't be able to charge seniors fee for service. The federal govt has some law that limits the max you can charge geezers. It says in effect "If we only give you 30 for an 88305, then you can only charge them 35 if you opt out of medicare" or something like that. In other words you can't bilk geezers. And to make it worse, I believe the govt gives the medicare rate to the patient and then you have to go try to collect it from the patient, and the geezer is probably saying "Screw it, I am going to die anyway, so I'll just keep the $30. Screw that pathologist guy, who the hell is he anyway. I never saw no Dr. Nilf. Is he even a real doctor? Don't pathologists just do autopsies and solve crimes".

You could try to start your own path lab and take only outpatient stuff and send out the medicare cases.

Or you could go into pediatric pathology.

 

[schrute]

....

So the Warhol Obama avatar wasn't doing it for you? What does John Merrick have to do with anything?

 

[Ziehl-Neelsen]

So the Warhol Obama avatar wasn't doing it for you? What does John Merrick have to do with anything?

Boom. Elephant Man reference.


And as far as the OPs original statement goes...

Aside from the assault on my liberties (which is my main objection to the bill), I'd happily work as a pathologist for 225 K a year. That's more money than I'll ever make in the military (though we have other benefits). But as far as medical specialties go, pathology sits smack dab in the middle of the Elysian Fields: continued intellectual stimulation, a self-set schedule, minimal interactions with demanding patients, minimal and easy call, etc. I can tell you who won't work for 225K--my wife. She's a Heme/Onc who deals with demanding and oftentimes unreasonable patients, constantly fights a losing battle in an emotionally and physically draining field, see hours of clinic after rounding on her inpatients, and of course has the occasional weekend totally ruined because a new leukemic strolls in on Friday afternoon or a patient develops ATRA syndrome. Her field (and a lot of others) sits smack in the middle of Tartarus.

And my wife's life doesn't come close to approaching the suck that is the lifestyle of the trauma surgeons or the neurosurgeons at our hospital (all of whom make more than me or my wife and absolutely should). Why do you think there is no wait to see a PCP in Canada or Britain but a 6 week wait for surgery. Some specialties in medicine require tremendous sacrifice, and those that make those sacrifices do so (in part) because the compensation allows them to provide a more affluent lifestyle for their family, retire early, etc. People ar going to find out the hard way exactly which physicians will continue to work for 225K.

 

[xanthines]

Well, there are more poor people than rich so all you do is redistribute some pennies or a dollar or two from each poor person and give to the wealthy. It adds up! Similar idea to Superman 3 and some dudes tried it in the '70's and got caught. Commence Office Space references... NOW!

-X

How does one redistribute wealth from the poor? That does not make any sense. The poor is poor, aka they have no wealth, how do you take something that does not exist? If you know how to take something that does not exist please let me know, Id like to get on this kind of action

 

[BrainPathology]

So...the country is broke, by your admission, and instead of objecting we should just accept it and move on...

I don't buy "inevitibility" as a principled position of support...like you're admitting the country is being financially run to the ground and you'd rather just get a free ride to the bottom than make a stand.

That's such a cop out...you have no principled argument to support the financial ruin of the country (other than speaking in terms of comparison to past presidents), just a complacent attitude to accept it.

OH please.. This bill is crap.. but to pretend that the alternative to the democrats is fiscal responsibility is rediculous.

Bankrupt the country so we can kill brown people or bankrupt the country so we can destroy medicine. We will have done both by the time I'm 45 yay!

I actually think the sooner the country goes into a huge crisis the better. The republicans have made being educated a dirty word. Being educated is now the same as being elitist. They have basically convinced an entire generation that it's better to be stupid and go to church than godless and smart. No one suggests it would be GREAT to be both. (Churchgoing and smarth.. not godless and stupid lol).

On the other hand, Democrats have everyone in their tent thinking that nobody has the common sense to decide anything for themselves and that ANYTHING bad that happens is the result of some unforseen disaster, bad parenting or evil rich people (as if being paid to do something HARD is a sin). Just as being educated is anathema to the republican base, being rich is anathema to democrats. The irony being most republican leaders are highly intelligent and educated and most democrats are rich beyond what most of us could ever achieve in the BEST days of medicine.

The republicans had nearly 2 full terms of controling everything.. all we got was debt and war, oh and an exclusively BRAND name perscription benefit for medicare. They could have gotten lawyers out of medicine, they could have contracted instead of bloated medicare they could have left their mark as restrained, CONSERVATIVE spenders.

Lets not pretend that THIS bill is the reason to NOW get angry.

 

[Nilf]

Well then no hospital based group will hire you nor any reference lab. And like I sort of explained you won't be able to charge seniors fee for service. The federal govt has some law that limits the max you can charge geezers. It says in effect "If we only give you 30 for an 88305, then you can only charge them 35 if you opt out of medicare" or something like that. In other words you can't bilk geezers. And to make it worse, I believe the govt gives the medicare rate to the patient and then you have to go try to collect it from the patient, and the geezer is probably saying "Screw it, I am going to die anyway, so I'll just keep the $30. Screw that pathologist guy, who the hell is he anyway. I never saw no Dr. Nilf. Is he even a real doctor? Don't pathologists just do autopsies and solve crimes".

You could try to start your own path lab and take only outpatient stuff and send out the medicare cases.

Or you could go into pediatric pathology.

bingo

 

[pathstudent]

Amusing comment to a CNN article

"We just passed a health care plan written by a committee whose chairman says he didn't understand it, passed by a Congress that exempts themselves from it, signed by a President that smokes, with funding administered by a treasury chief who didn't pay his taxes, all overseen by a surgeon general who is obese, and financed by a country that's broke"

 

[LADoc00]

Hold it, what?

STOP COVETING MY STUFF NANCY PELOSI! dont be all covetous, it makes the wierd veins in your head pop out.

Just say no to coveting your neighbors stuff.

 

[pathstudent]

I don't need your stuff. I own a vineyard, a pacific heights mansion, and millions of dollars of stock, and a real estate company.

My friend Obama will be worth a half billion dollars 30 years from now and will have every meal, every trip, private jets and every hotel comped for the rest of his life.

It is our reward for (your) wealth redistribution.

 

[mcfaddens]

And >75% of those are innane cheerleading continue-posts wherein you beg people to add more posts.

No S%$# Douche Its also gotten 1400 views and 44 replies, Im encouraging those 1400 views to post. Get a life instead of doing stats on SDN pathology.

(Sorry Yaah if you see this post this guy punched first I had to pummel him, he should also be banned for the lamest name on sdn ever)

 

[pathstudent]

The problem is that us younger attendings entered practice at a tine of great change. Go look at nyt right now there is article about how private practices are evaporating rapidly across all of medicine and now we also have this health bill which is about wealth redistribution as much is it as about healthcare.

I am severely worried about the impact on academic attendings like me. Reduced reimbusement will hurt our ability to have time to advance pathogy and be the vanguard of medicine.

But all of this bitching is more about expetations that won't be met more than anything else. The golden age of medicine was the 80s and early 90s. Pathology reimbursements have been cut 2/3 since then. Yes Medicare used to pay 90 to diagnose an 88305 back then. Now it has gotten closer to 30. Can it go any lower. Yes it likely will.

Well maybe you should have learned to hit a curve ball. Joe Mauer just got an almost two hundred million dollar contract to play baseball for the twins or maybe you should have gone into acting. Film star nineteen year old Kristen Stewart was seen shopping 10 million dollar homes in Beverly hills the last few days. You could work your whole life as a pathologist and unless you are Leboit, you could never by a 10,000,000 in malibu or beverly hills. Can you imagine being 19 and that being no big deal. So who is more important?

 

[LADoc00]

So Pathstudent is the intent to whip us into a frenzy and attack Nancy?

Because you could be putting any old white woman named Nancy in danger. A Pathologist's fists dont discriminate when they really get going. Just like Chuck Norris, the very first surgical pathologist ever.

Chuck will own Nancy.

 

[salt]

No S%$# Douche Its also gotten 1400 views and 44 replies, Im encouraging those 1400 views to post. Get a life instead of doing stats on SDN pathology.

(Sorry Yaah if you see this post this guy punched first I had to pummel him, he should also be banned for the lamest name on sdn ever)

57% of those 1400 views were you.

 

[salt]

And 8 of the 44 "replies" were you. so that really only 36 replies. Sorry.

 

[mcfaddens]

57% of those 1400 views were you.

Dude live with it you got spanked, Im rarely on this site, look at yourself you are doing stats on threads, Sorry I dont have time for that, Ive got a job and a life. Plus the come back " oh ... um .. well you looked at it 57% of 1400 times" is really lame. Just give up bro, and what kind of a name is "salt" anyway, do you have a mental block or are you just not that well versed in english or creativity. Please tell. Just give it up and go home.

 

[2121115]

pwned

 

[salt]

Im rarely on this site, .

1 out of every 5 replies on this thread are you.

 

[salt]

Sorry I dont have time for that, .

ibid

 

[Parts Unknown]

Just like Chuck Norris, the very first surgical pathologist ever.

I was just checking to see when Chuck Norris references were last in, and it was over 4 years ago.

Let us know when it gets to kitsch. I guess that's what happens when we become attendings...

 

[wild0ne]

I was just checking to see when Chuck Norris references were last in, and it was over 4 years ago.

Lol. That's what I was thinking. Next thing we know, someone's going to get rickrolled, a la 2008.

 

[yaah]

This thread is amazingly intellectual and stimulating. Just like politics.

 

[LADoc00]

This thread is amazingly intellectual and stimulating. Just like politics.

Once, while having sex in a tractor-trailer, part of Chuck Norris' sperm escaped and got into the engine. We now know this truck as Optimus Prime.

Fact SDN. Fact.

 

[SLUsagar]

To accept the fact that we shouldn't get rich doing this. Even if private practice pathologists have their incomes slashed from 400 k to 225k that is still a great living and 4x the median income.

I didn't bust my ass through high school, undergrad, med school, AND a top-notch residency for a mere 4x median. Sorry. ObamaCare owes me more than that.

 

[mcfaddens]

I didn't bust my ass through high school, undergrad, med school, AND a top-notch residency for a mere 4x median. Sorry. ObamaCare owes me more than that.

You have to understand that pathstudent does not have a job yet and he is fully content on making a living on his knees if he doesn't get one. Hey it is the worlds oldest profession

 

[mcfaddens]

and salt (what a lame name) will do his stats for him

 

[pathstudent]

I didn't bust my ass through high school, undergrad, med school, AND a top-notch residency for a mere 4x median. Sorry. ObamaCare owes me more than that.

You may feel entitled to that but that may not be available. The government can't make sure you earn 500K a year when it is running an enormous deficit and whose goal is to guarantee medical care for tens of millions of people (the elderly, the indigent, the uninsurable).

You should have considered plastics or cosmetic derm if money was the goal.

Or you should have went silicon valley or wall street route. The person I know who works at twitter says that average age of an employee there is 25 and they can all just cash out anytime for 8 figures (and those are just employees #15-25.) God only knows the founders could do. I know they aren't publicly traded but they have personal stock which other investors are eager to obtain.

Although I am from the opposite end of the spectrum, I agree with LADOC that US medicine will likely move to a two tier system where the ultra affluent and elite have access to medicine like it is today in and handful of hospitals like Mayo Clinic and satellites, Stafnord, Cleveland Clinic (and satellites), Harvard, Cedars Sinai and MSK and the like and the other 97% of Americans will be in the other system which is single payer government run like county/VA hospitals.

 

[salt]

and salt (what a lame name) will do his stats for him

That's the 3rd post in which you have pointed out the lameness of salt, and in 1 of those posts you question whether i "have a mental block" or am "just not that well versed in english or creativity". Not to mention that in 2 of those posts you tell ME to "get a life"!

I guess your "life" is so super fantastic that you have to take a break from it every once in a while to allow yourself to be baited by lame "lifeless" lame name having trolls like salt into pointless back and forths on internet message boards. Which you "are rarely on" and "don't have time for", no doubt due to your ultra stupendous "life". Wish my "life" was that grand.

Anybody home, McFaddie?

I criticized you, and fairly light heartedly I might add, for being self promoting. What you have on me is the lameness of salt. I guess salt stings when it hits a nerve.

 

[Pathwrath]

Maybe it's time to accept the fact that we shouldn't get rich doing this. Even if private practice pathologists have their incomes slashed from 400 k to 225k that is still a great living and 4x the median income.

I'm less concerned about whether doctors should or should not "get rich" plying their trade than whether "slashed" physician income affects quality of care. Having undergone multiple delicate surgeries with high risk, I do not begrudge my doc one penny of his fee.

It would be great if I could count on the same quality of care for a fraction of the cost, but unfortunately I also believe you more or less get what you pay for.

 

[yaah]

I'm less concerned about whether doctors should or should not "get rich" plying their trade than whether "slashed" physician income affects quality of care. Having undergone multiple delicate surgeries with high risk, I do not begrudge my doc one penny of his fee.

It would be great if I could count on the same quality of care for a fraction of the cost, but unfortunately I also believe you more or less get what you pay for.

I agree with that, although I might also suggest that too much financial incentive also negatively affects quality of care. I don't know where the balance lies.