operationivy

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Why is the internal medicine forum "silent" when it comes to discussion about medicare cuts? I realize that this topic has been covered in other forums, but this subject is critical to internists, subspecialists and students/residents who are making career decisions. It is this silence that equates to lack of lobbying power and ultimately the ability for politicians, insurance companies and lawyers to walk all over physicians. What is the AMA doing for internists and subspecialists? Why are the surgeons, anesthesiologists and radiologists all over this topic and the internists seemingly indifferent?
 

mercaptovizadeh

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Why is the internal medicine forum "silent" when it comes to discussion about medicare cuts? I realize that this topic has been covered in other forums, but this subject is critical to internists, subspecialists and students/residents who are making career decisions. It is this silence that equates to lack of lobbying power and ultimately the ability for politicians, insurance companies and lawyers to walk all over physicians. What is the AMA doing for internists and subspecialists? Why are the surgeons, anesthesiologists and radiologists all over this topic and the internists seemingly indifferent?
Because at the moment the pendulum is swinging against imagine, which hurts rads and cardio most, and rad/onc has been hit because they're lumped with these guys. General internists and most medicine subspecialties haven't been hit by the new medicare reimbursement proposal.
 

Kitra101

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Because at the moment the pendulum is swinging against imagine, which hurts rads and cardio most, and rad/onc has been hit because they're lumped with these guys. General internists and most medicine subspecialties haven't been hit by the new medicare reimbursement proposal.
Just an FYI for you -

You are correct. The cuts are meant to target specialists and increase demand to have AMGs go into primary care. Arguably, one of the reasons specialists are paid more for their services is because they train longer. Radiologists now train for 6 years after medical school. Longer training is also required for the medical subspecialties who traditionally get paid more. If Obama had his way, he would have family docs reading the MRIs, doing the surgeries, doing caths, etc. The reason why specialization exists is the medicine is too broad to be an expert in everything. Obama's complete unwillingness to pursue tort reform shows that he is not going to help the family docs that get sued for attempting to fill the role of the specialist. Furthermore and most important of all:

Obama has run a very successful and insidious campaign to help himself in his own political aspirations. The truth is that he knows very little about how health care works and cherry picks his data to make his case to the also generally uninformed public. The result from the AMA is go belly up and instead of explaining truth to the public, get sweeped up in Obama-mania.

Time and time again, Obama shows just how little he knows about medicine. Case in point and one of my favorites so far: At the last "town hall meeting" he said that reimbursement is done in such a way that if you bring your child to the doctor for a sore throat, rather than going ahead with conservative medical treatment or dealing with possible allergies, the physician (who in this case would be a pediatrician) would elect to take the child's tonsils because he/she is paid more for procedures. I ask you - when was the last time you heard of a pediatrician doing an tonsilectomy? NEVER. In fact, a referral to the ENT to have such a procedure done would not benefit the pediatrician financially whatsoever and would only be done in the patient's interest. However, this is what Obama thinks medicine is like and he wants to come in and take over and say how medicine should be done. Really?

The reality is this - he cares nothing about physicians - at all. He cares about one thing - lowering costs. He cares about this because he wants to get a quick fix to the health care problem so that the general public will hail him as one the best presidents of all time. This means, in order to prevent experts in the field from stepping out and publicly correcting his obvious mistakes and tearing up his campaigns, he had to divide the experts. He did this in quite a clever way - PCPs VS specialists. He makes 20% cuts to the specialists while increasing PCP pay by 8%? Where does the remaining 12% go? Who knows. More importantly, if PCPs can do the same thing as specialists for cheaper, why not replace PCPs with even cheaper nurse practitioners and physician assistants? BINGO - that is what he plans to do!! That is how he will fill this gap of PCPs that the nation faces because in a time of suddenly unprecedented access to medical care (socialized medicine) with a great shortage of PCPs (which will take minimally 3+ years to correct), he will have the golden opportunity to seek legislation that expands the power of alternative health care providers.

So in summary, comments like:
Because at the moment the pendulum is swinging against imagine, which hurts rads and cardio most, and rad/onc has been hit because they're lumped with these guys. General internists and most medicine subspecialties haven't been hit by the new medicare reimbursement proposal.
Really means that while you fight for the scraps at Obama's table, he will slowly have you dig your own graves. The day of the PCP will come to an end because why pay you twice the cost for a NP or PA who could do the same for half the price. At this point, who will come to your rescue against the politicians? Not the specialists - they will try to keep out of it just like you are doing now.

The truth - the medical community needs to come together address the public. If we allow Obama to talk as if his word is fact, the above is our fate. We will work the same for less pay (if we are not replaced by alternative health care providers) and will have no tort reform and no decrease in our medical school debt. There are a lot of bogus facts out there that need dispelling. For example, Obama time and time again says we pay so much more than other countries with nothing to show for it. We have plenty to show for it - he just leaves out confounding factors. Yes, our life expectancy may be shorter than other developed nations, but on the other hand, other nations are not as obese. This is never taken into account. The idea that obesity is a problem in our nation is laughed at in my opinion. For example, check out CNN.com's main article today. It is run from Elizabeth Cohen's empowered patient section. It is about how bad doctors are because they discriminate against skin color and obesity. He article comes to the conclusion that doctors discriminate against obese patients because a survey of doctors showed that doctors have a negative attitude towards obesity. Of course they do - it is associated with many medical problems, health care dollars, disability, medication, etc. This is another example of how we, as the medical providers, are being slammed my lay people to the public without any forum to reveal truth to the general public. Ms. Cohen would be surprised to know about the patients who come in for diagnostic imaging and cannot fit into the scanner. She would be surprised to know that not only does it increase risk for DM, CAD, CVD, CVA, MI, but also it can increase the risk for estrogen receptor positive cancer in women. Wow! You mean obesity contributes to the two leading causes of death in women in the US??? Conveniently left out of her article.

We as medical students, residents, private practitioners and attending physicians are in this together and desperately need to come together and put facts out there so that the public can be informed about what is really going on - not just what goes on in some alternative reality that Obama, Ms. Cohen and company have dreamed up (unless someone here knows that pediatrician he is talking about that does T and As).
 

OptimusPrime

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quite a mouthful of a reply. feel your pain bro but this whole "we as physians should get together and push for (blank)" is never going to happen. I wish it would but it just will not. Broadly speaking political action and business mindedness is not our thing bro (again i wish it was). we were specifically selected to make it this far because generally speaking we are good at shutting up, sealing ourselves from the world, cramming some stupid subject and purging all the knowledge on a test day. rinse, repeat. x10 years or so.

why do you think we let insurance companies run all over us, dictating everything from what we can order to what we get paid for what we order. Obama got the crowd and the charisma. he means well but his ideas are misguided. just sit back, take a pepto and let this mess wash over us. and encourage your genius kid to go work for AIG instead of becoming a physician, that way even if he causes another worldwide financial meltdown it only reduces his bonus from a few mils to couple hundared thousand per year ;-)
 

Kitra101

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I understand what you are saying - we are the nerds of the world generally speaking. That said, none of this is in the interest of the general public. While I am pretty upset that:

1. Politicians now dictate our salary and year by year chip it away
2. My medical school tuition went UP this year and continues to increase
3. No one will ever offer a bailout to us out
4. There will be no effort for tort reform which means malpractice will continue to rise
5. There will be a stronger drive to work more hours with total access to the entire nation whenever wanted and regardless of what the clinical scenario is
6. No one talks about cutting Obama's 400,000 USD salary of the nice salaries of congress, etc. No one talks about cutting entertainers' salaries.
7. We train longer and harder than any other job out there - period.

All of the above I resent strongly.

However, there is something worse out there -

1. We are not only allowing them to destroy us financially, but now we have been effectively dragged through the mud publicly. Obama and company have opened the floodgates to spread lies and misinformation about us to discredit us even further. Being a doctor was once a respectable profession where people listened to what you said and together, you and the patient could form a personal relationship where you, the expert, took the most current medical information and applied it in a manner most beneficial and acceptable to the patient. We do not deserve this and neither do patients.

2. Greedy politicians like Obama, Bush, etc care nothing about the people and in reality just care about their political ambitions. All Obama cares about now is increasing his popularity so that he can be re-elected. This shows through in that he is strongly pushing for fast and sweeping legislation in so many areas declaring himself a savior as he does it while in reality it is apparent that he is very misguided. Once again, the fact that he does not understand that pediatricians never perform surgery blatantly shows how misguided he is, yet he wants to quickly push congress to give the government the authority to ultimately assume complete control over the medical profession. To use his completely overused phrase/gimmick:
"Lets be clear..." Offering a save money at all costs to have coverage for all Americans, be it minimum and with many delays, while mandating employer coverage will do one thing - shift the vast majority of employers to the government plan which will ultimately drive private insurance companies out of business. Presto! Complete and indirect government takeover. When the American people get the efficiency and quality of VA care all the time with delays for months, we will see how popular Obama will be.
 

spyyder

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If you don't want to do the time then don't go into a specialty. Its about time deserving students got to go into the specialty of their choice instead of being bumped by those chasing money. 100k is more than enough for a physician of any specialty level.
 

OptimusPrime

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Well Spyyder the issue is a bit more complicated than just 100K yearly salary should be enough. Although I agree that 100K per year is no small amount and plenty of Americans live just fine on that amount. With that said most of your average Americans do not go through 8+ years of education and additional residency training prior to actually entering what we call the work force. Furthermore most Americans once they do enter the work force are not on average in their late 20s or early 30s with anywhere between 100K to 250+K in loans already on their back accumulating interest on yearly basis. It is a bit different and again while some physicians can and do live normal lives with 100K per year it is not the most comfortable life.

I understand that there are those among us that dedicate their lives to purely saving lives for the honorable cause that it is and those tend to travel frequently to 3rd world countries and volunteer their expertise. But for most that stay in the states they plan on raising a family, buying a house/car, saving for their children’s school tuition. It ads up bro. Why should physicians with all their sacrifices (10 years in the library studying for midterm after midterm) have to learn to squeeze a dollar out of 15 cents.

More troubling is that over the next decade as medical school tuition rises, length of residencies increases (if ACGME keeps insisting on make ******ed changes such as mandatory five hour nap time for interns than some residency may increase by a year), and if malpractice insurance is left unregulated and physician salaries decline… believe it or not some of the brightest young minds in our high schools and colleges may decide that it might be a much better idea to become a lawyer, a businessman or financial analyst (AIG anyone) than go the noble route of becoming a physician and that will be the true travesty of this whole process as we need the brightest minds to form the future of medicine.

Things are never just black or white.
OP
 

jdh71

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If you don't want to do the time then don't go into a specialty. Its about time deserving students got to go into the specialty of their choice instead of being bumped by those chasing money. 100k is more than enough for a physician of any specialty level.
are you a ******?
 

Larry Renal

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If you don't want to do the time then don't go into a specialty. Its about time deserving students got to go into the specialty of their choice instead of being bumped by those chasing money. 100k is more than enough for a physician of any specialty level.
You sound like a socialist. Medicine, like most jobs in the US is thankfully a free market. Physicians should be able to make as much money as they want, just like the rest of the capitalistic world. The government should have nothing to say if someone wants to work hard and increase their earnings, either by doing a fellowship or working their tail off to generate revenue.

Sure, I'll put in 14 years after high school, endless studying, late nights, critical decisions, life and death, delaying starting a family, not seeing my family, working 80 hours a week, 30 hour shifts etc. and then sacrifice my financial renumeration so someone who has NEVER done that can get government health care.

This whole health care proposal (structure and how it's being paid for) is just more of typical obama taking from the "haves" and giving to the "have-nots."
 

DrWBD

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Sure, I'll put in 14 years after high school, endless studying, late nights, critical decisions, life and death, delaying starting a family, not seeing my family, working 80 hours a week, 30 hour shifts etc. and then sacrifice my financial renumeration so someone who has NEVER done that can get government health care.
So you're against Medicare?
 

dreamfox

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If you don't want to do the time then don't go into a specialty. Its about time deserving students got to go into the specialty of their choice instead of being bumped by those chasing money. 100k is more than enough for a physician of any specialty level.
you must be one of those dnp's trying to be called a doctor with 6 months of online classes.
 

Labslave

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you must be one of those dnp's trying to be called a doctor with 6 months of online classes.
Nah, he just likes to ruffle feathers.

Physicians across the board (besides primary care docs - they're already eating at McD's every night) are going to have to be willing to take pay cuts, people. Despite the fact that we account for only a small fraction of total healthcare costs, what kind of message would it send to the general public if we demanded cost cuts throughout the rest of the system and didn't take a cut ourselves?

I certainly wouldn't advocate a system in which everyone was making 100k/year, but for there to be so much opposition to the idea of shaving physician salaries is impractical.
 

jdh71

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jdh71

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Nah, he just likes to ruffle feathers.

Physicians across the board (besides primary care docs - they're already eating at McD's every night) are going to have to be willing to take pay cuts, people. Despite the fact that we account for only a small fraction of total healthcare costs, what kind of message would it send to the general public if we demanded cost cuts throughout the rest of the system and didn't take a cut ourselves?

I certainly wouldn't advocate a system in which everyone was making 100k/year, but for there to be so much opposition to the idea of shaving physician salaries is impractical.
Oh gawd . . .

I hate the way this discussion always tends to find itself in the strawman territory with the argument from the government, loving social engineer being, "ur jus greeeeedy!!"

No genius. This has nothing to do with greed, even if most people cannot or will not specifically articulate the argument against this bull****. The reaction is against an ideology, and ideology that says that there are people best described as "philosopher-kings" who know best about how much money I can and should make - they know what I "need" and what I "don't need". And in their attemps to socially engineer society in such a manner that they find equitably just, they would place limits on those who they see as doing better than someone else, and I guess, this just isn't fair, right, because the people doing well don't "need" to do well, right? **** that mess. The reaction to that kind of thinking is the natural right to liberty that all men have inside them that says, "I have a right to work as much as I like and make as much money as the market will bear for my services." Anyone who would insist on placing limitations on this interaction is nothing more than tyrant - I don't live for you and nor you for me. Yet these people through the force of men with guns would like it otherwise.

Healthcare is not a right, it is a good and service. You want to lower healthcare costs within the context of the free-market and in a way that does not inhibit the freedom of the individual? Fine, then please pay attention to supply and demand - a very simple and established economic principle. What happens to the price when any good or service supply goes up? That's correct, price goes down. The solution is more health professionals and hospitals, NOT government controls.
 

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The reaction is against an ideology, and ideology that says that there are people best described as "insurance companies" who know best about how much care I should receive - they know what I "need" and what I "don't need". And in their attempts to profit off the backs of the American people in such a manner that they find most profitable for their CEOs, they would place limits on those who expect care in exchange for exorbitant premiums, and I guess, this just isn't fair, right, because the common people doing well don't "need" to do well, right? **** that mess....Anyone who would insist on placing limitations on this interaction is nothing more than a sellout liberal elitist ... Yet these people through the force of the will of the American people would like it otherwise.
Fixed that for you.
 

jdh71

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Fixed that for you.
How intellectually dishonest.

So were you planning on merely being a doubhebag per this discussion or what? Because if you're planning on being ****tard, you can save us both a lot of time by letting me know now. I mean it's ok if you cannot actually discuss this issue in your own words like a decent human being - doesn't make you a bad person, mildly ******ed perhaps but probably not a bad person. Some people just can't hang.
 

DrWBD

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How intellectually dishonest.

So were you planning on merely being a doubhebag per this discussion or what? Because if you're planning on being ****tard, you can save us both a lot of time by letting me know now. I mean it's ok if you cannot actually discuss this issue in your own words like a decent human being - doesn't make you a bad person, mildly ******ed perhaps but probably not a bad person. Some people just can't hang.


First, I don't think you know what "intellectual dishonesty" really means. I've provided a definition for your review here. For me to be intellectually dishonest, there would have to be overwhelming evidence that I am wrong and that I am arguing despite that. While you might think that your rant is gospel, it is still your opinion. In fact, if there was anything factual in your screed back there you might want to point it out for us.

Second, it's called levity and satire, not being a 'douchebag'. Do you really have such difficulty accepting that intelligent people think differently than you?

Third, you can stop flexing your e-penis. I doubt you would address any attending physician with such a condescending tone in real life.

Fourth, if you think I'm such an idiot why don't you educate us with something objective to support your position?
 
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jdh71

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First, I don't think you know what "intellectual dishonesty" really means. I've provided a definition for your review here. For me to be intellectually dishonest, there would have to be overwhelming evidence that I am wrong and that I am arguing despite that.
Actually, it was intellectually dishonest to take my words and then reword them and act as if that was the way it should have been said.

While you might think that your rant is gospel, it is still your opinion. In fact, if there was anything factual in your screed back there you might want to point it out for us.
My "rant" was anything but "my opinion" with regards to the right of a man to make a living and be unmolested in that endeavor by men with guns who think they know what is best for me or anyone else - that is tyranny and has been well established in political philosophy as such. You have yet to rebut any of that.

Second, it's called levity and satire, not being a 'douchebag'. Do you really have such difficulty accepting that intelligent people think differently than you?
No I don't have a problem accepting other people think differently from me. But the "intelligent people" actually engage in rational discussion. You so far have done none of that, and that is two posts and counting.

Third, you can stop flexing your e-penis. I doubt you would address any attending physician with such a condescending tone in real life.
You think that simply because you are done with your training that this grants you some sort of ****ing magical pass on the thinking and logic here with regards to political discussion, you are strangely deluded. Would I talk to one of my attending like this in real life? No. As a practical matter it would be rather inexpedient to not only work that day but career in general - it's a power position see? This, however, is the ****ing interwubz, have ya heard? And you have no, as in zip, zero, zilch, expectation that anyone is going to kiss your ass simply because you are an "attending".

Fourth, if you think I'm such an idiot why don't you educate us with something objective to support your position?
I've already given you an objective opposition in my original post.

Why don't you, try and respond? Two posts now, and no such response - you have spent a decent amount of time here trying to attack my definitions and my character - so can you respond to the original points or not? I'm beginning to think to can't, and I suppose that doesn't necessarily make you an idiot, but it does make it seem strangely suspicious.
 

Kitra101

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Dr. Wannadobe (yes I would address you that out of respect because I am a member of an organization where respect is given to their elders/experienced, though I feel that outside of the system, many patients and so called "experts" who write about how healthcare should run will offer no such respect),

In the mean time, I will offer the quote from what one medical student wrote on Sanjay Gupta's blog (a feeling shared by myself and others):
"Dr. Gupta,
I just graduated from medical school with over $280,000 in debt. How do you think the Health Care Reform policies will impact doctor's compensation? Do you think there will be anything included in the bill to reduce the burden on young and future physicians?
Thanks"

What about us? We are currently being made into villians and the fact that the AMA goes belly-up in an effort to seek approval from the Obama administration, an administration that cares nothing for the lives of the physicians and instead targets them as the core problem of healthcare, is absurd. I will repeat what I said earlier and ask you to defend President Obama's recent blunder comment:

"Right now, doctors, a lot of times, are forced to make decisions based on the fee payment schedule that's out there. So if they're looking and -- and you come in and you've got a bad sore throat, or your child has a bad sore throat, or has repeated sore throats, the doctor may look at the reimbursement system and say to himself, "You know what? I make a lot more money if I take this kid's tonsils out."
Now, that may be the right thing to do. But I'd rather have that doctor making those decisions just based on whether you really need your kid's tonsils out or whether it might make more sense just to change -- maybe they have allergies. Maybe they have something else that would make a difference."

I again pose, now to you, the question - Since when do pediatricians remove tonsils? Clearly, this is yet another example of when Obama is misinformed, yet leads his witch hunt against the evil physicians. He and people like Elizabeth Cohen from CNN and many other public personalities are doing a great job of dragging our once good name through the mud. What does AMA do? Agree with him. He made clear at his AMA address that tort reform, one of the things AMA wanted in negotiating with him, was not a top priority. He is a lawyer, just like the rest of his colleagues and therefore, this is not an issue to him.

Most importantly to me is the fact that politicians are completely full of hot air. Think of what a politician has to do in order to get elected. They are consumed by their quest for power and in doing so make poor long term decisions. To make things worse, when the next administration comes to power, they can make the situation worse. If Obama puts this into effect and the government plan severely cripples private insurance (leaving mainly government as the option selected by most businesses), what happens if the next administration cuts from this plan? They have a monopoly and healthcare is in disarray.

Most importantly to me is this - as Obama is a politician who is only concerned with his re-election and his legacy, he does not want to address the true issue at hand: personal responsibility. As a primary care physician, you of all people know the problem with patients who do not take responsibility to learn about their disease and comply with their recommended therapy. Obesity is a prime example of this problem. Billions of dollars are spent dealing with the obesity related health problems each year (not to mention the disability from work and lack of productivity that these patients suffer from). This is not the "make fun of the fat kid on the playground cause we are mean people" routine. This is a matter of dire need to control this problem. It is a significant cause of morbidity, mortality, disability, lack of productivity and spiraling health care costs. However, can you imagine if Obama pushed to somehow enforce patient compliance/involvement in their healthcare? I could see the impeachment hearings beginning. The same is true for the housing market. Do you realize what happened? Poor long term planning by previous administrations allowed for people to be sold homes they could never hope to pay back. At the core of this problem, there were a lot of people out there who knew it was too much, but lacked the responsibility to say "I cannot afford this." As a result, we had the bubble burst and everyone demanded answers. Obama could not ask those people pointing their fingers in every direction to look at the three fingers in their hand pointing back at them (political suicide). Instead, he looked for the scape goat - banks. He pointed to the wealthy bank CEOs and said "they did this to you" and lead the march. I agree that the banks were partly to blame, but the blame must shift back to the people who bought the homes as well. Similarly, the blame can come down partially on physicians as some may over-order tests (whether to pad the bottom line, to cover their asses from a liability issue or because they are immoral people), but a large portion of blame does lie in the American public and the lifestyle choices we make.

Interestingly, on a related note, I have noticed multiple people ask him questions pertaining to curving end of life care. He cleverly gets out of the situation without answering those tough questions. Why should he have to do it? He can demand congress to pass a bill and somewhere in the 11,000 page bill, there may be regulations for end of life care. For example, for the 50 year old dad who is diagnosed with GBM, are we going to tell him and his family, "You are going to die regardless and the XRT, chemo and surgery may give you hope and/or prolong your life a few months, but it is not worth the cost?" Obama does not want to touch that with a ten foot poll, but the reality is, this is how complex this problem is and issues such as that need to be addressed head on (not avoided).

Dr. Wannadobe, as an attending with much more experience, I implore you to please comment and answer my questions because I am very lost right now.
 

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Oh gawd . . .

I hate the way this discussion always tends to find itself in the strawman territory with the argument from the government, loving social engineer being, "ur jus greeeeedy!!"

No genius. This has nothing to do with greed, even if most people cannot or will not specifically articulate the argument against this bull****. The reaction is against an ideology, and ideology that says that there are people best described as "philosopher-kings" who know best about how much money I can and should make - they know what I "need" and what I "don't need". And in their attemps to socially engineer society in such a manner that they find equitably just, they would place limits on those who they see as doing better than someone else, and I guess, this just isn't fair, right, because the people doing well don't "need" to do well, right? **** that mess. The reaction to that kind of thinking is the natural right to liberty that all men have inside them that says, "I have a right to work as much as I like and make as much money as the market will bear for my services." Anyone who would insist on placing limitations on this interaction is nothing more than tyrant - I don't live for you and nor you for me. Yet these people through the force of men with guns would like it otherwise.

Healthcare is not a right, it is a good and service. You want to lower healthcare costs within the context of the free-market and in a way that does not inhibit the freedom of the individual? Fine, then please pay attention to supply and demand - a very simple and established economic principle. What happens to the price when any good or service supply goes up? That's correct, price goes down. The solution is more health professionals and hospitals, NOT government controls.
Yikes, man. Don't get your panties in a bundle. I never said your ideology wasn't right and certainly didn't accuse anyone of being greedy. What I am saying is that your position is impractical given the current state of affairs. How much money you and I stand to make is already dictated by "the powers that be." Cuts are going to be made by said powers - and certainly not in the way you proposed above (although your point is well taken) - whether we like it or not.

I do, however, appreciate the fact that you're passionate about the subject, seeing as so many of our colleagues are completely apathetic.
 
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operationivy

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If the federal government wants to cut reimbursements, then they should....
1) Subsidize medical education so students are not $250,000 in debt when graduating
2) Curb the amount of lawsuits. Perhaps every lawsuit should be dealt with by the government and any monetary awards issued by the federal government (as opposed to a blood thirsty "private" attorney)---obviously, if the federal government had to deal with the costs of a trial and a monetary award, they would think twice about dealing with most lawsuits.

The government "can't have their cake and eat it too." If they want to box physicians salaries, then they need to make medical education cheaper and help prevent ridiculous lawsuits and rising malpractice insurance costs.
 

Kitra101

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If the federal government wants to cut reimbursements, then they should....
1) Subsidize medical education so students are not $250,000 in debt when graduating
2) Curb the amount of lawsuits. Perhaps every lawsuit should be dealt with by the government and any monetary awards issued by the federal government (as opposed to a blood thirsty "private" attorney)---obviously, if the federal government had to deal with the costs of a trial and a monetary award, they would think twice about dealing with most lawsuits.

The government "can't have their cake and eat it too." If they want to box physicians salaries, then they need to make medical education cheaper and help prevent ridiculous lawsuits and rising malpractice insurance costs.
Can I get an amen brotha? Can I get a hallelujah? Seriously though, I am so sick of this crap. They are tilting the scales so against physicians it is crazy. Obama and his lawyer buddies need to make sacrifices too and push tort reform. People forget that in other nations with "free healthcare" taxes for everyone are much higher as they pay for medical education and healthcare in general for everyone. So, it seems there are a lot of people out there (in the medical field) who feel this way. There are a LOT LOT LOT of non-medical people with opinions who claim to be healthcare "experts." Much like Obama, they are dragging our good names through the mud and not sharing our side. I have written a few responses to some of these people, but there really needs to be more of a medical student/resident/fellow/attending grassroot effort through the media (be it internet, TV if you have a way of getting to it, radio, etc) to combat these "experts' facts" about the greedy physicians ruining medical care. I urge you all to comment on some of these frequented sites. Perhaps if they got more medical people who actually see what happens in hospitals and knows first hand what having 200,000 USD debt looming over your head and who actually takes call and works 80+ hours a week and who has had frivolous law suits brought against them, they would begin to see the other side (and not just Obama's world where the pediatrician decided to perform the kid's T and A because the pediatrician makes more money by doing surgery).

For example, on NPR, so called health care expert Maggie Mahar discussed her views on why the system is broken. While she at least acknowledges the debt of medical school education, she still misses the point on a number of issues. Oh and by the way, she has no health care training whatsoever, but writes books about it, makes guest appearances and is involved in documentaries about the health care system. She is an English PhD who has NO formal training in science, the scientific method or medicine (according to her own blog). Yet, I am pretty sure between her books, appearances and help with the film, she is standing to make some profit off the healthcare industry. She appeared this week on NPR's fresh air and some of the comments, in particular, to the non-sense behind malpractice, need some correcting.
http://www.npr.org/templates/story/storyComments.php?storyId=111063048
Her blog, in case you are interested is:
healthbeatblog.org

Next we have my favorite, Elizabeth Cohen on CNN's empowered patient section. Routinely, she runs articles that slam doctors for not caring about patients, discriminating against obesity, skin color, etc etc. She is a Master of Public Health, so at least she has some sense of the healthcare industry. However, I would venture to guess that a MPH is far from making someone a healthcare expert. Check out her "wonderful and factual" articles at:
http://www.cnn.com/SPECIALS/2007/news/empoweredpatient/

I would argue that her article about X percent of doctors have a negative attitude towards obesity probably is misleading. Doctors have a negative attitude towards obesity because of all the negative health care ramifications to it - not because they are being mean bullies on the playground and discriminating for no reason against the obese. Perhaps she should comment on all the reasons why it is in everyones' best interest to curve the obesity epidemic in this nation - from a health care perspective and from a monetary perspective?

Next we have Dr. Sanjay Gupta. He at least tries to explain the reality to people. However, many of the comments are full of misconceptions and undue negativity towards doctors. Perhaps a little dose of real like experience would be helpful to viewers (obviously without violating privacy issues).

http://pagingdrgupta.blogs.cnn.com/

There are so many people coming out of the woodwork who tarnish the good names of hard working physicians. Sure, there are corrupt physicians out there just as there are in any other profession. However, by and large, I believe, from my personal experience, that most physicians are not out there to harm patients and do whatever unnecessary tests and procedures to make money. They do not re-order CBCs for no reason other than making money. The ONLY times I have seen tests ordered that are obviously not necessary are those which are being ordered to cover the ass of the physician in case of a law suit. For example, I have seen MRIs ordered for new headaches that are most likely just migraines or tension headaches when there is any remote possibility of a mass lesion because though the doc knew 99.999% of the time, it will be nothing, to miss a lesion like that in order to save cost is something they are not willing to risk. Tort reform would make that go away though (along with ending self-referrals).
 

jdh71

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Yikes, man. Don't get your panties in a bundle. I never said your ideology wasn't right and certainly didn't accuse anyone of being greedy. What I am saying is that your position is impractical given the current state of affairs. How much money you and I stand to make is already dictated by "the powers that be." Cuts are going to be made by said powers - and certainly not in the way you proposed above (although your point is well taken) - whether we like it or not.

I do, however, appreciate the fact that you're passionate about the subject, seeing as so many of our colleagues are completely apathetic.
This is a matter of principle man!

Would you tell a women being raped to lay still and try and enjoy the violation?

EDIT: And this, the coercive artificial "capping" of reimbursements, is just ONE small, measly reason why this whole legislation is bad, bad, and bad. What troubles me most about all of this is that this is an issue that should be analyzed strictly according to an economic context but it is turned into an emotionally-driven freak show about how certain individuals cannot get adequate health care. What is evident here is that the majority of americans show a large degree of economic ignorance and/or sheer stupidity.
 
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OptimusPrime

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Pharmaceutical companies and health insurance companies have big lobby (I’m talking millions of dollars in backing) movement ensuring to the last fighting breath that their client’s best interest is protected and preserved. We on the other hand do not and that makes me feel a bit uneasy about the upcoming changes as the major lobbies duke it out with the politicians to curtail this health care reform movement.
 

koopa_troopa

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Pharmaceutical companies and health insurance companies have big lobby (I’m talking millions of dollars in backing) movement ensuring to the last fighting breath that their client’s best interest is protected and preserved. We on the other hand do not and that makes me feel a bit uneasy about the upcoming changes as the major lobbies duke it out with the politicians to curtail this health care reform movement.
Not only do we not have anyone fighting for us, but on top of that we have people pointing the fingers at us for the problem. Everytime I read the comments of any news article on healthcare reform there are people blaming doctors for the costs and expecting that doctors should work for free out of the kindness of their hearts. They ignore the debt and the work hours doctors put in. I really wish there was some group who would speak up for doctors. Even though I don't like the AMA, I had hoped they would put up a fight. But it appears they caved in. They'd rather jump on the bandwagon rather than being seen as the villains in the way of 'healthcare reform'.