Opting Out

[GUH]

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I'm not in an MD program but I'm skeptical of any plan to make a 2-tiered system of MD programs widespread.
If I were a patient being seen by an MD, I would like to be certain that I was being treated by a physician who completed medical school and residency at programs held to similar accreditation standards as other MD programs, especially with regards to length of training.

 

[Sephiroth]

You realize there are postive incentives like reimbursing people in accordance to their skill, training, and importance to patients health?

You can't force people into any of these contracts, if you forgot we have a bill of rights and forced servitude violates it plus the 13th amendment.

Its unenforceable in court and people can do whatever they want, people put all types of crazy crap into employee contracts to try to squeeze people knowing they have no legal recourse if they violate

I'll sign my name on a contract right now for $500 and 10 years as your personal assistant. But when you come to collect I'm gonna wipe with it and show you the door.

Furthermore when people are under duress or not fully informed to consent a contract is unenforceable. It protects you from extortion, so when you are desperate loan sharks and others can't take advantage.

dafuq are you talking about? no one is forcing anyone into any contract. you sign it to enter the accelerated primary care program and get their tuition waiver. If you don't want to, don't enter the program. It's clear upfront what you are getting into. And under duress? C'mon. No one's holding a gun to anyone's head when they're deciding on accepting a med school admission. Hell, they're not even done in person. The way it looks like you're using that here, anyone should be able to break a contract at any time by just claiming they were "under duress". It doesn't work that way, and courts have held up some pretty ****ty contracts. A contract is only as enforceable as a court says it is, but that doesn't mean they'l throw it out just because you don't like it or think it's unfair to one party.

And sure, you can't force someone to work - generally if a contract is voided you would have to repay whatever you got from it, and sometimes damages depending on the circumstances. In this case, as with currently existing programs within state med schools, if you break the contract, you're on the hook for a bunch of tuition to pay back. Except if you just graduated from a program in which you only did rotations through primary care specialties, it's gonna be tough getting into a specialty residency.

Tell ya what, given what you seem to think about contract, I'll pay you $1000 to do my housecleaning for the next 365 days. You gonna sign that and then tell me to shove it once I've paid you and want the work done? Here's what happens: The contract was violated, you'll have to pay me back, and probably pay for court costs as well (though in this case it'd be small claims, so that wouldn't be much).

And on the topic of incentives, there's a limit to what monetary incentives can achieve. Simply offering people more money doesn't solve everything.

Quit thinking like such a obedient dunce and realize theres 2.6 trillion in healthcare spending. Wages for physicians is a nominal percentage that could be increase for society's benefit if they had any representation as citizens or employees

uh... ok. I wan't even talking about anything on that subject. But nice insult, bro.

And don't worry about NPs or other workers as they don't control whats keeping physicians down like corporate interests and lobbying.

The knowledge base,clinical productivity, and ability to grow with the science of medicine is clearly more evident if you see mid levels and doc after pgy1. Patients see it too, maintain integrity and patient care as a focus and the public is the one friend physicians don't want to lose.

Nurses are more middle management and have great labor conditions compared to docs. They farm out duties to techs and administer some meds, break on the reg, get OT and all the other stuff a person should be entitled to. Hospitals still pay it out cause there bottom line works and nurse unions lobby to keep themselves relevant

State hosptial licensure, medicare payments and facility eligibility has specific nurse staffing requirements per shift, floor, unit, patient.

You don't see that with docs, the existence of a medical director for some places is it. They do have requirements like a doc has to do an admission, orders, discharge summaries, certain procedures, etc. But that gives hospitals the ability to spread MD labor as thin as they want and payment is based on billing alone. An MD doesnt make money till the hospital does. The nurses don't allow their labor the opening to be abused because they are there on their shift and can move as slow as they want or do as little as they want and clock out.

There should be a line between encouraging productivity (if patient care is in mind) and giving a worker some security and stability. As well as being foundation of healthcare that cant be worked around like nurses have. Or else they will find cheaper labor to do as much of the MD work as they can get away with, bill the same, and pay the MD less

can I assume you are no longer talking to me here?