Societal Interpretation of a Physician's Monetary Worth

Hello,

I wanted to share with you all a conversation I had with someone on Facebook. He posted a video that was really inflammatory and condescending with regards to physicians receiving kickbacks and such from BigPharma. Anyway, I messaged him and wanted to clarify that there are people who manipulate the system everywhere, but the vast majority of physicians got into medicine to do good. He responded that he had (probably baseless) facts and wished I wasn't so ignorant, and he began accusing me of getting into medicine for money after saying doctors deserve a competitive salary on the basis of the debt we incur alone! I asked him out of curiosity how much a doctor deserves to make and he said 100k max...

Am I unreasonable in saying that we deserve to make salaries that are in the upper quartile of society? This isn't really my first run-in with someone on this topic which is why I'm posting here, to see if any of you had similar run-ins. In fact, a person once said doctors shouldn't be paid at all and I'm really shocked people could be so ungrateful. We put in the energy, time and make tremendous social/familial/financial sacrifices to be able to heal our fellow man. Why doesn't this [hopefully] small subset of people believe doctors deserve a higher pay? Does the fact that I think our hard work deserves this higher income make me greedy? Also, has this been a general consensus among most people or has the tide changed recently (for the practicing docs)?

Thanks for listening to my mini-rant!
 
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Goro

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    A) You actually expected to have a rational conversation with someone who posted an inflammatory content on FB??

    B) You don't deserve anything. You earn it.

    Hello,

    I wanted to share with you all a conversation I had with someone on Facebook. He posted a video that was really inflammatory and condescending with regards to physicians receiving kickbacks and such from BigPharma. Anyway, I messaged him and wanted to clarify that there are people who manipulate the system everywhere, but the vast majority of physicians got into medicine to do good. He responded that he had (probably baseless) facts and wished I wasn't so ignorant, and he began accusing me of getting into medicine for money after saying doctors deserve a competitive salary on the basis of the debt we incur alone! I asked him out of curiosity how much a doctor deserves to make and he said 100k max...

    Am I unreasonable in saying that we deserve to make salaries that are in the upper quartile of society? This isn't really my first run-in with someone on this topic which is why I'm posting here, to see if any of you had similar run-ins. In fact, a person once said doctors shouldn't be paid at all and I'm really shocked people could be so ungrateful. We put in the energy, time and make tremendous social/familial/financial sacrifices to be able to heal our fellow man. Why doesn't this [hopefully] small subset of people believe doctors deserve a higher pay? Does the fact that I think our hard work deserves this higher income make me greedy? Also, has this been a general consensus among most people or has the tide changed recently (for the practicing docs)?

    Thanks for listening to my mini-rant!
     
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    RogueBanana

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      I've had similar conversations with relatives on the matter. Several have suggested that past girlfriends of mine only dated me because one day I would be their "rich trophy husband". Others suggested the biggest benefit of being a doc is the salary. Not the reward of helping our fellow man.

      Those same people often buy heavily into the whole "natural medicine" ideology. They have been semi-brainwashed by the media (both liberal and conservative) into believing we are simply shills for big pharma. (I have often been called a shill for pharma whilst arguing the importance of vaccination at my university). Unfortunately, due to the intellectual barriers to understanding scientific research, many people will rely blindly on what they are told. Add to this the failings of health 2.0 and the ridiculous cost of medical care in this country. People are upset that the US health system is, in many ways, not performing to 1st world standards. They don't get mad at politicians, because they don't interact with politicians. They get mad at doctors. To them, we are the faces of a failed system. Consider that, in the US, political fanaticism is the standard. Blind allegiance to party lines and ideals leads even the rational among us to forsake individual thought and defend their party to the point of fetishism. To me, science is the only real truth we can hold on to. Thus we have no problem questioning systems without factual bases. A wise man once said "The good thing about science is, it is true weather or not you choose to believe in it!"
      This tendency scientists (ie. physicians) often possess can make us seem condescending to the un-initiated.

      In addition to the socio-political factors, I think these people fail to realize the breadth of the sacrifices we make along the way to becoming a physician. They know medical school is "hard" but they don't know what its really like. I knew that my anatomy class would be "hard" but after making my first 300 notecards for the first test I realized just how deep over my head I was. They don't realize many of us give up happy relationships, marriages, sleep, and even our own health to have the privilege of waking to a 3 am call, leaving your girlfriend/ family and heading to the hospital to help a complete stranger.

      Do physicians deserve to be in the upper quartile of income for this? I believe so.
      The money, time & effort required to even attempt medical school is mind boggling to the majority of college students. We have to score higher than our peers on every test, we have to score exemplary marks on some of the hardest tests ever created. We have to endure long hours, low sleep, extreme stress, all the while preforming one of the most intellectually-demanding jobs in history. If that doesn't deserve a half-decent paycheck and a nice retirement in America, I don't know what does.
       
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      I've had similar conversations with relatives on the matter. Several have suggested that past girlfriends of mine only dated me because one day I would be their "rich trophy husband". Others suggested the biggest benefit of being a doc is the salary. Not the reward of helping our fellow man.

      Those same people often buy heavily into the whole "natural medicine" ideology. They have been semi-brainwashed by the media (both liberal and conservative) into believing we are simply shills for big pharma. (I have often been called a shill for pharma whilst arguing the importance of vaccination at my university). Unfortunately, due to the intellectual barriers to understanding scientific research, many people will rely blindly on what they are told. Add to this the failings of health 2.0 and the ridiculous cost of medical care in this country. People are upset that the US health system is, in many ways, not performing to 1st world standards. They don't get mad at politicians, because they don't interact with politicians. They get mad at doctors. To them, we are the faces of a failed system. Consider that, in the US, political fanaticism is the standard. Blind allegiance to party lines and ideals leads even the rational among us to forsake individual thought and defend their party to the point of fetishism. To me, science is the only real truth we can hold on to. Thus we have no problem questioning systems without factual bases. A wise man once said "The good thing about science is, it is true weather or not you choose to believe in it!"
      This tendency scientists (ie. physicians) often possess can make us seem condescending to the un-initiated.

      In addition to the socio-political factors, I think these people fail to realize the breadth of the sacrifices we make along the way to becoming a physician. They know medical school is "hard" but they don't know what its really like. I knew that my anatomy class would be "hard" but after making my first 300 notecards for the first test I realized just how deep over my head I was. They don't realize many of us give up happy relationships, marriages, sleep, and even our own health to have the privilege of waking to a 3 am call, leaving your girlfriend/ family and heading to the hospital to help a complete stranger.

      Do physicians deserve to be in the upper quartile of income for this? I believe so.
      The money, time & effort required to even attempt medical school is mind boggling to the majority of college students. We have to score higher than our peers on every test, we have to score exemplary marks on some of the hardest tests ever created. We have to endure long hours, low sleep, extreme stress, all the while preforming one of the most intellectually-demanding jobs in history. If that doesn't deserve a half-decent paycheck and a nice retirement in America, I don't know what does.

      Well said! Thanks for your insight.
       

      libertyyne

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        Hello,

        I wanted to share with you all a conversation I had with someone on Facebook. He posted a video that was really inflammatory and condescending with regards to physicians receiving kickbacks and such from BigPharma. Anyway, I messaged him and wanted to clarify that there are people who manipulate the system everywhere, but the vast majority of physicians got into medicine to do good. He responded that he had (probably baseless) facts and wished I wasn't so ignorant, and he began accusing me of getting into medicine for money after saying doctors deserve a competitive salary on the basis of the debt we incur alone! I asked him out of curiosity how much a doctor deserves to make and he said 100k max...

        Am I unreasonable in saying that we deserve to make salaries that are in the upper quartile of society? This isn't really my first run-in with someone on this topic which is why I'm posting here, to see if any of you had similar run-ins. In fact, a person once said doctors shouldn't be paid at all and I'm really shocked people could be so 1.ungrateful. We put in the energy, time and make 2.tremendous social/familial/financial sacrifices to be able to heal our fellow man. Why doesn't this [hopefully] small subset of people believe doctors deserve a higher pay? Does the fact that I think our 3.hard work deserves this higher income make me greedy? Also, has this been a general consensus among most people or has the tide changed recently (for the practicing docs)?

        Thanks for listening to my mini-rant!
        1. Why you thinking you deserve their gratefulness? You get paid for your services. Are you grateful to your cook at a restaurant? You are not doing them a favor, you get reimbursed handsomely for your time.


        2. Do you think you are the only person or profession in the world that works hard, or only professional that spends a large amount of time at work after training?

        3. If magically tomorrow physican salaries were halved would you still want to work as a physican? What about quartered?

        4. Do we overutilize services as a society? Yes.
        A. Do physicans contribute to that ? Yes.
        B. Do proceduralists have a conflict of interest in doing procedures? Yes.
        I. Do all of said procedures improve outcomes? No.
        II . Do said procedures continue to be performed? Yes.

        5. Are physicans in America overpaid? Probably.

        upload_2016-9-22_19-0-52.png


        6. Should physican education change to reduce loans/cost?
        Yes.
        7. Is quality of care related to reimbursement? No.
        8. Is the current healthcare spending trend unsustainable? Yes.
         
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        @567WingsO'Heaven The reason this view exists is due to the prevalence of medical bankruptcy. You are right that doctors aren't the underlying pathology, but they are representative of the problem. Market force dynamics, venture capitalist investments, and generally the nature of capitalism to promote unsustainable growth have leaked into medicine and will continue to drive care to unrealistic costs. It might as well be you holding the scalpel rather than someone else.
         
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        libertyyne

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          Hello,

          I wanted to share with you all a conversation I had with someone on Facebook. He posted a video that was really inflammatory and condescending with regards to physicians receiving kickbacks and such from BigPharma. Anyway, I messaged him and wanted to clarify that there are people who manipulate the system everywhere, but the vast majority of physicians got into medicine to do good. He responded that he had (probably baseless) facts and wished I wasn't so ignorant, and he began accusing me of getting into medicine for money after saying doctors deserve a competitive salary on the basis of the debt we incur alone! I asked him out of curiosity how much a doctor deserves to make and he said 100k max...

          Am I unreasonable in saying that we deserve to make salaries that are in the upper quartile of society? This isn't really my first run-in with someone on this topic which is why I'm posting here, to see if any of you had similar run-ins. In fact, a person once said doctors shouldn't be paid at all and I'm really shocked people could be so ungrateful. We put in the energy, time and make tremendous social/familial/financial sacrifices to be able to heal our fellow man. Why doesn't this [hopefully] small subset of people believe doctors deserve a higher pay? Does the fact that I think our hard work deserves this higher income make me greedy? Also, has this been a general consensus among most people or has the tide changed recently (for the practicing docs)?

          Thanks for listening to my mini-rant!

          @567WingsO'Heaven The reason this view exists is due to the prevalence of medical bankruptcy. You are right that doctors aren't the underlying pathology, but they are representative of the problem. Market force dynamics, venture capitalist investments, and generally the nature of capitalism to promote unsustainable growth have leaked into medicine and will continue to drive care to unrealistic costs. It might as well be you holding the scalpel rather than someone else.

          Being an Average Joe what really grinds my gears is when physicians say we deserve more money for being selfless. Its the equivalent of a CEO for a company saying I need more bonuses for the "value" I generate. Physicians are already in the top percentile of wage earners in the united states. No salaried group as a whole makes more money. Society already pays you well for your efforts. What has society gotten in return besides the increasing rates oh medical bankruptcy, healthcare costs growing at double rates of inflation, and poorer access and little to no improvement in outcomes? So dont focus on woe is me i went to 20 years of school and worked hard pay me. PHDS dont get paid well as a large group with a large number of years spent. Look at lawyers. Similar debt worse outcomes.

          What Physicians should say is: Yes American Healthcare is out of control, we need to find innovative ways to provide the best possible care for the money spent. We need to honestly have a conversation about quality and access. We as physicians need to display leadership in this area and take partial responsibility for being asleep at the wheel. Because you know what society will do if they keep on getting the same results? They will starve the entire establishment. Business should not continue as usual. Like seriously who gives a **** what peoples perceptions are regarding MD pay, do the right thing and care and improve the health of the communities you get paid handsomely to work in.

          This post and the entitlement and self centered BS has painted physicians in the current light. It is a surprise that more people dont have the view that OP is perplexed by.
           
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          libertyyne

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            @libertyyne Go through your four years of medical school and let me know what your stance on this matter is.
            Ha, thats if they let me in! Probably will continue to think along those lines. Or who knows I might become an interventional cardiologist and cath everyone who has a pulse. But seriously my SO has gone through med school and we both agree on this outlook.
             
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              Ha, thats if they let me in! Probably will continue to think along those lines. Or who knows I might become an interventional cardiologist and cath everyone who has a pulse. But seriously my SO has gone through med school and we both agree on this outlook.
              You know they aren't required to keep the money right? They can give it all away if they feel bad
               
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              saveourpens

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                1. Why you thinking you deserve their gratefulness? You get paid for your services. Are you grateful to your cook at a restaurant? You are not doing them a favor, you get reimbursed handsomely for your time.


                2. Do you think you are the only person or profession in the world that works hard, or only professional that spends a large amount of time at work after training?

                3. If magically tomorrow physican salaries were halved would you still want to work as a physican? What about quartered?

                4. Do we overutilize services as a society? Yes.
                A. Do physicans contribute to that ? Yes.
                B. Do proceduralists have a conflict of interest in doing procedures? Yes.
                I. Do all of said procedures improve outcomes? No.
                II . Do said procedures continue to be performed? Yes.

                5. Are physicans in America overpaid? Probably.

                View attachment 209234

                6. Should physican education change to reduce loans/cost?
                Yes.
                7. Is quality of care related to reimbursement? No.
                8. Is the current healthcare spending trend unsustainable? Yes.

                At the expense of going into a diatribe against your logic, I'll just say that, if anything doctors are underpaid.
                 
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                libertyyne

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                  So because physicians make more money than docs in Europe that means we're getting overpaid?
                  I wasnt definitive on that answer. I said "Probably" . You can argue either way. Are physicians in other developed countries providing less services? Do they botch surgeries at a higher rate? Or do their communities and societies have better outcomes than the patients here? Is a pretty strong argument that MD's here are probably overpaid.

                  Also: "
                  The United States spends far more on health care than any other nation. In 2009, health care costs reached $2.5 trillion—nearly 17 percent of the GDP. Yet despite this spending, health outcomes in the U.S. are considerably below those in other countries."

                  http://www.nationalacademies.org/hm...ve-Lowering-Costs-and-Improving-Outcomes.aspx


                  Let me hire a plumber. This guy overcharges me and yet my house seems to always be having more trouble than the comparable neighbors house. I know the solution. let me pay the plumber more.
                  You say underpaid huh.
                   
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                  Mad Jack

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                    1. Why you thinking you deserve their gratefulness? You get paid for your services. Are you grateful to your cook at a restaurant? You are not doing them a favor, you get reimbursed handsomely for your time.


                    2. Do you think you are the only person or profession in the world that works hard, or only professional that spends a large amount of time at work after training?

                    3. If magically tomorrow physican salaries were halved would you still want to work as a physican? What about quartered?

                    4. Do we overutilize services as a society? Yes.
                    A. Do physicans contribute to that ? Yes.
                    B. Do proceduralists have a conflict of interest in doing procedures? Yes.
                    I. Do all of said procedures improve outcomes? No.
                    II . Do said procedures continue to be performed? Yes.

                    5. Are physicans in America overpaid? Probably.

                    View attachment 209234

                    6. Should physican education change to reduce loans/cost?
                    Yes.
                    7. Is quality of care related to reimbursement? No.
                    8. Is the current healthcare spending trend unsustainable? Yes.
                    Physician salaries are a fraction of health care costs. It is amusing how people are quick to point the blame at the 8% of health care dollars that go to physician salaries without criticizing the 24% that go to administration and overhead. We aren't overpaid, not by a long shot, and anyone who thinks we are is misinformed. We could literally work for free and it would barely impact health care spending.

                    http://www.jacksonhealthcare.com/media-room/news/md-salaries-as-percent-of-costs/
                     
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                    @Mad Jack The issue is that he's stating that doctors should have a sense of social responsibility. That's what gets to me. He's saying that doctors have a responsibility to be altruistic and to give back of their own concern. It doesn't matter who makes more than you, it matters that doctors make enough to live comfortably and should be doing more for their community because they have the skill set to do so. However, this is completely devoid of the realistic ramifications of even doing so, the paycut you would take, or the amount of stress to run some sort of provisional health clinic. The task of which doctors struggle if they made it their entire career to run such a service.
                     

                    Mad Jack

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                      @Mad Jack The issue is that he's stating that doctors should have a sense of social responsibility. That's what gets to me. He's saying that doctors have a responsibility to be altruistic and to give back of their own concern. It doesn't matter who makes more than you, it matters that doctors make enough to live comfortably and should be doing more for their community because they have the skill set to do so. However, this is completely devoid of the realistic ramifications of even doing so, the paycut you would take, or the amount of stress to run some sort of provisional health clinic. The task of which doctors struggle if they made it their entire career to run such a service.
                      Legal hoops, regulation, and other such nonsense have made altruism difficult for physicians. I plan to do substantial volunteer work overseas precisely because of regulatory hurdles. The government has made it too difficult to care for my fellow Americans.
                       
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                      libertyyne

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                        Physician salaries are a fraction of health care costs. It is amusing how people are quick to point the blame at the 8% of health care dollars that go to physician salaries without criticizing the 24% that go to administration and overhead. We aren't overpaid, not by a long shot, and anyone who thinks we are is misinformed. We could literally work for free and it would barely impact health care spending.

                        http://www.jacksonhealthcare.com/media-room/news/md-salaries-as-percent-of-costs/
                        Compared to physicians in most OECD countries MDs in the US on average get paid more. I provided the chart above.
                        "
                        Framing synopsis. Healthcare cost increases continue to outpace the price and spending growth rates for the rest of the economy by a considerable margin (Bureau of Labor Statistics, 2009). At $2.5 trillion and 17 percent of the nation’s gross domestic product in 2009 (CMS, 2009), health spending in the United States commanded twice the per capita expenditures of the average for other developed nations, and concerns have never been higher on the economic implications for individuals, families, businesses, and even the overall capacity and fiscal integrity of critical functions for government at the federal, state, and local levels (Kaiser Family Foundation, 2009a; National Association of State Budget Officers, 2009; Orszag, 2007; Peterson and Burton, 2008).

                        Moreover, there are compelling signals that much of health spending does little to improve health, and, in certain circumstances, may be associated with poorer health outcomes. Between 2000 and 2006, for example, Medicare spending on imaging services more than doubled, with an over 25 percent increase in use of advanced imaging modalities such as nuclear medicine and CT scans compared to an 18 percent increase in readily available standard imaging modalities such as X-rays and ultrasounds, despite the increased risks associated with advanced imaging services (GAO, 2008). Several recent assessments of institutional and regional variation in costs and volume of treatment services indicate that, in many cases, care profiles that are 60 percent more expensive have no quality advantage (Fisher et al., 2003). Medicare spending per capita by hospital referral region, for example, varied more than threefold—from $5,000 to over $16,000—yet there appeared to be an inverse relationship between healthcare spending and quality scores.

                        In the face of these urgent challenges, the Institute of Medicine (IOM)—with the support and encouragement of the Peter G. Peterson Foundation—convened four meetings throughout 2009, under the umbrella theme The Healthcare Imperative: Lowering Costs and Improving Outcomes. These meetings explored in detail the nature of excess health costs, current evidence on the effectiveness of.......

                        extrapolation from observed geographic variation within the United States, contrasting overall U.S. expenditure levels with those of member countries in the Organisation of Economic Co-operation and Development (OECD), and summing the lower bounds of the various estimates for the six domains considered in the IOM workshops—amounted to approximately $750 billion, $760 billion, and $765 billion, respectively, for excess U.S. healthcare costs in 2009."

                        Just an honest question, who do you think is ordering those services? Nurses? Administrators? Physicians have been terrible stewarts of the system. Fix your overuse problem and then ask for a raise.
                         
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                        Mr. Beefy Lion

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                          I wasnt definitive on that answer. I said "Probably" . You can argue either way. Are physicians in other developed countries providing less services? Do they botch surgeries at a higher rate? Or do their communities and societies have better outcomes than the patients here? Is a pretty strong argument that MD's here are probably overpaid.

                          Also: "
                          The United States spends far more on health care than any other nation. In 2009, health care costs reached $2.5 trillion—nearly 17 percent of the GDP. Yet despite this spending, health outcomes in the U.S. are considerably below those in other countries."

                          http://www.nationalacademies.org/hm...ve-Lowering-Costs-and-Improving-Outcomes.aspx


                          Let me hire a plumber. This guy overcharges me and yet my house seems to always be having more trouble than the comparable neighbors house. I know the solution. let me pay the plumber more.
                          You say underpaid huh.
                          I wasnt definitive on that answer. I said "Probably" . You can argue either way. Are physicians in other developed countries providing less services? Do they botch surgeries at a higher rate? Or do their communities and societies have better outcomes than the patients here? Is a pretty strong argument that MD's here are probably overpaid.

                          Also: "
                          The United States spends far more on health care than any other nation. In 2009, health care costs reached $2.5 trillion—nearly 17 percent of the GDP. Yet despite this spending, health outcomes in the U.S. are considerably below those in other countries."

                          http://www.nationalacademies.org/hm...ve-Lowering-Costs-and-Improving-Outcomes.aspx


                          Let me hire a plumber. This guy overcharges me and yet my house seems to always be having more trouble than the comparable neighbors house. I know the solution. let me pay the plumber more.
                          You say underpaid huh.
                          Ahh the classic "we spend so much on healthcare and our outcomes aren't even better than other countries"

                          Let's completely ignore the obvious confounding factor of obesity though
                           
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                          Mad Jack

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                            Compared to physicians in most OECD countries MDs in the US on average get paid more. I provided the chart above.
                            "
                            Framing synopsis. Healthcare cost increases continue to outpace the price and spending growth rates for the rest of the economy by a considerable margin (Bureau of Labor Statistics, 2009). At $2.5 trillion and 17 percent of the nation’s gross domestic product in 2009 (CMS, 2009), health spending in the United States commanded twice the per capita expenditures of the average for other developed nations, and concerns have never been higher on the economic implications for individuals, families, businesses, and even the overall capacity and fiscal integrity of critical functions for government at the federal, state, and local levels (Kaiser Family Foundation, 2009a; National Association of State Budget Officers, 2009; Orszag, 2007; Peterson and Burton, 2008).

                            Moreover, there are compelling signals that much of health spending does little to improve health, and, in certain circumstances, may be associated with poorer health outcomes. Between 2000 and 2006, for example, Medicare spending on imaging services more than doubled, with an over 25 percent increase in use of advanced imaging modalities such as nuclear medicine and CT scans compared to an 18 percent increase in readily available standard imaging modalities such as X-rays and ultrasounds, despite the increased risks associated with advanced imaging services (GAO, 2008). Several recent assessments of institutional and regional variation in costs and volume of treatment services indicate that, in many cases, care profiles that are 60 percent more expensive have no quality advantage (Fisher et al., 2003). Medicare spending per capita by hospital referral region, for example, varied more than threefold—from $5,000 to over $16,000—yet there appeared to be an inverse relationship between healthcare spending and quality scores.

                            In the face of these urgent challenges, the Institute of Medicine (IOM)—with the support and encouragement of the Peter G. Peterson Foundation—convened four meetings throughout 2009, under the umbrella theme The Healthcare Imperative: Lowering Costs and Improving Outcomes. These meetings explored in detail the nature of excess health costs, current evidence on the effectiveness of.......

                            extrapolation from observed geographic variation within the United States, contrasting overall U.S. expenditure levels with those of member countries in the Organisation of Economic Co-operation and Development (OECD), and summing the lower bounds of the various estimates for the six domains considered in the IOM workshops—amounted to approximately $750 billion, $760 billion, and $765 billion, respectively, for excess U.S. healthcare costs in 2009."

                            Just an honest question, who do you think is ordering those services? Nurses? Administrators? Physicians have been terrible stewarts of the system. Fix your overuse problem and then ask for a raise.
                            Physician salaries only amount to 200 and some change billion out of 2.5 trillion. We don't run the system, we operate within it. Overhead and administrative costs alone amount to $500 billion per year, pharmaceuticals cost $310 billion, and yet you're not going for the $810 billion (4 times what physicians collect in salary), you're going for the low hanging fruit like someone that doesn't know how math works.
                             
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                            libertyyne

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                              @Mad Jack The issue is that he's stating that doctors should have a sense of social responsibility. That's what gets to me. He's saying that doctors have a responsibility to be altruistic and to give back of their own concern. It doesn't matter who makes more than you, it matters that doctors make enough to live comfortably and should be doing more for their community because they have the skill set to do so. However, this is completely devoid of the realistic ramifications of even doing so, the paycut you would take, or the amount of stress to run some sort of provisional health clinic. The task of which doctors struggle if they made it their entire career to run such a service.
                              Yes. I get it. it is difficult for Physicians to display their social responsibility. Then acknowledge that and be honest with each other about the profession. OP is pissing on me and telling me it is raining, blaming the guy who is concerned about rising healthcare costs in society, rather than looking inward at the system and acknowledging a ****ed up system that does not serve the communities it pays lip service to.

                              Legal hoops, regulation, and other such nonsense have made altruism difficult for physicians. I plan to do substantial volunteer work overseas precisely because of regulatory hurdles. The government has made it too difficult to care for my fellow Americans.
                              This is utter BS. Even if it is too difficult to care for fellow Americans dont **** them by misusing resources. Be good shepards of the resources society has entrusted in you, dont perform unnecessary procedures because you get paid more. Dont ask for raises when you are doing a **** job in improving outcomes and access to care. It comes off tone def and completely self centered. The exact opposite of what the profession claims to do.
                               

                              libertyyne

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                                Ahh the classic "we spend so much on healthcare and our outcomes aren't even better than other countries"

                                Let's completely ignore the obvious confounding factor of obesity though
                                yeah, completely ignore the highlighted portion showing overutilization of services and variation in care that is responsible for 30% of costs.
                                 
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                                deleted480308

                                  Yes. I get it. it is difficult for Physicians to display their social responsibility. Then acknowledge that and be honest with each other about the profession. OP is pissing on me and telling me it is raining, blaming the guy who is concerned about rising healthcare costs in society, rather than looking inward at the system and acknowledging a ****ed up system that does not serve the communities it pays lip service to.


                                  This is utter BS. Even if it is too difficult to care for fellow Americans dont **** them by misusing resources. Be good shepards of the resources society has entrusted in you, dont perform unnecessary procedures because you get paid more. Dont ask for raises when you are doing a **** job in improving outcomes and access to care. It comes off tone def and completely self centered. The exact opposite of what the profession claims to do.
                                  Who the hell in this thread is asking to do unnecessary procedures? Aim your disdain better
                                   
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                                  libertyyne

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                                    Physician salaries only amount to 200 and some change billion out of 2.5 trillion. We don't run the system, we operate within it. Overhead and administrative costs alone amount to $500 billion per year, pharmaceuticals cost $310 billion, and yet you're not going for the $810 billion (4 times what physicians collect in salary), you're going for the low hanging fruit like someone that doesn't know how math works.
                                    Are you even reading the bolded part? Overutilization and unnecessary testing costs 30% of healthcare.
                                     
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                                    Mad Jack

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                                      Yes. I get it. it is difficult for Physicians to display their social responsibility. Then acknowledge that and be honest with each other about the profession. OP is pissing on me and telling me it is raining, blaming the guy who is concerned about rising healthcare costs in society, rather than looking inward at the system and acknowledging a ****ed up system that does not serve the communities it pays lip service to.


                                      This is utter BS. Even if it is too difficult to care for fellow Americans dont **** them by misusing resources. Be good shepards of the resources society has entrusted in you, dont perform unnecessary procedures because you get paid more. Dont ask for raises when you are doing a **** job in improving outcomes and access to care. It comes off tone def and completely self centered. The exact opposite of what the profession claims to do.
                                      I'm not, nor do I ever intend to be, a proceduralist. I won't ever do anything that is unnecessary unless I'm doing it to cover my ass.
                                       
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                                      Mad Jack

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                                        That has almost nothing to do with wanting more money and almost everything to do with not getting sued.
                                        This. You could pay for physician salaries literally almost four times over if we could not be sued so long as we followed evidence-based practice. Unfortunately that is not the case, so we do unnecessary things to cover our asses.
                                         
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                                        libertyyne

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                                          That has almost nothing to do with wanting more money and almost everything to do with not getting sued.

                                          Why are you so pervasive about being sued? It's almost as if you don't want to give money to those in serious need.

                                          I'm not, nor do I ever intend to be, a proceduralist. I won't ever do anything that is unnecessary unless I'm doing it to cover my ass.

                                          This. You could pay for physician salaries literally almost four times over if we could not be sued so long as we followed evidence-based practice. Unfortunately that is not the case, so we do unnecessary things to cover our asses.

                                          But Doctor Mad Jack, this is only a Level 4 examination. If you check one more element of ROS we can make it a Level 5. Let's do it, together.

                                          Protecting ourselves from lawyers is a fault of the legal system, not the medical one. We do what we have to because if we don't we'll get sued into oblivion.


                                          Ah yes the old im afraid of being sued thats why i over use.

                                          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048809/
                                          only 2.4 % accounts for defensive medicine.

                                          Not really a thing. When people are actually harmed due to malpractice only a small percent sue.

                                          lets victim shame while we are at it.
                                           

                                          Tenk

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                                            Thats exactly why overutilization does not exist in states where damages are capped. Lets also ignore the fact that I get paid for each procedure I perform. sigh.
                                            Capped damages doesn't mean you won't get sued. Do you have any freaking clue how much of your soul gets sucked out of you in a lawsuit? How much sleep you lose? How you sit there and they attack you, attack your character and everything you spent your life working towards in a court room full of people? We have malpractice to cover the finances. It's the very act of being sued that drives people to overorder crap in this country.
                                             
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                                            Capped damages doesn't mean you won't get sued. Do you have any freaking clue how much of your soul gets sucked out of you in a lawsuit? How much sleep you lose? How you sit there and they attack you, attack your character and everything you spent your life working towards in a court room full of people? We have malpractice to cover the finances. It's the very act of being sued that drives people to overorder crap in this country.
                                            GrtohKb.jpg


                                            Buzz decided to quit midway through M1 to do law school.
                                            He's now a malpractice lawyer helping his friend Woody out who just started OBGYN.
                                             
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                                            libertyyne

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                                              The truth is its either change or be forced to change. We will be the same group complaining about loss of autonomy when the day of reckoning comes. This could turn into a france like situation. But what do I know, I haven't even gotten an acceptance yet. But sitting on the other side seeing physicians say they deserve more "respect" and "money" just appears tone deaf. Also if you think it cant be done, look at Mayo.
                                               

                                              LuluLovesMe

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                                                The truth is its either change or be forced to change. We will be the same group complaining about loss of autonomy when the day of reckoning comes. This could turn into a france like situation. But what do I know, I haven't even gotten an acceptance yet. But sitting on the other side seeing physicians say they deserve more "respect" and "money" just appears tone deaf.

                                                So people in this thread are arguing from personal experience and you're arguing from your gut feeling as someone not yet in the medical profession. Makes sense.
                                                 
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                                                libertyyne

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                                                  So people in this thread are arguing from personal experience and you're arguing from your gut feeling as someone not yet in the medical profession. Makes sense.
                                                  Actually no, I am arguing as someone who has both gotten a graduate degree focusing on healthcare systems, and a person who has closely worked with legal liability of physicals for almost a decade. Also, I am the one who has posted a wide range of legitimate sources. So sure man, believe what you want to believe.
                                                   
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                                                  Mad Jack

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                                                    Ah yes the old im afraid of being sued thats why i over use.

                                                    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048809/
                                                    only 2.4 % accounts for defensive medicine.

                                                    Not really a thing. When people are actually harmed due to malpractice only a small percent sue.

                                                    lets victim shame while we are at it.
                                                    Well, given that I'm not a proceduralist and never will be, and the only reason I'd order something unnecessary would be to cover my ass, in my opinion you can politely **** off. Levying your complaints on all physicians is throwing the baby out with the bath water, most of us are good people.
                                                     
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                                                    So people in this thread are arguing from personal experience and you're arguing from your gut feeling as someone not yet in the medical profession. Makes sense.
                                                    The litigation attorney in the office used rake in at least 350k a year before he left to go solo. I would love to suck his dick to learn how he did it. His cases weren't even medical. But alas, he didn't have any use for me. Actually wait. He totally used me to write his motion/summons documentation and didn't pay me for it. What a hoe.
                                                     
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                                                    deleted564680

                                                      Just some thoughts:

                                                      - No one can fully understand what you go through unless they do it themselves. An average person believes the first thing they see/read and that's usually the 50 year old cardiologist living on the lake and driving a mercedes.
                                                      - Here's the deal for medical school: 1. 350k+ debt. 2. Losing out on your 20's (and early 30s in some cases) 3. working/studying 80+ hours a week x 10ish years (that's like 20 years of working for our cubicle friends) 4. Extreme stress and mental health problems 5. Delayed gratification of EVERYTHING
                                                      -- So, just how many people would take that deal if you offered it to them that way? It's clear that the majority of us do not do this for the money (US grads at least). The AMA/AOA have done a terrible job at delineating the training/time/effort a physician goes through and it also hampers our ability to show that we are superior to NPs by a long margin (However, I personally believe we shouldn't compare ourselves to them at all because that gives them a legitimacy they don't deserve).


                                                      - Healthcare in other countries is difficult to compare and most places who do compare metrics will pick and choose whatever they deem noteworthy for headlines.
                                                      - Healthcare in the US is no. 1 in almost all metrics if you have insurance. It's only after throwing in the uninsured that we drop in certain metrics.
                                                      - All healthcare systems in the world have pros and cons and all of them have rising costs.
                                                      - Other countries don't exist in a vacuum either. The majority of technological advancement and research development comes from the US and is exported out. If the US did not exist then those countries would not have the same success. This is similar to the social democrats view of "let's be like denmark or let's be like sweden." Those countries are small and can only succeed in a global network.
                                                      - The US is a vastly diverse country with 315 million people across a landmass the size of Europe. Comparing anything (not just healthcare) against homogeneous countries of 10-40 million that are the size of Indiana is disingenuous. How does the US do against India, China, Russia, Nigeria, and Indonesia?

                                                      I could type pages and pages but it's not worth it.
                                                       
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                                                      LuluLovesMe

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                                                        Actually no I am arguing from someone who has both gotten a graduate degree focusing on healthcare systems and a person who has closely worked with legal liability of physicans for almost a decade. Also, I am the one who has posted a wide range of legitimate sources. So sure man believe what you want to believe.

                                                        No the previous post of yours that I quoted highlights the way you think very well. You get a gut feeling about how things should be then you seek data and experiences to support that opinion. Have you even given any serious consideration to any of the arguments the other posters here have made?
                                                         
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                                                        libertyyne

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                                                          The litigation attorney in the office used rake in at least 350k a year before he left to go solo. I would love to suck his dick to learn how he did it. His cases weren't even medical. But alas, he didn't have any use for me.
                                                          Can you imagine if that is how professional knowledge/training was transferred in society?
                                                           
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