I've noticed that threads addressing a very specific topic don't often get too far, but I figured I'd see if anyone wanted to discuss. There's a whole lot of talk in the surgery forum about insurance-executive slaughter of patients and mistreatment of doctors, nationalization of medicine, Orwellian-Randian nightmare, etc. I agree with all of it, and I'm a little disgusted that either the government or a private business-man, neither of whom know a thing about medicine, is ultimately going to dictate the way I practice and what I'm allowed to do. However I've spoken to a number of practicing physicians lately who've told me that higher specialization plays on supply and demand and can give you a lot of power over the craptastic directions in which the whole field is headed. Example: A neurosurgeon told me he's one of a few in his whole area, so he basically just demands payment...and he gets it. A pediatric surgeon told me something very similar. There's no large pool of lesser-qualified people with the same title (let's not get into who I'm referring to here) ready and willing to accept the insulting offers/conditions of the payors (thereby lowering the payment standards, which all in the field must then accept if they want any patients). A small, rare group of subspecialists can more easily adhere and take some of the power back. Anyone else see/hear much of the same?