Well damn

[jwk]

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Unbelievable - and John Roberts, of all people, the swing vote.

 

[MErc44]

Disappointing news, takes the wind out of my sails on the last day of residency.

 

[pie944]

Unbelievable - and John Roberts, of all people, the swing vote.

Most people in support of the law were planning on attacking him for being on the other side, bet they are just as shocked.

 

[periopdoc]

I am fascinated that they can rule it a tax and can then rule it constitutional. If it is a tax, then doesn't that trigger the Anti-Injuction Act which prevents the court from hearing challenges to a tax until the tax is actually in effect? If it is a tax, then they can't rule on it until 2015 when somebody has actually paid the tax. Hmmm. Could we see this re-addressed in 2015 with the ruling potentially overturned?

- pod

 

[pmichaelmd]

Unbelievable - and John Roberts, of all people, the swing vote.

Exactly my sentiment. Will be very interesting to see what fallout comes of this. I suspect that forcing insurers to cover more expenses will drive reimbursement to hospitals WAY down and that will trickle down to the medical professionals providing care. Add the escalating costs of medical education and the sacrifice required to become a physician and the writing may very well be on the wall. I doubt medical quality will improve as a result of this.

:\ Very disappointed in the SCOTUS today.

 

[Medstudentquest]

Exactly my sentiment. Will be very interesting to see what fallout comes of this. I suspect that forcing insurers to cover more expenses will drive reimbursement to hospitals WAY down and that will trickle down to the medical professionals providing care. Add the escalating costs of medical education and the sacrifice required to become a physician and the writing may very well be on the wall. I doubt medical quality will improve as a result of this.

:\ Very disappointed in the SCOTUS today.

Since you guys are discussing this, i'll chime in. Is it possible that covering more people will be beneficial at all? More insured, more payments to hospitals?

I also don't see why we simply start cutting from the bottom up. Cutting nurse/PA/NP salaries first. At what point do we say-it's no longer possible/worthwhile financially/sacrifice wise to become a doc?

 

[jwk]

I am fascinated that they can rule it a tax and can then rule it constitutional. If it is a tax, then doesn't that trigger the Anti-Injuction Act which prevents the court from hearing challenges to a tax until the tax is actually in effect? If it is a tax, then they can't rule on it until 2015 when somebody has actually paid the tax. Hmmm. Could we see this re-addressed in 2015 with the ruling potentially overturned?

- pod

That's what makes it such nonsense. Because Congress called it a penalty, not a tax, they rule the Anti-Injunction Act doesn't apply.

Then they turn around and rule it Constitutional AS A TAX.

WTF!!!!!!!

The four lib votes were expected - but nobody expected Roberts to wimp out. So much for his legacy.

 

[Precedex]

Hey folks, do any of you know of any good articles or web resources that describe, in a as much of an objective way as might be possible, the effect the health care legislation will have on our profession. I am not looking to start another discussion on that but trying to find something to help educate myself on the issues. THANKS.

 

[pie944]

I am fascinated that they can rule it a tax and can then rule it constitutional. If it is a tax, then doesn't that trigger the Anti-Injuction Act which prevents the court from hearing challenges to a tax until the tax is actually in effect? If it is a tax, then they can't rule on it until 2015 when somebody has actually paid the tax. Hmmm. Could we see this re-addressed in 2015 with the ruling potentially overturned?

- pod

People will argue that if the court knows how it will rule they don't have to wait to issue that opinion.

 

[pmichaelmd]

Since you guys are discussing this, i'll chime in. Is it possible that covering more people will be beneficial at all? More insured, more payments to hospitals?

I also don't see why we simply start cutting from the bottom up. Cutting nurse/PA/NP salaries first. At what point do we say-it's no longer possible/worthwhile financially/sacrifice wise to become a doc?

I don't think covering more people is the issue. That is, ultimately, a good thing for society. The question is, HOW DO YOU PAY FOR IT? Also, how do you impose personal responsibility for an individual's own health? Increasing taxes on the upper 2% in multiple areas does not seem to be the way to go, IMHO. Decresased reimbursement to hospitals/providers will leadto all sorts of issues. Decline in quality of providers and care, for starters. Panic in the admin system, which will spiral into lower reimbursement. Medicare/aid already reimburses at 1/5 private insurer levels.

Just watch.

 

[pgg]

Any Ron Paul supporters still want to argue that other Republican and Democrat candidates are indistinguishable from each other? McCain was a tool and Sarah "turtle on a post" Palin was ridiculous, but they wouldn't have given us Kagan and Sotomayor.

Since you guys are discussing this, i'll chime in. Is it possible that covering more people will be beneficial at all? More insured, more payments to hospitals?

It might make ERs less of a loss leader for hospitals.

It may help where I live, since such a huge % of the patient population are self-pay/no-pay. Lots of them aren't even citizens though, so that may be optimistic. There's even less reason to be optimistic in areas that don't have our southern-California-rural-agricultural patient population though, because the net effect of the law will surely be to drive down reimbursement rates for all insurers, as they're forced to insure people they'd previously have turned down.

Government health care (medicare, medicaid, tricare) already reimburse at levels that are break-even or a loss for many practices in many specialties. More patients covered by the government aren't going to be an improvement there.


And ... as someone who works in a monstrously large US government run HMO right now, I can tell you that when healthcare is "free" and "unlimited" there's a whole new level of abuse. A $40 copay keeps most people out of the hospital unless they need to be seen. A $0 copay produces healthy people dropping by the ER to demand Z-Paks to take on vacation, just in case junior gets a viral URI.


It'll also be interesting when (not if) more laws are passed to require private institutions and doctors to accept all government insurance.


The goal of affordable coverage for everyone is a great one. My brother is 48 and self employed. Health insurance is cost prohibitive for him, and he's mostly healthy to begin with. Though I'm disappointed with the ruling, part of me is relieved that he'll have some option beyond bankruptcy if he gets sick when he's 50.

A self-employed friend of his is going to Panama next week for a colectomy. That's ****ed up however you look at it.

 

[sevoflurane]

sigh.... 🙁

 

[Medstudentquest]

Any Ron Paul supporters still want to argue that other Republican and Democrat candidates are indistinguishable from each other? McCain was a tool and Sarah "turtle on a post" Palin was ridiculous, but they wouldn't have given us Kagan and Sotomayor.





It might make ERs less of a loss leader for hospitals.

It may help where I live, since such a huge % of the patient population are self-pay/no-pay. Lots of them aren't even citizens though, so that may be optimistic. There's even less reason to be optimistic in areas that don't have our southern-California-rural-agricultural patient population though, because the net effect of the law will surely be to drive down reimbursement rates for all insurers, as they're forced to insure people they'd previously have turned down.

Government health care (medicare, medicaid, tricare) already reimburse at levels that are break-even or a loss for many practices in many specialties. More patients covered by the government aren't going to be an improvement there.


And ... as someone who works in a monstrously large US government run HMO right now, I can tell you that when healthcare is "free" and "unlimited" there's a whole new level of abuse. A $40 copay keeps most people out of the hospital unless they need to be seen. A $0 copay produces healthy people dropping by the ER to demand Z-Paks to take on vacation, just in case junior gets a viral URI.


It'll also be interesting when (not if) more laws are passed to require private institutions and doctors to accept all government insurance.


The goal of affordable coverage for everyone is a great one. My brother is 48 and self employed. Health insurance is cost prohibitive for him, and he's mostly healthy to begin with. Though I'm disappointed with the ruling, part of me is relieved that he'll have some option beyond bankruptcy if he gets sick when he's 50.

A self-employed friend of his is going to Panama next week for a colectomy. That's ****ed up however you look at it.

So what happens if someone just cannot afford healthcare? They go on medicaid? And why would any employer continue to offer healthcare then? Wouldn't it be just more cost effective for them to drop insurance coverage and pay the penalty tax? That is disastrous for millions of people. If that happens, most people would go on gov healthcare, which would make it excessively $$$ for the country and pay to drop incredibly for doctors.

 

[aneftp]

Since you guys are discussing this, i'll chime in. Is it possible that covering more people will be beneficial at all? More insured, more payments to hospitals?

I also don't see why we simply start cutting from the bottom up. Cutting nurse/PA/NP salaries first. At what point do we say-it's no longer possible/worthwhile financially/sacrifice wise to become a doc?

A person with a 4 year degree working for federal contractor can usually earn close to 100K salary (my wife's college roommate with psychology degree).

An NP can earn between 60-90K. A PA similiar.

What they want to do is make docs earn about $150K and work like dogs.

 

[Skip2myLou]

So what happens if someone just cannot afford healthcare? They go on medicaid? And why would any employer continue to offer healthcare then? Wouldn't it be just more cost effective for them to drop insurance coverage and pay the penalty tax? That is disastrous for millions of people. If that happens, most people would go on gov healthcare, which would make it excessively $$$ for the country and pay to drop incredibly for doctors.

this is something I know many groups are looking into. cheaper to take the penalty for employees working for them. seems like a mass chaos will soon develop after this

 

[Medstudentquest]

A person with a 4 year degree working for federal contractor can usually earn close to 100K salary (my wife's college roommate with psychology degree).

An NP can earn between 60-90K. A PA similiar.

What they want to do is make docs earn about $150K and work like dogs.

This is exactly my point. What the heck is the point of going through over a decade of education, to make the same that a bachelors degree can make you get financially speaking? If we are not compensated as we should, there is no point of being a doc. Takes too much sacrifice and effort to make crap at the end of the day. I also think it's sad how none of the issues like tort reform, escalating med school costs, etc were discussed.

 

[Medstudentquest]

this is something I know many groups are looking into. cheaper to take the penalty for employees working for them. seems like a mass chaos will soon develop after this

Yep, exactly. If I was an employer, I would absolutely drop the healthcare coverage. So I guess in theory we have become a single payer system with the highest medical education costs in the world, and with the highest liability in the world.

Why do i see the exodus of thousands of older docs? Where does that leave us as younger docs?

 

[periopdoc]

Today's decision did nothing to alter my opinion that...

I don't think Obamacare is the death knell of anesthesia or of surgical careers. In fact, there was a good chance that surgery numbers would have gone up while reimbursement went down keeping our incomes somewhat buoyed at a lower level under his full plan. The plan that ultimately went through will, IMHO, set in motion the most painful possible path to a single payer system. Ultimately everyone gets sick of paying the insurance companies for minimal coverage, has to pay out of pocket for real care, and realizes how much of their health care dollar is increasingly going to insurance administrative costs, then they will scream for a single payer system. In the meantime, the majority of the fiscal pain will be carried by physicians and patients, not hospital admins, insurance folks or politicians.
...

- pod

 

[callsux]

your last sentence hits the nail on the head. the last thing anesthesia needs is an expansion of medicaid, which i believe is obamacare's method of extending coverage to those currently uninsured. while covering the uninsured is a worthwhile effort this will have negative consequences to physicians when as you mention small businesses will drop coverage and pay the penalty. this will especially harm practices in areas such as mine where the payer mix is bad already. practices such as mine depend on the relatively small percentage of insured patients to pay our bills, payroll, etc. when you factor in business costs, overhead, etc compared to the terrible reimbursement from government payers there isn't much left from a mc/ma/tricare case. interestingly the court seems to have not allowed the federal gov to force states to expand their medicaid programs via the threat of withholding funds, as i understand it.

 

[nitroglycerine]

Any Ron Paul supporters still want to argue that other Republican and Democrat candidates are indistinguishable from each other? McCain was a tool and Sarah "turtle on a post" Palin was ridiculous, but they wouldn't have given us Kagan and Sotomayor.





It might make ERs less of a loss leader for hospitals.

It may help where I live, since such a huge % of the patient population are self-pay/no-pay. Lots of them aren't even citizens though, so that may be optimistic. There's even less reason to be optimistic in areas that don't have our southern-California-rural-agricultural patient population though, because the net effect of the law will surely be to drive down reimbursement rates for all insurers, as they're forced to insure people they'd previously have turned down.

Government health care (medicare, medicaid, tricare) already reimburse at levels that are break-even or a loss for many practices in many specialties. More patients covered by the government aren't going to be an improvement there.


And ... as someone who works in a monstrously large US government run HMO right now, I can tell you that when healthcare is "free" and "unlimited" there's a whole new level of abuse. A $40 copay keeps most people out of the hospital unless they need to be seen. A $0 copay produces healthy people dropping by the ER to demand Z-Paks to take on vacation, just in case junior gets a viral URI.


It'll also be interesting when (not if) more laws are passed to require private institutions and doctors to accept all government insurance.


The goal of affordable coverage for everyone is a great one. My brother is 48 and self employed. Health insurance is cost prohibitive for him, and he's mostly healthy to begin with. Though I'm disappointed with the ruling, part of me is relieved that he'll have some option beyond bankruptcy if he gets sick when he's 50.

A self-employed friend of his is going to Panama next week for a colectomy. That's ****ed up however you look at it.

You a describing the Canadian model. We are forced to accept the Govt insurance and recently in Ontario the Govt for the first time decided to start decreasing reimbursements to physicians to keep 'free-for-all' system afloat. Many people seem to be able to afford a lot of things EXCEPT private health insurance. Does it really cost so much that a working person is not able to afford it?

 

[jwk]

This is exactly my point. What the heck is the point of going through over a decade of education, to make the same that a bachelors degree can make you get financially speaking? If we are not compensated as we should, there is no point of being a doc. Takes too much sacrifice and effort to make crap at the end of the day. I also think it's sad how none of the issues like tort reform, escalating med school costs, etc were discussed.

You're just now figuring out this part?

 

[pgg]

Does it really cost so much that a working person is not able to afford it?

I tend to believe my brother's self-employed friend wouldn't fly to Central America to get his recurrent colon cancer treated if he was insurable in the United States.

 

[naus]

You a describing the Canadian model. We are forced to accept the Govt insurance and recently in Ontario the Govt for the first time decided to start decreasing reimbursements to physicians to keep 'free-for-all' system afloat. Many people seem to be able to afford a lot of things EXCEPT private health insurance. Does it really cost so much that a working person is not able to afford it?

Just observe the number of Medicaid patients with a smartphone and a $100 a month cable plan...

 

[Medstudentquest]

You're just now figuring out this part?

No, I guess when i initially went into med school I didn't realize that I would be living in an environment where doctors are treated like trash, and we are hit from every possible angle. I don't have ability to see the future. I just cannot imagine how these people sit there and think that our healthcare system will survive/thrive under these circumstances. Seriously. Do they simply not want drs? No one will spend the time, money and sacrifice to become a doc if we don't get compensated. No, we are not greedy freaks but all this does deserve fair compensation.

I don't think the gov has really thought this through well. they are trying to increase 30+ million insured people, with already severe shortages in primary care docs, and they tell them-hey we'll pay you LESS! but you have to see more! people. And for those of you who are specialists, we require you to go through extra years of training, and make crap! But no, we won't change the huge problems present with liability, or subsidize medical education costs, and won't institute end of life care reform, or institute a 35 hour work week like physicians in other countries (like France!).

I see the job market improving very quickly in the upcoming months with the mass exodus of physicians who are near retirement, and any and all of those who can get the heck out of medicine.

 

[Doctor4Life1769]

Just observe the number of Medicaid patients with a smartphone and a $100 a month cable plan...

a part of me giggles and then sighs when I see a medicaid patient (and their families, also on medicaid) having androids or apple iphones with a nice case cover and all sorts of ringtones. oh, and that air jordan nike, too.

 

[partydoc]

a part of me giggles and then sighs when I see a medicaid patient (and their families, also on medicaid) having androids or apple iphones with a nice case cover and all sorts of ringtones. oh, and that air jordan nike, too.

I saw a patient the other day in a free clinic with a Movado watch.

 

[WEBB PINKERTON]

this is something I know many groups are looking into. cheaper to take the penalty for employees working for them. seems like a mass chaos will soon develop after this

I dont buy this argument. Why do they offer healthcare insurance to begin with? If they were gonna drop people wouldnt they have by now (without penalty)?

Im not crazy about the legislation but SOMETHING had to be done. Providers doing WAY too much uncompensated care.

 

[421822]

I dont buy this argument. Why do they offer healthcare insurance to begin with? If they were gonna drop people wouldnt they have by now (without penalty)?

Im not crazy about the legislation but SOMETHING had to be done. Providers doing WAY too much uncompensated care.

Even if that something is just more of what caused the problem?

 

[IlDestriero]

Today's decision did nothing to alter my opinion that...



- pod

That's the ultimate goal.

-
"The truth is incontrovertible, malice may attack it, ignorance may deride it, but in the end; there it is."

 

[doctor712]

Perhaps the next debate, since SCOTUS has spoken on this one - in a rather surprising turn of events with Roberts as the swing, should be socializing the f!$*P(!*$@ing medical education to match with the socialization of medicine, hospitals, insurance companies etc.

I mean, they want social, GIVE US SOCIAL. SUBSIDIZE med school for doctors who will get paid less because of...social medicine. My dear friend graduated from India, med school, he's here now, did PGY1-3, applying to Cards. Not a PENNY in med school loans. WHY? THEY FRIGGING cover it there.

That's the next debate, the first one, was answered today.

And if it were me, I'd learn a second language. If I'm going to make French doctor dollars, might as well be in...France.

D712

 

[Medstudentquest]

Perhaps the next debate, since SCOTUS has spoken on this one - in a rather surprising turn of events with Roberts as the swing, should be socializing the f!$*P(!*$@ing medical education to match with the socialization of medicine, hospitals, insurance companies etc.

I mean, they want social, GIVE US SOCIAL. SUBSIDIZE med school for doctors who will get paid less because of...social medicine. My dear friend graduated from India, med school, he's here now, did PGY1-3, applying to Cards. Not a PENNY in med school loans. WHY? THEY FRIGGING cover it there.

That's the next debate, the first one, was answered today.

And if it were me, I'd learn a second language. If I'm going to make French doctor dollars, might as well be in...France.

D712

You guys get it! Exactly what i've said. I think many people would be ok making less if everyone made less, medical education was free, and we worked 35 hours (what French docs work) or work until we hit the payment cap (i think it's 400k for orthopods in Canada, and they are off the rest of the year). Also minimal malpractice.

Also it's amazing that nurse/NP/PA salaries don't get cut first.

 

[doctor712]

You guys get it! Exactly what i've said. I think many people would be ok making less if everyone made less, medical education was free, and we worked 35 hours (what French docs work) or work until we hit the payment cap (i think it's 400k for orthopods in Canada, and they are off the rest of the year). Also minimal malpractice.

Also it's amazing that nurse/NP/PA salaries don't get cut first.

I think everyone will take a hit.

I'm not saying make less because everyone is making less. Just docs. Docs would be better willing (i think, voices anyone?) to make less if they didn't walk outta med school having a MORTGAGE to pay off. I would. If I made 400K with 200K in loans, that's doable I think. 200K with 200K in loans? REALLY?! How about 250K with 300K in loans, I know peeps with that picture. Maybe the match didn't go well, maybe Step 1 wasn't killer, maybe grades weren't stellar, not many options when they graduate, 300K hanging over their heads, they are UP THE CREEK.

I mean, can you really go into Psychiatry making 150K after graduating TUFTS MEDICAL (60$K a year) or as an out of state student at Univ. Colorado (also 60K$ a year)? 240K is 2K a month in loans, right? At 150K you're making 12500 a month. Before taxes. After, you're seeing what? 7 or 8? Rent/Mortgage: 2000-2500? In NYC? HAHAHAHAHAHAHA. In LA? HAHAHAHAHA. That's leaves 5000K for some. Cars? Kids? 2000 MORTGAGE PAYMENT to TUFTS? Leaves you at 3000K for the month. 700 and change a week. Savings? Bills? KIDS? Thus, the point, you should study for 8 years, owe a HOUSE in money, and face $150K whereby in the back of your mind, you wanna live in NY or LA or MIAMI and practice Psych?

F%$(@#{)(% insanity.

D712

 

[doctor712]

You guys get it!

Note: I'm not a doctor. Not that there's much confusion there. But for a newer member, just to be clear.

d712

 

[Medstudentquest]

I think everyone will take a hit.

I'm not saying make less because everyone is making less. Just docs. Docs would be better willing (i think, voices anyone?) to make less if they didn't walk outta med school having a MORTGAGE to pay off. I would. If I made 400K with 200K in loans, that's doable I think. 200K with 200K in loans? REALLY?! How about 250K with 300K in loans, I know peeps with that picture. Maybe the match didn't go well, maybe Step 1 wasn't killer, maybe grades weren't stellar, not many options when they graduate, 300K hanging over their heads, they are UP THE CREEK.

I mean, can you really go into Psychiatry making 150K after graduating TUFTS MEDICAL (60$K a year) or as an out of state student at Univ. Colorado (also 60K$ a year)? 240K is 2K a month in loans, right? At 150K you're making 12500 a month. Before taxes. After, you're seeing what? 7 or 8? Rent/Mortgage: 2000-2500? In NYC? HAHAHAHAHAHAHA. In LA? HAHAHAHAHA. That's leaves 5000K for some. Cars? Kids? 2000 MORTGAGE PAYMENT to TUFTS? Leaves you at 3000K for the month. 700 and change a week. Savings? Bills? KIDS? Thus, the point, you should study for 8 years, owe a HOUSE in money, and face $150K whereby in the back of your mind, you wanna live in NY or LA or MIAMI and practice Psych?

F%$(@#{)(% insanity.

D712

Well for one, psychiatrists make much more than that. Starting salaries in psych are usually 200k+, and private practice psychs make in the range of 300k. However, I agree it's laughable that people would be burdened with this sort of debt and get paid less than 200k in any specialty. It's a shame when NP/PAs are making 100k with little medical knowledge and much less debt/liability/work.

 

[IlDestriero]

Note: I'm not a doctor. Not that there's much confusion there. But for a newer member, just to be clear.

d712

You may not be a doctor, but you'll soon be better paid than most doctors.😉 Maybe you already are?... You're buying the Laphroaig.😀

-
"The truth is incontrovertible, malice may attack it, ignorance may deride it, but in the end; there it is."

 

[DrBeaker]

I think my decision to do a fellowship vs PP job just tipped toward getting a job.

 

[yappy]

AH! I could not believe it when I heard this. There needs to be a massive pushback from physicians on this bill. I predict that there is a huge brain drain coming to our country over the next 10 years.

 

[Medstudentquest]

AH! I could not believe it when I heard this. There needs to be a massive pushback from physicians on this bill. I predict that there is a huge brain drain coming to our country over the next 10 years.

We should start forming unions and striking, walking out, demanding better pay, cutting of nurse pay, immediately.

Why are we not doing this? Because we are a pansy profession. What are they going to do-fire us? ha!

 

[doctor712]

You may not be a doctor, but you'll soon be better paid than most doctors.😉 Maybe you already are?... You're buying the Laphroaig.😀

-
“The truth is incontrovertible, malice may attack it, ignorance may deride it, but in the end; there it is.”

It will be my PLEASURE to buy u more than one LAPHROIAG, Doc.

D712

 

[doctor712]

Well for one, psychiatrists make much more than that. Starting salaries in psych are usually 200k+, and private practice psychs make in the range of 300k. However, I agree it's laughable that people would be burdened with this sort of debt and get paid less than 200k in any specialty. It's a shame when NP/PAs are making 100k with little medical knowledge and much less debt/liability/work.

I know Interventional cards docs coming out of fellowship making 225k. You're saying PSYCH makes that out of the door? On avg? I don't believe it. 300k, to me is the journeyman PP psych. Maybe I'm off. Don't see it.

65$ an hour for a session... ONE SESSION. EVEN 100$.
are the anesthesiologists here that make 300k make 300 for a heart case from 9-1?
I don't know. No clue but would think more than the 100$ an hour
Psych...

D712

 

[DrAwsome]

I know Interventional cards docs coming out of fellowship making 225k. You're saying PSYCH makes that out of the door? On avg? I don't believe it. 300k, to me is the journeyman PP psych. Maybe I'm off. Don't see it.

65$ an hour for a session... ONE SESSION. EVEN 100$.
are the anesthesiologists here that make 300k make 300 for a heart case from 9-1?
I don't know. No clue but would think more than the 100$ an hour
Psych...

D712

I think medstudentquest is correct on this. From residency, offers range between 180-240ish, and usually for 4 days of work. Add some private practice with that, and you are making 300k easily. Remember that psychs also don't have a great deal of overhead-they dont' need equipment, nurses, etc. Just need a secretary/biller and you are good to good. Also, they dont' charge 65$/session. You are thinking therapists. Psychs in pp usually charge around $100/15 minute med check, around 300$/hr. For those working in wealthier areas, they can charge even more. I know because even though I'm not in psych, I was interested in psych as a student and interviewed at some pretty good places, and became acquainted with the stats.

Interventional cards makes significantly more than 225k. Maybe in the middle of Manhattan or something due to saturation, but otherwise salary is much more than that.

 

[BLADEMDA]

Originally Posted by periopdoc
I don't think Obamacare is the death knell of anesthesia or of surgical careers. In fact, there was a good chance that surgery numbers would have gone up while reimbursement went down keeping our incomes somewhat buoyed at a lower level under his full plan. The plan that ultimately went through will, IMHO, set in motion the most painful possible path to a single payer system. Ultimately everyone gets sick of paying the insurance companies for minimal coverage, has to pay out of pocket for real care, and realizes how much of their health care dollar is increasingly going to insurance administrative costs, then they will scream for a single payer system. In the meantime, the majority of the fiscal pain will be carried by physicians and patients, not hospital admins, insurance folks or politicians.


POD is correct. The path to a single payer system is set in motion and by the time we enact the MEDICARE USA FOR ALL plan in about 10-12 years the entire country will be clamoring for socialized medicine including all of us.
...

 

[med12345]

Young college students will never stop studying for the MCAT. They will always strive to have the title of doctor. I believe 18 year old kids don't have any concept of the financial impact of medical school, residency, increasing taxes, and decreasing physician salaries.

Think back to when you were in college. Why did you want to become a physician?

I believe those reasons are still very prevelant. Go to the premedical forum to understand what I mean.

This is difficult to grasp for some who are already physicians.

 

[pgg]

Young college students will never stop studying for the MCAT. They will always strive to have the title of doctor. I believe 18 year old kids don't have any concept of the financial impact of medical school, residency, increasing taxes, and decreasing physician salaries.

Think back to when you were in college. Why did you want to become a physician?

I believe those reasons are still very prevelant. Go to the premedical forum to understand what I mean.

This is difficult to grasp for some who are already physicians.

QFT

This thread is TEN YEARS OLD and still going strong.

The doctor pipeline will always be full.

 

[vector2]

Young college students will never stop studying for the MCAT. They will always strive to have the title of doctor. I believe 18 year old kids don't have any concept of the financial impact of medical school, residency, increasing taxes, and decreasing physician salaries.

Think back to when you were in college. Why did you want to become a physician?

I believe those reasons are still very prevelant. Go to the premedical forum to understand what I mean.

This is difficult to grasp for some who are already physicians.

I also think the brain drain thing is a myth. You've got 40k people applying to < 20k spots....there's surely a significant buffer of more-than-qualified folks just standing in line. Not to mention that the degree of competitiveness for med school in socialized European countries puts US admission standards to shame.

 

[BLADEMDA]

I also think the brain drain thing is a myth. You've got 40k people applying to < 20k spots....there's surely a significant buffer of more-than-qualified folks just standing in line. Not to mention that the degree of competitiveness for med school in socialized European countries puts US admission standards to shame.

Vector,

There is nothing wrong with wanting to be a govt employee with good benefits earning $200K and working 40 hours a week. In addition, you can help people get better and do some great things while at work. Plus, you get the title Doctor.

That is your job in 2022 but it isn't the one I Signed up for. Things change. I get it. But, I don't have to like it or agree with it even though I must accept it.

 

[yappy]

As a young professional you would not consider moving for higher pay, better career growth, or an overall better standard of living? I would. I would gian my degree/training and move for best opporunities no matter if it were medicine, engineering, science, business etc. etc.

For example, why work US hours for Can. pay when you could have Can. pay for Can. hours?

I also think the brain drain thing is a myth. You've got 40k people applying to < 20k spots....there's surely a significant buffer of more-than-qualified folks just standing in line. Not to mention that the degree of competitiveness for med school in socialized European countries puts US admission standards to shame.

 

[BLADEMDA]

As a young professional you would not consider moving for higher pay, better career growth, or an overall better standard of living? I would. I would gian my degree/training and move for best opporunities no matter if it were medicine, engineering, science etc. etc.

For example, why work US hours for Can. pay when you could have Can. pay for Can. hours?

Canada is about to get FULL. Better move quick as I expect few openings for U.S. trained Physicians in Canada circa 2020.

 

[IlDestriero]

Canada is about to get FULL. Better move quick as I expect few openings for U.S. trained Physicians in Canada circa 2020.

It's quite the temptress. Eh?

-
"The truth is incontrovertible, malice may attack it, ignorance may deride it, but in the end; there it is."

 

[DrAwsome]

Canada is about to get FULL. Better move quick as I expect few openings for U.S. trained Physicians in Canada circa 2020.

Why not do something about it? I do have to say though that anesthesiologists created this problem on themselves to some extent. By saying that nurses can do your job for less, albeit not so much less, it has created a huge problem for yourselves. Do something about it.
Stand up, work Canadian or even better! French hours (apparently they are capped at 35 hours). How long can they push us around for?