Well said

[michigangirl]

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Well put, doctor.

http://www.meandmydoctor.com/2012/07/setting-record-straight-on-doctor-pay.html

 

[AlmostJesus]

For those that dont want to click

The following is a response by Joseph Valenti, MD, to commentary published Friday in the Dallas Morning News by Eli Lehrer, president of R Street. In the article, Mr. Lehrer claims U.S. physicians and health care workers make too much money and are responsible for the high cost of medical care in America.

Dear Sir:

I am a physician in Denton, Texas. This morning, I sat and read your article in The Dallas Morning News titled “Your Doctor’s Big Fat Paycheck.” Frankly, I am in awe of the breadth of your ignorance.

Fact: Of the health care dollars spent in this country, physician salaries make up about 8.5 percent. That is one of the lowest percentages in the industrialized world. Germany, by contrast, is at 15 percent.

Fact: The graduate level course of study for nurse practitioners (NPs) and nurses is not even close to that of physicians — we have a little something called residency. Perhaps you’ve heard of it. When I did mine in OB-Gyn from 1994 to1998, it was 90-100 hours a week for four years with a take home pay of $20,000. I was raising a family on that, as my wife had to stay home to take care of premature twins. NPs and nurses do none of that.

Fact: Private insurers are already too strong. “Weak bargaining position”? If you don’t like the contract they offer, they tell you to take a hike. Doctors are the ones with no bargaining position. I haven’t had an increase from United Healthcare for 54 months. Meanwhile, it paid its shareholders an 11-percent dividend last year. And regarding your comment about how individual plans rarely cover one-half an area — do your homework! States like Alabama have Blue Cross and Blue Shield covering 90 percent of insured lives! In any other industry, this would constitute a monopoly.

Fact: Medicare increases have been had by every segment of the health care industry except doctors. (See the charts.)

Fact: Pilots may make less than doctors. They also belong to unions and walk out when they don’t get what they want. Doctors never walk out, and the pro bono and free care we hand out can’t even be deducted from our federal taxes as charity. Then try breaking it down per hour. Pilots fly about 60 hours/month. Doctors work in the office and hospital about 60 hours/week. And that doesn’t take into account nights and weekends on call. Don’t get me wrong — pilots are vital and do a great job. But on a per-hour basis, they are clearly ahead. By the way, I don't know a single primary care doctor who makes $200,000 a year. Most of the ones I know are barely getting by, and many are closing their practices or selling them to hospitals.

A huge doctor shortage is looming. We cannot and will not attract our best and brightest students to medicine unless their pay is commensurate with the level and intensity of work and commitment needed to fund a modern medical education. The student loan burden alone, which is now often exceeding $200,000, keeps many away.

The huge amount we spend in this country for health care has far less to do with medical professionals’ salaries than it does with the cost of almost everything else. Case in point: The same Mirena IUD, from the same single factory that Bayer uses in Finland, costs $700 in the United States but costs $250 in Canada. Really? That same case can be made for tens of thousands of drugs and medical products here.

Medicine is one of the only businesses I know of where the increasing cost of doing business can’t be passed on to the customer. Every year, the cost of running my office and paying my employees goes up, while insurance payments stay the same or go down. I am left to eat the difference. My salary the last three years is less than I made 14 years ago when I started in private practice. Hardly a source of bankrupting the health care system.

Shakespeare said that the eye sees what the mind knows. With that in mind, ask yourself if you would feel comfortable entrusting your care or that of your family to someone with less training, less knowledge, and less expertise. Would you? I think not. Now ask yourself how happy one of us would be treating someone like you, who wrote an article that is so misleading about us and who we really are and what we really have done to become really good at taking care of patients. Surprise. We would love to take of you. Why? Because that is what we took a vow to do, a vow that doesn’t allow us the luxury of being judgmental. So the next time you are lying in bed needing emergency surgery, remember this — we will be there. Pay or no pay. Assign a value to that ideal, and then consider whether or not we are “overpaid.”

Sincerely,
Joseph S. Valenti, MD, FACOG

 

[chessknt]

Comments section of that article was really disparaging, but thankfully just a vocal minority.

Also found this gem in there too:

"I will be a doctor but I am the son of a CRNA. I can tell you that my father who has worked on-call every year for the last 20years has put in more hours then a lot of doctors. The OB doctor at his hospital might reach my dad's hours but thats it. Even when he is not on call he can end up working 60-80 hours. Most of the time he gets no break during regular work hours and lunch is one bite on the go. in fact he had an 80+ on-call work week followed by a 60 hour off call work week. He also gets no respect from many doctors and administrators because of the RN in CRNA yet every single doctor wants him working their surgeries. He gets up and starts work around 6 or 7 everyday he works and half the time doesn't get to go home till 6-8pm.
I do believe most doctors do deserve to make more money then the rest (the exception being an anesthesiologist as most don't do crap and are paid on the backs of CRNA's. I will never let one touch me. The best thing a CRNA can do is find a hospital that doesn't have one) but their are many andvanced nurse practioners out there who are underpaid. Fact is nurse's and doctors are all important and deserve respect and Dr Valenti's rebuttal was very good but some of his facts were a little off."

 

[MD Dreams]

The Dad sounds like a work-a-holic. No wonder the Son is screwed up 🙂

 

[courtnes]

That, and why is he choosing to be a doctor instead of a CRNA or NP himself? If you're going to complain, put your money where your mouth is.

I thought the article was spot on, he distilled his rebuttal to the important points.

 

[cincincyreds]

Comments section of that article was really disparaging, but thankfully just a vocal minority.

Also found this gem in there too:

"I will be a doctor but I am the son of a CRNA. I can tell you that my father who has worked on-call every year for the last 20years has put in more hours then a lot of doctors. The OB doctor at his hospital might reach my dad's hours but thats it. Even when he is not on call he can end up working 60-80 hours. Most of the time he gets no break during regular work hours and lunch is one bite on the go. in fact he had an 80+ on-call work week followed by a 60 hour off call work week. He also gets no respect from many doctors and administrators because of the RN in CRNA yet every single doctor wants him working their surgeries. He gets up and starts work around 6 or 7 everyday he works and half the time doesn't get to go home till 6-8pm.
I do believe most doctors do deserve to make more money then the rest (the exception being an anesthesiologist as most don't do crap and are paid on the backs of CRNA's. I will never let one touch me. The best thing a CRNA can do is find a hospital that doesn't have one) but their are many andvanced nurse practioners out there who are underpaid. Fact is nurse's and doctors are all important and deserve respect and Dr Valenti's rebuttal was very good but some of his facts were a little off."

Why don't you become a cRNA if you don't want an Anesthesiologist to touch you. Some Anesthesiologists are lazy. But others like me do all our own cases and do work hard without breaks. We don't have cRNAs where I work, so if every group was like mine, all the cRNAs would be out of business. I agree, there are many nurses who are underpaid.

What fact was off by Dr. Valenti if you mind I ask?

 

[Consigliere]

What fact was off by Dr. Valenti if you mind I ask?

Ummmmm....you do realize that you are posing a question to comments posted by chessknt87 that he cut and pasted from someone else in response to the letter from Dr. Valenti, right? Probably not gonna get an answer to your question.

 

[BuckRx]

That, and why is he choosing to be a doctor instead of a CRNA or NP himself? If you're going to complain, put your money where your mouth is.

I thought the article was spot on, he distilled his rebuttal to the important points.

Though to be fair, "doctor" is a little ambiguous these days.

 

[courtnes]

Though to be fair, "doctor" is a little ambiguous these days.

True, but if you've grown up in healthcare to some extent, you should know the differences and represent yourself properly. That said, this is the internet so who knows?

 

[BLADEMDA]

USC sCRNA wrote:
As a student CRNA, I am also thinking of going and get my DNAP (Doctor of Nurse Anesthesia Practitioner). It is equivalent to being a physician. And as such, can introduce myself as being a doctor, because I am a doctor of nurse anesthesia. Its an additional training after nurse anesthesia school. Its the fastest way to becoming a practicing doctor.
I'm so glad the AANA thought of expanding our scope of practice.
<quoted text>

 

[WholeLottaGame7]

USC sCRNA wrote:
As a student CRNA, I am also thinking of going and get my DNAP (Doctor of Nurse Anesthesia Practitioner). It is equivalent to being a physician. And as such, can introduce myself as being a doctor, because I am a doctor of nurse anesthesia. Its an additional training after nurse anesthesia school. Its the fastest way to becoming a practicing doctor.
I'm so glad the AANA thought of expanding our scope of practice.
<quoted text>

On the plus side, at least people are still desperately trying to equate themselves with us. It's not like anybody's saying, "It's equivalent to being a DNAP!"

 

[Bertelman]

Though to be fair, "doctor" is a little ambiguous these days.

On the plus side, at least people are still desperately trying to equate themselves with us. It's not like anybody's saying, "It's equivalent to being a DNAP!"

 

[yappy]

lol. Imagine some mid-life secretary gone RN career changers.

"Yup. Goin' do my A&P prereqs at the community college to get my Nursin' degree. Then just work while I'm gettin' my DNAP. Same as a doctor".

Imagine the cultural divide between these providers and physicians? The educated VS the trained.

 

[pgg]

The DNAP thing is a racket.

I was talking about it with a CRNA the other day. Solid, skilled CRNA. He's looking into an online DNAP program. I asked him what he could possibly hope to gain or learn from an online degree mill, and he readily admitted it was letter-chasing for future employment and job security reasons. $40,000 "tuition" to sit at a computer for a while.

He's not the first one I've talked to with similar plans.

I thought it was interesting that there are CRNAs out there who plan to do it, not because they think it'll make them better clinicians, not because they want to because the knowledge is its own reward, not even because they have a doctor-wannabe chip on their shoulders ... but because they are anticipating an employment crunch and the way the nurse culture handles employment crunches is by adding irrelevant capital letters after their names.

What I'm seeing is resentment that the AANA is pushing this pseudo-doctorate nonsense, and frustration that they're going to have to cough up $40K or so because of it.

 

[Mman]

USC sCRNA wrote:
As a student CRNA, I am also thinking of going and get my DNAP (Doctor of Nurse Anesthesia Practitioner). It is equivalent to being a physician. And as such, can introduce myself as being a doctor, because I am a doctor of nurse anesthesia. Its an additional training after nurse anesthesia school. Its the fastest way to becoming a practicing doctor.
I'm so glad the AANA thought of expanding our scope of practice.
<quoted text>

I'm gonna start training CLPNAs. They are nurses. Same as RNs. We will give them 2 years of anesthesia training and then start replacing the CRNAs with the CLPNAs. By CRNA logic, that's totally cool.

 

[Bertelman]

I'm gonna start training CLPNAs. They are nurses. Same as RNs. We will give them 2 years of anesthesia training and then start replacing the CRNAs with the CLPNAs. By CRNA logic, that's totally cool.

Only if you make it an online course without patient contact.

Isn't there a website like gasman.com or something with an anesthesia machine simulator?

 

[PeepsLove]

Maybe the AAs should add a year to their schooling and call themselves DAAs or something. Then they can tell the CRNAs to shove off because they're "doctors" now too. I'm sure CRNAs would love that.

 

[PinchandBurn]

Well put, doctor.

http://www.meandmydoctor.com/2012/07/setting-record-straight-on-doctor-pay.html

great article. I admire this Doctor's rise to the ocassion. We should all be this vocal.

 

[2win]

Great!!!!
CLPNAS - the future .

 

[CrazyJake]

We have some good CRNAs (some bad too) at my program and it's great to listen to them talk trash on the AANA.

They hate their leaders more than I ever imagined. CRNAs had a great gig going, but have just ruined it from the top down by the pseudo DR title, opening up mills that any nurse can go to, attempting to broaden their practices into pain and joke fellowships. It's comical.

Interviewed with a group recently who has employed CRNAs for the last 20 years but will ONLY hire AAs going forward b/c of the AANA propaganda! I'd suggest we follow suit too.

CJ

 

[saratoga733]

"Interviewed with a group recently who has employed CRNAs for the last 20 years but will ONLY hire AAs going forward b/c of the AANA propaganda! I'd suggest we follow suit too."

We went one step further and recently decided to hire a couple of PAs for PACU and PAST help. AA's would be ideal but there are very few available and they get gobbled up fast. More AA schools would solve that problem... in time. Would have happily hired nurses but the AANA is making that option unpalatable to say the least.

 

[jwk]

Maybe the AAs should add a year to their schooling and call themselves DAAs or something. Then they can tell the CRNAs to shove off because they're "doctors" now too. I'm sure CRNAs would love that.

Thanks, but we'll pass. 😀

 

[deleted126335]

We have some good CRNAs (some bad too) at my program and it's great to listen to them talk trash on the AANA.

They hate their leaders more than I ever imagined. CRNAs had a great gig going, but have just ruined it from the top down by the pseudo DR title, opening up mills that any nurse can go to, attempting to broaden their practices into pain and joke fellowships. It's comical.

Interviewed with a group recently who has employed CRNAs for the last 20 years but will ONLY hire AAs going forward b/c of the AANA propaganda! I'd suggest we follow suit too.

CJ

They may resent some of the choices AANA leadership is making, i.e, flooding the market, creating "tiers" of CRNAs with DNAP/PhD CRNA)-but I guarantee you that they love what they are doing to us.
-Dollars to doughnuts all are dues paying AANA members.
-You could Suggest that they resign from AANA and join ASA as an affiliate (yes CRNAs are eligible)
See how that suggestion goes over.

 

[Mman]

They may resent some of the choices AANA leadership is making, i.e, flooding the market, creating "tiers" of CRNAs with DNAP/PhD CRNA)-but I guarantee you that they love what they are doing to us.
-Dollars to doughnuts all are dues paying AANA members.
-You could Suggest that they resign from AANA and join ASA as an affiliate (yes CRNAs are eligible)
See how that suggestion goes over.

Doubt they are all dues paying members. More than a few of our CRNAs are not AANA members. They decided to stop sending in money every year when they felt like they got nothing in return.

 

[Skip2myLou]

"...and chartered actuaries &#8212; who calculate risk for insurance companies and must pass complex exams longer and arguably more difficult than the medical boards &#8212; about $150,000."

basing salaries solely on difficulty of exams is asinine. actuaries also don't have someone life in their hands. also no malpractice or the risk of constantly being sued evens out the salaries in my eyes. when was the last time someone said ... help, is there an actuary in the house.

 

[chessknt]

Doubt they are all dues paying members. More than a few of our CRNAs are not AANA members. They decided to stop sending in money every year when they felt like they got nothing in return.

Quite a few at my institution dropped their memberships when the AANA instituted mandatory license renewal (different from re-cert) that would cost even more.