When to dilute IV meds?

[DVMDream]

I just don't know how we can control costs while people continue living unhealthy lifestyles. Health is getting worse and worse and costs are continuing to rise. Eventually our whole paychecks will go to healthcare.

I highly doubt that most of healthcare costs are related to unhealthy living. I know some is, but I doubt that is most of it. I think you are attempting to blame something that probably isn't the biggest contributor. Want to control healthcare costs? Look to any other developed nation in this world with government provided healthcare. They have checks in place to control raging costs. It isn't difficult, our country just likes to exaggerate and make things more difficult than necessary.

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[RNtoMD87]

I agree. I do think giving government direct control over costs and appointing physicians who are knowledgeable in charge of determining set cost controls would be a huge step forward.

I don't think providers should be paid for a procedure. For example for a gall bladder costs x dollars. This causes conflicting interests. Is the doctor doing whats best for the patient or best for his pocket? They should all be paid a yearly salary that is decided by perhaps the surgeon general. Someone elses illness should not be a wealth generator.

 

[DVMDream]

I agree. I do think giving government direct control over costs and appointing physicians who are knowledgeable in charge of determining set cost controls would be a huge step forward.

I don't think providers should be paid for a procedure. For example for a gall bladder costs x dollars. This causes conflicting interests. Is the doctor doing whats best for the patient or best for his pocket? They should all be paid a yearly salary that is decided by perhaps the surgeon general. Someone elses illness should not be a wealth generator.

You will lose every doctor if you attempt to blanket salary them. Certain surgeries should generate greater revenue because they are more complex and inherently have greater risk, which increases the risk of losing a patient which can increase costs for liability insurance as well as increase the chances of being sued.

You can't blanket cost surgery, it doesn't work, there is too much variable, plus if **** hits the fan in there and complications occur, the surgeon deserves to be compensated for dealing with those.

 

[RNtoMD87]

Something needs to change. I'm currently shadowing a surgeon and he literally says "man gallbladders are my bread and butter! If I can line up a bunch of people, I can KILL it making money. If not, I don't make so much".

Makes me suspect some people may get unnecessary surgeries..

 

[twelvetigers]

This thread is slowly spiraling towards the earth...

 

[DVMDream]

This thread is slowly spiraling towards the earth...

Slowly? I've seen the train wreck for a while and have already declared troll. This is just for entertainment value at this point.

 

[RNtoMD87]

Troll because I think America's healthcare system is BS? That's a huge reason I want to be a doctor. I don't need to get rich, I'd rather make a modest amount of money and have a clear conscience. I won't have student loans to pay off, so there won't be a conflict of interest between doing what's right for the patient or staying deep in debt.

I am excited to be able to get involved in preventative healthcare. I lost over 100 pounds of fat and got much stronger, and know if I can turn my health around, so can many others.

 

[dyachei]

Procedures should absolutely cost money.

Surgeons spend a lot of time in training to make their "bread and butter" at something they are experts at. It'd be like me telling a car mechanic they shouldn't charge for an engine replacement and just accept a salary because they shouldn't profit from someone else's misfortune.

Which is dumb.

Surgeons and other doctors have every right to make money and starting with them as the cost cutting begins will only leave us with a lack of doctors.

Procedures have a large amount of overhead. That needs to be paid for - sterilization of the surgery suite, nursing staff, after care, electricity etc all costs a lot of money

You really need to educate yourself before making these proclamations because they seem very naive.

 

[dyachei]

Just because you won't have loans doesn't mean other people don't. You should be able to do well in an industry you are trained for. Look at the UK system. Those doctors are paid poorly and they see having huge issues with a shortage

 

[RNtoMD87]

I'm not against doing well, just profiting off of others suffering. Healthcare is a right. I think physicians vets and all healthcare providers should be properly compensated, but I think that when the Canadian doctors said "We get paid too much" which was showcased on the front of this website, it really resonated with me. I dont think it's just physicians though. I get paid more than necessary also.

 

[DVMDream]

I'm not against doing well, just profiting off of others suffering. Healthcare is a right. I think physicians vets and all healthcare providers should be properly compensated, but I think that when the Canadian doctors said "We get paid too much" which was showcased on the front of this website, it really resonated with me. I dont think it's just physicians though. I get paid more than necessary also.

You're naive. Or just don't care to listen. Or both.


Yeah, I already know you'll comment to this with some random tangent that doesn't even apply to what I'm saying like you've been doing all thread.

 

[CalliopeDVM]

I highly doubt that most of healthcare costs are related to unhealthy living. I know some is, but I doubt that is most of it.

It's very multifactorial, especially in the US, which spends far more on healthcare and has generally poorer health, based on several metrics, when compared to the rest of the developed world.

 

[pinkpuppy9]

It will not be easy, but does that mean we should do nothing? Its just like more stringency on firearms. It won't be easy to pass but we must do something. Now that insurance coverage is a requirement (or face a penalty), we can further mandate healthy lifestyle choices, and simply implement penalties for not complying. For instance, nicotine tests. They did it while I was in the military. If you passed a nicotine test it saved money on insurance. My hospital has "healthy lives" which rewards individuals for maintaining a healthy lifestyle.

We can further implement more of these practices.

Okay, but what about people who work dangerous jobs? Maybe you don't like the fact that people are overweight or smoke, but everyone forgets that there are actual jobs that prevent an ideal 'healthy' lifestyle by nature. Exposure to carcinogens/pollutants, hard labor, animal work, etc. Those careers are usually just as much of a choice as smoking and being overweight (to an extent, we know there is more science to obesity than just eating).

Also, I suspect you haven't encountered this, but mandating healthy lifestyle choices sounds like such a noble thing until you realize that those struggling with poverty often cannot afford/physically cannot access healthy food. You can feed a family of 5 for cheap with fast food compared to groceries. $10-15, if that. As for access, haven't you ever heard of food deserts? For example, for a very long time (years and years), Detroit did not actually have a grocery store. Party stores, gas stations, sure, but not an actual grocery store. No one can afford to buy/lease a car, take a cab, or take a two hour (one way) bus ride to the nearest store. Families survive on fast food. I always got a little annoyed with people saying 'Well they don't look hungry/poor because they're all overweight' when no one bothers to consider the fact that some people in this world can only feasibly feed their families McDonalds. You would be penalizing people for being poor. We already do enough of that with our current state of healthcare, education, jobs, etc.

Also, before you bring up the fact that McDonald's has salads, compare the price of a salad to a large fry and you have your answer. Calories/nutritional value aren't all that different between the two, either.

Oh, and the first grocery store that finally hit Detroit after however many years? Whole Foods, a store that middle class families cannot even afford to shop at weekly.

 

[dyachei]

I'm not against doing well, just profiting off of others suffering. Healthcare is a right. I think physicians vets and all healthcare providers should be properly compensated, but I think that when the Canadian doctors said "We get paid too much" which was showcased on the front of this website, it really resonated with me. I dont think it's just physicians though. I get paid more than necessary also.

You are, though. You keep telling me why doctors are overpaid, but for their debt to income, they really aren't.

what other professions do you know that put in the same amount of hours with on call?

 

[RNtoMD87]

I'm not saying they don't work hard. But many people work hard and barely make a living wage.

I know they work VERY hard.

 

[DVMDream]

I'm not saying they don't work hard. But many people work hard and barely make a living wage.

I know they work VERY hard.

So you believe the people who quite literally save lives should be scrapping by off rice and beans and barely making a living wage?



Why don't you go attack professional sports players or actors for "making too much money" and leave those in medicine really not making all that much alone.

 

[RNtoMD87]

I'm not saying we as healthcare providers should be impoverished. And yes, it is a travesty that entertainers make that much. But why do I make over 100k a year in complete safety working fewer hours, with much more ease than when I was in Iraq literally putting my life on the line in 140 degree heat? I made maybe 32,000 a year then and worked 6 days per week all day. Its very much backwards. Our servicemembers still serving deserve much more. And so do our police who put their lives on the line, and many other professions.

I have no problem with a physician making 150,000 a year because they do work hard. Harder than I do. But 400k a year? 500k a year?

We need to decide how much money one person really needs.

 

[DVMDream]

I'm not saying we as healthcare providers should be impoverished. And yes, it is a travesty that they make that much. But why do I make over 100k a year in complete safety working fewer hours, with much more ease than when I was in Iraq literally putting my life on the line in 140 degree heat? I made maybe 32,000 a year then and worked 6 days per week all day. Its very much backwards. Our servicemembers still serving deserve much more. And so do our police who put their lives on the line, and many other professions.

I have no problem with a physician making 150,000 a year, but 400k a year? 500k a year?

We need to decide how much money one person really needs.

Instead of claiming a physician should be making less. You should remain your focus on others should make more.

You don't accrue 6 figures of debt to become a police officer or firefighter or paramedic. Yes, they have difficult and dangerous jobs, but they don't pour hundreds of thousands of dollars into education. They also don't have to pay for license renewal or CE or malpractice insurance, etc, etc.

You are comparing careers that don't have similar outputs.

This isn't to say that those people don't deserve more but that doesn't mean that physicians deserve less.

When it takes literally 12+ years of advanced education and insane amounts of money to become a police officer then they can for sure request a 400k per year salary.

 

[RNtoMD87]

Well education should be free, just like healthcare. So that is a problem, that it costs so much debt to go to school. But shouldn't risking ones life be worth more than 30,000? Every soldier should be paid at least 100,000 per year, and every policeman and firefighter as well.


So I suppose you have a point. We should just pay everyone else more. Hopefully minimum wage will be 15$ an hour nationwide soon.

 

[DRider13]

Well education should be free, just like healthcare. So that is a problem, that it costs so much debt to go to school. But shouldn't risking ones life be worth more than 30,000? Every soldier should be paid at least 100,000 per year, and every policeman and firefighter as well.

So I suppose you have a point. We should just pay everyone else more. Hopefully minimum wage will be 15$ an hour nationwide soon.

Have you ever taken a basic economics course? Cause basic economics covers a concept called risk vs. benefit.

This concept basically states that if the risk is too high, you don't proceed with a certain action. However, if the perceived benefit outweighs the risk, you make the decision to proceed.

People in dangerous professions such as policemen, firefighters, etc. either consciously or subconsciously do a risk vs. benefit analysis when making the decision to pursue these professions. By choosing to become a policeman/firefighter/WHATEVER, a person is forced make the internal decision that the low pay is worth the risk, otherwise he or she wouldn't pursue that job. When/if the risk finally outweighs the perceived benefit, they pursue an alternative course of action (in this case, a different position or profession).

I don't disagree that some of these professions should make more money, but that's just my personal risk/benefit analysis of why I personally wouldn't pursue those jobs.. the pay isn't worth the risk, and these professions aren't enticing enough for me to want to pursue them and accept a low pay.

If NOBODY feels the risk is worth the benefit, pay would increase until someone feels it is worth the risk.

 

[dyachei]

Well education should be free, just like healthcare. So that is a problem, that it costs so much debt to go to school. But shouldn't risking ones life be worth more than 30,000? Every soldier should be paid at least 100,000 per year, and every policeman and firefighter as well.


So I suppose you have a point. We should just pay everyone else more. Hopefully minimum wage will be 15$ an hour nationwide soon.

So what are your solutions to make those things happen. I hear a lot of idealism and judgements based off that instead of realism

Do you know the cost of malpractice insurance for a pediatric neurosurgeon? I do. And I know one who had to stop practicing because the risk was too high and he didn't make enough

Stop talking about them making too much because they make $400k. You don't know what all that goes to

 

[RNtoMD87]

My solution is first we increase minimum wage to 15$ maybe 25$. Everyone deserves a living wage. The rest we can have politicans and field experts negotiate and decide.


In the military all people a certain rank and time in grade make the same money. It doesn't matter if you are a physician or a military police officer. a Captain with x years in makes x dollars.

We could figure out a way to implement this in the civilian world.

 

[twelvetigers]

We need to decide how much money one person really needs.

#socialism

 

[DVMDream]

My solution is first we increase minimum wage to 15$ maybe 25$. Everyone deserves a living wage. The rest we can have politicans and field experts negotiate and decide.


In the military all people a certain rank and time in grade make the same money. It doesn't matter if you are a physician or a military police officer. a Captain with x years in makes x dollars.

We could figure out a way to implement this in the civilian world.

You have no ****ing clue. And because you are naive (not your fault we all start that way) I can't possibly get through to you the exact whys as to why what you are proposing could never work.

Go actually look at what a physician forks out monthly then yearly just to maintain their license. Then come back and tell us they deserve to make as much as a fast food worker.

 

[DVMDream]

You want to put an end to anyone becoming a doctor ever, you've sure found the way to do it. I sure as **** wouldn't go through 10 years of schooling to make $100k and deal with the BS that occurs daily in the medical field.

 

[RNtoMD87]

You want to put an end to anyone becoming a doctor ever, you've sure found the way to do it. I sure as **** wouldn't go through 10 years of schooling to make $100k and deal with the BS that occurs daily in the medical field.

You missed where I said it's fine that they make a comfortable salary. 150,000 a year is pretty reasonable. I never said they should make the 15-25$ that a fast food worker should make. I simply think we should figure out a reasonable pay cap and increase the minimum wage. I'm not saying we should all be paid the same but it should be fairer.

Do you have any ideas? I'm open to new ideas. There has to be some good alternative to this immoral capitalism that has been allowed to corrupt America to its core.

 

[dyachei]

I think you should really educate yourself because it doesn't feel like you actually understand this stuff.

And that's OK. But do something about it instead of assuming you do understand how everything works.

Because that's how you've acted with a lot of topics in this thread.

 

[RNtoMD87]

Well I've taken a few sociology classes, and that's how I came to these conclusions... I mean besides what ive seen for myself.

 

[pinkpuppy9]

Every soldier should be paid at least 100,000 per year, and every policeman and firefighter as well.

There are a good number of soldiers who are only soldiers because they have no other options in life (such as a decent number of my high school classmates). The people with criminal records, didn't graduate high school, etc should get $100,000 just because they have a dangerous job due to them eliminating their own options by choice? Anyone working hard labor should be paid the same, then. Hell, the people working at a gas station in Detroit should be paid $100,000 because that's just as dangerous as any deployment.

You missed where I said it's fine that they make a comfortable salary. 150,000 a year is pretty reasonable. I never said they should make the 15-25$ that a fast food worker should make. I simply think we should figure out a reasonable pay cap and increase the minimum wage. I'm not saying we should all be paid the same but it should be fairer.

Do you have any ideas? I'm open to new ideas. There has to be some good alternative to this immoral capitalism that has been allowed to corrupt America to its core.

$150k is actually not reasonable given the debt every doctor has, vet or MD/DO. And keep in mind that while vets have 4 years of vet school +/- further training, human physicians have 4 years of med school and then have to go on to an internship/residency. Interest on $160k of debt (the average number according to google) adds up FAST, and keep in mind residencies can be anywhere from 3-11 years depending on your career goals. We have human physicians on here that I'm sure can give you a better picture, but I'm pretty sure residents might make around $50k a year. Not enough to live and make a real dent in your debt. Less so if you live in a high COL area.

I have no problem with a human physician owning a nice car/home once they work off that debt. I just wish vet med could see the same light at the end of the tunnel.

 

[DVMDream]

You missed where I said it's fine that they make a comfortable salary. 150,000 a year is pretty reasonable. I never said they should make the 15-25$ that a fast food worker should make. I simply think we should figure out a reasonable pay cap and increase the minimum wage. I'm not saying we should all be paid the same but it should be fairer.

Do you have any ideas? I'm open to new ideas. There has to be some good alternative to this immoral capitalism that has been allowed to corrupt America to its core.

Once you average out the number of hours a physician actually works per week, a $150k salary would be equivalent to $25/hour. So, yes, you are expecting them to make as much as a fast food worker .


This is why you need to shut up about things you clearly don't understand and go learn. You do not get it. End of story. You live in a fantasy world.

 

[battie]

We need to decide how much money one person really needs.

Why should someone decide how much I make, besides how much they're willing to pay me for my service? How would this be decided?

I don't even have a problem with entertainers making as much as they do. I was will to go see The Last Jedi four times in theater, then bought the blue ray/dvd combo pack. Probs ~$80 blown on one movie. Even if the average person only spent a quarter of that, that more than pays for an actor's salary. More over, a ton of other "lesser" jobs are tied to that actor. You're movie will generally have more draw if you pick actor a over actor b. That means more money to production, which means more digital artists, gaffers, etc needed for the movie. More people employed, in part, because this big name actor was tagged onto the production. Look at the discussion over who should have played Han Solo in Solo. A lot of people didn't see it partly because of the actor picked to play him and how he possibly wasn't prepared for the role like a more experienced actor could have been. Solo flopped despite its Star Wars power.

 

[RNtoMD87]

I saw this and it really made sense of why healthcare is expensive

 

[DVMDream]

 

[RNtoMD87]

I'm serious, watch it. Highly informative

 

[DVMDream]

I prefer to get my information from actual sources, not from videos made by youtubers and wanna-be celebrities.

 

[RNtoMD87]

I prefer to get my information from actual sources, not from videos made by youtubers and wanna-be celebrities.

He has sources, helps if you actually watch it. His guests are also subject matter experts.

 

[DVMDream]

He has sources, helps if you actually watch it. His guests are also subject matter experts.

:troll:

 

[RNtoMD87]

Sounds like someone making judgement without taking the time to investigate.

 

[DVMDream]

View attachment 235239 Now this message makes sense..

Go for it. No sweat off my back.

It is interesting that they somehow know I am commenting despite having "blocked" me. If you block people you can not see their posts.

Do as you wish, but notice, those who are responding to you in this thread have all agreed with me. So, clearly, I am not giving you some sort of falsehood, but I am speaking the truth and from actual experience.

 

[RNtoMD87]

Go for it. No sweat off my back.

It is interesting that they somehow know I am commenting despite having "blocked" me. If you block people you can not see their posts.

Do as you wish, but notice, those who are responding to you in this thread have all agreed with me. So, clearly, I am not giving you some sort of falsehood, but I am speaking the truth and from actual experience.

I appreciate the insight, but you are not discussing. My mind is open, but however I sense like you feel like you know everything and are very condescending. I welcome stimulating discussion because I like to sharpen my mind, but being dismissed doesn't help.




And they probably saw your posts when I quoted them.

 

[RNtoMD87]

This also helps Adams credibility. They correct mistakes openly when corrected.

 

[DVMDream]

I appreciate the insight, but you are not discussing. My mind is open, but however I sense like you feel like you know everything and are very condescending. I welcome stimulating discussion because I like to sharpen my mind, but being dismissed doesn't help.




And they probably saw your posts when I quoted them.

Quoted posts by blocked members do not show either. I have blocked a few people and it kind of interrupts the forums a lot the way it works.

I have repeatedly tried open discussion and explanation, you ignore, redirect, repost things that have already been discussed. Then go off and post a video by a comedian who works for College Humor who legitimately has NO idea of what he is talking about.

Yes, I looked things up, but I don't have to explain every single detail to you of why I am not going to sit there and watch through a video from a guy I know makes these for the "lols". He doesn't have a clue and unless there is a list of places he researched to get the info from at the end of the video, then, no he has no resources.

Hence, my much more simplified statement above of "I prefer to get my information from actual sources, not from videos made by youtubers and wanna-be celebrities."

I don't need to explain that further because this is clearly a video by a comedian/wanna-be celebrity. I think my post was straightforward enough.

If you want actual conversation, then please provide something better than that video. You should know this going into any type of scientific field. You provide good, quality sources, not laughable youtube videos.

 

[DVMDream]

This also helps Adams credibility. They correct mistakes openly when corrected.

These videos are made for the laughs and views. They probably got a lot of complaints on multiple videos so they made a single video poking fun at themselves and that's it, people now believe that they will admit to anything.

Seriously, they are not reliable sources on how hospitals do billing and how the system evolved/developed. They are comedians making entertaining videos for the sake of views and entertainment. That is it.

 

[RNtoMD87]

It really makes you think though. It shows how the rich elite pretty much own everything. Maybe I was too hasty to say doctors shouldn't make so much.

But we need to level the playing field. That's all I'm saying. We all deserve to live well.

 

[twelvetigers]

I like Adam Ruins Everything and I agree that the human healthcare system (and insurance) is borked, but that definitely doesn’t mean I agree with you about any of the other stuff. Sorry, your proposed solution sucks. And posting that PM was a wah-wah baby thing to do. Move on please.

 

[DVMDream]

We all deserve to live well.

No one is arguing against this.

We are arguing against you saying that doctors and vets and other professionals who work their butts off only deserve some pre-negotiated, random salary that doesn't take into account their insane education, stress, liability, etc.

The playing field doesn't need to be "leveled". Just leave it as simple as that others deserve more.

 

[DVMDream]

I like Adam Ruins Everything and I agree that the human healthcare system (and insurance) is borked, but that definitely doesn’t mean I agree with you about any of the other stuff. Sorry, your proposed solution sucks. And posting that PM was a wah-wah baby thing to do. Move on please.

Not to mention against TOS to post those. I am sure that member would rather that not be out there. Especially since he didn't clip off enough of it and "veterinarian" along with "5+ year member" really narrows that down to like maybe two or three people in these forums.

 

[RNtoMD87]

I still think we could determine a good set amount. We can agree to disagree. If it worked in the military it will work for us all.

 

[DVMDream]

I still think we could determine a good set amount. We can agree to disagree. If it worked in the military it will work for us all.

Ok, we can agree to disagree. I do have another idea for you. Go post this idea of a flat salary for MD's over in the allopathic forums, see what they have to say. They are really the ones "in the trenches", they will for sure tell you what they think of it and whether or not it will actually work.

 

[RNtoMD87]

Well I work with two nurses that were physicians before they came to America. One was a family doctor in Ukraine, and one was a histologist in China. We discuss how the healthcare systems were superior in their counties opposed to the overly capitalistic system here.