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Which system would you prefer to work in?

Discussion in 'Pre-Medical - MD' started by autotroph, Aug 2, 2011.

?

Which system?

  1. System A

    8.9%
  2. System B

    80.0%
  3. A, but with these changes (respond below)

    4.4%
  4. B, but with these changes (respond below)

    6.7%
  1. autotroph

    autotroph Car-nommer
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    System A

    Tuition: Free
    Salary: $65,000
    Malpractice: $650/year

    In this system, everyone has health insurance paid for in cooperation between individuals and their employers (or if unemployed by the government). Costs for care are negotiated between health unions and the government entities that run a public "sickness fund." These costs are paid up front by the patient and reimbursed within a month by their insurer, guaranteed. Billing is automatic.

    Medical records are kept electronically on encrypted, patient-carried cards that are brought to each visit giving the doctor the ability to read and add to the medical record within a central framework that is universal to all health care facilities.

    System B

    Tuition: $155,000
    Salary: $350,000
    Malpractice: $20,000/year

    Insurance is not mandatory, and patients decide how they wish to pursue coverage if at all. Most people opt for employer-assisted health insurance plans. Coverage for those not eligible for insurance through an employer must meet criteria of age or poverty to be eligible for government assistance outside of emergency care (which must be provided regardless of ability to pay). Billing is done by employees dedicated to just that, as there are many different compensations between the many different payers, and denial of claims is routine enough to merit having staff to collect on insurance claims.

    The medical infrastructure is second to none, but record keeping is kept in a combination of electronic and physical copies. These records can be shared between medical practices just as often as not.


    Tried to keep it relatively short, so don't shoot me if this isn't complete. I know it isn't. :oops:
     
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  3. Narmerguy

    Moderator Emeritus 10+ Year Member

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    No offense OP, but should we care what system a bunch of premeds think they want to work in? It's really nothing but an empty/blind argument.
     
  4. postbacpremed87

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    System B has a greater earnings potential over the long run so B. One incentive you might throw in is less hours per week/less on call. I would cut my salary requirements from maybe $200K a year to $150K a year say if I did IM at 40 hrs/wk as opposed to 60/wk and no on call. More time with family and to do hobbies is worth 50k less.

     
  5. paul411

    paul411 ANES
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    Salary for option A is a little unrealistically low, I think. Even places with socialized medicine like the UK offer ~100K/year (on average, US docs work 50% more hours for a 35% higher net income. [source])
     
  6. autotroph

    autotroph Car-nommer
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    Just FYI, my primary goal here isn't to determine which one is more lucrative in the long term.
     
  7. Forca Barca

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    Bbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbb
     
  8. Forca Barca

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    Its more like 150K/year .. thats for a primary physician.
    Source: michael moore's sicko :D
     
  9. paul411

    paul411 ANES
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    What are some other reasons besides $$$ that people are choosing B?
     
  10. Kekeirda

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    +1 :thumbup:
     
  11. autotroph

    autotroph Car-nommer
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    +1

    I wanted to look at this from multiple angles. Perhaps I made a mistake in listing the financial figures first. However, I am not looking at simply which one will make you more money or which system you think is better or worse--that is really beyond our knowledge as pre-meds. I am curious about which arrangement(s) would be preferable and why as someone going into the field.
     
  12. Forca Barca

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    How the heck are you gonna pay for your secretary/nurse/NA with 65000
     
  13. desi0chick

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    System A just seems so unrealistic..
     
  14. autotroph

    autotroph Car-nommer
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    I would go ahead and assume for the sake of this situation that any supporting staff or paid help are paid for by overall income at your practice, and they do not take out of the 65k salary.
     
  15. ElCapone

    ElCapone Don't Lawyer Me
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    Or we can have a private system with a public option.

    Build a free public system along the lines of the VA program, but on a much larger scale, while paying doctors a salary competitive with the private sector.

    Agreed. As much doctors love their work, they deserve to get paid.
     
  16. StephanieZ

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    For me, it's also about the feeling that once I'm done med school, I own my degree and my ability to practice medicine. If the state pays for your schooling, that implies that they own your future labor, which is solidified with the stipulation that "Costs for care are negotiated between health unions and the government entities that run a public "sickness fund."
     
  17. Web MD

    Web MD Doctor of the Internets
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    Uh, the state owns your labor anyway unless you stop paying taxes, in which case they'll go ahead and own your everything.

    OP, I like how option A makes people pay up front for care then get reimbursed a month later. I think it'd be hilarious watching the impoverished go to "check into cash" or "ca$h for gold" to pay for their chemo and organ transplants
     
  18. BMEN

    BMEN Bow ties are cool.
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    UK is a little bit of an exception. Germany is really close to system A. Only problem is there is an over-saturated market for physicians in germany. Most end up working in drug companies or going to UK to work and earn big bucks
     
  19. iqe2010

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    That film is more biased than fox news lol..but I liked it. It points out some really bad flaws in our system. There was a story about a hospital denying emergency care for a woman's young daughter because of their H.M.O and the little girl ended up dying..I find that kind of hard to believe. If it was true then some of those hospital employees need to be thrown in jail.
     
  20. Drrrrrr. Celty

    Drrrrrr. Celty Osteo Dullahan
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    B, because honestly I'd rather not spend 8 years of my life in medical school to get a salary you can get straight out of college. However this does not translate to me going into medicine for money only, this translates to me being realistic.
     
  21. autotroph

    autotroph Car-nommer
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    Haha thats something I should have clarified. In systems like that there are often caps on how much patients can be charged up front. In this case we'll say $100.
     
  22. StephanieZ

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    The state owns your labor in as much as income tax. But wouldn't that be even more true if they foot the bill for your education? I'm not a fan of socialized medicine.
     
  23. Web MD

    Web MD Doctor of the Internets
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    My electronic pay stub came out today and I'm looking at federal income tax, then my state's income tax, then social security, then medicare deductions. If that isn't "owning my labor" then I don't know what is. And no, I know plenty of people getting state scholarships and who have gotten full rides to state schools who aren't "owned" by the state except for paying taxes. Do they hope you'll stay and work around where you went to school? Yeah. Can you say **** it and leave? Yeah.
     
  24. tn4596

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    system B...
    system A is just pure socialism...
     
  25. isoquin

    isoquin Allopathetic
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    I think the thing a lot of pre-meds and lay people don't realize is that med school and residency essentially require a large time sacrifice. It's not just the money. Residents get paid ~$45,000/year working 80 hours per week. That's $10.80 per hour, which is barely tolerable. Attendings are not bound by the 80 hour restrictions.

    All I'm saying is that you should not neglect the fact that doctors pay for their education in time as well as money. That's not to make any comment on whether the attending salary is appropriate or not, but making med school free only addresses one of those two things.
     
  26. caliQ

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    This is probably going to come off a bit troll-ish, especially due to my low post count, but...

    What's wrong with socialism?

    Seriously. It's like a curse word in the US, and I don't understand the negative connotations that come from just using the word. There are European countries with legitimate Socialist political parties, many with strong support. It's seen as just another economic/political theory, not some kind of "evil society-undermining terrorist organization". The US has been terrified of anything remotely related to communism since the Cold War, when we were hysterical about a "red threat" that barely existed within our own borders.

    Personally, I voted for option A. First, the stereotypical "I'm going into medicine to help people" reasoning, which for me is debatable, since I arrived at my goal by starting with PhD plans, and am currently planning MD/PhD. I have a feeling Option A would lead to much higher overall health in the population. Second, the low malpractice costs imply malpractice reform, which could very well lead to/be a part of other systemic reforms (like residency hours, academic system, etc), not to mention political systemic reforms, which I would most likely support. :thumbup: And malpractice reforms are really needed.
     
  27. Blarry

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    while we are at it would fairies and unicorns be covered under said new plan A? come on people stop making STUPID threads.
     
  28. Blarry

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    here is where A falls apart.
    person A: i just graduated from hick no name school and am making 50k a year. I also enjoy a 40 hour work week with no stress and lots of time for family friends and outings.
    Person B: I'm going to school for 4 more years then a residency that will pay what (15k in this system) for 3-5 years all the while i get to make 15k more than you and have no free time along with no way to save for retirement. ya i want to be working when i'm 90 years old just to support a family..
     
  29. StephanieZ

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    Nothings WRONG with socialism. It's not an inherently bad system. But its not the system I personally want to live under, and the US constitution does not give the federal government power to divert taxes to most social programs. They just do anyway.
     
  30. autotroph

    autotroph Car-nommer
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    That's how it actually works though. You take in money as a practice and then distribute the money among the people in the practice and cover overhead. At the end of the year, you take home 65k in this scenario...this is not saying that your practice is making 65k.

    For the sake of your needs, unicorns are covered, but fairies are only covered under a short list of providers and only for work-related complaints.

    Hope this is helpful in improving your critical thinking! :thumbup:

    Are there laws prohibiting them from contributing money to social programs? Honest question, I really do not know the answer to that.
     
  31. Blarry

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    o man thanks i couldn't get my head around the concept that the practice made over 65k:confused: how much would a nurse make in this system? because if the doctor is making 65k and percentile wise nurses pay decreases what is that 25k a year for a nurse. good luck bringing in a competent group of nurses for 25k.
     
  32. caliQ

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    I think the biggest issue is that you just plopped a 5-figure salary into a bunch of pre-meds who are expecting a lot more. The numbers are figurative, and probably quite low. I think the two systems are so different, in that System A would require basically a societal overhaul, that it's really hard to compare them. Especially when you think of making 65k a year in the current US economy/society after 12 years of post-secondary education. The big difference is that you would also be benefiting from a socialist-style system, not just losing money to it. For example, your personal health insurance costs would be negligible, as would your children's college tuition, and your retirement, etc. In order to truly compare the two systems you have to think of the big picture, not just the actual number amounts of one hypothetical salary.
     
  33. StephanieZ

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    No, but there is nothing in the constitution saying they can. Technically, federal government powers are supposed to be limited to only those outlined in the constitution. But I don't want to derail the thread with a political rant, so you can PM me if you want to talk about it more.
     

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