Where have all the doctors gone?

[Anonymous]

Anonymous wrote:I think a lot went to telemedicine.

Which I think is really negligent.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm tired of NP being offered as a substitute for a MD.

When it finally caused me problems due to the NP getting multiple things wrong, I left my pcp's practice for a concierge one. It was pretty clear that the practice was so busy I'd never see my actual doctor again except for my annual physical -- and that needed to be scheduled 6 months in advance.

I don’t have one doctor who uses NP’s.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think many do not take Insurance..they just cater to those who can pay out of pocket.

Concierge medicine seems burgeoning.

I felt a bit guilty, like part of the problem, when I finally decided to pay for a concierge doctor. But guess what has happened -- in a year my health is significantly better.

YMMV, of course. I had multiple health issues that the pcp I couldn't get in to see very often ignored, most of them interacting with each other and exacerbating things. The concierge doctor has addressed all of it, and I feel so much better and am much healthier. But without a complicated situation like mine, you probably don't need a concierge doctor.

Who is this great doctor you love so much?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Pay has no increased in decades, docs are leaving networks or choosing to not work for Pennies on the dollar. Thank you Obama care.

All those poor, struggling doctors?

Who have a 100k in student loan debt. Doctors should be paid well to compensate for 8 years of education plus 4-6 years in residency and training working 60-70 hours a week for a lot less pay.

Do you feel the same way about professors ? Scientists? They go to school 4-6 years after college, then do very low paying post doctoral fellowships. They will never earn what a MD makes.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm tired of NP being offered as a substitute for a MD.

When it finally caused me problems due to the NP getting multiple things wrong, I left my pcp's practice for a concierge one. It was pretty clear that the practice was so busy I'd never see my actual doctor again except for my annual physical -- and that needed to be scheduled 6 months in advance.

I don’t have one doctor who uses NP’s.

That's not economical. Most appointments can be handled by mid-levels.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

What makes the patients miserable? I mean, specifics in terms of behavior thet shouldn't be doing.

Just angry about wait times in the office (that I can’t control), having a lot of things that they “insist “ on being tested for despite it not being relevant for their symptoms - and some tests will yield a lot of false positives if you test everyone for them. It sounds wrong- like, “if I test positive, and the test is 99% accurate, then it’s a real positive!” but google the Bayes Theorum and you’ll see that’s actually wrong. But patients INSIST on testing for things. And it muddies the waters and makes my job harder and doesn’t make their symptoms go away because now they’re convinced they have, for example, chronic Lyme disease and they won’t consider that their fatigue is actually probably from sleep apnea or depression. Anyways I’m ranting.

You are a bad doctor if you let your patients dictate what tests you order.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think a lot went to telemedicine.

Which I think is really negligent.

Clearly not a doctor or a lawyer, lol...

[Anonymous]

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

Tell us your name please, since you consider patients to be “so miserable.”

Why the hell did you go into medicine?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm tired of NP being offered as a substitute for a MD.

When it finally caused me problems due to the NP getting multiple things wrong, I left my pcp's practice for a concierge one. It was pretty clear that the practice was so busy I'd never see my actual doctor again except for my annual physical -- and that needed to be scheduled 6 months in advance.

I don’t have one doctor who uses NP’s.

You are fortunate then. All of the hospital-affiliated primary care practices have been using them for years, and the last several years it ahs become very hard to get in with the MD. In October my pcp's office told me the first available appointment with my doctor for an annual physical would be in April. Unless I wanted to see the NP, which could happen right away. Nope. For multiple reasons.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I think many do not take Insurance..they just cater to those who can pay out of pocket.

Concierge medicine seems burgeoning.

I felt a bit guilty, like part of the problem, when I finally decided to pay for a concierge doctor. But guess what has happened -- in a year my health is significantly better.

YMMV, of course. I had multiple health issues that the pcp I couldn't get in to see very often ignored, most of them interacting with each other and exacerbating things. The concierge doctor has addressed all of it, and I feel so much better and am much healthier. But without a complicated situation like mine, you probably don't need a concierge doctor.

Who is this great doctor you love so much?

Eileen West. She's awesome and very knowledgeable and focused on women's health.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

Tell us your name please, since you consider patients to be “so miserable.”

Why the hell did you go into medicine?

Not PP, and not a doctor, but come on ... you know dealing with patients has got to miserable. It's akin to dealing with the general public with the added layer of people who are feeling sick or in pain etc.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

Tell us your name please, since you consider patients to be “so miserable.”

Why the hell did you go into medicine?

Not PP, and not a doctor, but come on ... you know dealing with patients has got to miserable. It's akin to dealing with the general public with the added layer of people who are feeling sick or in pain etc.

Then again, why go into medicine? To rake in money and be called Dr.?

[Anonymous]

Anonymous wrote:

Anonymous wrote:How about we build more medical schools and train more doctors?
We’ve had the same number of schools and graduates for decades but our population has surged. 🤷‍♀️

The limiting step isn't the number of seats for medical school classes, but the clinical spots for training in vivo.

For example, one of the biggest problems with NP diploma mills is that they send NP students out to find their own placements for clinical training. They can't, or what they do find is insufficient. Medical students (like NPs) don't make a clinic or hospital run more efficiently -- they are a drag on time and attention, and that's fine! They are supposed to be learners. But that means slower patient care, and when clinical situations are being driven by profit metrics (especially with private equity firm control), they are a real liability.

Upper level residents are different, as they can help quite a bit and function with some measure of autonomy. But it takes forever to get them there, and nobody in the current medical environment able to do it is willing to do it.

And the AMA wants that residency cap to stay so that there are fewer doctors and higher salaries. It is the patients who suffer, but they don’t care. Maybe take a hard cold look at the type of people who are going into medicine. It’s bad enough now, but at least there are some decent people still left in the profession. With the arms race that is medical school admissions today, this will get even worse. It is selecting for a bunch of robots who never have any intention of seeing or touching a patient.

[Anonymous]

I am not sure concierge practice is a panacea for patients.

I had a concierge PCP for several years. The fee was $4000 for an individual, $6000 for a couple. Medicare was accepted.

I could get text replies quickly and appointments quickly, although the Dr. was in only two days per week.

But when I had a serious issue and asked the Dr. to speak to the surgeon before my scheduled surgery, he refused. So I did not experience any coordination of care.

Assuming he was on his way to retirement, I switched to a hospital-based practice.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I think a lot went to telemedicine.

Which I think is really negligent.

I think you working from home is negligent too.