are physicians really altruistic?

[Anonymous]

I am in an HMO and have been very happy with the treatment I have received. My primary care (internal medicine - young female) is incredibly thorough and caring. The two middle-aged guys before her were as well. I also had two parents become gravely ill and die right before COVID in the Midwest and also was impressed with all of the care, minus one doctor in one hospital who was reluctant to “call it” and let my father move to hospice. We did it regardless and he died in a few days and we were glad we did not listen to him. However, during this, he wasn’t unpleasant or a jerk but given his many years in practice should have “known better” that the end was near, IMHO, and either recommended the move himself earlier or immediately supported our decision.

[Anonymous]

Anonymous wrote:

Anonymous wrote:We hold doctors on such high pedestals in this country. My best friend is chief surgeon, and the stories he tells about his docs are truly shocking. He says it is extremely common to have to reprimand his docs who try to get info on their patients' insurance first to see if they'll get a good payment from them. If they have something crappy like medicaid or some other terrible insurance, my friend says docs will initially diagnose a patient with something else that is very closely related to what they know the person has. That way they can avoid having to do surgery on the patient and pass the buck to someone else later who'll get stuck with the patient with crappy insurance. My friend has to routinely make sure that when he is on duty that his docs treat everyone who comes in like they have the same exact insurance so these shenanigans don't go on, but the point here is that how often do things like this go on elsewhere where they don't have chiefs who do ethical jobs who look the other way. How many scummy docs are out there looking to soak as much money as they can out of the system and refuse their services for someone who needs it if they know that the patient's insurance will pay lower rates.

Doctors are scummy especially when it comes to money. I had a family member dying of pancreatic cancer and had been signed into hospice. She had been in the hospital for 3 weeks at this point. Once you’re signed into hospice the hospital medical treatment stops and you are just made comfortable until you die. She had great insurance and her bill was already topping 250k so everything was on the insurance company at this point. I watched a cavalcade of various doctors come in and start doing exams while she was waiting to be transported to the hospice facility. You better believe they billed for these services even though she had been placed under hospice care at that point and they had no right or reason to examine her. It was like they knew it would be guaranteed money. Disgusting.

I’m a doctor. I’m sorry that you had this experience. I had a terrible experience with end of life care for one of my parents, too, which was further complicated by the pandemic. It is extremely stressful.

There might be, however, confusion about physician billing in the hospital. I am at a university hospital and am paid a salary. I do not get paid for seeing an individual patient. I also do not know what insurance the patient has nor have I ever checked. So, I’m not sure why the doctors were in seeing your relative, but at least at a big teaching hospital we aren’t paid for individual patient visits. I am just required to take care of the patients who are there during the time-frame that I am on service, and it doesn’t impact my salary.

I know that some doctors are jerks, but it’s been rough for us since the pandemic. It was stressful going in during the spring of 2020, and I was terrified that I would bring COVID home and kill my family. We never got to WFH, which was really hard when the kids were home from school for months. A lot of my co-workers, nurses, etc have quit or retired since the pandemic, and we are now chronically short staffed. Our bonuses were cut and our salaries frozen even though we were working more under crazy conditions. And I make about 200K/year (though I’m in the Baltimore area), which is embarrassingly low according to most posters on this board.

A lot of us think that the “medical industrial complex” is in the process of imploding. My hospital-based colleagues think we need a single-payer system - the current insurance company mess is untenable. But the doctors have continued to show up in person through the pandemic (unlike those who get to WFH), and the last 2.5 years have been a pretty bad trip. Which is not to say that we are altruistic - maybe just stupid or stubborn or scared of change? Honestly, I feel really stupid for not jumping to biotech/pharma like a lot of my former colleagues. But then I wonder who will take care of people if we all get fed up leave. And what was the point of all that training? I’m good at my job - I should use my skills. It’s just been a bad 2.5 years for doctors, nurses, laboratory workers, and other staff. We are all burned out.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We hold doctors on such high pedestals in this country. My best friend is chief surgeon, and the stories he tells about his docs are truly shocking. He says it is extremely common to have to reprimand his docs who try to get info on their patients' insurance first to see if they'll get a good payment from them. If they have something crappy like medicaid or some other terrible insurance, my friend says docs will initially diagnose a patient with something else that is very closely related to what they know the person has. That way they can avoid having to do surgery on the patient and pass the buck to someone else later who'll get stuck with the patient with crappy insurance. My friend has to routinely make sure that when he is on duty that his docs treat everyone who comes in like they have the same exact insurance so these shenanigans don't go on, but the point here is that how often do things like this go on elsewhere where they don't have chiefs who do ethical jobs who look the other way. How many scummy docs are out there looking to soak as much money as they can out of the system and refuse their services for someone who needs it if they know that the patient's insurance will pay lower rates.

Doctors are scummy especially when it comes to money. I had a family member dying of pancreatic cancer and had been signed into hospice. She had been in the hospital for 3 weeks at this point. Once you’re signed into hospice the hospital medical treatment stops and you are just made comfortable until you die. She had great insurance and her bill was already topping 250k so everything was on the insurance company at this point. I watched a cavalcade of various doctors come in and start doing exams while she was waiting to be transported to the hospice facility. You better believe they billed for these services even though she had been placed under hospice care at that point and they had no right or reason to examine her. It was like they knew it would be guaranteed money. Disgusting.

I’m a doctor. I’m sorry that you had this experience. I had a terrible experience with end of life care for one of my parents, too, which was further complicated by the pandemic. It is extremely stressful.

There might be, however, confusion about physician billing in the hospital. I am at a university hospital and am paid a salary. I do not get paid for seeing an individual patient. I also do not know what insurance the patient has nor have I ever checked. So, I’m not sure why the doctors were in seeing your relative, but at least at a big teaching hospital we aren’t paid for individual patient visits. I am just required to take care of the patients who are there during the time-frame that I am on service, and it doesn’t impact my salary.

I know that some doctors are jerks, but it’s been rough for us since the pandemic. It was stressful going in during the spring of 2020, and I was terrified that I would bring COVID home and kill my family. We never got to WFH, which was really hard when the kids were home from school for months. A lot of my co-workers, nurses, etc have quit or retired since the pandemic, and we are now chronically short staffed. Our bonuses were cut and our salaries frozen even though we were working more under crazy conditions. And I make about 200K/year (though I’m in the Baltimore area), which is embarrassingly low according to most posters on this board.

A lot of us think that the “medical industrial complex” is in the process of imploding. My hospital-based colleagues think we need a single-payer system - the current insurance company mess is untenable. But the doctors have continued to show up in person through the pandemic (unlike those who get to WFH), and the last 2.5 years have been a pretty bad trip. Which is not to say that we are altruistic - maybe just stupid or stubborn or scared of change? Honestly, I feel really stupid for not jumping to biotech/pharma like a lot of my former colleagues. But then I wonder who will take care of people if we all get fed up leave. And what was the point of all that training? I’m good at my job - I should use my skills. It’s just been a bad 2.5 years for doctors, nurses, laboratory workers, and other staff. We are all burned out.

Hospitals are being bought by corporations and they're stiffing the Doctors as well. They charged my Dad a fee for maintaining the surgical unit even though my Dad doesn't perform surgery.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We hold doctors on such high pedestals in this country. My best friend is chief surgeon, and the stories he tells about his docs are truly shocking. He says it is extremely common to have to reprimand his docs who try to get info on their patients' insurance first to see if they'll get a good payment from them. If they have something crappy like medicaid or some other terrible insurance, my friend says docs will initially diagnose a patient with something else that is very closely related to what they know the person has. That way they can avoid having to do surgery on the patient and pass the buck to someone else later who'll get stuck with the patient with crappy insurance. My friend has to routinely make sure that when he is on duty that his docs treat everyone who comes in like they have the same exact insurance so these shenanigans don't go on, but the point here is that how often do things like this go on elsewhere where they don't have chiefs who do ethical jobs who look the other way. How many scummy docs are out there looking to soak as much money as they can out of the system and refuse their services for someone who needs it if they know that the patient's insurance will pay lower rates.

Doctors are scummy especially when it comes to money. I had a family member dying of pancreatic cancer and had been signed into hospice. She had been in the hospital for 3 weeks at this point. Once you’re signed into hospice the hospital medical treatment stops and you are just made comfortable until you die. She had great insurance and her bill was already topping 250k so everything was on the insurance company at this point. I watched a cavalcade of various doctors come in and start doing exams while she was waiting to be transported to the hospice facility. You better believe they billed for these services even though she had been placed under hospice care at that point and they had no right or reason to examine her. It was like they knew it would be guaranteed money. Disgusting.

Thank you for your story. I’m the op who you are responding to. I’m sure that you and other doctors are hardworking and not money grubbing but my experience watching this just left a terrible taste in my mouth for the medical industry. The doctors that showed up after she was waiting for ambulance transport to the hospice were a cardiologist (she had no prior heart condition and didn’t see one in the hospital while there for cancer) a nephrologist and a gastroenterologist. I received bills from them to her estate that were zeroed out because insurance paid the balance due. They were private practice physicians with admitting privileges. I just wanted her to die in peace and could believe the 3 of them in the room like 3 clown at the same time trying to examine a hallucinating, cancer riddled, dying woman because the insurance was going to payout.

I’m a doctor. I’m sorry that you had this experience. I had a terrible experience with end of life care for one of my parents, too, which was further complicated by the pandemic. It is extremely stressful.

There might be, however, confusion about physician billing in the hospital. I am at a university hospital and am paid a salary. I do not get paid for seeing an individual patient. I also do not know what insurance the patient has nor have I ever checked. So, I’m not sure why the doctors were in seeing your relative, but at least at a big teaching hospital we aren’t paid for individual patient visits. I am just required to take care of the patients who are there during the time-frame that I am on service, and it doesn’t impact my salary.

I know that some doctors are jerks, but it’s been rough for us since the pandemic. It was stressful going in during the spring of 2020, and I was terrified that I would bring COVID home and kill my family. We never got to WFH, which was really hard when the kids were home from school for months. A lot of my co-workers, nurses, etc have quit or retired since the pandemic, and we are now chronically short staffed. Our bonuses were cut and our salaries frozen even though we were working more under crazy conditions. And I make about 200K/year (though I’m in the Baltimore area), which is embarrassingly low according to most posters on this board.

A lot of us think that the “medical industrial complex” is in the process of imploding. My hospital-based colleagues think we need a single-payer system - the current insurance company mess is untenable. But the doctors have continued to show up in person through the pandemic (unlike those who get to WFH), and the last 2.5 years have been a pretty bad trip. Which is not to say that we are altruistic - maybe just stupid or stubborn or scared of change? Honestly, I feel really stupid for not jumping to biotech/pharma like a lot of my former colleagues. But then I wonder who will take care of people if we all get fed up leave. And what was the point of all that training? I’m good at my job - I should use my skills. It’s just been a bad 2.5 years for doctors, nurses, laboratory workers, and other staff. We are all burned out.

[Anonymous]

Doctors are like anyone else in any other profession. Some are altruistic, and some are selfish narcissists. Some go into it to help people, some go into it for money and prestige. The one thing most doctors have in common is strong work ethic. It takes a lot to get admitted to and complete medical training.

[Anonymous]

Anonymous wrote:What is wrong with wanting to be paid for the work you do? What other field doesn’t get paid for their efforts? Why would someone slave away studying for years and not want to be fairly compensated?

+1000

[Anonymous]

Anonymous wrote:

Anonymous wrote:What is wrong with wanting to be paid for the work you do? What other field doesn’t get paid for their efforts? Why would someone slave away studying for years and not want to be fairly compensated?

+1000

Oh you are fairly compensated
I also slaved away and studied for years, except I do not expect anyone to think that I am special because of that

[Anonymous]

Absolutely not. My family are all doctors. Not a single one went into it to help people. They all did it to get paid $$$, just like all the lawyers I know. I have no idea why doctors are viewed more benevolent than attys or finance guys. It’s all the same pot

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What is wrong with wanting to be paid for the work you do? What other field doesn’t get paid for their efforts? Why would someone slave away studying for years and not want to be fairly compensated?

+1000

Oh you are fairly compensated
I also slaved away and studied for years, except I do not expect anyone to think that I am special because of that

Had this become a posting theme for you?

[Anonymous]

I’m a doctor. I’m sorry that you had this experience. I had a terrible experience with end of life care for one of my parents, too, which was further complicated by the pandemic. It is extremely stressful.

There might be, however, confusion about physician billing in the hospital. I am at a university hospital and am paid a salary. I do not get paid for seeing an individual patient. I also do not know what insurance the patient has nor have I ever checked. So, I’m not sure why the doctors were in seeing your relative, but at least at a big teaching hospital we aren’t paid for individual patient visits. I am just required to take care of the patients who are there during the time-frame that I am on service, and it doesn’t impact my salary.

I know that some doctors are jerks, but it’s been rough for us since the pandemic. It was stressful going in during the spring of 2020, and I was terrified that I would bring COVID home and kill my family. We never got to WFH, which was really hard when the kids were home from school for months. A lot of my co-workers, nurses, etc have quit or retired since the pandemic, and we are now chronically short staffed. Our bonuses were cut and our salaries frozen even though we were working more under crazy conditions. And I make about 200K/year (though I’m in the Baltimore area), which is embarrassingly low according to most posters on this board.

A lot of us think that the “medical industrial complex” is in the process of imploding. My hospital-based colleagues think we need a single-payer system - the current insurance company mess is untenable. But the doctors have continued to show up in person through the pandemic (unlike those who get to WFH), and the last 2.5 years have been a pretty bad trip. Which is not to say that we are altruistic - maybe just stupid or stubborn or scared of change? Honestly, I feel really stupid for not jumping to biotech/pharma like a lot of my former colleagues. But then I wonder who will take care of people if we all get fed up leave. And what was the point of all that training? I’m good at my job - I should use my skills. It’s just been a bad 2.5 years for doctors, nurses, laboratory workers, and other staff. We are all burned out.

Thank you for writing this. Your careful and considered response to an attack on your profession from someone who clearly does not know better is the perfect response. Many people do not understand that, at least at teaching hospitals, insurance rarely enters the discussion, and only does when the insurance company refuses to approve a needed test without a "peer to peer" conference with a foreign doctor who has never practiced in the United States. Her pay is the same either way whether she sees 1 patient or 100 patients or orders 1 test or 100 tests. There is no bonus for doing more tests or seeing more patients in those hospitals. Your response also captures the very real fear that my wife felt after going into the hospital every day during the height of the pandemic. While many people worked from home and while day cares shut down, doctors, nurses, patient care techs (along with police/firefighters/EMS etc) went into work every day, without the benefit of a vaccine, and oftentimes without the proper PPE. It was truly a scary time that many people either do not understand or have quickly forgotten.

[Anonymous]

Anonymous wrote:

I’m a doctor. I’m sorry that you had this experience. I had a terrible experience with end of life care for one of my parents, too, which was further complicated by the pandemic. It is extremely stressful.

There might be, however, confusion about physician billing in the hospital. I am at a university hospital and am paid a salary. I do not get paid for seeing an individual patient. I also do not know what insurance the patient has nor have I ever checked. So, I’m not sure why the doctors were in seeing your relative, but at least at a big teaching hospital we aren’t paid for individual patient visits. I am just required to take care of the patients who are there during the time-frame that I am on service, and it doesn’t impact my salary.

I know that some doctors are jerks, but it’s been rough for us since the pandemic. It was stressful going in during the spring of 2020, and I was terrified that I would bring COVID home and kill my family. We never got to WFH, which was really hard when the kids were home from school for months. A lot of my co-workers, nurses, etc have quit or retired since the pandemic, and we are now chronically short staffed. Our bonuses were cut and our salaries frozen even though we were working more under crazy conditions. And I make about 200K/year (though I’m in the Baltimore area), which is embarrassingly low according to most posters on this board.

A lot of us think that the “medical industrial complex” is in the process of imploding. My hospital-based colleagues think we need a single-payer system - the current insurance company mess is untenable. But the doctors have continued to show up in person through the pandemic (unlike those who get to WFH), and the last 2.5 years have been a pretty bad trip. Which is not to say that we are altruistic - maybe just stupid or stubborn or scared of change? Honestly, I feel really stupid for not jumping to biotech/pharma like a lot of my former colleagues. But then I wonder who will take care of people if we all get fed up leave. And what was the point of all that training? I’m good at my job - I should use my skills. It’s just been a bad 2.5 years for doctors, nurses, laboratory workers, and other staff. We are all burned out.

Thank you for writing this. Your careful and considered response to an attack on your profession from someone who clearly does not know better is the perfect response. Many people do not understand that, at least at teaching hospitals, insurance rarely enters the discussion, and only does when the insurance company refuses to approve a needed test without a "peer to peer" conference with a foreign doctor who has never practiced in the United States. Her pay is the same either way whether she sees 1 patient or 100 patients or orders 1 test or 100 tests. There is no bonus for doing more tests or seeing more patients in those hospitals. Your response also captures the very real fear that my wife felt after going into the hospital every day during the height of the pandemic. While many people worked from home and while day cares shut down, doctors, nurses, patient care techs (along with police/firefighters/EMS etc) went into work every day, without the benefit of a vaccine, and oftentimes without the proper PPE. It was truly a scary time that many people either do not understand or have quickly forgotten.

While this doctor may receive a salary that isn’t tied into how she cares for her patients many other doctors are in private practice and get bonuses for HMO gate keeping or are specialists who’s income is not a true salary.

[Anonymous]

Anonymous wrote:The doctor hating on here is so ridiculous. No one is forcing you to see a doctor or have a doctor. When you have an emergency then just treat yourself since they all suck so much. Again just like any profession most people do the work because they like helping people but they also want to be paid fairly for the training they had to endure and to pay off their +200000 loans and to also support their families. Surgeons spend 7+ years in residency crafting their art. At the end of the day, who cares if they are doing it for altruistic reasons? If they can do the surgery you need then that’s all that matters. I don’t see people asking for plumbers to have altruistic reasons to unclog toilets.

Basically, if you don’t like doctors then don’t see them. No one is forcing you.

I would love to skip the doctors appt for routine prescription refills. Such a waste of money and time.

[Anonymous]

Ronnie Chieng (the comedian) does this hilarious bit about Asian parents becoming doctors - he says the funny thing is that "helping people" is not even on the list of why they want their kids to be doctors, and in fact, they are actually disappointed that "helping people" even makes the list. I'm telling it wrong but anyway it rings true with my Asian family.

Anyway, who cares if they are altruistic - they have a really hard job and should get paid. We are so fortunate that there are people who actually want to go to school and work long hours so they can learn how to safely take out your gallbladder.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

I’m a doctor. I’m sorry that you had this experience. I had a terrible experience with end of life care for one of my parents, too, which was further complicated by the pandemic. It is extremely stressful.

There might be, however, confusion about physician billing in the hospital. I am at a university hospital and am paid a salary. I do not get paid for seeing an individual patient. I also do not know what insurance the patient has nor have I ever checked. So, I’m not sure why the doctors were in seeing your relative, but at least at a big teaching hospital we aren’t paid for individual patient visits. I am just required to take care of the patients who are there during the time-frame that I am on service, and it doesn’t impact my salary.

I know that some doctors are jerks, but it’s been rough for us since the pandemic. It was stressful going in during the spring of 2020, and I was terrified that I would bring COVID home and kill my family. We never got to WFH, which was really hard when the kids were home from school for months. A lot of my co-workers, nurses, etc have quit or retired since the pandemic, and we are now chronically short staffed. Our bonuses were cut and our salaries frozen even though we were working more under crazy conditions. And I make about 200K/year (though I’m in the Baltimore area), which is embarrassingly low according to most posters on this board.

A lot of us think that the “medical industrial complex” is in the process of imploding. My hospital-based colleagues think we need a single-payer system - the current insurance company mess is untenable. But the doctors have continued to show up in person through the pandemic (unlike those who get to WFH), and the last 2.5 years have been a pretty bad trip. Which is not to say that we are altruistic - maybe just stupid or stubborn or scared of change? Honestly, I feel really stupid for not jumping to biotech/pharma like a lot of my former colleagues. But then I wonder who will take care of people if we all get fed up leave. And what was the point of all that training? I’m good at my job - I should use my skills. It’s just been a bad 2.5 years for doctors, nurses, laboratory workers, and other staff. We are all burned out.

Thank you for writing this. Your careful and considered response to an attack on your profession from someone who clearly does not know better is the perfect response. Many people do not understand that, at least at teaching hospitals, insurance rarely enters the discussion, and only does when the insurance company refuses to approve a needed test without a "peer to peer" conference with a foreign doctor who has never practiced in the United States. Her pay is the same either way whether she sees 1 patient or 100 patients or orders 1 test or 100 tests. There is no bonus for doing more tests or seeing more patients in those hospitals. Your response also captures the very real fear that my wife felt after going into the hospital every day during the height of the pandemic. While many people worked from home and while day cares shut down, doctors, nurses, patient care techs (along with police/firefighters/EMS etc) went into work every day, without the benefit of a vaccine, and oftentimes without the proper PPE. It was truly a scary time that many people either do not understand or have quickly forgotten.

While this doctor may receive a salary that isn’t tied into how she cares for her patients many other doctors are in private practice and get bonuses for HMO gate keeping or are specialists who’s income is not a true salary.

I am well aware of that, thank you. As I stated my wife is a physician. Many of our friends are physicians. I am painfully aware that those in private practice are paid a lot more and that their pay increases as the number of procedures they do increases. All I was saying was that I agreed with the prior poster that most people are not aware that in teaching hospitals (which is what many large city hospitals are) MOST of the doctors you see are paid the same either way. It is not a well known fact to people who do not live in the medical world. The common assumption is that all doctors are paid exceptionally well and that they run tests to increase the bills.

[Anonymous]

Anonymous wrote:

Anonymous wrote:The doctor hating on here is so ridiculous. No one is forcing you to see a doctor or have a doctor. When you have an emergency then just treat yourself since they all suck so much. Again just like any profession most people do the work because they like helping people but they also want to be paid fairly for the training they had to endure and to pay off their +200000 loans and to also support their families. Surgeons spend 7+ years in residency crafting their art. At the end of the day, who cares if they are doing it for altruistic reasons? If they can do the surgery you need then that’s all that matters. I don’t see people asking for plumbers to have altruistic reasons to unclog toilets.

Basically, if you don’t like doctors then don’t see them. No one is forcing you.

I would love to skip the doctors appt for routine prescription refills. Such a waste of money and time.

You should not be called into the office for routine refills as long as you are receiving regular treatment. However, insurance and other regulations often require the doctor to see you (virtually or in person) every once in awhile (annually/ every few months depending) in order to write a refill. This is not really the doctor trying to scam you.