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Any other doctors thinking of calling it quits?
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Anonymous
I am sorry, I meant "what will we do to replace them?" |
Anonymous
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I'm in health care policy and here is my take:
Some of health care reform, including what the dreaded insurers want to do and are doing in some cases, is to pay doctors for quality work, not quantity of patients and treatments. Right now docs are not incentivized to keep folks healthy. They get paid by the test, procedure, etc. Not saying all docs are evil by any means but it is a bad/backwards system and it's one reason docs have to take on so many patients, and therefore squeeze them all in - in 10 minute increments. We pay to treat now, not to prevent or keep healthy. I agree the government needs to step in and provide incentives for young people going to medical school. Primary care is shrinking because docs can make a lot more if they specialize - again, not saying docs are money-hungry, but many take a look at their $200,000 student loans, long hours, etc. and decide it's more appealing to specialize. Another option is to start taking more advantage of the non-doctors out there who can help people - like trained health coaches, case managers who can answer a lot of questions and help coordinate care, to use the dr.'s time and expertise more efficiently. Finally, a lot of our increasing health care costs are caused by things outside the health care system, - like people smoking, people eating crap and never moving, working long hours, etc. So our culture need to change - flexible schedules would help, employer support of exercise, walkable communities, more access to healthy foods in urban areas, etc. The problem is we live like crap, get sick, and then are all moved into the health care system that is overburdened and can't deal. There are a lot of great ideas on the table, we just need to get there. I know this doesn't help you as an individual right now OP, just trying to get in on some of the deeper issues at play. |
Anonymous
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PP, I agree that we are the most responsible for our own health. Obesity, smoking and so on have little to do with not seeing a doctor.
That said, I am in medicine, and I can't tell you how I envy people that have lunch hours, or get to the school play, or sleep at home, or don't have to be nervous every time the phone rings. So much is expected of us. We have to move so fast, and do so much that we wear out quickly. My main issue is that I can not even afford the "support" services like a nanny, to help me do my job. Usually jobs that are this demanding come with compensation that helps pay for the "luxuries" that help keep you going. |
Anonymous
| All you have to do is get rid of med mal suits, and you're hooked. Seriously. |
Anonymous
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"PP, I agree that we are the most responsible for our own health. Obesity, smoking and so on have little to do with not seeing a doctor."
No not the way doctors and health care professional are currently trained but that is part of the problem. The health care system and doctor model now is about recognizing a disease or pathology once it presents itself and intervening with therapies that halt, delay or in some cases can reverse the damage. Doctors aren't really trained or paid to prevent. A system that uses nurse practioners more heavily and people trained on prevention with more well visits to influence health choices would be a cost saver. Ob/gyn is a great example. What value was there having a trained surgeon doing a 2-5 minute check each month. The doctor certainly didn't spend enough time to catch something that wouldn't have presented in the labs. A nurse practioner could probably do a far better time screening for issues by actually spending time with the patient. In countries that use this model and midwives backed up by ob/gyns they see far fewer complications and far more unmedicated or c-section birth which significantly drive the cost down. |
Anonymous
What inspires wrath about OP's post is that she's a privileged, highly-educated person complaining that she works long hours and is not paid enough. Most of us are working far more hours than we expected and see our children far less than we want. And most of us are not making nearly as much as a physician. OP chose medicine, and she chose her specialty. Why didn't she choose anesthesiology or dermatology? Not exciting, but at least the hours are regular and the pay is good. And OP has another degree -- she has more choices than most people, who are stuck in a single profession or occupation they are trained for. Her post sounds whiny because she doesn't seem aware of how lucky she is to have a job and to have so many choices. Sure, she's tired, but what working parent isn't? |
Anonymous
Who said that anesthesiologists have good, regular hours? Every hospital I know of keeps one in-house 24 hours a day. Unlike acne, which can wait a day, people expect sedation or pain meds for their labors, emergency surgeries, planned surgeries that go until 3 am, etc. Anesthesiologists are, in fact, often the ONLY attendings at the hospital overnight - very different from a surgeon who can take call from home on evenings, weekends and holidays. My DH works VERY long hours as an anesthesiologist, and I can't tell you how many dinners, weekends, holidays or family occasions he's missed. It's not at all comparable to a 9-5 derm office. Yes, he is compensated for that work. But if you calculated it as an hourly rate, our electrician earns more. |
Anonymous
| I get so tired of the nastiness. So what if someone went into a career that was suposed to be financially lucractive. What is wrong with that? I would expect someone who was the top of their class and who spent 10 years in tough school situation to be paid well. Good for them. Always I hear the oh I don't feel sorry for them baloney and it is baloney. Some people have unique skills that that all of us do not have..and getting through medical school is unique and almost all of us couldn't get through it..they deserve to be well compensated. The route our healthcare is going is scary. I predict if Obama has his way that we will be in a single payer insurance system that will have rationing the same way as in Europe. I see that Obama says he doesn't want healthcare to go this far but the train is leaving the station so to speak. With the government involved with limitless (god help us- tax dollars..the privates will be forced out--ten years tops). All because 15% of the country lacks insurance--most of whom choose not to be insured. Sorry but I know too many people who put healthcare too low on their priorty list. If we just helped the few who just can't get it together due to mental,physcial problems we would be around 90% insured which is damm good. Also think if we finally got around to tort reform --insurance prices would go waaaaaaaaaaay down. Too many frivilous lawsuits. I also think there are a lot of people who have good insurance who are thinking--yeahhhhh I will just get free government insurance so I don't have to contribute to my insurance through company not realizing how expensive this will be to companies and how bad this is overall. Of course I also think the train has left the station in terms of entitlments--now it seem far too many people want the government to just handle everything. It's bad an I feel terrible for my kids..I had the shot to be successful and make my way..they will have no shot. This reality keeps the thought of more kids at bay. |
Anonymous
Well I am a privileged, highly educated person as well, and I would like to have more options with flexibility, and also more $ for things like a weekly cleaning person, groceries delivered, etc. to maximize the time with my family. Moms have a right to want that. I didn't get the feeling she was griping - just looking for other thoughts from other mom Drs. Yes I realize privileged women could have it much worse, but if people went around not trying to change things because they could have it worse, we really wouldn't make much progress would we? Many women "opt out" of careers not because it's a choice, but because like OP, they have dedicated themselves to a career for 10-15 years before having kids, than realize, shoot, I work 60 hour weeks. I have a child. My boss/company/system under which I work won't settle for less, so I have to quit. Yes, it's great that they have that CHOICE - and they are privileged, but it is still crappy. The workforce would benefit from having some women have flexiblilty. I wouldn't mind having a dr. that was not frazzled and working long hours. I don't have all the answers, it just gets me upset when people get angry at posts like this because this person is not homeless and therefore can't have problems. |
Anonymous
Please back this statement up with statistics. Facts. It sounds patently false to me, but if it's true, prove it. |
Anonymous
I hear you, it stinks. |
Anonymous
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the following are from gov stats
Health Insurance Coverage (Data are for the U.S.) Persons under age 65 Number uninsured at the time of interview: 43.0 million (2007) Percent uninsured at the time of interview: 16% (2007) Percent with private insurance at the time of interview: 67% (2007) Source: Early release of selected estimates from the National Health Interview Survey, Tables 1.1a-b, 1.2b Children under age 18 Percent uninsured at the time of interview: 8.9% (2007) Percent with private insurance at the time of interview: 60% (2007) Percent with public health plan coverage at the time of interview: 33% (2007) Source: Early release of selected estimates from the National Health Interview Survey, Tables 1.1a-b, 1.2b More data Early release of selected estimates from the National Health Interview Survey Health, United States trend Tables with data on the uninsured Health, United States trend Tables with data on private health insurance Health, United States trend Tables with data on Medicaid Health, United States trend Tables with data on Medicare Health Data Interactive State, Regional, and National Estimates of Health Insurance Coverage for People Under 65 Years of Age: National Health Interview Survey, 2004-2006 Consumer-Directed Health Care for Persons Under 65 Years of Age with Private Health Insurance: United States, 2007 Marital Status is Associated With Health Insurance Coverage for Working-age Women at all Income Levels, 2007 Related Links National Health Interview Survey Agency for Healthcare Research and Quality Centers for Medicare and Medicaid Services U.S. Bureau of the Census Text size: s m l xl Email page Print page Bookmark and share Add this to... Favorites Del.icio.us Digg Google Bookmarks Yahoo MyWeb Contact Us: National Center for Health Statistics 3311 Toledo Rd Hyattsville, MD 20782 1 (800) 232-4636 cdcinfo@cdc.gov Share Add this to... Favorites Del.icio.us Digg Facebook Google Bookmarks Yahoo MyWeb PDF Reader What I find interesting is how stats can be deceiving--you see 40 mil and you think WOW but then realize how many people are in the US so it's around 85% who are insured which is pretty good. Then you add the number of people who are just temp. uninsured--so there is a core group of people who choose not to be insured..leaving a small percentage of people who will always need some sort of assistance but are not getting it usually due to be so "out of society that they don't realize there is help. I do think if there was tort refom..these numbers could be better. Also realize that there are a number of people who already are insured through the gov.-if you are realllllly poor the gov always helps out even with the strictest conservatives. But these numbers are not bad. They just aren't and if you are one of the 85% who is happy with your care, do you really want to change it? I don't want to be in a place where I find out I didn't get okayed by the "rationing" board like in Britain. It's something to think about but is not really discussed beause the media refuses to tell both sides of the story. |
Anonymous
I just read through this quickly - but at first glance I agree with a lot of this. Our current system is in crisis but single payer is not the way. Many people will think the public plan is a nice middle ground but I do think it will ultimately drive employers and private plans out of insurance business and in a few years we will be in a single payer system. |
Anonymous
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Just because 85% have health insurance, it doesn't mean they are sufficiently insured and/or happy with it. Many people go broke trying to foot a $13,000 a year premium for family coverage. If you don't get it subsidized by your employer, it's very difficult to pay for. As a result, many people are underinsured. They go without needed health care, and often get sicker as a result, costing the system more money. A significant percentage of your insurance premium reflects the cost of uncompensated care. Get those people insured, and your premiums go down.
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Anonymous
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ITA with 13:40. OP violated the fundamental rule of DCUM: If you are not a single mom making less than $50K/year and about to be evicted from your apartment then you are not entitled to have any problems (or complain about them if you do). It's an idiotic rule that attempts to limit discussion of what is an otherwise interesting topic. News flash: there are all sorts of users of DCUMs, including other doctors and people who make over $50K a year, and some of them would be happy to have an intelligent discussion of this problem with the OP.
~Another highly-educated professional who works long hours, is fairly compensated and STILL - horrors - manages to have a few problems. |