Anonymous wrote:I am an attorney who specializes in working with doctors and insurance plans to negotiate reimbursement levels. I am daily shocked at doctors, though I shouldn’t be anymore. I would say the majority of mental health providers that begin the negotiation process stop it and say they’d rather have high, private pay patients than deal with other people who need any type of insurance. With such a lack of in network providers, it’s always disheartening. And I’ll say, the reimbursement levels offered from plans are high (in my experience). The docs just claim they can get 4x that with a small (rich) subset of people.

Do you work for a non-profit?

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?

Absolutely nothing wrong with that, but don't pretend that you're altruistic. It's a profession, not the priesthood.

There are plenty of bad doctors but also plenty who, while certainly varied and flawed as is any segment of the population, view it as “more than a job” in that they feel a moral obligation to their professional responsibilities that IS different than many other jobs. I’m the last person to say doctors are uniformly noble but to pretend there aren’t many who feel an ethical duty beyond strictly what they’re paid for or are legally obligated to do is absurd. You would definitely notice the difference if all doctors started behaving like that.

Anonymous wrote:A bunch of what you describe would be clear medical malpractice.

Medical malpractice is so difficult to prove and doctors know this. Even getting a 2nd or 3rd opinion doesn't always help you. Orthopedic surgeons are the absolute worst and greediest.

A very important lesson I teach my kids when they go to college is that most doctors suck. If you see a doctor at a college clinic he’s probably not well informed so take everything with a grain of salt.

Doctors should be researched and chosen very carefully.

Great doctors may be total a-holes but they are arrogant enough to never want to be wrong, so they might be the best doctor.

If you go to well renowned hospitals you are most likely getting a better doctor, never go to your local doctor for major issues.

Anonymous wrote:I am an attorney who specializes in working with doctors and insurance plans to negotiate reimbursement levels. I am daily shocked at doctors, though I shouldn’t be anymore. I would say the majority of mental health providers that begin the negotiation process stop it and say they’d rather have high, private pay patients than deal with other people who need any type of insurance. With such a lack of in network providers, it’s always disheartening. And I’ll say, the reimbursement levels offered from plans are high (in my experience). The docs just claim they can get 4x that with a small (rich) subset of people.

How are you paid for your services? If you do not offer a sliding scale fee option as part of your practice, I would find that very.... disheartening.

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?

Absolutely nothing wrong with that, but don't pretend that you're altruistic. It's a profession, not the priesthood.

DP. Tell you what, I can absolutely do that as long as nobody expects me to be altruistic. The grift is that we are criticized for not being altruistic (and for failing to provide all the free labor and bottomless caring that goes with that) but also expected to accept other people seeing it as just a job.

You can't have both. Pick a lane.

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?

Absolutely nothing wrong with that, but don't pretend that you're altruistic. It's a profession, not the priesthood.

Anonymous wrote:No - but some have very difficult jobs, as does anyone dealing with the public. It is a different world for them, and DH (an MD) counsels our DC NOT to go into medicine. I don't know how anyone works in an urban ER anymore.

My brother does and he loves it. He loves seeing the best and worst of humanity on a daily basis. The drama and the interesting cases. it's not for most people but for some it's the only work they can see themselves doing.

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?

They really are a segment of the population representing all personality types...then add to that ego and wealth and it leaves a small pool who really do care. Caring is hard work and health care burns the altruism out of most.

Medicine is also a narrow track. Once you specialize, you do a lot of the same thing. Time and money become metrics that direct care. You have to make hard decisions and caring too much makes you a bad doctor. There is a lot asked of them and even with great salaries, the humanity of it all can be crushing. Doctors mostly see complaining, pain, sickness, weakness, vulnerability, suffering, frustration sadness, irritability etc. That is why most focus on their craft and not the person.

Different specialties attract different personalities and skill sets and some specialties really.

I've worked in health care for almost 30 years. Direct patient care is incredibly hard work.

I had an incredible GP once but she quickly burned out. Being too caring really comes at a high cost as well.

They need to reduce the cost of medical school and saturate the market with more doctors.

No, but they are expected to be. They are expected to work around the clock and be available for patients but not ask be paid for their time.

I'm a nurse, so obviously a little different than a doctor, but my experience is that the altruistic ones who get into it because they "really want to help people" are the ones who burn out the quickest. It is important for healthcare workers to care about their patients, of course, but I find that pure altruism is not a great match for the US healthcare system as we know it. The ones who get into nursing because they like science, enjoy problem solving, and like working with people have a much healthier approach to their work and last longer.

Anonymous wrote:The ones I know (that is a very small subset of the profession) seemed more like they enjoyed the scientific aspect of it. The patient is a science project to figure out a solution for. They weren’t necessarily motivated by helping someone as much as solving a problem/understanding the solution. So not altruistic but not just trying to maximize returns in the shitty insurance environment we live in.

My spouse is an MD (not a surgeon). This describes him and most of his friends from med school/residency. He is happy when he can help people/that he has special skills to help people and legit save lives etc., but he is really drawn to the science part of it.
FWIW, he and his colleagues has no idea which of his pts have insurance or not. This is a hosptial-based speciality.

The ones I know (that is a very small subset of the profession) seemed more like they enjoyed the scientific aspect of it. The patient is a science project to figure out a solution for. They weren’t necessarily motivated by helping someone as much as solving a problem/understanding the solution. So not altruistic but not just trying to maximize returns in the shitty insurance environment we live in.