My doctor basically just fired me

[princesss]

I'm kind of surprised by all of the anti-doctor posts, honestly. Why do we feel like doctors should be in it only for the joy of helping people? Quite frankly, unless we offer them a good standard of living, I can't see the best and brightest going for medicine. It's got terrible hours, lots of stress, and a risk of malpractice suits every day. It doesn't matter to me what my cardiologist's motives are for going into cardiology - what matters to me is his skill level and my level of care. If a doctor or a researcher dedicated their lives to finding a cure for a disease and manages to find one, does it matter if their motivation was primarily that they wanted to be famous for finding a cure/to win a Nobel Prize (and the prize money)? Does that change the fact that peoples lives are better?

Doctors can change their business plans. It sucks if you can't afford them any more, it can be very hard to find a good doctor that you click with. But I don't see a need to call them greedy and attack them for it.

 

[ksinger]

I'm kind of surprised by all of the anti-doctor posts, honestly. Why do we feel like doctors should be in it only for the joy of helping people? Quite frankly, unless we offer them a good standard of living, I can't see the best and brightest going for medicine. It's got terrible hours, lots of stress, and a risk of malpractice suits every day. It doesn't matter to me what my cardiologist's motives are for going into cardiology - what matters to me is his skill level and my level of care. If a doctor or a researcher dedicated their lives to finding a cure for a disease and manages to find one, does it matter if their motivation was primarily that they wanted to be famous for finding a cure/to win a Nobel Prize (and the prize money)? Does that change the fact that peoples lives are better?

Doctors can change their business plans. It sucks if you can't afford them any more, it can be very hard to find a good doctor that you click with. But I don't see a need to call them greedy and attack them for it.

Physician is one of the traditional professions since ancient times. Yes, it required training and dedication, but along with that came, if not always loads of money, then a social standing and a certain respect that could not be gained any other way. These people were NOT bricklayers. They cared for other people in the most intimate way possible. Yes it was a service, but it was not the same as other services, because it was not about your car, it was your LIFE.

Healthcare, along with education, is a public good. I know: a concept not in vogue at present in the US. But suffice to say that in an advanced society, neither one of those is optional. I can't reasonably make a market decision to NOT avail myself of either one, unless I truly want to starve or die. So right there, neither of these professions is like dishwasher repairman, and choosing a doctor is not at all like choosing a dishwasher repairman - you can reasonably choose to NOT own a dishwasher, but when the bleeding's arterial you can't reasonably eschew medical care, nor do you have time to shop for the best deal. You are under stress and in the dark - neither one of which is conducive to making an informed market decision possibly about your continued existence.

What I see is that doctors increasingly want to enjoy the benefits of that captive, failed market - and it IS a failed market, without much if any, of the social responsibility or genuine care for the patient(widget?) that has also traditionally come with the job. So that being the case, doctors have no right to complain when they lose the socially ingrained respect that has usually come with the profession. If you're going to treat people like widgets, then get ready to enjoy the social standing of widget repairman.

This is a very good explanation of how medicine is a failed market, and it contains a link to an article from 1963 no less, about how medicine does not lend itself to "the market".

July 25, 2009, 5:07 PM - by Paul Krugman

Why markets can’t cure healthcare
Judging both from comments on this blog and from some of my mail, a significant number of Americans believe that the answer to our health care problems — indeed, the only answer — is to rely on the free market. Quite a few seem to believe that this view reflects the lessons of economic theory.

Not so. One of the most influential economic papers of the postwar era was Kenneth Arrow’s Uncertainty and the welfare economics of health care,
http://www.who.int/bulletin/volumes/82/2/PHCBP.pdf
which demonstrated — decisively, I and many others believe — that health care can’t be marketed like bread or TVs. Let me offer my own version of Arrow’s argument.

There are two strongly distinctive aspects of health care. One is that you don’t know when or whether you’ll need care — but if you do, the care can be extremely expensive. The big bucks are in triple coronary bypass surgery, not routine visits to the doctor’s office; and very, very few people can afford to pay major medical costs out of pocket.

This tells you right away that health care can’t be sold like bread. It must be largely paid for by some kind of insurance. And this in turn means that someone other than the patient ends up making decisions about what to buy. Consumer choice is nonsense when it comes to health care. And you can’t just trust insurance companies either — they’re not in business for their health, or yours.

This problem is made worse by the fact that actually paying for your health care is a loss from an insurers’ point of view — they actually refer to it as “medical costs.” This means both that insurers try to deny as many claims as possible, and that they try to avoid covering people who are actually likely to need care. Both of these strategies use a lot of resources, which is why private insurance has much higher administrative costs than single-payer systems. And since there’s a widespread sense that our fellow citizens should get the care we need — not everyone agrees, but most do — this means that private insurance basically spends a lot of money on socially destructive activities.

The second thing about health care is that it’s complicated, and you can’t rely on experience or comparison shopping. (“I hear they’ve got a real deal on stents over at St. Mary’s!”) That’s why doctors are supposed to follow an ethical code, why we expect more from them than from bakers or grocery store owners.

You could rely on a health maintenance organization to make the hard choices and do the cost management, and to some extent we do. But HMOs have been highly limited in their ability to achieve cost-effectiveness because people don’t trust them — they’re profit-making institutions, and your treatment is their cost.

Between those two factors, health care just doesn’t work as a standard market story.

All of this doesn’t necessarily mean that socialized medicine, or even single-payer, is the only way to go. There are a number of successful health-care systems, at least as measured by pretty good care much cheaper than here, and they are quite different from each other. There are, however, no examples of successful health care based on the principles of the free market, for one simple reason: in health care, the free market just doesn’t work. And people who say that the market is the answer are flying in the face of both theory and overwhelming evidence. (emphasis mine)

 

[princesss]

I actually don't disagree, Ksinger, I'm just surprised by the sentiment around here. (I think there needs to be an overhaul of the healthcare and educational fields, esp. focusing on financing both, just to give my background on the topics at hand.) I just see this as similar to people complaing about teachers that want to be paid more. Yes, teachers should get paid more. Absolutely. But people seem to take issue with teachers actively asking for it because shouldn't they be in it just for the joy of shaping young minds and not for any financial reward? There are a lot of people that would make amazing teachers that choose not to go into teaching because they wouldn't make much money and they can be better rewarded in other fields.

The other thing that surprises me is that people are taking issue with the doctor's stated motivation - he wants to be able to spend more time with his patients, give them better care, and he wants to charge for it. And he can do that because there is no way the current system will allow him to give his patients the care he wants to. Yes, he's charging for that. But given the way the system works right now, I don't see how that's wrong, or something worth blasting this doctor or doctors in general with. I don't see why somebody who went into massive debt and worked for years and years isn't allowed to set up their own practice to care for their patients as they see fit.

 

[Imdanny]

Kenny, I should tell you about the time my doctor tried to fire me.

Suffice it to say:

Danny 1, Doctor 0

 

[princesss]

Okay, Danny, I hope Kenny asks, because now I'm curious!

 

[ksinger]

I actually don't disagree, Ksinger, I'm just surprised by the sentiment around here. (I think there needs to be an overhaul of the healthcare and educational fields, esp. focusing on financing both, just to give my background on the topics at hand.) I just see this as similar to people complaing about teachers that want to be paid more. Yes, teachers should get paid more. Absolutely. But people seem to take issue with teachers actively asking for it because shouldn't they be in it just for the joy of shaping young minds and not for any financial reward? There are a lot of people that would make amazing teachers that choose not to go into teaching because they wouldn't make much money and they can be better rewarded in other fields.

The other thing that surprises me is that people are taking issue with the doctor's stated motivation - he wants to be able to spend more time with his patients, give them better care, and he wants to charge for it. And he can do that because there is no way the current system will allow him to give his patients the care he wants to. Yes, he's charging for that. But given the way the system works right now, I don't see how that's wrong, or something worth blasting this doctor or doctors in general with. I don't see why somebody who went into massive debt and worked for years and years isn't allowed to set up their own practice to care for their patients as they see fit.

Everyone thinks that people choose not to teach because of the pay. And in some states like mine, the pay for teachers IS just dismal - we are 48th in the nation last I checked. So in that case, it's not so much that teachers are greedy, it's that in some states you could make much more as an assistant manager at McDonald's. It becomes a living wage issue, not an "I'm not able to afford the Jag" issue.

But the real motivator for most people not going into teaching is not the pay, it is the working conditions, lack of actual power, and lack of professional respect, and the fact that teaching is so tied to the political winds. Pay is NOT the primary motivator that people outside the profession assume it is, that's one of the reasons why all the harping about pay for performance doesn't carry much weight with most teachers. They already aren't in it for the money - if money were the motivation they never would have come in in the first place. And in those states that require advanced degrees to teach, those people go to school almost as long and are racking up almost as much debt as doctors. Neither person should be required to do that IMO, but at least a doctor has some chance of knocking it down.

In any case, aside from the fact that neither profession responds well to market theory, IMO there are certain areas of our life that should NOT be invaded by purely market motivations. All I can say is, if you haven't yet been to a doctor that you perceive as not giving a damn, they day you do, you will understand how completely important a doctor's motivations can be. There is a huge imbalance in the doctor patient relationship, in society's NEED for healthcare, and without trust that the motivations are not strictly self-centered on the part of the doctor, it begins to break down. You see it happening right here.

And can you imagine if a huge chunk of doctors go to Kenny's doctor's model? Lessee...1800 retainer for my GP, and since he's not a specialist, another 1500 for my gyno, and the cardiologist is 2000. Where does it stop?

 

[zoebartlett]

I'm just catching up with this thread, but Icekid, I enjoyed your post on the first page. I'm not too familiar with the healthcare issue from a doctor's point of view, so it was interesting to read yours. I think it's a sticky situation (to put it mildly) for doctors and patients alike.

 

[princesss]

I have spent time thinking I was going to die at any second because a doctor didn't listen and gave me medicine that interacted with my heart condition in a really terrible way, and I have spent about a year thinking I would spend the rest of my life forced to sit on the sidelines and never be able to climb a flight of stairs without worrying about my heart giving out. All because, at two different times, two doctors weren't listening or asking the right questions. Even after that, I still don't think that doctor's motivation matters as much as their effectiveness at their job. I don't care what's driving people to be good at what they do. I think if doctors wanted to go into healthcare and didn't have money as a major factor, there are other ways to be employed in the medical field and still help people. There are good and bad people in every profession, and I am for higher salaries for doctors and their abilities to open their own practices and run them however they wish if that keeps smart, motivated people in the field. To me it matters less why a person chooses to help people than the fact that they do help people.

From here, however, I believe I will defer to icekid as she stated my position much more eloquently on page one of this thread.

 

[zoebartlett]

I'm kind of surprised by all of the anti-doctor posts, honestly. Why do we feel like doctors should be in it only for the joy of helping people? Quite frankly, unless we offer them a good standard of living, I can't see the best and brightest going for medicine. It's got terrible hours, lots of stress, and a risk of malpractice suits every day. It doesn't matter to me what my cardiologist's motives are for going into cardiology - what matters to me is his skill level and my level of care. If a doctor or a researcher dedicated their lives to finding a cure for a disease and manages to find one, does it matter if their motivation was primarily that they wanted to be famous for finding a cure/to win a Nobel Prize (and the prize money)? Does that change the fact that peoples lives are better?

Doctors can change their business plans. It sucks if you can't afford them any more, it can be very hard to find a good doctor that you click with. But I don't see a need to call them greedy and attack them for it.

Great post, Princesss!

I've never heard of concierge service in the medical field until this thread. I can understand how some people wouldn't approve, but as Princesss and others have pointed out, doctors have the right to follow a business plan (model?) that works best for them. We can choose to keep them or look elsewhere.

 

[Rhea]

Also, countries that have universal health don't ban private care, either. In most countries I know, you can always choose to pay for treatment as an individual, bypassing lines or getting treatment that isn't usually offered. My primary doctor works half the week in a public hospital and half the week in his clinic.

Yep! This.

I do wish I had private healthcare here in the UK. I've been on the waiting list for 5 months for a non-urgent surgery, but I feel like it's having an effect on my health. Not that I can't get around or walk, but that eventually it'll effect my kidneys and I shouldn't get pregnant while I'm waiting for surgery. I love the option of having universal health care - I've been unemployed and stressed about that before - but wish I had private healthcare on top to cut down my wait right now.

 

[kenny]

Kenny, I should tell you about the time my doctor tried to fire me.

Suffice it to say:

Danny 1, Doctor 0

Well, he will let me keep the job of being his patient if I give him $1,800 a year for the privilege.
BTW, I still get billed for everything; that $1,800 pays for nothing.

Is your story also about your doctor going concierge?

 

[miraclesrule]

I never knew that the this process had a name. I do know that many traditional physicians became very concerned and upset when their business practices were transitioning from fee for service wherein their employees billed each individuals insurance carrier and then billed the patient for the balance (if any, as all fees are negotiable as I have learned and had to use on several occasions and now help others do as well).

Once the HMO's basically came in and usurped the tradtional model, very few physicians could afford to maintain their status quo. The HMO's were determined to squeeze the traditional model out of existence and into the HMO model. Few physicians survived the transition. Those that did found that they just couldn't maintain their practices due to the fact that most employee's could not afford the non-HMO plans. It was an economic issue for the patient and those of us who remember, we were just as upset as our physician when we both discovered that "we" were not in the same plans and thus were forced to abandon the physicians who were so familiar with our medical history.

HMO's destroyed medical care in the country and the physicians are beginning to rebel in the way that other physicians' have been doing over the past 10-15 years. Family practitioners have had to watch as their reimbursement rates have dwindled while plastic surgeons switched to cosmetic surgery and became less encumbered with paperwork, processes, bureaucracy and became more in control of their practice and their profits.

Then came the "Longevity" practitioner. These physicians were the first to offer their services to you for a "annual fee" ranging from 4800 to $2000 in addition to having to be paid for the services you may need during the year. These physicians were targeting a specific type of patient. One that was upper middle class, in relatively good health, and who wanted to remain that way and work with a primary care physician who would act more as a preventitive practitioner.

At first, many primary care physicians were hostile to the this type of practice and resented the physicians who they felt were capitalizing on aging baby boomers. However, this new "concierge" model is being adopted by traditional primary care physicians and it may become something that we will see more of in the future.

Personally, I miss having a consistent person who is familiar with my history and is competent. It just seems as though that is becoming increasingly rare in this mess we have made of health care in the US. Like some much of what is going wrong with this country, the people that the industry is designed to serve...the patient and the physician, are the ones who are suffering the most. The powerful health care industry and the politicians they support are the true beneficiaries of our national sick system.

 

[Missy]

I never knew that the this process had a name. I do know that many traditional physicians became very concerned and upset when their business practices were transitioning from fee for service wherein their employees billed each individuals insurance carrier and then billed the patient for the balance (if any, as all fees are negotiable as I have learned and had to use on several occasions and now help others do as well).

Once the HMO's basically came in and usurped the tradtional model, very few physicians could afford to maintain their status quo. The HMO's were determined to squeeze the traditional model out of existence and into the HMO model. Few physicians survived the transition. Those that did found that they just couldn't maintain their practices due to the fact that most employee's could not afford the non-HMO plans. It was an economic issue for the patient and those of us who remember, we were just as upset as our physician when we both discovered that "we" were not in the same plans and thus were forced to abandon the physicians who were so familiar with our medical history.

HMO's destroyed medical care in the country and the physicians are beginning to rebel in the way that other physicians' have been doing over the past 10-15 years. Family practitioners have had to watch as their reimbursement rates have dwindled while plastic surgeons switched to cosmetic surgery and became less encumbered with paperwork, processes, bureaucracy and became more in control of their practice and their profits.

Then came the "Longevity" practitioner. These physicians were the first to offer their services to you for a "annual fee" ranging from 4800 to $2000 in addition to having to be paid for the services you may need during the year. These physicians were targeting a specific type of patient. One that was upper middle class, in relatively good health, and who wanted to remain that way and work with a primary care physician who would act more as a preventitive practitioner.

At first, many primary care physicians were hostile to the this type of practice and resented the physicians who they felt were capitalizing on aging baby boomers. However, this new "concierge" model is being adopted by traditional primary care physicians and it may become something that we will see more of in the future.

Personally, I miss having a consistent person who is familiar with my history and is competent. It just seems as though that is becoming increasingly rare in this mess we have made of health care in the US. Like some much of what is going wrong with this country, the people that the industry is designed to serve...the patient and the physician, are the ones who are suffering the most. The powerful health care industry and the politicians they support are the true beneficiaries of our national sick system.

It really is sick. The politicians have the best best care and leave us to muddle through their mess. That really upsets me- that they have top notch care available to them forever while everyone else doesn't. So what incentive do they really have to find a system that works? They aren't suffering in the least!

Rhea, so sorry about your situation. That sucks. And is what I was referring to in a previous post. One of my friends needed what was considered non urgent surgery in her country but she couldn't function or have any quality of life till she could receive it. The waiting list they put her on was 18 months! So she came here and had it done. Luckily she could afford it. But what about the people who can't? They have no choice but to wait.

 

[Mico]

Kenny, I'm sorry to hear you are hurt by your doctor's change in practice. While reading through this i've agreed with some posts, and been angered by others. I believe this is all due to a huge misunderstanding by those not in the medical profession. The quote I took most to heart was this:

I personally do not want to listen to the Drs complaints about schooling, loans, time away from family, as any idiot knows that about medicine. If you go into it, try to own up to your own decisions and not expect the world to make you exempt from your life choices. When a PHD drives a cab because he can't get a job, we don't here the litany of -I work so hard, you must pay me a lot. Or lawyers, who have a hard time of it as well in life at times. They don't bo ho like Drs do. I say cool it Drs.
Annette

This is by far one of the most hurtful and disgusting things I've read in awhile. I don't think I'll be reading the rest of this thread, it makes me sad for my future, and the respect people have for the effort i've put into my profession.

 

[Imdanny]

Health insurance should not be eliminated, it DOES need to cross state lines. Insurance in general can be described as a scam but it doesn't have to be. I think that is pretty much all I have to say about my stance.

Missy you make valid and great points, I agree with most if not all. I really appreciate this discussion.

Health insurance is a cartel. I don't mean it's a cartel in the colloquial sense. I mean it's literally a cartel. It was exempted from the Sherman Antitrust Act by Congress in the 1940''s. There is no use defending health insurance on "free market" grounds. It is not a free market.

I didn't support the ACA. It is a textbook case of corporations writing law, it is deeply unpopular, and it's not what my Party ran on. However, I believe after the Supreme Court's ruling, it's here to stay and we're going to have to live with it while finding ways to improve it.

Maria, that quote was hilarious! Thanks! guess some people are more "interested" in their health and, you know, staying alive than others. /s

 

[Imdanny]

Kenny, I should tell you about the time my doctor tried to fire me.

Suffice it to say:

Danny 1, Doctor 0

Well, he will let me keep the job of being his patient if I give him $1,800 a year for the privilege.
BTW, I still get billed for everything; that $1,800 pays for nothing.

Is your story also about your doctor going concierge?

I'll email you.

 

[makemepretty]

I don't buy it that any doctor becomes a doctor just for the means of helping other. It's a big fat paycheck. It'd be like saying lawyers just want justice. Suuuure. Some of the hardest, most rewarding jobs offer little to no pay. I have a hard time when listening to people complain about insurance/health care when so many people can't afford health care or don't have any at all. It's not free, it's not like you can bargain shop or use a coupon. If your doctor wanted to scale down, he could do so without the fee of $1800 for the luxury of being his patient. You're better off without him.

 

[wildcat03]

Kenny, I should tell you about the time my doctor tried to fire me.

Suffice it to say:

Danny 1, Doctor 0

Well, he will let me keep the job of being his patient if I give him $1,800 a year for the privilege.
BTW, I still get billed for everything; that $1,800 pays for nothing.

No, kenny, it does pay for something. It pays for you to have pretty much unlimited access to your physician - email, cell phone, etc. It pays for his time as well. Insurance does not reimburse differently if you have a 10 minute visit or a 30 minute visit if they address the same concerns. So that money buy you more face time with your doctor, and likely a much shorter wait time to make an appointment. Now, you may not think that those are worth the price that your physician has attached to them, but that is YOUR perception.

FWIW, based on the price of other concierge practices, your doctor's price is actually very reasonable. My grandmother's doctor left to be part of a concierge practice back in 2003, and she charged about 1200/yr at that point. The cost of being a patient in a concierge practice in Boston or New York can easily be >10,000/yr (which is, yes, patently ridiculous, but I guess people are willing to pay).

Just as a note, some people find it actually LESS expensive than regular health insurance to pair a concierge physician with a high deductible health insurance plan. I think the good part of concierge medicine is that it allows the patient and the doctor to remove the elephant from the room - there's no more health insurance as a middle man between you and your doctor.

 

[LoveLikeCrazy]

Kenny, I'm sorry to hear you are hurt by your doctor's change in practice. While reading through this i've agreed with some posts, and been angered by others. I believe this is all due to a huge misunderstanding by those not in the medical profession. The quote I took most to heart was this:

I personally do not want to listen to the Drs complaints about schooling, loans, time away from family, as any idiot knows that about medicine. If you go into it, try to own up to your own decisions and not expect the world to make you exempt from your life choices. When a PHD drives a cab because he can't get a job, we don't here the litany of -I work so hard, you must pay me a lot. Or lawyers, who have a hard time of it as well in life at times. They don't bo ho like Drs do. I say cool it Drs.
Annette

This is by far one of the most hurtful and disgusting things I've read in awhile. I don't think I'll be reading the rest of this thread, it makes me sad for my future, and the respect people have for the effort i've put into my profession.

+1. Unfortunately your doctor decided that the only way for him to maintain excellence in patient care and afford his patients the time they deserve in an appointment was to move to a conceirge model. I'm sorry this happened to you but it is about to occur much more often with all this healthcare legislation and low reimbursement. Doctors vary.

 

[sstephensid]

Kenny, I'm sorry to hear you are hurt by your doctor's change in practice. While reading through this i've agreed with some posts, and been angered by others. I believe this is all due to a huge misunderstanding by those not in the medical profession. The quote I took most to heart was this:

I personally do not want to listen to the Drs complaints about schooling, loans, time away from family, as any idiot knows that about medicine. If you go into it, try to own up to your own decisions and not expect the world to make you exempt from your life choices. When a PHD drives a cab because he can't get a job, we don't here the litany of -I work so hard, you must pay me a lot. Or lawyers, who have a hard time of it as well in life at times. They don't bo ho like Drs do. I say cool it Drs.
Annette

This is by far one of the most hurtful and disgusting things I've read in awhile. I don't think I'll be reading the rest of this thread, it makes me sad for my future, and the respect people have for the effort i've put into my profession.

I agree! I really wish a lot of people here understood what it takes to become a doctor. It is amazing that people think doctors shouldn't get paid very well. I mean come on, are/were you willing to give up pretty much all of your twenties to studying? You probably had to delay most "life events" such as dating, marriage, kids etc. True, you could still do those things, but you would miss out on a lot due to the incredible amount of time spent at school and at home studying. Even if you are willing, are you capable or motivated to be able to complete med school?

To be a doctor, you have pretty much given up an income from 18-29ish or more? Plus, not only were you not able to work and save, but you more than likely accrued tens, if not HUNDREDS of thousands of dollars of debt to pay for all of the schooling. But then once you get a job, why would you deserve a big paycheck?

Sure, if you think doctors should make the same as a librarian or teacher or the "average" person, maybe they shouldn't have to go to school for so long. But who really wants to put their life in the hands of a doctor who doesn't know what he is doing?

 

[natascha]

Missy- Did you read the article Ksinger posted? If so, what did you think of it?

 

[GliderPoss]

Wow. I will never ever complain about the Australian health care system again... ever...

 

[jstarfireb]

Big +1 to icekid and Rosetta on the first page. Most people don't understand just how much a sacrifice medical training is (at least in the US - I have little knowledge of other countries' medical training). It is unlike any other profession out there. You are not only in intense studying mode for 4 years (med school), but you're essentially an indentured servant for the next 3-7 years (residency), more if you do a fellowship, and you don't start working for real until you're 30. In many programs, you make less than minimum wage considering the hours worked, since the hourly rate you get paid is based on a 40-hour week. It certainly makes having a family or a real life of your own nearly impossible. Work hour restrictions are a step in the right direction, but even the current limits (maximum 80 work hours a week and 24 hour call shifts) are inhumane. You become inundated with debt from med school (which I argue is typically more expensive than other professional programs) such that you have a 30-year plan for paying it off. Who else has to pay off loans over 30+ years?!? You're expected to be a martyr to your profession because you have the privilege of taking care of patients. But often the rewards of taking care of patients diminish over time, especially when we feel disrespected and ignored by many patients, judged and even paid based on things outside of our control (e.g. patient adherence to a medication regimen), yelled and cursed at by people frustrated with the system, etc. We're constantly viewed as the scapegoat for the nation's high cost of medical care, which is completely inaccurate.

Regarding Medicare and Medicaid, one of our lecturers said it well: "it is impossible to work your way out of a bad payor mix." That is, if you're in an underserved area where many patients are insured by Medicare and Medicaid, which reimburse at much lower rates than private insurance companies, you will barely make enough to get out of debt and have a comfortable living. Reimbursement is going down with changes in the health care system. Concierge medical practices are emerging from this as a way for doctors to make a living.

I am sorry you ended up uninsured and un-doctored, kenny. That really, really sucks. But it's not greed that forced your doctor to change his practice; it's survival. Your health care was a casualty of changes in the medical system (and for what it's worth, I agree the current system sucks, but I think a government-controlled single payor system is not the solution for our country).

 

[ksinger]

Kenny, I'm sorry to hear you are hurt by your doctor's change in practice. While reading through this i've agreed with some posts, and been angered by others. I believe this is all due to a huge misunderstanding by those not in the medical profession. The quote I took most to heart was this:

I personally do not want to listen to the Drs complaints about schooling, loans, time away from family, as any idiot knows that about medicine. If you go into it, try to own up to your own decisions and not expect the world to make you exempt from your life choices. When a PHD drives a cab because he can't get a job, we don't here the litany of -I work so hard, you must pay me a lot. Or lawyers, who have a hard time of it as well in life at times. They don't bo ho like Drs do. I say cool it Drs.
Annette

This is by far one of the most hurtful and disgusting things I've read in awhile. I don't think I'll be reading the rest of this thread, it makes me sad for my future, and the respect people have for the effort i've put into my profession.

+1. Unfortunately your doctor decided that the only way for him to maintain excellence in patient care and afford his patients the time they deserve in an appointment was to move to a conceirge model. I'm sorry this happened to you but it is about to occur much more often with all this healthcare legislation and low reimbursement. Doctors vary.

Unfortunately your child's teacher decided that the only way for him to maintain excellence in instruction and afford the students who arrive each day ready and willing to learn, the time they deserve in the classroom was to move to an IQ and outcomes-based model. I'm sorry your child's IQ scores and behavioral issues preclude him going to that school anymore, but it is about to occur much more often with the emphasis on test scores and the push to privatize all education.

 

[crown1]

my humble opinion. most professions could list how they are overworked, under appreciated, spent years becoming educated or trained, had to obtain loans for their education and the list goes on. respect is due all but few get it. i personally feel that doctors have been well respected until the last few years. maybe they are going to have to accept what others already have. they are not immune any more than others. everything has gotten out of hand. it is time for reason. just something to think about.

most jobs bring something to the table. while doctors are important they would have a hard time doing their job without power, water, plumbers, nurses, janitors, store clerks, restaurant workers and the list goes on. many workers are on call 24/7. no one is above the other. at least, that is how i was raised. our country has many who feel entitled. that attitude is not what brought us to where we once were. hard work and pride in a job well done seem to me to be the things that helped this nation grow and prosper. i hope we all can do some self examination and get back to those values. sorry for the preachy sounding post but this is something i think of often.

 

[iheartscience]

Kenny, I'm sorry to hear you are hurt by your doctor's change in practice. While reading through this i've agreed with some posts, and been angered by others. I believe this is all due to a huge misunderstanding by those not in the medical profession. The quote I took most to heart was this:

I personally do not want to listen to the Drs complaints about schooling, loans, time away from family, as any idiot knows that about medicine. If you go into it, try to own up to your own decisions and not expect the world to make you exempt from your life choices. When a PHD drives a cab because he can't get a job, we don't here the litany of -I work so hard, you must pay me a lot. Or lawyers, who have a hard time of it as well in life at times. They don't bo ho like Drs do. I say cool it Drs.
Annette

This is by far one of the most hurtful and disgusting things I've read in awhile. I don't think I'll be reading the rest of this thread, it makes me sad for my future, and the respect people have for the effort i've put into my profession.

+1. Unfortunately your doctor decided that the only way for him to maintain excellence in patient care and afford his patients the time they deserve in an appointment was to move to a conceirge model. I'm sorry this happened to you but it is about to occur much more often with all this healthcare legislation and low reimbursement. Doctors vary.

Unfortunately your child's teacher decided that the only way for him to maintain excellence in instruction and afford the students who arrive each day ready and willing to learn, the time they deserve in the classroom was to move to an IQ and outcomes-based model. I'm sorry your child's IQ scores and behavioral issues preclude him going to that school anymore, but it is about to occur much more often with the emphasis on test scores and the push to privatize all education.

HA, well played. Something tells me there would be a lot more outrage (even by doctors!) if teachers took this route. Because they knew what they were getting into, they just did it for the summer vacations, they're tenured, UNIONS!, etc.

 

[pandabee]

To springboard off the education tangent, what would be so bad with an iq based educational system? Are you afraid your child wouldn't succeed in that type of system? that's pretty much the basis of higher education. Regardless of iq or performance, children can be motivated to learn, whereas a sick cancer patient can't just be motivated to get better. I'm not saying that teachers are not necessary, because they absolutely are. but why is it that we are accepting of public employees like teachers and policemen and firefighters fighting for their right to an appropriate amount of pay and benefits for the work they do but not ok with when doctors and other healthcare professionals? they don't have a union fighting for their rights and if they do it is severely underrepresented. I don't see the general population being outraged when teachers demand more pay, like you say they do.

 

[sstephensid]

my humble opinion. most professions could list how they are overworked, under appreciated, spent years becoming educated or trained, had to obtain loans for their education and the list goes on. respect is due all but few get it. i personally feel that doctors have been well respected until the last few years. maybe they are going to have to accept what others already have. they are not immune any more than others. everything has gotten out of hand. it is time for reason. just something to think about.

most jobs bring something to the table. while doctors are important they would have a hard time doing their job without power, water, plumbers, nurses, janitors, store clerks, restaurant workers and the list goes on. many workers are on call 24/7. no one is above the other. at least, that is how i was raised. our country has many who feel entitled. that attitude is not what brought us to where we once were. hard work and pride in a job well done seem to me to be the things that helped this nation grow and prosper. i hope we all can do some self examination and get back to those values. sorry for the preachy sounding post but this is something i think of often.

No one said doctors were better or "above" others. But come on, do you really think a janitor, waiter, etc. should get paid the same as a doctor? How would that work exactly?

 

[CJ2008]

I think it's also a matter of plain and simple...resistance to change.

We're just not used to paying $1,000 or whatever the amount may be in advance - so the initial reaction is to resist it. Who wants to pay $1,000 today they didn't have to pay yesterday?

If I felt I was going to get much better quality of care and the doctor was going to be able to give me undivided attention and interest, I see the benefit.

But of course I / we want it all...but if I look at it objectively, it's impossible to get anything substantial done in 20-30 minutes/patient.

So I don't "like" it because I'm used to not having to pay more...but I can see the other side...and I can see the benefit.

 

[madelise]

my humble opinion. most professions could list how they are overworked, under appreciated, spent years becoming educated or trained, had to obtain loans for their education and the list goes on. respect is due all but few get it. i personally feel that doctors have been well respected until the last few years. maybe they are going to have to accept what others already have. they are not immune any more than others. everything has gotten out of hand. it is time for reason. just something to think about.

most jobs bring something to the table. while doctors are important they would have a hard time doing their job without power, water, plumbers, nurses, janitors, store clerks, restaurant workers and the list goes on. many workers are on call 24/7. no one is above the other. at least, that is how i was raised. our country has many who feel entitled. that attitude is not what brought us to where we once were. hard work and pride in a job well done seem to me to be the things that helped this nation grow and prosper. i hope we all can do some self examination and get back to those values. sorry for the preachy sounding post but this is something i think of often.

No one said doctors were better or "above" others. But come on, do you really think a janitor, waiter, etc. should get paid the same as a doctor? How would that work exactly?

SIGN ME UP if I can make a physician's salary by waiting tables! Let me throw away all my textbooks now!